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Chapter 5: Medicine for the Body and Soul: Healthy Living in the Age of Bishop Grosseteste c. 1100-1400

Chapter 5: Medicine for the Body and Soul: Healthy Living in the Age of Bishop Grosseteste c. 1100-1400

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88



C. Bonfield



names as Hippocrates (d. c. 377 BCE), Galen (d. c. 200 CE) and Avicenna (d. 1037)

(Rawcliffe 1995; Nutton 1995; Lindberg 1992). Most medical historians today,

however, would suggest that rather than being diametrically opposed, the relationship between medicine for the soul (Medicina sacramentalis) and therapeutic

medicine in the past was symbiotic (McCleery 2014). In other words, just as the

body and soul were unified entities, so physical and spiritual health was essential for

health and well-being.

This paper will flesh out these ideas and concepts in more detail, setting out how

men and women in the age of Bishop Grosseteste would have explained health and

disease. It will address three main points: firstly, how the Church defined good

health, and what wider impact this had on institutions caring for the sick and poor.

Second, to what extent ‘religious’ explanation of sickness and disease sat alongside

so-called ‘medical’, or ‘scientific’, explanations of healthy living. Here, particular

emphasis will be placed on the genre of self-help guides to health called the

regimen sanitatis (regimen of health). This advice took many forms, including a

wide and varied collection of manuscript and early printed copies of the Regimen,

commonplace books, popular collections of medical recipes, regulations promulgated by urban magistrates, political propaganda and homiletic literature.1 Having

thus established the importance and interconnected nature of sin and sickness, the

final part of the paper will examine the impact that medical explanations had on

wider spiritual concepts of health and disease, focusing in particular on homiletic

literature, such as the handbook for preachers, Fasisculus morum. Written about

fifty years after Robert Grosseteste’s death in 1253 by a Franciscan friar, it contains

a selection of popular religious and moral stories that would have been heard from

the pulpit throughout England (Wenzel 1989).



5.2



Medicine and the Church



Church authorities were never slow to point out that death and disease, and all

man’s other troubles, were seen to be a direct consequence of Original Sin. The

fateful event incurred punishment for Adam and Eve and all their descendants

ranging from the pains of childbirth and menstruation to illness, epidemics and even

death itself. The consequences were felt by everyone, rich or poor, young or old. St

Augustine maintained that the Fall had upset the harmonious relationship between

body and soul which had hitherto preserved Adam and Eve in a perfect state of

health (Ziegler 2001; Brown 1988). As St Thomas Aquinas (1215–1274) would

later argue, this resulted in the balance of health being ‘so utterly wrecked that life

is destroyed; so as to cause sickness’ (Aquinas 1982). The characteristics of Fallen

man included ‘mortality, death, misery, suffering, crimes, [and] the war of flesh



1

For the Regimen sanitatis and its reception in late medieval England (see Gil Sotres 1998;

Bonfield 2006).



5 Medicine for the Body and Soul: Healthy Living in the Age of Bishop. . .



89



against the spirit’ (Deane 1963). Put simply, in the final analysis all imbalances

could be traced to Original Sin. In fact, Robert Grosseteste, who is known to have

been influenced by the works of the famous physician and scholar Avicenna,

himself noted that rational thought and the ability to see clearly were impeded

because of the corrupt nature of the body. He wrote that as a consequence of the

Fall, mankind had to rely on the senses which, according to Richard Southern, was

for Grosseteste like ‘a blind man’s use of a white cane’ (1986; Harrison 2007).

Yet there was hope. As noted above, Christ had the ability to heal. Augustine

urged that the sick man should drink from the ‘bitter cup [of death] in order to

become well’. Do not fear to drink from this cup, he reassured the reader, for:

. . .to dispel your fear the Physician [i. e. Christ] drank first, that is, the Lord drank first the

bitterness of the passion. He had no sin, he had nothing to be cured; yet he drank. Drink

until the bitterness of this ages passes away, until there comes a time when there will be no

scandal, no anger, no wasting disease, no bitterness, no fever, no deceit, no enmities, no old

age, no strife (Trans. Arbesmann 1954).



In addition to the heavy load of Original Sin, which was carried by everyone,

came the burden of individual, personal wrongdoing, likely to bring down the wrath

of God, either in this world or—even worse—in the next. It is perhaps no surprise,

therefore, that in 1215, the Fourth Lateran Council ruled throughout the whole of

Western Christendom that:

As sickness of the body may sometimes be the result of sin . . . so we by this present decree

order and strictly command physicians of the body, when they are called to the sick, to warn

and persuade them first of all to call in physicians of the soul so that after their spiritual

health has been seen to they may respond better to medicines for their bodies; for when the

cause ceases so does the effect (Garcı´a 1981).2



These ideas endured and gained popularity; they also found concrete expression

in institutions responsible for ‘caring’ and ‘curing’, such as hospitals (Horden

2007).3 There were well over a thousand hospitals documented in medieval

England, which between them ranged considerably in size and means, and dealt

with a variety of diseases (Carlin 1989). Four main types can be identified: leper

houses; hostels for pilgrims; institutions for the sick poor; and alms-houses. Generally, these were primarily religious institutions ‘with liturgy at their heart’, and in

their wards patients received a combination of a therapeutics, such as clean bedding

and a good diet, and Medicina sacramentalis (the medicine of the soul) (Rawcliffe

2008; Park and Henderson 1991). The latter has recently been termed the ‘true’

medicine of hospitals which, unlike drugs or invasive surgery, did not require the

presence of physicians or surgeons yet could potentially affect the body. Indeed, the

Mass and the Daily Offices were performed daily in hospitals, and many patrons

invested heavily in liturgical items and vestments. For instance, at St Leonard’s

hospital (York), the liturgy was sufficiently important to justify an impressive

complement of thirty secular choristers—then more than Exeter and Salisbury

2

3



My emphasis.

