‘Well, until we know what happened to your parents we are in the dark and won’t make any progress there. What we will do is the following . . . Besides,’ he interrupted his own train of thought, ‘you are a free person. You can do what you want and you do not have to follow my advice if you don’t think it wise. Let us make a rule in this house between the two of us: each may say what he or she wants and also criticise the other in whatever regard without fear of any repercussions. But on one condition: everything that is said will remain between us. Nothing gets out. Otherwise, we will quickly be considered heretics. That I am Jewish is problematical enough. Do you agree?’
‘Yes, I do,’ Anna replied firmly.
Aaron continued: ‘We have an agreement between us regarding your education. Nothing has changed in this and nothing will change, because I am deeply indebted to you and I always repay my debts.’
‘I have gladly accepted your offer to live with you and assist you in your work. I very much want to be your pupil, not because I have no other choice but because I could not learn as much from anybody else in the world,’ Anna replied.
Aaron smiled and patted Anna on the shoulder.
‘I think we have flattered each other sufficiently. Now let’s face the facts. Unfortunately, outside this house, you will have to pretend to be my long-lost relative who has suddenly reappeared, otherwise people will gossip. It might be best if we invent a credible story of your origins right now.’
He noticed that Anna did not seem to relish this idea, especially now that she did not have to play a role any longer. But then, with a shrug of her shoulders, she accepted it.
‘I will refer to you as my niece. We will say that you have come from far away and that should discourage curious questions. How about Nuremberg? Anna from Nuremberg – it sounds well, doesn’t it?’
‘Nuremberg – why not,’ Anna replied unenthusiastically.
Aaron ignored the girl’s ungracious consent. As an experienced teacher he simply continued. ‘Fine, so that’s settled. Whenever there is time for it I will teach you what I know and what I have learned myself over many years of work. I assume that the teaching you received at the monastery was based on the theory of the four humours? What do you know about it?’
Anna began enthusiastically: ‘There are four humours flowing in the human body: blood, phlegm, yellow bile and black bile. It is the balance of these humours which regulates the human body. If the balance is disturbed and one of the humours dominates, the person falls ill. In addition, there are external influences such as heat and cold, moisture and dryness, the influence of the stars and their constellations as well as temperament and state of mind.’
She wanted to continue but Aaron raised his hand. ‘Stop, stop, that’s enough.’
He was mildly amused by Anna’s holy fervour but tried not to show it. ‘Very nice,’ he said, ‘and now you can forget the theory of the four humours. Delete it from your memory. For it is fundamentally wrong and only helps to worsen the state of a sick person instead of improving it.’
Anna stared at him dumbfounded.
‘Your reaction is understandable and I expected it,’ Aaron said cheerfully. He obviously enjoyed alienating his pupil with his heretical theories. At last he had somebody with reasonable expertise with whom he could argue.
He continued to talk enthusiastically. ‘I know that this opinion is considered heretical and that it violates the accepted canon taught for centuries. But you know, I don’t mind. On the contrary it spurs me on to do better. Here, we have to clarify something fundamental. I have nothing against conventional ideas just because they are represented by the Christian Church. I have something against them because they are contradicted by my experience as a medicus and because they are mostly harmful. Medicine as taught in monasteries, which deals with the healing power of herbs and plants, offers much that is beneficial and correct. But I just fail to understand how it could be appropriate and useful to bleed somebody who is already physically weak. That is only one example of a procedure which to my mind makes no sense. Every illness has its own causes and takes its own course – and here we are not talking about external wounds and injuries or fractures. But when somebody complains of abdominal pain it can be for a hundred different reasons, from simple constipation or overindulgence to a woman’s monthly complaints or even an internal haemorrhage. Consequently it does not seem to make any sense always to use the same method of treatment. Am I boring you?’ he interrupted himself even though he had noticed how attentively Anna had listened to him.
‘No!’ she said, ‘on the contrary. What you are saying makes sense to me. But why did my infirmarius never say anything like this to me? He certainly was a good medicus and he did whatever he could. And I do not know anybody who knows more about the healing power of plants.’
‘That I do not mean to call into question,’ Aaron said. ‘Nor do I wish to criticise him; it is not my place. But treatments and healing methods that are shaped by religion and astrology or, worse, by superstition and witchcraft do harm the patient. That at least is my experience.’
‘Father Urban was certainly not a dogged advocate of church teaching when it came to the treatment of the sick, but he would have thought such a statement blasphemous.’
Aaron nodded understandingly and lifted a finger: ‘Let’s talk about history and the teachings of the ancients. I own some copies of Greek and Roman books, also of books from the Orient which were compiled more than 100 years ago. They all deal with processes in the human body and the treatment of diseases. The Egyptians, Greeks, Romans and Moors all had great knowledge, which over the centuries was largely lost and forgotten. We must regain this knowledge through the study of old manuscripts and try to develop it further. Not everything that they did in their time was correct, but in many respects they were more successful than we are today. Consider for example how you treated open wounds in the monastery. Did you ever clean the instruments before removing an ulcer?’
‘No, we did not. Father Urban dipped them in turpentine oil or rose water. An open wound we treated with flour or butter or honey.’
