91.In compiling these medical materials, I have greatly benefited from Manual of the Writings in Middle English, library catalogues from the Wellcome Library and the British Library, and the electronic database edited by L. E. Voigts and P. D. Kurtz, Scientific and Medical Writings in Old and Middle English: an Electronic Reference (Ann Arbor: University of Michigan Press, 2000). George R. Keiser, Works of Science and Education. Vol. 10 in A Manual of the Writings in Middle English, 1050–1500, ed. Albert E. Hartung. (New Haven: Yale University Press, 1998).
92.Richard Newhauser, “Introduction,” in In the Garden of Evil, ed. Newhauser, pp. vii–xix (p. vii); Henry of Suso, Wisdom’s Watch Upon the Hours, trans. Edmund Colledge (Washington, D.C: Catholic University of America Press, 1994), p. 258. Luckily Richard Newhauser, along with Morton Bloomfield and others, have done so and generously surveyed them. See Morton Bloomfield et al., Incipits of Latin Works on the Virtues and Vices, 1100–1500 A.D. (Cambridge, Mass.: Mediaeval Academy of America, 1979); Newhauser, The Treatise on Vices and Virtues; and Richard Newhauser and Istvan Bejczy, A Supplement to Morton W. Bloomfield et al. Incipits of Latin Works on the Virtues and Vices, 1100–1500 A.D. (Turnhout: Brepols, 2008).
93.Due to the scope of the material, I rely on what has been edited with a few exceptional gems, often found with the help of resources such as Repertorium of Middle English Prose Sermons. Veronica O’Mara and Suzanne Park, eds., Repertorium of Middle English Prose Sermons. 4 vols. (Turnhout: Brepols, 2007).
94.For a discussion of theories of allegory and personification, see Helen Cooper, “Gender and Personification in Piers Plowman,” Yearbook of Langland Studies 5 (1991): 31–48.
95.John Gower, Confessio Amantis, ed. Russel A. Peck TEAMS Middle English Texts Series. 3 Vols. (Kalamazoo: Medieval Institute Publications, 2006) Vol. 1, Book 1, lines 131.
96.Gower, Confessio Amantis, Vol. 1, Book 1, lines 133, 185.
97.Ibid., line 197.
98.See Virginia Langum, “Medicine, Passion, and Sin in Gower,” SPELL: Swiss Papers in English Language and Literature 28 (2013): 117–30.
99.On the history and practice of ordering the sins, see Lester K. Little, “Pride Goes Before Avarice: Social Change and the Vices in Latin Christendom,” The American Historical Review 76.1 (1971): 16–49; Bloomfield, The Seven Deadly Sins, pp. 72–3.
100.See, for example, Stephen Greenblatt, The Swerve: How the World Became Modern (New York: W. W. Norton & Company, 2012). A notable counter-argument is provided in James Hannam, God’s Philosophers: How the Medieval World Laid the Foundations of Modern Science (London: Icon Books, 2009).
