The Literature of Misogyny in Medieval Spain: The Arcipreste de Talavera and the Spill (Cambridge Studies in Latin American and Iberian Literature, Series Number 10) 9780521152785, 052115278X

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The Literature of Misogyny in Medieval Spain examines the medical under-

pinnings of two major misogynist works from the fifteenth-century Iberian: Alonso de Martinez’s Arcipreste de Talavera and Jacme Roig’s Spill. Michael Solomon argues that these works gained their rhetorical force by linking concerns over health and illness with men’s behavior toward women. Solomon shows how the demonization of women in medieval society was more than vaguely cultural; it was a part of the healing arts, considered vital to the well-being of men.

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Cambridge Studies in Latin America and Iberian Literature 10 The literature of misogyny in medieval Spain

CAMBRIDGE STUDIES IN LATIN AMERICAN AND IBERIAN LITERATURE General Editor ANIBAL GONZALEZ- PEREZ

Pennsylvania State University Editorial Board ROLENA ADORNO

Yale University CARLOS J. ALONSO

Emory University CLIVE GRIFFIN

Trinity College, Oxford K. DAVID JACKSON

Yale University JOHN W. KRONIK

Cornell University LucrE LOPEZ-BARALT

University of Puerto Rico SYLVIA MOLLOY

New York University Book in the Serves

11. Gerard Aching: The politics of Spanish American modernismo 10. Michael Solomon: The literature of misogyny in medieval Spain: the “Arcipreste

de Talavera” and the “Spill” 9. Kathleen Ross: The baroque narrative of Carlos de Siguenza y Gongora 8. Anibal Gonzalez: Journalism and the development of Spanish American narrative 7. René Prieto: Michael Angel Asturias’s archaeology of return 6. Antonio Cussen: Bello and Bolivar: poetry and politics in the Spanish American revolution 5. Derek Flitter: Spanish romantic literary theory and criticism 4. Sylvia Molloy: At face value: autobiographical writing in Spanish America 3. Roberto Gonzalez Echevarria: Myth and archive: a theory of Latin American narrative 2. Carlos J. Alonso: The Spanish American regional novel: modernity and authochthony 1. Gustavo Pérez Firmat: The Cuban condition: translation and identity in modern Cuban literature

The literature of misogyny in medieval Spain The Arcipreste de Talavera

, and the Spill

Michael Solomon Emory University

CAMBRIDGE i) UNIVERSITY PRESS

PUBLISHED BY THE PRESS SYNDICATE OF THE UNIVERSITY OF CAMBRIDGE

The Pitt Building, Trumpington Street, Cambridge CB2 1RP, United Kingdom CAMBRIDGE UNIVERSITY PRESS

The Edinburgh Building, Cambridge CB2 2RU, United Kingdom 40 West 20th Street, New York, NY 10011-4211, USA

10 Stamford Road, Oakleigh, Melbourne 3166, Australia © Cambridge University Press 1997

This book is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published 1997

Printed in the United States of America Typeset in Baskerville Library of Congress Cataloging-in-Publication Data

Solomon, Michael (Michael Ray) The literature of misogyny in medieval Spain : the “Arcipreste de Talavera” and the “Spill” / Michael Solomon.

p. cm. — (Cambridge studies in Latin American and Iberian Literature : 11) Includes bibliographical references (p. ) and index. ISBN 0-521-56390-9

1. Martinez de Toledo, Alfonso, 1398?—-1466. Corbacho. 2. Roig,

Jaimé, d. 1478. Spill. 3. Misogyny in literature. 4. Lovesickness in literature. 5. Diseases in literature. 6. Health in literature. I. Title. II. Series. PQ6412.M7C637 1997

868'.207-dc21 96-44935 CIP

A catalog record for this book 1s available from the British Library

ISBN 0 521 563909 hardback

Contents

Acknowledgments .. 0.0... ce ee ee eee ee eee eee VEL Introduction: The preacher and the physician ............... ] PART ONE: DISEASE AND THE MEDIEVAL CLINIC

1 Disease, discourse, and illness: ‘The structure of healing in late

medieval Spain .......... 0. cee eee eee eee eee eee ee eee 17 2 Sexual pathology and the etiology of lovesickness .......... 49 PART TWO: THE ARCIPRESTE DE TALAVERA AND THE SPILL

3 The poetics of infection .............. 0.0.0 eee ee 67 4 The poetics of the compendium and the conditions of

the clinic 2... Le ee ee eee eee eee ees = GA

5 The tortured body and the abjectified voice: Additional

therapeutic strategies .. 1... . eee eee eee ee eee eee 124 PART THREE: THE TRIUMPH OF THE CLINIC

6 Women, the power to disease, and the fictions of the

counter-clinic ... 2... . ee ee ee eee eee eee eee es LAY

Notes . 6. ccc ccc eee eee eect nett eee eeceeee 175

Works cited 2... cc ce eee eee eee eee eee LOY

Index oo. ce eee eee cece e eee ee 217 V

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Acknowledgments

The preparation of a book generates its own pathologies. The anxiety of the unfinished manuscript disrupts the routines of daily life and creates for the writer a sense of alienation, disintegration, discomfort, and even pain. As with all illness, the process of recovery requires the intervention of healers and caretakers whose role is to encourage and motivate, as well as to provide technical mediation. In this regard, I owe an enormous debt to many friends and colleagues who provided assistance along the way.

First, I am deeply grateful to Carlos Alonso for his technical expertise, suggestions, and most of all, friendship. I owe a similar debt to Brad

Epps and Emilia Navarro, who provided encouragement at various stages of the manuscript. I thank Kate Gilbert, Lisa Dilman, and the two anonymous readers from Cambridge University Press for their editorial

interventions. My thanks go to Maria Teresa Herrera and Nieves Sanchez from the Universidad de Salamanca for helping me with medical manuscripts and medieval Castilian medical lexicography. Various

friends and colleagues offered suggestions and support, particularly Jean Dangler, Karen Stolley, Hazel Gold, Miriam Moore, Emilio Medina,

Tim Jacob, Dale Seidenspinner-Nunez, Anthony Zahareas, and Catherine Mancing. I offer a word of thanks to my early mentors, Juan C. Temprano and John Nitti from the University of Wisconsin-Madison, for drawing my attention to medieval medical treatises. I offer a similar acknowledgment to Carolyn Morrow from the University of Utah, who

encouraged me in the early stages of my career to explore the more arcane aspects of Iberian literature. Finally, my deepest gratitude goes to Victoria and Ben for their unconditional love and affection.

The initial research for this book was generously funded by the Emory University Research Committee.

Vil

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Introduction The preacher and the physician

One afternoon in the early fifteenth century, Christine de Pizan, while searching the shelves of her library for some light reading, came across the Lamentations of Matheolus, a small antifeminist treatise that harshly denounced the vices of women. Although Christine claimed that the work lacked authority, that it was full of lies, and that it was of little value

in developing virtue, its very existence (and the recognition that there

were many more like it) caused her great anxiety. After skimming through the book, comparing it to similar treatises by poets and philosophers, she asked “how it happened that so many different men — and

learned men among them — have been and are so inclined to express both in speaking and in their treatises and writings so many wicked insults about women and their behavior” (Book of the City of Ladies 3-4). Her

question, which seeks to uncover the prolific roots of misogynist discourse, offers a fundamental yet often overlooked point of departure for the works of her Spanish contemporaries, Alfonso Martinez and Jacme Roig.

Martinez and Roig are well known for their relentless attacks on women. Readers familiar with Martinez’s Arcipreste de Talavera and with Roig’s Spill know that these authors represent women as envious, vain, lustful, lazy, avaricious, and anthropophagous. Using anecdotes, either

told in the first person or represented as coming from a firsthand witness, Martinez and Roig illustrate the way women badger, trick, corrupt,

mutilate, and even devour their male companions. These authors inform their male readers that women are uncontrollable, contentious, and insatiable creatures who will only lead men to physical pain, mental anguish, and spiritual misery. In general, editors and literary historians have tended to sidestep the misogynist content of these works while commending the authors for

their rhetorical and literary ingenuity. Martinez, for example, has received considerable praise for his use of colloquial language, his fluid narrative style, his concrete observations on everyday life, and his satir1

2 INTRODUCTION: PREACHER AND PHYSICIAN ical and ironic portrayals of fifteenth-century Castile.! His work has been

identified as a precursor to Cervantes and the picaresque novel, as a bridge between Juan Ruiz and Fernando de Rojas, and as a forerunner of literary realism. According to Angel del Rio, Martinez’s incorporation of learned vocabulary combined with an artistic manipulation of pop-

ular speech reflects the new literary tendencies of Renaissance Spain (246). For Michael Gerli, “Without Martinez de Toledo’s example to signal the way, the unrestrained facility of Spanish Renaissance and Baroque narrative might never have reached the heights it did” (Alfonso Martinez 37). In a similar fashion, critics have praised Jacme Roig’s Spill for its rich

vocabulary and stylized narrative. The vivid descriptive element in the work has been identified as a forerunner of the picaresque novel, one that bridges the gap between the Libro de buen amor and Lazarillo de Tormes. Critics have admired the originality of the autobiographical

frame and the way the engaging anecdotes, told in the first person, mirror the customs and traditions of fifteenth-century Spain. As of late, intense feelings of Valencian nationalism have led some critics to elevate the author to astronomical heights: “There are those men who are born predestined to conquer the zenith of glory. Such is the case of the writer that concerns us in this work, Jacme Roig, who stands out in his own light among the stars in the Valencian sky.”* Like the historian of technology who ignores the headless victim to celebrate the mechanical ingenuity of the guillotine, orthodox medievalists have generally disregarded or denied the social consequences of the misogyny in these works to celebrate the literary inventiveness of their authors. For some critics, notably Jacob Ornstein, “in early Castilian letters misogyny was but a tardy and microscopic growth,” which really didn’t take hold in Spain until the last decade of the fifteenth century with the works of Fernando de Rojas and Luis de Lucena (Introduction to Luis de Lucena’s Repeticion de amores 31). These writers, Ornstein quickly points out, were not Spaniards or Castilians, but rather converted

Jews who drew from the “triste amargura discernible en todos los escritores hispano-judios” (“La misoginia y el profeminismo” 231) [bitter

sadness discernible in all Hispano-Judaic writers]. Other writers, including Barbara Matulka and Per Nykrog, see antifeminist writing as a literary game, a social pastime, or a joke designed to do nothing more than provoke laughter; “the very topic of women’s nastier sides was apparently a standard joke in the Middle Ages, a joke enjoyed by many women, too, and — what is more — not infrequently indulged in by men who were

INTRODUCTION: PREACHER AND PHYSICIAN 3 really fond of women” (Nykrog 447). More recently Marina Scordilis Brownlee has offered a sophisticated reading of Martinez’s misogyny in which she shows that through a series of textual indeterminacies and contradictions, the author presents himself as an unreliable narrator

(“Hermeneutics of Reading in the Corbacho”). Using Augustinian hermeneutics, Brownlee suggests that Martinez undermines his own dis-

course in order to deflate his authority and to call into question the exemplary power of language. Since the interpretation of a text, according to Augustine, is ultimately a function of the reader’s moral condition or predisposition, misogyny can only reside in the reader, not in the text or in its author. By placing antifeminism in the “eye of the beholder,” Brownlee denies the textual existence of misogynist discourse; Martinez is after all not against women, but rather against language itself; in this way his text, now cleansed of nasty woman-hatred, gains a stamp of approval for modern consumption. By far the most common way of treating the misogynist discourse in the Arcipreste de Talavera and the Spill is to simply situate these works

within a long tradition of authors, including Tertullian, John of Salisbury, Walter Map, Andreas Capellanus, Jehan le Févre, Boccaccio,

Chaucer, Francesc Eiximenis, Bernat Metge, and Pere Torroella. By pointing to the tenacity of antifeminist writing, these critics hope to account for the authors’ women-bashing as part of an ongoing tradition. The unfortunate, and perhaps unwitting, effect of such a strategy is to naturalize antifeminism and render it, as Howard Bloch suggests, a cultural constant, which, like “the mace or chastity belt, participates in a

vestigial horror practically synonymous with the term medieval” (“Medieval Misogyny” 1). Dangerously, such an approach fails to seek out the specific historical and cultural conditions that encourage men to write against women. By collapsing all antifeminist writing into the transhistorical, this approach fails to ask why, in a particular historical moment, men choose to perpetuate traditional (mis)representations of women. It undermines attempts to analyze institutions and ideologies that foster misogynist discourse, and it fails to answer the most rudimentary question of all: what did Martinez and Roig hope to gain by writing treatises against women? As a partial response to these questions, I will suggest that the act of composing treatises replete with discursive fragments that speak ill of women, such as we find in the Arcipreste de Talavera and the Spill, is bound up in medical strategies for maintaining sexual well-being. It is

not my intention to ignore the literary ingenuity of these works, but

4 INTRODUCTION: PREACHER AND PHYSICIAN rather to propose that devices such as the first-person narrative voice and the rich vernacular vocabulary — those very characteristics that critics praise as literary innovations — were, in fact, necessary compo-

nents of a medical technology designed to cure men of inordinate sexual desire. Medieval theorists believed that amorous desire could cause pathological conditions in the human body. They also reasoned that this desire was partially constituted by discourse: stories, fables, arguments, and descriptions. If certain words could disrupt the body, they reasoned, then other words were needed to counter their ill effects. The ingenuity of the Arcipreste de Talavera and the Spilllies in the authors’

attempt to manipulate, control, and even strengthen those fragments of discourse that were useful in promoting good health and curing pathological desire. One of the general aims of this study is to describe the medical poetics of sexual well-being that informed Martinez and Roig as they composed their treatises. There are compelling reasons to examine the works of Martinez and Roig in the context of medical theory. In general, the fifteenth century was an age in which theories of human sexuality elaborated and transmitted among the highly educated since antiquity emerged in forms that could be grasped by a more general public. Health guides, hygienic manuals, plague treatises, herbals, and surgical handbooks were written in or translated into the vernacular with the express purpose of educating non-specialists. ‘Translations of works such as Bernard of Gordon’s

Lilium contained sections that taught basic principles of sexual wellbeing in a form unencumbered by technical jargon and theoretical speculation. Other treatises, such as the Speculum al foderi, were dedicated solely to sex-related matters of impotence, aphrodisiacs, foreplay, coital

positions, and intercourse. In fact, the author of the Speculum states explicitly that he designed the treatise to be used by many people, not just physicians (Mirror of Coitus 1). The fifteenth century was also an age

when biomedical information began to play a significant role in political affairs, as seen in the case of Henry IV, whose celebrated penis (described by the German physician Munzer in 1495) was deemed incapable of producing a legitimate heir. It was an age in which repeated outbreaks of the plague, the rise of medical licensing, and the advent of official permission to dissect cadavers encouraged extensive discussion of the human body. We can also point to the fifteenth century as the age that generated a new discursive climate of human corporeality in which noblemen wrote satirical poems describing genitalia and penned theatrical debates that pitted the penis against the vagina. In this age, even

INTRODUCTION: PREACHER AND PHYSICIAN 5

the most lofty expressions of amorous desire were never entirely removed from the physical condition of being sick with love. There are more specific reasons, however, to contextualize medically the Arcipresie de Talavera and the Spill. In the case of the Spill, its author, Jacme Roig, was an illustrious physician who practiced in and around Valencia. Born the son of a physician in the early years of the fifteenth

century, Roig was educated first in Lérida and later at the prestigious faculty of medicine in Paris. In 1435, shortly after his return to Valencia, the city council named him the official examiner of physicians, an office that he held repeatedly during the next forty-three years.? Documents show that at various times he administered the affairs of the hospitals of En Clapers, the Hospital d’Inocents (recognized as the first hospital for the mentally ill in the Christian West), and the Hospital of En Bou.4 He

was the private physician to Queen Maria de Castella (wife of King Alfons el Magnanim), and at one time served as metge de covent for the Dominican friars in Valencia (Alminana Vallés 915, 1073). If the inventory of his books made after his death gives us an accurate indication,

Roig spent much of his time reading and consulting works on medicine, surgery, and astrology; of the fifty-eight books listed in the inventory, only one does not pertain to medical theory and practice.> As a successful physician, well known and respected in Valencia, it is highly

probable that Roig incorporated into the Spill medical concepts of health and disease. A close reading will reveal that the work contains dietary advice, pharmaceutical remedies, hygienic guidelines, and therapeutic methods. Lexical studies have identified the mention of over 120 different diseases and maladies (Aluminana Vallés 917-9).

