Doctors Have Always Gotten a Bad Rap

In their 2013 guide to help physicians curate their online personas, Kevin Pho, M.D., and Susan Gay tell the story of a doctor who, upon Googling herself, finds out that she shares her name with an optometrist accused of deliberately blinding patients. In the age of WebMD, Twitter, and online rankings, the challenges of managing both one’s reputation and the endless stream of misinformation permeating the web have generated new ways of talking about medicine and its practitioners. Skepticism of medical doctors, however, has been around since long before the profession was recognized as such.

The Elisha Whittelsey Collection, The Elisha Whittelsey Fund, 1959

The standardization of technical medical training in universities was a late development in the Middle Ages, in part because many academics considered the activities of wise women and barber surgeons to fall below the study of Aristotelian natural philosophy, astrology, and religious council. Even after universities across Western Europe began teaching hands-on medical procedures, they struggled to obligate patients, including aristocratic and royal patients, to rely exclusively on those with degrees. Well into the fifteenth century, it was inconceivable to mandate that English medical professionals be university-trained. This was because, first, the institutions that gave out these credentials in England, Oxford and Cambridge, were far removed from the most populated areas like London. Second, these urban communities were far too vast to be served by the handful of medical graduates.

The works of two major fourteenth-century authors demonstrate that the skepticism and ridicule with which doctors are often treated to this day existed even as the occupation of the medical professional was still being defined. In his “General Prologue” to the Canterbury Tales, for instance, Geoffrey Chaucer heavily satirizes his Physician, who knows little of the Bible, dresses extravagantly, and reaps financial rewards from the plague. A trained alchemist, he uses his claimed expertise in the scientific properties of gold to benefit from its economic value: “For gold in physic (medicine) is a cordial,/ Therefore he loved gold especially” (1.443-44). Like so many of Chaucer’s professional academics in the Canterbury Tales, the Physician abuses his qualifications in order to line his pockets.

William Langland’s B text of Piers Plowman anticipates the “General Prologue”’s criticism of the Physician. In the last passus, the personification Life seeks out a “phisik” to cure him of Old Age (B.20.169). The “Physician with a furred hood,” to whom Life gives gold “that gladdened his heart,” is similar to Chaucer’s Physician in that, in his greed, he takes advantage of Life’s illness. He plays a greater role in Langland’s allegorical theology when it becomes clear that his craft obscures the need for spiritual healing. The “glass helmet,” or placebo, that he offers Life is an ineffective diversion from the true purpose of Old Age: to direct Life toward virtue and cast out spiritual despair (B.20.172). Just as the Physician of the “General Prologue” has studied a long list of Greek, Arabic, and other medical sources, “but little of the Bible” (1.438), Langland’s “phisik” transgresses in that he displaces spiritual action with medical practice.

L0029312 Woman and doctor talking, Disease man
Credit: Wellcome Library, London. Wellcome Images
images@wellcome.ac.uk
http://wellcomeimages.org
Woman and doctor talking; text from accompanying treatise on scrolls – Woman and doctor hanging a nude woman upside down by her feet from a scaffold over a bucket for suffumigation – Disease man
Ink and Watercolour
1420? MS. 49
Wellcome Apocalypse
Published: –
Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/

Both Chaucer and Langland portray physicians who use the cachet of their expertise to exploit their patients. One of Langland’s earliest adaptors, however, demonstrates that not everyone took such a caustic view. The maker of Piers Plowman Z, takes care to specify that medical knowledge is valuable, and that at least some of its practitioners are worth consulting. In interpolated lines not present in any other version of Piers, Hunger says:

I defame not fysyk (medicine), for the science is true,
But incompetent scoundrels that cannot read a letter
Make themselves masters men for to heal.
But they are master murderers who slay men,
And no leches (doctors) but liars, Lord amend them!
In Ecclesiastes the clerk that can read
May see it there himself and then teach another:
‘Honor the doctor,’ he says, on account of the ‘need.’ (Z.7.260-267)

In this passage, the Z maker is more concerned with the intellectual hierarchy generated by medical knowledge than he is with “fysyk” itself. He criticizes those without what he deems sufficient education, he applies the logic that the misuse of medicine can be fatal in order to encourage the exclusion of the untrained, and he adds to this sense of hierarchy by immediately asserting that “the clerk that can read” should mediate the Bible for his less educated audience. This passage indicates that understanding not just of the medical material, but also of the ethical implications underpinning it, must be mediated by a professional. The Z maker’s frustration is akin to that of many of today’s physicians when their patients diagnose themselves using pharmaceutical commercials and online forums. In the case of Piers Plowman Z, this tension is amplified by the integral nature of bodily and spiritual healing in medieval culture.