© The Author(s) 2016
Virginia LangumMedicine and the Seven Deadly Sins in Late Medieval Literature and CultureThe New Middle Ages10.1057/978-1-137-44990-0_2
2. Medicine, Sin, and Language
Virginia Langum1
(1)Umeå University, Umeå, Sweden
The body and its health are pliable images in Christian theology. 1 In addition to positive references to physical health in the Old Testament, Christ performs many acts of healing in the New Testament. He heals leprosy, blood disease, paralysis, blindness, deafness, fever, physical deformity, dropsy, and so on. Yet in Luke 5:31–2, Jesus describes himself as healing spiritual sickness. 2 “They that are whole [sani] need not the physician [medico]: but they that are sick. I came not to call the just, but the sinners to penance.” This explanation opens up the stories of physical healing in the New Testament to spiritual interpretation. When medieval sermons and other theological writings narrate the biblical stories of Christ as healer, the diseases and conditions that He heals often represent sins. Medical theories of contraries—that which is cold heals that which is hot, that which is moist heals that which is dry—allowed the easy transfer of the biblical theme to works on the vices and virtues. From an early date, contrary virtues were considered to heal vices. 3
Later pastoral writers also forged Christus medicus into an effective confessional image. 4 In confession, the penitent displays the wounds of sin, and the priest diagnoses an appropriate penance and cures by absolution. Penance is medicine that heals the sinner, and pastoral materials preserve countless examples of Christus medicus. The fourteenth-century Lay Folks Mass Book, for example, describes Christ as a trustworthy doctor and advises penitents to prepare for Eucharist, the ultimate goal of confession, which they will receive as the sick person who receives medicine. Biblical images of Christ’s healing also found their way into the liturgy; for example, in the eleventh-century Sarum Rite, which was used widely in the British Isles until the Reformation. 5 Although conventional in theological and pastoral texts spanning well over a millennium, Christus medicus varies in its medical specificity and develops to enfold emerging and expanding medical practices, such as surgery. 6
Through this image and its extensions, medieval texts medicalize the seven deadly sins in a variety of ways, and this chapter proposes and examines three models: medicine as metaphorical, as metonymic, and as material. As metaphor, medicine and the sins have an analogical relationship. In this first section, I consider medieval and some modern theories of metaphor, specifically examining how metaphor makes meaning, the significance of metaphor in medieval culture, and, by implication, the meaning and significance of medicine as metaphor in medieval culture. As metonyms, medicine and the sins have a proximate relationship. Here, I focus on the passions, whereby the body relates to sin by proximity. The physical experience of the passions can influence or move the will, and the will is the proximate cause of virtuous or vicious action, according to thinkers such as Aquinas. In material terms, sins function as both the material causes and effects of bodily diseases. However, it is worth remembering that these metaphorical, metonymical, and material operations of medicine are highly contiguous. Finally, in this chapter, I consider the use of confessional and penitential imagery—the language of sin—in medical contexts, in which medicine is not metaphor but rather metaphor is medicine.
Medicine as Metaphor
Before thinking about how medicine might function as a metaphor, we need to define our terms somewhat. What do we mean by metaphor? How did medieval readers and listeners understand metaphor? What kind of responsibility did medieval texts and thinkers confer on metaphor for shaping ideas and ideologies?
Metaphor existed as a term and concept in the Middle Ages, deriving from the Greek and in turn Latin metaphora, or “carrying across.” However, medieval writers often borrowed from scriptural exegesis to describe the operation of metaphor, using words such as “spiritually” and “figuratively.” The use and interpretation of figurative language is critical to exegesis, the analytical methodology and practice of interpreting the scriptures. Origen (d. 254) and Tertullian (d. 240), theologians of the early Church, debated the spiritual and historical interpretation of the Old Testament. 7 Origen read the Old Testament spiritually in terms of what is to come in the New Testament, whereas Tertullian thought that both the historical narrative and spiritual reading had value. These two methods of reading the Old Testament are useful for thinking about metaphor more generally; those in Tertullian’s camp valued the historical (or figure) and the spiritual (or fulfillment) equally, while those in Origen’s camp valued the spiritual over the historical. 8
In place of the historical and the spiritual, or figure and fulfillment, recent texts on metaphor often describe the two parts of metaphor as tenor and vehicle, or focus and frame. 9 The tenor is the primary subject of the metaphor, or the ordinary and expected concept, and the vehicle is the unexpected concept, employed to illuminate some aspect of the tenor. In the metaphor of Christ the physician used by confessional writers, for example, Christ is the tenor and the physician is the vehicle. The question of whether metaphor and its interpretation prioritize the vehicle or the tenor is unresolved in contemporary discussions of metaphor. So, too, is the nature of their relationship. Although various philosophical theories concerning metaphor have been articulated in the last few decades, I
focus on two schools of thought with reference to both the medieval and the modern: the idea of metaphor as substitution and the idea of metaphor as a cognitive experience.
