Introduction
An eleventh-century remedy for sickness caused by the influence of elves and the temptations of devils instructs the practitioner to write a number of biblical verses across a dish used for bearing the Eucharist, create a tonic of herbs and wine, wash the writing ink off the dish into the drink, have multiple masses and psalms said over the concoction, and then administer the drink to a sick patient, purifying them from the inside out.Footnote 1 This Element offers an introduction to ideas about sick and healthy bodies that gave rise to this complex remedy and others like it in early medieval England – that is, the period between the advent of written literature in Old English in the seventh century and the Norman Conquest in the eleventh. This Element necessarily focuses most closely on the latter half of that period, when the extant Old English medical texts were written and copied.
At this time, medical practice in Europe was largely dependent upon both vernacular traditions of which only traces survive, and the dissemination of late antique Latin medical texts within and between monastic intellectual centres – modes of medical practice that mutually influenced one another. The vast majority of celebrated medicine written in Greek and Arabic would only become available in Western Europe in the twelfth century, after scholars from the Arabic-speaking world translated these texts into Latin. The first medical school in Europe, the famed Schola Medica Salernitana, would not rise to prominence – and establish a set medical curriculum used across the European continent – until that time.
Old English medical literature is one of the few, and by far the largest, surviving corpuses of vernacular medicine from the early medieval period in Europe. Both Old English remedies without identifiable Latin sources – likely representatives of a medical tradition specific to early medieval England – and the numerous English translations of Latin remedies that adapt and alter their source material, offer an unusual degree of insight into how patients and practitioners in the pre-Conquest period thought about disease, what constituted medicine, and how that medicine worked. The themes and anxieties that animate the Old English medical corpus as well as Old English literary depictions of the sick body persisted into late medieval and early modern English medicine, transmuting with time to accommodate new cultural and political concerns. These themes are reflected in the smaller, more enigmatic medical corpuses of related languages like Old Norse and Old High German.Footnote 2 And as a result, these Old English texts offer scholars some of the clearest possible access to the ways early medieval English people understood the structure, functions, strengths, and vulnerabilities of their bodies.
This Element begins with an overview of what is currently known about medical practice in England in the early medieval period, before turning to a detailed discussion of the ways Old English medical texts conceive of and depict sickness and health. These ideas are expanded upon in an examination of attitudes towards impairment and disability in the Old English textual corpus. The Element concludes with a literary case study: an analysis of the vernacular and Latin texts describing the life and death of Guthlac of Crowland, one of England’s first native saints. Reading medical and poetic texts together in this way illuminates depictions of and ideas about sickness and health that are not available to us if either genre is siloed. Across these four linked analyses, a coherent early medieval English view of the body comes into focus: one in which disease breaks open and penetrates a container-like body; one in which health is synonymous with visual wholeness; and one in which illness and impairment are understood as a loss of power in a zero-sum game, a threat to the integrity of the individual’s embodied self.
Medicine in Early Medieval England
The Old English Handbook, a penitential containing a list of sins and the penances that should be prescribed for them, describes confession in the following way:
This metaphor, aside from telling us how seriously the early medieval English took their spiritual health, offers us some insight into what medicine was like in the pre-Conquest period. This passage suggests that a good doctor (OE læce) is skilled, has good judgement in selecting remedies, and has access to some sort of teaching on how to examine and treat sick patients. His professional practice includes healing wounds, but also using emetics to remove harmful substances from within the patient. A skilled doctor makes the difference between a good cure and a bad one, and such a doctor is to be respected.
The written record makes it clear that there were medical practitioners in pre-Conquest England, and that they were treated as respected authorities on the sick body. ‘Lef mon læces behofað’ (An injured man needs a doctor), the gnomic poem Maxims I tells us.Footnote 4 A speaking shield or chopping block in an Old English riddle reveals itself to be non-human by declaring that it cannot find a physician (læcecynn) capable of healing its wounds.Footnote 5 Homilies, sermons, and religious poetry hail God or Christ as the true doctor, capable of curing the soul.Footnote 6 Saints’ lives describe the miraculous healing of intractable illnesses that even the best practitioners (OE læceas, Latin medici) are unable to treat.Footnote 7 Penitentials and lawcodes mention doctors and doctors’ fees (læce-feoh) when discussing the legal compensation owed for inflicting a wound on another person, suggesting medics were normally available and treated injuries.Footnote 8 All of these texts, however, raise more questions than they answer. Who were doctors in pre-Conquest England? How did they gain their expertise? Where did they practice, and on whom? What kinds of wounds did they heal – and what sort of ‘poison’ (OE attor, unlibban) was thought to be inside a sick person’s body by the writer of the Old English Handbook? What was in this doctor’s salves and drinks, how were they made, and were they effective? Evidence concerning the earliest English doctors is relatively limited and scattered across the textual and archaeological records – but piecing this evidence together creates a working picture of medical practice in England between the seventh and eleventh centuries.
Practitioners of Medicine
Much of the surviving textual evidence from the early medieval English period suggests that physicians belonged to a relatively small community of elite, educated practitioners. They could have included secular clergy and monks as well as laypeople, and it is often impossible to determine a physician’s specific affiliations or personal background beyond the simple fact of their participation in powerful institutions. According to the royal biographer Asser, medici were present at the court of King Alfred, attempting to treat the monarch’s various maladies.Footnote 9 The historian, monk, and prolific eighth-century writer Bede records several instances of high-ranking persons – abbesses, abbots, bishops – being attended by physicians in monasteries, though he never clarifies whether these physicians are monks themselves.Footnote 10 Texts from the eighth and ninth centuries, particularly Bede’s Ecclesiastical History of the English People, mostly describe travelling clergy giving miraculous cures to sick people upon arriving in their isolated villages; for example, St Cuthbert and John of Beverley, both of whom were bishops, administer cures to sick persons while fulfilling their duties of visitation.Footnote 11 Other physicians are occasionally present in these narratives, though we hear very little about them. Bede describes monks, nuns, and guests at monasteries falling ill and receiving miraculous cures, suggesting that monasteries had some kind of sick room – and, presumably, a designated person or persons to manage the sick room and provide at least basic nursing. Some ecclesiastical centres also had direct access to written medical knowledge and an interest in applying that knowledge practically: soon after 754, Cyneheard, Bishop of Winchester, wrote a letter to Lull, Bishop of Mainz, noting that while Winchester had a number of medical books, the remedies contained therein required too many foreign ingredients, and therefore Winchester was in need of new medical compendia with ingredients more readily available in England.Footnote 12 There is a strong possibility that medicine was one of the subjects taught at the first school in England, established at Canterbury in the late seventh century by Archbishop Theodore (a Greek-speaking monk from Tarsus) and his colleague Hadrian (a Latin-speaking abbot from northern Africa).Footnote 13 The general picture that emerges is one of literate clergy and ecclesiastics interested in the application of medicine as an aspect of pastoral care; some medical care associated with monasteries, largely for patients affiliated with the institution; and the suggestion of some secular physicians present in the upper echelons of their communities.
We find similar evidence in texts from the tenth and eleventh centuries. One of the defining cultural developments of the tenth century was the Benedictine Reform, a religious and intellectual movement that sought to separate monks from secular clergy, bring monasteries under the Benedictine Rule and found new Benedictine institutions, and revive monastic learning and production of vernacular (i.e. English) literature. The ideal Benedictine Reform monastery possessed an infirmary, and the Benedictine Rule and Regularis Concordia charge monks with the care of their sick brethren.Footnote 14 Some English monastics evidently took an interest in medical study and application. The personal prayerbook of Ælfwine, abbot of the Winchester New Minster (d.1057), includes bloodletting information, medical prognostics, and a remedy for boils.Footnote 15 The Durham Collectar, a liturgical manuscript made for the monastic community in Chester-le-Street, features a number of tenth-century additions, including multiple prayers for healing and remedies that also appear in an Old English medical compendium usually referred to as Lacnunga (Remedies).Footnote 16 The Winchester monk Ælfric Bata casually mentions in his late tenth-century Colloquy, a Latin exercise for students designed to teach vocabulary, that the monastic herb garden is tended by a monk medicus, who is thought to be a good physician.Footnote 17 Abbot Baldwin of Bury St Edmunds (d.1097) was a physician to Edward the Confessor, William the Conqueror, and William Rufus, and may have established a school of medicine at the abbey.Footnote 18 While we cannot determine to what extent monastic medical practitioners – especially someone like Ælfwine, an educated non-specialist – attended patients outside the monastery or royal court, the Benedictine Reform period also saw a surge in secular clergy living amongst the laity, and laypeople increasingly relying on local minster churches for religious services and pastoral care.Footnote 19 Visitation of the sick was an essential pastoral duty, and indeed missals and liturgical books from this period include multiple rites for such visitations and sometimes include prognostics, lunaria, and other medical information.Footnote 20 Old English medical texts copied down in the later part of the pre-Conquest period include remedies calling for the recitation of masses and liturgical prayers and the use of ecclesiastical materia medica, including eucharistic wafers, patens, and even church bells.Footnote 21 This combined evidence suggests that minster priests were likely candidates to be medical practitioners, although the occasional requirement to involve a ‘mass-priest’ (massepreost) in a given medical remedy suggests that the main user of the text was not assumed to be a cleric.
Most of our evidence for medical practice in early medieval England comes from the survival of the major Old English medical texts, four distinct collections of written medical material contained in manuscript copies dating to the tenth and eleventh centuries. These texts are so important they are discussed individually and in detail in a later sub-section: the Old English Herbarium Complex, an interpretative translation of multiple Latin treatises; Bald’s Leechbook, a learned medical miscellany divided into two parts (here I and II); Leechbook III, a shorter miscellany appended to Bald’s Leechbook; and the remedy collection Lacnunga, mentioned earlier. These compendia demonstrate that clerical and ecclesiastical interest in written medicine was, at least in certain centres of learning, profound and sustained. Much of the available evidence suggests that the practitioners who used these written Old English medical collections were hyper-educated Christians engaged in practices not only sanctioned by the church, but integrated into both monastic and clerical religious and pastoral practice. The medical and liturgical manuscripts themselves were expensive to create, must have been compiled by scholars with significant education and familiarity with Latin, and were necessarily only available to the literate. These texts may well have had a reciprocal relationship with popular medicine, but in their surviving form they are intellectual artefacts specific to a particular social class.Footnote 22 The remedies they contain almost certainly required training and apprenticeship to be used correctly. The texts assume readers know how to identify, harvest, and preserve specific herbs; what amounts, measurements, and ratios one should use in preparing salves and tonics; how to distinguish between diseases; how to scarify, bloodlet, and cauterise; what equipment to use; how to apply prognostics and consult lunaria; and how to recite and perform multilingual rituals, including liturgical excerpts in Latin.Footnote 23 Physicians are often described as learned: the Lacnunga refers to gelærede læceas (educated physicians) and afandad læcecræft (proven medical practice), and describes naming diseases as the province of physicians.Footnote 24 Bald’s Leechbook refers to tonics ‘as doctors know how to make them’ and suggests that the educated user should do both ‘as you think good’ and as the ‘wisest’ doctors teach.Footnote 25 The community of early medieval English physicians was probably small. Bald’s Leechbook mentions two English physicians by name, Dun and Oxa, suggesting that the compendium was intended for the use of a select stratum of people who knew of one another, a medical community passing remedies between them.Footnote 26
At the same time, however, most medical care in the early medieval period was probably carried out by practitioners with no knowledge of these elite medical texts. Patients were probably treated by secular clergy at isolated minster churches, community-based lay healers trained in apprenticeships with older local experts or simply through experience, and caregivers working within the home. Such practitioners leave little mark on the textual record, but must have existed. Numerous archaeological sites contain the graves of persons who experienced significant illness and impairment, but survived to adulthood and into old age – at least some of whom would have required and evidently received some form of care.Footnote 27 The prolific religious writer and scholar Ælfric, abbot of Cerne and Eynsham, repeatedly mentions the value of learned medicine in his homilies, but also insists that such practices must be distinguished from forbidden or illicit ones. This juxtaposition suggests that care from trained physicians competed with what Emily Kesling calls ‘doctrinally unacceptable forms of healing’.Footnote 28
Some of these practitioners were almost certainly women. Midwives likely existed in early medieval England as they did on the continent: the Junius manuscript, a magisterial codex of biblical poetry in Old English, contains three illustrations of mothers giving birth attended by other women.Footnote 29 Women probably also practiced medicine beyond obstetric care. Ælfric, in his homily ‘On Auguries’ (ll. 124–8), declares: ‘ne sceal se cristena befrinan þa fulan wiccan be his gesundfulnysse, þeahðe heo secgan cunne sum ðincg þurh deofol’ (the Christian man shall not ask the foul witch about his health, even though she is able to say something through [the power of] the devil). Penitentials and homilies mention women working with poisons, healing their children in evidently ritual modes, and providing abortions.Footnote 30 These texts collectively suggest that women did indeed practice medicine, including in ways that may have been considered unsanctioned, heterodox, or simply belonging to a more expansive definition of Christian devotion. The obstetric and gynaecological remedies preserved in the Old English medical texts are derived from classical sources, and if a popular feminine medical tradition existed, it has left few textual traces.Footnote 31 Yet the repeated association of women with medical care of children within the home and with reproductive expertise is telling. Indeed, nursing in individual homes and communities was probably one of the primary forms of medical care in the period, mentioned (albeit briefly) in several texts.Footnote 32
The medieval hospital was generally an institution for the sick poor rather than a centre for medical intervention. It was also largely a post-Conquest innovation in Britain.Footnote 33 Certain early English burial sites – St John’s Timberhill, for example, in which one-fifth of the graves contain individuals with leprosy advanced enough to be visible on the skeleton – have unusually high concentrations of persons with illnesses or physical differences that would likely have caused them impairment in life. Some archaeologists posit that these burial sites may have reflected the existence of an establishment providing nursing care nearby.Footnote 34 It is entirely possible, but by no means provable, that such establishments existed in England before the Conquest. Regardless, however, early medieval English medicine was mostly small-scale. Medical practice would have been centred around intimate interactions between patient and doctor – from a farmer consulting his minster priest, to a local midwife attending her neighbour’s birth, to a king having his blood let by an abbot trained in France.