Erica Machulak
PhD in English
University of Notre Dame
Founder of Hikma Strategies

References and Further Reading

Chaucer, Geoffrey. The Riverside Chaucer. Edited by Benson, L.D. and Robinson, F.N. 3rd ed. Boston, MA: Houghton Mifflin Co, 1987.

Chen, Pauline W. “Doctors and Their Online Reputation.” New York Times, March 21, 2013. https://well.blogs.nytimes.com/2013/03/21/doctors-and-their-online-reputation/.

Dumas, Geneviève, and Faith Wallis. “Theory and Practice in the Trial of Jean Domrémi, 1423–1427.” Journal of the History of Medicine and Allied Sciences 54, no. 1 (January 1, 1999): 55–87.

Fuller, Karrie. “The Craft of the ‘Z-Maker’: Reading the Z Text’s Unique Lines in Context.” Yearbook of Langland Studies 27 (2013): 15–43.

Getz, Faye. Medicine in the English Middle Ages. Princeton, NJ: Princeton University Press, 1998.

Kerby-Fulton, Kathryn. “Confronting the Scribe-Poet Binary: The Z Text, Writing Office Redaction, and the Oxford Reading Circles.” In New Directions in Medieval Manuscript Studies and Reading Practices Essays in Honor of Derek Pearsall, edited by Sarah Baechle, John J. Thompson, and Kathryn Kerby-Fulton, 489–513. Notre Dame, IN: University of Notre Dame Press, 2014.

Langland, William. Piers Plowman: The B Version: Will’s Visions of Piers Plowman, Do-Well, Do-Better and Do-Best. Edited by George Kane and E. Talbot Donaldson. London: Athlone Press, 1975.

McVaugh, Michael. Medicine before the Plague: Practitioners and Their Patients in the Crown of Aragon, 1285-1345. Cambridge History of Medicine. Cambridge, UK; New York: Cambridge University Press, 1993.

Pho, Kevin, and Susan Gay. Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices. Phoenix, MD: Greenbranch Publishing, 2013.

Rawcliffe, Carole. Medicine & Society in Later Medieval England. Stroud, England: Alan Sutton Pub., 1995.

Rawcliffe, Carole. Urban Bodies: Communal Health in Late Medieval English Towns and Cities. Woodbridge, Suffolk: The Boydell Press, 2013.

Rigg, A.G., and Brewer, Charlotte, eds. Piers Plowman: The Z Version. Studies and Texts 59. Toronto: Pontifical Institute of Mediaeval Studies, 1983.

Reading the Z-text of Piers Plowman

Answering the who, what, where, when, and why of a medieval manuscript can be like trying to solve a who-done-it without that convenient answer key supplied by the author. Imagine then, that the same who-done-it exists in fragments. Such is the case of the 14th century work Piers Plowman, composed by William Langland in several successive stages and extant in not one, not two, not three, but four versions which vary significantly in length and sometimes content: the A-, B-, C-, and Z-texts. Scholars have been debating the relation between the first three versions of the text for well over a century, and with the discovery of the Z-text in the 1980s the conversation became even more complex.  The Z- text is of greatly contested authorship and complicates our understanding of Piers Plowman as a radical, reform-minded text.

British Library, Harley MS 2376, f.1r; England, 1st half of the 15th century. Opening page to William Langland’s C-text of Piers Plowman, the final revision of this work.

The A-, B-, and C- texts (c. 1370, 1378-9, and 1386 respectively) are widely regarded as the work of a single author, William Langland, who appears as the main character Will in the text. Will falls asleep in the Malvern Hills, lulled by the sweet trickle of a nearby stream, and enters the world of Christian allegory. As the work unfolds, we can see Langland’s deep concern for the state of Christianity and the corruption which could destroy its true tenets. Many scholars view Piers Plowman as a work highly appealing to the followers of John Wyclif, an Oxford philosopher and theologian who called for Church reform, arguing against what he regarded as the worldliness of the medieval Church and notably denying the doctrine of transubstantiation as his views progressed; Wyclif also argued for lay access to vernacular scripture, condemned the papacy and the Church hierarchy (particularly monasticism), and denied the validity of the cult of the saints.  He highly esteemed evangelical poverty and criticized the Church’s failure to adhere to this ideal. In Piers Plowman, William Langland displays a great concern for the plight of poor, hard-working Christians who often suffer because of the opulence and corruption of the higher classes of aristocrats and clerics.