In the theory of metaphor as substitution, the vehicle merely replaces the tenor. Aristotle famously defines metaphor in the Poetics as “giving the thing a name that belongs to something else.” 10 When considering a metaphor through the lens of substitution, two opposed propositions present simultaneously: first, on its face, that the vehicle is the tenor; second, that the vehicle is not the tenor, applying Ricoeur’s “critical incision of the (literal) ‘is not’ within the ontological vehemence of the (metaphorical) ‘is.’” 11 In the metaphor of leprous sin, for example, both is leprosy and is not leprosy. Metaphor as substitution or complicit comparison cannot be cognitive. Or, as Ricoeur explains, “if the metaphorical term is really a substituted term, it carries no new information, since the absent term (if one exists) can be brought in.” Rather, “if there is no information conveyed, then the metaphor has only an ornamental, decorative value.” 12
What would medieval thinkers have made of this substitution theory? The concept of an—“absolute equal sign of metaphor,” in which the vehicle simply substitutes for the tenor, does not parse with Augustinian theories of language. 13 For Augustine (d. 430), the Fall, as a fall of language as much as the body, necessitates metaphor and all figurative language. Augustine argues that in the Garden of Eden, Adam and Eve could see directly to the souls of others, obviating all misunderstanding. 14 Post-lapsarian people can no longer communicate internal thoughts and intentions without the aid of external language. Stripped of extra-linguistic, transparent communication, humans must rely on a discursive system of signs and signifiers. These material signs and signifiers, which represent “inner words,” constitute a land of unlikeness [regio dissimilitudinis]. Or as one modern commentator glosses, “the fallen material world ‘differs’ or ‘others’ the ineffable world of God as embodied in signs and words, particularly metaphor and allegory, which are forms of alieniloquium (‘other-speech’).” 15
As this invocation of Jacques Derrida demonstrates, there are clear parallels between modern semiotics and Augustinian language theory. As one recent metaphor theorist explains, metaphor deals in “unlikeness and dissimilarity” as much as it does likeness and similarity. By making us “look at the world afresh,” it challenges and interrogates our understanding of the relationship between things. “How alike they are; and in what ways, in fact, they are irreconcilably unalike …. it seeks to ‘fix’ our understanding, but at the same time it reveals how any such fixity, any such desire for stability and certainty, is constructed on shifting sands.” 16 For Augustine, post-lapsarian language is beyond “fixing.” All assertions are “figurative, displaced, and fraught with (dis)similitudes.” 17 Medieval language theory would seem to exclude the possibility of metaphor as substitution.
However, despite their inherent flaws, language and metaphor do possess a potential cognitive function, at least in the medieval view. Eloquently vivifying his argument, Gregory the Great writes that “if by drawing an example from exterior things you penetrate the interior, you fill the stomach of your mind as it were filled with the game of the field.” 18 Metaphor demands interpretation, thus engaging the mind of the listener or speaker. Arguing against the proposition that theology differs from poetry, because “poetry contains the least truth” due to its “metaphorical locutions,” Aquinas compares the apprehension of poetry with that of theology in his commentary on the Sentences of Peter Lombard:Poetic knowledge is of things which on account of a defect of truth cannot be grasped by reason and that is why reason must be seduced by certain likenesses; theology, however, concerns things which are above reason. The symbolic mode is common to them both, therefore, because neither is proportioned to reason. 19
Instead, the theologian assigns a cognitive function to poetry. When writing in Summa Theologica about the appropriate use of metaphors [metaphoris] in the scriptures, Aquinas comments that:the ray of divine revelation is not extinguished by the sensible imagery wherewith it is veiled … and its truth so far remains that it does not allow the mind of those to whom the revelation has been made, to rest in the metaphors, but raises them to the knowledge of truths. 20
Following Aquinas, then, as regards the use of medicine as vehicle, an effective metaphor should cause the listener or reader to focus on the tenor of sin.
