Albeit to a lesser extent, pastoral writers also take up the question of habits and passions in their discussion of the vices. The compiler of Fasciculus Morum roundly condemns the invocation of habit to excuse sin: “sometimes they blame their own habit [consuetudinem],” saying “‘I would gladly correct myself, but I am so used to swearing that I can in no way leave it.’” Such an excuse heaps more blame on the confessant, the compiler argues, first “because it increases rather than decreases one’s sin” and “second because you yourself have brought yourself to the vile habit and no one else.” The text emphasizes this point by comparing confession to the court. If the defendant stands before the judge, saying “‘Certainly, my Lord, I am so used to these that I cannot abstain from them,’ what good would such an argument do you, I ask? Surely, with it you would condemn yourself.” 113
The precise nature and role of the passions and habits in influencing human behavior are significant to legal texts, which are worth considering briefly here in relation to pastoral theology. The early fourteenth-century Anglo-Norman Le mireur a justices [Mirror of Justices] outlines several significant issues related to the body and sin. Steeped in the language of sin and penance—the text distinguishes between spiritual sins [pecchiez espiriteus], which are governed by canon law, and material sins [pecchiez materieus], which are governed by princes and common law—the Mirror distinguishes between the will and action to characterize sin as distinct from fault.
Furthermore, the text offers classifications for madness that measure blame in terms of the will, particularly as regards homicide. All fools, the text argues, can be judged as homicides except les foux nastres, those born with intellectual impairments or those who develop them from accidents, and children under seven years old (typically the age of discretion in medical and religious discussions). 114 What distinguishes the fol nastre and the child from other murderers is their lack of corrupt will [parmi voluntie corumpue]. Their innocent conscience and lack of discretion—here, the ability to distinguish right from wrong—ensure that there can be no such corruption of will. However, not all madmen are exempt from sin and corrupted will. 115 Those suffering from acute madness, the “raging fools” [fous ragie] can be held accountable for their actions.As to madness we must distinguish [des arragez ensement fet a destincter], for those who are frantic or lunatic can sin feloniously [ar les frenetics e les lunatics poent felonessement pecchir], and thus may sometimes be accountable and adjudged as homicides [e issi sunt il contables pur homicides ascuns foit e jugeable]; but not those who are continuously mad [mes ne mie les continuelement arragez]. 116
This passage posits that the temporarily or sporadically insane could be held accountable not that they always were. 117 Indeed, evidence shows that English juries in the later Middle Ages most often acquitted the mentally ill. 118
Although it will be immediately clear how certain passions correlate with the sins—anger for wrath; the concupiscible passions for gluttony and lechery—others are less evidently connected, and will be discussed at greater length in their individual chapters, drawing on the ideas sketched previously. Wrath, however, is the ultimate example of the urgency of attempts to disentangle passion from sin. The passage quoted above from the Mirror of Justices concerns homicide, and it is the passion of wrath or anger that commonly brings together moral and material motivations, as it does in many legal systems today. 119
However, it is worth noting that religious writers also use medical explanations of the passions metaphorically. For example, Summa Virtutum de Remediis Anime, a thirteenth-century English pastoral treatise on the virtues commonly circulated with Summa Viciorum of William Peraldus, provides the following physiological etymology for the cardinal virtues:They are called “cardinal” as if of the heart, because according to Isidore cardias in Greek means heart. Whence a passion is also called cardiaca. For as the heart is the principle of life in an animate being, giving it motion and sensitivity through which the soul goes outside itself into external actions, so these virtues rule actions and direct them toward a proper end and teach the means by which one comes to the good. 120
While offering a figurative explanation for the importance of the cardinal virtues, the author reveals a medical understanding of the function of the passions as directed by the movement of the vital spirits through the heart, the soul spurring the body to action.
Medicine as Material
This section considers the material relationship between medicine and the sins: the use of medicine and illness to deter and cure sin, material sickness as a sign of spiritual sickness or sin, and medical conditions as a cause of sin.
