Siobhán Barrett
Dublin, Trinity College MS 1435, p. 260: a diagram showing the layers of the eye (Image courtesy of Irish Script on Screen).
The term ‘holistic medicine’ is used to describe an approach to health and healing that considers the wellness of the whole person and the capacity of the human body to heal itself. From a modern perspective, this philosophy is sometimes viewed as an alternative approach to conventional medicine. However, the origins of holistic medicine can be seen in Greek medical theory, where the universe was understood to be made from four basic elements: fire, water, earth and air. The human body was thought to function in the same way as the universe did, and in humans these elements were manifested in the four ‘humours’: yellow bile, phlegm, black bile and blood. A balance between the four humours preserved good health, even though one humour could dominate, causing a person’s personality to be described as ‘choleric’, ‘phlegmatic’, ‘melancholic’ or ‘sanguine’. An imbalance of humours could avoided by leading a moderate lifestyle. Hippocrates is credited with saying: ‘If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health’. The didactic poem Regimen Sanitatis Salernitanum (‘The Salernitan Rule of Health’) was very popular with educated laypeople in the twelfth century and one frequently quoted verse states that: Si tibi deficiant medici, medici tibi fiant. Haec tria: mens laeta, requies, moderata diaeta, ‘If doctors fail you, let these three be doctors for you: a joyful mind, rest, and a moderate diet’.
Dublin, King’s Inns Library MS 15, fol. 77r: the beginning of a tract on diseases (Image courtesy of Irish Script on Screen).
Many Irish medical texts bear witness to this philosophy of rebalancing the the humours to restore health. To illustrate this, I will refer to a tract on pathology in Dublin, King’s Inns Library MS 15 and specifically the chapter of this tract that deals with eye diseases (fols 96v31–97v25). The scribe of this text is Máel Eachlainn Mac an Leagha, a member of a prominent medical family, whose brother Conla was the scribe of Dublin, Royal Irish Academy MS 24 B 3 (see the Manuscript of the Month entry for February 2024). Other copies of sections of Máel Eachlainn’s tract on pathology are preserved in Dublin, Trinity College MS 1315; Dublin, National Library of Ireland MS G11; and Edinburgh, National Library of Scotland MS 2076, but this list is not exhaustive. The text in question seems to be a fusion of Irish translations of texts such as the Lilium medicinae by Bernard of Gordon, professor of medicine at the University of Montpellier; a commentary on of the ninth book of Almansor of Rhazes by Geraldus de Solo, who also taught at Montpellier; and the writings of a thirteenth-century English medical writer, Gilbertus Anglicus. It is arranged in a head-to-toe order, with a chapter dealing with each part of the body. There are also explanations of how imbalances of the humours can cause the symptoms presenting in the patient with instructions for improvements to environmental and dietary regimes. Following this, there are suggestions about how the humours might be rebalanced by purging, cupping or by bloodletting. These recommendations aim to restore the general health of the patient in the hope that the body, once restored to equilibrium, will have the power to heal itself. Remedies, poultices, salves, pills and syrups to treat specific diseases of the eyes are listed in the text following these guidelines.
Dublin, King’s Inns Library MS 15, fol. 96v: the beginning of the chapter on eye diseases (Image courtesy of Irish Script on Screen).
The section dealing with the eye begins by listing ‘the things that are harmful to the eyes above all things in the world’ and that should be avoided. These include: too much sexual intercourse; sleeping fully clothed; sleeping immediately after food, before digestion has taken place; gazing for too long at bright objects like the sun, moon or fire; sitting in places that are too dark, like prison; and reading small script. This is followed by a list of foods to be avoided: hot, gassy, indigestible foods like garlic, leek, onion, strong new wine, hard eggs, old cheese, kale, beef and similar things that cause congestion in the head and heaviness in the stomach.
The text details that eyes can be comforted by looking at the colour green or the colour of a monk’s habit, or by walking through a vineyard, or by washing in cold water.
The discussion then continues by addressing the topic of the purging of humours, which is described as being possible by bleeding the patient from the cephalic vein or from between the shoulderblades, or by applying leeches to the temples. Purgatives are also prescribed to be taken orally to dissolve the troublesome humour: for example, if the illness is caused by phlegmatic matter, as it often is according to the text, one should take three handfuls each of marjoram, sage, rue, bog myrtle and eyebright and two drachmas of saxifrage, strawberry, fennel, wild carrot and bog myrtle. These are crushed and mixed with a pound and a half of honey to make a syrup and it is drunk morning and evening.
The text goes on to describe the anatomy of the eye and the names of the many diseases that affect it. It tells us that the eye is made up of seven layers or membranes and of three humours. Some of the eye diseases that are named in this text are difficult to equate with modern medical terminology, but include ophthalmia, which is described as being an abscess of the conjunctiva of the eye; a disease called ungula (a fingernail-like growth over the eye?); ulcers of the eye; web (a web-like growth over the eye?); cloth (a cloth-like growth covering the eye?) and cataracts. Each disease is described in a Latin incipit followed by an Irish translation, like this one for opthalmia on fol. 97v25: Obtalmía est apostema coniunctive tunice oculi etcetera .i. ised is obtolmia ann neascóid te an inair renabar coniunctiua, ‘Ophthalmia is an abscess of the conjunctiva of the eye etc. Ophthalmia is a hot abscess of the membrane called conjuntiva’. The remedies for each disease are often marked in the text by the subheading: Labrum anois do leigis na hesláinti so, ‘I will now speak of remedies of this disease’ (fol. 98r6). Among the ingredients that are repeatedly listed in the eye remedies are eyebright, breast milk, rose water, and the white of an egg. Some of the ingredients, if they were used, would by necessity have been imported: gums, for example, frankincense, sarcocolla and myrrh; spices including cinnamon; and a medicinal clay called Armenian bole.
The order in which the methods of treatment are presented in this text seems to be significant and this order is repeated in those chapters which deal with the rest of the body. The priority is to restore the balance of the body so that it can cure itself, with recommendations for modifications in diet and behaviour, followed then by instructions for purging and bloodletting. Only towards the end of the chapter are medicines for local application introduced. The tract draws upon at least three Latin texts, but it is impossible to know if our scribe Máel Eachlainn Mac an Leagha was the compiler and/or translator. The textual links to the University in Montpellier may be worth exploring further. The name of another physician/translator, Tadhg Ó Cuinn, who is believed to have trained in Montpellier, is associated with at least two other manuscripts that contain sections of this tract on pathology, namely, Dublin, National Library of Ireland MS G11 and Dublin, Trinity College MS 1315. These are the sort of research questions that the LEIGHEAS project aims to address.
Further reading:
- Connelly, Erin (2016), Lylye of Medicynes: An Edition of the Fifteenth-Century Translation of Bernard of Gordon’s Lilium Medicinae. Unpublished PhD thesis, University of Nottingham.
- Getz, Faye M. (1991), Healing and Society in Medieval England: A Middle English Translation of the Pharmaceutical Writings of Gilbertus Anglicus (Madison, WI: University of Wisconsin Press)
- Rawcliffe, Carole (1995), Medicine & Society in Later Medieval England (Phoenix Mill: A. Sutton)
- Walsh, Paul (1947), ‘An Irish Medical Family ‒ Mac an Leagha’, in Irish Men of Learning. Studies by Paul Walsh, ed. by Colm Ó Lochlainn (Dublin: Three Candles), pp. 206–18