Reading the Physician: Experiments with Patient Authority in Medieval Medical Literature

Emily Price // The Régime du corps is a medical manuscript written in the 13th century by Aldobrandino da Siena, a compendium of medical knowledge that uses historiated initials and chapters on health and diet to catalogue common medical practices and methods for caring for one’s own body. Most surviving copies of the manuscript are written in vernacular languages rather than in Latin, making them much more accessible to a wide variety of readers than typical medical manuscripts. This made it possible for the Régime to be a household book by the late Middle Ages, one that was intended to be used by people without medical expertise. At the time, the larger canon of medieval medicine was mainly aimed at physicians, teaching them how to care for patients. The Régime, however, shifts the onus of care from the physician’s expert opinion to the patient’s own ability to keep his or her individual body balanced, and situates the reader as an autonomous individual informed by the authority of the text, rather than a passive recipient of medical advice.

Unlike most of the seventy copies of the Régime that survive, Morgan Library MS 165, which was made in France between 1440 and 1450, is illustrated. In the first and second sections of the Régime, the majority of images feature people engaging in an activity related to their own health, whether caring for themselves by performing an action (sleeping, having sex, drinking wine) in a way prescribed by the text, directly accessing medical care, or being assisted by a medical practitioner with a procedure or being taught about a particular illness. These images all exhibit different understandings of how medical knowledge can be produced and enacted. Some conditions needed the express care of a physician; others could be performed independently, without necessitating external involvement.

The images are integral to the manuscript’s didactic function; they play a key role in helping readers understand how to take charge of their own bodies, and they often blur the lines between physician and patient. For example, on f.34v., there is an image of a man in blue robes speaking to another man in red, beside which is rubricated text reading, “How to guard against pestilence and corruption” (fig. 1).[1]

Figure 1. Physician lectures an onlooker. Régime du corps. France, c. 1440-1450. Morgan Library MS M. 0165 f. 34v. Image courtesy of the Morgan Library.

Although this scene depicts someone receiving advice from an external source of authority, the text of this section does not instruct the individual to go to a physician for assistance. Rather, it simply contains an overview of the things that can cause disease, including when they are most prominent (in September) and what can be done to combat them (having a house with good ventilation and multiple windows, planting aromatic plants around any openings, and using a “chantepleure,” an instrument similar to a watering can, to clean the floors, among other strategies). This image is confusing at first glance, because although it seems to tell the reader to seek outside help in order to prevent disease, the message of the text is just the opposite: that the information in this book is enough on its own to teach the basics of disease prevention, without the involvement of a physician.

If the Régime du corps really is a prophylactic text whose aim is to give individuals ways to heal their own bodies, why include images of medical practitioners? One possible explanation is that the wideness of the category “disease” in this section presents a problem for the illustrator. Presumably, the actions required to prevent “corruption and pestilence” are too nebulous and varied to be visually represented or innately understood, but not so complex that someone reading about them would need to seek additional help from a medical authority in order to understand them. The illustrator of the Morgan MS solves this representational problem by presenting an image of a physician lecturing another man, whose reception of the physician’s knowledge becomes a stand-in for the learning process that the reader is expected to go undergo while reading the text.   The physician in f.34v., through teaching the man opposite him, becomes a figural representation of the text that follows the initial in which he stands. Rather than show a plague-ridden body or illustrate someone taking steps to prevent a generic disease, the illustration represents two figures outside of time, discussing the contents that are about to be presented to the reader. In this case and elsewhere within the Régime, the solution to a problem of representation is simply to represent the text metaphorically, by making it into the figure of medical authority.

This metaphorical construction of these “teaching” images extends to representations of physicians’ bodies, specifically their hands. As with other lecturing images in the manuscript, the physician’s pointer finger in f. 34v. is elongated and is central within the image, pointing at the listener but attracting the reader’s eye as well. This calls to mind the manicule, the typographical image often used in the margins of medieval manuscripts to highlight a particular section of text. These hands sometimes point skyward, as in the case of the physician on f.7v., whose gesture upward, accompanied by the scene of God creating the universe that appears on the previous page, seems to represent the physician’s ceding authority to God and the intertwined relationship between Christian spirituality and medicine (fig. 2).