The positive use of material medicine in the promotion of spiritual health has a long pedigree. Both theologians and physicians discuss the roles of medical treatment and physical health in correcting immoral behavior. Theological passages on material medicine, as well as medical passages justifying their own practice, often cite the book of Ecclesiasticus. 121 After claiming that “there is no riches above the health of the body” in 30:16, Ecclesiasticus warns against sadness, envy, and anger as detrimental to health and causing death, yet praises joy and abstinence for their contribution to health and the preservation of life. A few chapters later, Ecclesiasticus 38 expressly praises material medicine as created by God: “the most High hath created medicines out of the earth, and a wise man will not abhor them.”
Specifically, medicine restores the body and reason, enabling the faithful to make ethical choices. For the physician Haly Abbas, medicine restores a person’s humoral balance, allowing him or her to exercise the highest reason and ethical judgment. The human mind [animus] cannot prosper “without the health of the rational soul, and the health of this is obtained only when the vital soul and the natural soul are healthy, nor can either of these be healthy without a healthy body, and this comes about from the balance of the humors.” 122 Later texts, such as an anonymous fifteenth-century medical treatise, echo such arguments for the necessity of medicine, on the grounds that physical health preserves reason. 123
Some medieval religious texts advocate the use of material medicine to prevent sins, or spiritual sicknesses, in general. Measures to prevent sin were practiced by the desert fathers and took on a renewed vitality under the Cistercians in the eleventh and twelfth centuries. 124 One example of the role of medicine in religious life is the use of bloodletting in monastic houses. Healthy religious practiced bloodletting as a preventative measure guarding spiritual and physical health. 125 Knowledge of such material practices enriches our understanding of how medical metaphors, such as bloodletting, might have been understood.
Furthermore, pastoral and theological texts enumerate the spiritual benefits of material sickness. These passages often occur in discussions of patience or anger. The author of the Summa Virtutum de Remediis Anime offers a surgical metaphor—“diseased flesh which cannot be healed by a poultice or a plaster is sometimes healed by cautery; thus a spiritual sickness by bodily pain”—before listing 12 benefits of bodily infirmity. Furthermore, the text creates a context in the extraordinary suffering of Christ and his role as Christus medicus for the more ordinary suffering of the ordinary faithful:He literally [ad litteram] bore the defects of human weakness [defectus humane infirmitatis] when he had no causes of infirmity from the good constitution of his own nature [cum ex bonitate sue conplexionis non habuit causas infirmitatis] … he took away, sickness from the sick as a physician, not that he might receive it in himself but that he might heal …. the heavenly physician [medicus] brought not only the remedy of patience for bodily infirmities, but also the remedy of penance for spiritual ones. 126
This passage draws attention to the material infirmities and weaknesses adopted by Christ for spiritual purposes. They are not metaphorical but ad litteram. The significance of physical suffering is clear in an exemplum in Fasciculus Morum in which a sickly friar feels punished by God when his sickness vanishes. 127
However, beyond this broad sense of the poten
tial of physical illness to engender spiritual health, specific medical cures were held to render specific behavioral changes. Special diets feature regularly, as examined in more detail in the chapters on gluttony and lechery. References to such diets, often designed to combat lechery and promote continence, occur in both medical and religious texts. However, thinkers disagree on the moral significance of these cures. Ockham thought that such diets were purely a matter of physic. As we have seen in the previous section, according to Ockham, the virtue (continence) rendered by medical fasts is not virtue at all. Likewise, other writers urge against the use of medical cures strictly for the body. In the penitential treatise rounding off the Canterbury Tales, for example, Chaucer’s Parson argues against abstinence for its own sake. Although citing the wisdom of Galen, the Parson remarks that he holds abstinence “nat meritorie” if a person “do it oonly for heele of his body.” 128
