Medicine and the Seven Deadly Sins in Late Medieval Literature and Culture

by Virginia Langum

  Bodley 649 makes extended use of the images of the Christus medicus and the Medicina Iesus, who heals “men of hor [their] dedle sekenes” with “the ointment of his blood.” 38 However, the cycle positions Christ’s healing within material medical practice by referring to medical authorities such as Hippocrates, Avicenna, and Galen, as well as enumerating medical techniques and providing detailed accounts of illness and physiology. Furthermore, the metaphor of medicine serves complex and sophisticated arguments about heresy. The homilist incorporates medicine into at least ten of the twenty-three macaronic sermons in this collection, often in detail.

  Scholars have considered the Bodley 649 sermons’ relation to heresy and language. As for the first, the threat of Lollardy and affirmations of clerical authority saturate the sermons, probably reflecting the concerns of university men at Oxford, which was the epicenter of the period’s heretical and anti-heretical movements. 39 The Lollards are attacked in almost every sermon in this collection. As for language, Siegfried Wenzel has looked at the macaronic quality of the sermons in the blending of English verses and phrases with the Latin text. 40

  The cycle is probably of Benedictine provenance, dating back to the early fifteenth century. Several of the sermons praise Henry V; one mentions his victory in battle, presumably the Battle of Agincourt in 1415. As the sermon refers to the king as living, we can assume that the text was written before 1421. 41 In one sermon, the homilist identifies himself with Oxford, and four sermons in this manuscript are also found in another manuscript known to have been produced at Oxford. In addition to paleographical evidence, the repeated disparagement of the Lollards and expressions of support for clerical authority strengthen an Oxford provenance. In the fourteenth century, Oxford was the university home of John Wycliffe (d. 1384), whose teachings were taken up by the heretical Lollards as well as the great adversary of the Lollards, Bishop Thomas Arundel (d. 1414), who convened an anti-Lollard council at Oxford in 1408. 42 The audience may have comprised both clerics and lay people, as both are addressed in the sermons.

  Although much less established than on the continent, the study of medicine at Oxford existed during the fifteenth century, according to medical historians. 43 Although increasingly secular as the century progressed, medicine retained its clerical connection at the university. The 54 known Oxford medical men of the fifteenth century included two bishops and other, lesser clerics. The Benedictine order, in particular, had long demonstrated a strong appreciation for medicine. For Benedict, care of the sick was a central concern, to which he devoted an entire chapter in the Rule. Compared with several other religious orders, the Benedictines made far more effort to preserve medical learning. Every Benedictine monastery had its own infirmarer, a monk in charge of the infirmary who oversaw the care of the sick, and larger monasteries often had their own physicians. 44 The surviving book lists from Benedictine libraries in Oxford include books of medicine. 45

  Regardless of whether the compiler was a physician himself, or of how many physicians might have been in the audience, Bodley 649 was undoubtedly produced against a cultural backdrop of medical learning in late medieval Oxford. Medicine, illness, and physiology have various functions in the cycle. First, illness and health represent post-lapsarian life. Second, illness serves as a tool provided by God. Third, medicine and illness contend against heresy. Finally, human physiology affords analogies for various didactic purposes. However, these categories are not mutually exclusive and often blend into each other, creating a continuum between material and metaphorical disease and treatment.

  This coalescence is clear in the image of the diseased body as both symptomatic and representative of post-lapsarian life. As mentioned earlier in this chapter, medieval theologians argued that the Edenic body was free of disease. Labor, childbirth, disease, and death were punishments for the Fall. The homilist of Bodley 649 develops this theology in the first sermon in the cycle. He begins by translating the Gospel theme from 2 Corinthians 6, Nunc dies salutis [“Now is the day of salvation”] into English:Alle seke and woful come to weele [prosperity],

  Now is a day of gostle hele [health]. 46

  The homilist glosses the passage in medical terms. He first describes the pre-lapsarian body as free of grief and illness, then compares the course of human life to that of a disease:And just as long-term illnesses, which according to the physicians are called chronic illnesses, begin at sunset and end at sunrise, so the long-term illness of the human race began when the sun of justice, God, receded from the human mind. And never would it be cured by plaster, syrup, or cordial until the Sunday of grace dawned in the birth of Christ. 47

  Here, illness is both metaphorical and material as well as chronic and acute. Illness is to life (or death) as acute illness is to chronic illness.