Perhaps the most compelling reason to approach Roig’s work in search of its relation to fifteenth-century medical practices emerges from the initial lines of the Spull: Trobant-me’n aquesta vall / Callosa, per les morts fuyt, / ocios, trist, sens fer

fruyt, / empres he, no sens treball, / de dones scriure llur tall / natural he voluntari. ... (g-24)® [Finding myself in that valley of Callosa, a fugitive from death, idle, sad, and jobless, I undertook, and not without great effort, to write about the nature and will of women... .]7

Epidemics and pestilence repeatedly took their toll on human life in Mediterranean Spain in the later Middle Ages. In Valencia the plague hit no fewer than twenty-five times from 1348 to 1501, leaving no gen-

6 INTRODUCTION: PREACHER AND PHYSICIAN eration immune from its devastation. Municipal documents indicate that the single outbreak of 1439 killed as many as eleven thousand citizens. The onset of the plague helped foster a tradition in Valencia and Catalonia in which eminent physicians attempted to mediate the threatening devastation by disseminating, in the form of brief treatises in the vernacular, health information on preserving the body during times of epidemic. One of the first of these treatises, Regiment de preservacié de pestilencia by Jacme d’Agramont, appeared in Lérida in 1348 with the plague virtually knocking at the door of the city. The author relates in the opening lines his desire to serve his fellow citizens by writing a treatise against the plague: Hon, com jo sia natural d’aquesta ciutat e aja reebut ésser en aquella, e encara continuament reeba e aja reebuts honors diverses e grans profits per

tota la ciutat e per singulars d’aquella, volén de ma pocha sciéncia fer e procurar alcun profit e esquivar tot dampnatge a la ciutat damont dita e als singulars d’aquella, per preservar casci e cascuna d’ésser malaut ho malauta per temps pestilencial. (47-8) [Since I am a native of this city and have received my being in it, and since I have received and still continually receive diverse honors and great benefits from the whole city and from its people, I wish from my small store of knowledge to (make and) provide some benefit and to avoid all harm to the abovementioned city and its people, to save every man and woman from illness during pestilence. |8

Plague treatises were not unknown in antiquity or the earlier Middle Ages. The originality of Jacme’s work, however, lies in its explicit desire to disseminate medical information to all people: E com lo damontdit tractat, segons que ja he dit, sie feyt a utilitat comuna e publica, placie-us, seynnors, de donar-ne treslat a tot hom qui.n vuylle copia. (48) [And since the before-mentioned treatise, as I have already said, is prepared for public and common use, may it please you, my Lords, to give it to anybody who wishes to make a copy of it. ]

Other physicians and theorists soon imitated Jacme, to such a degree that vernacular treatises on the plague as well as Valencian translations of Latin plague tracts became fairly common in the years following the first outbreak of the Black Death.

INTRODUCTION: PREACHER AND PHYSICIAN 7 Roig ostensibly wrote his diatribe against women at a moment when the extensive presence of disease had disrupted his professional routine in Valencia. It is, therefore, not too far-fetched to suggest that a welleducated and highly respected physician, freed from the burden of his

regular patients and following the steps of the eminent physicians before him, would have taken upon himself the responsibility of educating the public. If this is true, it stands to reason that the anecdotes and tales in the Spill are somehow closely tied to questions of disease and well-being. Glending Olson has shown that the amusing stories in the Decameron — a work critics often evoke when naming Roig’s literary antecedents — offered the medieval reader a medically recognized form

of hygienic therapy for avoiding the ill effects of the plague. My contention is that the poignant anecdotes and derogatory descriptions of women in the Spill are likewise bound up in the effort to protect and cure men from what Roig deemed to be a different form of pestilence, the epidemic of disordered and excessive sexual desire. Unlike Jacme Roig, Alfonso Martinez de Toledo was a clergyman,

not a physician. We know that he was university-educated and that he lived an active ecclesiastic life in and around the city of Toledo during the first half of the fifteenth century.9 Except for his role as arbiter in a dispute between the patients and administrators of the Hospital of Mercy in Toledo, there is no evidence to suggest that Martinez worked within the confines of institutional health care.10 Nevertheless, Martinez expresses in his Arcipreste de Talavera a formi-

dable understanding of the human body. Throughout his treatise he identifies love and sexuality as diseases, he reminds his readers that illicit love destroys the body, and he lists the physical maladies that tor-

ture those who indulge in amorous relations. Martinez continually appropriates medical warnings against sexual behavior and supports these arguments by citing medical authorities such as the physician Johannitius (Hunain ibn Ishaq), the Arabic translator of Galen. Part 3 of the treatise is dedicated solely to outlining the relation between sexual drives and bodily complexions. Whereas the onset of an epidemic encouraged Roig to compose his treatise on the vices of women, Martinez chose to describe the effects of loving women in epidemic proportions. For Martinez, disordered love

was so devastating that it reduced all social institutions to rubble and

chaos, instigating calamities, vices, and corruption at every turn. Martinez, in fact, describes the outcome of amorous behavior as a form

of moral plague. Compare Jacme d’Agramont’s description in the

8 INTRODUCTION: PREACHER AND PHYSICIAN Regiment de preservaci6 de pestilencia to Martinez’s warning of the effects of “amor disordenado” in the Arcipreste de Talavera:

Pestiléncia és mudament contra natura de coratge e de pensament en les gents per lo qual venen enemiztats e rancors, guerres e robaments, destruccions de lochs e morts. ... (Regiment de preservacio 91, emphasis added)

[Pestilence is a contra-natural change in spirit and in the thoughts of people, from which come enmities, rancors, wars and robberies, destruction of places, and

deaths... .| E como uno de los usados pecados es el amor desordenado, especialmente de las mugeres, por do se siguen discordias, omezillos, muertes, escandalos, guerras e perdicgiones de bienes e, aun peor, perdigion de las personas, e mucho mds peor,

perdicion de las tristes de las dnimas por el abominable carnal pecado con amor junto desordenado. (Arcipreste 63, emphasis added) !1

[And as one of our most common sins is disorderly love, especially love of women, whence follow discords, murders, deaths, scandals, wars, and the loss of goods and even worse, the ruin of our bodies, and much worse, the loss of our miser-

able souls, because of this abominable carnal sin together with disorderly love. | 12

For Martinez and Roig the attraction of women was a disease that not

only destroyed the body and mind of the individual, but infected the very core of civic order as well. The explicit goal of their treatises was to remedy this malady both in the individual and in society. Antifeminist discourse, as I will show in this study, is at the heart of this therapy.

I have chosen to examine the works of Martinez and Roig because their distinct professional backgrounds allow us to make a useful com-

parison that, under other circumstances, might be overlooked.!3 Martinez, trained as a theologian and clergyman, was charged with saving the soul, while Roig, learned in the art of medicine, was responsible for preserving the body. Indeed, there are other roughly contemporaneous authors, such as Francesc Eiximenis, Bernard Metge, Pere Torella, and Francesc de la Via, whose treatises bear thematic similarities with the Arcipreste and the Spill, but by bringing a clergyman and a physician together in this study I hope to show a complicity between

practicing medicine and preaching morality. My intent is to identify habits of mind in which mental phenomena such as thoughts, fears, worries, anxieties, joys, and jubilations can be spoken of in the same breath as belching, abscesses, coughing, bowel movements, and hemor-

INTRODUCTION: PREACHER AND PHYSICIAN 9 rhoids. I will show how composing sermons and compounding medicine are analogous activities; how textual instruments can be used in the same context as surgical tools; and how prescribing the correct diet goes hand in hand with delivering the proper discourse. When disruptive biological forces manifest themselves as pain and dysfunction, the afflicted person usually seeks out the expertise of others to restore his or her health. But in every age there are certain diseases

that are thought to mask the traditional symptoms of illness, leaving these patients unaware that they are suffering from an ailment. In antiquity and the Middle Ages diseases such as passions of the soul were not immediately recognizable. Unlike purely somatic disorders — blisters, hemorrhoids, nausea, and diarrhea — that quickly informed the sufferer of the presence of illness, diseases of the soul and mind were thought to camouflage the compelling subjective symptoms of illness, causing the patient to languish in the malady, and even avoid medical intervention. Plutarch, in his essay on “Whether Passions of Soul or Disorders of Body Are Worse,” explained: And if diseases are detected in the body by the pulse and by pallors and flush-

es, and are indicated by heats and sudden pains, while the diseases of the mind, bad as they are, escape the notice of most people, the latter are worse because they deprive the sufferer of the perception of them. For reason, if it be sound, perceives the diseases of the body, but he that is diseased in his mind cannot judge of his sufferings, for he suffers in the very seat of judgment. (140)

Plutarch concludes that “doctors wish a man not to be ill, or if he is ill to be ignorant of it.” Therefore, it was as much the responsibility of the physician to inform patients of their diseases as it was to cure them.

Inordinate sexual desire fell into the category of diseases that required the informing art of the healer. The pathology of this disease was fairly simple. Upon seeing a beautiful woman, a man’s mind fixated on her form and began to imagine the potential pleasure to be derived therefrom. If the fixation was not broken, it became progressively more intense, creating a somatic imbalance. In this condition, the body and the mind began to deteriorate, and the lover became so consumed by the beloved that he was unable to see himself as suffering from a disease. The eminent medieval physician Bernard of Gordon explained that a man suffering from this affliction (technically known as amor hereos) loses his ability to distinguish sorrow from joy, and becomes so blinded by his vile longing for pleasure that even sadness seems like joy.

10 INTRODUCTION: PREACHER AND PHYSICIAN Bernard compares these lovers to ruffians and knaves who go around in

the winter half-naked and who are willing to sleep on the ground in order to take pleasure in the taverns and in the throw of dice (108). In dealing with men suffering from this disorder, the first problem facing the physician was to make the sufferer acknowledge that he was diseased. ‘To do this the physician attempted to represent, or even more powerfully to reproduce in the patient, those very symptoms that caused

sufferers of other diseases to recognize their pathological condition. Physicians tried to reason with the patient, pointing out the way his behavior and bodily movements indicated the presence of disease. They could also choose to beat the patient and thereby replicate, in the form of pain, a compelling physical indicator of illness. But the very nature of

this disease, in that it destroyed the capacity to reason correctly and caused the sufferer to confuse pleasure with pain, undermined the effcacy of these remedies. If the physician was unable to make the patient see the disease within himself, then as an alternative form of therapy he could help the patient

see disease in the beloved. This therapy consisted of befouling the beloved by presenting images of her that manifested all the abject symptoms commonly associated with the disease. In this form of therapy the

aim was to inform the patient of his disease by transforming and ultimately deforming the image of the beloved, thus allowing the mind to conform itself to a more salutary object. Once the image of a woman had been re-presented as diseased, when that which promised pleasure was seen as a source of pain, when what was thought to be beautiful was perceived as being hideous, and when that which once was so attractive became utterly repulsive, the fixation on the beloved was thought to be

broken and the body and mind were healed. In this way, the act of informing the patient of his disease was regarded as tantamount to curing the disease. The antifeminism in the Arcipreste de Talavera and the Spill emerged,

at least in part, from this medical theory of amorous pathology. For Martinez and Roig, women are able “to disease” men because men lose their ability to see women as potential sources of disease. ‘The solution was simply to inform men of the pathological potential of women. As both a preventative and a curative strategy, Martinez and Roig offer their readers a collection of discursive instruments that re-present women as

disease in the hope that the mind will turn away from the images of women. To the degree that masculine sexual well-being was thought to depend on the ability of the physician or healer to “speak medicinally,”

INTRODUCTION: PREACHER AND PHYSICIAN 11 that is, to speak to the patient in a way that was thought to heal the body and mind, it is possible for us to identify in the works of Martinez and Roig a poetics of sexual well-being. My objective in this study is not only to describe the medicinal properties of misogynist discourse, but also to show how these two authors attempted to manipulate, control, dissemi-

nate, and administer this discourse to those thought to be ailing from the disease of inordinate love. I hope to demonstrate that there is a complicity between medieval medical theory and the rhetorical conventions of misogynist discourse. In this study I use the term “lovesickness” to identify broadly a variety of symptoms and ailments associated with sexual desire, such as heroic love, love-madness, and melancholic love, seminal superfluity, amorous

dehydration, erotic fatigue, and impotence. For Martinez and Roig, sexual desire was a disease that, as Martinez was fond of reiterating, “destroys the body and damns the soul.” The great body of criticism on the phenomenon of “courtly love” tends to portray descriptions of the pains, wounds, and sufferings of love as if they were mere literary conventions, detached from “real” diseases and corporeal disorders. From

the onset of this study, I want to establish for modern readers that lovesickness was as much a disease in the fifteenth century as AIDS, leukemia, and cholera are today. In equating lovesickness with a modern disease, I by no means intend to trivialize the pain and suffering of those

diagnosed as “victims” of these illnesses; rather I hope to argue with Peter Wright and Andrew Treacher that disease - modern, medieval, and ancient—is “a socially-generated way of grouping phenomena which endows them with a particular significance” (g).14 Disease is a social construct and, as such, is dependent on a complex codification of patterns, images, and forms that are produced within the conventions of an interpretive community. To become diseased is less a process of being ill than one of putting our ills — or having our ills put for us — into

categories, fables, fictions, and myths that offer explanations for suffering, strategies for coping, and hopes for cure. Any biological or social phenomenon can be classified and mythified as disease. Therefore, the process of creating diseases is a highly motivated activity that is tied to ideologies and institutional frameworks.

One of my concerns in completing this study lies in the political implication of (re)writing the Middle Ages. What is to be gained by representing the link between medieval misogyny and medieval medicine?

My hope, of course, is that by describing the discursive workings of another age we may be encouraged to reflect on our own practices.

12 INTRODUCTION: PREACHER AND PHYSICIAN Although there is a danger in collapsing the Middle Ages into our own age, my greater fear is that the alterity of medieval medical practice may distance us from it to the point where the past loses its ability to speak to the present. It is easy to see therapies such as bloodletting, leeches, and bodily purges as ignorant practices of a dark age. We have been led to believe that the benevolent and detached contemporary physician can effectively “cure” disease while the medieval doctor could only dabble in unsophisticated procedures that were ultimately painful, ineffective, and often dangerous to the patient’s health. Today we use the adjective “medieval” to place ourselves in benign opposition to the dark and superstitious practices of the past. We often describe contemporary phenomena such as torture as “medieval,” as if they were unfortunate vestiges of a bygone era rather than products of current political and social institutions. Nowhere is this more true than in the medical profession, which thrives on the opposition between modern science and ancient superstition. The image of the medieval physician who, with his crude instruments and irrational assumptions, reads ridiculous diseases in urine and describes physical discomforts as the results of sin, plays nicely into the hands of the modern physician who, with his sophisticated technology and “proven” scientific methods, claims to be able to eliminate pain and to cure complicated diseases. My intention, therefore, is not to compare the “primitive” medical practices of the Middle Ages with the elevated claims of the contemporary physician, but rather to focus on the way institutional frameworks and biomedical discourses form powerful mechanisms of social control. How did it happen, as Christine de Pizan asked, “that so many different men — and learned men among them — have been and are so inclined to express both in speaking and in their treatises and writings so many wicked insults about women and their behavior”? There is no single or simple answer that can account for every discursive act of medieval misogyny. Nevertheless, in the specific cases of Martinez and

Roig, I hope to show that the need to denigrate women was closely linked to the anxieties of disease and the therapeutic technologies of well-being that flourished in fifteenth-century Spain. Every culture turns to the benevolence and skills of certain designated practitioners to ease the fear of disorder and moderate the alienation of pain that accompa-

nies conditions of illness. But when the abjectification of women is drawn into this healing process, it acquires the same power and legitimacy as cauterizing wounds and settling upset stomachs. In this way even men who bore no particular malice against women unwittingly

INTRODUCTION: PREACHER AND PHYSICIAN 19 reinforced an economy of well-being in which the momentary health of men came at the long-term expense of women. For Martinez and Roig, the world of early fifteenth-century Spain was falling in on itself. Political chaos, fratricidal wars, struggles between the nobility and the monarchy, ecclesiastic discord, repeated outbreaks of plague, sudden deaths by the thousands, warnings of apocalypse, and rumors of the advent of the Antichrist pointed to a society in disarray.