Pathologies and Treatments
The archaeological record suggests that the people of early medieval England were generally well-nourished, with a substantial proportion of the population surviving into old age.Footnote 35 Illness, however, would have been common and often dangerous. The infant mortality rate was high, as was the percentage of women who died in childbirth or postpartum.Footnote 36 Burials and village archaeological sites reveal that intestinal parasites were more or less chronic, and osteoarthritic degeneration and other joint diseases occur frequently in excavated remains – unsurprising given the amount of regular physical labour completed by the average person.Footnote 37 Many skeletons also reveal signs of periostitis (inflammation of the connective tissue surrounding the bone), which can indicate a variety of different infections or stress injuries. Sinusitis, tuberculosis, leprosy, and dental diseases all appear fairly regularly in the archaeological record; several burials have also been documented of persons with cancer and poliomyelitis.Footnote 38 Diseases of the soft tissue leave no trace on the skeleton, but the medical manuscripts include numerous remedies for, among others, skin and eye ailments; fevers; pain in the head, ears, limbs, and joints; stomach and digestive tract ailments; coughs and lung diseases; internal pains in various locations; and boils, blains, and ‘swellings’ ranging from styes to haemorrhoids to tumours. A handful of surviving remedies address the starting and stopping of menstrual flow and the provision of obstetric care, but represent a small percentage of the medical corpus as a whole.Footnote 39 Other less quotidian sicknesses are also noted, including liver disease, paralysis, and necrosis of the flesh. Brief mentions are made of conditions that may be types of mental illness, such as wedenheort (lit. ‘frenzied heart’), ungemynd (lit. ‘un-mind’, ‘no mind’), monaþseocnes (‘monthly-sickness’, ‘sickness at intervals’, lunacy), and gewitseocnes (lit. sickness of the wits or sense), but in the absence of further details, we cannot be sure how these illnesses manifested in patients. Words for madness do gloss Latin terms referring to demonic possession, like daemoniacus and energuminus, and so it is possible that hagiographic descriptions of demonic possession provided a cultural explanation for certain kinds of mental illness, treated by ordained exorcists or clergy.Footnote 40 Bræcseocnes (breaking-sickness) and fellseocnes (falling-sickness), often grouped with mental illness words in glosses and medical texts, may have included symptoms we now understand as epilepsy or muscle control disorders. Though the Anglo-Saxon Chronicle mentions epidemic disease and the medical texts treat ailments that are undoubtedly signs of infection, all are too vaguely described to be parsed accurately, though we can be relatively certain that both influenza and ergotism were threats to the population.Footnote 41 The medical texts also feature illnesses whose names we cannot accurately translate, or which are difficult to map onto modern categories of disease – for example, the illness þeor, for which we have no satisfactory translation, or the relatively mysterious ælf-adl (elf-disease) or feondes costunga (temptations or trials of a demon).
The Old English medical texts are largely pharmaceutical, in that the vast majority of remedies they offer involve the creation of salves and poultices for external application, or tonic and emetic drinks for internal healing. Plants and herbs are by far the most important element in early medieval pharmacology, often blended with liquids like beer, wine, and water or with the products and parts of various animals, most commonly butter, gall, honey, and eggs.Footnote 42 This selection from the medical compendium Bald’s Leechbook is typical:
A select few remedies include substances like spittle, blood, urine, breastmilk, and animal faeces. Some remedies also involve surgical procedures, though such techniques are mentioned far more rarely in the medical texts than the making of salves and drinks. Intentional amputation, trepanation, and the setting of broken bones are all attested in the archaeological record, and the texts also mention cautery, lancing, bloodletting, cupping, scarifying, and suturing.Footnote 44
Plant names in Old English are famously hard to translate: how, for example, would we identify attorlaþe (‘poison-loather’), which glosses betony, cockspur grass, black nightshade, and other plants in Old English–Latin glossaries and whose appearance is never described in the medical texts?Footnote 45 Only a small proportion of names, like chervil and dill, are indisputably clear to us. Some, like crabapples, bindweeds, and berries, grew wild in England; others may have been cultivated in monastic gardens of the type tended by Ælfric Bata’s medicus. Still others, like black pepper, could be obtained through what some sources suggest was a fairly robust spice trade with the continent.Footnote 46 Some remedies would have been relatively easy to make, involving native English herbs and inexpensive beer; others, as Bishop Cyneheard’s plaintive letter reminds us, would have been all but impossible. Some Old English translations of Latin remedies swap out expensive or uncommon ingredients for more readily available ones: beer as an alternative to wine, oil of any kind (ele) instead of the labour-intensive rose oil (oleum rosacium) found so often in classical medicine.Footnote 47 Several pre-Conquest archaeological sites have turned up evidence of heavy use of plants that have some application as medical herbs or drugs, including – among many others – docks, nettle, elder, mayweed, bindweed, knotgrass, cinquefoils, self-heal, hemlock, nightshade, henbane, opium poppy, campions, various cresses and mints, meadowsweet, alliums, fennel, and hemp.Footnote 48 However, we do not know whether these plants were cultivated, imported, or gathered wild, and there are relatively few cases of incontrovertible medical use.
A relatively small but notable percentage of the remedies in the Old English medical collections feature ritual elements apparently integral to their healing function. These include the recitation of prayers, masses, biblical quotations, and exorcistic formulae; the use of holy water, holy salt, and other church paraphernalia; spoken incantations in English, Latin, Greek, Hebrew, and Irish; written amulets; instructions to gather herbs in certain ways, visit certain locations, speak or keep silent, or make certain symbolic gestures; and the use of symbolically loaded ingredients, like the milk of a cow of one colour. A subset of these remedies are often designated in scholarship as ‘charms’: texts designed for performance that include a verbal (spoken or written) incantation, conjuration, or adjuration.Footnote 49 The difference between charm and prayer is often difficult to satisfactorily define – and a great number of indisputable prayers to God and his saints appear in the Old English medical texts. Charms and prayers both certainly belong to a paraliturgical ‘penumbra’ of texts used in early medieval England for practical devotion.Footnote 50 The prevalence of ritual remedies varies hugely by text: only seven to eight per cent of remedies in the hyper-scholarly Bald’s Leechbook; eighteen per cent in the miscellany Leechbook III, which is especially interested in ailments caused by or related to non-human agents like demons; and twenty-seven per cent in the ecclesiastically influenced Lacnunga.Footnote 51 These remedies are rationally conceived within their early medieval cultural context, indistinguishable from other kinds of medicine within the Old English corpus, and cannot be dismissed as ‘superstitious’.Footnote 52 The overlap between personal devotion and practical medicine was entirely sensible for medieval Christians, who considered the human body to be a microcosm of God’s creation, medicinal healing a reestablishment of the divine order of a Christian universe, and pastoral care an essential aspect of clerical religious duty. The health of the body and the health of the soul are utterly interdependent, often conceptually inextricable, in these texts.Footnote 53 The ritual remedies included in the medical texts are heterogeneous and draw from many sources, but all contain Christian material; though they may not be entirely orthodox, they are unlikely to have been considered significantly heterodox.Footnote 54 Take, for example, a charm so popular it is occasionally referred to only by its first word, which appears in the Lacnunga in the following form:
Sing this prayer nine times on the black blains; before that the Our Father:
The apparent ‘nonsense’ in this incantation includes multiple words and phrases in distorted Irish and possibly Hebrew, and is followed by Vulgate quotations from the Bible. The remedy also includes the phrase adiuro te, which appears in ecclesiastical exorcistic rites, and an evidently traditional rhyming phrase appearing in multiple medieval charms separated by geography and time (non crescas sed arescas).Footnote 56 The incantation as a whole is explicitly Christian, though it appears in no offices or books of prayer. It makes use of Latin as a sacred language, but also Irish – a language associated with religious learning in early medieval England – to create a commanding, otherworldly verbal performance. It may have been orally transmitted, given the garbling of the Irish words it contains, but in its recorded form is intended for a literate practitioner with some facility with Latin and familiarity with ecclesiastical rites.
Looming over any discussion of early medieval medicine is a fundamentally unanswerable question: did these remedies work – and if so, how and for whom? Many ingredients listed in these texts have genuine medical properties: painkillers, antibiotics, anti-inflammatories, emmenagogues.Footnote 57 Scientific explorations have offered mixed results: one study found the remedies had no medical effect, whereas another found a Leechbook remedy for an eye infection to be effective against antibiotic-resistant MRSA.Footnote 58 We know so little about preparation that it is difficult to determine which, if any, remedies would have alleviated symptoms, though many elements involved – honey, alliums, gall, wine, copper salts – are in theory medically efficacious. We are also missing a key element of cultural context: the power of the placebo effect.Footnote 59 Modern scientific studies have consistently shown that if we believe we are receiving an efficacious treatment for certain ailments, our symptoms will improve. The performance of an incantation by a priest coupled with an herbal salve might well have alleviated the ailments of early medieval patients. The medical texts do not often discuss anatomy or aetiology, but they are constantly interested in the mitigation of symptoms: him bið sona sel (he will soon be better), the texts repeatedly promise.
More medicine survives in Old English than any other medieval vernacular: over sixty extant manuscripts contain medical information, from herbal remedies and charms to prognostics and bloodletting instructions, and the Old English medical collections constitute more than a thousand folios.Footnote 60 The dedication of so many expensive manuscript pages to medical writings, along with the addition of notes and new recipes to the collections and the modification of remedies for English ingredients, testifies to their immense cultural importance, and so it is to these medical writings that this section now turns.
Medical Texts in Early Medieval England
Many of the remedies preserved in the pre-Conquest literary record are originally sourced from Latin texts that were the height of medical learning on the continent, while others have no known source and are presumably English in origin. Remedies travelled individually or in small groups, often abridged, recompiled, copied, and excerpted.Footnote 61In addition to the four major Old English medical collections, small groups of remedies also appear in non-specialist manuscripts, including psalters, liturgical manuscripts, computistical treatises, and natural science texts. Examples include London, British Library, Cotton MS Caligula A xv, which contains extracts from Jerome and Isidore of Seville, numerous computus texts, and a collection of healing charms; Cambridge, Corpus Christi College MS 41, an edition of Bede’s Ecclesiastical History in Old English whose margins contain medical remedies, a number of now-famous verse charms, and liturgical excerpts; and London, British Library, Cotton MS Vitellius E xviii, a psalter with a prefatory collection of remedies and prognostics.Footnote 62 Prayerbooks also often contain remedies – like London, British Library, Royal MS 2 A xx, featuring two groups of devotions for the cessation of menstrual bleeding (ff. 16 v, 49 r–v). These codices point to the close connection between spiritual and bodily health that animates many Old English texts.
It is often difficult to determine which Latin texts were available complete and which simply served as sources for translated remedies that circulated more or less independently. Texts that were available in their entirety in early medieval England prior to the mid-eleventh century include Pliny the Elder’s Naturalis historia, Galen’s Ad Glauconem de methodo medendi, the Liber medicinalis of Quintus Serenus Sammonicus, and possibly, given their prominence in the Old English medical collections, the Latin Alexander of Tralles, Oribasius’s Euporistes and Synopsis, and the Galenic Liber tertius.Footnote 63 Sources for Old English remedies also include the other venerated Greek and Latin authors whose work was available on the continent: Vindicianus, Marcellus of Bordeaux, Philagrius of Epirus, Theodorus Priscianus, Caelius Aurelianus, Soranus of Ephesus, and Cassius Felix.Footnote 64 In the mid-eleventh century, major Galenic texts – including the Gariopontus-Petrocellus material that would soon anchor the curriculum of the Schola Salernitana – arrived in England.Footnote 65 Much of the Gariopontus-Petrocellus material was translated into the vernacular in the twelfth century, creating a text called the Peri didaxeon.
All translations of Latin remedies into Old English involve interpretation. The remedies are often edited, simplified, or stylistically altered, and many involve the synthesis of information from multiple sources.Footnote 66 Nowhere is the intellectual effort involved in such translation clearer than in the Herbarium Complex, a sizeable text (185 continuous chapters) that offers some of the most important Latin pharmaceutical treatises of the time translated into Old English: the herbal De herba vettonica liber; the popular fourth-century North African Herbarius of Pseudo-Apuleius; a selection of remedies from pseudo-Dioscorides’s Liber medicinae ex herbis femininis and Curae herbarum; the pseudo-Apuleian De taxone liber; and the Liber medicinae ex animalibus attributed to Sextus Placitus Papiriensis, along with several chapters of unknown origin.Footnote 67 The translation was likely completed in the middle or second half of the tenth century and must have been a Benedictine Reform project undertaken by an experienced specialist at a major centre – Winchester, Canterbury, Worcester – and designed to create a comprehensive pharmacopoeia in the vernacular.Footnote 68 The survival of four copies of the Herbarium Complex, dating from the late tenth to the twelfth centuries, testifies to its popularity.Footnote 69
Older than the Herbarium Complex is the medical compendium referred to as Bald’s Leechbook (London, British Library, Royal MS 12 D xvii). Consisting of more than one hundred folios of medical remedies drawn largely from major Latin sources (the Physica Plinii; the Liber tertius; Marcellus; Alexander; Oribasius), Bald’s Leechbook seems to have been made for a user called Bald by a scribe called Cild, according to a Latin colophon in the text.Footnote 70 Like the Herbarium Complex, the Leechbook was a massive intellectual undertaking, but in this case the compiler gathered and sorted remedies that were already circulating pre-translated into English, and also translated new remedies specifically for the compilation.Footnote 71 The text is divided into two books: Book I begins by offering remedies in head-to-foot order, and then switches to remedies grouped by disease, while Book II describes different internal organs one by one and lists remedies for ailments associated with them, including some passages on medical theory. The Royal manuscript was copied at Winchester in the mid-tenth century, by the same scribe who copied the entries for 925–955 ce in the Parker manuscript of the Anglo-Saxon Chronicle.Footnote 72 The collection itself, however, was likely compiled for Bald in the late ninth century, probably also at Winchester, making it part of the program of written vernacular knowledge spearheaded by King Alfred, in his reign-defining efforts to make Latin learning accessible to an English-speaking population.Footnote 73 Indeed, several remedies in Bald’s Leechbook claim to have been sent to Alfred by the Patriarch of Jerusalem,Footnote 74 firmly associating either the original compilation or the Royal copy with Alfred, the court of Wessex, and the vernacular renaissance of the ninth century.
Following Bald’s Leechbook in the Royal manuscript is an eighteen-folio medical miscellany copied by the same scribe, referred to as Leechbook III.Footnote 75 The remedies are in a much looser head-to-toe order, and the text is less comprehensive and features almost no medical theory. It has the smallest percentage of remedies with identifiable Latin sources and a particularly large percentage of remedies containing only native ingredients and using exclusively English plant names.Footnote 76 It also contains a particular concentration of remedies for illnesses ascribed to anthropomorphic agents, including elves, demons, and nihtgengan (night-walkers), discussed in the following section.
The fourth major Old English medical collection is a miscellany without a table of contents or clear organising scheme, given the scholarly title Lacnunga. It is preserved in London, British Library, Harley MS 585, alongside the Herbarium Complex. Lacnunga was compiled in the late tenth or early eleventh century, potentially at Winchester, and shares a number of short remedies with both Bald’s Leechbook and Leechbook III.Footnote 77 The overlap suggests the compiler(s) drew on the same body of pre-translated remedies circulating individually and in small groups that furnished the other medical compendia. Some scholars describe Lacnunga as a commonplace book or working notebook for a physician, but parchment was expensive and the copying in the manuscript itself is clean, making it more likely to have been a compilation of all the available medical material gathered in a particular scriptorium, written down without discarding or sorting.Footnote 78 Scholars have also characterised Lacnunga as particularly interested in folklore and exotica.Footnote 79 Lacnunga does have a high percentage of remedies involving ritual, but they are overwhelmingly ecclesiastical in nature, clearly made by and for literate users, with significant liturgical elements. The collection contains remedies with notable parallels in Old English liturgical and ecclesiastical manuscripts – prayers, litanies, biblical quotations, and selections from the mass and the Divine Office – and remedies that also appear in major devotional texts, including the Book of Cerne and the Book of Nunnaminster. The compiler seems to have been particularly interested in remedies that assert the power of language, including Latin prayers, Greek and Hebrew phrases, and a significant percentage of the surviving incantations that contain recognisable Old English verse.Footnote 80 These charms, like the remedies in Leechbook III, often attribute disease to a range of supernatural beings, including elves, dwarves (dweorges), night-walkers, and witches – perfectly compatible with a Christian world view, though culturally specific to early medieval England.Footnote 81
These brief mentions of malevolent supernatural creatures, however, raise a new set of questions: who are these agents of disease? How does this idea of illness fit in with remedies that have sources in classical texts adhering to humoral theory? How did the early medieval English think about health and sickness? The answers to these questions offer new insights into early medieval understandings of the body, the supernatural, and the place of humankind in the postlapsarian Christian cosmos – and so it is to metaphors of illness that this study now turns.