  Although material illness begins with sin, it also introduces the long-term illness of human life. The sermon then compares this long-term illness with metaphorical illness and the healing of Christ. However, the rhetorical shift from material medicine to metaphorical medicine comes full circle with reference to King Hezekiah of the Old Testament, a recurring exemplum in the cycle. In this sermon, Hezekiah embodies the previous notion of the healing sun. The homilist writes that Hezekiah was “never cured of his fatal illness until the material sun moved backwards ten degrees.” 48 The sermon glosses the sun as a person’s behavior and way of life. Although the movement of the clock and sun is inevitable, it can be slowed down by adopting a moderate lifestyle and virtuous behavior.

  Medical diagnoses and prognoses emphasize the inextricability of bodily and spiritual health. In one sermon, the homilist appeals to the audience who “can see every day before [their] eyes that through the misuse and excess of food and drink men fall into cotidian fever, from the cotidian into the quartan or acute, and there is nothing else but death.” 49 The sermon calls both the audience and the medical authority of Constantine the African’s eleventh-century Viatica as witnesses to the post-lapsarian body.

  The homilist explains that the deterioration from fever to death isMorally [moraliter] speaking, Adam … who was pure without corruption, healthy in every way without any bodily infirmity or spiritual excess, by eating the forbidden fruit in paradise fell into the cotidian [fever] of original sin that just like a fever made his tongue lose taste so that he could not savor God or the spiritual food that was able to nourish his soul. At one moment it made him shiver with the cold of sorrow and fear, at another it burned him with the raging heat of carnal desires. This did not leave him, it hung continually over him, it was a cotidian fever. And by it man rushed through the misrule into worse, into the acute [fever] of actual mortal sin which burned him so grievously, body as well as soul, that as all doctors said there was only one way for him. 50

  Speaking moraliter or spiritually, material illness serves as a common term on both sides of the analogy between spiritual and bodily health, as in the previous sermon. Adam’s sin is punished by a metaphorical fever that represents the introduction of the passions, such as sorrow, fear, and desire; those who come after him are subject to material punishment. Bad behavior progresses like a fever, leading to inevitable death. Medical imagery thus illuminates the spiritual dimension of what we “see” [videmus] or witness in the material body.

  Continuing his discussion, the homilist describes how “the experienced doctor Jesus out of his great mercy gathered cold herbs in the field of his humanity to reduce our burning fever.” 51 Although there are both hot and cold herbs to be found in this garden, those that temper the fever of sin are hunger, thirst, poverty, and sickness. Following the theory of contraries—here, that cold cures hot ailments—material sickness cures metaphorical sickness. The homilist concludes with a passage from Luke 4:38–9, in which Jesus cures Simon’s wife’s mother of her fever. For the homilist, the woman’s material fever is also “the fever of mortal sin.” 52

  This rich concatenation of metaphorical and material fever demonstrates that human physiology is a physic
al manifestation of spiritual disposition. Inspired by the biblical tale in which Jesus heals the son of a regulus who suffers from fever, the condition is also used as a symbol for sin in an influential sermon collection by Jacobus de Voragine (d. 1298), whose sermons were circulated in England and were translated into English. As Jacobus writes on the 21st Sunday after Trinity, “as there are various kinds of fevers, so there are various kinds of sin.” 53 However, the homilist of Bodley 649 draws an explicit connection with the material phenomenon of fever, with reference to both Constantine and the experience of the listener. 54

  While intricately connected with sin, illness also comes from God to instruct and rectify the faithful, as conventionally claimed in writings on patience and tribulation. In the macaronic sermons of Bodley 649, God sends illness “so that we might flee to his mercy and master ourselves.” 55 Elsewhere, the homilist compares the world to a sea that ebbs and flows between sickness and health. 56 This tribulation provides “interior insight and knowledge of oneself.” The homilist then moves from this material disease that provides spiritual health to consider how a metaphorical disease generates spiritual disorder.

