And yet one finds evidence for marked, punctual growth in medical writing. Thousands of medical texts in Middle English and Anglo-Latin survive from the late fourteenth and fifteenth centuries.32 While many kinds of informational writing were on the rise in the period, “the greatest growth was seen in the number of medical and surgical texts written in medieval English. The increase was nothing less than explosive,” writes historian of medicine Faye Getz.33 The acceleration of textual production is evident in the calculations of Peter Murray Jones, based on Dorothea Waley Singer’s hand-list of scientific manuscripts in the British Isles from before the sixteenth century—which deals with an estimated 30,000 to 40,000 texts across several languages. Jones estimates that six times as many texts survive from the fifteenth century as do from the fourteenth—despite the falling population and the more ephemeral (because more utilitarian) manuscript formats. These numbers “argue sufficiently strongly for dramatic developments in the way medical and scientific books were valued and used.”34 Moreover, Jones’s analysis shows the strongly medical orientation of the developing interest in science: the sum of texts and manuscripts dealing with medicine “amounts to more than all those dealing with the remaining subjects.”35
The database of scientific and medical writings in Old and Middle English, compiled by Linda Voigts and Patricia Deery Kurtz, provides another window onto the remarkable growth of medieval English medical writing. In 1995, when the first iteration of the database was nearly complete, it included “records for approximately 7,700 witnesses to texts, of which two hundred are Old English and the rest Middle English.”36 When the CD-ROM version of the database was issued five years later, it contained entries from 1,200 manuscripts.37 A search of the updated and revised version, made available online in 2014, turns up 7,048 scientific and medical texts when sixteenth-and seventeenth-century witnesses, as well as Old English texts, are omitted.38 Not all of this enormous number are medical, but the majority are, falling under such indexed subject categories as medical recipe-collections (1,926 records), herbs and herbal medicine (624), urine and uroscopy (459), bloodletting (408), humors (349), regimens of health (298), diet (274), gynecology and obstetrics (197), plague (174), etiology (146), and surgery (132). Other popular genres—works of alchemy, charms, aids to prognostication, astrological and calendrical texts, and veterinary medicine—often overlapped phisik’s concerns, aided in its practice, or shared its ways of perceiving and interacting with the material world.
Chapter 2 continues these reflections of the expansion of Middle English medical writing, but one point bears emphasizing in the meantime. Anglo-Latin medical writing also flourished during the later fourteenth and fifteenth centuries. Though exact figures are wanting, it is clear that England’s Latin medical corpus grew in absolute terms, even if it declined as a proportion of all medical and scientific writing.39 In an earlier study, Voigts examined 117 medical and medical-scientific manuscripts (or discrete booklets) from late medieval England. Of these, only 30, or about a quarter, are entirely in Middle English; the rest are either entirely in Latin (16 manuscripts) or partly so (71 manuscripts).40 Thus the uptick in scholarly resources devoted to Middle English medicine should not obscure the reality that Latin and especially macaronic medical texts flourished at the same time. Latin works often appeared in the same codices as Middle English ones or in identical textual formats. No straightforward differentiation in audience was indicated solely by the choice of Latin or English.
The best name for this freshly textualized, decentralized discourse of medicine is phisik, a Middle English word that became prevalent just as the increase in medical writing was underway. Phisik sediments in its etymological history two successive developments in the medieval history of medicine: what might be called healing’s intellectualization and its subsequent popularization. The intellectualization began in the late eleventh century with the Latin term physica.41 In classical Latin physica denoted the branch of philosophy concerned with the natural world, deriving from physis, the Greek term for (roughly) “nature.” As classical natural philosophy, physica encompassed all inquiry into the qualities and operations of the mobile universe. During the Middle Ages, however, it took on a new meaning. As new Latin translations of Greco-Arabic medical writings began circulating first in southern Italy and then the rest of Europe, physica came to function as an alternative for the Latin term medicina, derived from the verb medeor, mederi—to heal or cure. To call medicine physica was to make claims about the rational character of medical knowledge—that it concerned fundamentally philosophical questions about what causes bodies to be as they are and to change. These are questions concerning the general order of nature, its categories and regularities. Physica in its medical sense, then, was inquiry into the human body insofar as the body was part of the orderly, rule-bound cosmos.
This sense of physica gained intellectual prominence in western Christendom through projects of translation, commentary, and teaching.42 Constantine the African (d. c. 1099) was the first major translator of Arabic medical writings into Latin. Working in the Benedictine monastery of Monte Cassino, he translated what would become some of the most widespread texts of medieval rational medicine, including the Isagoge of Joannitius, the Viaticum (based on a treatise by Ibn al-Jazzar, d. c. 979), and the Pantegni (from the compendium by Ali ibn al-Abbas al-Majusi, d. 994). By the 1130s, Constantine’s translations are recorded in England. At the nearby “school” of Salerno, the Isagoge became a foundational text in the medical curriculum and so part of the articella, the collection of texts that would serve as the basis of medical teaching in Europe until the sixteenth century. Meanwhile, the labor of scientific translation picked up steam elsewhere in Europe. Gerard of Cremona (d. 1187), working in Toledo, translated inter alia several works of Galen and the very influential Canon on Medicine by Avicenna (Ibn Sina, d. 1037).43 Burgundio of Pisa (d. 1193) produced perhaps ten translations of Galenic treatises from Greek.44 As Michael McVaugh observes, the wealth of translations was such that by the latter half of the thirteenth century, “it was no longer possible to assume that a scholar could easily search out whatever text he might happen to want,” and ingenious précis and concordances, adapting developments in biblical scholarship, began to be devised, so that (in the words of one of these précis-makers, John de Saint-Amand) “students who pass sleepless nights looking for information among the works of Galen may be relieved of their struggles.”45 Medicina was established as one of the three higher faculties at medieval universities, and elite physicians and surgeons across Europe began composing “a newly self-conscious medical literature” of their own.46 Centers of medical learning took root in Montpellier and Paris in the late twelfth century and in Bologna in the early thirteenth.
The art of healing, then, had become a full-blown intellectual discipline. Thanks to the prominence of Aristotelian philosophy in the thirteenth century, the sense of natural philosophy as a science whose principal end was truth rather than practical action gained ground. But if medicina and scientia naturalis came to be defined against one another in this way, physica could still name their overlap in the newly rational medicine. And that systematic knowledge reached new audiences in formats like encyclopedias, how-to manuals, sermons, vernacular translations, miracle collections, and poetry.
When phisik became part of the standard vocabulary of Middle