CW: Visual and textual depiction of violence against a Black body
The legends of Saints Cosmas and Damian, the patron saints of medicine, pharmacy, and surgery, are dramatic miracles to the highest degree. These early Christian martyrs lived and died in the third century, in what is now modern-day Syria. As two traveling doctors, the saints refused to take payment for their services, and subsequently received the epithet anargyri (Greek ανάργυροι) meaning “the silverless ones,” which underscored their Christian humility. Together, they performed cures of ailments like blindness and paralysis, resolving fevers and everyday sicknesses. Other times, their legends present them in their more necromantic element: raising the dead, expelling snakes from the breast, and praying with camels. But in the Middle Ages, these two holy physicians became best known for their miracle of leg transplantation. The saints’ leg-grafting miracle was popularized in Jacobus de Voragine’s thirteenth-century compilation of saints’ lives, the Legenda Aurea (the “Golden Legend”). De Voragine’s Latin translation of the Greek stories is the first text to describe the grafted leg as Black. The miraculous transplantation occurs between a Black man and a white verger.
This curious detail of the Black leg in the saints’ leg-grafting miracle is as an example of what medievalist Cord Whitaker calls medieval “race-thinking” present in racial metaphors, that is, “black metaphors, or the literary and rhetorical presentation of black humans and inanimate objects, as well as the white metaphors they call forth…” (7). In this short piece, I want to think through the implications of a medieval medical imaginary—in texts and images—that privileges white healing over Black life and embodiment. Considering the violence and racism embedded within the history of science and medicine, the “Miracle of the Black Leg” shows an unforgiving prefiguration of racialized medical practice long before the pseudoscience of eugenics.
“The Miracle of the Black Leg”
The medical miracle of the leg transplantation performed by the physician-saints Cosmas and Damian was most often depicted in visual art from the medieval and early modern periods. In the image above, the depiction of the saints performing the “Miracle of the Black Leg,” painted by Matteo di Pacino c. 1370-1375, shows the saints in brightly colored vestments, conveying the limb from the Black man to the ailing white man in bed (Figure 1). Medieval art often depicts scenes of multiple temporalities: through the image of the Black leg, Figure 1 moves the viewer from the ailing white verger’s newly transplanted Black leg on the left to the corpse of the Black man on the right. Let’s recount the story:
Felix papa attavus sancti Gregorii in honore sanctorum Cosmae et Damiani nobilem ecclesiam Romae construxit. In hac ecclesia quidam vir sanctis martiribus serviebat, cui cancer unum crus totum consumserat. Et ecce dormiente illo sancti Cosmas et Damianus devote suo apparuerunt unguenta et ferramenta secum portantes; quorum unus alteri dixit: ubi carnes accipiemus, ut abscisa carne putrida locum vacuum repleamus? Tunc ait alter: in cimiterio sancti Petri ad vincula hodie Aethiops recen sepultus est, de illo autem affer, ut huic suppleamus. Et ecce ad simiterium properavit et coxam Mauri attulit, praecidentesque coxam infirmi loco ejus coxam Mauri inseruerunt et plagam diligenter ungentes coxam infirmi ad corpus Mauri mortui detulerunt. Evigilans autem cum se sine dolore sensisset, manum ad coxam apposuit et nil laesionis invenit, apponensque candela cum in crure nil mali videret, cogitabat, an non ipse, qui erat, sed alius, alter esse rediens autem ad se prae gaudio de lectulo prosiliit et quid in somnis viderat et qualiter sanatus fuerat, omnibus enarravit. Qui conciti ad tumulum Mauri miserunt et coxam Mauri praecisam et coxam praedicti viri loco illius in tumulo positam repereunt.(Legenda Aurea, Chapter 143, De sanctus Cosma et Damiano)
Felix, the eighth pope after Saint Gregory, had made a noble church at Rome of the saints Cosmas and Damian. In that church there was a man who served the holy martyrs, who had a cancer that consumed his whole thigh. And as he slept, the saints Cosmas and Damian appeared to him their devout servant, bringing with them an instrument and ointment; one said to the other: Where shall we take away flesh to fill the empty space when we have cut away the rotten flesh? Then the other responded to him: There is an Ethiopian that today is buried in the churchyard of Saint Peter from Vincula, which is still fresh, in order that we supply this. And so, they quickly fetched the limb of the Moor, and cut off the limb of the sick man and grafted the limb of the Moor into his place and carefully transferred the anointed wound of the sickly limb from the dead Moor’s body. And when he awoke, he did not sense any pain, so he placed his hand on the limb and discovered no injury, and then he took a candle to his leg and saw no harm, he thought whether it was not himself or that he was another person. However, when he returned to himself, he jumped out of bed for joy and recounted to all what happened to him, and all he had seen in his sleep, and how he was healed. So, they rushed to the tomb of the cast-off Moor and found the limb of the Moor severed and found the other man’s destroyed limb in the tomb in place of his.