Sickness and the Body
Different sociocultural communities use a wide variety of models to explain how disease works, and therefore how the sick body can be safeguarded and returned to health. Anthropologist Nigel Barley notes that there are three major ways of thinking about sickness:
The Old English medical texts often seem uninterested in disease aetiology. The majority of remedies do not describe the causes of a particular illness but simply address the symptom they intend to cure – a headache, knee pain, swollen eyes, skin lesions – or name the function of the tonic or emollient they describe – a lung-salve, a spiwdrenc (emetic). Their primary concern is the amelioration of suffering. A representative recipe for a salve reads as follows:
Wenn is a word used to describe cutaneous swellings (cysts, boils, tumours) as well as chest oppression – hence, perhaps, the relationship between wennas and nyrwet (shortness of breath).Footnote 84 Chest oppression may have been understood to be a kind of internal swelling, as there can apparently be ‘wennas æt mannes heortan’ (wens at a person’s heart).Footnote 85 This semantic linking of ‘internal’ and ‘external’ illnesses suggests that the cutaneous swellings designated by the term wenn were not considered to reside on the surface of the body, but underneath it. The same illness can be deep within the flesh or reside just below its defining outer bounds. As in the vast majority of other Old English remedies, the symptoms – wennas and nyrwet – are presented on their own, isolated from the context of the rest of the body. This localisation of the ailment or dysfunction suggests the idea of a body that is otherwise and by its nature free of sickness, or which by nature functions in a certain way, until individual problems located in specific body parts arise and must be individually corrected through the application of the corresponding remedy. The physician creates the salve from a variety of plants, which must be correctly processed, employed in concert with one another, and evaluated for their individual mæð (measure of power). The Old English medical corpus elsewhere ascribes mægen (might, strength) to plants and in a number of remedies treats plants themselves as agents with will, intention, and a capacity for both capriciousness and danger.Footnote 86 The correct, multi-stage processing of the plants transforms this natural, and perhaps ambivalent, power into a positive instrument of the physician’s science with the ability to diminish or erase symptoms: a gode sealfe (good salve). God seems to be multivalent here, likely indicating efficaciousness, value, and the capacity to enact a moral good – the healing of the sick.
Only a relatively small percentage of remedies ascribe illness to a cause; most, like the wen salve recipe, treat the patient’s symptoms as their own cause. When medical remedies do assert that disease is produced by a specific mechanism, therefore, it is both interesting and notable that they refer most often to anthropomorphised supernatural agents, creatures who seek to break open and invade the body. The individual patient’s experience of illness is elevated into a struggle against hostile forces in a postlapsarian world, a microcosmic battlefield reflecting the macrocosmic dynamics of the medieval Christian universe. Remedies with ritual elements more frequently identify an agent of disease causation than those without such elements, suggesting the possibility that different kinds of medicine apply to different illnesses (or assessments of those illnesses by the physician in question). Yet this ‘invasive model’ of disease is of a piece with the remedy already discussed, which assumes the body is afflicted with an anomalous symptom that must be removed from, or undone within, otherwise healthy flesh. Other learned models of the sick body appear in the surviving corpus – Bede, for example, cites changes in the air as a cause of epidemic disease,Footnote 87 and the medical texts engage with humoral theory in subtle and unusual ways, as discussed in the following – but consistent reassertions of the metaphor of disease as invader in the medical texts and in numerous Old English literary texts point to its cultural importance, and reveal a preoccupation with policing the boundaries of the body, shoring up its points of entry against incursion, and maintaining the self as an invulnerable, inviolate whole.
Humoral Theory in Early Medieval English Medicine
Humoral theory is arguably the most widespread model of the human body and its various ailments found in the literature of the European Middle Ages. The humoral model is derived from the works of Galen of Pergamon, a Greek physician and philosopher active in the second century, whose writings dominated medieval understandings of medicine. Humoral theory posits that the body contains four humours: blood, red or yellow bile, black bile, and phlegm, which each possess a different combination of heat or cold with moisture or dryness – red bile, for example, is hot and dry, while blood is hot and moist. The humours must exist in balanced proportions in the body for optimum health, and an excess of any given humour causes sickness, as well as changes in the patient’s emotional state. Humoral excess is corrected by the ingestion of medicines with opposite properties (cold for heat, moisture for dryness, etc.) as well as bloodletting, scarification, cupping, and induced vomiting, which purportedly drain humours physically from the patient.
Latin medical texts available in early medieval England, and Latin source remedies for a great number of Old English medical texts, implicitly rely upon humoral theory, and some articulate that theory explicitly. The humoral model of the body was certainly known in early medieval England as early as the eighth century. Bede discusses the four humours – though he does not mention their role in medicine – in his De temporum ratione, presumably drawing on both the Epistola Vindiciani, a medical treatise that circulated whole or in part in early medieval England, and Isidore of Seville’s Etymologiae, a highly influential and popular etymological encyclopaedia that circulated extensively in medieval Europe and includes a medical treatise drawing on the works of Caelius Aurelianus.Footnote 88 Humoral theory persisted in scientific treatises written by educated, Latin-literate authors: the Enchiridion, a scientific manual written by the monk Byrhtferth of Ramsey (c.1011), names the four humours in Latin and associates them with the four elements (air, fire, earth, and water), while the twelfth-century medical treatise Peri didaxeon directly translates a passage on the humours from the Petrocellus Tereoperica, noting that there are four humours (feower wætun) named as blod, swerta gealle, ruwa gealle, and wæte.Footnote 89 A number of pre-Conquest Old English medical or medical-adjacent codices include instructions for bloodletting, a methodology inherently indebted to humoral theory. In the four major pre-Conquest texts of the Old English medical corpus – the Herbarium complex, Bald’s Leechbook, Leechbook III, and the Lacnunga – a handful of remedies note that illnesses can be generated by excessive heat, cold, moisture, or dryness, and that the remedies change accordingly for each cause, along with several mentions of fluids in the body that can be either hot or cold.Footnote 90 The majority of these references appear in Bald’s Leechbook II, which largely deals with internal medicine and has theoretical ambitions not shared by other Old English medical texts; Leechbook III, by contrast, which contains the highest percentage of English remedies without Latin sources, does not mention humoral theory at all.Footnote 91 Some scholars take these references collectively to mean that early medieval English physicians universally understood imbalances of the four natural humours to be the foremost cause of diseases in their patients.Footnote 92
The Old English medical texts as a whole, however, arguably do not show a high level of engagement with the fullness of humoral theory as detailed in their Latin source texts. Instead, they seem to adhere to an altered, adjusted model of the role of bodily fluids in disease causation. The four pre-Conquest medical compilations contain no texts or remedies that articulate the central tenets of the humoral model. Even Old English bloodletting texts, and remedies that mention hot and cold sources for illness, do not discuss the humours, and indeed no pre-Conquest Old English medical text acknowledges that they are four distinct substances.Footnote 93 The Old English translation of Boethius’s De consolatione philosophiae, an immensely popular text in early medieval Europe, in fact removes Galenic humoral metaphors present in the original, suggesting that such metaphors were considered either incomprehensible or unimportant by the translator(s).Footnote 94 It is telling that neither Bede nor Byrhtferth names the four humours in the vernacular or addresses their medical functions in any detail, because the pre-Conquest Old English medical texts essentially lack a humoral vocabulary. Old English remedies discussing bodily fluids universally use the word wæta, which can apparently refer to humours but simply means ‘moisture, fluid’ and can refer not only to any ‘humour’ but also to pus, mucus, liquids for drinking, or any kind of wetness.Footnote 95 Translations of Latin remedies that mention humours refer only to wætan, not to phlegm or black bile. Very occasionally the medical texts use the difficult word oman, which might refer to red bile but is also used of skin ailments like erysipelas.Footnote 96 A single Bald’s Leechbook remedy refers to ‘þæs geallancoðe þa readan’ (this red ‘gealle’ disease), but it is unclear whether the word gealle here means ‘bile’ in the humoral sense or refers instead to a raised sore.Footnote 97 The same chapter goes on to say that ‘þa hwitan lichoman beoð mearuwran ⁊ tedran þonne þa blacan ⁊ þa readan’ (the white bodies/fleshes are softer and weaker than the black and the red), which could refer to bodies in which a given humour predominates, but the preceding remedy consistently uses ‘black’ (sweart, blac) – and possibly also ‘red’ (read), in this context – to describe the literal colour of diseased flesh.Footnote 98 The description of bodily fluids with medical words that have other unrelated meanings, as well as a general refusal to distinguish bodily fluids from one another, indicates that knowledge of the identities and functions of the four humours likely was not considered universally essential to the medical practice documented in the Old English textual corpus.
More importantly, the Old English translations of remedies that refer to the humours do not ascribe disease to the imbalance of naturally occurring bodily substances, but to the presence of yfelan wætan (evil fluids) in the body, which must be done away with (don aweg), healed (lacnian), drawn out (ateon ut), driven out and diminished (todrifð ond lytlað), or cleansed (cleansian) from the flesh.Footnote 99 These fluids are described as poisonous and treated as venoms to be extracted; they are disease agents in and of themselves, evil substances that must be purged from the patient. One Bald’s Leechbook remedy is simply a set of instructions for ‘du man sceal þa wætan ond þa wonsceaftan utan lacnian’ (how one may heal fluids and misery) with a salve, treating the presence of bodily fluids themselves as a disease symptom and the cause of the patient’s distress.Footnote 100 These remedies work to accommodate the humoral theory of their Latin source material – describing ‘evil’ bodily humours as the cause of disease, acknowledging the importance of distinguishing between hot and cold ailments – without necessarily including or drawing upon its fundamental model of disease causation, that of imbalance between four distinct, naturally occurring bodily elements. English translators of Latin medical material were willing to alter their sources where important or convenient, making such adjustments as removing a reference to the spirit (Latin anima) residing in the liver because early medieval English models of the body elsewhere attested locate the spirit in the heart.Footnote 101 Such changes are not a sign of misunderstanding but of intellectual and cultural reinterpretation. The simplified, looser version of humoral theory targets evil fluids within otherwise healthy flesh, much in the way the wen-salve remedy treats swellings as isolated anomalies to be targeted for correction. While Old English iterations of Latin remedies retain a number of humoral principles – bloodletting and emetics work to purge the body of undesirable substances, altering its internal function – they distinguish the fluids of illness from the substances of the patient’s normally functioning flesh and treat them instead as invaders or poisons. Such an interpretation brings the Latin source material conceptually in line with the most prominent model of disease aetiology found in the Old English medical texts, insofar as they address causation: illness as incursive agent.
Agents of Disease
When Old English medical remedies refer to the causes of disease, they most frequently use an external–internal model: the body is entered from without by alien matter or forces, often described as adversarial, mobile entities usually possessing some kind of volition or intent.Footnote 102 Wyrmas (worms) are mentioned over a hundred and fifty times as the cause of ailments in the medical texts, including inwyrmas (inward-moving worms) and smeawyrmas (creeping or penetrating worms), described as eating flesh and growing inside patients.Footnote 103 The word wyrm is a multivalent term that presumably refers to any number of parasites in a medical context, and Old English remedies treat worms in all parts of the body, from the eyes to the innards to the feet. In literary and religious texts, worms are persistently linked to mortality, decay, disease, and the consumption of the human body, featuring prominently in descriptions of Hell. Indeed, medical descriptions of penetrating worms eating flesh recall the images in Old English poetry and homiletic prose of corpses consumed by wyrmas who bore through eyes, crack open heads, and chew holes in necks – where the imagery is of being entered, laid (burst, split, torn) open, and exposed.Footnote 104 Poison (attor) is another frequently named cause of disease.Footnote 105 Remedies for attor do not merely seek to counteract harmful ingested substances. Rather, ‘poisons’ are several times described as flying venoms (fleogende attor) that move through the air seeking out human flesh, and may be a metaphor for infectious disease.Footnote 106 They thus demonstrate a kind of hostile intent, and in one verse charm, they are also conflated with ‘þam laþan þe geond lond færeð’ (the loathsome one that travels throughout the land),Footnote 107 a personified disease agent that, like these ‘flying poisons’, seems to originate in undomesticated spaces, to move pervasively through the landscape, and to breach the defences of the flesh. These disease agents may represent real observations of illness – intestinal parasites, the spread of symptoms between persons – but also reveal essential cultural concerns explicitly present in a subset of the Old English medical writings. Illnesses emerge from a hostile natural world. They are fundamentally opposed to humanity, and in some cases aligned with the demonic. The human body is evidently fragile, subject to constant menaces, and vulnerable to being entered, broken open, or consumed.
Indeed, a number of Old English medical remedies also refer to supernatural, anthropomorphised disease agents. A number of illnesses are attributed or somehow related to beings called ylfe (sing. ælf), a term usually translated by its modern descendant ‘elves’.Footnote 108 We know very little about early medieval elves, though they also appear in Old Norse and Middle High German texts.Footnote 109 They are likely humanoid supernatural beings, associated with brightness and beauty in certain texts but closely linked to demons in the majority of the corpus.Footnote 110 Elf-related illnesses, including ælfadl (elf-sickness), ælfsiden (elvish influence), and ælfsogoða (elf-related internal pain) appear across the Old English medical corpus.Footnote 111 Elves are consistently linked to spasmic and delirious symptoms, including epilepsy; internal pains; and sores or wounds on the skin.Footnote 112 Elves are named as one possible agent among several who can cause the ailment gescot (‘shot’, i.e. internal pain) – including in a verse charm that equates gescot with sudden, severe pain caused by an invisible spear shot by elves, witches, or (possibly) non-Christian gods.Footnote 113 Internal pains and skin wounds may well be linked to elves because both were understood to be caused by this sort of projectile intrusion, evidence that the patient had been ‘stabbed’, assaulted, or penetrated. A greater number of illnesses are attributed to the malevolent influence of demons (deofles or feondas). Demon-caused ailments, like the elf-related illnesses mentioned earlier, are generally grouped with remedies for mind-altering and convulsive afflictions.Footnote 114 While the medical texts do not mention the kind of indwelling or manipulative possession found in saints’ lives, demonic influence on, access to, and injury or invasion of the body seems to be a relevant concern.Footnote 115 The ailment referred to as feondseocnes and deofolseocnes (fiend- or devil-sickness), for example, is defined in Bald’s Leechbook as ‘þonne deofol þone monnan fede oððe hine inan gewealde mid adle’ (when a devil nourishes a man or controls him within with disease).Footnote 116 The Old English Herbarium equates devil-sickness with gewitleaste (madness, senselessness)Footnote 117 and the word elsewhere glosses daemoniacus, suggesting that the ailment was understood on some level to be a displacement of the patient from control of their own body. The Lacnunga also contains three remedies against a dweorh, a term usually translated by its modern descendant ‘dwarf’, which seems to refer to both a supernatural creature and a dangerously high fever.Footnote 118 Like elves, dwarves as supernatural beings are mentioned in Old Norse texts, but we know little about them in an English context other than that they were probably thought to be humanoid and small. A lead amulet found in Norfolk dating to anywhere between the eighth and eleventh centuries bears the inscription Dead is dwerg (the dwarf is dead) above a drawing of a face in profile, and the word glosses Latin terms for semi-mythical small peoples across the early medieval period.Footnote 119
The remedies for these sicknesses consistently make use of exorcistic elements, liturgical prayers, ecclesiastical materia medica, and adjurations or commands that a hostile being be expelled from the patient. This textual evidence suggests that names like ‘elf-sickness’ or ‘devil-sickness’ are not fossilisations but rituals intended to combat ‘real’ anthropomorphised disease creatures. Several remedies speak explicitly about the reality of such supernatural beings: a Leechbook remedy for ‘feondes costunge’ (the trials, temptations, or afflictions of a demon) encourages the patient to put herbs under their pillow and over their door ‘ne mæg þe deofol sceþþan inne ne ute’ (so the devil cannot hurt you within or without), while a remedy copied a few folios later for ælfadl warns the physician that they may encounter ‘hwæthwega egeslices’ (something terrifying) during the ritualised gathering of elecampane to treat the patient.Footnote 120 Even if these disease names and disease-banishing rituals are metaphorical rather than literal, however, they reflect an understanding of illness as external, incursive, and malicious.
