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

by Virginia Langum

  In another passage on the illness of the tongue, Bartholomaeus constructs a system of relationships based on linguistic and digestive processes: “somtyme it happiþ þat þe tonge buffeþ [stutters] and stamereþ by to moch moisture, whene þe strengis of þe tonge may not strecche in þe vttir parties þerof for to moche moisture.” Such a speech defect is apparent in “dronken men þat stamereþ whanne þey ben [to] moche in moisture in þe brayn.” This excess moisture also causes the condition of “ratelinge” [stuttering], causing people to mispronounce certain letters. The same moisture that causes verbal indigestion “comeþ to þe stomak and makeþ ofte þe bowels slider and brediþ diariam, þat is þe flux of þe wombe.” 44 Having been ingested through the mouth, food and drink pass to the stomach for digestion. However, surfeit causes smoke to rise to the brain, which in turn affects the product excreted: speech. As this passage illustrates, excess food and drink alter the shape and sound of utterance. Bartholomaeus relates this affected speech, or ratelinge, to another digestive process caused by the same excess water, which mixed with food and drink causes diarrhoea. Galenic medicine teaches that children and guttons suffer from balbus. Where gluttons create excess moisture from their dietary habits, children have excess moisture by nature. This weakens the brain, muscles, and nerves, causing imperfect speech and diarrhea. 45

  Excess consumption and the resulting improper indigestion harm the body in yet another manner. Any residue left in the stomach and liver after digestion becomes putrefied, corrupting the blood and causing fever and other injury. If it passes from the stomach to the liver “not parfitly digested,” “there may he not han his kynde dwellyng, ne re[ceyuyn] his kynde deoctioun and digestiown, ne han his kynde chawnging and turnying into parfit b[l]ode.” Instead, it “turnith into matere [of] corrupcioun, whiche is cause of diuerse sekenesses and maladyis and passiowns in man.” 46 Among these ailments are scrophula, lupus, and various other outgrowths of the pores. The surgeon Guy de Chauliac names “glotonye and malice of goueranance” as causes of these outgrowths. 47

  Clearly, some of these medical ideas about digestion and speech may have influenced pastoral writing. As we have seen, pastoral writing on gluttony emphasizes the general detrimental effects of gluttony on the body and the mind. Richard Lavynham’s fourteenth-century Litil Tretys on the Seven Deadly Sins relates gluttony more specifically to the break-down of healthy digestion: “surfet of metis wastyth & rotyth a mannys body & pryuyth it with long seknesse & afterward bringith it to a foul deth’ in part because he ‘may not browke [digest] it with hele.” 48 The compiler of Jacob’s Well combines bad diet, indigestion, and illness in a dynamic image. He describes swearing and perjury as “a pot sethyng ouer þe fyir boyleth out in swiche lycour as in þer-in; So, synfull lyuerys full of lycour of lustys boylen suche synfull othes & forswerynges as arn norysched wyth-inne here synne.” 49 In the images of cooking and boiling, the writer conjures medical descriptions of digestive concoction and expulsion. Instead of expelling the harmful “lycour,” the glutton re-ingests his undigested words.

  Pastoral writers depict the effects of gluttony in terms of venom that spreads in the body’s blood through digestion and produces venomous speech. Just as surgical writers conceive of speech in terms of the body’s health, so pastoral writers use medical imagery to describe the effects of bad diet and bad speech on the soul. Urging priests to speak well, John Mirk states that “rybawdy and vice ys poyson to a praystys mowth an atture, for hit poysynnyth his one sowle, and envenomyth oþir þat heryn hym.” 50 This poison is the result of a digestive system overworked by a surfeit of food and drink. Conversely, wholesome speech eases the digestive tract. The author of Jacob’s Well urges his listeners to ingest “þe tryacle of my techyng in-to þe stomak of ʒoure soule.” 51 He offers this “tryacle” as an alternative to the devil’s “crewettys,” which are full of “enpoysoun.”

  Furthermore, gluttony was associated with phlegmatics in both medical and pastoral texts. The Book of Vices and Virtues warns that the devil tempts the “flewmatike of glotonye and slowþe.” 52 The natural coldness of the phlegmatic leads them to seek warmth in the digestion of food and drink. Indeed, due to gluttony’s inextricability from the body, some theologians ask whether it is a vice at all.