Figure 2. Physician points at the heavens. Ibid, f.7v. Image courtesy of the Morgan Library.

In another lecturing image, the physician points at the man listening and also through him, towards the rubricated header, emphasizing what he is teaching to the reader, “How to care for the body at each age.”[2] In each case, the accentuated hand points out some facet of authority, something the reader should pay special attention to. In addition, in the case of f. 34v., the pointed finger suggests a counting process—the finger points to the instructional rubric above the initial, and it simultaneously counts down the remedies that the section’s text goes on to outline. Not only does the physician’s body occupy the metaphorical position of the text, but his hands also literally become typography, connecting him even more explicitly with the book he appears in.

The connection between physicians’ bodies and their books of medical knowledge has been noted previously in a variety of different contexts. In her work on medieval doctors’ almanacs, Jennifer Borland notes that “there was an important performative element to their use, activating the potential space between physician and patient, [that] contributed to the aura of the knowledge contained inside the book” (Borland 223). Almanacs and other medical texts are symbols of authority that require touch, engagement, and performance to make the knowledge they contain available. However, the direct conflation of physicians with a book explicitly meant to be read by those who are not trained as physicians, rather than one written in the language of medical experts, is surprising, because it suggests that the expertise of the physician can be available to anyone capable of reading and identifying with the text they hold.

The symbolism of the physician as book also helps situate the Morgan Régime within the larger structure of manuscript production and knowledge transmission that it participates in. As Elizabeth Mellyn points out, the advent of printing in the sixteenth century allowed for the proliferation of self-help books to the general public (Mellyn 87). Morgan MS 165 is roughly contemporaneous with the beginning of printing, although the text of the Régime predates it by nearly two hundred years. It occupies a space between academic books written by physicians, for physicians, and the cheaper printed copies of medical manuals that the printing press made widely available. In that sense, the Régime du corps is an experimental text investigating the consequences of giving medical knowledge to the public, one that would come to greater fruition in the proliferation of printed self-help books in the sixteenth century. The images of the Morgan MS that equate physicians with the books they wrote show an awareness of the Régime’s status as a manuscript being similarly produced by a medical authority for a larger readership, one that transmits the physician’s advanced medical knowledge in accessible terms and represents a midpoint between the medieval doctor’s almanac and the early modern printed self-help manual that laypeople could easily read, own, and use. As it offers readers ways of caring for their own bodies, the Regime du Corps also troubles the concept of what it means to be a medical authority, and whether individuals are capable of having autonomy over their own health and that of their family, friends, and communities.

Works Cited

Borland, Jennifer. “Moved by Medicine: The Multisensory Experience of Handling Folding  Almanacs.” Sensory Reflections: Traces of Experience in Medieval Artifacts. Ed. Fiona Griffiths and Kathryn Starkey. De Grutyer: Boston, 2018. 203-224.

Buren, Anne van. Illuminating Fashion: Dress in the Art of Medieval France and the Netherlands, 1325-1515. The Morgan Library & Museum ; D Giles Limited, 2011.

Mellyn, Elizabeth. “Healers and Healing in the Early Modern Health Care Market.” The Routledge History of Madness and Mental Health. Ed. Greg Eghigian. Routledge: New York, 2017. 83-100.

Emily Price is a doctoral student in English at the Graduate Center, CUNY. Her work focuses on disability and mental health in the medieval period by way of manuscript studies, life writing, and material culture, and she is currently researching the creation of readerly authority in early printed medical texts.

Cover photo: A physician bleeds a male patient. Régime du corps. France, c. 1440-1450. Morgan Library MS M. 0165, f. 19v. Image courtesy of the Morgan Library.

[1] “Pour quoy on se doit garder de pestilence et corruption.”

[2] “Comment on doit garder son corps en chacun age.”

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