This model of the body is in no way incompatible with the humoral theory that informs the Latin medical texts available in pre-Conquest England and appears in a somewhat altered form in Bald’s Leechbook. Both models see the ideal, healthy body as a closed system capable of self-regulation. Both models also propose to mediate and rehabilitate the imperfect reality of the body as a dangerously porous entity, susceptible to outside influence that can cause internal disruption or imbalance but also capable of adjusting in response to environmental changes. Remedies that adhere to the incursive model – ascribing disease to demonic agents or using religious language and materials to remove malign influence – see the solution to be the extraction and removal of the dangerous agent, followed by a shoring-up of the body’s defences. Remedies that are informed by the humoral model or its modified English iteration use the porousness of the body to their advantage, introducing curative substances to help the body right itself or counteract the presence or excess of a dangerous substance. Both models are interested in purgation: exorcism, banishment, spitting, blowing, bloodletting, induced vomiting. The true vulnerability – and potential – of the body, in the early medieval English medical understanding, is its ability to act as a site of interchange between self and other, inside and outside, individual and surrounding world.
Bodily Metaphors in Early Medieval English Medicine
Remedies that attribute sickness to demonic influence, elvish assaults, and the insidious creeping of worms reveal a specific, persistent anxiety in the Old English medical texts: a concern with the violent and intentional breaking-open of the body through intimate contact with the inhuman other. Illness is treated as a breach or violation, and many of these remedies seek to treat the ailment in question by expelling or banishing the antagonistic agent and restoring the body to wholeness. Sickness is fundamentally an exchange of power. To be diseased is to surrender agency, to submit to or be violently overcome by a malevolent force.
Remedies that adhere to this model of illness use a variety of images and metaphors, and employ specific language, to describe and address these boundary violations. Liturgical quotation and ecclesiastical materia medica counteract and banish demonic or elvish influence. Poison, too, can be drawn out through Christian ritual, as in one multilingual remedy that asks God to destroy the venom within the patient’s body.Footnote 121 Not infrequently, however, the metaphors are martial. ‘Penetrating’ worms are removed from the body by a garbled Irish incantation that begins Gonomil orgomil marbumil (roughly: I wound the beast, I hit the beast, I kill the beast).Footnote 122 A long charm against flying poisons and the ‘loathsome one that travels throughout the land’ calls upon nine plants, some of which are poisonous or inedible themselves, to ‘stand against’ (wiðstandan), ‘crash against’ (wiðstunan), ‘put to flight’ (fleon), and ‘drive out’ (wrecan, weorpan) the venoms that the charmer eventually blows out of the patient (of ðe geblawe) to banish them from the flesh.Footnote 123 Another medical incantation found in Leechbook III intended to treat chickenpox or a similar skin ailment addresses the patient’s lesions as battle wounds. The incantation begins: ‘Ic benne awrat betest beadowræda’, which may be translated as either ‘I have written out for the wounds the best of battle troops’ – perhaps referring to the names of the plants used in the accompanying herbal remedy – or ‘I have bound around the wounds the best of battle bandages’ – perhaps referring to either literal dressings or to the incantation’s magical action designed to seal off and close up the sores.Footnote 124 The tools of the healer are transformed into the tools of war, and the blisters of chickenpox are transformed into injuries sustained in conflict with an armed enemy. The illness, unsurprisingly, is named as wæterælfadl (watery elf-disease).
Wið færstice (‘against a sudden, stabbing pain’), the aforementioned charm for gescot, sees disease as a consequence of a battlefield defeat:
Illness is a battlefield conflict, in which the patient has suffered a defeat by weapon-bearing, feminine supernatural warriors. The ‘spear’ causing the patient’s pain represents an obvious penetration of the flesh, undone when the physician engages the ‘mighty women’ in combat and eventually banishes the spear back to the wilderness space from which its original wielders emerged. Falling sick is an act of unwilling submission to a superior opponent – but, by the same token, the resulting battle takes place on as grand a scale as a fight against literal invaders, reestablishing and policing the boundaries of the patient’s body with the intensity of a military rout. Similarly, outside the medical corpus, illness is depicted as the placing of metaphorical bonds, fetters, or weights on a person, suggesting that disease – like sorrow, old age, extreme cold, and poverty – was understood to involve or evoke oppression and restriction, and to have recognisable commonalities with a state of captivity, servitude, and loss of personal bodily autonomy.Footnote 126 One medical charm in Lacnunga refers to a monstrous creature placing literal bonds, traces, or harnesses on a victim.Footnote 127
Another medical charm that sends a disease agent back to the wilderness and away from human bodies and spaces uses a different metaphor to indicate invasion, violation, and breaching. The remedy is for a wen, like the salve discussed earlier. Here, too, a wen is a disease that has literally gotten under one’s skin, a visible mark of the presence of something unwanted in the body. A wen under the skin and a wen on the heart differ only in the degree to which the swollen disease agent has penetrated into the body; it is a question not of what kind of malicious force seeks to enter the flesh, but how far it has progressed. The charm presents the sentient disease agent as a parasite:
The wenn seeks to construct a tun (homestead, enclosed dwelling) inside the patient’s body – what should be the patient’s own most personal, private, and intimate ‘enclosed dwelling’. The metaphor here is one of colonisation and settlement. The wenn builds a mockery of early medieval English home life, a kind of malicious parody or inversion of human community, and creates its own enclosure within an already-enclosed space from which it should rightly be expelled. Indeed, imagery associated with the early medieval English tun – pails of water, coals on the hearth, chickens – is used to shrink and belittle the wenn, which is banished not only from its own inappropriate homestead but also from all social and domestic spaces. Like the spear in Wið færstice, it must be sent back to a mountain or hill where its proper kin lives. As the boundaries of the patient’s body are restored, the lines between human and non-human, tun and wilderness, are redrawn. Scholars have noted the tendency in Old English literature to treat the natural world as fundamentally hostile to humanity, a consequence of the disruption of the harmonious relationship between man and creation generated by the Fall.Footnote 129 These disease agents – spear-wielding women, the ‘loathsome one that travels throughout the land’, the wenn and its sibling – are not merely individual or personal threats, but representatives of all dangerous forces opposed to humanity and to the Christian God in a postlapsarian world.
The medical texts also fleetingly suggest that the violation of the body by disease could be metaphorically understood as an act of sexual violence. The medical corpus contains three mentions of a disease agent called a mære, who is described as ‘riding’ her victims. Old English glossaries consistently use the term mære to gloss the unusual Latin word incuba, a feminised form of the word incubus. The gloss is derived from Isidore’s Etymologiae, which defines an incubus as a sexual demon who rapes its victims.Footnote 130 The presence of the mære in the Leechbooks and the treatment of her ‘riding’ as a sickness in and of itself draw an explicit conceptual equivalence between illness and sexual assault. Indeed, the medical texts hint at multiple types of erotic night demons: Leechbook III contains instructions for a salve operating ‘wið ælfcynne ⁊ nihtgengan ⁊ þam mannum þe deofol mid hæmð’ (for elf-kind and night-walkers and those people the devil has intercourse with).Footnote 131 The devil’s sexual predations apparently either cause illness or empower the people so afflicted to injure others. Remedies for the mære also address other incursive disease agents and forces, including elvish ‘influence’ (ælfsiden), the ‘night-walkers’ mentioned earlier (nihtgengan), and the temptations or afflictions of demons.Footnote 132 If certain diseases were understood to be caused by the aggressive incursion of a supernatural agent, the forced submission of the human victim could be understood as an act of physical violence, as in the martial metaphors already discussed, or an act of eroticised violence.
What all these images have in common – from battlefield defeat to colonisation of the flesh to forced intercourse – is that they treat disease as a zero-sum power exchange and a near-complete loss of human autonomy, threatening the integrity of the entire body. This model of sickness has striking implications, in turn, for the concept of health, and the ways a healthy body is expected to look and function.
Hal and Unhal: Whole, Holy, Healthy
If sickness was indeed treated by many Old English medical texts as an anomalous dysfunction on the part of an imagined body that otherwise existed in a ‘normative’ state of integrity and functionality, and if sickness could – at least in some texts – be understood as a result of violation by the malevolent supernatural, we should expect to see evidence that its opposite, health, was thought to be a state of invulnerable wholeness safeguarded by God. The crux of this concept is the Old English adjective hal and related noun hælu, the words used to refer to health in the medical texts. These terms appear more than a hundred and thirty times in the medical corpus,Footnote 133 suggesting the importance of the concepts they convey to early medieval English understandings of the body, the practice of medicine, and the treatment of illness. The primary meaning of hal in the Old English corpus is ‘whole, undivided’, or ‘entire, lacking no part’. In some cases, the term specifically means ‘undamaged’ or ‘free from physical defect’, while in religious verse and prose it also means ‘safe from spiritual danger’ or ‘under the protection of God’.Footnote 134 Hælu, similarly, means ‘good health’, ‘safety’, and ‘spiritual deliverance or salvation’.Footnote 135 The medical texts use the word hal and its opposite unhal – not whole, not healthy, damaged – to make fundamental distinctions of kind, between healthy and unhealthy patients, between living and dead flesh.Footnote 136 This conflation of health with wholeness, the erasure of damage, and holiness also permeates other medical vocabulary: the word bot means ‘cure’, ‘healing’, or ‘remedy’ in the medical texts, but also refers to compensation paid for infractions of the law or received for injury; atonement or penance for sin; relief or deliverance from suffering both physical and spiritual; and the literal repair or restoration of material objects.Footnote 137
To be healthy in early medieval England, then, was literally to be ‘all in one piece’. Health is the maintenance of the self as a continuous, invulnerable whole, without injury, defect, or point of entry. Physical wholeness also entails safety from spiritual threats, a state of being infused with the salvific protection of Christ. God’s protection consists precisely of the maintenance of wholeness in the face of invasion. Latin supplications called loricae, ‘breastplate’ prayers, appear several times in the Old English medical corpus and in religious texts that contain remedies in their margins or prefatory material.Footnote 138 The speaker requests that God guard the entirety of their body, listed part by part, including individual internal organs. The speaker preserves his health by inviting God to permeate his flesh, shielding the body from penetration by malicious forces. In particular, the Lorica of Laidcenn, a Hiberno-Latin prayer popular in early medieval England, asks God to guard each of the body parts of the speaker in turn and to protect the flesh as a whole from invasion – being torn open by devils and pierced with Satan’s arrows – with his divine inpenetrabile tutela (impenetrable protection), glossed in Old English as unþurhsceotendlicre gescyldnesses (defence that cannot be shot through).Footnote 139 Ritual remedies also call on other symbols of wholeness and inviolacy to protect the patient: the use of milk from unmæle (unmarked, single-colour) cows, the employment of virgins as ritual assistants, and references to the perfected, fleshless, ‘resurrection bodies’ given to the faithful when they rise from the grave at Judgment Day all attest to the importance of maintaining the inviolate self in order to maintain health.Footnote 140 Indeed, the Christian emphasis on virginity is emphatically about wholeness in the Old English vocabulary: virgins of all genders are unmæle and ungewemmed – unspotted, uncorrupted, uninjured – and gesund, sound and entire. When physical and spiritual suffering overlap, medicine can be seen as linked to Christian devotional practice, an act of warding the body against the enemies of God and mankind and an invocation of Christian fleshly transcendence.Footnote 141
These themes are also apparent in the ways Old English literary texts approach the body. Poetic terms for the body describe it as a closed container, a defended and defensible residence: it is the banhus (bone-house), bancofa (bone-chamber), and ferðloca (life-enclosure) containing the sawelhord (soul-treasure). The consequences of breaching the container can be dire. A number of poems refer to death and injury as the breaking open of the bodily structure or shell, the breaching of boundaries to sever life from the flesh.Footnote 142 The idea of the body being laid open for consumption also consistently preoccupies Old English religious texts. In the grave, the body is chewed by greedy worms, as noted earlier; descriptions of uncorrupted saintly corpses escaping that fate, and the transmutation of rotting bones into transparent, radiant resurrection bodies offer contrasting images of the ideal wholeness ordinary flesh cannot achieve. Vivid depictions of man-eating and cannibalism also mark the monsters of pre-Conquest literature, from Beowulf’s famous enemy Grendel to the hybrid creatures described in Wonders of the East. One of the most common poetic motifs in Old English verse is that of ‘the beasts of battle’, a formulaic description of birds and wolves eager to consume the slain on battlefields, turning human bodies into carrion. These texts are also concerned with projectile intrusion: the devil, for example, is often described as assaulting humanity with darts, arrows, and iron weapons that metaphorically penetrate the flesh and injure the soul with sin.Footnote 143 The Prose Dialogue of Solomon and Saturn, one of three Christian esoteric texts recounting dialogues between the biblical King Solomon and the prince of the Chaldeans, describes devils penetrating the mouths, skin, flesh, and bowels of unwary men and using their bodies as a kind of lightning rod to travel into the earth towards Hell.Footnote 144 The profusion of these collected examples suggests a profound cultural preoccupation with bodily integrity and bodily wholeness.
Illuminating these early medieval English attitudes towards the body, however, begs an essential question: what does a model that conflates healthiness with wholeness – with the potentially troubling idea of being ‘undamaged’ – mean for people with physical or bodily differences and impairments? What did it mean to be ‘abled’ or ‘disabled’ in early medieval England, and what can the textual, historical, and archaeological records tell us about both the lives of disabled persons and the way that ‘disability’ was understood and discussed in literature, medicine, law, and religious thought? The following section seeks to address these questions and their complex, multifaceted answers.