  However, it is in another of these seas—“false Lollardy”—that the homilist most fully demonstrates his medical sophistication and creative application of medicine as metaphor. The infection of heresy is a conventional image, but the homilist’s version is idiosyncratic:Whoever, man or woman, falls into these false beliefs, dries up immediately, loses his spiritual life … You wish to see this with your own eye? According to the Philosopher, bodily life rests in the proper proportion of natural warmth and deep-rooted moisture. Likewise, the spiritual life rests in the proper proportion of the heat of charity and the moisture of devotion. But this spiritual life withdraws itself from the heart as quickly as someone falls into these false beliefs. As soon as he is infected, he begins to detract from his neighbors, to reprimand religious. 57

  Citing Aristotle on humoral balance, the homilist uses medical physiology to convey spiritual disease or imbalance. Similar to fever, which is compared to post-lapsarian life, the drying of the body provides a palpable analogy for heresy. What makes the homilist’s physiology of heresy so intriguing here is its distance from more conventional images.

  In by far the most established symbolic tradition, heresy aligns with leprosy. The physical spots of leprosy represent the defilement of the body of the Church by heresy. An early example in Gregory’s Morals on the Book of Job, for example, glosses the ten lepers healed by Jesus in Luke 17 as heretics returned to the body of the Church. Likening heresy to the condition of the skin during leprosy—healthy and of normal color mottled with bright patches—Gregory writes that “lepers therefore are a figure of heretics, for in that they blend evil with good, they cover the complexion of health with spots.” 58 Likewise, Aquinas considers the physical symptoms, contamination, and contagiousness of leprosy with the characteristics of heresy in Summa Theologica. 59

  Several scholars have shown how these conventional images of the leprosy of heresy were deployed in ideological campaigns against various heretical sects from the eleventh to the thirteenth centuries. R. I. Moore traces the image of leprosy used to castigate groups seen as heretical, such as Jews and Waldensians. 60 During these centuries, the disease of leprosy was also a material epidemic, which began to decline dramatically in the thirteenth century. Nevertheless, leprosy persisted as an image for heresy in writings contemporary with the Bodley 649 cycle. For example, in Loci e libro veritatum, Thomas Gascoigne (d. 1458) attacks Reginald Pecock (d. 1460) for his unorthodox beliefs with such imagery: “this Bishop Reginald of St Asaph in Wales had many kinsmen who were lepers and was disposed to leprosy of the body; also this bishop had leprosy in the mind, i.e. he was rumored to have been a heretic.” 61 Gascoigne here suggests not only that Pecock’s ancestors were lepers and therefore that Pecock is physically disposed to the disease but also that he exhibits symbolic symptoms of leprosy due to his heretical beliefs.

  The compiler of Bodley 649 does not reference leprosy in the sermon quoted above, instead developing a more specific physiological analogy to show how heresy might function in the body. To the best of my knowledge, this physiology of heresy is unique. However, it is consistent with the general view of decline and death represented in medieval medicine, specifically as the loss of warmth and moisture. Most of the other references to heresy in the collection are less detailed and more conventional than the previous description. In other sermons, for example, Lollards “infect” the people with false doctrine. However, the disease of heresy is also material, as where “pestilence and misery” fall upon those who support the Lollards and allow them to thrive. 62

  The homilist extensively exploits the connection of heresy with disease in Sermon 18, using the theme He cured him from Luke 14. This biblical passage offers the story of Jesus healing a man with dropsy. Where we would expect conventional analogies, such as comparisons of salvation to health and sin to disease, the sermon incorporates the additional concerns of literalism and the threat of Lollardy, knitting medical analogies into a complex and cohesive rhetorical argument.

