All Things Medieval

Natural magic was inseparable from what we’d consider “real” herbal lore. Since the chemistry of why some plants were medicinal was very, very far out of reach, “that’s just how its natural magic works” was the best explanation.

In pre-Christian times, natural magic didn’t cause any philosophical problems. In some religious systems, God is in everything, not separate from creation. In others, the plants are effective because using them is a supplication to some god to help. But for the early European Christians, the use of magic posed a dilemma. What was okay and what was not?

Most of what we know is from penance manuals, the books sent out into the field for priests to use at confession. Sins were carefully defined and, in a sense, rated or scored by how much penance was required. Calling on the pagan gods was obviously a sin, but many charms could be Christianized by calling on angels and saints, instead. I’ll have examples of these in future essays.

Using a plant in a direct way was never considered the wrong kind of natural magic. Plants were crushed, steeped, strained, and burned. They were mixed with wine, water, butter or other substances. Sometimes even animals were used for direct use in medicine, burning some or all of an animal and using the ashes. As long as the remedy went directly onto the wound or into the patient, it was fine.

The church was less comfortable with indirect use of plants, for example, to tie a bunch of leaves with a red string to the patient’s forehead. Some of the rules for using plants were right on the border, such as not using iron to cut or dig. Since chemistry was not understood (after all, using a copper or iron dish did make a difference in how a brew turned out), it was allowed. What about picking a plant only at dawn or midnight? Well, perhaps its virtues fluctuate with the day’s cycle. Who knows? When there was doubt, it was best to say the Our Father or invoke a saint, to be safe.

Everyone agreed on the basic principle of sympathy: similar appearance indicated that a plant (or, sometimes, animal) could treat a problem. If a plant’s flower looked like a snake’s head, it could probably cure snake venom. Garlic was good for spear wounds because the garlic bulb was shaped roughly like a spear-head (“gar” was spear in Anglo-Saxon). Jaundice was treated with plants that were yellow; tree bark could help with skin ailments.

Oddly, everyone also agreed that minerals had properties of natural magic. The lodestone pointed north, which was certainly natural magic, so why would not coral protect its wearer from lightning? Every gemstone had properties like this; one of the standard types of book listed the minerals and what they could do.

Thomas Aquinas, probably speaking for everyone in the Middle Ages, stated that all natural magic properties were caused by the stars’ influence on the earth. Astrology and astronomy were still one science in that time. Most of their lore came from the East, so it had a particularly exotic, scientific sheen.

In the Middle Ages, what was disease? Everyone agreed that health was wholeness: it was the body functioning as it ought to. I guess our contemporary writers who talk about “wellness” are taking a similar view. So loss of health meant that something had been taken away; it needed to be restored.

Loss of health had two primary, concrete causes: imbalance and some kind of attack, a direct theft of health.

Imbalance of humors was the Greco-Roman theory, imported to Northern Europe first with the Roman legions, then with the monastic tradition that was heavily based on Latin sources. Their answer to the question “why am I sick?” was that you ingested some substance that imbalanced your system, or else you have an inherent humor-balancing problem.

The substance was probably food: you ate too many cold and wet foods, which cooled the fires of the stomach, so that food was not properly digested. The body tried to remedy the situation by heating you up. That’s why you have a fever. Or perhaps you ate foods that were too warm or dry for your system. Maybe you were greedy at a feast and glutted yourself on spiced wine; perhaps you could not hold back from eating far too many roast birds.

Bad air might also imbalance your system. Air near the sea was cool and wet, while in low inland places it was warm and wet. We’ve often remarked from the standpoint of current knowledge of mosquito-borne illness that “bad air” most often had mosquitos whining about, although this connection was not made at the time. When people traveled to foreign places, they often came home sick, which was obviously caused by bad air or unfamiliar air that imbalanced a traveler’s system even if it was okay for the inhabitants.

The native Germanic idea of illness seemed to focus most on attacks. Your health was stolen, or something pierced your body and brought unwholeness to it.

In pre-Christian times, the attackers were often elves and dwarves. These creatures lived a life apart from mankind, in woodlands or in mountains and caves (respectively). They were not considered evil. They were just dangerous because they took no care for mankind or might be angered. Elves shot arrows, so sudden attacks of illness, especially if it appeared localized with swelling or a wound, were viewed as elf-shot attacks.

Another type of attack came from a worm. This included literal parasites, as well as imaginary evil serpents. But just as cancer is named for the microscopic crabs they thought were eating the flesh, other illnesses could be caused by invisible worms.

It would simplify things too much to reduce all illness to imbalance and outside attacks; there seems to have been also a general awareness that illness just happens. However, it was still a loss: a loss of balance or wholeness. Plants might restore what was lost, or charms might induce the loss to be reversed.

In early medical books, diseases and remedies were organized from head to foot. This suggests, too, that the illness was generally seen as localized. Disorders like diabetes and gout, which stem from internal organs but show up in limbs or eyes, were out of their reckoning. How much comprehension there was in the linkage of symptoms depends a lot on the place, time, and chain of influence among writers.

When the Celtic and Germanic tribes of Europe converted to Roman Christianity, they adopted a long-established written tradition of scientific principles. Their own herb lore continued, probably in many cases without reference to the new “science.” But it became, increasingly, the medicine of the countryside and the poor. Aristocrats wanted medical men trained in the Roman sciences.

