Medieval medicine meets the digital age

Claire Burridge (2019-2020, Rome Scholar) provides a valuable insight into medieval medicine and the research she has undertaken at the BSR.

Let’s begin with a sample of medical advice from the ninth century — but please note: although these remedies may look tempting in our current circumstances, do not try them at home!

Picture1.pngFor cough: chew oregano on an empty stomach; it is wonderful.

Likewise: drink pounded fennel roots in wine on an empty stomach for 9 days.

Likewise: take mallow with food.

Likewise: drink agrimony with old wine on an empty stomach.

Likewise: betony – 2 [units not given] – ground with honey; take for 9 days on an empty stomach.

Likewise: bake elecampane roots among hot ashes and then soak them in honey; chew as much as possible on an empty stomach.

Picture2For dry cough: skimmed honey – 1 ounce, black pepper – 2 ounces, myrrh – 1 ounce, long pepper [no amount given]; grind this up well and mix it in honey; use 3 spoonfuls morning and night.

Likewise, an electuary for those affected by a cough: butter – 4 [units not given], terebinth – 2, horehound – 4, nard, this is also called spica [i.e. spikenard] – 9; grind and mix together; chew 1 spoonful with honey.

Picture3Picture4For those who cannot breathe: 1 part fenugreek, 9 parts pepper, 10 parts costus – as much as you think seems fit – mix together into a powder and give a full spoon mixed in water.

Picture5Picture6Pills for cough: poppy – 2 scruples, myrrh – 3 scruples, storax – 2 scruples, galbanum – 4 scruples; then make into pills and use.

Background

Pre-modern medicine has been in the news more than usual in recent weeks, with comparisons of our current situation to past plague pandemics, a growing interest in the origins of ‘quarantine’, and so on. Yet unlike many areas within the history of health and medicine, my research offers few potential points of comparison with our present circumstances, though it has provided a fascinating glimpse into the ways individuals in the early middle ages may have sought to treat some of the symptoms associated with COVID-19. (Note: for those interested in how historians of medicine (and not just medievalists!) have reflected on the current coronavirus crisis and responded to the media’s use/abuse of history, I have included some links in an addendum below.) In this post, I shall endeavour to keep things topical by using the remedies for coughs and breathing difficulties illustrated above as an entry point into my current research.

My project at the BSR, ‘The Movement of Early Medieval Medical Knowledge: Exchange in the Italian Peninsula’, is underpinned by two linked objectives: a) the identification of non-classical information recorded in early medieval remedies (and possible sources for this information), and b) an investigation into the role of Italian centres of manuscript production in the introduction and movement of this knowledge. Both objectives are dependent on first transcribing and editing medical recipes from a dozen manuscripts today held in libraries in Rome, and then analysing this material with a combination of recently developed digital tools. Much of my time at the BSR has therefore been focused on assembling this material: transcribing, editing, and translating texts while establishing my digital ‘toolkit’. The creation of a complex database that tracks individual recipes, their ingredients, and any additional information associated with them (such as units of measurement, instructions for preparation, etc.) in concert with their manuscript context allows for a systematic analysis of this material. While it is impossible to condense the full extent of these results into a blogpost, the remedies above showcase a number of important findings from my research so far. In particular, my development of a remedy database has highlighted the vast range of medical knowledge preserved within these manuscripts, a topic we shall explore in more detail below.

Diversity between and within manuscripts

Given the complex processes involved in the composition and production of manuscripts, it has long been accepted that no early medieval codex is identical. When considering manuscripts containing medical texts, this degree of variability can be taken even further: cataloguers and historians have shown that all surviving manuscripts with medical texts preserve a unique combination of writings. My research not only confirms this great diversity between codices, but it also sheds light on the varied nature of the information contained within individual manuscripts. More specifically, by considering not simply the composition of manuscripts as a whole, but by analysing their recipes down to the level of their constituent parts (namely, their ingredients, instructions for preparation and dosage, units of measurement, etc.), it is possible to take a much closer look at the range of material preserved within these texts.

Consider the remedies exhibited above: Figures 1–4 present a total of ten treatments, including seven remedies for a cough (Figures 1 and 4), one remedy for a dry cough (Figure 2), and two remedies for ‘those who cannot breathe’ (Figure 3). These ten prescriptions list a total of 27 ingredients, meaning that this sample contains an average of less than three ingredients per remedy. Significantly, of these 27 ingredients, only four occur in multiple recipes: wine, myrrh and black pepper are each listed twice, while honey appears four times. In other words, there is very little overlap among the ingredients listed in these treatments. In fact, each of the ten remedies offers an entirely unique treatment. This general pattern of diversity holds up when considering the entire sample of remedies in my corpus; although there are examples of parallel or related treatments within the full collection (which contains several thousand remedies), the enormous range in information presented in these prescriptions remains a consistent pattern.