Historians of science often trace the medical history of limb transplantation to this story. As Donatella Lippi puts it, the legend of Saints Cosmas and Damian’s miracle is “one of the best documented instances of leg transplant” in medical literary history (517). Yet some historians, such as Thomas Schlich, are dubious of literature’s value in historical inquiry. Schlich asks “why intelligent and educated people, such as transplant surgeons, engage in producing a sort of history that for many historians looks little short of absurd” (311). The saints’ legend and the story of the “Miracle of the Black Leg,” as pseudo-historical and fantastical as it may be, is a reflection of a medieval medical imaginary that deliberately relies on racial violence to effect a salvific cure.
There has to be more at stake than history. The question posed to the “Miracle of the Black Leg” should not be when the first literary limb transplantation occurred but rather whose limb was transplanted. The historical violence against Black people in medical science is a historical reality that has consequence for communities of color in our present day. As Harriet A. Washington shows in Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present (2006), the experimentation on and exploitation of Black bodies for medical “advancement” was in practice “since the eighteenth century” (7). And still, long before the institutionalization of medical practice in the 1700s, the “Miracle of the Black leg” is a story of two saints—often depicted as white—who heal a white man’s ailment by taking the limb of a Black man’s corpse and grafting it onto a white body. There is a double violence in the miracle story: first, a nonconsensual seizure of a Black man’s body for the benefit of a white man; second, a grafting of a diseased limb onto a Black body. In his articulation of necropolitics, Achille Mbembe asks “What place is given to life, death, and the human body (in particular the wounded or slain body)?” (12). Mbembe questions how power and sovereignty is inscribed at the expense of the body. In the “Miracle of the Black Leg,” the Black man’s leg is forcibly removed from his corpse. The Black man’s body, already dead, is further maimed in order to (1) supplement white health, (2) convey the saints’ miracle, and (3) act as a receptacle for the white, gangrenous leg. In other words, de Voragine’s detail that the miracle is made possible by a Black leg underscores salvation’s white hegemony in a medieval imaginary.
The story ends with the viewer’s gaze on the Black man’s corpse, his own body severed and replaced with the “destroyed limb.” This transference of disease, depicted textually and visually, from the white verger’s body to the Black man’s corpse highlights the presumed service of Black bodies to medical curative fantasies. The sick white man, the verger of the church, is described as having cui cancer unum crus totum consumserat, “a cancer that consumed his whole thigh.” By the thirteenth century, when the Golden Legend was composed, the Latin cancer would have referred to afflictions of the leg such as gangrene or carcinoma. The word would stick; by the fifteenth century William Caxton’s 1483 printed version of the story in his reproduction of the Golden Legend described the ailing white man as one “whom a cancre hadde consumed all his thye” (folio 263). The Middle English “cancre,” too, referred to some sort of spreading ulceration or wound (see Norri). The holy physicians’ miracle can only work through the transference of white disease onto a Black corpse.
