Medieval Bodies: Life, Death and Art in the Middle Ages 
by Jack Hartnell.
Wellcome, 346 pp., £25, March 2018, 978 1 78125 679 4
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For​ medievalists, the bodily turn has had a profound impact not just on the histories of medicine and sexuality, as one would expect, but also on those of art, religion and ideas. Thirty-five years or so after the body emerged as a newly problematic category, an entity with a tangled history or a rebellious subaltern that had finally found its voice, ‘medieval bodies’ have become such a rich field of inquiry that Jack Hartnell can use them to ground a History of Everything for the common reader: ‘life, death and art in the Middle Ages’. Hartnell is an art historian, so his book is copiously illustrated. But it’s also a history of medicine and much more, treating each topic under its pertinent body part. Thus the head inspires discussions of mental illness, hairstyles, beheading, and the rival relics of John the Baptist’s head. Under the rubric of skin, Hartnell ad-dresses flaying, leprosy, plastic surgery, racial difference and manuscripts – for, as others have pointed out, most of what we know about the premodern past is written on the skins of dead animals. Blood raises questions about phlebotomy, the antisemitic ‘blood libel’, bleeding icons, and devotion to the blood of Christ. Hartnell’s Middle Ages encompass the Jewish, Islamic and Byzantine worlds as well as Christian Europe, with technical terms supplied in Greek, Arabic and Hebrew. The result is a thick, spicy plum pudding of a book.

Saints Cosmas and Damian performing the miracle of the leg, from a Spanish painting c.1495.

Saints Cosmas and Damian performing the miracle of the leg, from a Spanish painting c.1495.

What exactly makes a body ‘medieval’? Life expectancy was shorter, maternal mortality higher and epidemic diseases rampant, yet those who managed to survive childhood often lived to a ripe old age. Once we get beyond the caricature of squinting, hunchbacked peasants little brighter than their oxen, we cannot help but wonder: did bodies eight hundred years ago not enjoy food, drink and sex just as we do? Did they not suffer the same ills all flesh is heir to? Perhaps the most interesting question is how ideas about the body affected its concrete experience, as they do even now. Optimists in drug trials can be cured by the placebo effect, while thousands claim to feel better after going vegan or gluten free. By the same token, remedies that now seem wrongheaded or bizarre probably helped patients who believed in them. The countless records of miracle cures at saints’ shrines can’t be entirely fiction – and saints, unlike medieval doctors, at least did no harm. In contrast, practices like bloodletting to purge noxious humours can’t have offered any real benefit, and must have caused many infections. Yet the practice persisted for centuries, and friends would even arrange to be bled together to share the intimate period of bed rest during recovery. A doctor’s reputation, his bedside manner, trust in the validity of a treatment, and the trouble and expense required to procure it might all contribute to its perceived efficacy. Scrofula, ‘the king’s evil’, could be cured by the royal touch, so French and English monarchs laid their charismatic hands on patients at special audiences. Powdered unicorn horn, as priceless as it was rare, supplied a panacea for many ills.

One key to health was thought to be a moderate diet, but that was not always available in a subsistence economy, just one failed harvest away from famine. Writers, in any case, took more interest in the extremes of feasting and fasting. About fifty medieval cookbooks survive, all from upper-class households. When John Stafford was made archbishop of Canterbury in 1443, his banquet menu included venison, roast beef, capons, pheasant, swan, heron, bream and custards – and that was just the first course. Midway between food and entertainment were the edible sculptures called ‘subtleties’: castles, knights in armour, fantastic beasts, and so forth, moulded from pastry or sugar paste. A familiar nursery rhyme celebrates a concoction of ‘four and twenty blackbirds, baked in a pie:/When the pie was opened, the birds began to sing./Now wasn’t that a dainty dish to set before the king?’ Far-fetched as it may seem, that singing pie might actually have happened. At the other end of the spectrum, heroic fasting could be equally impressive. Monks and nuns renounced meat, largely because animal foods were believed to awaken lust. But late medieval holy women, the true virtuosos of abstinence, mixed ashes with their meagre food to destroy its taste, and some allegedly lived for weeks on the Eucharist alone.