  To this end, Robert Rypon distinguishes between natural and unnatural gluttony. Providing a physiological explanation for why infants and children are naturally “lazy and gluttonous,” Rypon writes that the natural moistness of children causes them to consume more food to restore their humoral balance. The association of this particular physiological complexion with gluttony is medically consistent. Describing the growths mentioned above, Guy de Chauliac notes that “children, for glutonye and þennes of body, þei fallen ofte into scrophulus, and olde men ful selden, for þe contrarie.” 53 However, while children are susceptible to gluttony due to their nature and complexion, Rypon explains that others commit gluttony for reasons other than their complexions. “These eat and drink not to restore their natural heat but rather to mitigate their unnatural heat” prompted by their excess.

  Gluttony also appears in astronomical texts. In a treatise found in Shrewsbury School MS 3, the seven sins are aligned with seven planets. Although the author claims to only “spiritually” compare the moon to the sin of gluttony, the imagery used reflects a material understanding of the impact of excess food and drink. First citing Albumasar on the moon as the cause of the ebbing and flowing of the sea, the compiler develops the image as follows: “this see is manys bodye, which ebbeth and wasteth by natural euacuacion, and floweth by nutritiff recreacion vnmesurable ebriositie and dyuers excesse of delicate meites and drinkes, by the whiche the litill poore ship, the soul.” 54 As we have seen, medical writers explain how the brain and stomach drown in the excess steam produced by the overworked digestive system.

  How was gluttony to be cured? Many pastoral texts recommend temperance or abstinence as remedies. The compiler of Summa Virtutum de Remediis Anime draws on medical authority in prescribing abstinence as a remedy for gluttony. “Abstinence in general is the restraint of all illicit impulses, just as Galen says that abstinence is medicine for all diseases that come from excess.” 55 The compiler goes on to cite Boethius on the perfection of nature, which provides enough natural heat to “burn and digest” the correct amount of food; yet does not relate these medical details to his earlier claim that abstinence for medical purposes is not virtuous that we saw in reference to pride. 56 Medicine and medical knowledge thus provide an instructive tool to recognize but not to achieve right living.

  Yet further complicating matters, abstinence was both a medical and a spiritual cure. Elaborating on the Christus medicus, the author of one thirteenth-century confessional manual from Exeter explains that Christ “gives us relief from our pain through contrition, and through confession we receive a purgative; he recommends a healthful diet through our keeping of fasts.” 57 While the purgative of confession was spiritual, as discussed above, fasting was a material and integral part of the Church year.

  Fasting was both curative and preventative. Priests assigned fasts of bread and water as penance for various sins. The faithful fasted—that is, refrained from consuming meat, eggs, and dairy—during Lent, in preparation for Easter, and at several other times during the year. Explanations of these fasts in pastoral literature often exhibit a language and structure reminiscent of medical writing. Speculum Sacerdotale outlines a quarterly programme of fasting: in order to “refreyne these fowre humours fro synnynge … we faste fowre tymes in the yere.” 58 In spring, which is moist and warm, the faithful fast to restrict blood; in summer, which is hot and dry, they fast to restrict choler; in autumn, which is cold and dry, they fast to restrict melancholia; and in winter, which is cold and moist, they fast to restrict phlegm. 59 In his popular sermon cycle, John Mirk recommends fasting in particular seasons to quell particular “humerus” and their related sins. 60 However, the text recommends fasting to “clensyth a mannus flesse of eu
el stering and luste to synne of glotonye and of letcherye, for þese ben synnes of flesse.” 61 Against other sins, Mirk prescribes prayers and alms.

