by Robert Lacey
There are modern archaeological experts who study excreta intensively, rummaging through the latrine pits of ancient settlements to discover such fundamental details as the fact that the toilet paper of the year 1000 was moss. “Coprolite” is their name for the humble turd, from “copros,” the Greek word for dung, and thanks to their familiarity with the size and shape of their dried and mineralised quarry, they have discovered that the medieval Englishman’s best friend was his dog - whose droppings have varied little in appearance in the course of a thousand years. Human stools, on the other hand, have not often survived in a similarly cohesive form, suggesting that bowels in the year 1000 were subject to significantly looser motions than they are today. Recurring gut infections and a diet with a high vegetable content are the likely reasons for this, though the presence in the latrine pits of animal bone fragments and painful-looking herring, eel, and stickleback spines suggest that our ancestors were well supplied with protein. The frequency of apple pips, plum and cherry stones also suggests that, when it came to fruit, medieval men and women did not let a morsel go to waste.
The siting of the latrine pits of the first millennium shows how imperfectly people understood the basic rules of cleanliness and health. Plans that survive from a later period show that monasteries worked out a sensible and sanitary location for their necessarium - their Latin contribution to history’s list of euphemisms for the smallest room. The monks were careful to site their latrines over running water, and to choose positions for their monasteries that gave access to drinking water that was unpolluted by that stream. Plans for the French monastery of Cluny show a guest wing with seventy beds and an adjoining latrine with seventy separate stalls. (81)
But few other people operated so fastidiously. Both in villages and towns, the latrine was sited at or near the backdoor of most houses, with no apparent concern for the odour, nor for the flies that had so little distance to travel from the refuse to the food that people ate. There was no awareness of how disease can be spread by bacteria, and people took it for granted that their bodies should provide hospitality for parasites that ranged from the relatively inoffensive whipworm to the more sinister maw-worm, which could grow as long as 30 centimetres, migrating all over the body, including the lungs and the liver. The maw-worm could emerge unexpectedly from any orifice, including, most alarmingly, the corners of people’s eyes.
The flea was a parasite towards which people were less tolerant, since it nipped its host quite nastily, and remedies for dealing with the nuisance were much canvassed. One late medieval survey ran the gamut of options, from locking flea-ridden garments inside an airtight chest, to laying down sheepskins around a flea-infested bed so that when the insects jumped out, they would show up black against the white background. (82) At this point, presumably, the medieval flea hunter leaped forward with a cudgel, heavy cloth, or the equivalent of a rolled-up newspaper, to beat the insects to death.
The modern remedy for fleas and grubbiness - a good scrub of the body crevices - did not not accord with the medieval mentality The regulations of one tenth-century European monastery prescribed five baths for every monk per year, but that was fanaticism by Anglo-Saxon standards of personal hygiene. One later commentator derided the Danish practice of bathing and combing the hair every Saturday, but did admit that this seemed to improve Danish chances with the womenfolk. (83) The thatched roof, rough organic walls, and beaten-earth floor of the medieval house provided a myriad of refuges for insects and bacteria. There were no modern “working surfaces” that could be washed down in an antiseptic fashion. Indeed, there was no concept of antiseptic at all. If a morsel of food fell off your plate, the advice of one contemporary document was to pick it up, make the sign of the cross over it, season it well - and then eat it. (84)
The sign of the cross was the antiseptic of the year 1000. The person who dropped his food on the floor knew that he was taking some sort of risk when he picked it up and put it in his mouth, but he trusted in his faith. Today we have faith in modern medicine, though few of us can claim much personal knowledge of how it actually works, and we also know that the ability to combat quite major illnesses can be affected by what we call “a positive state of mind” - what the Middle Ages experienced as “faith.”
The comparison may not seem exact. Hygiene is hygiene, and no amount of positive thinking can spare you the consequences of eating contaminated meat. Nor do we need to understand the technicalities of modern medicine, it could be argued, to draw the obvious lesson from the numbers of sick people who trust themselves to modern medicine and are cured. But the believer in the year 1000 could point to the Bible, which listed no less than thirty-five miracles in which Jesus defeated illness through the power of faith, and every believer knew that the saints were keeping that miraculous tradition alive. Aelfric described the tangible evidence of St. Swithin’s healing touch in Winchester as the millennium approached:”The old church was hung all round with crutches (from one end to the other, on either wall), and with the stools of cripples who had been healed there, and not even so could they put half of them up.” (85)
While people had no knowledge of modern germ theory in the year 1000, they were well aware of the contagiousness of diseases. Leprosy was a European illness in those days, and the eleventh and twelfth centuries saw a dramatic growth in the construction of charitable leper hospitals, partly to take care of the victims, but principally to confine them safely away from the rest of the population. History records how the Roman church at one stage became suspicious of human dissection and sought to ban anatomy lessons, but that was a later development. In the year 1000, the internal workings of the body had been explored and were understood as thoroughly as people knew that the world was not flat. A much-copied ninth-century manuscript, now in the Royal Library of Brussels, shows thirteen anatomical drawings illustrating the positions that the foetus could adopt in the womb. (86) These must have been based on practical, obstetrical observation, as surely as this description of foetal development from an eleventh-century Anglo-Saxon document in the library at Canterbury: “In the sixth week the brain is covered with a membrane on the outside; in the second month the veins are formed . . . and the blood then flows into the feet and into the hands, and he is then articulated in limbs and altogether developed; in the third month he is man, except for the soul” (87) - which meant, presumably, that abortion could carry no ethical connotations before the fourth month.