Avoiding both conspicuous consumption and conspicuous self-denial, physicians recommended a golden mean. They understood the body in terms of balance. In a model dating back to Hippocrates, different proportions of four basic qualities (hot, cold, moist and dry) established four complexions or temperaments: sanguine (hot and moist), choleric (hot and dry), phlegmatic (cold and moist) and melancholic (cold and dry). Each complexion was dominated by a different element and a different humour or bodily fluid – respectively, air and blood, fire and yellow bile, water and phlegm, earth and black bile. In addition, men were thought to be warmer than women, and the old to be cooler than the young. Disease resulted from an excess or deficiency of one humour, so treatment aimed to restore equilibrium. Hot, fiery spices could compensate for a lack of warmth, while cooling herbs and balms tamped down excess. But remedies had to be tempered to the patient’s natural complexion, age and gender, the season of the year, and the position of the stars, which were thought to influence the ebb and flow of humours in the body. Beautiful, complex diagrams illustrate this set of correspondences; a famous example is carved above the entrance to the Warburg Institute.

Academic medicine, grounded in the doctrine of humours, was a textual rather than experimental science. So great was the authority of ancient writers that no amount of practical failure could shake the profession’s faith in its core theory. In less prestigious areas of medicine, however, empirical progress was made. Surgeons stood at the bottom of the hierarchy because they acquired their craft through apprenticeship, rather than books, but they developed considerable skill in setting fractured bones and treating wounds – always in plentiful supply from battle. Their medical diagrams are not for the squeamish. One favourite image, called the Wound Man, depicts a naked figure whose body bristles with swords, knives and arrows. He is also afflicted with plague buboes and suffers the simultaneous bites of a rabid dog, a snake, a bee and a scorpion, not to mention a toad that ravages his stomach. Around this gruesome figure, dozens of captions suggest treatments for each wound. An illustration in Henri de Mondeville’s Chirurgia (‘Surgery’), from 1306, portrays a flayed man carrying his skin, complete with a shaggy head of hair, draped over a pole across his shoulder. Powerful taboos militated against dissection, but sporadic exceptions emerged in late medieval Italy, where professors of medicine anatomised the corpses of condemned criminals. Illustrations portray these early gross anatomy labs as the theatrical events they were. And there are more shocking cases. In 1475 a petty thief in Paris was sentenced to hang. But on the date set for his execution, a group of physicians and surgeons petitioned Louis XI to let them vivisect the living man instead, opening his belly to examine his entrails. On completing their experiment, the surgeons sewed the man up and, within a fortnight, he made a full recovery, receiving amnesty and generous compensation for his pains.

Some operations fell within the purview of specialists. The tenth-century dentist Abu al-Qasim al-Zahrawi, working in Muslim Spain, described a form of orthodontia, replacing extracted teeth with dentures made of carved animal bone and tied in place with gold thread. Rhinoplasties, performed in Byzantium as early as the fourth century, were perfected by the Sicilian surgeon Branca Minuti in the 1490s, after an outbreak of syphilis created growing demand for that surgery. (In its advanced stages, syphilis can cause the bridge of the nose to collapse.) Cosmas and Damian, third-century brothers who became the patron saints of physicians, performed a unique operation that became known throughout Christendom. A Roman cleric whose leg was being devoured by gangrene prayed to the saints before falling asleep and experienced their healing ministrations in a dream. After amputating the diseased limb, Cosmas and Damian exhumed an Ethiopian man who had been buried the same day and grafted one of his black legs onto the cleric’s white body. Though the miracle was often illustrated, the tale offers no comment on the biracial transplant.

Race was just one of many forms of bodily difference, often accentuated in art and law. Demons were always black or brown, and artists frequently exaggerated the hue of dark-skinned enemies. Interracial mating gave rise to profound anxieties. In Parzival, a Grail romance by Wolfram von Eschenbach, the marriage of a European prince with an African queen produces a piebald son, though no stigma attaches to him. Indeed, he is considered handsome. But in the Middle English King of Tars, after a sultan weds a Christian princess she gives birth to a lifeless, formless lump of flesh. The monstrous birth provides a testing ground for the rival faiths. Prayers to ‘Mahoun’ (Muhammad) prove fruitless, but after being baptised by a Catholic priest, the shapeless lump becomes a well-formed child. Needless to say, the sultan converts – whereupon his black skin turns miraculously white. Jews, unlike Muslims, could be indistinguishable from their Christian neighbours, so a majority bent on making their difference visible enforced it by law, requiring them to wear special hats, yellow badges, or other distinctive garb. Some late medieval Passions show a very white Christ tortured by darker, hook-nosed Jews.