  However, gluttons were also liable to use medical grounds to excuse themselves from fasting. As the devotional text Book for a Simple and Devout Woman warns, gluttons use symptoms of their own making to get out of their duties: “þe gloton seiþe: ‘I may nat faste ne no penaunce do, for myn hede is so feble þat hit al-to-brekeþ if I faste a day.’ … þorw his vuel costome so he hit haþ made.” 62 However, there are some reasonable grounds for excusing oneself from fasting. As the author of Quattuor Sermones explains, five groups of people may legitimately be excused: pregnant women, laborers, pilgrims, children, and “olde folke and seeke.” 63 None of these people sin “to ete twys on the day that is mesurable to susteyne nature and not theyr appetyte.” 64

  Compared with the other sins, gluttony elicits more comparisons between earthly and spiritual medicine, because diet and digestive health are considered the foundation of medical cures. Through the products of digestion, particularly urine, physicians measured the body’s health; and through diet, they regulated the humors. Langland’s Hunger goes so far as to claim that if men were to “diete” properly, doctors would have to pawn their “furred hodes” and “lerne to laboure with lond [lest] lifelod [hym faille].” 65 Rather than condemning or competing with earthly medicine, pastoral texts expand the significance of health and medicine to a wider context, as a social and moral good. We recall Chaucer’s Parson and other pastoral warnings against dieting for the health of the body alone. 66

  Furthermore, some theologians warn that abstinence not performed voluntarily or performed for non-spiritual reasons is not holy. Such cases include fasting due to illness, poverty, or avarice. 67 Likewise, abstinence performed only on the grounds of health may be physically dangerous, according to some pastoral writers. Unsurprisingly, in Book for a Devout and Simple Woman, also based on Peraldus, the compiler offers similar warnings. “Þei þat leden hure lif by fisike, þei kepe mesure as Ypocras hem techeþ. Þei eteþ litel and drynkeþ lasse and outrage wiþdraweþ from þe flesh þat þe flesh ʒerneþ for couetise of bodiliche hele.” Therefore, striving for health becomes its own sin, which counter-intuitively destroys the body: “suche men beþ comenliche lene and pale; bot noþer for þe loue of God ne for hure soule hele suche men holdeþ mesure and outrage forberen.” 68

  So where does that leave the practice of modifying diet to improve behavior, specifically by repressing gluttony? Pastoral texts are chock-full of affirmations of the value of abstinence, persuading the faithful of both spiritual and physiological benefits: in addition to cleansing the soul, preserving the mind, assuaging sin, destroying lechery, abstinence “sharpyth thy witte … dressyth thy sight … makyth strong thy blood, norisshyth thy mary … renewyth thy blood, and lengthyth thyn age.” 69 Furthermore, nature encourages abstinence. Citing Galen and familiar medical processes, Peraldus writes that the body has just enough natural heat to digest moderate amounts of food. 70 Peraldus claims that nature discourages people from excessive eating and drinking. For example, humans have tightly drawn mouths, unlike other animals. 71 Yet despite these natural cautions, gluttons deliberately trick their bodies to allow them to consume more than nature advises. Although their thirst is satisfied, “þey woll ete salt colopes [meat] y fryed in a panne or mony perched peses [roasted peas] or els they wolt salt here bred to make hit sauery.” 72

  However, as we have seen elsewhere, immoderate fasting is a sin in its own right. The desert fathers warned against excessive fasting as deleterious to body and spirit: “immoderate fasting is capable of not only destroying the steadfastness of the mind but also, due to bodily weariness, of emasculating the efficacy of prayer.” 73 Yet immoderate fasting also incorporates inappropriate or misdirected fasting. Jacob’s Well actually condemns fasting out of hypocrisy or avarice or for “lechys fyskyk”—as a form of gluttony. 74 Medical texts also warn against immoderate fasting. De Proprietatibus Rerum warns that “þe same cause of stoffinge is in hem þat eteþ and drinkeþ ouer mesure. And þe same resoun of failinge is in hem þat fastiþ ouer myȝt, and beþ ispendid and iwastid.” 75

  Indeed, in the late fourteenth-century Chastising of God’s Children, moderation and simplicity, rather than abstinence, are the remedies recommended for gluttony. 76 Rather than abstinence, food that is consumed in moderate quantities and well-digested “makiþ a man hoole in bodi and sharpiþ a mans wittis, and makiþ hym wele disposed to serue god,” whereas excess enfeebles and dulls the brain, engendering sickness, hastening death, and making the sufferer akin to a beast devoid of reason. Avoiding “curiouse and delicate metis and drinkis” also remedies “þis passion” of gluttony. 77

  The compiler of Chasting rounds off his passage on gluttony with the following warning: “for þe lasse we stryue þerwiþ, þe strengger it wil be: and þe lasse it is ouercome, þe strenger al oþer vices bien astens us.” 78 Although accounts of the concatenation of the sins—one leading ineluctably to the next—were generally inconsistent among theologians if not completely absent, gluttony was exceptional in this regard. Most writers made firm causal links between gluttony and lust and gluttony and sloth, if between gluttony and the other sins.