However, while some texts debate the positive uses of medicine and illness for spiritual health, others postulate a materially causal relationship between sin and disease or bodily deformity. As the Archbishop of Canterbury John Pecham (d. 1292) states, “a defect of the body is caused by a defect of the soul.” 129 The basis for this reasoning is biblical—Leviticus 21:17–21 lists the physical deformities of priests—and underpins the injunction against parish priests with deformities from performing the mass. However, later medieval Church records of supplications by priests exhibiting defectus corporis [defect of body] suggest that papal dispensation was quite common. Supplicants often pleaded that their deformities were not on account of their own actions. 130 However, texts appear to single out lepers to be excused from their duties. As the author of a well-circulated penitential manual and an English cleric at Saint-Victor at Paris who died in the first half of the thirteenth century, Robert of Flamborough, writes that leprosy should exclude would-be priests from ordination; and Thomas Aquinas writes that leprous priests should celebrate the mass privately. 131
One fourteenth-century English encyclopedia explores the question clericus debilitatus per infirmitatem ministrans, quid juris, or “what is the law regarding ministration by a cleric who is disabled by illness?” in more depth. 132 The text makes distinctions, based on factors such as whether the cleric is a bishop and whether the disease “happens naturally” or “by divine judgment.” 133 An example of the latter would be if a cleric had contracted leprosy from a woman who had sex with a leprous person. However, the text is quite inclusive, suggesting that priests must not be removed from office for any disease other than leprosy. And even in the case of leprosy, an assistant should be hired if the cleric is a bishop, due to the long and difficult process of removing a bishop from his position, which might prove more damaging to the Church. Other diseases and impairments, however, should not be punished, “because an affliction must not be added to those afflicted.” 134
Despite the potential of physical disease to be a marker of sin, many texts argue against castigating those with illnesses, a “ful grisly sin” in its own right, according to Chaucer’s Parson. 135 The early thirteenth-century confessional manual Perambulauit Iudas warns that it is sinful to turn away from sick brothers because of their odiferous sores or breath. 136 Instead, pastoral texts usually demand that the healthy look after the sick. However, such passages also frame the care of the sick with associations with sin. Conventionally, the care and visitation of the sick together constitute one of the species or branches of mercy; as, in The Book of Vices and Virtues, “to haue pitee and rewþe of sinful and of hem þat ben in anger and teene [adversity] or in pouerte or seknesse. For þat member schal bere sekenesse wiþ þat oþere, wherof Seynt Poule seiþ, ‘Who is seke, and I am not seke wiþ hym?’” 137 Furthermore, the compiler argues that “to visite þe seke þat moche pleseþe God, more þan fastynges or oþere bodily trauaile.” 138 As an illustration, the compiler includes a brief exemplum of a hermit who visits an elder and asks whether it is worthier to fast for six days of the week (or to perform other penitential acts) or to visit the sick. The holy elder responds that it is unequivocally worthier to serve the sick, no matter how extreme the mortification—even “þeiʒ he henge himself bi þe noseþerles [nostrils].” 139 The sinner is most like the sick person “in kynde.” Hence to visit the sick is to “visite þin owne sekenesse,” keeping the sinner from sinning further. 140 Although the text also references Christ’s healing of and interaction with the sick, the reference to Paul and the comparison with sin ensures that this transaction is not selfless.