Sumptuary laws, adopted within all three faiths, disciplined many kinds of body. In Mamluk Cairo, Jews were required to wear yellow and Christians blue. Prostitutes throughout Europe could legally ply their trade as long as they dressed differently from respectable matrons. Certain furs, styles and colours could be worn only by the upper classes, under penalty of fines. Such laws, which aimed to restrict social mobility after the Black Death, could be remarkably specific. As of 1360, for example, French prostitutes could not wear embroidery, pearls, gilt buttons or robes trimmed with squirrel fur; German burghers and their wives had to renounce gold and silver jewellery; and the English, to protect the wool trade, could not wear fabrics woven on the Continent. By the late Middle Ages, stylish male attire had become so revealing that in 1375, one Italian town passed a law against breeches so short that they exposed the genitals. Women, on the other hand, were denounced for wearing excessively long trains, flaunting their consumption of costly fabric.

Even though the Bible prohibits cross-dressing (Deut. 22:5), both saints’ lives and romances celebrated women who donned male garb to spend their lives as monks, clerics or soldiers. The legendary Pope Joan, said to have adopted a man’s guise in the ninth century in pursuit of learning, rose to St Peter’s throne through her exemplary scholarship. But, inevitably, her female body betrayed her. Unable to resist taking a lover, she became pregnant and gave birth during a papal procession, dying either in labour or, according to other accounts, at the hands of horrified spectators. St Wilgefortis, popular in the 15th and 16th centuries, appears in art as a crucified woman with long blonde hair and a beard. To preserve her virginity and avoid an unwanted marriage, she prayed for a deformity that would keep suitors away and grew a beard overnight, only to reap crucifixion for her pains. (In England she was called St Uncumber, the patron saint of wives who wished to be ‘uncumbered’ of abusive husbands.) Where transgender bodies are concerned, it’s hard to know how often life imitated art. But in 12th-century Germany, Hildegund of Schönau apparently played out the legend of the female monk in real life. And in 14th-century London, a sex worker known as John (or Eleanor) Rykener alternated between male and female dress to serve clients of both sexes and varied tastes.

Falling somewhere between the permanence of skin tone and the flexibility of clothing, hair could be a revealing signifier. Allegorically, hairs sprouting from the head denoted thoughts arising in the brain, so the quality of a person’s hair could demonstrate his or her character. A shaggy, unkempt head revealed an undisciplined mind; thick, knotty hair indicated brutishness; and quick tempers were ascribed to redheads, probably due to prejudice against the Irish. Chaucer’s Pardoner sports ‘hair as yellow as wax’, hanging in thin strands down to his shoulders – a sign of his effeminate, hypocritical nature. Madmen (at least in literature) betrayed their loss of reason by going naked, letting their hair grow wild to cover their whole bodies. Yet the penitent saints Mary Magdalene and Mary of Egypt did the same, in their case to atone for their former careers as prostitutes. Of course Mary the Virgin, surpassingly beautiful, had no need of penance. Relics of her hair prove that she was a blonde, just like romance heroines with their milk-white skin, rose-red lips and golden locks. As a perpetual virgin, Mary was entitled to wear her long hair unbound throughout her life, while other (non-virginal) matrons had to cover theirs. For a period in the 15th century, broad foreheads were so much in vogue that women shaved their brows and concealed their hair beneath the tall, conical hats called hennins. But no hairstyle was more iconic than the tonsure of priests, with their circlet of fringe forming a ‘crown’ around the shaven head. Clerics guilty of severe misconduct lost their tonsure, equivalent to being defrocked. Conversely, a quick-witted Jew, fleeing a pogrom in Prague in 1389, seized a razor and hastily tonsured himself to pass as a priest.

Medieval thought​ about the body straddled a line between head-centred and heart-centred models. Medical thinkers mapped different aspects of cognition onto specific areas of the brain, much like neurobiologists today. Proceeding from front to back, the ‘cells’ of the brain housed the communis sensus or ‘common sense’, which co-ordinated input from all the sense organs, then transmitted it to the imaginativa or image-making faculty, which in turn nourished the cogitativa, the power of forming concepts. Two more faculties, the estimativa (judgment) and memorativa (memory), at the back of the head, completed the apparatus. Memory, being soft and permeable, received impressions just as wax receives the imprint of a seal – a metaphor that derives from Plato. If the wax was too soft, as in women’s and children’s brains, impressions would be easily received but soon forgotten; if too rigid, it was difficult to learn new things. The function we now assign to the nerves was ascribed to pneuma or spiritus, a fine, subtle, but not quite immaterial substance that flowed from the brain throughout the body and linked it to the soul. This was the preferred medieval solution to the mind-body problem.