Trinity College, Cambridge, MS R.3.14 fol. 1v; 14th century; image of ploughing from William Langland’s Piers Plowman.  Unlike most contemporary images of peasants which portrayed their subjects as grotesque, the faces and disposition of these are pleasant and wholesome.

 Within the Z-text of Piers Plowman, found in MS Bodley 851, we can find an inscription which identifies the manuscript as the property of Brother John Wells, a Monk of Ramsey. We have a likely candidate for the identity of this John Wells, namely, an Oxford scholar and opponent of Wyclif. To add another layer of intrigue, Wells is also the satirized subject of a pro-Wycliffite macaronic verse published on a broadside in 1382 which appears to refer to Piers Plowman (see Kerby-Fulton, “Confronting the Poet-Scribe Binary,” 498-499).  What is an active opponent of Wyclif doing with a manuscript of Piers Plowman included in his personal anthology?

MS Bodleian 851, fol. 124r; England, 15th century. This image is from the sole manuscript of the Z- text.

In fact, recent scholarship has pointed to the author of the Z-text as an enthusiastic imitator of Langland rather than Langland himself. Significantly, the Z-text contains several passages portraying very orthodox views on the sacraments which are less prominent in other versions of Piers Plowman. For example, in a very orthodox move, the Z-text uniquely contains these lines highlighting the importance of the mass and the Eucharist:

[God’s word] maketh the messe ant the masse that men vnderfongeth / For Godus body ant ys blod, buyrnes to saue
(Passus Quintus, ll.37-38).

Lines such as these may point to the creator of the Z-text as one who greatly admired Langland’s work, but who sought to add moments into the text which reinforce the orthodox view of the centrality of sacraments in the medieval church.   Analyzing moments such as these may bring us closer in solving this medieval who-done-it, and I hope to explore this issue in future work.

Maj-Britt Frenze
PhD Candidate
Medieval Institute
University of Notre Dame

Works for Further Reading:

Fuller, Karrie. “The Craft Of The ‘Z-Maker’: Reading The Z Text’s Unique Lines In Context.”    The Yearbook of Langland Studies 27 (2013): 15–43.

Kerby-Fulton, Kathryn. “Confronting the Scribe-Poet Binary: The Z Text, Writing Office     Redaction, and the Oxford Reading Circles.” In New Directions in Medieval Manuscript Studies and Reading Practices: Essays in Honor of Derek Pearsall, edited by Kathryn Kerby-Fulton, John J. Thompson, and Sarah Baechle, 489–515. Notre Dame: University of Notre Dame Press, 2014.

Kerby-Fulton, Kathryn. “Piers Plowman.” In The Cambridge History of Medieval English Literature, edited by David Wallace. Cambridge ; New York: Cambridge University Press, 1999.

Rigg, A.G. and Charlottes Brewer, Ed. Piers Plowman: The Z Version. Toronto: PIMS, 1983.

 

 

Sounds of Medieval London

If you and I were to go for a stroll through the streets of London—let’s say, one summer afternoon in 1392—what kinds of sounds would we hear?

City of London with Tower Bridge and Tower of London, Royal 16 F II, f. 73r; poems by Charles, due of Orléans, Bruges, third quarter of the 15th century, courtesy of the British Library

According to William Langland’s late fourteenth-century poem Piers Plowman, we might hear a cacophony of street cries including the shouts of cooks and tavern-keepers: “Hote pyes, hote! / Goode gees and grys! Ga we dyne, ga we!” (Prol. 228-35). (Incidentally, London’s street cries have been featured in musical compositions from Renaissance madrigals to twentieth-century composer Luciano Berio’s “Cries of London.”) But if we happened to be in London at just the right moment, we might hear something remarkable—the arresting sounds of a procession.

Religious procession at Saragossa, Royal 16 G VI, f. 32v, Chroniques de France ou de St Denis, Paris, after c. 1332 and before c. 1350, courtesy of the British Library

A procession–broadly defined as a group of individuals moving along a specific route to a certain destination–would capture our attention in numerous ways. As Kathleen Ashley has written, processions offered a “fusion of sensory experiences, or synaesthesia” (13). Indeed, they were both visually compelling, featuring canopies, torches, reliquaries, crosses, and flowers, and also aurally compelling, with singing voices, ringing bells, and the sounds of lutes, drums, and cymbals.