‘It stops the bleeding but from time to time the wound will still get inflamed and leave a big scar.’
Aaron touched the suture on his head again which was healing well. He beckoned Anna to come close.
‘Come here, I want to show you something.’
He went ahead to the laboratory where a man-sized cauldron with tubes and pipes of various dimensions was simmering away and hissing as it spouted steam through a few leaks. There was a pungent smell of wine. Aaron pointed proudly to the metal construction. ‘See this,’ he said, ‘this is a distillation unit. One might think it was out of a witch’s or an alchemist’s kitchen and, confidentially, the apparatus is indeed out of the kitchen of an alchemist. I bought it from one claiming to be a gold-maker in Cologne.’
Aaron giggled conspiratorially and opened a small tap which was boiling hot. He recoiled and blew onto his hand to ease the burn. Then he turned back to the apparatus where a clear liquid was dripping from the tap into a container.
‘I heat the wine, and through evaporation I get a colourless liquid. This process I repeat several times according to the formula of Taddeo Alderotti, who is a friend of mine from Florence and who first showed me this apparatus.’ Aaron leaned over the container. ‘Here, smell this . . .’
He held the vessel under Anna’s nose without asking and she sniffed it cautiously. ‘It smells strongly,’ she said. ‘But not unpleasantly. It is rather aromatic and pure.’
‘You must be asking yourself what use I have for this liquid which the alchemists call aqua ardens and my friend Taddeo calls aqua vitae, water of life. Well?’
Aaron was amused by Anna’s questioning gaze.
‘So! This brings us back to our starting point. With this liquid, diluted of course, we always wash our hands – and I mean always – when dealing with open wounds or cleaning our instruments to remove an ulcer or simila
r from the body.’
He took a tome off a shelf and waved it almost triumphantly before Anna. ‘The idea came to me through this work which is almost two hundred years old. And it has paid off. If I prepare my hands and the instruments with aqua vitae before a procedure, the patient suffers much less frequently from a fever or gangrene. This is only one example. Let’s call it lesson number one.’
He put the heavy tome back on the shelf and took a deep breath.
‘We end the lesson for today and move to practical matters. But wait, there’s one other thing before I forget it, the basic rule for dealing with patients. What do you do when somebody consults you and tells you that they are sick?’
‘Well, I question him closely. About his complaints, what he has eaten or drunk, whether he has a fever.’
‘Very good. And what next?’
‘Then I think about what I might give them for relief and healing.’
‘Wrong.’
‘Wrong?’
‘Yes, the second step in a successful treatment is the precise and careful inspection of and, if need be, the palpation of the focus of the disease. Has the patient got any redness, swelling, bleeding, does he feel tender or can you feel any unnatural hardening under the skin, especially in the abdomen? But you will learn all of this. You must not be shy either to look at the focus of the ailment where the problem seems to be centred. Wherever that may be. There is nothing evil or unnatural about the human body as God has created it. It is only when you have done all of this that you are ready to think about a suitable treatment. Now we will do a tour of my patients who are most in need of our assistance. You take along that big satchel in the corner. It contains most of the essential instruments, remedies and medicines that we might need.’
Anna lifted the satchel, which looked like a large saddlebag, and had some difficulty swinging it over her shoulder as it was so heavy. Suppressing a slight smirk, Aaron headed towards the door.
At that very moment there was a knock, and Esther looked in.
‘I am sorry to disturb you. But you will have to postpone your usual round, Aaron. The news has spread quickly that you are back in the country and the first patients are already waiting outside. What could I do?’ she said, raising her hands in a gesture of helplessness. ‘One day they will break the door down!’
Aaron sighed and gestured to Anna. ‘You can put the satchel back in its corner. First we had better see what we have here.’
He walked off behind Esther, and Anna followed them through the house to the barn.
Chapter VIII
A handful of people were ensconced in front of the barn in the courtyard. There were two farmers chatting together, a very pregnant woman who was breathing heavily and being comforted by an older woman, as well as an old, hunchbacked fragile-looking man with a silver-topped cane who, to judge by his expensive clothing, must have been a wealthy merchant. He was sitting on a bale of straw looking very impatient.
All fell silent the instant that the medicus stepped out into the courtyard followed by Esther and Anna, who had pulled her hood over her short hair.
Seeing the collection of patients, Aaron took a deep breath, turned around to his new famula and said almost apologetically: ‘It may well be evening by the time we have examined everybody.’
Then he turned to those waiting and announced clearly: ‘I will look after each and every one of you and do what I can. But I can only see you one after the other. You will have to be a little patient!’
The old man with the cane pushed forward. ‘I am Albert the cloth merchant. I have been waiting for a long time. I need a remedy for my gout and I pay well, medicus,’ he said, pulling out a purse and jingling it.
Aaron looked at him thoughtfully. The pregnant woman was moaning. Pointing to her, the medicus replied, ‘Sorry, Albert, but I always treat my patients according to the severity of their illness. The young woman seems to be in terrible pain. You will be next – after her.’
The cloth merchant was indignant at not being treated as a priority and was about to leave. But when he realised that nobody took any notice, he acquiesced and sat down again on his bale of straw, muttering quiet curses.