  In particular, many religious writers claim that gluttony directly causes lust. The author of a long early fifteenth-century treatise on the Ten Commandments, Dives and Pauper, condemns gluttony using the Sixth Commandment, and urges the faithful to avoid gluttony in order to remedy lust. 79 One sermon provides a medical reason for this association: “for when a man is dronken or full of mete and lyethe warme in his bedd then rysythe lechery thorouʒ the foule vnkyndly hete that rysythe in his flesche.” However, even then, physiology is but a handmaid, for after the body’s heat rises, “then is the deuyll redy to brynge hym ther too.” 80

  As in our own day, gluttony in the later Middle Ages was thought to be a distinctively contemporary problem. Although assertions of the decline of the age were common, gluttony was particularly associated with the vices of the age, along with lechery and pride. Caxton’s Mirror explicitly links the rise of gluttony with the decline of asceticism and the strict regimens of the desert fathers. Caxton’s contemporaries “fylle their paunche with good wynes and good vitailles,” but the “auncyent faders gouerned them not in this wyse.” Rather, they ingested food and drink only to “susteyn their bodyes and to holde hem in helth in such wyse as they might helpe them self by their wittes.” 81

  Some homilists gesture to an even earlier time: “at the begynnynge of the worlde mannys fode was bot brede and water, and now sufficeth nouʒt to glotenye alle the fruytes of treene, of alle rotes, of alle herbes, of alle bestes, and of alle foules, of alle fysches of the see.” 82 Such descriptions resonate with the Edenic landscape and prefigure the Fall, which is as much as about quantity as curiosity; the homilist lists various types of wines and the fashion that “metys schul be y-sode with grete busynes and with craft of cokys.” 83 Such “busynes and “craft” are “more for lykynge of mannys body than for susteynaunce of mannys kyynde: ffor the kynde of man is lytel ther-wth amendyd.” 84

  Gluttony’s relationship to the body and its physiology were pressing problems throughout the Middle Ages. Yet with the circulation of dietary knowledge, the motivations for particular dietary choices and behavior—whether the faithful diet for God or for Galen, to dampen gluttony or promote their own health—become increasingly significant.

  Notes

  1.The list of vices with which the devil tempts Christ appears as a theme in Life of Christ literature. See, for example, A Stanzaic Life of Christ: Compiled from Higden’s Polychronicon and the Legenda Aurea, ed. from ms. Harley 3909, ed. Frances A. Foster EETS o.s. 166 (London: Oxford University Press, 1926), p. 178.

  2.Cassian, The Conferences V.19.1.

  3.Carole Straw, “Gregory, Cassian, and the Cardinal Virtues,” in In the Garden of Evil, ed. Newhauser, pp. 35–58 (p. 42).


  4.Young, p. 171.

  5.Hilton, Scale of Perfection, p. 114.

  6.Langland, Piers Plowman, I.34.7.

  7.Rawcliffe, Urban Bodies, p. 57.

  8.George Khushf, “Illness, the Problem of Evil, and the Analogical Structure of Healing,” in On Moral Medicine: Theological Perspectives on Medical Ethics, ed. Stephen E. Lammers and Allen Verhey (Grand Rapids, Mich.: Eerdmans, 1998), p. 32.

  9.At least 57 manuscript copies exist from the later Middle Ages. See Melissa Raine, “Searching for Emotional Communities in Late Medieval England,” in Emotions and Social Change: Historical and Sociological Perspectives, ed. David Lemmings and Ann Brooks (New York: Routledge, 2014), pp. 65–81 (p. 77n.16).

  10.Edited by W. L. Braekman as “Queen Isabel’s Dietary,” in Studies on Alchemy, Diet, Medecine [sic] and Prognostication in Middle English (Brussels: Scripta, 1986), p. 68.