This section has thus far focused on coherently medical manuscripts from late medieval England. Less commonly, however, medical works might appear in the same manuscripts as works of devotion or entertainment. One well-known example is Lincoln, Lincoln Cathedral MS 91, written by the Yorkshire landowner Robert Thornton, which includes three large thematic sections, dedicated respectively to romances, to moral and devotional materials, and to medical and pharmaceutical knowledge.122 Another similar manuscript, which echoes Thornton’s in its deliberate planning and in its codicological divisions by genre, has been reconstructed by Kathleen L. Scott; I refer to it here as the “Rawlinson-Sloane” manuscript.123 It was originally divided into five sections: a didactic and moralistic part; a historical part; a sequence of narrative and literary works; a sequence of “functional and informative” texts, first on hunting and hawking and then on medicine; and finally a religious text, the confessional guide Manuale curatorum.124 It was probably assembled for a family of the provincial gentry.125
The medical portion of the Rawlinson-Sloane manuscript is exceptional in its searching attitude toward the status of medical knowledge itself. George Keiser has drawn attention to the uniquely moralistic bent of the plague treatise attributed to “Master Thomas Multon,” which alone among Middle English plague texts begins by designating “plague as divine retribution for sin.”126 That text’s unusual mingling of religious and medical explanations has a parallel in the manuscript’s dialogue on surgery. The dialogue, unfolding between two “brothers,” is an engaging device added by the translator to frame the contents Roger of Parma’s Practica Chirurgica. However, the dialogue’s opening departs from the surgical source-text to pose unusual questions about the place of medicine in a divinely controlled world. One “brother” queries the other:
Brother, seth thou sayst that God sendeth men syknes and helth hem aftirward when Hym liketh, wherto shuld eny man studien in lechecraft syth God, yf Hym liketh, may hele a man wythout leches, and yf He wil that a man be nat heled, travayle of leches nys but in vayne?127
[Brother, since you say that God sends men sickness and heals them afterward when it please him, why should any man study medicine?—since God, if he likes, may heal a man without doctors, and if He wishes that a man not be healed, the work of doctors is but in vain?]
The speaker wants to know—in light of God’s omnipotence, how one to understand the utility of phisik? More broadly, how does one resolve the different versions of causation offered by medicine and religion? The other brother answers quite conventionally by explaining that God imbues his “vertu in word, in ston, and in grasse and bestis, for profite of mankynd” and “men shuld studien in lechecrafft” to help their “bretheren.”128 Nonetheless, the question asked explicitly by the first brother continues to be posed tacitly by the very shape of the Rawlinson-Sloane manuscript. Its wide-ranging contents would have required readers to decide when and how to use its differing generic sections. Do romance, religion, and medicine have anything to say to one another? Their material unity in the manuscript suggests that they do, and the nature of that relationship would have been negotiated in the book’s use.
A final example illustrates the textual dynamism of phisik in late medieval England. John Lydgate’s poem the “Dietary” is a close translation of an anonymous Latin Dietarium.129 Evidently, the “Dietary” was remarkably appealing to late medieval and early modern readers. It survives in fifty-nine manuscripts and is Lydgate’s most widely attested composition—“topping everything in popularity,” as A. S. G. Edwards comments.130 As I have argued elsewhere, the “Dietary” was copied and read as part of at least three distinctive categories of Middle English writing.131 Two are familiarly Lydgatian: it was treated as a work of literary art, frequently found in poetic anthologies centered on Lydgate’s and Chaucer’s verse, and it also circulated as a piece of moralistic didacticism, for instance accompanying Benedict Burgh’s rendering of the Distichs of Cato. The third tradition of the poem’s circulation is within medical compilations. At least eleven witnesses of the “Dietary” appear within medical and scientific manuscripts, in the company, variously, of Latin, Anglo-Norman, and English medical works, in verse and in prose. Neighboring texts include recipes, charms, phlebotomies, uroscopies, prognostication aids, astrological charts, alchemical instructions, herbals, a treatise on the virtues of rosemary, a lapidary, plague tracts, mnemonics for the four humors, and a Middle English poem on embryology.
In its own contents, Lydgate’s poem itself cannily capitalizes on medicine’s wavering between a specialized, technical discourse and a more general model of moral didacticism and poetic wisdom. The first stanza provides a kind of physiological “hook,” seeming to establish the poem on straightforwardly medical grounds:
For helth of body cover fro cold thi hede.
Ete non raw mete—take gode hede therto—
Drynke holsom drynke, fede thee on lyght brede,
And with apytyte ryse fro thi mete also.132
[For bodily health, cover your head from cold. Eat no raw meat—take heed of that; drink wholesome drink, feed yourself on light bread, and with appetite remaining rise from your food.]
The “Dietary” invites its audience into the poem for the sake of “helth of body,” and the reader embarks amid the typical precepts of medical regimens. Of course, the personalized regimens that physicians would provide to noble clients were tailored to each patient’s particular humoral disposition and way of life. Lydgate’s poem, by contrast, transmits advice so general as to be applicable to everyone. The “Dietary” even eliminates the broad distinctions found in closely related works like the Regimen sanitatis Salernitanum, which differentiates advice for sanguine, choleric, phlegmatic, and melancholic types. This abandonment of physiological nuance facilitates the poem’s blithe weaving between medical and moral advice:
If so be that lechys do thee fayll,
Make this thi governans if that it may be:
Temperat dyet and temperate traveyle,
Not malas for non adversyté,
Meke in trubull, glad in poverté,
Riche with lytell, content with suffyciens,
Mery withouten grugyng to thy degré.
If fysyke lake, make this thy governans.133
[If doctors fail you, make this your rule if you can: temperate diet and work, no resentment for adversity, meek in trouble, glad in poverty, rich with little, content with the necessities, merry in your rank without complaining. If phisik is lacking, make this your rule.]
The remaining eight stanzas continue the pattern, weaving between physiological advice and ethical and spiritual precepts. This generic flexibility, which apparently helped make Lydgate’s “Dietary” so popular, is internal to the poem’s meaning: its theme is the inextricability of phisik and ethics, body and soul, and medicine and broader practices of self-governance.
The books that spoke of English phisik in the later fourteenth and fifteenth centuries were diverse, but as an aggregate they materialized a new sense of what medical codices could encompass and how they could be designed and used. Books of practical science, including phisik, became a prevalent genre that appealed to a broad spectrum of readers and affected an even wider number of medieval men and women. The banns in Harley 2390 show the technical vocabulary of medicine put to use as aural advertising in late medieval towns. The surgical dialogue in the Rawlinson-Sloane manuscript dramatizes medicine’s subordination to theological rubrics. From the redefinition of Hippocratic medicine as “noght elles bot [but] abstynens, and conquest of foule covetus lustes” to the contents of Lydgate’s most popular poem, writers showed themselves interested in integrating the newly prominent discourse of medicine into other models of self-governance. We should also be alert to the corporeal benefits of literary pleasure, or what Glending Olson has called the “hygienic justification” of narrative and poetic delight.134 John Arderne, after all, recommends