Cemetery excavations in several corners of England have to date revealed thirteen Anglo-Saxon skulls that have been pierced with neatly drilled holes, and nine of these show evidence of subsequent bone healing, which removes the possibility that this trepanning was part of some sinister sacrificial or posthumous ritual. Today trepanning is carried out as a surgical treatment after head injuries. Drilling through the skull can relieve the pressure created by a bruised and swollen brain, and this may have been the reason why these thirteen Anglo-Saxons underwent this dramatic but comparatively safe therapy. The modern doctor deploys the surgical equivalent of a Black Decker power drill to pierce the skull, and in the year 1000 the trepanner had at his disposal the semi-mechanical bow drill that was used by the carpenters and masons of the time. Known to the Romans, the bow drill had a sharp metal bit that was turned alternately to and fro by a strap wrapped around a wooden handle, on the same principle as the overhead pole lathe - so we can assume that, even in the absence of anaesthetic, the trepanned Anglo-Saxon experienced comparatively little discomfort from the procedure.
We should not, however, take the analogy with modern medicine any further, since there is little likelihood that medieval trepanning was carried out on the basis of any physical diagnosis that we would recognise today. It was, more probably, executed as an exorcism to free the soul of what was seen as affliction by evil spirits. Devils, elves, and spirits were the other side of a medicine in which sufferers believed they could be made better through divine intervention, for if it was God who provided cures for illnes
s, it was logical to assume that the Devil had caused the trouble in the first place.
The Anglo-Saxon identified elves as the Devil’s particular lieutenants in the mortification of the body. People spoke of “elf-shot” as we today would talk of germs, explaining infection as something that had been caused by an invisible arrow or dart fired off by some malevolent sprite - and the logic of that was that an arrow should feature in the cure. If you suffered from a stitch in your side or from a particularly bad pain, one tenth-century German remedy recommended placing an arrowhead or some other piece of metal on the sore spot, and then uttering this charm:”Come out, worm, with nine little worms, out from the marrow into the bone, from the bone into the flesh, from the flesh into the skin, from the skin into this arrow.” (88) And just in case this invocation sounded pagan, the sufferer was told to add the prayer: “So be it, Lord.”
An English charm against a wen, or lump on the skin, addressed the wen as if it were a person - and as if it belonged to a clan of related lumps that extended from small bodily extrusions to the hills on the horizon. Could the awkward body lump now please pack its bags and go back home to its family in the mountains?
Wen, Wen, little Wen,
here you must not build, here have no abode
but you must go north to the nearby hill
where, poor wretch, you have a brother.
He will lay a leaf at your head.
Under the paw of the wolf, under the eagle’s wing,
under the claw of the eagle, may you ever decline!
Shrink like coal on the hearth!
Wizen like filth on the wall!
Waste away like water in the pail!
Become as small as a grain of linseed,
and far smaller than a hand-worm’s hip-bone and so very small
that you are at last nothing at all.
Anglo-Saxon charms were literally charming. Cajoling and gently humorous, they had a friendliness and empathy with nature which may have provided tenth-and eleventh-century invalids with the most healing impulse of all. Successful medicine has several components, and one can find them all set out in a tenth-century Winchester document known as “Bald’s Leechbook” - “Leechbook” meaning medicine book because of the medieval reliance on leeches for medicinal purposes, and Bald being the otherwise unknown owner of the book whose name was inscribed on the title page.
The manuscript shows that this was very much a working manual. With its practical drawings and commentaries in a later hand, it could almost be Dr. Bald’s Casebook, and its remedies were conveniently listed in descending order from the head to the toe. One cure for a headache involved binding the stalk of the herb crosswort to the head with a red bandana, while chilblains were to be treated with a mixture of eggs, wine, and fennel root. Right in the middle of the remedies, along with other ministrations to the groin area, was listed the Viagra of the year 1000 - the yellow-flowered herb agrimony. Boiled in milk, agrimony was guaranteed to excite the man who was “insufficiently virile” - and if boiled in Welsh ale, it was described as having exactly the contrary effect.
Bald’s remedy for shingles revealed the Anglo-Saxon’s connoisseurship of trees, since the potion involved bark from no less than fifteen different varieties: aspen, apple, maple, elder, willow, sallow, myrtle, wych-elm, oak, blackthorn, birch, olive, dogwood, ash-tree, and the quickbeam or mountain ash. The presence of such Mediterranean woods as olive reflected the Leechbook’s reliance on classical authorities like Pliny, and suggests that olive bark and other such exotic panaceas must have been traded in Lombardy and packed into the English saddlebags along with pepper and spices.