Impairment and Disability
The Welsh monk Asser, in his biography of Alfred the Great, describes the king as the best of warriors, devoted to his education, courageous as a wild boar, a builder of cities, and a consummate diplomat – and the sufferer of numerous illnesses unknown to physicians. Alfred, Asser tells us, had prayed to God to grant him an infirmity ‘quam posset sustinere’ (that he could tolerate) to help restrain his carnal desires, but which would not render him ‘indignum et inutilem in mundanis rebus’ (unworthy and useless in worldly affairs).Footnote 145 He is soon afflicted by ficus, a disease that is difficult for modern scholars to identify but which may have been haemorrhoids.Footnote 146 Plagued by this ailment, Alfred asks for divine mercy:
Alfred is consequently struck by severe internal pain at his wedding feast, which replaces his ficus but assails him for the rest of his life. Alfred’s suffering, and his constant fear that the pain would return, ‘quasi inutilem eum, ut ei videtur, in divinis et humanis rebus propemodum effecit’ (rendered him as if virtually useless, as it seemed to him, in heavenly and worldly affairs), but he continues to prove himself on the battlefield and as a ruler. His tribulations, according to Asser, only make his political success more impressive and demonstrate his martyr-like capacity for endurance and faith.
This narrative provides a rich case study for discussions of impairment and disability in early medieval England. Alfred’s greatest concerns are that he will have a visible disease – that is, an illness that disrupts the integrity of his body as a unified whole – and that his condition, like (apparently) blindness and leprosy in other people, will render him useless and unworthy of respect. Asser’s constant, laboured repetition that Alfred seeks specifically to avoid becoming inutilis and that he is only useless in his own perception (quasi … ut ei videtur … propemodum) suggests that a contemporary audience would otherwise have been inclined to see Alfred’s chronically ill body as a sign of unfitness, unworthiness, or contemptibility.Footnote 148 The worst thing a king can be, apparently, is ineffective. Asser’s repeated emphasis on Alfred’s battlefield prowess and courage compensates narratively for his illness. Yet Alfred’s body is also a tool of political power. His ability to persevere through an ailment that threatens to limit his power and diminish his social status – that would, in other words, be disabling – demonstrates his Christian devotion and his superhuman leadership. His illness is a mode of self-discipline, a way of modelling Christian and secular virtue, service, and sacrifice. Alfred’s bodily pain must be kept invisible to maintain his worthiness but revealed at certain moments to allow praise of his strength and self-control; he is sick enough to be righteous, but well enough to maintain his position of social dominance.Footnote 149 Alfred the Great is, to use a term coined by disability activists, a ‘supercrip’: a man treated as worthy of admiration because he succeeds in spite of his impairments, which are assumed to be oppressive burdens antithetical to his thriving.
These themes resonate throughout the Old English and Anglo-Latin textual corpus in depictions and discussions of impaired people. Impairment is treated as a burden, a source of oppression, a manifestation of original sin, a trial sent by God to purify his chosen favourites, and an opportunity for the non-impaired to demonstrate charity and for saints to perform miracles. Always, however, impairment is treated as the absence of, or an obstacle to, individual and social power or agency.
Concepts of Impairment and Ability in Early Medieval England
The field of disability studies has long operated on a set of assumptions known as the ‘social model’ of disability: impairment describes an organic physical or mental conditionFootnote 150 that inhibits or alters bodily function, while disability is socially constructed – the barriers, disadvantages, and instances of exclusion an individual with an impairment encounters.Footnote 151 The cultural model of disability revises and builds upon this social model to assert that disability is ‘largely but not strictly synonymous with sites of cultural oppression’, an interaction between social obstacles and biological capacities.Footnote 152 Impairment is as culturally constructed as disability: physical difference is not ontological or ‘purely’ natural, but created through encounters in which a person has meaning imposed upon their body.Footnote 153 Ability, too, is culturally determined and context-dependent. There is no singular societal response to impairment and no singular definition of ability; both must be observed within their cultural context and without a priori assumptions about their nature.
In Old English, however, there is no word for ‘disability’ as an identity, community, or broad category of experience, and very little evidence of any kind of disabled culture.Footnote 154 The mutability of impairment as a cultural signifier essentially defies the imposition of any single model. The present discussion distinguishes between impairment and disability because it can be difficult to determine which impairments would have had disabling consequences for early medieval English individuals, and what those consequences would have been. Certain kinds of impairment were likely more common in pre-Conquest England than in present-day Western Europe, and thus some conditions we might now consider ‘bodily difference’ may have been considered part of the course of ordinary life. A great deal of socially essential labour is available to, or can be adjusted for, persons with impairments, so certain impairments might have been disabling in some ways but not in others.Footnote 155
Old English terms for individual impairments survive – for example, one may be blind, deaf, dumb, or assigned a catch-all term for those with mobility impairments, words whose modern descendants have come to be used as profound insults (lam, ‘lame’; healte, ‘halt’; crypol, ‘cripple’, ‘one who crawls’). One might fall somewhere on a spectrum of ‘ill hearing’ or have ‘dim’ and ‘misty’ eyes.Footnote 156 Blindness, deafness, and mobility impairments are often grouped together in Old English prose and verse as conditions that mark the suffering of humanity on earth and that can be healed by Christ and his saints – but such groupings follow biblical convention, rather than necessarily testifying to an understanding of these impairments as belonging to a single, recognised social category.Footnote 157 Instead the sources contain words that refer to illness, impairment, and injury as contiguous and overlapping states, without differentiating between acute and chronic. The most common terms used are unhal and unhælu, discussed in the previous section. Illness and impairment are both a state of un-wholeness, of damage and vulnerability. Depictions of the long-term sick and impaired, which are found most commonly in saints’ lives describing healing miracles, often emphasise the ‘leakiness’ of these bodies: they swell up, emit effluvia, have open wounds, and manifest ulcers and tumours. Their ailments disrupt their visual and conceptual wholeness. The medical texts use the word unhal to refer to anyone who is currently sick and seeking medical attention; lawcodes and hagiography use the term to refer to anyone who deviates, for a short or long period of time, from a standard of bodily strength, functionality, and completeness that is positioned as normative.Footnote 158 Another word used in this way is untrumnesse (lit. ‘un-firmness’), while multiple lawcodes use unmiht (lit. ‘un-strength’, ‘un-power’) and unmaga (lit. ‘un-strong’, unable) to refer to persons who are legally dependent on others, including the old, the very young, the poor, and those with a range of physical impairments.Footnote 159 The repeated use of negating prefixes in these terms suggests that sickness and impairment were understood to be an absence of health, strength, power, and wholeness – again positioning such health and strength as normative, with impairment treated as a deviation or defect. Some texts make this attitude explicit. The Old English Boethius, for example, describes walking as ‘eallum monnum gecynde’ (natural for all people), while those who cannot walk lack power over their bodies (næfð his fota geweald) – and everyone knows (wat ælc man) that a person who walks is stronger (mihtigra) than one who crawls. The walking man, the text reveals, is a metaphor for a good person who desires, and moves, on riht (rightly) and the crawling man is an evil person who desires, and moves, on woh (in error).Footnote 160 These moralising judgements about natural, correct bodies and unnatural, incorrect ones speak for themselves. Full humanity belongs to bodies that are ‘whole’.
A number of late Old English lawcodes codify these oppositions between healthy and unhealthy, powerful and weak, and associate impairment with old age, dependent childhood, poverty, and slavery as conditions that include certain legal debilitations and also require certain degrees of legal protection.Footnote 161 VI Æthelred (c.1008) declares:
The text goes on to group women, children, enslaved persons, and impaired persons in this way. II Cnut (c.1018) contains nearly the same proclamation, stressing that ‘a man sceal unstrangam menn for godes lufe and ege liþelicor deman and scrifon þonne þam strangan’ (one must, for love and fear of God, judge and penalise weak persons more gently than the strong).Footnote 163 Such articulations of complete and fundamental opposition between healthy and sick, strong and weak – without acknowledgement that an individual could move between states – are both protective and restrictive, relegating entire classes of people to a form of legal dependency. The lawcodes make provision for impaired individuals, but also qualify their legal personhood, simultaneously including them in and excluding them from social and legal communities. Unhal serves as a broad category for bodies perceived as less capable, less powerful, entangled with other social markers of (dis)empowerment like gender and rank.
Despite the fact that illness and impairment are treated as an absence of health, the hal body – whole, holy, healthy – is almost always defined in comparison to and in the context of bodies that lack hælu, the presence of health only made visible by its absence. In the medical texts, health is simply the amelioration or eradication of sickness; a patient ‘bið sona hal’ (will soon be whole) if the remedy is effectively deployed. The lawcodes of Æthelberht and Alfred offer long lists of the varying amounts of monetary compensation owed to a person if damage is done to each of their body parts.Footnote 164 Æthelberht assigns fifty shillings – the same price demanded for the killing of a free man – to the loss of eyes and of hearing, injuries to the shoulders, the loss of a foot, and destruction of the genitals. Alfred’s lawcode concurs that castration, the loss of the leg or foot, and wounds to the eyes and shoulders command the greatest compensation, along with damage to the hands and to the sinews of the leg and neck. The fact that these injuries merit financial compensation suggests both that the default body is expected to have two eyes that can see, two ears that can hear, shoulders that can lift and rotate, two legs that enable walking, two hands with ten fingers that can grip items, and so forth, with the loss or alteration of these body parts representing a grave detriment, and also that such loss or alteration might have economic consequences for the individual against which reparative payment is a bulwark. The normative body comes into view at the moment it is rendered non-normative.
This ‘itemised’ body is also a marker of health and normativity in early medieval English religious literature and prayer. The Lorica of Laidcenn, the protective prayer discussed in the previous section, asks God to preserve more than a hundred of the speaker’s discrete body parts, including at least thirty-three individual parts of the head and face (nose, nostrils, pupils, irises, gums, teeth, epiglottis, etc.).Footnote 165 A similar Latin prayer in Lacnunga banishes the devil from eleven individual body parts and from ‘ab uniuersis confaginibus membrorum eis’ (the whole framework of [the patient’s] members).Footnote 166 An exhaustive excommunication formula similarly expels a person from the Christian community by cursing each of their body parts in turn, including eyes, ears, tongue, lips, windpipe, shoulders, chest, feet, and legs, while a confessional formula instructs the penitent to confess all the sins committed by their eyes, ears, mouth, skin, flesh, bone, sinew, vein, gristle, hair, and marrow.Footnote 167 Ælfric of Eynsham, in a homily for the fourth Sunday after Easter, explains that Christ’s followers knew he had been truly resurrected in body because they could witness all of his functioning parts:
Christ’s body is ansund (sound, whole, entire) because it has the correct number of components and because all of those components function as they should and operate collaboratively: teeth, tongue, and throat; hands, arms, and shoulders; inside and outside. Indeed, Ælfric’s insistence that Christ’s digestive system and larynx were operating correctly after his resurrection draws attention to a perpetual theme in early medieval English discussions of health, sickness, and impairment: the importance of function, and what Asser calls utilitas. Æthelberht and Alfred’s lawcodes increase compensation for injuries that impair function: hearing, sight, walking, gripping, rotating the shoulders, and holding up one’s own head and neck.Footnote 169 Æthelberht’s lawcode states that full compensation – the same as for a death – should be paid if a servant loses an eye or a foot, presumably because such a loss would diminish their capacity to serve.Footnote 170 Saints’ lives describe numerous impaired people seeking healing from relics and at shrines, and the emphasis is always on what these people cannot do – see, hear, speak, walk, sit up, move their limbs.
The normative, healthy body is thus a unity assembled from a long list of individual parts that all must operate correctly and collaboratively, with particular importance attached to eyes, ears, speech organs, shoulders, hands, the abdomen with innards, and legs with feet.Footnote 171 Any one of those parts failing to operate at full capacity within the whole – or indeed ceasing to be – is a detriment to the integrity of the body and constitutes both an impairment and, potentially, a disability. Indeed, the Old English Boethius notes that if the body is missing a limb, ‘þonne be bið hit no full mon swa hit ær wæs’ (then it is no longer as complete a person as it once was).Footnote 172 The healthy body is not just an assemblage, of course: its visual and conceptual wholeness remains important. Visible wounds and scars explicitly merit higher compensation in the lawcodes than ones that can be hidden.Footnote 173 Alfred was apparently desperate not to have an illness outwardly visible on his flesh. Even Christ’s side wound, which his followers behold as proof that he died, is described in Ælfric’s homily for the fourth Sunday after Easter as only a dolhswæþ (scar, trace; l. 142): the holy, resurrected body is marked but has no vulnerable gape. The body must be closed and complete, as discussed in the previous section – but this completeness also depends on all individual members being present and accounted for. In Exeter Book Riddle 82, the solution to which is ‘a one-eyed garlic seller’, the person’s single eye does as much work to signify non-normativity as their twelf hund heafda (twelve hundred heads): too many heads, the riddle indicates, and too few eyes, with the phrases an eage and twelf hund heafda framing a list of ‘normal’ numbers of ears, feet, hands, arms, and shoulders.
This evident bias against impaired bodies in the textual record, however, does not suggest banishment, ostracism, or total exclusion of impaired persons from social communities. Impairment was evidently considered an undesirable state, but the lawcodes make provision for unhal people within social and legal structures, not outside of them. An emphasis on function provides opportunities for the economic and social contributions that impaired persons can make to their communities to be considered ‘normative’.Footnote 174 A number of studies on the ‘history of disability’ assume that the Middle Ages was a period of unrelenting persecution for persons with impairments,Footnote 175 but the archaeological and textual records suggest instead complex and varied attitudes towards people with bodily differences and a range of experiences for those people within their communities.
Disabled Persons in the Historical Record
Early medieval English cemeteries from the sixth to the eleventh centuries include individuals with a variety of conditions that might have caused them impairment in life. The burial record attests to persons with osteoarthritis of differing degrees, tuberculosis, leprosy, limb differences of many kinds including fractures and other trauma, paralysis, cleft palate, spinal morphologies that could affect posture, movement, and body shape, various types of neuromuscular differences, hydrocephaly, cancers, Paget’s disease, deafness, and numerous other bodily conditions, including signs of osteomyelitis and inflammation that may be the result of any number of illnesses.Footnote 176 Graves have also survived of individuals with dwarfism, gigantism, and facial differences. This list is not complete. Experiences of pain or loss of function can be hard to determine from skeletal remains alone, and the list necessarily does not include conditions of the soft tissue, like blindness, that undoubtedly existed in the population. In addition, very little can be gleaned about intellectual disabilities in early medieval England from either the textual or archaeological record. Words that may reflect the existence of intellectual disabilities, like ungewit or dysgunge, are elided with terms for mental illness.Footnote 177 The Life of St Margaret describes Margaret’s blessing on households as preventing the birth of ‘nan unhal cild … ne crypol, ne dumb, ne deaf, ne blind, ne ungewittes’ (no unhealthy child … neither mobility-impaired, nor mute, nor deaf, nor blind, nor without wits), the last item of which seems to refer to intellectual disability, but otherwise the evidence is thin.Footnote 178 Madness itself (wod), which probably refers to multiple conditions, is treated as disabling in hagiography and occasionally also included in lists of impairments.Footnote 179
In addition, conditions and experiences that we would not consider impairments may have been treated as such: menstruation is described as a form of untrumness, as is pregnancy, suggesting a distrust of such bodies bound up in early medieval English understandings of sex and gender.Footnote 180 Old age, too, is described as socially disabling – to become old, according to homilies and religious verse, is by definition to acquire numerous impairments – and death is treated as the ultimate impairment of the body, blinding the eyes, deafening the ears, and paralysing the feet and hands.Footnote 181 The continuum of ability on which real, embodied people in early medieval England lived defies the clean separations between hal and unhal that the Old English lawcodes and medical texts seek to enforce.