London would have seen many different kinds of processions—all of them with distinctive sounds. There would be royal processions creating an atmosphere of splendor and pomp.

Queen Isabel entering Paris; Harley 4379, f. 3r; Jean Froissart’s Chroniques; Bruges, between c. 1470 and 1472, courtesy of the British Library

Often (as in the image below) musicians would accompany these regal processions, and sometimes dancers would also perform.

King in a cart escorted by mounted musicians, Harley 4372, f. 79v, Valerius Maximus’s Les Fais et les Dis des Romains et de autres gens, trans. by Simon de Hesdin and Nicolas de Gonesse, Normandy, c. 1460-1487, courtesy of the British Library

Religious processions would also pass through the streets, celebrating various holy days (e.g., Christmas, Easter, and Corpus Christi). These often featured ringing bells and chanting voices, and such sounds were thought to ward off demons and elicit divine grace.

Corpus Christi Procession with a Bishop carrying the monstrance under a canopy, Harley 7026, f. 13r, Lectionary, England, c. 1400-1410, courtesy of the British Library

Of course there were funeral processions, where corpses were carried through the streets as mourners wailed and bells tolled–undoubtedly an almost constant sound during the time of the plague. As the popular medieval philosopher Boethius wrote, “The cause for weeping might be made sweeter through song” (8).

Funeral procession of Queen Jeanne, Royal 20 C VII, f. 200r, Chroniques de France ou de St Denis, Paris, last quarter of 14th century, courtesy of the British Library

Like Langland, Chaucer infuses his writing with the sounds he experienced in London, and in the Prioress’s Tale, he specifically incorporates the sounds of processions.

In the beginning of the story, the clergeon sings the antiphon Alma redemptoris mater as he walks to school and back home: “Ful murily than wolde he synge and crie” (553). It is a kind of solo procession.

[iframe width=”560″ height=”315″ src=”https://www.youtube.com/embed/kIXNIZxXwoI” frameborder=”0″ allowfullscreen]
Later, we find a foreshadowing of the clergeon joining a heavenly procession of virgin martyrs where he will follow “The white Lamb celestial” and “synge a song al newe” (581, 584).

Towards the end, the clergeon’s body is carried through the streets to the abbey “with honour of greet processioun” (623). Miraculously, he continues to sing the Alma, serving as the musician at his own funeral.

It seems fitting that such a series of processions should take center stage in the Prioress’s Tale since the Prioress herself would have come from a nunnery where processions formed a significant part of life. In fact, we have medieval documents (e.g., the Barking Ordinal) that provide instructions for nunnery processions. As the image below suggests, these processions would have been aurally compelling. Notice the one nun pulling the bell rope and the others singing from books with musical notation.

Illustration of a Procession and (above) Mass in a Nunnery, Yates Thompson 11, f. 6v, “Traité de la Sainte Abbaye,” France, c. 1290, courtesy of the British Library

We can add a new dimension to our understanding of life in the Middle Ages by reconstructing some of the sounds of the streets of medieval London. Such sounds have not altogether died away. In closing, here is a performance from the 2015 Mummer’s Parade in Philadelphia — a parade with roots reportedly dating back to the Early Modern period.

[iframe width=”560″ height=”315″ src=”https://www.youtube.com/embed/n0w0MiATTF8″ frameborder=”0″ allowfullscreen]
Ingrid Pierce
PhD Candidate
Department of English
Purdue University

Sources

Ashley, Kathleen and Wim Hüsken. Moving Subjects: Processional Performance in the Middle Ages and the Renaissance. Amsterdam, Atlanta: Rodopi, 2001.

Chaucer, Geoffrey. The Wadsworth Chaucer, formerly The Riverside Chaucer. 3rd ed.
Ed. Larry D. Benson. Boston: Wadsworth, 1987.

Langland, William. Piers Plowman: A New Annotated Edition of the C-text. Edited by
Derek Pearsall. Liverpool: Liverpool University Press, 2008.

Reynolds, Roger. “The Drama of Medieval Liturgical Processions.” Revue de Musicologie   86.1 (200): 127-42.

Yardley, Anne Bagnall. Performing Piety: Musical Culture in Medieval
English 
Nunneries. New York: Palgrave, 2006.