Whether or not the saints’ leg grafting miracle points to an “origin” narrative of limb transplantation, it is remarkable and deeply unsettling that the Golden Legend is the first to include the detail of a Black leg in the saints’ transplantation miracle. In the Latin, Jacobus de Voragine first uses the term Aethiop, “Ethiopian,” to describe the body of the Black man. Thereafter, the corpse of the Black man is identified as Mauri, a term which described an individual from Northern Africa, sometimes translated as “Moor” or “Mauritanian.” Geraldine Heng notes that studies on premodern race look to skin color as the “paramount index of race” (181). And while her study, The Invention of Race in the European Middle Ages, demonstrates the interlocking configurations of religion, economy, and war, for instance, that materialize race, attention to physiognomy in the “Miracle of the Black Leg” cannot go unremarked. The very materiality of the Black leg in the miracle functions as proof of the saints’ thaumaturgy (working of miracles) and God’s grace at the expense of the nameless, unidentified, Black corpse (Figure 1). While the verger, too, is unnamed, the Golden Legend describes him as a devout servant of the church. His service to the church-as-institution is rewarded through the saints’ medical intervention; the verger is healed. Yet, the service of the Black body—a corpse that has not consented to its dismemberment and “service”—is “rewarded” with the cancerous, white leg. This brief miracle story reminds us that premodern curative fantasies of health, wellness, and whiteness are racialized. Medical or miraculous, the “Miracle of the Black Leg” relies on Black embodiment as an interface for white salvation.
 Throughout this piece I refer to the Black leg with a capital B following The Diversity Style Guide (2016). While there are various debates on how to confront stylistic injustices, I opt to recognize the textual and visual depiction of Black embodiment with a capital B in its adjectival form, unless I am quoting from another source.
 As Kees Zimmerman notes, there are over forty different images of the miracle from the fourteenth to the twentieth century. See: Kees Zimmerman, “Introduction,” One Leg in the Grave Revisited, ed. Kees Zimmerman. (Barkhuis, 2013): 11-21.
 Jan L. de Long notes that visual representations of the “Miracle of the Black Leg” are not present in “the art of the Orthodox Church, while they can hardly have appeared in the Roman Catholic world before c. 1270,” in “Transplantation and Salvation,” in One Leg in the Grave Revisited, ed. Kees Zimmerman. (Barkhuis, 2013): 37-49, here 39.
 See also Alessandra Foscati, “Historian questions paleopathological diagnosis in a work of art,” Journal of Vascular Surgery 70.2 (2019): 657.
 See “Mauri” and “Maurus” in A New Latin Dictionary, eds. Charlton T. Lewis and Charles Short. (Oxford: Clarendon Press, 1891).
Legenda Aurea. Edited by T. Graesse. Lipsiae: Impensis Librariae Arnoldiane, 1850.
de Jong, Jan L. “Transplantation and Salvation,” in One Leg in the Grave Revisited. Edited by Kees Zimmerman. Barkhuis, 2013, pp. 37-49.
Demaitre, Luke. “Medieval Notions of Cancer: Malignancy and Metaphor,” Bulletin of the History of Medicine vol. 72, no. 4, 1998, pp. 609-637.
Duffin, Jacalyn. Medical Saints: Cosmos and Damian in a Postmodern World. Oxford University Press, 2013.
Foscati, Alessandra. “Historian questions paleopathological diagnosis in a work of art,” Journal of Vascular Surgery vol. 70, no. 2, 2019, p. 657.
Lippi, Donatella. “The Transplant of the White Man’s Leg: A Novel Representation of Cosma and Damian’s Miracle,” International Journal of Immunopathology and Pharmacology vol. 22, no. 2, 2009, pp. 517-520.
Mbembe, Achille. “Necropolitics,” trans. Libby Meintjes. Public Culture vol. 15, no. 1, 2003, pp. 11-40.
Norri, Juhani. Dictionary of Medical Vocabulary 1375–1550: Body Parts, Sicknesses, Instruments, and Medicinal Preparations. Routledge, 2016.
Washington, Harriet A. Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. New York: Doubleday, 2006.
Zimmerman, Kees. “Introduction,” One Leg in the Grave Revisited. Edited by Kees Zimmerman. Barkhuis, 2013, pp. 11-21.
Author bio: Micah James Goodrich (he/him) received his PhD at UConn in 2020 and currently teaches in the WGSS program and the English Department. Micah works on the resonances of gender, embodiment, and science in premodern and modern literature. His research interests include: queer-feminist science studies, transgender studies, queer/trans-ecofeminism, literary history of gender, sexuality and the body, and history of science and technology. He is working on his first monograph, Somatographies: Trans Natures in the Premodern Wake which explores the queer and trans logics of premodern “nature” by putting premodern scientific and medical literature in dialogue with contemporary theory and politics.