Martinez and Roig blamed lust and the proliferation of disordered amorous practices (el amor desordenado) as the root of all this upheaval. Martinez tells us: E en tanto e a tanto decaimiento es ya el mundo venido quel moco sin hedat e el viejo fuera de hedat ya aman las mugeres locamente. Eso mesmo la nina infanta, que non es en reputacion del mundo por la malicia que suple a su hedat, e la vieja que esta ya fuera del mundo, digna de ser quemada biva; oy éstos y éstas entienden en amor e, lo peor, que lo ponen por obra. Entanto que ya ombre vee que el mundo esta de todo mal aparejado: que solia que el ombre de XXV anos apenas sabia qué era amor, nin la muger de XX. Mas agora non es para se dezir lo que ombre vee, que seria vergoncoso de contar. (63-4) [The world has fallen into such a state of decay that nowadays the young man and the old man full of years alike love women madly. It is the same for the

tender maiden who loses her good name in the world because of the malicious gossip that makes her out to be older in sin than she really is, and the old woman in the shadow of the grave, deserving to be burned alive! Everyone knows about love these days and, worse, they practice it! Consequently, one sees the world plainly going to ruin. Once upon a time a youth of twenty-five hardly knew what love was, nor did a maiden of twenty; but what one sees today is too shameful to relate. ]

As a consequence, Martinez warns, por ende bien parece que la fin del mundo ya se demuestra de ser breve. Demas, en este pecado ya non se guardan fueros nin leyes, amistades nin parentescos nin compadrazgos: todo va a fuego e a mal. (64)

[And so it seems obvious that the end of the world is at hand. Furthermore, neither privileges nor laws nor friendship nor kinship nor neighborliness is a deterrent for this sin anymore, and everything is headed straight for the burning and no good end. |

Upon identifying the etiology of social disorder in the uncontrolled and unnatural sexual practices of the early fifteenth century, Martinez, like

14 INTRODUCTION: PREACHER AND PHYSICIAN Roig, objectifies this disorder in the form of women. Women become the medium through which Martinez and Roig hope not only to “heal” men, but to amend troubling social tendencies. If there is to be a proper order in the body and in society, men must learn to recognize a “natural” disorder in women. To this end Martinez and Roig present their readers with a highly stylized series of descriptions, arguments, warnings, anecdotes, and demonstrations. Their collections of discrete medical utterances, designed to duplicate a quasi-clinical encounter between

reader (patient) and text (physician), were intended to represent women as bearers of abject conditions who, like disease itself, held the power to inflict pain relentlessly, to stigmatize the sufferer socially, and to destroy the body permanently.

PART ONE Disease and the medieval clinic

BLANK PAGE

i Disease, discourse, and illness The structure of healing in late medieval Spain

One of the problems in investigating notions of well-being is finding a working definition for the concept of disease. In modern biomedicine and medical anthropology there is no agreed-upon definition. As Harold Merskey points out, “purely biological definitions are inadequate and combined biological and social definitions are not yet satisfactory” (215). Attempts to define disease range from simple statements such as “what doctors treat is disease,” to complicated formulations such as “[disease is] the sum of the abnormal phenomena displayed by a group of living organisms, in association with a specified common characteristic, or set of characteristics, by which they differ from the norm for their species in

such a way as to place them at a biological disadvantage” (Campbell, Scadding, and Roberts 761).! Defining disease becomes even more complicated when we try to establish a transcultural and transhistorical definition that is capacious enough to include diverse anatomical, etiological, and pathological assumptions.? Illness and disease

To understand the idea of disease in medieval Spain it will be useful to make the distinction accepted by many medical anthropologists between disease and illness. Although the terms are synonymous in contemporary English usage, it is helpful to see disease as an objective description of abnormalities (corporeal, behavioral, and social), whereas illness is an experience of “disvalued changes in states of being and in social function” (Eisenberg 11). Stated more simply, patients suffer illnesses while doctors and health care professionals diagnose and treat diseases. IlIness makes itself known in the individual through various forms of pain, dysfunction, deformity, and alienation; diseases are those “pathophysiological or psychopathological generalizations used to correlate the elements of a disease state in order to allow (1) an explanation of its course and 17

18 DISEASE AND THE MEDIEVAL CLINIC character, (2) prediction or prognosis concerning its outcome, and (3) therapy through manipulating variables important to the course of the illness” (Engelhardt, “Ideology” 257). Succinctly, disease is socially constituted whereas illness is experienced individually. One significant advantage of this distinction is that it allows us to see

that there is no one-to-one relationship between illness and disease (Eisenberg 11). It is entirely possible for humans to have a disease but not be ul. A doctor may diagnose hypertension by means of a routine measurement of blood pressure, but since the disease is asymptomatic

in its early stages, the patient — still able to act, think, and feel as normal — does not consider himself as being sick. It is also possible for a person to be ill and have no disease or diagnosis for his or her ailment.

Thus chronic sufferers of pain find themselves discouraged and frustrated when physicians inform them that there are no detectable signs of disease in their bodies. Since disease is constituted outside (and often even independent of) the pains and disability suffered by the patient, any constellation of signs and symptoms can be classified and treated as a disease. In fact, since medicine is inescapably bound up in ideology, it is possible to categorize any phenomenon that is deemed to disrupt the social as well as the biological order as a disease. Any type of behavioral aberration, complaint, criticism, or discontent can be somatized and pathologized.* Historically, we can see how African-American slaves who made repeated attempts

to escape were diagnosed as suffering from a psychosomatic disorder known as drapetomania.° During the eighteenth and nineteenth centuries

men and women who masturbated regularly were said to be sufferers of onanysmus, a disease that called for surgical treatments such as vasectomy, castration, and the insertion of needles into and around the genitalia.®

In his important article on reification in medical practice, Michael Taussig points out that the body is not only a mosaic of biological entities, but a container of highly charged symbols — excretions, fluids, textures, scents, surfaces, emotions, cycles. Illness, with its terrifying phantoms of despair and hope, makes the body ripe as little else for encoding all that society deems real and true (“Reification” 4). Every society recognizes the practice and professional status of certain healers above and beyond the authority of other practitioners. ‘These orthodox healers are socially authorized to read the signs of the body and thereby transform

corporeal and behavioral phenomena into categories of disease. It is this power to disease that distinguishes the orthodox practitioner from other practitioners. To disease a patient is to give meaning to his or her

DISEASE, DISCOURSE, AND ILLNESS 19 biological being, conferring on the patient all the privileges, rights, and limitations of the socially defined status of being ill. We like to believe that the encounter between orthodox healer and patient is simply a benevolent activity in which the well-being of the suffering patient is the only concern. Healing, however, also reinforces the dominant values and subtends the determinant ideology of the culture in which it takes place: “In any society, the relationship between doctor and patient is more than a technical one. It is very much a social interaction which can reinforce the culture’s basic premises in a most powerful manner” (Taussig, “Reification” 4). What is at stake in healing is

not merely the health of the patient, but the authority of the practitioners and the well-being of the society that grants those practitioners their authority. Thus the power to disease is inextricably linked to the responsibility to maintain social order. As such, socially empowered

healers reinforce and defend the dominating social structures, and thereby act as agents of social control.’ Taussig argues that serious illness interrupts daily routines, causing the patient to question the heretofore uncritical acceptance of cultural life. [IIness turns people, he explains, into “metaphysicians and philosophers,” seeking meaning for their pain and answers for questions such as “why me?” When illness is brought into the clinic, practitioners gain “a powerful point of entry into the patient’s psyche” that allows them to manipulate the “patient’s conventional understandings and social personality. It is the function of the relationship between the doctor and the patient to restructure those understandings and that personality: to bring them back into the fold of society and plant them firmly within the epistemological and ontological groundwork from which society’s basic ideological premises arise” (“Reification” 4). One of the most effective techniques that healers use to extend their power into the realm of the social is to recast the beliefs and practices that threaten the social order into objects of disease, or to identify these beliefs and practices as diseased objects. By medicalizing and pathologizing disturbing social practices, healers relate the state of well-being — a sense of meaningful order, absence of pain, social acceptance, and maximum mobility — with adherence to the norms of operative ideology. The clinic

In Western medicine the orthodox healer has always been connected to the developing conventions of the clinic. The origin of the word “clinic” is found in the Greek verb klinikos, “to incline,” and its derivative klines,

20 DISEASE AND THE MEDIEVAL CLINIC “bed.” In the early Middle Ages the Latin clinicus referred both to the physician who treated the patient on the sickbed and to a dying patient who requested baptism on his deathbed.’ The etymology is useful in that it draws attention to the idea of the clinic as a setting in which the bedridden patient meets both the priest and the physician. In this study I use the word “clinic” to identify the encounter between authorized healers and ailing patients. This includes the social and technical conventions that govern the behavior and expectations of both healer and patient. Although the modern usage tends to denote a specific institutional edifice such as a hospital, doctor’s office, or university faculty, it will be to our advantage to keep in mind that the clinic is fundamentally an interaction between patients and healers that occurs, as the etymon suggests, at the bedside. Clinical healing differs from other forms of health care (familial and empirical) in that it is controlled by socially empowered practitioners. Within the tightly organized conventions of the clinic, these professional practitioners are authorized to read the body of the sick and to develop therapeutic strategies for the patient’s recovery. They are permitted to orchestrate the services of subordinates, such as nurses, pharmacists, and family members, as well as to make use of restricted tech-

nologies and controlled substances. One of the principal goals of clinical medicine is to obtain absolute control over the phenomena that disrupt the body. This entails the ability not only to manipulate exogenous and internal conditions, but to control the patient’s behavior and his relations with auxiliary health care workers. The idea is fully present in Hippocrates’ first aphorism: Life is short, and Art long: the crisis fleeting; experiment perilous, and decision difficult. The physician must not only be prepared to do what is right himself, but also to make the patient, the attendants, and the externals cooperate.

Maimonides, commenting in the late twelfth century, explains: It is as though he [Hippocrates] is commanding in this aphorism that the physician must apply his abilities to the management of the illness, and facilitate such treatments as the drinking of the bitter medications, the clyster, the dissection, the cautery, and their like. He should address the patient and those about him, warn them against making mistakes, and make those about him undertake his care as is proper in the absence of the physician. In a like

manner he should remove the external impediments as much as he can, according to each and every case. For example, if the patient is poor and in

DISEASE, DISCOURSE, AND ILLNESS 21 a place that increases his illness, but he can afford no other place, the physician should remove him from this place to another. (Bar-Sela 35,4)

Medieval theorists interpreted Hippocrates’ notion that the longevity of art opposes the brevity of life as a warning of the need for physicians to dominate a theoretical body of knowledge. Life is too short for the physician to experience every contingency: experimentation is too dangerous when death is knocking at the patient’s door. Practice, therefore, must be tied to firm control over an enormous amount of information about the body and the world. Only through reasoned judgments based on principles of anatomy (temperament of each organ, the state of its substance in firmness, softness, density, and looseness), the types of diseases and their consequences in the body, the rules of deduction, the function of medical tools (including drugs, bandages, knives, medica-

ments), and a recognition of the patient’s temperament and state of health, could a physician effectively cure disease. Clinical healing in the Middle Ages was eminently connected to an intellectual currency contained and disseminated in books. Isaac Israeli, in his reworking of the first aphorism, makes this clear when he explains, the knowledge of medicine is very extensive, and the days of men are too short to attain its perfection, the accomplished physicians are set apart, and refined, and purged of the ignoramuses, by their constant occupation in the study of books and their meditation over them day and night, and their dedication to it apart from other men, before they are needed in their profession. (150)9

In contrast to modern clinical research, medieval physicians advanced medical knowledge by spending time reading books, scrutinizing etymologies, and collecting anecdotes, rather than laboring in the laboratory, dissecting corpses, and amassing data.!° Clinical healers

Although today clinical medicine lies in the hands of the physician and health scientist, during the early fifteenth century clergymen shared this responsibility with the university-trained practitioner. Medieval thinkers recognized that the disorders of the soul could manifest themselves in the body, and that the diseases of the body could affect the condition of the soul. Consequently, the concern of the clinical healer was to promote health in both of these realms. ‘The same practitioner, if he was an ordained priest, could treat both areas; if not, he was required to subor-

22 DISEASE AND THE MEDIEVAL CLINIC dinate himself to those clinical practitioners who could offer the patient healing technologies for the soul. Together, these two types of healer were socially authorized to read the signs of the body and organize plans for treating the diseased.

From a traditional point of view the physician and the clergyman made for uneasy clinical bedfellows. Popular medical historiography has often characterized the Middle Ages as a period in which religious men frustrated the efforts of “rational” and “scientific” thinkers: With the passing of Galen at the end of the second century, the thread of rational medicine snaps. Wherever we turn, the ear of magic is upon us. Greek medicine, which in its classic days had been free from superstition, has ceased to function. Experiments are not performed, but miracles are expect-

ed. It is a period of morbid fascination when meaningless incantations replaced medicine. Mysticism, spiritualism, superstitions and other varieties of magic were the order of the day.!!

Although recent historians of medicine have greatly modified and contested such views, there is a lingering paradigm, no doubt perpetuated by the nature of contemporary clinical practice, in which the physician with his rational and empirical inclinations stands in historical opposition to the clergyman and his supernatural forms of healing. It is misleading, nonetheless, to assume that during the medieval period secular medicine and sacred healing were mutually exclusive.

Thanks to the scholarship of medical historians such as Owsei Temkin and Darrel Amundsen, we know that early Christian authorities were able to embrace Hippocratic (Galenic) medicine with little difficulty.!2 The major reason for this was that Greek and Roman medical theorists tolerated and often encouraged recourse to divine medicine. The mutual benefit of cooperative healing is expressed by a Hippocratic writer in On Regimen: “prayer indeed is good, but while calling on the gods a man should himself lend a hand.”! Three characteristics of ancient medical practice facilitated its trans-

mission into the world of the Christians. First, ancient physicians respected the cult of the gods, notably Asclepius, and recognized the usefulness of divine medicine. Consequently, the Christian God had little trouble entering into a theoretical framework that had already made room for sacred healing. Second, ancient writers acknowledged a close relation between philosophy and medicine: “philosophia et medi-

cina due sorores sunt” [philosophy and medicine are two sisters]; “Medicina est philosophia corporis; philosophia est medicina animae”

DISEASE, DISCOURSE, AND ILLNESS 23 [Medicine is the philosophy of the body; philosophy is the medicine of the soul].!4 In Christian terms this translated into a relation between

theology and medicine in which the priest healed the soul while the physician healed the body. Since it was widely acknowledged that disruptions of the body affected the soul and vice versa, medicine and philosophy (theology) were inextricably united. Third, ancient deontological writings emphasized that the character of the physician was directly related to the effectiveness of his therapy. According to Erasistratus, the physician should be perfect in his art and most excellent in his moral conduct. But if one of the two should have to be missing, then it was better to be a good man devoid of learning than to be a perfect practi-

tioner of questionable morals. In other words, a good character was thought to be powerful enough to compensate for what was missing in art, while an evil disposition was thought to corrupt and confound even the most perfected art (Temkin, Hippocrates 20-1) .!5

We should also keep in mind that there was no rigid separation between the knowledge of the priest and that of the physician. Learned clergy throughout the Middle Ages were well versed in medical theory.