Although these passages clearly associate sin with material sickness, the relationship between the two is complex. As we have already seen in the theology of original sin, all sickness relates to sin at a very general level. After the Fall, sin and sickness characterize human nature. However, the idea that particular sins cause particular illnesses does not follow from a general correlation of sin and sickness. 141 Instead, naturalistic schemes often seem symbolically rather than materially conceived, such as Thomas of Chobham’s explanation in his Summa Confessorum that “it is customary to say that for a mortal sin a penance of seven years must be imposed because man consists of body and soul. For man consists of four elements and his soul has three powers.” 142 Such schemes are often loose and not described in much depth. William Peraldus, for example, divides the sins into the three faculties of the soul, which lead to pride, envy and wrath and the four elements, which lead to sloth, greed, gluttony and lechery. Although some of these associations are consistent with contemporary medical accounts—particularly the connection between the cold and dry earth and avarice, others are not; the association of the hot and dry element of fire with gluttony is one example. 143
However, in terms of associating particular sins with particular humors and complexions, other pastoral texts are more specific and seemingly more material. When describing the sixth degree of evenhede, the author of The Book of Vices and Virtues, one of several English translations of the French La Somme le Roi, instructs the faithful to be vigilant against the devil as he will exploit their complexions:Þe enemyes ben þe deueles þat ben strong & wise, sly and besy to bigile vs, for þe lynnen [let up] neuere nyʒt ne day, but euere-more beþ in a wayʒt to bile [besiege] vs bi here sleiʒtes and soteltees which þei vsen in a þousande wyse and moo. And, as seynt Gregori seiþ, þe deuel seeþ wel sliliche þe staat of a man and his manere and his complexion and to what vise he is most enclyne to, or bi kynde, or bi wone [habit], and on þat side he saileþ hym most. Þe colereke of wraþ and cunteke [strife]. Þe sanguyn of iolite and lecherie. Þe flewmatike of glotonye and slowþe. Þe malencolen of enuye and anger of herte. And þerfore schal euery man defende on þat side þat hym þinkeþ his hous most feble and fiʒt aʒens þat vice þat hym þinkeþ most assaileþ hym. 144
The faithful must take care to avoid sins to which they are predisposed, as the devil will exploit their biological weaknesses. This might appear to us, as modern readers, to be a mixed metaphor. The sins are simultaneously given an internal, natural basis in the four humors and an external, supernatural basis in the devil. Yet as the examples in this book demonstrate, supernatural and natural causes are often believed to co-exist in the period in question.
Furthermore, confessional manuals advise priests to consider their confessants’ complexions when determining an appropriate penance. To this end, confessors are advised to examine the complexion of the sinner. For example, in the basic and enduring pastoral Templum dei, which exists in more than 90 manuscripts from the thirteenth to the fifteenth centuries, Grosseteste explains that it is the duty of the confessor to determine the sinner’s complexion, because each sinner is more impelled to one sin than another. 145 The material weight of these instructions, beyond the rhetorical and symbolic, is strengthened by the text’s inclusion with medical texts, which also bears witness to the varied functions of the secular clergy in the community. 146 In the same vein, the late thirteenth-century Summula of Bishop Peter Quivil of Exeter includes temperament and the health
of the body in a list of mitigating circumstances, stating that “a priest should consider these things, and using his discretion, adjust the quality or the quantity of the prescribed penance based on them.” 147
The most obvious way to examine a penitent’s complexion is through external, physiognomic investigation. Handlyng Synne, an early thirteenth-century loose verse translation of the French Manuel de Pechiez adapted and much expanded by the English Gilbertine monk Robert Manning (d. c. 1338), provides an instructive illustration. In one of the text’s exempla, penitents present to the priest with various signs of their sins, including different complexions. 148 Some confessants are simply white or black. Others present more detailed and specific diseases, such as leprosy, or symptoms, such as swelling. Although Mannyng describes this diagnostic process metaphorically—only the priest is able to see the internal conditions of the penitents’ souls through a special vision from God—the material and practical uses of physiognomy in confession find support in the preservation of physiognomic tracts alongside treatises on the vices and virtues. 149
Such instructions to priests might seem incongruent with warnings against using the body as an excuse for sin. Lists of the potential excuses that sinners might make to priests include many related to the material body and its physiology. Peraldus includes an extensive section in his treatise on luxuria [lechery] of the various arguments that sinners make for the physical impossibility of chastity and the counter-arguments. 150 Physically based excuses that, in effect, argue that God has created moral laws against natural laws, are pronounced blasphemous by Peraldus and later pastoral writers, such as the fifteenth-century Alexander Carpenter, who in Destructorium viciorum [Destroyer of Vices] identifies particular humoral compositions that sinners correlate with their sins: lechery due to their hot nature; gluttony due to their cold nature. 151 The indignant sinner, Chaucer writes, in his section on wrath wants to “answeren hokerly [scornfully] and angrily, and deffenden or excusen his synne by unstedefastnesse of his flessh … or elles he dide it for his youth; or elles his compleccioun is so corageous that he may not forbere.” 152
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