Accessing the experience of persons with impairments in early medieval England is difficult, but we can draw a handful of reasonable conclusions from the available evidence. The majority of burials of impaired persons are in central locations within cemeteries and have been given normative rites, including features of burial that seem to prioritise the comfort of the corpse, like carefully propping up paralysed limbs.Footnote 182 Such a lack of differentiation means that these people were integrated into their communities – or at least that they were not so discriminated against in life that they faced exclusion in death. It is important to note, however, that a disproportionately high number of non-normative burials are of impaired persons, particularly notable in a period in which burial is generally standardised, and by some counts around 30–40 per cent of excavated graves of impaired individuals are non-normative burials or are found in marginal locations.Footnote 183 Some early cemeteries have noticeable spatial associations between impaired persons, non-adults, and skeletons that archaeologists have sexed female; these patterns lessen in the later pre-Conquest period.Footnote 184 Distinctive burials are hard to interpret, but generally suggest some kind of differentiation in life.
Many graves of impaired persons show signs that they lived with and managed their illness or impairment: adults with conditions that would have been present since childhood, evidence of healed amputations and fractures, impaired persons who lived into old age. Survival does not necessarily indicate compassion or acceptance, but in some cases these individuals lived with impairments that would have required care, which they evidently received.Footnote 185 Saints’ lives often describe impaired persons visiting shrines with the assistance of kin and friends. Alfred’s lawcode contains a telling provision: ‘Gif hwa oðrum his unmagan oðfæste, and he hine on ðære fæstinge forferie, getriowe hine facnes se ðe hine fede, gif hine hwa hwelces teo’ (If someone entrusts his dependant/unable person to another, and he [the dependant] dies during that time of fostering, he who sustained him is to clear himself of guilt, if anyone accuses him of any crime).Footnote 186 This suggests that some impaired people received care in their communities, that such care was expected to ensure the survival of those people, and that sometimes their care was insufficient. Accounts of wealthy impaired persons with access to resources describe them as relying on servants to move about. Saints’ lives also describe individuals being carried on litters or by friends, as well as using crutches, staves, and stools, and blind persons are described as having or hiring guides.Footnote 187 The Anglo-French monk Lantfred included in his Translation and Miracles of Saint Swithun accounts of people with impairments helping one another on their journeys to Swithun’s shrine in Winchester (e.g. a man who could not speak serving as a guide for three blind women), suggesting perhaps a nascent concept of community among people with physical impairments.Footnote 188 Other individuals undoubtedly managed without care from others, whether by choice or necessity.
Some impairments probably had relatively little impact on a person’s social position and economic role, even if they affected daily life. The high-status Castledyke burial of a woman who would have been at least partially deaf in life suggests that she was a wife and mother, for example, and would likely have been able to engage in important economic and cultural labour like weaving.Footnote 189 Other impairments would have impacted a person’s ability to participate fully as an adult member of society. Some lawcodes impose fines on free men for neglecting military service. Cnut’s lawcode is adamant that to be a legal witness, a man must be able to see and hear. Alfred’s lawcode declares that ‘Gif mon sie dumb oððe deaf geboren, þæt he ne mæge synna onsecgan ne geandettan, bete se fæder his misdæda’ (If a person is born mute or deaf, so that he may neither deny nor confess his sins, let his father make reparations for his misdeeds).Footnote 190 Paired with the declarations that the hal and unhal cannot be treated alike under the law, these provisions collectively suggest that an adult man who could not walk and ride a horse, carry weapons, see, hear, or speak might well be prohibited from participating in essential aspects of social and political life.Footnote 191 Certain impairments may also have prevented one from holding public office, especially royal and war leadership, as Asser and Alfred’s shared anxiety suggests; attempts to blind rival heirs to the throne indicate that impairment might have lessened one’s eligibility to rule.Footnote 192 In the entry for 1055, the Anglo-Saxon Chronicle also notes that Bishop Æthelstan was replaced because he was unfere (infirm, feeble, incapacitated), a word that elsewhere refers to a lack of health, strength, and social power.Footnote 193
For the ordinary person, however, the available evidence suggests that the degree to which an impairment could be socially disabling varied depending on economic status. High-status burials of impaired individuals suggest that impairment need not be an impediment to social status if one belonged to a wealthy and well-resourced kin network.Footnote 194 The relatively high number of impaired persons buried in non-normative graves, however, along with evident political and legal restrictions based on physical difference, frequent depictions of impaired persons as living in poverty in hagiography, and the textual treatment of impairment as an undesirable state suggest that if one was not well-resourced, impairment might have been one of several factors that could render one socially vulnerable and more likely to experience exclusion.Footnote 195 Two episodes in Bede provide an excellent example: Tortgyth, a noble-born nun, holds a position of significant power at Barking Abbey which she retains while experiencing paralysis and muteness, while a poor youth treated by John of Beverley for muteness and skin disease is destitute, abandoned by his community due to his impairment.Footnote 196 The degree to which impairments would have been disabling probably varied greatly between individuals depending both on the nature of the impairment and on social circumstance.
Literary Approaches to Sickness and Disability
Approaches to illness and impairment in medieval literature are ‘manifold and ambiguous’,Footnote 197 but distinct themes are traceable in the Old English corpus, most notably that impairment is consistently positioned as an absence of power. As we have already seen, impairment in the lawcodes, medical texts, and other literature is often treated as a detriment to the body that must be compensated for. Like sickness, it is also often described in Old English verse and prose as a form of bondage and torment, or a physical burden that oppresses the individual with its weight.Footnote 198 Other sources treat it as a tragic misfortune to be avoided: the person ‘on feðe lef, / seonobennum seoc’ (injured with respect to motion, sick with a sinew-wound) must ‘sar cwanian, / murnan meotodgesceaft’ (lament his wound, mourn his meted-out condition).Footnote 199 The birth of children who are impaired in various ways – blind, deaf, unable to speak or walk – is cited as a punishment in several homilies for having intercourse on Holy Sunday and fast days.Footnote 200 Prognostics offer strict dietary advice for expectant mothers so that their children are not born disig (stupid), hoforode (humpbacked), or healede (hydrocephalous), and one of the obstetric charms preserved in Lacnunga instructs the woman to banish the possibility of ‘þære laðan lambyrde’ (the loathsome ‘lame’ birth).Footnote 201 Though the Old English medical texts rarely blame illness on a person’s individual actions – this language of maternal responsibility for neonatal health is perhaps an exception, though it also grants bodily control to expectant mothers even while implicitly attributing fault should this medical advice not be followed – religious texts do occasionally mention that disease and impairment can be evidence of or punishments for sin.Footnote 202 There is, however, relatively little emphasis on the idea of sickness as punishment across the corpus as a whole.Footnote 203 Far more often, impairments are used as metaphors for sin as a concept, as we have already seen in the Boethius. Didactic texts equate physical ‘deficiencies’ with spiritual ones: blindness as a metaphor for the inability to perceive religious truth, deafness as a metaphor for the refusal to listen to God’s commands, and so forth.Footnote 204 Impairment here is not a symbol of individual sin, but of original sin. It becomes a shorthand for the ways in which humanity is estranged from God in a postlapsarian world, a sign of divine absence.Footnote 205 Illness and unhealthiness, early medieval English discussions of Genesis note, came into existence with the Fall; numerous homilies teach their audiences that God afflicts the bodies of mortal men because humanity has fallen from grace.Footnote 206 The impaired body is legible, available for use as a parable, a metonymic stand-in for all human suffering and imperfection.
Ælfric offers several possible aetiologies of impairment: ‘hwilon for heora synnum, hwilon for fandunge; hwilon for godes wundrum, hwilon for gehealdsumnysse goddra drohtnunga; þæt hi þy eadmodran beon’ (sometimes for their sins, sometimes as a trial; sometimes for the miracles of God, sometimes for the preservation of good conduct; so that they might be more humble).Footnote 207 The same texts that use impairment as a metaphor for sin and human failure also treat the experience of impairment as a trial of faith, a mode of purifying the soul on earth, and a marker of special holiness given by God to test his favourites. The examples are numerous: St Cuthbert’s endurance of an inflamed and foreshortened leg is proof of his self-discipline; the abbess Hild receives an illness from God ‘so that her strength might be made perfect in infirmity’ (ut … uirtus eius in infirmitate perficeretur); the abbess Æthelthryth endures a neck tumour to purge her soul of the sin of wearing necklaces in her youth; King Alfred, of course, is made a martyr and paragon of self-control by his illness, as is St Guthlac of Crowland, discussed in the next section.Footnote 208 Numerous homilies and religious texts, following the writings of various church fathers, explicitly state that sickness and impairment are a trial to be endured to obtain a place in heaven.Footnote 209 Impairment is thus used to signify membership in an exalted community of the pure and chosen, which undoubtedly confers a kind of social power – but that power is derived from the endurance of a condition that is only ever treated as a source of suffering, and from a willing submission to God and the embrace of a powerless state. Many of the figures experiencing holy impairment are treated by their texts as supercrips, worthy of admiration because they persevere through their illnesses and injuries.
The lawcodes, by contrast, treat the impaired body as a legible sign of both crime and criminality. The list of injuries meriting compensation means that the body is itself a witness to and evidence for the occurrence of a crime, but in many lawcodes mutilation is also a means of punishment and restitution. Hands and feet should be struck off, tongues cut out, eyes blinded, ears ripped from the head, and genitals removed as punishments for a variety of crimes including theft and rape.Footnote 210 The body becomes a site for the demonstration of the power of the king and his law, but the lawcodes also frame such punishment as an opportunity for the guilty person to purify their soul through the suffering of impairment, in much the same manner as the trials of holiness described earlier – here offered as torture, discipline, and gift by a secular authority in a supposed act of Christian mercy.Footnote 211 Whether any of these punishments were enacted – or, indeed, compensations extracted – is up for debate, as medieval laws are generally understood to be a record of ideals and intentions rather than strictly applied codes for judicial authorities. Regardless of enforcement, however, these texts testify to an attitude about the body and its ‘missing’ parts: visible impairment is associated with embarrassment, victimhood, criminality, guilt, and submission to or defeat by another.
If the impaired body in a legal context is an opportunity for the demonstration of the power of secular authority, in hagiography and didactic religious texts, it provides an opportunity for the demonstration of the power of God. As Christ heals the man blind from birth in John 9:1–7, he declares that the man is not blind because he sinned, but so that the works of God could be made manifest in him. Ælfric follows John, declaring that God has chosen the wanhal (unhal), blind, and mobility-impaired so that they can be healed and thus demonstrate his power.Footnote 212 This is the principle that undergirds the depictions of parades of impaired persons visiting holy places throughout early medieval English hagiography. A significant majority of saints’ lives feature blind, deaf, non-speaking, and mobility-impaired people, as well as those mysteriously and mortally ill, cured one after the other as they handle a relic, kneel before a tomb, or pray at a shrine – a litany of fleshly miracles worked on persons portrayed as existing in a state of unremitting suffering. The impaired body reads as powerless and imperfect, and the formerly impaired body healed by contact with the saint testifies to Christian truth. Visible impairments and illnesses become a representation not only of human estrangement from heaven, but of the frailty of all flesh. All human bodies are incomplete in that no body on the postlapsarian earth can be perfect.Footnote 213 Indeed, the miraculous resurrection bodies the faithful will receive at the Last Judgement are specifically defined not only by their celestial beauty – ‘ænlic ond edgeong’ (peerlessly beautiful and rejuvenated), as one poem has it – but by the absence of impairment – ‘hælu butan sare’ (health without pain), as another poem puts it.Footnote 214 Following Augustine’s declaration in his De civitate Dei that the sick and impaired will be made whole at the resurrection and given perfect adult bodies and minds, Ælfric insists that resurrection bodies have no awyrdnys (injury, damage) or wamm (mark, blot, stain) even for those who were alefed (weak) or limleas (limbless) in life; they will be gehæled to ansundre (healed to soundness).Footnote 215 Impairment itself becomes indisputable evidence of the fact that humanity is not yet reunited with God, and its healing in hagiography is a promise and a demonstration of the wholeness the faithful will experience at Judgment Day.
Yet these beatifying narratives and doctrinal sermons require impaired bodies: relics are proven true by the act of healing. An endless supply of unhal bodies is narratively essential, and those bodies are useful only when they are unhal. The numerous impaired persons in saints’ lives are defined only by their impairments (the blind women, the limbless man) and appear in the narrative only to have their impairments miraculously removed from them. The pilgrim generally vanishes from the narrative immediately once healed, is left with a scar or mark indicating the ‘resealing’ of the body and providing a permanent reminder of the wound that was miraculously closed, or appears in a brief scene in which their kin and neighbours exclaim over their newfound ability, noting that they were once impaired and now are not. All of these narrative scenarios suspend the pilgrim in a liminal state in which their body can be neither healthy nor unhealthy, but must perpetually be both, only whole because once impaired. The Old Minster at Winchester, which contains the tomb of St Swithun, is ‘eall behangen mid criccum and mid creopera sceamelum fram ende oð oþerne on ægðrum wage, þe ðær wurdon gehælede and man ne mihte swaðeah macian hi healfe up’ (entirely hung with crutches and with the stools of ‘cripples’ who were healed there from one end to the other in either direction, and they could not put even half of them up).Footnote 216 These prosthetic devices stand in for the bodies of pilgrims, permanently preserving the sign of the unhal body made hal as a show of power legible to other visitors. The very presence of supposedly abandoned crutches at the shrine stands in for the moment of physical transformation. More broadly, the Church requires the existence of poor and impaired people in order to bestow charity, amply demonstrated in the saints’ lives by stories of wealthy Christians who prove their piety by briefly adopting an impaired person and making a public spectacle of their generosity.Footnote 217 Impairment is what disability studies scholars call a narrative prothesis: ‘a crutch upon which literary narratives lean for their representational power, disruptive potentiality, and analytical insight’, seeking to expose and then rehabilitate the impaired body as a symbol of deviance.Footnote 218 In early medieval England, the impaired body signifies not deviance per se but original sin and the suffering of humanity, redeemed through the mercy of God, endured as a demonstration of spiritual humility, and erased at the resurrection.
In the early medieval English literary record, the body is a text that can be read, that can be made to speak. Perceptions of impairment rest upon one base assumption that can then be interpreted in multiple ways: impairment is a lack of power and an absence of strength. That absence can provide the opportunity for healing, for a purifying ordeal, and for the intrusion of the divine, but it can also be a marker of pain, misfortune, loss, and shame. The disempowered body merits compensation and a protection that doubles as restriction in the lawcodes, treatment for its recalcitrant parts in the medical texts, and access to divinity in the religious material – but only because it serves as a symbol of humanity’s fallenness and estrangement from God, as a reason for pity, a cause for humility, and a source of suffering. Yet the normative body is only defined in comparison to the non-normative body. The saint’s miraculous gifts are only proved by the healing of the ‘cripples’ and the hanging of their crutches and stools as a sign of divine transformation. The perfected resurrection body is only meaningful in contrast to the earthly body. Feverish abbesses and limping saints can only reach the profound Christian empowerment of union with God through visible, performed submission to the powerlessness of illness. The idea of health as wholeness and completion has profound theological and cultural implications revealed only through depictions and discussions of the impaired.
This Element has, thus far, drawn from a wide variety of texts to trace essential themes and cultural concepts on a grand scale. Now we must turn to the application of these concepts, and ask how an understanding of health and the body in early medieval England can help us better understand early medieval English literature and vice versa. We conclude with a case study of holy suffering and a detailed depiction of illness as martyrdom in a nexus of texts concerned with intrusion, invasion, and the protection of purified spaces: the Old English and Anglo-Latin versions of the life of St Guthlac of Crowland.