For the therapeutic regime (see Bonfield 2013).



90



C. Bonfield



cathedrals combined (Bowers 1975). Records from a number of larger institutions,

including St Katharine’s by the Tower (London), St Leonard’s (York) and St Mary

in the Newarke (Leicester), reveal also that regulations were in place to ensure high

standards of performance, and, equally important, that prayers would be said at

each of these times for the spiritual health of patrons or benefactors (Jamison 1952;

Dugdale 1817–1830; Thompson 1937).

If we jump ahead to the end of the sixteenth century, we can even note the

continued influence of these enduring ideas on hospital architecture. The Savoy,

London, whose earliest surviving statutes, dated 1523, were based on the model

established at Santa Maria Nuova, Florence, include detailed specification about the

linen on the hospital’s 100 beds; an overriding concern with cleanliness; and special

provisions for the care of the sick, who were to be attended twice daily by a

physician, an apothecary and a surgeon, each salaried by the hospital (British

Library, MS Cotton Cleopatra C V, ff. 25r–28v.). Clearly, the physical health of

patients was import; yet, even here, spiritual health was given (almost on an hourly

basis) precedence over that of the body. Furthermore, the hospital’s layout was, like

its Florentine counterpart, based on a cruciform ground plan: the hospital literally

embodied Christ’s redemptive cross.

Evidently, religious explanations of health, sin and disease impacted upon both

the theory and practice of medicine. However, although heavy emphasis was placed

on the soul and spiritual medicine, there was also current a very different idea: that

healing and medicine came from God, and that he wanted man to be fit and derive the

most from life on earth. Medicinal plants and other cures came from God, and were

to be exploited to the full. Indeed, the absorption of Greek, Arab and Jewish concepts

of man and the natural world in the twelfth and thirteenth centuries encouraged this

more positive outlook.4 The force of this tradition dominated medical teaching in the

West from Bishop Grosseteste up to the seventeenth century—the best part of

500 years—and dated back to the fourth century BCE. Indeed, Grosseteste obtained

a considerable level of medical knowledge himself, and his theology in known to

have been influenced by Galenic medicine (Murray 1991; Grosseteste 1861). This

brings us to the powerful impact of non-Christian tradition on Western medicine.



5.3



‘Medical’ Ideas About Health



Ideas about the preservation of health have a long pedigree, for an impressive

corpus of medical treatises circulated in Ancient times. The Western tradition of

medicine can, indeed, be traced back to the Ancient Greeks, as:

. . .generations of doctors and surgeons have proclaimed their intellectual descent from

Hippocrates of Cos (d. 377 BC) and their adherence to a practice of medicine based on ethical,

rational, and independent judgement, sound experience and fine learning (Nutton 1995).



4



For the translation and transmission process (see Lindberg 1992).



5 Medicine for the Body and Soul: Healthy Living in the Age of Bishop. . .



91



Even among his contemporaries Hippocrates, who is now known as the father

of medicine, was so revered that authors were keen to attribute their works to his

name; he was often invoked by medieval writers to authenticate their writings

and appeal to a wider public. Certainly, although a medical practitioner called

Hippocrates did live on the island of Cos over 400 years before the birth of

Christ, the corpus, or body, of works attributed to him was compiled much later

in Alexandria.5 In fact, the legendary Hippocrates of medical times acquired such

a lasting reputation because he was praised by both Aristotle (383–322 BCE) and

Galen (d. 129 CE), who acquired even greater posthumous celebrity than he did.

Indeed, it was the Greek physician and surgeon, Galen, who commanded the most

respect in the medieval medical world. Trained at Pergamum he was a practitioner, scientist and prolific author (Touwaide 2014). He was also a physician to

Marcus Aurelius in Rome. It was he who hailed Hippocrates as a great authority,

and elaborated many works in the Hippocratic Corpus, which themselves were

disseminated and transmitted to the West, along with works by Galen and later

commentaries and compendiums, such as the Canon of Medicine by Avicenna

(Gruner 1930).6

It is in Ancient Greece that we find a series of precepts on diet and hygiene

meant to preserve health, and that these precepts were a step in the progressive

discovery of a regimen of life (Gil-Sotres 1998).7 In the earlier Hippocratic

treatise De natura hominis (On the Nature of Man), it was argued that the body

owed its existence and growth to an admixture of four humours: sanguine (hot

and wet); choleric (hot and dry); phlegmatic (cold and wet); and melancholic

(cold and dry) (Littre´ 1839–1861). As humoral imbalance appeared to be responsible for disease, maintaining a state of equilibrium was of vital importance. The

all-pervasive Classical doctrine of health hinged upon the avoidance of dyscrasia

or excessive imbalance, the favoured means of achieving which was through diet

or a broader regimen of health.

By the time these ideas reached Galen, the greatest advocate of preventive

medicine, On the Nature of Man had been joined together with another treatise

called Regimen in Health which recommended that:

. . .he who aspires to treat correctly of human regimen must first acquire knowledge and

discernment of the nature of man in general—knowledge of its primary constituents and

discernment of the components by which it is controlled. . .These things therefore the

author must know, and further the power possessed severally by all the foods and drinks

of our regimen. . . Even when all this is known, the care of man is not yet complete, because

eating alone will not keep a man well; he must also take exercise (Hippocrates 1931).



Galen went on to argue that physical and spiritual well-being relied on the

existence of an ideal equilibrium between two extremes, warning that, in order to



5



For an introduction (see Jouanna 2001).

Robert Grosseteste, who took a keen interest in such medical writers, is known to have referred to

the Canon (Crombie 1971).

7

For an examination of medicine in the Graeco-Roman World (see Jouanna 2012).

6



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