  Although initially citing Luke as the theme, the homilist proceeds immediately with a story from Joshua 7 in which Achan steals a scarlet mantle and a bar of gold, and buries them in the ground, against God’s commandments. Joshua raids the city in retribution; the goods are recovered and Achan is stoned to death. The sermon states that “this is the story according to the sound of the letters,” indicating that a greater spiritual dimension will be unfolded. The homilist explains that the bar of gold signifies the Christian religion and creed hidden by “Lollards who examine sacred scripture and take only the letter and not the meaning [litteram et non sensum].” 63 The mantle is understood ascommunity, for just as the mantle covers the body, keeps the heat within, and protects it from the great cold and storms, so the spiritual mantle that covers each one preserves the natural heat of the virtues and defends it against the sharp assaults of bodily and ghostly enemies. 64

  Once again, the Lollards are linked to pestilence, as without the “coverlet of love and charity,” the faithful are exposed to the “loss of property and disease of animals, pestilence of men.” 65 Although the story of Achan is cited by earlier medieval homilists in reference to heresy, particularly to justify aggressive anti-heresy measures, the homilist here develops the image of the cloak, emphasizing the danger and vulnerability created by escaping heat, as an extension of the physiology of heresy presented earlier in the collection. 66

  However, the entire sermon can also be seen as a discourse on literalism. In the Christus medicus image that follows, the most extensive in the collection, the homilist provides interpretative readings of the biblical text. However, material things—bodies, illnesses, and medicines—are not merely signifiers; on the contrary, they are integral to the meaning. After telling Achan’s story, the homilist expounds on three biblical examples of Christ’s acts of material healing in the New Testament, including that which with he began the sermon. These stories concern the three sicknesses that most grieve the children of Adam: dropsy, palsy, and blindness. The homilist then describes these three illnesses in detail, referencing Jesus’ healing of people with equivalent conditions in the Gospels, and thus, suggesting the inter-relatedness of moral and medical conditions.

  The man with dropsy from Luke 14:2 either spiritually or metaphorically [moraliter] represents greed, as per well-established tradition (see the chapter on avarice). 67 However, people suffer many physical ills in pursuit of material gains, such as chills, hunger, and thirst, from which the homilist concludes that “this is a sorry sickness” [Ista est a sory siknes.] 68 Although Jesus is previously mentioned as the healer of material dropsy in the biblical story, the cure for greed is not directly associated with Him but rather with works of mercy.

  Next is the shivering palsy, which is compared to sloth [bene comparari accidie]. Just as paralyzed limbs break down and weaken “so
they cannot accomplish the required motion, so sloth, by repelling virtues and by accepting vices, delights so much that one cannot work meritoriously and so fix love or heart on God as one ought” (see the chapter on sloth). 69 The use of figurati to gloss John 5, in which a paralyzed man claims that he cannot be healed by baptism as no one will carry him into the water, underlines the necessity of interpreting medicine in spiritual terms. The habitually sinful fuerunt figurati [“were symbolized”] by this man, and must think of Christ’s counsel: “rise up from your sin through contrition, take up the sordid mat of sins and bear it in heart to your curate, and lay it there, and go do penance, pursue virtue and good living.” 70

  Finally, the sermon compares blindness to the condition of “those who fall in despair and wanhope [hopelessness].” 71 These blind people are advised to bathe and wash “by frequent meditation, in the precious stream that flowed from [Christ’s] wounds.” 72 Although obviously connected with the healing of the blind Longinus and reiterated in other miracle stories, blood was prescribed as a cure for blindness in a host of medical recipes. 73

  At the culmination of this sermon, which begins with Lollard literalism and works through greed (dropsy), sloth (paralysis), and despair (blindness), the homilist shows how the crucified Christ cures the heritage of Adam’s sinfulness. This image, however, expands the traditional metaphor of the Christus medicus into a protracted and provocative image. Christ here acts according to medical convention, initially taking the pulse of the sufferer and diagnosing the ailment as “the great illness and disease that mankind suffered: hunger and thirst, sickness and cold, anguish and poverty.” He then prescribes a diet of spiritual food in the form of preaching and teaching, “that he should reject the uncleanness of sin and live in virtue and honesty.” Finally, “for complete healing,” he makes an ointment by crushing his own body against the wood of the cross, and laying it against the wound of sin. In this final procedure, Christ is both medicus and patient. The three tenets of medicine are practiced here: diet, pharmacology, and—the most radical—surgery.