While cognition took place in the brain, the heart was responsible for feeling and desire, for it was there, according to Aristotle, that the sentient soul dwelled. Likened to a glowing sun, the heart flooded the body with vital heat. Although the full circulatory system was only discovered in the 17th century, physicians were aware that the heart pumped blood outward to all the limbs. No other organ was so profoundly symbolic. Endlessly invoked in love poetry, the amorous heart quarrelled with the eyes and the rational mind. Lovers exchanged hearts on parting and claimed to bear the beloved’s name or image carved into the organ’s very flesh. Metaphor became reality in the body of Chiara of Montefalco, an Italian nun, who had always claimed that the cross of Christ was inscribed on her heart. After she died in 1308, her sisters performed an autopsy and found it there – a tiny, sculptured image of the crucifixion, along with instruments of the Passion, all carved in flesh and henceforth to be cherished as holy relics. Christ’s own heart was an object of fervent devotion. Entering it through the wound in his side, mystics discovered an intimate world of love within. But hearts had to be pierced to reveal their treasures, for to love was above all to suffer. A startling print by Caspar von Regensburg, c.1485, portrays the Venus-like figure of Frau Minne (Lady Love) as a nude dominatrix trampling on a hapless lover’s heart. With her right hand she impales another heart on a spear, while her left pierces one with a sword. Surrounding the goddess, 16 more hearts are roasted in flames, guillotined, crushed in a winepress, sawn in two, and tortured in other imaginative ways, all in the name of love. Here is an erotic equivalent of the Wound Man.

Not all organs possessed the same dignity. If the Holy Spirit made its home in the heart, demons (in a case of possession) inhabited the bowels. The process of digestion was well understood and gave rise, as always, to scatological jokes. An Anglo-Saxon riddle asks ‘How do you make an asshole see?’ The answer: ‘by adding an o’. (It’s a Latin vocabulary quiz: add an o to culus, asshole’, and you get oculus, ‘eye’.) More fraught with anxiety were jokes about ‘penis trees’. A marginal image in a Romance of the Rose manuscript shows two nuns cheerfully plucking fruit from one. But the notorious Malleus Maleficarum (‘Hammer of Witches’), a 15th-century witch-hunting manual, fuelled panic with its claim that women in league with the devil could glamour away the male organ. A witch leads one castrato, seeking to reclaim his member, to a penis tree and invites him to select any organ he wants – except the largest, which belongs to the priest. In the Italian town of Massa Marittima, a public fountain displayed a large, extremely odd painting of such a tree. The women cavorting beneath its boughs, with a swarm of ominous black birds, may represent these witches.

Dead bodies received as much ritual attention as live ones. Judaism and Islam, religions born in the torrid desert, demanded swift burial. But Christian funeral customs, rooted in the doctrine of bodily resurrection, grew ever more elaborate. The practice of dividing a saint’s relics among multiple churches developed early, to the presumed benefit of the faithful, because even a tiny fragment of sacred bone possessed healing powers. By the 12th century, European royalty had adopted a parallel custom, choosing to have their bodies buried in one place and their hearts in another to maximise prayers for their souls. After Good King René of Anjou died in 1480, his heart was interred in a silver coffin, shrouded in crimson cloth of gold, and carried in procession to its burial place in Angers, where it rested in state before a second funeral, solemnised with great pomp. Even more curious was a custom of the Capetian dynasty. While their bodies were laid to rest in the royal necropolis of Saint-Denis, their intestines were buried separately, with their own monuments, at the nunnery of Maubuisson. Tombs of the rich and famous proclaimed the duality of death, at once mortal decay and (one hoped) celestial glory. Typical is the transi tomb of Alice Chaucer, granddaughter of the poet, who died a duchess. Beneath the dignified, idealised figure carved on her monument at St Mary’s, Ewelme in Oxfordshire, visitors can glimpse a very different sculpture through a grille – a skeletal cadaver, emaciated and stiff with rigor mortis.

Hartnell ends with a bracing look at the future of the past. More medieval bodies continue to be unearthed through planned excavations and accidental discoveries. New technologies enable us to investigate their general health, determine their cause of death, and even sequence their DNA. Pages of parchment, shoe leather and textiles can also be analysed to learn what animals they came from and where they were bred. The subaltern speaks at last: long-dead bodies unveil their secrets to living minds.

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