Body, Spirit, and Disease in Stories of St Guthlac: A Case Study
St Guthlac of Crowland, early medieval England’s most famous hermit saint, spent years maintaining a solitary stronghold in the East Anglian fens against the incursion of ravenous demons. Eventually, however, he fell mortally ill, narrated in the poem scholars call Guthlac B. Guthlac endures the assault of this untrymnes (infirmity) with determination and joy, understanding his departure from life as a reunion with God:
The poet piles on metaphor after metaphor to describe what disease is doing to Guthlac’s body. He is gebysgad and geswenced, two participles that mean ‘afflicted, harassed, oppressed’ but also refer to attacks by an enemy. The word sar describes pain but also mortal wounds and physical blows. Death is an unnatural sundering of the union between soul and body – the undoing and violation of two things that ought to be bound together – and an anthropomorphised warrior and a thief who seeks to break into Guthlac’s flesh, to unlock his bodily container by penetrating it with a key that cracks it open. Illness is also a shower of hot arrows sinking into the saint’s body, a mortal injury on an invisible battlefield. Many of these images are immediately recognisable from the medical texts discussed in previous sections. The fundamental integrity of Guthlac’s flesh is at stake, the wholeness of his embodied self, and disease threatens to defeat him in ways easily interpreted as humiliating, or as forcing him into a position of submission. His controlled endurance of this painful unhælu and untrymness – like the endurance of Alfred, Hild, or Cuthbert – purifies him, liberates him, and martyrs him all at once. Despite the proliferation of fascinating metaphors for sickness in this poem and their clear relationship to the concepts evinced by the Old English medical corpus, no published study has yet examined the portrayal of illness specifically in the Guthlac narratives. These texts – in Latin and Old English, prose and verse – collectively provide an ideal case study in early medieval English perceptions of and ideas about the body, and the differences between Latin prose and Old English poetry bring into sharp focus the vernacular vocabularies, conventions, and concepts of sickness and health that animate the literature of this period.
Invasion and the Body in Guthlac Narratives
The Anglo-Saxon Chronicle notes the death of St Guthlac of Crowland in 714; if the surviving account of his life is to be believed, he must have been born in 673 or 674. Guthlac was a Mercian aristocrat of royal blood and, in his youth, a successful warrior on the Mercian-Welsh border.Footnote 220 After experiencing a sudden revelation of his own mortality, Guthlac abandons the battlefield and the secular life and becomes a monk at the double monastery at Hrypadun (Repton). There, he learns about the eremitic saints and their solitary battles with demons in the wilderness and determines to engage in the same struggle. He builds himself a dwelling near Cruglond (Crowland) in the uncultivated, unsettled East Anglian fens, an English equivalent to the Egyptian desert that famously served as the retreat of St Paul and St Antony. Guthlac builds his new hermitage by a burial mound that has been plagued by devils, whom he banishes. He then engages in numerous battles with these demons, who assault him, attempt to reclaim the barrow, and, at one point, drag him to the mouth of Hell, where he is saved by the intercession of St Bartholomew. Guthlac becomes a respected spiritual authority and a counsellor to the future king of Mercia, Æthelbald, before he dies of an unnamed illness. A Latin prose Life of St Guthlac was written at the behest of the East Anglian king Ælfwald by a monk (likely also East Anglian, or living in East Anglia) named Felix, probably between 730 and 740.Footnote 221 Felix’s vita was translated into Old English prose in the ninth or tenth century, and the portion detailing Guthlac’s battles with demons is preserved separately as one of the Vercelli Homilies.Footnote 222 Two Old English poems about Guthlac also survive in the tenth-century Exeter Book miscellany: Guthlac A describes Guthlac’s struggle with the demons, his visit to the Hellmouth, and the intercession of Bartholomew, while Guthlac B expands vividly on Chapter 50 of Felix’s vita to describe Guthlac’s final illness, his last preaching to his devoted servant Beccel, and his death.Footnote 223 In all its forms, the immanent Guthlac narrative revolves around the defence and regulation of both Guthlac’s body and the barrow in which he dwells.
Felix drew on a number of Latin sources for his narrative, including the lives of the desert fathers and other saints known for their interactions with devils.Footnote 224 Writing (probably) in an English monastery and (undoubtedly) for an English audience, however, he arguably transformed his source material to focus on concerns about physical violation that are not present in the originals. Felix describes in great detail the devils who come to force their way into Guthlac’s hermitage and injure, damage, and break open his body. The Life of St Antony and other vitae of the eremitic saints portray demons as self-evidently psychological, representations of the saint’s internal struggles. By contrast, Felix’s demons are flesh and blood: they take the forms of a dozen roaring, snarling, clawing animals, assault the saint with weapons to cause physical injuries, and tow him through water and air.Footnote 225 Felix emphasises that these demonic attacks – in which Guthlac is bound, struck with iron whips, and dragged through muddy water and bramble patches – happen to the saint corporaliter (carnally, bodily) rather than extra corpus.Footnote 226 The demons also seek to re-enter and reclaim the barrow from which Guthlac has displaced them. They do not appear in the wilderness when the saint does, as in Antony’s vita, but rather inhabit the fens prior to Guthlac’s holy act of settler-colonialism. Guthlac reclaims a territory that is described repeatedly as monstrous, hellish, and estranged from God; he then reconsecrates the tumulus as space in which he can be in a prelapsarian relationship with nature, commanding the birds in the air and the waters of the fen to obey him.Footnote 227 The devils who previously lived there, however, constantly seek to breach these newly established bounds. The imagery is vivid:
The depiction of devils squeezing themselves into Guthlac’s cell through floor holes and door joints has no clear parallel in Felix’s sources. The endless details of their physical appearances – including their human body parts, listed in a litany like those we have seen in the previous section, but made abject, animalistic, and diseased or impaired – along with the focus on the way they burst into what should be consecrated space indicates a profound anxiety around literal, physical boundary violation and penetration as a threat to both the saint’s body and his Christian project. Indeed, once inside, the demons are able to seize Guthlac and subject him to the torments described earlier. Gaining access to the barrow gives them the ability to manhandle and wound his body. The saint’s defence of the mound and his defence of his body are made analogous: the walls of the hermitage are equivalent to the flesh that contains Guthlac’s soul. Felix continually focuses on the ways devils try to enter both human spaces and human bodies, describing instances of demon possession and influence that he explicitly likens to the ingestion of a poison that the victim must subsequently vomit up. When Guthlac experiences despair, similar to an episode in the Life of St Antony that describes internal struggle only, Felix turns it into a weaponised assault: Satan ‘tum veluti ab extenso arcu venenifluam desperationis sagittam totis viribus iaculavit, quousque in Christi militis mentis umbone defixa pependit. Interea cum telum toxicum atri veneni sucum infunderet, tum miles Christi totis sensibus turbatus de eo’ (shot, as from a bow fully drawn, a poisoned arrow of despair with all his might, so that it stuck fast in the very centre of the mind of the soldier of Christ. Now when meanwhile the poisoned weapon had poured in its potion of black venom, then every feeling of the soldier of Christ was disturbed by it).Footnote 229 Poison and supernatural arrows are, as previously discussed, favoured images in the Old English medical corpus as well as popular Hiberno-Latin loricae, and common in vernacular poetic depictions of the devil. Again Felix transforms his source material into a narrative that resonates with cultural concerns found specifically in the literature of the medieval North Atlantic. The Old English prose translation further describes the geættredan stræle (poisoned arrow) as penetrating Guthlac’s heort (heart-organ) and mod.Footnote 230 Mod means, simultaneously, ‘mind’, ‘spirit’, and ‘heart’. As discussed in what follows, the vernacular early medieval English understanding of the mind locates it in the heart and treats it as a near-physical part of the chest or breast. A penetrative threat to Guthlac’s mind, spirit, and self is also a threat to the body – and vice versa. Sainthood consists in the successful banishment of demons from his presence, his hermitage, and the bodies of others; sainthood is the ability to maintain inviolate boundaries.
Guthlac A’s account of these demonic assaults focuses even more closely on the potential human vulnerability, and demonstrated saintly invulnerability, of Guthlac’s flesh, and the fact that this concern intensifies in a vernacular, poetic text suggests the importance of the idea of the impenetrable body in the Old English literary imagination. As in Felix, Guthlac reclaims the fenland mound for God, Christianity, and humanity, and transforms this mearclond (lit. ‘boundary-land’) into paradise.Footnote 231 Just as Guthlac’s mod is both arena and prize in a battle between an angel sent by God and a devil who seeks to prevent his Christian awakening, Guthlac ‘þæt lond Gode / fægre gefreoþode’ (defended that land well for God) against military troops of demons and their færscytum (sudden shots).Footnote 232 The demons threaten to overrun the barrow, burn him alive within his hermitage, and summon an even greater army that will trample him and carry off his wounded body, leaving only bloody tracks behind. The text continually asserts, however, that Christian power – wielded by Guthlac, by Bartholomew, and by God on Guthlac’s behalf – lies in the prevention of bodily penetration. Guthlac declares, ‘þeah þe ge hine sarum forsæcen, ne motan ge mine sawle gretan’ (although you afflict [my body] with wounds, you cannot approach/touch/attack my soul, l. 377), and repeats constantly that the demons who assault him cannot truly injure or kill him, because his mod – or hyge, breost, feorhloca, and other words that denote the mind held within the chest – is filled up with the light and love of God. Though God permits the demons to take Guthlac in their gifrum grapum (greedy grips), the poem asserts that he is not hurt. When intervening for Guthlac at the entrance to Hell, Bartholomew declares:
Bartholomew then commands the demons to ‘him sara gehwylc / hondum gehælde’ (heal every wound on/in him with [their] hands, ll. 704–5), suggesting that Guthlac’s body has in fact been injured, despite Guthlac and the narrator’s repeated insistence that he cannot be wounded. He is and is not hurt; is and is not overcome, entered, or violated. The fantasy of Guthlac’s mod and breost rendered invulnerable through the presence of God’s light within them – the idea that the saint has a radiant soul within his flesh-covering that cannot be touched or entered – is a fantasy of gesundnes (soundness), bound up with the same ideas about the body found in the medical texts and filtered through contemporary debates about the relationship between soul and flesh. Guthlac’s blod and ban, which will be consigned to death (l. 380), are a liability; his sainthood is proven through a lack of damage, and the healing of wounds that never successfully pierced his flesh. By insisting on Guthlac’s untouchability so often and in such detail, vacillating on whether or not he is physically injured, Guthlac A draws even greater attention to the anxiety produced by the vulnerability of normal human flesh – both despite and because of the fact that Guthlac supposedly lacks such vulnerability. The oldest English iteration of the eremitic saint is concerned in every version with boundary violation, bodily integrity, and the erasure or undoing of damage to the flesh. This is the literary context in which we read Guthlac B, the longest depiction of a person suffering from illness within the Old English corpus.
Guthlac’s Mortal Illness
Felix’s vita depicts a sick person in great detail – but it is not Guthlac. Offa, retainer of Æthelbald of Mercia, comes to the saint having stepped on a thorn, a wound that quickly becomes infected:
When Offa is wrapped in Guthlac’s robe, the thorn shoots out of his foot like an arrow from a bow (‘velut sagitta ab arcu demissa’) and his body returns to its normal proportions. The image of an arrow-like penetrative agent of pain and sickness is familiar from texts like the verse charm for a stabbing pain discussed in the second section. This affliction, too, reaches far into the body, into the bones (‘ab imis ossium medullis’), even if the Latin tellingly does not refer to vernacular ideas of animate disease. Indeed, the Old English prose translation adds a highly relevant phrase, noting that when Offa is wrapped in the holy garment ‘þa ne mihte þæt þæt sar aberan’ (then the wound/pain could not abide it), imputing intention and agency to the sickness.Footnote 235
Yet Felix describes almost nothing of Guthlac’s illness. Using Bede’s equally restrained Life of Cuthbert as a blueprint for the saint’s death scene, all Felix tells us of Guthlac’s sickness is that ‘subito illum intimorum stimulatio corripuit’ (a spasm of his inward parts suddenly seized him). He then repeats that the saint was seized (arreptare) with illness (infirmitate).Footnote 236 The Old English prose follows his reticence.Footnote 237 Both Guthlac A and the prose excerpt found in the Vercelli Book elide Guthlac’s death entirely. Guthlac A simply declares that his soul is brought to heaven, and Vercelli Homily XXIII that he is taken up to heaven in both body and soul by St Bartholomew. This evident discomfort with Guthlac’s death is of a piece with these narratives’ concern with the restoration of consecrated bodies and spaces to wholeness – the penetration of the body by a malevolent force is for ordinary people like Offa to experience, not the saint. Guthlac B, however, devotes hundreds of lines of verse to exploring precisely this anxiety, drawing our attention – as Guthlac A does – to the contrast between the saint’s penetrable flesh and untouchable soul.
Guthlac’s disease is named as bancoþa, a difficult word to translate but one that only appears otherwise in the medical corpus.Footnote 238 The fact that the Old English poet uses medical language where Felix uses the more generic infirmitate suggests that Guthlac B is aware of an early medieval English vocabulary of and discourse around illness, and indeed the images the poet uses are strikingly similar to those found in medical charms. Disease is a fatal or deadly arrow (wælstrælum, wælpilum) or shower of arrows (hildescurum, flacor flanþracu) that has pierced the saint’s body.Footnote 239 It is the assault of armed enemies (feonda gewinna) who attack (gebysgian) Guthlac, and death is personified as a wiga wælgifre (warrior greedy for slaughter).Footnote 240 The sickness is a surging heat that consumes Guthlac’s body like fire, and that heat itself is presented as part of a martial struggle: ‘wæs se bancofa / adle onæled … wæs seo adl þearl, / hat ond heorogrim. Hreþer innan weol, born banloca’ (the bone-container was ignited by disease … the sickness was severe, hot and battle-grim. The breast boiled within, the bone-enclosure burned, ll. 954–80). Illness enters (in gewod) Guthlac, and indeed when death arrives, ‘him duru sylfa / on þa sliðnan tid sona ontyneð, / ingong geopenað. Ne mæg ænig þam / flæsce bifongen feore wiðstondan … ac hine ræseð on / gifrum grapum’ (one soon opens the door for himself at that cruel time; the entrance opens. Nor can any enveloped in flesh resist it with life … but it rushes on one with greedy grips, ll. 991–6). Some of these images also have liturgical parallels, but the selection and juxtaposition of these particular metaphors in a text employing medical language is especially resonant.
Sickness is also an oppressive pressure, and it fetters and binds (gebindan). Guthlac is inbendum fæst (held with inner bonds, l. 955) and his body is legerbedde fast (held in the sickbed, l. 1032). Multiple times, however, the poem also says that sickness or death onleac (unlocked) his lichord or feorhhord (body- or spirit-hoard).Footnote 241 Scholars have noted that these images seem contradictory,Footnote 242 but in the language of disease as submission, defeat, or loss of power, they need not be. Sickness seizes and binds Guthlac’s body because it forces him into a position of submission; thus bound, he is also broken open and entered in an act of invasion or penetration. Other instances of the phrase x-hord onlucan describe a voluntary sharing of words, verse, or information; the person concerned opens their intellectual faculties to communicate with another. Here, by contrast, Guthlac’s body is opened against his will. Framing illness and death in this way martyrs Guthlac – he dies in conflict with an enemy of both God and humanity, enduring that opponent’s tortures until he is joyously released – but also explores the cultural anxieties surrounding sickness on a grand scale. Guthlac’s bodily ‘unlocking’ leads to his attainment of heaven, but as with the experience of holy impairment, the assault and breaking-open is a loss of power that must be endured, to which the saint must consciously and deliberately submit. The separation of body and soul is a sundering and a curse visited upon humanity through Adam and Eve’s sin (ll. 857–71), even if it does allow Guthlac’s spirit to dwell with God.