Although most famously denounced by empiricists working much later, such as Locke and Hume, metaphor would not have needed Aquinas’ justification had similar ideas about its deceptiveness not been in circulation during his period, such as the opposition of figure [figura] and truth [veritas]. Framed as the opposite of veritas, metaphors can be sinister, deluding listeners and readers with their rhetorical flourish. As Paul de Man claims, “metaphors are much more tenacious than facts.” 21 Metaphors are politically and ideologically expedient, “naturalizing” conflicting and ambiguous social phenomena. Specifically, the use of disease as a metaphor for social ills as well as the use of other rhetorical domains to describe disease have been examined in historical and contemporary discourse. 22
To be effective, metaphors require a shared cultural context and shared beliefs. As the philosopher Max Black argues, metaphor works because of shared associations not because of the truth value of those associations. 23 Borrowing a phrase from Stanley Fish, we can say that metaphors rely on an “interpretive community.” 24 How does an understanding of the interpretive community of late medieval England help us to parse the use of medicine as metaphor? Post-lapsarian theology, particularly regarding the body and language, collapses simplistic substitutions or equivalences of the body and transgression as “bad” in the metaphor of confession as medicine. Penance is less about punishment than it is about treatment. The processes of medical and spiritual healing are deeply intertwined and demonstrated even more clearly in the next two models of medicine addressed here: medicine as metonymic and material. For example, pastoral texts liken confession to a particular kind of medicine: betony. The correct response of the sinner to his own sin should be akin to that of a hart shot by an arrow. Once shot, the hart seeks running water, washes itself, and applies the herb betony, which “as leches saye … wyll draw owte þe [iron] and hele þe wounde.” 25 When struck with the arrow of sin, the sinner should seek “þis precius erbe bethanye, that is to sey, a preste.” 26 The herb is commonly described in medieval herbal collections and learned surgical texts, such as those by Guy de Chauliac and Lanfranc of Milan. As the healing herb, penance is palliative.
Similarly, many texts feature analogies between the stages of penance and medical and surgical procedures. The homilist of a fifteenth-century sermon cycle describes how “a discrete confessore” prepares three herbs for the health of the soul. With the first, contrition, sinners “muste make a drynke” or weep for their sins. The second is confession of mouth and the third satisfaction. 27 In the next sermon in the cycle, the homilist develops this image further, drawing on “experiens we haue in bodily sekenes as it is opynly previd in fesyke” where the “fecissian” gives the sick person a certain order of medicines. 28 These include “preparatyfe” [contrition], a “purgatyfe” [confession of mouth], and a “proper sanatife” [penance and satisfaction]. 29 Building on surgical practices, the fourteenth-century English pastoral manual Jacob’s Well likens the soul’s “hard obstynacye” [hard obstinacy] to the “deed flesch” [dead flesh] of a wound. The priest or surgeon must cut the wound with a “scharp corryzie” [sharp corrosive] that represents contrition, and then cleanse it with a “drawyng salue” [extracting medicine] that represents absolution, so that the wound of the soul does not “rotyn & festyr aȝen” [rot and fester again]. 30 Although drawing on the generic Christus medicus metaphor, the language of the passage is steeped in the material reality of late medieval surgery, analogizing bodily inquisition by the surgeon to the verbal inquisition of the confessor. 31
Furthermore, p
astoral and poetic texts describe the sins themselves metaphorically through the vehicle of medicine. 32 Some texts liken the symptoms of a particular disease or medical condition to the seven deadly sins. Often in reference to Christ’s healing miracles, for example, homilists correlate the sins with types of blindness or symptoms of leprosy. One homilist extrapolates from Christ’s miracle of healing a deaf and dumb man “v perlus [dangerous] thyngis” to which the sinner is disposed. 33 These traits relate to the experience of illness: ignorance of illness, “abhominacioun of remedy,” “wilfull frowardnesse [disobedience],” “corrupcion and infeccion of tho þat hurtiþe hole pepyll be þere venomose langage [corruption and infection of those who hurt healthy people with their venomous language],” and “induracion in synne [stiffening or hardening of sin].” 34 I describe diseases and symptoms most commonly correlated with each sin in later chapters.
However, this broad outline and these few examples fail to do justice to the color and sophistication with which some medieval texts negotiate medicine as metaphor. Therefore, I use the set of edited macaronic sermons from Bodley 649 to illustrate in detail one example of the varied and complex ways in which medicine serves religious writers as a metaphor. 35 In this early fifteenth-century collection, the homilist deploys medicine as metaphor in a complicated argument about literalism and the interpretation of the scriptures. Although debated since the early days of the Church, literal and metaphorical truth, particularly regarding the Bible, were increasing theological concerns in England in the later Middle Ages. 36 Several proto-Protestant movements encouraged readings of the scriptures as literal truth. 37
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