Tertullian, Origen, Ambrose, Roger Bacon, Albert the Great, and Ramon Llull, to mention but a few, wrote entire treatises on medicine or incorporated discussions on natural science into their more general works. St. Ambrose, for example, included a description of the human digestive system in his hexahemeric sermons (Siraisi, Medieval and Early Renaissance Medicine '7); Petrus Hispanus (Pope John XXI) combined his medical practice with his ecclesiastical activities, publicly teaching and writing on medicine; Thomas of Chobham listed a number of remedies for the disease of insane love in his manual for confessors.!6© Many

of the physicians educated in the new medical faculties of medicine during the later Middle Ages were beneficed clergy or clergy in major orders (subdeacons, deacons, and priests) .!7 It is also safe to assume that clergymen, if their education consisted of nothing more than learning to read Latin, could easily have come in

contact with the theoretical principles of medieval medicine. Perhaps the best example of this is Alfonso Martinez. Unquestionably he was familiar with medical theory, although we have no record of his having officially studied medicine. The treatment of the bodily compositions that appears in part 3 of the Arcipreste de Talavera demonstrates a sound

understanding of humoral pathology. We could speculate that he received a cursory education in natural science while studying canon law at Salamanca (Toledo?), or perhaps he simply read one or several of

24 DISEASE AND THE MEDIEVAL CLINIC the numerous learned and popular medical texts that circulated in Spain during the early fifteenth century.!®8 If Martinez had studied nothing more than Johannitius’s /sagoge, which he mentions in the Arcipreste de Talavera (98), he would have acquired a fundamental understanding of medical theory.!9 We should also keep in mind that Martinez

traveled extensively throughout the kingdom of Aragon, where medicine had flourished during the thirteenth century.2° Moreover, Toledo, the most important urban center for the translation of Arabic scientific literature into Latin from 1150 to 1300, continued to support an intensive production of medical and scientific literature in Arabic well into the fifteenth century (Garcia-Ballester, Historia social 33). It was here also that Gerard Cremona made the first Latin translation of Avicenna’s Canon, the single most influential medical text of the late Middle Ages and Renaissance. Ecclesiastics and monastic institutions also encouraged religious men to care for the body. Early medieval medicine was rooted in a monastic tradition that had required certain members of the community to learn the manual skills and theoretical underpinnings of caring for the ill. At his monastic retreat at Vivarium, Cassiodorus urged monks to read the medical works he had collected for their use (Kibre 3). The influential Benedictine Rule insisted that attentive care be given to sick monks: “all things and above all things, care must be taken of the sick, so that they will be served as if they were Christ in person” (Benedict 54). Even after the decline in the monasteries’ importance as centers of medical knowledge in the eleventh century, medical books were continually donated to monastic communities.?! In addition to the formal training that a priest might receive during the course of his study or through his reading of medical textbooks,

there were powerful models that encouraged participation in the healing arts. At the top of the list was Christ himself, the Christus medicus and “Divine Healer.” The Christus medicus concept developed out of the struggle in the second and third centuries between the cult of Asclepius

and the worship of Christ. Patristic writers —- notably Jerome and Tertullian — became concerned over the large number of people crowding into the shrines of Asclepius in search of healing miracles. These writers saw a need to separate the claims of the pagan god from those of Christ, who for them was the verus medicus, the true healer of both body and soul (Arbesmann 2-4; Pease).22 Building on the depiction of Christ in the synoptic gospels as that of a healer, patristic writers represented almost every aspect of Christ’s work on earth with a med-

DISEASE, DISCOURSE, AND ILLNESS 25 ical metaphor. St. Cyprian described Christ’s mission on earth as that of a Divine Physician “who healed the wounds inflicted on mankind by Adam’s fall, neutralized the old poison of the serpent, and gave to the sound man wholesome prescriptions as to how to avoid a relapse into the disease” (Arbesmann 7). St. Augustine, whose works are replete with references to Christ as physician, describes him as the Ipse medicus, ipsa medicina, both physician and medicine:

Just as a cure is the way to health, so also this Cure [Christ incarnated] received sinners to heal and strengthen them. And just as physicians when they bind up wounds do not do so haphazardly but neatly so that a certain beauty accompanies the utility of the bandages, the medicine of Wisdom by taking on humanity is accommodated to our wounds, healing some by contraries and some by similar things. He who tends the wounds of the body sometimes applies contraries, such as cold to hot, moist to dry, and so on; at other times he applies similar things like a round bandage for a round wound or an oblong bandage for an oblong wound, not using the same bandage for all members but fitting similar things to similar. Thus the Wisdom of God, setting out to cure men, applied Himself to cure them, being at once the Physician and the Medicine. (On Christian Doctrine 15,2 By extension, the figure of the Christus medicus attributes to the clergy

the function of physician in the church.24 Ambrose, Chrysostom, Origen, and Jerome identified great men of the Old Testament such as Abraham, Jacob, Joseph, and Daniel as physicians who by word and example had instructed mankind as medical assistants of the Divine Doctor (Arbesmann 26). From antiquity and throughout the Middle Ages, there was a tendency to speak of two medicines and two corresponding medical practices (Ell, “Concepts” 154): an earthly medicine concerned itself with the preservation of the body while a spiritual medicine, the more lofty of the two, attempted to uplift the soul (Ell, “The Two Medicines” 16). Despite the dichotomy, Christians reasoned that the perfect physician was a holy man who knew how to blend the medicine of the soul with the earthly medicine of the body. Since writers such as Jerome insisted that God, rather than the physician, controlled the healing process, it stood to reason that the “holiest man was not only the best spiritual leader, he was also the best physician because he shared most fully in the power of God” (Ell, “Concepts” 159). Conversely, if holy men were the best physicians, then it followed that secular physicians could become more effective to the degree that they

imitated, in disposition and actions, the example of holy men. In late ,

26 DISEASE AND THE MEDIEVAL CLINIC medieval Spain secular physicians were told to emulate the model of “holy physicians.” Medical deontologists such as Estéfano, son of a prominent surgeon in Seville, admonished physicians to follow carefully the example of Christ in their professional affairs. In his Visita y consejo de medicos (a curious guide on basic hygiene and medical ethics written for the archbishop Pedro Gomez Barroso in 1381) Estéfano identified

Christ as the “true and eternal healer” (fol. 44v) who compounded remedies and applied them to the afflicted: Commo es avido enla ssacratissima doctrina euangelica, Johanes nono, [Cristo] puso la infinita ssapiencia del poluo enla ssu mano, & fizo lodo, & puso lo al ciego; & vio luego. (39V) [As we see in the holy gospel of St. John, Book Nine, [Christ] put the infinite

wisdom of the dirt in his hand, made mud of it, and applied it to the blind man who was then able to see. |

For Estéfano, corporeal health cannot exist apart from spiritual wellbeing.® Thus, “like daughter and mother,” medicine and theology are closely related: Commo la buena fija en algunos casos es ajunativa ala su dilitissima madre, assi es la rreverendissima ciencia medecinal ala clementisima ciencia theological. (40v—411)

[As the good daughter in some cases is linked to her beloved mother, so is the most revered science of medicine to the very merciful science of theology. |

Estéfano emphasized that the physician as well as the clergyman should follow in the footsteps of Christ, the buen pastor and médico vero. The good clergyman and the good physician needed to know their medicine and their patients as a good shepherd knows his sheep (fol. 1): todo buen pastor debe conoscer a ssus ouejas . . .; todo buen pastor deue auer & enssi ffazer el bien, & despues amostrar lo a ssus ouejas que assi lo fagan aprendiendo del nuestro pastor eterno . . .; el buen pastor deue guiar ssus ovejas & poner las en los buenos pastos assi commo el medico vero que pone los ssus acomendados enel buen pasto dela rregla rrecta conservadera dela ssalud. (fols. 1v—2r)

[Every good shepherd should know his sheep; every good shepherd should possess and also do good, and after teach it to his sheep so that they may thus learn from our Eternal Shepherd; the good shepherd should guide his sheep

DISEASE, DISCOURSE, AND ILLNESS 27 and place them in good pastures, like the true physician who should place those in his charge in the good pastures of correct rules to preserve their health. |

I do not mean to imply that there were no tensions or ambiguities between secular medicine and sacred healing. Hagiographical writers were quick to illustrate — even gloat over — the limitations of the secular physician when compared to the healing powers of the saint or religious man. St. Augustine narrates in great detail the healing of a man who suf-

fered from a complicated case of multiple rectal fistula. The man, who had suffered intensely while the physicians relentlessly cut the sinuses, remained uncured until the holy man Saturninus, then bishop of Uzalum and Gulosus, urged him to pray; he was subsequently healed (City of God 22:8).26 Gregory of Tours tells about the epileptic whose condition actu-

ally worsened after several visits from doctors; relief came only after praying at the tomb of St. Nicetius of Lyons. Gregory was also fond of collecting the dust from the tombs of saints and mixing it with water as a kind of take-two-aspirin remedy for all sorts of ailments; he reports that the physicians were unable to cure him of a terrible attack of dysentery,

but that within three hours after drinking a mixture of water and the dust from the tomb of St. Martin, he was well enough to eat a full meal (Flint 133-8). Berceo recounts how Santo Domingo de Silos cured a woman of her paralysis after the earthly medicines (plasters, ointments) had failed (Vida de Santo Domingo de Silos 117-22). However, not all of

the cures offered by holy men and women were supernatural. St. Dominic, for example, responded to a mother’s request that her son be cured of a painful scrofula by simply revealing to her how to compound and apply the proper medicine to the child’s neck (Peter of Spain 351). On the other hand some medical men, such as the outspoken French surgeon Henri de Mondeville, harshly criticized patients who were all too willing to attribute their ailments to God and thus seek holy remedies rather than the skills of the professional physician: [There are] people simple and unintelligent enough to believe that all diseases come from God above . . . such people take no care of themselves and have no confidence in professional surgeons, except perhaps for afflictions with an external cause, like wounds and fractures. ... Moreover, the ignorant believe that God and the disease would both rebel against the surgeon and that God alone smites mankind, brings remedies and cures them.... And when they are asked, “Do you want to be healed?” they reply: “Not by human hands, that is not possible and would not please God, since if he

28 DISEASE AND THE MEDIEVAL CLINIC wished it, I should be healed at once.” As to the treatment of these patients, they shamefully repulse excellent and expert surgeons. (Pouchelle 43)

Mondeville’s indignation, however, seems to be the exception rather than the rule. Many physicians willingly accepted the premise that God could inflict and cure diseases. Even Mondeville acknowledged the divine aspect of health and healing: “The surgeon who tends wounds should place his hopes in two things only: firstly, the supreme Doctor; secondly, nature. In the Great Doctor because He holds life and death in His hands, and he alone smites and cures, makes wounds and closes them” (Pouchelle 42). The patient’s belief in the divine relation between health and disease no doubt helped secular practitioners negotiate difficult situations. By pointing to God as an agent of disease and procurer of well-being, the secular physician gained a convenient way of explaining his inability to treat effectively every disease.?7

Another source of contention arose internally between clergymen and their superiors. Various concerns over the time clerics spent on matters of the body at the expense of the soul, as well as the temptation to pursue temporal compensation rather than spiritual rewards, led to

canonical decrees discouraging medical education and practice. For example, canons from the Councils of Clermont (1130) and Rheims (1131) and from the Second Lateran Council (1139) decry clerics’ study of medicine for the sake of temporal gain: “Moreover, the care of

souls being neglected and the purpose of their order being set aside, they promise health in return for detestable money and thus make themselves physicians of human bodies.”28 Many medical historians have

read these edicts and others like them as a prohibition against medical study and practice. Amundsen, however, has argued that these canons cannot be taken as broad statements to the effect that clerics were forbidden to practice medicine. Many of these canons were based on curtailing avarice; others arose in response to local conditions that were not applicable to the Church as a whole (“Medieval Canon Law”). Even if clergymen were discouraged from studying and practicing

medicine by their superiors, this did not mean that they abandoned their clinical role in healing the sick. Through preaching and the sacrament of confession the clergyman forcefully addressed several of the

etiological underpinnings of disease. Although seldom recognized today, there was a longstanding tradition in antiquity and in the Middle Ages that set medicine alongside rhetoric, placing the physician next to the preacher. Tertullian described Christ as Praedicator et Medicator,

DISEASE, DISCOURSE, AND ILLNESS 29 whose work — and the work of his followers — was preaching and healing

(Arbesmann 6). Humbert of Romans, writing during the middle of the twelfth century, explicitly connected preaching to medicine, saying: the word of God is the medicine which heals everything, and preachers are doctors, as Matthew 9:12 shows, “It is not the healthy who need the doctor, but the sick”; and so, when there is a lack of preaching, epidemics of disease rage unchecked. This is why, by contrast, Wisdom 6:26 says, “An abundance of wise men is the health of the world,” which the Gloss paraphrases, “The company of preachers is the health of the world.” (On the formation of Preachers 189) 29

Under the influence of the Dominican order, preaching in the Iberian Peninsula increased dramatically. During the thirteenth and fourteenth centuries some of Spain’s greatest orators —- Ramon Llull, St. Vicent Ferrer, and Francesc Eiximenis ~ traveled through the villages and

_ urban centers, moving the faithful with their sermons and homilies. Dominicans such as Humbert of Romans firmly believed that preaching was the single most important means of preserving the world from utter destruction: Without preaching the whole world would be in darkness, everything would be choked by the abundance of wickedness, a most dangerous famine would prevail universally, a plague of diseases would bring countless men to their death, cities would become desolate, the lack of water of saving wisdom would lead to an unbearable drought, and no one on earth would be able to identify the ways that lead to salvation. (190)

Humbert’s claims that “the word of God heals everything” and that the “company of preachers is the health of the world” stand as more than just an analogical comparison between preaching and medicine. As we shall see, the words of the preacher, like the chants of the shaman and the prayers of priests, have often formed part of the healing process in the Western world. As Lain Entralgo notes, “Logotherapy is as ancient as Western Culture itself” (The Therapy of the Word 32). The power and

influence of speech not only served as an extramedical instrument for describing the diseased body or explaining the conditions that led to illness; it also was believed to remedy troubling affectations of the mind, and thereby to help restore the body. Another priestly activity that could be used in a clinical setting was encouraging the sick to confess their sins. Confession, which became

30 DISEASE AND THE MEDIEVAL CLINIC compulsory in the early thirteenth century, created a nexus between medical and ecclesiastic practice. It reinforced the idea that disease was

rooted in sin and granted the clergyman an irrefutable right to stand alongside the physician at the patient’s bedside. The twenty-first canon of the Fourth Lateran Council of 1215 required that all Christians confess at least once a year.39 As a papal law that was universally binding,

the decree of 1215 obligated Christians to meet annually with their priest. At this time they were expected to reveal their sins, accept the conditions of penance, and receive the sacrament of the Eucharist. Failure to comply resulted in harsh penalties such as the denial of a Christian burial. The authors of the Edict of 1215 metaphorically envisioned the practice of confession as a medical procedure, likening the role of the priest to that of a skillful physician who attempts to heal the afflicted:

Let the priest be cautious and discreet, so that, like a skilled physician, he may pour wine and oil on the wounds of the injured man, diligently examining the circumstances of both sin and sinner, through which he may prudently learn what kind of advice he should offer, and what kind of remedy he should apply — trying various methods — to heal the sick man.*!

By associating sickness with sin, healing with confession, and well-being

with absolution, all in the context of offering advice to the sinner, the edict points to a practical — as well as a metaphorical — parallel between

physician and priest. The role of the priest in this confessional encounter was not only to listen to the penitents confess their sins, but to force them to reflect carefully on their thoughts, words, and deeds. By means of a lengthy process of interrogation the priest was to help the penitents classify their life experience using the appropriate category of sin. The therapeutic value of this was confirmed by medical theorists. The fifteenth-century physician Alfonso Chirino, who identified disease as a punishment for certain sins, warned that illness could be healed only by the intervention of the priest: Las enfermedades que es fama que vienen por penitencia de pecados. Estas conuienen a confesores que las curen, que de su derecho son, onde conuiene a los pacients ser obidientes a ellos sin ningunt themor de peligros. (Espejo 437)

[The diseases that are known to arise as penance for sin. These are best cured by confessors whose right it is to cure them. Therefore, the patient should be obedient without any fear of dangers. |

DISEASE, DISCOURSE, AND ILLNESS 31 One additional way that the clergy participated in healing activities without having to treat the ill manually was through the codification and dissemination of medical information. Faye Marie Getz has argued that the rise of vernacular medical treatises in the late Middle Ages was closely connected to the clergyman’s concept of Christian charity and his desire to aid the sick and to show compassion for the poor. Thomas Moulton, a

Dominican in England, began his hugely successful health handbook, Mirror or Glass of Health, by explaining that he had undertaken the task of writing his work in the vernacular because of the “compassion that I have

of poor people”; Henry Daniel, author of a widely circulated translation of a Latin uroscopy, explained that “charity brought me more to do this

translation than courage” (Getz 10). In Spain, the clergyman Jacme d’Agramont, recognized as the author of the first plague treatise following the outbreak of the Black Death in 13,48, offered up his little treatise for the benefit of all men in the town of Lérida. Getz suggests that the vernacular medical translation and treatise was “a kind of medical sermon, with a pastoral, indeed charitable, function in mind” (9). This is evident in Agramont’s treatise, Regiment de preservactd, in which the reader can find medical information alongside biblical citations and concerns over spiritual well-being (Veny i Clar, ed., 23). There was, however, a practical as well as theological reason behind

the clerical production of vernacular medical treatises. To translate a medical work from Latin into a vernacular language was a difficult task. Many translators complained that there were simply not enough words in the vernacular to translate important concepts adequately. Berenguer Sariera, the early fourteenth-century translator of Arnau de Vilanova’s Regiment de sanitat, tells his readers that if they should find confusing expressions or irrational discussions in the Romance, they should consult the Latin text before they criticize his translation, “because there are many words and arguments in the works of medicine that can hardly be translated into Romance.”32 Clergymen, many of whom were also skilled

preachers, were uniquely suited to disseminate medical information in the vernacular languages. Accustomed to presenting theological information from Latin sources to their medieval public, a skilled preacher — even one ignorant of the intricacies of medical theory — might

find it less difficult to translate a treatise into the vernacular than many secular theorists who worked almost entirely in Latin. The translator Henry Daniel insisted that God had taught him how to write about urines: “I have not learned uroscopy from anyone, save ... from the gift of the holy spirit.” As Getz summarizes, “here was an argument that allowed no

32 DISEASE AND THE MEDIEVAL CLINIC recourse, an authority that permitted no challenge. Who better to impart knowledge of uroscopy than the Logos itself, and who better to impart that teaching than one of God’s preachers?” (16).