The first underlying principle of Greco-Roman medicine was that each person is unique, in health as well as in sickness. We’re slowly coming back to partial acceptance of this idea with DNA definitions of how people differ. However, for a long time, one of our bedrock ideas has been that healthy people are fundamentally alike, and the diseases that make sick people different are also fundamentally alike. We deal in forests, not trees.

Greco-Roman medical practice identified diseases, but it focused more on balancing the four humors that every person was made of. In that one way people were alike, I suppose: they were made up of the same four elements, though in different combinations. The essence of disease was imbalance.

The physical world was already divided into earth, air, water, and fire. The body was similarly made of liquids that corresponded to these four elements. To a Roman doctor, we are made of blood, phlegm, yellow bile, and black bile. Every healthy person had a personal balance of these liquids, and every disease showed itself in signs of imbalance of humors.

The physical world also could be defined by the attributes of heat and water, and lack of heat (coldness) and of water (dryness). The four humors could be described in these terms also. Blood was hot and wet, while phlegm was cold and wet. The two kinds of bile were both perceived as dry; the black bile was additionally cold.

A healthy man could be defined by the humors that dominated in his system. If he was sanguine, it meant literally that he was full of blood. It would be considered normal for him to feel too warm frequently, and to be optimistic. Blood corresponded to air, which was warm and dry. The phlegmatic man had too much phlegm and was cold and wet, like water; he was resistant to action. The melancholy man had more black bile and was both cold and dry, like earth. The choleric man had yellow bile, was warm and dry, and got angry easily, like fire.

When doctors prescribed, they had to take into account the patient’s fundamental system as well as his symptoms of imbalance. Fever was a hot, dry symptom; diseases characterized by fever, like measles, were hot, drying disorders. They needed to be cooled and watered, to bring the system into balance again. A choleric man with a fever needed extra consideration; the fever might be a result of his system having cooled too much, so instead of cooling and hydrating, he might need more warming and drying.

The Greco-Roman system had the great advantage of logic. It organized everything neatly in basically one 2 by 2 table. Our culture may have a tendency to love binary options so much that we simply cannot resist a binary split by another binary.

The drawback was that the system had no factual basis; it was all theory.

Christianity came first to the Near East; its earliest adherents were in the Roman provinces of Palestine, Egypt and Ethiopia, Syria, Macedonia, and other places around the Mediterranean rim. In 301, Armenia formally adopted the Christian religion. During the next century, the Roman Empire also adopted it, and we can assume that the Gauls who lived in the Roman parts of modern France were presented with the new faith.

A surprising amount of the new faith’s transfer came through slavery. Wulfilas was born among the Goths, to Cappadocian Greek slaves in the Trans-Danube region around 310. His parents raised him in the Christian faith, but he was culturally Gothic otherwise and spoke at least three languages. He became a bishop among the Goths, translating parts of the Bible into Gothic (linguists are forever indebted to Wulfilas). Similarly, while Roman economic ties brought the new faith to the Celtic Gauls, we remember St. Patrick as the boy captured by the pagan Irish, enslaved so that he learned their language, and later returning as a free man to be a missionary and bishop. Other Roman-Britons had also brought the faith; we can’t put a date on its introduction to Ireland, but we know it was accomplished before about 400.

The other overlooked vehicle for transferring the new faith came from aristocratic intermarriages. In 490, one of the early Frankish kings, Clovis I, married a princess whose family had become Christian through contact with the Roman Empire. Clovis converted to her faith, with a large contingent of his war band. After the Angles, Saxons, and Jutes migrated/invaded into the island of England, King Aethelberht of Kent married a Frankish princess, Bertha, who brought a bishop to be her chaplain. There were probably many more such marriages.

The Visigoths and Lombards, who attacked different parts of Italy in the 500s, both were converted to a non-Roman form of Christianity, known now as Arianism. Perhaps to compete with the spreading Arianism, Pope Gregory the Great sent missionaries out to England in 596. This mission established a Roman Catholic church in Canterbury, in Aethelberht’s kingdom. Monasteries in Ireland also sent missionaries. From Christian England, missionaries crossed the Channel into the Low Countries and then to Saxony.

For the story of medicine, the important part is that in most European cases, conversion to Christianity meant the adoption of some portion of Roman culture. Ireland remained a non-Roman holdout for a long time, while the Lombards in Pavia were often in open war against Rome. But these were exceptions. During those same centuries, Rome had struggled to become dominant over Egypt, Syria, and Constantinople. While missionaries from Constantinople went into the eastern parts of Europe, Western Europe became a post-imperial colony of Christian Rome.

There were, then, (at least) three major belief systems present in early medieval Europe. First, the bedrock of their Celtic or Germanic pagan worldview. Second, the Roman worldview, which for a long time dominated science and medicine. Of course, Roman philosophy was largely based on the very advanced work of Greek culture a few centuries before. Third, the Christian Bible was Jewish in origin, and its worldview was different from either of these two.

So in tracing the story of medieval medicine, we need to look at all three ideas of how the world operates and who we are, as minds and bodies, within the world. The three systems competed and blended, finally creating the modern set of beliefs we inherited.