The penetrability of the saint’s body is counteracted by the poem’s assertion – like Guthlac A’s – that only Guthlac’s flesh-covering can be injured, and that his inner core, both his mod (mind/heart) and his sawle (soul that persists after death), are unbroken and untouched. Though sickness burns his body, Guthlac’s heart also burns (vb. beornan) with eagerness for heaven and love for God, an answering inner heat that overcomes (vb. forswiðan) his pains. The poet constantly reiterates that Guthlac’s untouched spirit is joyous, unafraid, and unburdened by sorrow, but Guthlac also fortifies his mod specifically against incursion. He is ‘heard ond hyge-rof’ (hard and valiant of mind, l. 953) and ‘he his modsefan / wið þam færhagan fæste trymede / feonda gewinna’ (he securely firmed up his mind-heart against the sudden onslaught of enemies’ attacks, ll. 959–61). That he makes his mind trym against the assault of an illness described as untrymnes is telling. Multiple times a description of Guthlac’s physical exhaustion is paired with a description of the heardnes (hardness) of his mod or hyge.Footnote 243 Both Guthlac A and Guthlac B engage with this idea of a fortified, inviolate self within the body, an invulnerable core ‘flæsce bifongen’ (enveloped in flesh, l. 994). Guthlac’s inner hardness counteracts the anxiety provoked by the assaults on the saint’s physical form, an anxiety raised in Felix’s Latin prose but made the nearly unremitting focus of the Old English verse. Guthlac’s untouchable, contained mod must apparently be constantly shored up, given the poem’s regular reiterations that he made his mind firm against his enemies. His sainthood consists in his perpetual refortification of his self and soul against malevolent intrusion.
Guthlac does also achieve a moment of bodily invulnerability and perfection. Death is described several times in the poem as a wrongful separation of the soul and flesh, a sundering of what should be whole,Footnote 244 but Guthlac’s strength of mind promises a resurrection of the hal body. The poet of Guthlac B takes care to note that had Adam and Eve not sinned, they would not have died in Eden but rather would have been taken up to heaven ‘leomu lic somud ond lifes gæst’ (limbs, body, and the spirit of life together, l. 838). The poem positions Guthlac between Adam – who brought death and sickness into the world – and Christ, who ‘in lichoman … ærist gefremede’ (brought about a resurrection of the body, ll. 1099–100). The saint imitates Christ, dying at Easter after eight days, and thereby helps to redeem Adam’s sin.Footnote 245 As he releases his soul to heaven, Guthlac ‘his eagan ontynde, / halge heafdes gimmas … ond þa his gæst onsende / weorcum wlitigne in wuldres dream’ (opened his eyes, the head’s holy gems … and then sent his spirit, made beautiful by his deeds, into the joy of glory, ll. 1301–4). The kenning heafod-gimm appears elsewhere in the corpus to describe the eyes – always emphasising their value, especially in Christian bodies under threat or divine scrutiny – but juxtaposed between Adam’s consignment of the body to the grave and Christ’s embodied resurrection this choice of formula recalls the transfigured resurrection body, which is beautiful like ‘golde and seolfre and swa þam deorwyrðestan gemcynne and eorcnanstanum’ (gold and silver and like the most precious gems and pearls), according to Vercelli Homily IV.Footnote 246 At the exact moment of transcendence, as Guthlac’s similarly transfigured and beautified soul departs his body, his body is elevated into something other, and holier, than flesh. The attacking demons, by contrast, are adloman (‘crippled’ by fire).Footnote 247
Reading Guthlac B in the context of the language, metaphors, and central cultural anxieties of the Old English medical texts illuminates the poem, and draws attention to the ways in which vernacular literature expands on and draws out particular anxieties around the body that the Anglo-Latin prose only begins to explore. Yet Guthlac B also offers us insight into another essential vernacular approach to the body, in the person of Guthlac’s servant Beccel: the so-called hydraulic model of emotionality and thought.
Beccel’s Emotional Body
The descriptions found throughout Old English literature of the body as a container – bancofa, ferðloca, sawelhord – not only interact with ideas about sickness and health but also contribute to ideas about the feeling, thinking self. These links between illness and emotion, health and self-restraint, further illuminate the ways the early medieval English conceived of their bodies. Pre-Conquest, vernacular descriptions of the relationship between mind, body, and soul evince a coherent and specific understanding of how the mind-in-the-body works – distinct from contemporary Platonist-Christian ideas of mind-body dualism.Footnote 248 Old English poetry and prose see the mind and heart as one corporeal entity, residing in the chest cavity. The mod, hyge, sefa, or ferð encompasses consciousness, rational thought, will, desire, agency, memory, and emotion. It is distinct from the sawol, the entirely non-corporeal part of the self that persists after death and attains heaven but participates very little in conscious life. Strong emotion or exertion of the will happens in the mod, and causes heat to rise around the heart and inside the chest (a concept referred to as the ‘hydraulic’ or ‘cardiocentric’ model of emotionality). Because the mind is part of the body, the heat of emotion causes physical symptoms, including swelling, chest pressure, feelings of boiling and surging within the body, and occasionally leakage like sweat, tears, or sound. The mod and its internal seething must be appropriately constrained by the individual: boiling emotions must often be kept inside the body-container and sealed off unexpressed. This restraint is gendered – numerous Old English texts treat it as an element of aristocratic Christian masculinity – and related to a model of the masculine body as one that penetrates and is not penetrated, a body that is (ideally) closed rather than open.Footnote 249 The hydraulic model of the body thus interacts with the invasive model of illness on multiple levels. When sickness is treated as a martial defeat or sexual assault, then the experience of disease becomes – like the boiling over of emotion – a threat to the maintenance of a hegemonic masculine body. Sickness and emotion also act upon the body itself in similar ways. Illness breaks into the body from without, and (as in the case of Guthlac) can then cause surges of heat within the flesh. Emotion, too, causes heat to surge up in the body and push on its bounds from the other direction, leading to distension and leakage.
Guthlac B draws attention to precisely this correspondence. Guthlac does not experience surging or boiling within his mod, only a burning eagerness to enter heaven. The heat of illness seethes within his flesh, where it has inappropriately entered, but he fortifies his mind-heart against both intrusion and the inner threat that hot emotional turmoil poses to the bounds of his embodied self. Guthlac’s servant, however – named as the monk Beccel in Felix, unnamed in Guthlac B, perhaps to render him a symbol of human grief or an allegory for the body bereft of the soul – is unable to restrain his mind-heart within his breast as his master’s death approaches.Footnote 250 Beccel feels modceare (mind-sorrow) and is repeatedly described as grieving in his sefa and sad or mourning in his hyge. His emotion causes heat to rise in him: his sorrow is ‘hatost on hreþre’ (hottest in the breast, l. 1020) and he is repeatedly described as ‘hat æt heortan’ (hot at heart, ll. 1209, 1336). That heat also results in burning bodily leakage: ‘he hate let / torn þoliende tearas geotan, / weallan wægdropan’ (suffering grief, he let hot tears pour out, the drops of water surge, ll. 1055–7). Beccel’s emotions are explicitly likened to the illness his master suffers, both in that he burns with emotion while Guthlac burns with disease, and in that Guthlac himself describes Beccel’s boiling grief as a sickness. ‘Ne beo þu on sefan to seoc’ (do not be sick in heart, l. 1077), Guthlac commands his servant, and insists that ‘nelle ic lætan þe / æfre unrotne æfter ealdorlege / meðne modseocne minre geweorðan, / soden sorgwælmum’ (I will not let you ever become sad after my death, weary and sick in mod, boiled in surges of sorrow, ll. 1259–62). Guthlac’s maintenance of his mind as an inviolate part of his corporeal body thus not only counteracts the penetration to which his flesh is subject but also contrasts with his servant’s human weakness and the physical vulnerability caused by his lack of emotional control. Guthlac performs an idealised version of a spiritual masculinity, meeting enemies in battle and proving the impenetrability of his mind and self. Beccel is wise and able to learn from Guthlac’s fortitude, but it is precisely his lack of such fortitude that draws the audience’s attention to the impenetrability of the ideal, saintly body and the way in which the assault of illness provides a dramatic poetic foil to the rigorous self-control that is its opposite and spiritual antidote.
The Guthlac materials collectively illustrate the explanatory power of the medical and literary concept of the assailable container-body. Depictions of invasive illness in Felix’s Anglo-Latin prose suggest the cultural currency of these ideas about sickness and the embodied self, and gesture towards their universal appeal and the points of contact they share with other intellectual traditions. The profound intensification of, and increased focus on, these themes in the vernacular texts – and in poetry specifically – shows the fascination and prominence of these ideas and anxieties about the body in the early medieval English literary and intellectual imagination. Other texts – ranging from the Lives of Swithun, Margaret, and Cuthbert to Beowulf – could benefit from such an approach. Guthlac B, in particular, points scholars towards productive new readings of the interactions between illness, gender, and emotion that are inherent to the understanding of the body as a sealed container, vulnerable to intrusion from without and disruption from within.
Conclusion
To ask what it means to be sick and healthy – what it means to have a body that can get sick and be restored to health – is to interrogate some of the most fundamental concepts available to a given culture in a given time period. How does a body function ideally, and how does it function in lived experience? Is the body meant to be a site of interchange with others and with the environment, or is it meant to be rigorously individuated and self-contained? What do hegemonic bodies look, act, and feel like? What are the boundaries between self and other, and how are they maintained? What is the place of humanity in the (super)natural world? How do we define and distinguish inside and outside, human and non-human, order and chaos, whole and fragment? Any literary-historical study that begins with pre-Conquest medical practice and the Old English medical corpus must grapple with themes and anxieties that undergird the entirety of the surviving Old English textual record.
The ideas of sickness, health, and bodies that we find in Old English medical texts – and which appear across the early medieval English literary corpus – are rooted in a prioritisation of the individuated and contained ‘embodied self’. Power and safety are treated as equivalent to autonomy over the bounds of one’s flesh and the avoidance of both intrusion and obtrusion. The actual, physical body is necessarily a site of mutual exchange with the surrounding world, and that porousness of the flesh becomes a potential source of suffering, powerlessness, and shame. Power is derived from the protection of one’s mind-body complex from outside influence and penetration, the expulsion of any force that attempts to intrude, disciplined transcendence of the flesh, and the use of experiences of bodily abjection as a spiritual trial to propel the incorporeal element of the self to Christian union with God. The body is almost never treated as fundamentally dysfunctional or evil, but it is a liability, and its lack of wholeness is evidence of humanity’s estrangement from the divine. The Old English corpus is marked by the fear of infection, pollution, or contamination. This literature treats both the individual human body and humanity at large as being constantly assailed by external, hostile agents – whether that agent be Grendel forcing his way into the recedes muþan (mouth of the hall) to rip apart and consume Danish warriors in Beowulf, a horde of arrow-shooting demons in the Guthlac material, or a troop of screaming women armed with invisible spears that cause internal pain. The work of preserving or reestablishing bodily health is constant, because such wholeness cannot be maintained: the body ages, sickens, receives wounds, becomes impaired, experiences violent emotion, and interacts with other bodies. Old English texts use the body to express and encode dichotomies of good and bad, powerful and powerless, healthy and sick, whole and broken open. Yet all of these literary and medicalised bodies are necessarily fragile, permeable, chaotic, and forever changing – they disrupt easy dichotomies. Is Guthlac injured by demons, or is he physically and mentally impenetrable? Are the impaired persons who make their way to St Swithun’s tomb exercising their agency or seeking to remedy a fundamental lack of power? Will the sick body, in fact, ‘soon be whole’? Early medieval English texts across the surviving corpus treat the body as a perpetual, ever-shifting battleground in a cosmic struggle between Christian humanity and forces inimical to God and mankind, a site of vulnerability and a vehicle for salvation.
Megan Cavell
University of Birmingham
Megan Cavell is Associate Professor in Medieval English Literature at the University of Birmingham. She works on a wide range of topics in medieval literary studies, from Old and early Middle English and Latin languages and literature to riddling, gender and animal studies. Her previous publications include Weaving Words and Binding Bodies: The Poetics of Human Experience in Old English Literature (2016), Riddles at Work in the Early Medieval Tradition: Words, Ideas, Interactions (co-edited with Jennifer Neville, 2020), and The Medieval Bestiary in England: Texts and Translations of the Old and Middle English Physiologus (2022).
Rory Naismith
University of Cambridge
Rory Naismith is Professor of Early Medieval English History in the Department of Anglo-Saxon, Norse and Celtic at the University of Cambridge, and a Fellow of Corpus Christi College, Cambridge. Also a Fellow of the Royal Historical Society, he is the author of Early Medieval Britain 500–1000 (Cambridge University Press, 2021), Citadel of the Saxons: The Rise of Early London (2018), Medieval European Coinage, with a Catalogue of the Coins in the Fitzwilliam Museum, Cambridge, 8: Britain and Ireland c. 400–1066 (Cambridge University Press, 2017) and Money and Power in Anglo-Saxon England: The Southern English Kingdoms 757–865 (Cambridge University Press, 2012, which won the 2013 International Society of Anglo-Saxonists First Book Prize).
Winfried Rudolf
University of Göttingen
Winfried Rudolf is Chair of Medieval English Language and Literature in the University of Göttingen (Germany). Recent publications include Childhood and Adolescence in Anglo-Saxon Literary Culture (with Susan E. Irvine, 2018). He has published widely on homiletic literature in early England and is currently principal investigator of the ERC-Project ECHOE–Electronic Corpus of Anonymous Homilies in Old English.
Emily V. Thornbury
Yale University
Emily V. Thornbury is Associate Professor of English at Yale University. She studies the literature and art of early England, with a particular emphasis on English and Latin poetry. Her publications include Becoming a Poet in Anglo-Saxon England (Cambridge, 2014), and, co-edited with Rebecca Stephenson, Latinity and Identity in Anglo-Saxon Literature (2016). She is currently working on a monograph called The Virtue of Ornament, about pre-Conquest theories of aesthetic value.
About the Series
Elements in England in the Early Medieval World takes an innovative, interdisciplinary view of the culture, history, literature, archaeology and legacy of England between the fifth and eleventh centuries. Individual contributions question and situate key themes, and thereby bring new perspectives to the heritage of early medieval England. They draw on texts in Latin and Old English as well as material culture to paint a vivid picture of the period. Relevant not only to students and scholars working in medieval studies, these volumes explore the rich intellectual, methodological and comparative value that the dynamic researchers interested in England between the fifth and eleventh centuries have to offer in a modern, global context. The series is driven by a commitment to inclusive and critical scholarship, and to the view that early medieval studies have a part to play in many fields of academic research, as well as constituting a vibrant and self-contained area of research in its own right.