Legal mechanisms arose within the privileged domain of clinical medicine in the Middle Ages that theoretically stratified the practice of

physicians and priests, subordinating the former to the latter. In the same Lateran Council that required annual confession, church authori-

ties took steps to assure that the growing body of lay physicians remained under ecclesiastical control. Pope Innocent II prohibited physicians from visiting a sick person more than twice without the patient’s being visited by a priest.33 Similar edicts were pronounced in

the Council of Paris (1429) and the Council of Tortosa of 1429 (Delaunay 3). The Valencian Furs of 1328 echoed these prohibitions, requiring all physicians to inform seriously ill patients of the need to confess their sins to an ecclesiastical authority.34 Preachers and moralists, such as St. Vicent Ferrer, also insisted that the physician had a moral obligation to require his patient to confess.3°

Physicians and medical theorists accepted these edicts and encouraged practitioners to remind their patients of the need to confess. Arnau de Vilanova instructed physicians, saying that when you come to a house, inquire before you go to the sick whether he has confessed, and if he has not, he should immediately or promise you that he will confess immediately, and this must not be neglected because many illnesses originate on account of sin and are cured by the Supreme Physician after having been purified from squalor by the tears of contrition. (“Bedside Manners” 141)

Alfonso Chirino, court physician for Juan I, proclaimed outright that

certain diseases could only be healed by confession (Espejo 437). Interestingly, one of the arguments against Morisco doctors, in spite of

their great learning in the natural sciences, was that they would not encourage their patients to undergo confession and penance (GarciaBallester, Historia social 51).

The discursive dimension of clinical healing

Disease and illness find a common ground in the perception of disorder. Whether it be detected by the patient who suffers painful and alienating experiences or by the physician who identifies cosmic and

DISEASE, DISCOURSE, AND ILLNESS 33 corporeal collapse, the idea of disorder is at the heart of both illness and disease (Margolis 253). When humans suffer afflictions they imme-

diately sense that something is wrong, that the world is out of order, that they are moving toward dissolution and death. This disorder, as Comaroff explains, “disturbs the unquestioned harmony between physical, social, and moral being, and it sets in motion the search for reconstitution” (“Medicine: Symbol and Ideology” 51). It is upon the ground created by the sense of disorder that the mechanisms of healing take place. The healer’s primary function is to mediate this disorder and channel the experience of chaos into systems of meaning that restore the patient to a non-alienated state.36 Healing “means human intervention in disorder — culturally specific self-conscious attempts to mend the

physical, emotional and social breaches caused by illness” (Comaroff, “Medicine” 51).

Cross-cultural and historical studies of caring for the sick show that healers attempt to restore order through two interrelated forms of intervention: (1) the application of technologies deemed useful in mitigating

or curing disease, and (2) the process of bringing meaning to the patient’s experience. In addition to applying bandages, prescribing drugs, and setting broken bones, healers must offer their patients mechanisms for understanding the ailment, strategies for coping with its neg-

ative effects, and techniques for adapting to the personal and social changes that illness creates. A fundamental role of the healer is to map the patient’s experience (this includes the knowledge of himself and his world) in a way that helps to restore a socially constituted concept of that order. Illness creates a profound threat to the social and personal existence of the individual; the individual searches for a way of inter-

preting that threat, as well as for the means to control its ill effects. Healers, to be completely effective, must restore the body and also sat-

isfy the patient’s need to know the “how” and “why” of illness (Blumhagen 198-9).3”

Healing attempts to restore order by alleviating the disconcerting effects of illness and by assigning meaning to the destructive symptoms of suffering. Discursive strategies play a role in both of these functions. While it is easy to see how a healer’s verbal skills can be used to identify and organize the patient’s ills into socially meaningful signs, it is often

less clear how discursive strategies enter into manual procedures. In general, when medical technology can offer the patient an immediate solution to the symptoms of illness — the dressing of a wound, a shot in the arm to ease pain — there is less of a need for discursive intervention.

34 DISEASE AND THE MEDIEVAL CLINIC But when medical technology is ineffective or unavailable, when therapy

requires the participation of the patient, when the healer can find no adequate disease to match the patient’s ailments, or when the patient refuses to acknowledge the disease, the healer relies on discursive maneuvers such as descriptions, explanations, instructions, and anecdotes. In fact, there are cases in which the only type of therapy that a healer can offer the patient is a verbal one. In the Middle Ages, healers relied on discursive technologies to diagnose disease, to facilitate therapy, and to cure physical and mental afflictions. Much like contemporary physicians, medieval healers questioned the patient to formulate, refine, and clarify a diagnosis.38 Answers to questions concerning the six non-naturals — air, food and drink, sleep and watch, motion and rest, evacuation and repletion, and passions of the soul — were instrumental in determining the proper form of therapy:

“You must know from the beginning how long the sick has been laboring, and in what way the illness has befallen him, and by inquiring about the symptoms, if it can be done, ascertain what the disease is.”99

Discourse was also used to identify more complicated diseases. Constantine the African, for example, devised a verbal test to determine

if a patient was suffering from epilepsy or demonic possession; since both disorders manifested themselves in similar ways, a simple test of speaking in the afflicted’s ear would help to determine the need for a sacred exorcism or for an herbal compound.‘? To diagnose leprosy, Jordan of Turre (fl. 1313-35) suggested that the physician have the patient cover his eyes, and that the physician say, “‘Look out, ’m going to prick you!’ The physician, however should not touch the patient, but rather say to him, ‘I pricked you on the foot’; and if the patient agrees, it is a sign of leprosy.”4! In the case of sexual ailments, there was also a discursive version of Erasistratos’s well-known technique for diagnosing

lovesickness. The Greek physician allegedly discovered the cause of Antilochus’s ailment (the boy’s illicit love for his stepmother, Stratonice)

by noting that when Stratonice walked into the room, the boy suffered from stammering speech, fiery flashes, darkened vision, sudden sweats, and irregular palpitations of the heart. Similar diagnoses were attributed to Galen and Avicenna, who reportedly monitored the heartbeat while repeating the names of women, rather than having the beloved

parade in front of the patient. Once the physician assigned a disease to the patient, the next step was to prescribe a therapy that would remedy the disorder. In this stage of healing the practitioner also employed discursive techniques. At the

DISEASE, DISCOURSE, AND ILLNESS 35 very least the practitioner had to provide the patient with instruction for the part of therapy that required patient participation: a man suffering an abscess on his penis would be told to “wash it with warm wine”;

a patient suffering from dizziness might be told to “avoid sexual relations with women and eat good and nutritious food”; an impotent man would be told to “eat chick peas, turnips, and carrots.”43 Since much therapy called upon the patient to alter his habits, an effective cure was thought to depend on the ability of the physician to impress upon the patient the importance of compliance. To encourage or persuade the patient, the practitioner could remind him of the pains, discomforts, and baneful effects of the disease: a man suffering from dehydration caused by excessive sexual intercourse could be told that “the face of a man who copulates excessively becomes thin and hollow, and his blood, eyesight, body heat, and physical beauty diminish; his hair begins to fall out, the marrow of his brain dehydrates, and his nerves and bodily members become damaged” (Mirror of Coitus 3). A physician might coerce the patient by reminding him of the prognosis: sufferers of amor hereos,

for example, could be told that the disease, left untreated, “drives the patient mad or to his death” (Bernard of Gordon, Lilio 108). Practitioners could also retell personal experiences to reinforce a thera-

peutic opinion. To remind patients of the need to discharge excess semen, Galen tells them: I also knew a man who refrained from sexual pleasure because of grief for his

wife. Since he had previously enjoyed intercourse quite frequently, he became nauseated, could hardly digest the little food he consumed and evi-

dently, if he forced himself to eat more, promptly vomited. He became despondent neither for this reason nor for any other obvious cause, as do melancholic patients. This condition subsided, however, as soon as he took up his earlier habits. (On the Affected Parts 184)

In the Middle Ages a successful practitioner needed at his disposal an arsenal of rhetorical strategies and communicative skills from which he could formulate the proper way to inform patients of their therapeutic responsibilities, and to encourage them to comply with the doctor’s orders. In this way discursive skills complemented manual therapy. There were certain diseases whose cure depended entirely on discursive methods. The Middle Ages inherited a long tradition of collective belief in the power of words to alter the body. Thus discourse could not

only be used to identify a disease or to encourage compliance with therapy, but could be employed as the cure itself.

20 DISEASE AND THE MEDIEVAL CLINIC In antiquity people acknowledged the efficacy of logotherapeutic practices, and in times of illness they eagerly sought healers who could restore their health with the skillful use of chants, hymns, spells, and prayers. In the Greco-Roman world the most enduring of these verbal therapies was the epode a (charm or incantation). Ulysses, for example,

is wounded in the leg by a wild boar while hunting with the sons of Autolycus; his companions bind up his wound with a bandage and then recite a charm (epode) to stanch the flow of blood (Odyssey, book 14, line 475; recounted by Lain Entralgo, Therapy of the Word 21). The popular use of the epode appears in the works of Aeschylus, Sophocles, and Euripides (Lain Entralgo, Therapy of the Word 47-50). Closely connected

to magic, the epode acted either to command or move material substances (blood, humor, corporeal heat), to coerce supernatural forces (demons, devils), or to entreat and supplicate deities. Its efficacy often

depended on the power and virtue of the priest or healer as well as those of the divine powers invoked (22).

Similar charms and conjurations persisted throughout Europe during the Middle Ages and Renaissance. In the Book of Household Management from Wolsthrun Castle in the Tyrol, a compilation of

household and domestic advice, there are prayers, blessings, and conjurations that were to be used for their healing capabilities. The book recommends giving people sick with fever a particular plant upon which certain Latin words were written to invoke the Holy Trinity (Kieckhefer 2-3). A cure for a speck in the eye required that the

ailing person perform an adjuration addressed to the speck itself in the name of St. Nicasius, whom the Lord had once cured of a speck in the eye: Thus I adjure you, O speck, by the living God and the holy God, to disappear from the eyes of the servant of God N., whether you are black, red or white. May Christ make you go away. Amen. In the name of the Father, and of the Son, and of the Holy Spirit. Amen. (Kieckhefer 3)

A person suffering from a toothache should write a mixture of Latin and nonsense on his face to cure the affliction: “rex, pax, nax in Cristo filio suo” (Kieckhefer 4). In Spain saludores and ensalmadores frequently attempted to cure ailments with words, prayers, and chants; to stop bleeding ensalmadores uttered the words, “Sanguis, mane in te, sicut sanguis Christi mansit in

se”; to cure a headache, “Maria Jordanem transivit, et tunc Sanctus Stephanus” (Herrero 185). There is ample evidence to show how

DISEASE, DISCOURSE, AND ILLNESS 37 psalms, Ave Marias, and paternosters were used in medicinal practice. An addendum to a group of Catalan medical treatises offers the following “cure for all illnesses”: Conjur-ta, fich, de part de nostro senyor Déu, Jhesu Christ, E per Luch e per March e per Johan e per Meteu, los quatra avengelistes de Déu e per le berga meria, tant gentill, que.t sech lo cap e.t podrescha la rahill.

The following instructions accompany the chant: E sia-y dit per tres vegades e per cade vegada astiga nou jorns € sia-y anomenat lo nom del pasient tres vegades e sien-hi dits tres paternostes e tres avemerias.*

[And this should be said three times and each time nine days should pass,

and the patient’s name should be mentioned three times, and three Paternosters and three Ave Marias should be said. |

I point to these examples to illustrate a collective faith in the power of words to affect the body.46 It is well known that these practices were condemned during the later Middle Ages and Renaissance.*”7 However, their condemnation and subsequent prohibition were not based on the theoretical impossibility of the word curing the body, but on the illegitimate status of the healer - most often a woman — and on the healer’s alleged demonic associations. Even in antiquity, the healing power of the word had come under the scrutiny of philosophers and physicians who attempted to purge the therapeutic speech of magical associations. Plato, for example, attempted to rationalize the Greek epodé, removing it from the realm of magic and superstition and placing it in the domain of philosophy and medicine (Lain Entralgo, Therapy of the Word 121-3). For Plato the healing epodé was any tale, story, or myth that could effectively be used to extinguish troubling fears and harmful emotions. Fully present in the Platonic dialogues is the notion that physicians cannot heal part of the body without ministering to the greater whole: “as you ought not attempt to cure the eyes without the head, or the head without the body, so neither ought you

to attempt to cure the body without the soul” (Charmides 103: Lain Entralgo 114). Therapeutically the epode was thought to carry out this function by tempering the soul, which, in turn, facilitated the corporeal healing process:

28 DISEASE AND THE MEDIEVAL CLINIC And the cure of the soul, my dear youth, has to be effected by the use of cer-

tain charms, and these charms are fair words, and by them temperance is implanted in the soul, and where temperance comes and stays, there health is speedily imparted, not only to the head, but to the whole body. (Charmides 103, in Lain Entralgo 114)

Thus the epode, which began as a conjuration or magical charm, became

associated with persuasive tales, moving speeches, and beautiful discourses. The curative power of language was acknowledged — albeit with some reservation — by medical theorists. Bernard of Gordon, one of the most

respected theorists in the later Middle Ages, offered a therapy for epilepsy that required the physician to repeat into the ear of the patient the names and the gifts of the three Magi: “Gaspar fert mirrham, thus Melchior, Baltasar aurum.” The patient who listened to these words, according to Bernard, would be healed by the grace of God. He also explained that these words could be written down and hung around the

patient’s neck as a possible cure. Another form of logotherapy, according to Bernard, consisted of having a clergyman read portions of one of the Gospels over the head of the patient (Lilo 116) .48 Medieval physicians recognized that words could both cure and disrupt the human body. From a theoretical standpoint the proper use of language was closely related to control over the exogenous conditions,

or non-naturals, that influence health. It was well understood that the imaginative faculty, like other sundry effects of the mind, could gen-

erate pathological or salutary conditions in the body. Thus medical deontologists suggested that healthy men who feared a disease became sick, while sick men who imagined their recovery became well. ‘Theorists warned physicians to be on guard not to say anything that would cause

patients to worry about their condition. Estéfano emphatically cautioned against revealing the possibility of death to the patient, for he, like Plato, recognized that such talk would only dishearten the soul, and thus further complicate the condition of the body ( Viszta fol. 63r). Perhaps more important than what a physician should not say while in the presence of the patient for fear of worsening the condition were those

things that should be said to restore the patient’s health. Isaac Israeli, whose treatise on fevers was well known in late medieval Spain, advised physicians to “reassure the patient and declare his safety even though you may not be certain of it, for by this you will strengthen his Nature” (Book of Admonitions 152).49 Estéfano likewise encouraged medical practitioners

DISEASE, DISCOURSE, AND ILLNESS 39 to greet the patient with “a good countenance, a cheerful face, and some solid arguments that promise health.” Estéfano goes on to suggest that this can best be accomplished by presenting the patient with examples of how illnesses much more serious than the patient’s were cured with divine aid. He also suggests that the physician learn from the example set by the Muy Alto Medico (the Physician on High) who spoke to them in parables. Thus through the use of words and good exempla, the physician can restore the patient’s imagination to a healthy state (Viszta 63r). As I will discuss in detail in Chapter 2, medical theorists believed that lovesickness could also be cured by discursively altering the patient’s imagination. Bernard of Gordon tells us, “Let a wise man confront the patient with words and warnings, showing him the dangers in this world

and in the day of the final judgment, and the joys of paradise” (Lilio 108); Constantine the African recommended “conversing with dearest

friends” and the “recitation of poetry” (Viaticum I.20, in Wack, Lovesickness 188-9); Gerard of Berry suggests that the “counsel of old women is very useful” because they are able to “relate many disparage-

ments and the stinking dispositions of the desired thing” (Notule (Glosule) super Viaticum, in Wack, Lovesickness 202-3); the Italian theorist

Bona Fortuna suggested that the patient be burdened with necessary

business, “so that he is persuaded to be worried about food and clothing, and that he might become impoverished and that it be said to him: “How will you eat? What will you drink? What will you spend? How will you live? All your goods will perish and thus you will be wretched’” (Tractatus super Viaticum, in Wack, Lovesickness 262-3).

