Guest post by Adrienne Albright
Syringes and scalpels aren’t pretty.
Yes, you could argue that contemporary art and pop culture have made them subversive and symbolic, but I doubt you would hang one on your wall. However, pretty much everyone would agree that they are invaluable, albeit disposable, medical instruments. I think the 15th century British folding almanac know as “Wellcome MS 40” (a tag made up of the library it is housed at, The Wellcome Library, and its accession number, manuscript 40) can be seen in much the same way.
No, it isn’t as pretty as many contemporary illustrated books of hours, but it was an invaluable material tool for medieval physicians.
Composed of seven pages that were each folded like a road map and bound into a rough parchment cover, the manuscript could be suspended from the belt of a traveling doctor (sadly, there aren’t any images of them in use).
The similarities between many modern medical instruments and MS 40 can be broken down into two parts. The first was its usefulness to a medieval physician. To understand this purpose we must first understand just what type of medicine the folding almanac was used for. A clue to this can be found in one of the manuscript’s two figural illustrations. In this image stands a man whose dignity is preserved by the careful placement of some strange drawings of men, animals, and objects.
If you’ve ever read a glossy then you might recognize these funny pictures as the twelve zodiac signs, and, while we might scoff at the idea of trusting astrology, medieval astrological medicine a mainstream method of diagnosing and treating patients.
This practice was based on the idea that man was the mirror of the universe in which he lived – an idea that was articulated by describing man as a microcosm within the larger macrocosm. Just like that, stars and planets were made up of four elements (fire, water, earth, air) so too was man made up of four humors (yellow bile, phlegm, black bile, blood). While the proportions of each of these elements and humours lent individualized characteristics to both planets and people, it was important for one’s health that they be kept in relative balance. The favored method to achieve this equilibrium was phlebotomy, better known as bleeding.
Physicians did not simply slice open their victims patients. Instead, it was believed that bleeding from particular points on the body would cure specific ailments. These guidelines are recorded in MS 40’s other figural drawing in which a human figure is shown with red lines, reminiscent of the blood about to be drawn.
These ‘indication lines’ connect the figure to the surrounding text which provides a guide to treatment. For example, the line extending from the figure’s head ends in text that, when translated from the Latin, advises that cutting from the head will relieve hemorrhoids and frenzy.
Treatment, however, was not simply a matter of where, but also when, which brings us back to our zodiac man. Just as an individual is associated with a sign, so too was each body part, beginning with Aries at the head and continuing to Pisces at the feet – a theory known as melothesia. Melothesia was relevant to bleeding because as the moon moved through each sign of the zodiac it would cause blood to pool in the corresponding part of the body, exerting something similar to a tidal force on the body’s most evocative liquid– blood. A physician had to balance the need to treat specific ailments with the risk of bleeding his patient out. The strange tables and diagrams crammed with numbers and words allowed physicians to take into account the astronomical calculations necessary to complete their astrological treatment.
These calculations are organized within the framework of the calendar year as it was defined by the church’s annual liturgical celebrations like saints’ days and Easter, making this not just a medical manuscript, but also an almanac. While there is not enough space here to discuss it in detail, you should know that this was just one, albeit important, function of astrological medicine. The data in the manuscript could also be used to determine the astrological conditions at the onset of disease, the conditions any given patient might be susceptible to, and more.
This practical application is only the first similarity MS 40 shares with modern medical instruments. The second is its ephemeral, almost ‘disposable,’ nature. Unlike a beautifully illustrated book of hours whose worth comes not only from its content, but also expensive materials that compose its pages, MS 40 was a relatively cheaply made manuscript whose value lay in its practicality. It utilized the cheapest parchment and avoided expensive decorative features like lavish pigments or gold leaf. Check out the zodiac man – he is a simple pen drawing whose cheeks were hastily colored to enliven an otherwise flat figure.
The information it contained was also time sensitive. The astronomical and astrological data that made it a useful manuscript was only calculated for about a ten-year period (the eclipses date from 1461-1481).
A physician could only safely consult the manuscript during those years, after which he would need an updated version of the calculations. This time sensitive data must have acted as a sort of ‘expiration date’ for such folding almanacs, and, while you can use medicine or instruments after their expiration date, they often prove to be less effective or even dangerous. I believe this is why there are so few manuscripts like MS 40 left. Once their data was outdated they may have been discarded or recycled – making MS 40 a very special glimpse at both the material culture and medical practices of 15th century England.
Adrienne Albright is a recent graduate of the Courtauld Institute of Art with an MA in medieval art history. She is also completing a work placement at the Wellcome Library, one of the leading history of medicine collections.