Medicine as Metaphor

Overview and Abstracts (44^th International Congress on Medieval Studies, Western Michigan University at Kalamazoo, May 2009)

The representation of the surgeon in medieval manuscripts underscores the intersection of secular and sacred discourse in the material culture of the Middle Ages. The papers in this session adopt an interdisciplinary approach to examine the significance and symbolism raised by both image and text in the medical and theological discourse of late medieval surgical texts. Both papers are especially attentive to the means by which the texts delineate a dependent relationship between the surgeon's ethical character and professional status.

Papers

The Surgeon as Confessor and Priest

Virginia Langum, Magdalene College, Cambridge
2009 Medica Graduate Student Award Recipient

The paper considers similarities in the emergent professional discourses of pastoral care and surgery in the later Middle Ages. Surgical prologues suggest the pastoral tradition in a variety of ways. Some make direct reference to confessional practice, for example, advising the surgeon to be ‘priuy as a confessour’. Other prologues provide something like an exemplary compendium or confessional dialogue. However, beyond these superficial similarities, this paper argues that both surgical and pastoral ethics are organized around discretion. An ancient, idea that incorporates both physical and spiritual health, discretion was also quality demanded of priests in the reforms and writings related to the Fourth Lateran Council.

While pastoral literature was systematizing the professional obligations and behaviours of priests, and books of surgery were doing the same for surgeons. Pastoral discretion provides medical ethics with a concept by which to integrate traditional medical ideas, such as the importance of moderation, as well as the association of the practitioner’s behaviour with professional reputation, to newer concerns about balancing experiential knowledge with medical theory.

The new emphasis on the doctor and confessor’s judgment in deciding treatment drew attention to their capacity for judgment. The observer is also the observed. Thus, the new professional writing for priests and doctors emphasizes the practitioner’s own body. Writing about the practice of medical and pastoral care stressed the need for doctors and confessors to gain the patient or penitent’s trust through their own behaviour. This behaviour is often measured through their ‘discrete’ speech. Speech is the medium by which the doctor and the priest are judged, and the means through which they validate themselves and their professions. A material and metaphorical physiology underlines this speech and judgment.

Medical writers extend this same need for self-governance to their translations. Based on their own experiential knowledge gained from practice, they use their discretion to ‘trim the fat’ of excess verbiage, as well as to separate incorrect and out-dated learning. In this sense, surgical writers wield something akin to the pastoral ‘sword of discretion’, which separates the unfaithful from the faithful when preaching and teaching fail. However, medical writers also allow for the production and inclusion of new knowledge. Readers are invited into the process of amending texts by using their own discretion. -- vel23@cam.ac.uk

Christ among the Surgeons: Piety and Surgical Practice in a Fourteenth-Century Manuscript

Julia E. Schlozman, Harvard University

Although famous for the quality and extent of its illumination, the prefatory cycle to British Library MS Sloane 1977 has long remained elusive. Sixteen full folia of miniatures precede the text of Roger Frugardi’s Chirurgia, incorporating scenes of surgeries described in the text with a richly illuminated Christological cycle unfolding across the top of each page. Such an unprecedented conflation of religious and medical imagery accompanies the extended textual comparison at the beginning of the Chirurgia comparing God as sovereign physician to his earthly counterparts. Through a loose system of compositional parallels and repeated gestures, the images complicate a familiar, if lengthy, recapitulation of the christus medicus theme.

The significance of the cycle shifts constantly, tailoring its message to fit particular episodes from the Christ story as well as the corresponding surgeries. At various points, the surgeon is shown pulling off feats as diverse as head surgeries and anesthesia. At others, he is compared to Judas and those who cared for Christ after his death, who are presented as exemplars of greed and selflessness that the surgeon should avoid and emulate, respective. On an opening late in the cycle, Joseph of Arimathea is shown asking Pilate for Christ's body, preparing burial cloths, and anointing Christ’s chest, while the surgeon goes about his work in compositionally similar scenes below. Christ himself is less often healer than healed; none of Christ's healing miracles is shown, and everywhere on the page, healing is effected through human skill alone. During the Passion, Christ shares the pain of the patients. On the page showing the Crucifixion, for example, a patient with arrows lodged in his chest appeals to a surgeon diagonally below the scene in which Christ suffers the wound from the lance. Taken together, the cycle adds up to a complex statement of what it meant to be a late medieval surgeon. He understood the body and knew how to cure a variety of maladies, took care never to be greedy, and because the patients suffered as Christ had, treated the patient with the same compassion that Christ’s companions had shown him. These goals were easy to achieve if he had mastered the content of the Chirurgia and had internalized the message of the pictorial cycle through repeated, reflective viewing. -- julia.schlozman@gmail.com

Titles recorded above represent adjustments made at the time of presentation. Information about the International Medieval Congress appears at: http://www.wmich.edu/medieval/congress/. Information about our sessions in previous Congresses appears on Medica’s website: Events.