In addition to explaining to the patient the how and why of illness, healers in the Middle Ages relied on discursive strategies to diagnose disease, to facilitate therapy, and to cure certain logo-responsive disorders. Although its importance is often overlooked or minimized in contemporary biomedical education, the ability to speak to patients is as important as the ability to manipulate their bodies. Drawing on their authority and privileged status, medieval health care professionals ques-

tioned their patients to establish a medical history. They attempted to explain the pathology of the disease, to describe the etiology, and to narrate the prognosis. They listed the symptoms, prescribed therapeutic behavior, and recounted experiences of having successfully treated other patients with similar disorders. In the case of mental and asymptomatic diseases, they even had to convince patients that they were ill, and often had to persuade them to undergo therapy. In some cases, physicians recognized the benefit of reciting medicinal words to alter

40 DISEASE AND THE MEDIEVAL CLINIC the workings of the mind and thereby correct the imbalance in the body. This questioning, describing, and narrating — which for many modern

physicians are skills ancillary to the technical aspects of curing disease — were indispensable techniques of effective healing in antiquity and the Middle Ages. Explanatory models of medieval disease

The talk that goes on between patient and healer is bound up in larger theoretical suppositions. When healers in the clinical context speak to the patient in an effort to treat a disease, they simultaneously communicate something about the patient’s experience of disorder. Inscribed in even the briefest clinical utterance are physiological and pathological inferences about the workings of the body and the conditions that disrupt the corporeal order. It is through larger concepts of disease that healers formulate their discursive interventions and attempt to offer the patient explanations for illness and a cure for suffering. In the 1970s the medical anthropologist Arthur Kleinman devised a mechanism to help ethnologists describe how human beings understand their illnesses (“Concepts and a Model”). An explanatory model of illness is a belief or set of beliefs that “contain explanations of any or all of five issues: etiology; onset of symptoms; pathophysiology; course of sickness (severity and type of sick role); and treatment” (87-8). I have

adopted a modified version of Kleinman’s explanatory model. For Kleinman and his followers there are three major sources of explanatory models: idiosyncratic, popular, and expert (Blumhagen 200). Kleinman is interested in the way illness is understood in all three of these domains. As an anthropologist whose primary concern is contemporary medical practice, Kleinman pays special attention to the way individuals, in the clinical setting, create explanations for their ailments. Given the historical limitations of my study — it is impossible to interview sick people from the fifteenth century — ]am more concerned with the development of a medical therapy than with the medieval patient’s response to such a therapy. Therefore, I have limited my definition of explanatory model to the way culture (1.e., the healer) rather than the individual attempts to impose meaning onto the illness experience.

During the later Middle Ages there existed a lengthy chain of explanatory models that could be discursively enacted to give meaning to the experience of illness. In addition to the five issues that Kleinman lists, I have added three qualifying characteristics. First, these models

DISEASE, DISCOURSE, AND ILLNESS Al contain beliefs about disease that were embraced by socially authorized practitioners. In the Middle Ages the right to translate signs into socially important symptoms was dominated by a certain group of empowered healers. This is not to suggest that nonprofessionals did not appropriate and subsequently disseminate these notions, but that only professionals were granted the privilege of reading the signs of the body. This group of healers consisted of clergymen and university-trained (or licensed) physicians. Second, these models were not idiosyncratic, created out of the esoteric theory of one physician or philosopher, but were grounded, developed, and contested in centuries of theological and natural philosophical thought. Third, these models upheld the determinant ideology and the ulterior goals of the society in which they were enacted. In late medieval Spain we can identify at least six interrelated, and often highly nuanced, beliefs about disease and corporeal disorder: 1. Disease is a normal condition of mortal existence. Disease is a natural result of Adam’s fall and a normal and expected condition of this life. By

“natural” I refer to the conditions of mortal life that all human beings inherit. Infirmity had its origins in Adam’s sin, and by means of sin it was

thought to be perpetuated from generation to generation. For medieval theologians, to be alive was to be diseased and, therefore, the most basic of mortal activities — shelter building, food gathering — could be looked upon as healing practices. This idea was supported by medical theorists as well as theologians. For example, the Italian master of surgery Guido

Lanfranc began his surgical treatise, the Practica, by emphasizing that bodily misfortune was the punishment that all men suffer because of Adam ’s sin (Pouchelle 40). The idea that disease came into the world on account of the fall of Adam and that all humans were bound to suffer the consequences of mortal existence provided an etiological umbrella that could account for even the most painful, dysfunctional, distressful, and displeasing experiences of life. 2. Disease is a punishment for, or the result of, sin. “Without a doubt, sin

is the first cause of physical maladies,” wrote St. John Chrysostom (c. 347-407) (Delaunay 10). Closely connected to the idea of life as a diseased state is the notion that God permits or even inflicts disease as a punishment for sin.59 Early Christian writers, such as St. Basil and St. Isidore, emphasized the punitive nature of disease.5! Later in the Middle Ages, a number of “punitive miracles” circulated illustrating how moral transgression quickly resulted in a physical ailment: the hand of a woman

42 DISEASE AND THE MEDIEVAL CLINIC who baked bread on the Lord’s day withered; a man who violated the sanctuary of St. Julian’s basilica at Brioude was struck blind; an envious bishop, who openly expressed his ill will at the grave of St. Lupus, became

epileptic as punishment (he recovered upon repenting) .5? 3. Through disease God tests, strengthens, and corrects human beings. One

of the central paradoxes of New Testament thought is that strength comes through weakness (Amundsen and Ferngren, “Medicine and Religion” g6).°3 Paul welcomed his “thorn in the flesh,” a metaphor for his chron-

ic illness, explaining: “For the sake of Christ, then, I am content with weaknesses, insults, hardships, persecutions, and calamities” (2 Cor. 12:10). St. Isidore believed that health from disobedience was harmful, whereas diseases controlled by God were healthy (Zaragoza Rubira, “El

| concepto” 437). Closely related to this idea was the notion that disease keeps humans from sinning. For St. Isidore disease is, paradoxically, a

type of medicine that helps God’s elect when they begin to stray (Zaragoza Rubira, 438). San Gil, wounded by a stray arrow, purportedly begged God never to heal him, for in his pain he would grow stronger

and more divine (Espéculo de los legos 225). The bishop Dionysius explained that the plagues that hit his city, Alexandria, in the middle of the third century were not a source of fear for the Christians as they were for the pagans, but rather a source of discipline and testing (Amundsen and Ferngren, “Medicine and Religion” 98). 4. Disease is demonic. There was a collective belief in the Middle Ages,

popular as well as erudite, that recognized the power of the Devil and demons to disrupt the body and the mind.54 Some medieval theologians believed that God permitted demonic intervention as a means of conditioning humans against sin.°> Stories of men and women becoming ill on

account of demonic possession were plentiful: a prince who witnessed the execution of St. Thomas, we are told, was seized by a devil who caused

him to fall down in an epileptic fit; Bede tells us of a guest at Bardney Abbey who was troubled night after night by an unclean spirit that caused

him to foam at the mouth while his limbs were twisted by convulsive movements; Guibert of Nogent recounts how the Devil held the feet of a peasant washing his legs in a stream after a hard day of work. Sometimes the Devil tricked humans into mutilating their own bodies; there is the well-known story, retold by Berceo, of a devil, appearing as St. James, who persuaded a sinful pilgrim to castrate himself and slit his own throat.56 Diseases such as epilepsy were particularly suspected of being engen-

DISEASE, DISCOURSE, AND ILLNESS 43 dered by demonic possession. No doubt the spectacle created during an epileptic seizure — grinding of teeth, bodily contortions, babble — encouraged belief in a demonic rather than a natural cause for the illness (Temkin, The Falling Sickness 86-92). 5. Disease is imbalance caused by excess or deficiency. Medieval Christians

inherited from Greek, Latin, and Arabic theorists a highly systematic physiological framework in which disease was identified as an imbalance

in the individual’s bodily complexion.5’ The underlying pathological assumption was that all human beings were uniquely endowed with a distinct corporeal makeup and that illness was the result of disrupting this

complexion (destroying the bodily temperament). Disease, therefore, was thought to arise out of an imbalance in the body caused by an excessive or insufficient amount of, or imbalance or defect in, seven categories of phenomena known as the naturals: the elements (fire, air, water, and

earth); the qualities (hot, cold, moist, and dry); the humors (blood, phlegm, yellow bile, and black bile); the members (principal members: brain, heart, liver, and testicles; service members: nerves, arteries, veins, and spermatic vessels, etc.); the energies (natural, spiritual, and animal); the operations (simple: appetite, digestion, retention, and expulsion; compound: desire); and the sperits (natural, vital, and animal). Theorists argued that the naturals became disrupted by certain non-

naturals: a lack or an excess of air, food, drink, sleep, wakefulness, motion, rest, evacuation, repletion, emotions, and coitus.°8 Joannitius explained that “all of these [the non-naturals] if in moderation as to quantity, quality, ime, function, and order, tend to preserve health. But if in excess in one of these matters they tend to produce sickness and to maintain it” (Isagoge 771). Thus disease was thought to arise from excess or deprivation. A glance at any medieval medical treatise illustrates how pathological excess constitutes the underlying medical notion of disease: too much cold, Avicenna tells us in the Canon, “induces constipation because the anal muscles remain tightly contracted and the rectum does not respond to the call of the intestines” (Gruner 187); lethargy, Bernard of Gordon explains, is caused by drunkenness and the eating of too many cold or hot foods at one sitting (Lilio 97); too much coitus, Constantine the African warns, causes headaches, fatigue, and loss of hair (De cottu 131).

6. Disease is related to cosmological and political disorder. Learned medieval clergymen as well as educated physicians recognized that dis-

44 DISEASE AND THE MEDIEVAL CLINIC ease could be precipitated by the disordering effects of external phenomena. Many theorists believed, for example, that the outbreak of epidemic diseases was caused by the adverse conjunction of planets (Siraisi 129). Although during the later Middle Ages the astrological explanation of disease would come increasingly into conflict with theological notions of free will and determinism, physicians persisted in acknowledging that while the stars could not absolutely determine behavior, the movements of the planets could disrupt the body and dispose the patient to certain diseases.°9

Beyond the more scientific concepts of astrological etiology there existed also a general notion that the illicit and improper actions of the eminent and powerful could disrupt the well-being of their subjects. This idea is clearly embedded in the Garden of Eden myth. Adam’s sin, which led to his fall from grace and subsequent exile into a “diseased state,” affected not only Adam and his immediate family, but also generation after generation of his posterity. A similiar explanatory model of

disease lies in the medieval concept of translatio imperi, in which the unrighteous dominion of one monarch or ruler was thought to bring about a transfer of power from one empire to another. What is often overlooked is the pathological ramifications of such a transfer. In the retelling of the events of 711, medieval Spanish historians typically point to the illicit actions of King Rodrigo, Count Julian, and Julian’s daughter as the fundamental cause of the fall of Spain to the Moors. Historians

such as Alfonso X describe the state of collective illness that ensued from the misdeeds of these leaders: toda la tierra uazia del pueblo, lena de sangre, bannada de lagrimas, conpli-

da de appellidos, huespeda de los estrannos, enagenada de los uezinos, desamparada de los moradores, bibda et dessolada de sus fijos, coffonduda de los barbaros, esmedrida por la llaga. . . . (Primera cronica general 312)

[all the land empty of people, full of blood, bathed in tears, replete with cries, inhabited by strangers, abandoned by neighbors, forsaken by the dwellers, widowed and grieving for her children, brought to ruin by the barbarians, afflicted with sores... .] The objectification of disease in the medieval clinic

Several observations should be made about these six models of disease. First, etiologically speaking, these explanations are highly complementary. In clinical encounters different explanations could easily have col-

DISEASE, DISCOURSE, AND ILLNESS A5 lapsed into one another, offering a variety of interrelated causes for illness. There is no reason why a person suffering from a pain in his chest, for example, could not be led to envision his disorder as a combination of several factors, such as a result of the natural condition of the diseased state of mortal existence, a punishment for sinful deeds (no doubt there were several in his mind to choose from), and a disruption of his corporeal makeup (complexion). Only in therapy might conflict have

arisen between various models, but even here one healing technique did not necessarily preclude or undermine another. In fact, physicians encouraged their patients to confess their sins — acknowledging the eti-

ological aspect of sin, while also working on the assumption that the

complexion was unbalanced and insisting that the patient take the proper medicines to temper the body. Second, these explanatory models of disease are essentially abstractions, which must be discussed in a clinical encounter if they are to

inform the patient about his or her illness. During this process of explaining illness it is often helpful, especially from the point of view of

therapeutics, to objectify these concepts of disease. There is a need among human beings, both modern and medieval, to see disease as something tangible and concrete. Healers often find it therapeutically useful to point to objects or objectified forms of behavior that they can

relate to the process of disordering the body. Even when disease is understood in purely physiological terms, as a condition of the body rather than as an inimical entity that attacks the body, the objectification of disease helps healers to identify for the patient those substances, forms of behavior, and circumstances that disorder the body.®!

Explanatory models are beliefs about disease that healers use to attach meaning to the patient’s objectified ills. To be of any help, however, these models must be discursively formulated and communicated to the patient. The healer can choose from an infinite number of ways to do this. The efficacy of any explanation of disease — that is, its ability

to satisfy the patient’s need to understand his or her disease, to persuade the patient to comply with the appropriate therapy, and, in some cases, to cure the patient’s disorder — depends on the way the particular discursive enactment fits in with the patient’s intellectual and emotional disposition. A patient, although vulnerable and highly receptive to the

persuasive talk of the healer, is not a blank slate. In times of illness patients recall events, circumstances, sensations, and feelings that have

cohered and persisted in the mind in the course of their lives. This knowledge may include highly theoretical concepts of disease acquired

46 DISEASE AND THE MEDIEVAL CLINIC through past encounters with physicians or educated people. It may also consist of purely empirical impressions, such as recollections of pain, images of family members during moments of suffering, or memories of therapeutic practices. Whereas the explanatory model lies in the domain of the healer and is usually constructed of strongly causal or highly developed propositions, a patient’s view of a particular disease

often consists of nothing more than a string of feelings, sensations, images, and recollections. Since these subjective notions of disease are

constantly changing and are never completely shared with other patients, they are difficult to codify and classify. ‘Today we can only imagine what went through the mind of ill people in the Middle Ages: reverberations of sermonic fragments on death; images of infernal sufferings and truncated limbs floating aimlessly in the enormous “Mouth of Hell”; sensations recognized as corporeal excess (too much heat, not enough moisture, overflowing fluids); stories of miraculous healings and impossible cures; the midnight cries of an ailing neighbor; the stench of vomit and infected wounds; the anxiety of dissolution; visions of abjection; recollections of former pains. Recognizing the existence of the patient’s sense of disease, despite our limitations in describing it, is significant because it allows us to see

how practitioners may alter their clinical speech to appeal to the patient’s knowledge of his illness. Most health care practitioners intuitively know that in order to explain the nature of a patient’s disease or convince him or her to comply with therapy, they often must resort to various forms of speech that must be tailored to the background, competency, and resistance of the patient. They know that by speaking in

euphemisms, employing technical jargon, recounting anecdotes, or casting information in analogies they can manipulate a patient’s conception of illness. This allows the physician to counter any resistance to _ therapy while encouraging patients to comply with the prescribed steps for recovery and helping them to cope with an unpleasant prognosis.®5 Externally visible factors, such as age, gender, race, and class (to the degree that the patient’s class is manifest in clothing, speech, and mannerisms), as well as the recollection of past encounters with the patient, help orient the practitioner’s speech. In the later Middle Ages, especially among preachers, there was an

understanding that a single way of speaking could never generically

serve the needs of all human beings. The Dominican Humbert of Romans (1200-77) in his De eruditione praedicatorum (On the Formation of Preachers) compiled material for nearly four hundred different kinds