Aaron went into the house with the pregnant woman and her companion, and Anna followed a little later.
When Anna entered the treatment room, the pregnant woman in her richly embroidered tunic already lay on the treatment table, the older woman holding her hand. They turned around to Anna who had entered without knocking.
‘This is my famula,’ Aaron said, ‘she helps me with all my patients.’ And he pointed to the wash basin where he was just washing his hands carefully.
‘Wash your hands before and after every treatment,’ he instructed Anna. ‘It is diluted aqua vitae – you are already familiar with it.’
Anna did as she was told.
Aaron asked the women: ‘Have you been to see a midwife?’
‘Yes,’ the older woman replied. ‘But she said that because my daughter keeps having these abdominal cramps and because the constellation of the stars is unfavourable she could foretell that the child would be stillborn and in the circumstances could not do anything.’ The woman began to cry and so did her daughter on the treatment table.
‘She leafed through a book with drawings of stars,’ the woman continued. ‘Then she held her hand over my daughter’s belly, closed her eyes and murmured some incantations which I did not understand. Finally she put this on my daughter’s stomach.’
She pulled something wrapped in a cloth from the pocket of her tunic and unfolded it to show the foot of a goose.
‘This goose’s foot is magical,’ the woman said. ‘The midwife told us that it had lain on a molehill during a night of the full moon to acquire its magic.’
With thumb and forefinger Aaron took the goose’s foot and showed it to Anna with a look showing his contempt for all occult objects of this kind and skilfully threw it into the leather bucket where he disposed of old bandages and refuse.
‘How much did she charge you for this piece of magic?’
‘Oh, it wasn’t cheap. Ten hellers.’
‘Ten hellers?’ Aaron exclaimed annoyed. ‘You can buy fifty hens on the market for that! Is there anything else that this . . . midwife has given you, for appropriate payment, of course?’
‘Yes, this here,’ she said handing him a small linen bag.
Aaron took the bag, opened it and smelt it.
‘She told me to put these herbs into water, boil and stir them and give the brew to my daughter to drink and it would give her relief. My daughter has taken it, but it made everything worse,’ the mother explained in a tearful voice.
Aaron handed the small linen bag to Anna. ‘What do you smell?’ he asked. Anna put the open bag to her nose and after some thought suggested nettle, savory and a touch of avens.
‘Very good,’ Aaron replied with surprise. ‘You have an extremely good sense of smell. And what can be effected with nettle, savory and avens?’
‘The sick person becomes constipated,’ Anna replied.
‘Correct. So here we have another case of quackery.’
He turned to the mother again.
‘With your permission I will examine your daughter and then we will see.’ He turned to the treatment table. ‘What is your name, lady?’ he asked the pregnant woman.
‘Ruth,’ she answered faintly.
‘And roughly when is the expected time of your delivery?’ he continued.
The mother answered for her daughter: ‘It should be in two or three weeks. But she keeps having these cramp-like pains in her abdomen. And the baby hardly moves.’
The medicus asked: ‘Does she have premature labour pains?’
‘I do not think so.’
Aaron went to the shelf and took down a strangely shaped wooden tube wide at one end and narrow at the other. Anna had never seen anything like it but he put it into her hand. The tube was one cubit long and looked like a drinking horn sawn off at the na
rrow end. The medicus began by palpating the pregnant woman’s abdomen gently on all sides.
Then he asked: ‘Where do you feel the cramps? Here, perhaps?’ His hand was close to the pubic bone.
Ruth nodded. ‘Yes, exactly there.’
Aaron held out his hand for the instrument which Anna handed to him. He discreetly pushed the pregnant woman’s tunic up a little and placed the thicker end of the tube on her abdomen, putting his ear to the other. In this manner he moved it around her entire belly before handing back the tube to Anna who returned it to the shelf.
Finally Aaron felt Ruth’s forehead and then offered her his hand. ‘I must congratulate you, Ruth. You are expecting twins. And as far as I can tell, they are moving and are healthy. Your cramps are colics of the lower abdomen, not labour pains; they can happen and they are not really dangerous. I will give you a light remedy to ease your discomfort and should you need me again, just come back or call me in time.’
With Anna’s assistance, he helped the pregnant woman up carefully.
‘Twins, did you say?’ she asked, beaming.
‘Yes,’ the medicus replied.
The mother was completely shaken and pressed her hands to her mouth in surprise. She looked at Aaron with a mixture of fear and disbelief and finally managed to ask the question which was written all over her face. ‘How do you know? Are you a clairvoyant?’
Aaron shook his head. ‘I could feel and hear them. I am not a clairvoyant, alas; if I were it would make my work as a medicus much easier.’
While the mother stared at him blankly, Aaron simply said: ‘I will now get the medicine for your daughter. Wait here.’
He beckoned to Anna and went to the adjacent laboratory where he searched in the cabinet with the many drawers. ‘What do you give to a patient with abdominal cramps?’ he asked Anna abruptly.
Anna thought briefly and replied, ‘Fennel and caraway.‘
‘Correct,’ Aaron said. ‘And I will add a little celandine to it.’
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