Why does this variety matter, and what can we learn from it? Crucially, the diversity of treatments reflects the differences in the sources used to compile these collections of remedies at two levels. First, variation seen between manuscripts composed at different scriptoria indicates that each site of manuscript production contained a unique collection of sources. Again, consider the remedies exhibited above: Figures 1 and 2 present recipes from Biblioteca Apostolica Vaticana (hereafter BAV) pal. lat. 1088, a manuscript written in the area around Lyon in the middle or third quarter of the ninth century, while Figures 3 and 4 offer treatments from BAV reg. lat. 1143, an early ninth-century manuscript composed near Mainz. In addition to the treatments sampled here, both codices contain a number of other medical texts, such as excerpts from earlier medical authors. For example, BAV pal. lat. 1088 contains excerpts from Galen and a medical poem by Quintus Serenus, whereas BAV reg. lat. 1143 includes a selection from Theodorus Priscianus’ Euporiston and Alexander of Tralles’ Therapeutica, revealing that their libraries likely held different collections of medical writings (or at least distinct exemplars on which each of these manuscripts was based). Both manuscripts, however, also contain excerpts from the letters of the late antique physician Vindicianus, testifying to some shared sources.

Secondly, there is a tremendous range in the information contained within a single manuscript. Take the six different prescriptions to treat a cough, Ad tussem, illustrated in Figure 1. The penultimate remedy in this cluster can be traced to a late antique medical treatise that describes the medicinal uses of the herb bettony, De herba vettonica liber. Many recipe collections were structured by their ingredients, suggesting that the compiler of the collection of recipes in BAV pal. lat. 1088 sought to present treatments in a different format, instead arranging them by symptom. This individual would therefore have drawn on a range of different sources, selecting relevant material from other texts; in this case, he or she assembled six recipes related to coughs. As above, this range of information demonstrates that an individual scriptorium likely had access to a diverse array of sources. This diversity has important implications for understanding the process of manuscript production, the movement of knowledge, and the composition of these remedy collections. These topics are all central to my project at the BSR and thus illustrate the value of the new digital tools involved in my research.

While this blog has used remedies for coughing and breathing problems as an inroad into my project, there is much more to share. Perhaps a future post can discuss more specific findings relating to the introduction of new sources for medical knowledge in the Latin west and the role of scriptoria in the Italian peninsula in this process — stay tuned!

Addendum: The history of medicine meets current affairs

Finally, for those interested in how historians of medicine (and not just medievalists!) have reflected on the current coronavirus crisis and responded to the media’s use/abuse of history, I would recommend the following lectures, podcasts, articles, etc.—many thanks to Monica Green, Winston Black, Guy Geltner, and others for sharing them originally:

Brief bibliography

Manuscripts seen above:

BAV pal. lat. 1088, digital facsimile: https://digi.vatlib.it/view/MSS_Pal.lat.1088
BAV reg. lat. 1143, digital facsimile: https://digi.vatlib.it/view/MSS_Reg.lat.1143

Printed sources:

Pseudo-Antonius Musa, De herba vettonica liber, ed. Howald and H. E. Sigerist, Corpus Medicorum Latinorum IV (Leipzig, 1927), 3-11

Secondary scholarship:

Beccaria, A., I Codici di medicina del periodo presalernitano (Rome, 1956)

Bischoff, B., Katalog der festl.ndischen Handschriften des neunten Jahrhunderts (mit Ausnahme der wisigotischen), 3 vols (Stuttgart 1998)

Glaze, F. E., ‘The perforated wall: the ownership and circulation of medical books in medieval Europe, ca. 800-1200’, unpublished Ph.D. thesis, Duke University (1999)

Horden, P., ‘What’s Wrong with Early Medieval Medicine?’, Social History of Medicine 24 (2011), 5-25

Wallis, F., ‘The Experience of the Book: Manuscripts, Texts, and the Role of Epistemology in Early Medieval Medicine’, in D. G. Bates (ed.), Knowledge and the Scholarly Medical Traditions (Cambridge, 1995), 101-26

Figure captions

Figure 1: Biblioteca Apostolica Vaticana pal. lat. 1088, f. 36r: For a cough (Ad tussem), 6 remedies

Figure 2: BAV pal. lat. 1088, f. 48v: For a dry cough (Ad tussem aridam), 2 remedies

Figure 3: BAV reg. lat. 1143, ff. 105r–v: For those who cannot breathe (Ad eos qui non suspirant), 1 remedy

Figure 4: BAV reg. lat. 1143, ff. 170r–v: Pills for a cough (Cataputias ad tusse), 1 recipe

 

Claire Burridge, Rome Scholar, 2019/2020