DISEASE, DISCOURSE, AND ILLNESS yy of occasions. Implied in the presentation of these discursive materials is

the idea that there is “no single exhortation which is suitable for everyone.” Humbert explains: We must also notice that, even in situations in which it is right to preach, it is

not right to preach the same thing to everybody. Different people should

have different things preached to them, according to their condition. Gregory says in his Pastoral Rule “As Gregory Nazianzen of blessed memory taught us long ago, there is no single exhortation which is suitable for everyone, because men are not all held in any necessary equality of moral standards. Often what helps one man harms another, just as many plants nourish one kind of animal and kill some other kind, and a soft whistle soothes a horse and excites a dog, and a medicine which reduces one sickness makes another more virulent, and the bread which nourishes the life of the healthy adult is death to a baby... .” (246)

Significantly, Humbert compares the skills of the preacher with those of the physician. The idea that a preacher cannot give the same sermon to all men, just as a physician cannot administer the same medicine to all patients, points to the important homology between pharmacology and

rhetoric. Since disease was explicable in terms of an imbalance in a patient’s complexion, pharmaceutical therapy consisted of adjusting or tempering the complexion with substances that compensated for this imbalance. To cure a disease, a physician needed only to administer those substances whose dominating qualities compensated for the lack or excess in the patient’s complexion. Therapy, however, was complicated by the recognition that there was not one complexion for the entire human race but many, and that each individual had his own constantly changing distribution of qualities. The physician Alfonso Chirino poetically expressed this idea when he explained that “este cuerpo non esta en cierto estado

vn momento tanpoco, como el agua del rio corriente que non es esa mesma en ese lugar en el vn momento tal como en el otro siguiente” (Espejo 3'75,) [this body is never in a fixed state, but rather is like the water

in a running river that is never the same in that place at one time as it is in the next]. Thus the usefulness of any particular medicine depended not on its intrinsic characteristics but on its ability to compensate in a

given moment for the imbalance in the individual complexion. 4 Analogously, if the same medicine could not cure all patients, the same form of discourse was unable to move all listeners. Thus a successful preacher was one who learned to adapt his speech to fit the needs of the individuals. Humbert of Romans offers an exhaustive list in which he pro-

48 DISEASE AND THE MEDIEVAL CLINIC vides more than one hundred human conditions to which a preacher must tailor his sermons: So the teacher must devise a sermon which fits the quality of his congregation. There is one way to address men, another way to address women, one way for the young, another for the elderly, one way for the poor, another for the rich, one way for the cheerful, another for the sad. .. . (246)

The development of medieval pharmaceutical theory parallels the rise of the rhetorical arts, namely the ars dictaminis (epistolary arts) and

the ars praedicandi (sermonic arts). These arts were grounded in the premise that individuals differ in various ways, and that no single utterance or drug could satisfy the needs of all of them. The emergence in thirteenth-century Bologna and Orléans of the dictamina, enormous collections of model letters that could be appropriated for any occasion, corresponds with the development in Montpellier of a pharmaceutical

theory based on the assumption that medicines restore health almost exclusively by means of their individual, specific properties.

To understand the clinical value of misogynist discourse in the Arcipreste de Talavera and the Spillwe must recognize that medieval physi-

cians and orators perceived the need to dispense their drugs and discourse according to the requirements of the individual. The Arcipreste de

Talavera and the Spill are huge collections of clinical dicta that offer rhetorically intensified verbal therapies for inordinate sexual desire to readers of diverse physiological and mental dispositions. The codifica- — tion of these discursive fragments was designed to allow the male patient

to administer therapy to himself independently of a practicing physician. Thus, the diversity and volume of these utterances attempted to cover the large spectrum of possible corporeal and mental conditions. In the clinical context of healing a patient suffering from inordinate sexual desire, the practitioner was instructed to modify the corrupt imag-

ination that had fixated pathologically on the desire for a pleasurable encounter with the beloved. To do this, the healer often focused the patient’s attention on the beloved, pointing to the way she embodied his disease. To intensify this image, the healer could also attempt to enter deeply into the patient’s psyche, drawing experiences, knowledge, and

sensations of illness to the surface, where the practitioner could then associate these with the beloved, and thereby counter images of pleasur-

able well-being with those of painful, alienating illness. The ultimate effectiveness of the therapy depended on the power of this speech to mediate those images and feelings of illness harbored in the patient’s mind.

2 Sexual pathology and the etiology of lovesickness

The seed, as we have said, is roused in us when maturity first gives strength to our limbs. One thing moves and stirs

one thing, another stirs another; but human influence alone summons human seed from man. As soon as the semen is moved and goes forth from the place of origin, it passes from the whole body through all the members and,

gathering in the designated part of the tissues, at once excites the generative organs themselves. These parts, being aroused, swell with the semen, and the desire is formed to direct it where detestable lust strains. It seeks that body whence the mind has received the wound of, love; for wounded men for the most part fall upon the wound, blood spurts in the direction from which came the

stab, and red gore covers the enemy if he be near. So if anyone has been wounded by the weapons of Venus, whether the dart has come from a boy with effeminate limbs or from a woman hurling weapons of love from her whole frame, he strives in the direction from which he has been pierced, and struggles to unite with that body and to pour into it the liquid drawn from his own; for a wordless desire foretells the pleasure. Lucretius, On Nature 147

The fifteenth-century Espéculo de los legos, a sourcebook of exempla and other materials for preachers, includes a story about a man who wanted to have sex with his wife on All Saints’ Day. Although the ecclesiastic

- authorities warned him of the dangers involved in such a sin, the man arrogantly replied, “Not even for the sake of all the Saints will I refrain from making love to my companion.” While the rest of the Christians went to mass, he took his wife to bed. During the act of making love

they were both injured, and the following morning they were found stone dead, wrapped in each other’s embrace. “Be assured,” the com-

49

50 DISEASE AND THE MEDIEVAL CLINIC mentator warns us, “that just as their bodies were then wrapped together, their souls are now wrapped in hell” (186). The relation between sexuality and disease permeates the dominant explanatory models of clinical illness and holds a prominent place in clinical etiology. St. Bonaventure articulated the general suspicion of many healers by explaining that sexual acts are a form of disease, for they cannot be performed without disorder (Brundage 424). For men such as Bonaventure, lust and unbridled sexual desire were at the heart of civic chaos, corporeal pain, and spiritual damnation: On account of this detested sin the world was once destroyed with a universal flood and the five cities of Sodom and Gomorrah were burned with a celestial fire so that their inhabitants descended live into hell. Likewise as a result of this sin — which calls forth divine vengeance — famines, wars, plagues, epidemics, floods, betrayals of kingdoms, and many other disasters come more frequently.1

Although some healers, especially in the medical tradition, argued that moderate coitus was necessary to keep the body healthy, they nevertheless agreed that the intense and compelling pleasure involved in sexual relations made the body highly vulnerable to corporeal imbalances and mental disorders. From the early Middle Ages, sexuality edged its way into the center of attention as a privileged cause of illness. Church fathers, promoting the

idea that Adam and Eve introduced sex and the evil of lust into the world when they partook of the fruit of the tree of knowledge, linked sexual misconduct with the etiological underpinnings of medieval disease.* Sex was identified as the means by which horrible afflictions were thought to be passed from woman to man and man to woman. Leprosy,

perhaps the most dreaded, the most symbolically saturated, and certainly the most socially stigmatized disease of the Middle Ages, was linked to hypersexuality in the sufferer, who was thought to transmit venereally the horrors of autoamputations, nasal destruction, facial coarsening, and vocal changes.° Early church theologians taught that sexual intercourse had been invented by the Devil and that anyone engaging in intercourse was serving the Devil and not God (Bullough and Brundage 7). From a cosmological standpoint, collective illness was

thought to be rooted in sexual misconduct. In the sixth century Justinian explained that “we know that God brought a just judgment upon those who lived in Sodom, on account of this very madness of intercourse, so that to this very day the land burns with inextinguish-

SEXUAL PATHOLOGY AND LOVESICKNESS 5l able fire” (Bullough and Brundage 20). The downfall or triumph of entire nations hinged upon the control of sexual desire. Perhaps the most powerful reminder of this, one with which many fifteenth-century

Spaniards were familiar, was the interpretation of Spain’s fall to the Moors in 711 as due to the sexual misconduct of King Rodrigo.4 Sexuality was also an area of great concern for physicians and natural philosophers, who paid special attention to the physiological and pathological nature of coitus and amorous affection.5 These men dedicated

lengthy chapters and entire treatises to discussing questions of impotence, foreplay, coital positions, and conception, as well as the dangers and benefits of intercourse and sex-related behavior. The most influen- : tial of these treatises was Constantine the African’s (d. 1085) De coitu. Drawing his theoretical knowledge from Arabic theorists who in turn had synthesized Galenic theories of human sexuality, Constantine outlined the general principles of sexual physiology, detailing the function of the internal organs, the nature of semen, the role of the testicles, and the relation between bodily composition and sexual activity. He also dis-

cussed the foods that prepared the body for coitus, the ointments that stimulated desire, and the conditions in which intercourse was most beneficial and least harmful. A number of similar treatises, such as the anonymous Liber minor de coitu, circulated among the learned public from the twelfth century, as did complete chapters of larger medical compendiums such as the chapter “On Increasing the Size of the Male Member in Length and Width,” which appeared in William of Saliceto’s Summa conservationis. Likewise, Avicenna’s Canon, the most important university textbook on medicine during the later Middle Ages, fully discussed all aspects of human sexuality from erection to conception.®

From the fifteenth century on, biomedical information on human sexuality became widely disseminated to the more general public in the form of vernacular handbooks. Perhaps the most remarkable of these works was the Catalan (Valencian) Speculum al foderi, translated into English as the Mirror of Coitus or the Mirror for Fuckers.’ This little hand-

book, which incorporated medical knowledge from Christian and Arabic sources, explicitly claimed to be written in a non-technical form for anyone who desired to read it. Likewise, a lengthy section in the late fifteenth-century Compendio de la humana salud (attributed to Johannes de Ketham) entitled “De las dolencias de las mujeres y de los miembros

generatiuos’ [On the Disorders of Women and the Reproductive Organs| provided questions and answers on sexual physiology, such as “Why is moderate sexual intercourse useful?”8 The Compendio is typical

52 DISEASE AND THE MEDIEVAL CLINIC of a variety of vernacular works that enumerated the salutary and harmful effects of sexual intercourse. Another example is Juan de Avinon’s popular medical guide Sevillana medicina, which lists back-toback twelve benefits of coitus followed by twelve dangers of excessive sexual relations (109r). To a lesser degree, hygienic guides such as the

Catalan translation of Arnau de Vilanova’s Liber de regimine also described the benefits and dangers of intercourse, while noting the precautions that one must take before and after coitus (Regiment de sanitat 131).9

Medieval medical theorists described sexual intercourse as a complex process involving the use of three internal organs (the heart, the

liver, and the brain) and three corresponding elements (desire, pneuma, and humor), all combined with the proper amount of heat and moisture (Constantine, De coitu 80). In a sexual encounter, theorists explained, desire or appetite emerging from the liver caused the heart to pump more rapidly, thus pulling air into the lungs and the hollow of the penis. As the ensuing pleasurable movements of coitus warmed the body, the semen, which was believed to be lodged in the brain, liquefied. Once it became watery, the semen was able to make the serpentine pilgrimage through the veins behind the ears, into the spinal chord, through the testicles, and into the erected penis, whence it was ejaculated into the female womb. The root of sexual activity was thought to lie in the erotic imagination, which produced the necessary sexual appetite.!9 Albert the Great

explained, : the mental picture of the opposite sex, imagined in the mind of a lover, is an

important prerequisite to human mating because the image of a lovable woman has an exciting effect on a man when he perceives her form with the eyes of his heart and, likewise, the fancied image of a desirable man rouses a

woman to yearn for sexual intimacy. This preliminary perception of each other’s image sparks their interest in love-making. (Man and the Beasts: De animalibus 60)

As Andreas Capellanus explained, love “arises not from any action, but

solely from the thought formed by the mind as a result of the thing seen.” Once the figure of the beloved is erotically formulated in the mind, the lover begins to desire that figure, causing his body to heat up and burn with increasing intensity; this leads to a stage of more detailed reflection in which he “starts to think of her several attractions, con-

SEXUAL PATHOLOGY AND LOVESICKNESS 53 templating her different parts; he begins to picture the role he can play and to pry into her body’s hidden features” (On Love 34). Handbooks on coitus, such as the Mirror of Coitus, detail for the reader the types of physical features that a man should contemplate as the body prepares itself for intercourse: A noble and beautiful woman has four black features: her hair, her eyebrows, her eyelashes, and her pupils. She has four red features: her complexion, her

tongue, her gums, and her lips. She has four white features: her face, her teeth, her legs, and the whites of her eyes. She possesses four small features: her nostrils and ears, her mouth, her nipples, and her feet. She has four thin features: her eyelashes, her nose, her lips, and her ribs. She has four large features: her forehead, her eyes, her breasts, and her buttocks. She has four round features: her head, her neck, her arms, and her legs. Finally she has

four features that smell good: her mouth, her nose, her armpits, and her vagina. (32-3)1!

This mental presencing of the eroticized (and fetishized) female body points to an often-recommended discursive technique for conditioning men — especially impotent and shy men — for sexual intercourse. John of Gaddesden, writing of male sterility, urges men to amuse themselves with bawdy songs, to discuss openly the sexual act (and even watch humans or animals in the act), and to start up conversations with beautiful women. Another fifteenth-century theorist, Michael Savonarola, likewise urges men to “listen to stories, songs and other similar things” and then “imagine the sexual act at great length until they feel fortified.” As these theorists clearly illustrate, there was a recognized discursive component to sexual physiology in which speaking about love, conversing with beautiful women, and listening to erotic stories contributed to the imaginary preconditions of coitus. In the Hispano-Arab world

these discursive aphrodisiacs were abundantly described in the numerous treatises on sexual hygiene. Works like the Perfumed Garden prescribed listening to erotic stories to prepare the body for intercourse

and offered the reader anecdotes that could be appropriated, like.an herbal compound or ointment, to stimulate sexual desire.” The act of figuring the object of desire in the mind was thought to have a material component that was capable of altering and disrupting the body. Theorists reasoned that a spirit (pneuma) transmitted by the optic nerve was emitted outward and apprehended the things beyond the body. When this happened, blood, engendered in the liver, nourished and reinforced the members, causing a pleasurable sensation.

54 DISEASE AND THE MEDIEVAL CLINIC This caused the body to become hot and moist and caused the blood in the liver to evaporate. The now-pneumatic form of blood then spread

from the liver to the heart, from which it was pumped into the penis through the arteries, causing the male organ to stiffen (Jacquart and Thomasset 83). The Salernitan physician and theorist Urso reinforced

this idea in less technical terms, explaining that when a husband admires the beauty of his wife, and her form revolves in his mind, his desire is amplified. To satiate his burning libido the spirit follows the path outlined by the imagination and runs to the virile member so as to carry out in the body what had been concocted in the mind.!3 In the physiological mechanics of sexual intercourse, the air (spiritus in Latin and pneuma in Greek) was thought to be responsible for im-

portant movements in the body and the mind. Of the four elements (earth, fire, air, and water) air was considered the finest and lightest, capable of carrying out functions needing a penetrability and permeability that other elements lacked. Air entered the body through inspiration or through consumption of foods with “windy” qualities. Once inside the body, certain pneumatic material (known as animal spirits) became rarefied in the brain and moved by means of the nerves through the body; this accounted for sensual and mental activities such as pleasure, pain, thought, and imagination. Other pneumatic material passed through the heart or the liver, where it was transformed into a different type of spirit that circulated in the veins. This second type of pneuma (often identified as natural or vital) was gaseous by nature and was the same substance that caused flatulence, bowel movements, and vomiting.!4 Sexually speaking, it was this type of pneuma that filled the hollow of the penis, making it rigid and ready for sexual intercourse; it then caused the sperm to be ejected out of the penis and into the vagina.!5 Another function of the pneuma in the body was to move the semen

from the brain to the testicles and erect penis. Semen, a humid and warm substance of humoral quality, was thought to be lodged far from the testicles and the penis in the cavities of the brain.!6 The pneumatic element of semen, when combined with heat and moisture, was capable of moving the seed through the body. Constantine the African, echoing the words of Galen, described semen as pneuma and frothy humor; it is frothy, he tells us, because as it moves through the body it foams like a stormy sea.!7 The foamy, warm, and moist nature of semen was thought to cause an intense pleasure as it moved through the body, climaxing in its discharge from the penis.