A number of the ingredients in the Leechbook had hallucinogenic qualities, suggesting that the potions were designed as palliatives to make the patient feel pleasantly high without any remedial effect - medieval morphine, rather like the “skin of frog” cited in Shakespeare’s famous witches’ brew in Macbeth, which has been shown to possess definitely psychedelic properties. Macbeth, the play, was, of course, written in the early 1600s, but King Macbeth himself was a real-life character, born sometime around 1000 a.d. with a wife to whom the chronicles give the name of Gruoc. Macbeth ruled Scotland from around 1040 to 1057, and spent much of his reign keeping the Vikings out of Scotland with more success than Ethelred enjoyed to the south.
Several of the Leechbook recipes would have done credit to the witches in Macbeth. Spider bite could be cured with fried and crushed black snails; lower-back pain was said to respond to the smoke of smouldering goat’s hair, while baldness could certainly be removed by applying an ointment from the ashes of burned bees. Modern research has failed to confirm that these recipes contained ingredients of any medicinal significance. But their bizarre rarity must have impressed practitioners and patients in the same way that rhinoceros horn and lamb’s foetus do the trick for some today, and the Leechbook was by no means devoid of medical understanding. It explained the operation of the liver in modern textbook style: “It casts out the impurities which are there and collects the pure blood and sends it through four arteries, chiefly to the heart.”
Bald’s prescription for dysentery showed a particularly well-balanced combination of folk remedy, religious conviction, and tender loving care - which probably constituted the most efficacious ingredient in the recipe: “Take a bramble of which both ends are in the earth, take the newer root, dig it up, and cut nine chips on your left hand, then sing three times: Miserere mei deus [Psalm 56] and nine times the Our Father. Take then mugwort and everlasting and boil these three in several kinds of milk until they become red. Let him then sup a good bowl full of it, fasting at night, sometime before he takes other food. Make him rest in a soft bed and wrap him up warm. If more is necessary, do so again; if you still need it then, do so a third time. It will not be necessary to do so more often.”
The medical theory on which the Leechbook and much Anglo-Saxon medicine was based was the ancient classical concept of the four bodily fluids - blood, phlegm, red choler or bile, and black bile - which were believed to parallel the natural elements of fire, water, air, and earth, and which combined in the body in varying proportions to create varying emotional and physical make-ups, or “humours”: “When blood predominates,” explained Bede, “it makes people joyful and glad, sociable, laughing and talking a great deal. Red cholic makes them thin, though eating much, swift, bold, wrathful, agile. Black cholic makes them serious of settled disposition, even sad. Phlegm renders them slow, sleepy, forgetful.” (89)
The shifting tide of these humours was seasonal. “Bloodletting is to be avoided for a fortnight before Lammas,” commanded the Leechbook, “and for thirty-five days afterwards, because then all poisonous things fly and injure men greatly.” At these times of year, counselled the manual, the Englishman should not go out in the midday sun, but should follow the example of the Romans and the southern races who built themselves houses with thick earthen walls that would shelter them from “the air’s heat and poisonousness.
The theory of the four humours attributed fevers and many other disorders to an excessive buildup of blood in the body, and the removal of that ”bad blood” played a major role in the medical practices of the year 1000. The application of leeches and the slicing open of veins were standard treatment for conditions that ranged from life-threatening illness to simply feeling out of sorts - and it is difficult to see the justification for this gruesome and debilitating remedy, which weakened the body beyond any perverse psychological tonic that its suffering might have inspired. Modern doctors nod benignly at some of the remedies and principles in Bald’s Leechbook, but none has a good word to say for bloodletting - nor for cautery, the other medieval method of balancing the humours.
Cautery involved the applying of red-hot iron pokers to different parts of the anatomy in an excruciatingly painful version of acupuncture. One ninth-century Italian manuscript details the points on the body to which the hot iron should be applied, and shows the physician holding up a dri
nking goblet in an apparent promise of relief from the pain. It is the earliest known European illustration of a medical procedure, and the presence of some attempt at anaesthetic is comforting. But the potion - which must have been a strong sleeping draft or its opposite, a stimulant or hallucinogen - can only have mitigated the agony. It all sounds hopelessly primitive to us, but the modern techniques by which microcameras and lasers enable surgeons to enter the body through the smallest of incisions already offer some indication of how future generations are likely to look back on the gall bladder operations and appendix scars of the twentieth century.
As one studies the array of remedies and medical treatment that was available to the sick in the year 1000, one would hardly blame the patient who foreswore human intervention and decided to let nature take its course. As Aelfric sagely put it: “He that is sick, let him pray for his health to the Lord God, and endure the pain patiently.” (91)
September: Pagans and Pannage
With a stirring toot on their hunting horn, these two Anglo-Saxon adventurers are heading into the woods in search of big game - though to judge from the herd of pigs munching tranquilly in the undergrowth, the hunters may not get much of a chase. There were some wild boar in the forests of England in the year 1000, as there were a few surviving wolves, but much more numerous were the herds of free-range pigs which roamed the woodlands. Villagers started to cull the pigs as September heralded the beginning of winter, and it is quite possible that these boar chasers with their long spears and greyhound may simply come home with the slowest and most wobbly old sow in the herd.