The contents of the manuscript, then, stand at odds with the moralistic redefinition of medicine offered at the end of the story of Hippocrates and Philomon. The tacit argument from the collection of texts is that phisik is a specialized and technical art, one that entails familiarity with cosmology, herbal and lapidary lore, diagnosis from urine, phlebotomy, and sophisticated accounts of pharmacopeia. When the physiognomic treatise turns from bodily signs to the management of vices, it does so within the horizons of a very learned medical manuscript. In an important essay on scientific and medical books, Linda Voigts picks out Sloane MS 213 as especially representative of this new class of books.111 The essay analyzes 178 English scientific and medical manuscripts produced between 1375 and 1500 to show that they share not only a common archive of texts but “physical features that set them off from belletristic, theological, philosophical, chronicle, legal, pedagogical and household manuscripts.”112 These manuscripts testify to an apparently broadly shared sense of what constituted scientific and medical books in late medieval England. Voigts has elsewhere uncovered evidence that this common sensibility supported a medical “publisher,” who in the 1450s and early 1460s produced “a specific kind of manuscript, uniform in appearance and scientific and medical in subject matter.”113 All of these codices made implicit claims about how medical writing should be used and understood.
Sifting through even a fraction of the medical manuscripts that survive from late medieval England soon reveals that they fail to sort according to ready-made categories. There is no strong or consistent divide between Latinate academic learning and vernacular practicality. The cases where ownership can be traced demonstrate that in plenty of cases elite physicians owned simplistic practical texts and manual practitioners possessed elaborately theoretical ones. For instance, a remarkably learned treatise of nearly two hundred pages in Cambridge, Gonville and Caius MS 176/97—which cites from Joannitius’s Isagoge, Constantine’s Pantegni, Galen’s Tegni, the Canon of Avicenna, Isaac Israeli, Giles of Corbeil, Rhazes, Hippocrates, Galen’s commentary on the Aphorisms, and Walter Agilon and which expounds on a technical difference between Galen and Avicenna on the nature of synochal fever—is, according to its preface, addressed “nought to clerkys, but to myn dere gossip [friend] Thomas Plawdon, citiseyn and barbour of London,” so that he might “betir entre into the worchynge of fisyk in tyme of lakkyng [scarcity] of wise fysicians.”114 Traditionally, barbers held an unexalted position in the hierarchy of medical practitioners, performing at most bloodletting and minor surgeries, but the preface assumes that with the treatise’s help, Plawdon could perform “the worchynge of fisyk.”
Conversely, a medical manuscript known to belong to the elite physician John Argentine (d. 1508) contains “unsophisticated calendrical, uroscopy, bloodletting, and remedy material in the vernacular.”115 Argentine was among the most eminent physicians of fifteenth-century England, having studied medicine in Italy (probably at the medical school in Ferrara), practiced at the English court from 1478 onward, and become provost of King’s College, Cambridge in 1501.116 In his own medical commonplace book, Argentine cites the craft-trained English surgeon John Arderne more than any other medical authority and seems to give equal credence to experimenta, or the empirical cures he comes across in the course of his practice, and the prescriptions of written authorities.117 In England, as these examples suggest, there was no automatic correlation between a reader’s social status and the degree of intellectual sophistication in the medical texts he or she owned. This variability points to the remarkably dynamic and heterogeneous nature of medical literacy in England.
Medical writings affected not only those who read them but also those who experienced the care that was influenced by them. The medical compendium that is now London, British Library, Harley MS 2390 includes a particularly fascinating document mediating between the practioner-reader and his potential patients. Apparently compiled for an itinerant care-giver, the book originally opened with the words of a public proclamation, or banns, advertising services:
Hoyit, hoyit, yiff there be any man or wymman that is dyshesyd in any dyversse seknesses, that is for to sayne, al maner wonddes, hurttes, wit hegge tooll, swerd or daghard, here is a man that is a conyng man in leche-craftis bothyn in ffysykke & surgere that wylle curyn alle manere off seknesses be the grace off god the qwiche ben curabele.118
[Hear ye, hear ye! If there is any man or woman diseased with any of these diverse sicknesses, that is to say, all kinds of wounds and hurts—with hedge tool, sword, or dagger, here is a man that is a knowledgeable man in leechcrafts, both in phisik and in surgery, who will cure all manner of sicknesses which are curable, by the grace of God.]119
The banns originally occupied the first pages of a compilation of primarily Latin medical texts, including an herbal, two guides to diagnosis from urine, and a collection of medical recipes. After the opening call to attention—hoyit, hoyit—the crier’s script launches into a list of more than thirty ailments that the doctor could cure—from mormals to migraines, from toothache to flux, deafness to gout, scalding to saucefleme, morphew to mouth-worms, epilepsy to hemorrhoids—in other words, “all maner wounddis and dyshesys [diseases] in any partes of mankende qwyche is possybele for to ben curyd [which are curable] be [by] the grace off god and mannys connynge [expertise].”120 In the manner of effective advertising, the list both conjures anxieties and offers the possibility of their relief. The disturbing evocation of bodily vulnerability is balanced against the promise of expertise. All these disease names signal simultaneously the teeming plethora of illness and the specialized knowledge of the “connyng man.” In case listeners missed the point, the banns run through a second, similar list: constriction of breath, pains at the heart, aposteme, bladder, stomach, phlegm, costiveness, gas, spleen, swelling, stopping of the kidneys. The paratextual apparatus of the book has a peculiarly immediate relationship with the banns’ vernacular orality. As Voigts has demonstrated, the banns’ catalogue of ailments corresponds almost exactly to the list of rubrics heading the manuscript’s Latin receptarium. The table of contents, it seems, is the source for the startling litany of ailments. Here, a Latinate finding aid is thus turned outward, reaching past the boundaries of the manuscript to address a broader audience, “any man or wymman that is dyshesyd.” Broadcast into the town’s public soundscape, the list of disease names seeks to draw members of the community into contact with the healing knowledge of the book and its user.
What the leech actually offers, according to the banns, are not surgical procedures or prepared medicines. Rather, for a penny a patient can have his or her “water,” or urine, evaluated—“and he xall demyn thoo watteres & tellyn hem of thoo evellys in any man or womanis body & qwatte maledy soo evere it be [and he shall judge those waters and tell them about those harms in any man’s or woman’s body and whatever disease it is].” For another penny, the doctor will “wryttyn hem here medycynes in a bylle [write them their medicines in a document].”121 The medical practitioner traffics in words—the spoken words of diagnostic consultation and the written words of remedies. The banns show how the language of medical learning might have entered the lives of individuals in the fifteenth century, even those who did not own or read books. If they paid their two pennies, they would have come away with new information about what was going on inside their bodies, information framed in the terms of “leechcraftis.” They would also possess a “bylle” inscribed with a remedy aimed at improving their health by “the grace off