SEXUAL PATHOLOGY AND LOVESICKNESS 55 Much of the material written in handbooks and treatises on coitus concerned itself with prescribing the proper food, drink, and medicines

that compensated for the insufficient amount of heat, moisture, and pneuma in the body. The Mirror of Coitus explains, men whose temperaments are cold and dry need to eat hot, humid foods and drink wine when they copulate. ... For men whose temperament is hot and dry, you must moisten their bodies and take care not to ignite more heat. This is done with humid foods such as vegetables, fruits, fresh fish, softboiled eggs, and fresh milk, and by washing with warm water... . Hot and

humid things in equal proportion are necessary to increase the sperm because moisture generates pneuma which is necessary to realize the act. Let he who wants to increase the sperm eat foods with the following three characteristics: moisture, heat, and pneuma. When all three of these qualities are present in one food, it is very good and you should use it. But if you can’t find

all three qualities in one food, combine one food with two qualities with another food which will make up the difference. The following foods contain all three qualities: chick peas, turnips, and carrots. Beans contain two qualities, much moisture and sufficient pneuma, and they provide good nutrition, but they lack the necessary heat to move the moisture and pneuma. (19-20)

As long as the body contained sufficient amounts of moisture, heat, and pneuma, in proportion to the frequency of coitus and the exogenous conditions (weather, cosmos, season, time of day), medical theorists saw no physical danger in sexual intercourse.!8 However, an excessive depletion of these elements caused by frequent intercourse or an insufficient

amount of them during intercourse could pathologically alter the body

and initiate a number of diseases and disorders. Albert the Great explained that “excessive emission of sperm particularly weakens the brain and the neighboring organs.”!9 The most oft-repeated warnings against excessive sexual intercourse detailed the damage that could occur

to the brain and to the organs adjacent to the cerebral cavity. The fifteenth-century court physician Alfonso Chirino attributed dizziness (“quando la cabec¢a se anda aderedor”) to excessive coitus.29 Bernard of

Gordon in his Lilio, like many other medical authorities, warned that excessive coitus caused men to lose their hair (75). Albert the Great asserted that “coitus drains, above all the brain,” and thus a man who copulates excessively damages or loses his eyesight; at very least his eyes will

become noticeably sunken into the cranium.?! Medical theorists regularly identified headaches, loss of the olfactory faculty, bad breath, ringing

56 DISEASE AND THE MEDIEVAL CLINIC in the ears, vertigo, and loss of appetite as disorders associated with immoderate coitus.22 Three of the most frequently cited dangers of inordinate sexual inter-

course were loss of strength, accelerated aging, and premature death. Medical theorists, preachers, theologians, and even lawyers taught that coitus weakened the body.?3 Aquinas explained that in wartime wise commanders cast women forth from their camps so that soldiers might not spend their strength in carnal indulgence (Brundage, Law, Sex 425). Bonaventure, the son of a physician, argued that all sexual intercourse _ was dangerous to the health and that the sex act helped to shorten one’s life. Even today in Spanish folklore there exists the idea that sexual rela-

tions make men old and weak: “Si quieres llegar a viejo / Guarda la leche en el pellejo” [If you want to reach old age / Keep your semen in your skin] (Brandes 84—7).4 In general excessive coitus was thought to deplete the body of its nat-

ural moisture while increasing the heat in the body, a condition that quickly left the body dry and led to an overall state of weakness and illness. Additionally — and often with little etiological explanation — theo-

rists claimed that excessive coitus caused chest ailments; lung and kidney failure; increased gas, flatulence, and rumblings in the stomach; ulcers and abscesses on the penis and testicles; painful joints; shivers; body tremors; and intense fevers. Another frightening eventuality of immoderate and improper coitus was congenital defects and disfigurations. Bernard of Gordon tells us that those who copulate frequently are either incapable of producing offspring or only able to engender ugly and deformed creatures.25 Theorists

warned that improper coitus, such as intercourse with menstruating women, could produce monstrous births or afflict the child with horrible diseases such as leprosy.2© Congenital diseases produced a double afflic-

tion by deforming the child and stigmatizing the parents. As the etymology suggests, the engendering of a monstrous child “demonstrated” the errors and excesses of the parents.2”7 Some theorists suggested that the parents’ sins were re-created in the imagination during intercourse. Theorists such as Avicenna commented on the power of the imagination to make the body conform with the images in the mind: “imagining the color red causes an increase in the movement and flow of the blood; a person terrorized by an uncontrolled dread of leprosy may display symptoms of the disease.”28 If the imagination could alter one’s own body, it likewise could play a role in the development of the fetus. As Paracelsus

explained, “the child is the earth upon which the imagination does its

SEXUAL PATHOLOGY AND LOVESICKNESS 57 construction” (Las enfermedades invisibles 58). Paracelsus, writing at the beginning of the sixteenth century, articulated a long tradition that identified the imagination as the primary determinant in the development of the child: “when a painter imagines something, he paints it with a brush;

when a woman imagines something, it is painted on the body of her unborn child” (58). The point in time when the imagination had the greatest influence on the unborn child was during sexual intercourse, as suggested in an anonymous treatise on generation: La causa de parescer a sus abuelos 0 a otros parientes es por la animosidad e benivolencia que tienen los engendradores con aquel abuelo o pariente por lo qual se les faze presente enel pensamiento o fantasia en aquel tiempo que la muger e el baron estan juntos, usando de aquel acto luxurioso, conel qual la generacion se haze. Y la causa que parescen ha otros estranos es la mesma dicha: por que se les representa a amos 0 al vno dellos alguna figura de algu-

na persona que mucho quieren bien o mucho mal. E aquesta tal ymaginacion faze que lo engendrado paresca a aquella persona en quien esta puesta la fantasia. (Tratado de la generacion de la criatura 2v)

[The reason a child looks like his grandparents or other relatives is that the parents feel animosity or benevolence for the grandparent or relative and they make this present in their thoughts or imagination during the moment when man and woman are together, engaging in that lustful act by which

generation takes place. And the reason why the child looks like other strangers is the same: because one or both of the parents imagines the figure of a person to whom they desire much good or much evil. And this very imagination causes the engendered to look like the person who was placed in the fantasy. |

A powerful force, the imagination could be as disruptive as creative. Left uncontrolled, especially during the sexual act, it could lead to all kinds of congenital deformities: “E acahesce algunas vezes que las

mugeres o hombres en aquel acto ymaginando en algun lebroso o manco o feo engendra el fijo lebroso o manco o feo” [And it occurs sometimes that women or men while in the act, imagining a leper, a maimed (one-armed) or an ugly person, engender an ugly, a maimed, or a leprous child] (Compendio de la humana salud 211). The imagination was also the source of another sexual disorder, known as the lover’s malady, technically called amor hereos.?9 The etiology of the disease pointed to the lover’s obsessive and inordinate imaginary fixation on the object of his desire. Simply stated, the disease was thought to be caused by a powerful apprehension of the form and figure of the beloved

58 DISEASE AND THE MEDIEVAL CLINIC that deprived the lover of his ability to reason, understand, and behave normally. It was, according to Bernard of Gordon, a “passion del celebro, e es por causa de la corrupcion de la imaginativa” [a disease of the brain

caused by the corruption of the imaginative faculty] (Lilio 108). The intense fixation on the beloved led to the “rana/Diana syndrome,” a malfunction in the brain’s estimative faculty (produced by excessive desire) that caused a man to envision in something that was plain, disagreeable, or even repulsive (such as a frog, rana) beautiful and desirable characteristics (such as those possessed by the goddess Diana): “El que ama la

| rana piensa que es estrella diana.”°° Some theorists argued that there was an element of pleasure in this fixation, for it was the anticipation of the pleasure of coitus that encouraged men to cogitate so assiduously on the object of desire.3! Other theorists attributed the disease to melancholy;

still others attempted to identify the affected part of the brain; some argued variously that the disorder originated in the testicles, the liver, or

the heart. Regardless of the etiology, most theorists agreed that men afflicted with this disorder became so obsessed with their beloved that they began to suffer various physical and mental disorders. Heroic love caused men to lose their appetite and their desire to drink; their faces became yellow, their eyes hollowed, and their eyelids turned heavy; they suffered rapid mood swings, bursting out in laughter one moment, languishing in sorrow the next; they fell into deep depression, their pulse was quick and unsteady, and they suffered from insomnia. If left uncured, the disease led to madness and an untimely death. Beyond merely speculating as to the nature and cause of sex-related disorders such as excessive intercourse and heroic lovesickness, theorists offered techniques to mitigate painful symptoms, to temper corpo-

real and mental imbalances, and to prevent the diseases from happening in the first place. Many of these therapies were somatic in nature, requiring the use of herbs, selective foods, and the relegation of sexual activity to the proper time, place, and circumstances in which coitus was apt to be least harmful to the body. For example, men whose natural complexion was cold and dry were told to eat humid foods such as mutton and wheat breads and to season their food with ginger, cin-

namon, or pepper.?* All men could avoid the debilitating effects of coitus by not copulating on a full stomach, after leaving a bath, or when

hungry, thirsty, or angry.°3 In the case of heroic love, theorists also pointed to somatic therapies and herbal remedies for the disease. Bona Fortuna, in his commentary on Constantine’s Viaticum, suggests that a partial cure for amor hereos is to purge the body with an herbal concoc-

SEXUAL PATHOLOGY AND LOVESICKNESS 59 tion composed of wild endive, honeysuckle root, basil, and dandelion; violet honey or an electuary of rose juice also helps to evacuate the body of harmful humors (Bona Fortuna, Tractatus super Viaticum 258-9). Theorists also prescribed bathing, sleep, mild drunkenness, and coitus to mediate the disorder. Despite the alleged efficacy of such cures, clinical etiology, in that its understanding of disease extended beyond the scope of medical theory,

regarded all sexual interaction between men and women as being potentially dangerous. Even if the damage to the body could be mitigated by herbal remedies, there persisted in all sexual activity the more serious possibility of damning the soul. Consequently, clinical practitioners sought a way to simply abrogate illicit and inordinate sexual activities, rather than help the patient endure negative consequences. To this end they focused on what they believed to be the fountain of

sexual disorder: the imagination. If the somatic conditions of coitus — the heating of the body, the liquefying of the sperm, the filling of the penis with pneuma — were initiated by erotic thought and sexual images, then it stood to reason that the dangers of intercourse could be controlled by eliminating, countering, and supplanting the erotic imagination. For the treatment of heroic love, such a strategy would not only arrest the progression of the disease by preventing an obsessive fixation

on the beloved, but according to many theorists it could also serve as the only effective cure. Inspired, no doubt, by the ascetic technologies of corporeal contain-

ment developed during the patristic age and in the early monasteries, medical theorists offered several methods to rid the mind of harmful erotic images. One way was to provide alternative stimuli for the patient:

send him on a trip, have him listen to music, let him contemplate the beauties of nature, have him smell sweet and fruitful gardens, encourage him to travel to distant places where diverse and curious things will occupy the mind.34 Another technique was to inflict pain: “let him be harshly beaten many times until he starts to stink,” Bernard of Gordon recommends, as the cure for heroic love (Lilio 108). Still another method consisted of forcing the patient to witness or participate in an abject demonstration such as smelling the burning excrement of the beloved or being required to stare at a dirty cloth that had been soaked in menses or urine.°5 These three therapies, which were formulated around the theoretical effects of distraction, pain, and abjection on the psyche, could be discursively administered to the patient as well. The idea of confabulatio, in which

a physician, a close friend, or a person of authority attempted to heal the

60 DISEASE AND THE MEDIEVAL CLINIC patient by speaking to him, endured throughout antiquity and the Middle Ages as an effective cure for many disorders, especially for those whose etiology was rooted in mental disturbances. Glending Olson has recently shown how the confabulator occupied an important place in the hygienic counsel of the Middle Ages. Pointing to medieval health handbooks such as the Tacuiunum sanitatis as well as more theoretical treatises such as the Isagoge, he shows how medieval physicians believed that by telling stories,

reciting poetry, and acting out anecdotes and fables, the confabulator could restore or maintain in the patient’s body a cheerful disposition (gaudium temperatum) whereby the body stood to gain strength and resist

disease. The theoretical underpinnings of the confabulatio consisted of the recognition that the affections of the mind, such as anger, fear, excessive joy, sorrow, and anxiety, could disrupt the body.°® One way of read-

justing this imbalance was to counter the pathological emotions with therapeutic discourse. Like a drug or medicine, the type of discourse administered to the patient depended on the patient’s individual needs. Whereas a cheerful and happy story could help those plagued with sadness and anxiety, it could have the reverse effect on patients who were already suffering from too much joy. This type of patient required the exact opposite kind of discursive intervention. For example, in the

sixteenth century the Spanish theorist Francisco Valles (1524-92) recounted how he cured a woman of repeated faintings by telling her a sad story; according to Valles, the woman was experiencing a pathological sense of joy in anticipation of the return of a son who had been away from home for several years (Peset 16).

It was the idea of the confabulatio, the tempering of the body by dis-

cursively countering the accidents of the mind, upon which medical theorists used to base many of their therapies for sexual disorders. Although never systematically articulated, confabulation theory identi-

fied the preferred nature of both the interlocutor and his therapeutic locutions. In general, the confabulator had to be a good teller of stories (vecitator fabularum) who could appropriate, alter, and employ the dis-

cursive instrument that would most effectively heal the patient. The author of the Tacuinum sanitatis explains: Confabulator: A teller of stories should have good discernment in knowing the - kind of fictions in which the soul takes delight, should be able to shorten or extend his presentations of stories as he may choose, and to decorate, ampli-

fy, and arrange them as fitting. ... [He should be] a good judge of discourses (not only histories of great princes but also delightful stories that provoke laughter), and be conscious of verses and rhymes. (Olson 82-3)

SEXUAL PATHOLOGY AND LOVESICKNESS 61 For love-related ailments theorists noted that the interlocutor should be a respected person of high moral standing, or a good and trustworthy

friend. Constantine the African explained that nothing helped the erotic lover to avoid excessive thoughts more than conversing with

dearest friends and listening to the recitation of poetry (Wack, Lovesickness 188-9). Bernard of Gordon was more specific, insisting that the confabulator be a wise man whom the patient respects, one capable

of shaming the patient with words and counsel (Lilo 108). Francisco Lopez de Villalobos, in his metrical summary of Avicenna’s Canon, emphasized the interlocutor’s authoritative posture, insisting that he be

a good friend, a member of a noble family, or a prudent man of authority (Sumario 324). To prevent and cure pathological erotic cogitation, the confabulator, be he a physician, a sagacious man of authority, or simply a dear friend, must not only be able to appropriate discursive medications, but, as the

Tacuinum suggested, he must also be able to decorate, amplify, and arrange his arguments and anecdotes to fit the needs of the patient. The poetics of sexual well-being that medical theorists created to help confabulators select, decorate, and amplify therapeutic discourses was based on the same psychic stimuli as the nonverbal cures: the fragments

of discourse selected to be used in a therapeutic encounter between interlocutor and patient became more effective to the degree that they preoccupied, frightened, hurt, and disgusted the victim of excessive erotic imagination. Thus the effective physician was one who could offer his patient words, expressions, aphorisms, descriptions, warnings, ser-

mons, fables, and anecdotes that contained one or more elements of distraction, pain, fear, and abjection. For the mildest cases simple distraction was thought to suffice. The idea was to get the patient to abandon his erotic thought and turn his

attention to other things. Bona Fortuna urged the confabulator to “burden him with necessary business, so that he is persuaded to be worried about food and clothing, and that he might become impoverished.” He even offers the reader a few useful questions that might be posed to the patient: “How will you eat?’ “What will you drink?’ “What will you spend?’ “How will you live?’ “All your goods will perish and thus you will be wretched” (Tractatus super Viaticum 262-3).

A more powerful method was for the confabulator to infuse fear into the conversation. Bernard of Gordon says that it is therapeutic to point out the dangers of mortal existence and those of the day of judgment (Lilio 108). Following Bernard’s advice, the interlocutor could remind

the patient of the horrors that the wicked would suffer on the day of

62 DISEASE AND THE MEDIEVAL CLINIC judgment. Here Bernard calls to mind the numerous medieval representations of the gaping mouth of hell in which screaming, dismembered, and horrified sinners, often engulfed in flames and surrounded by taunting demons, were sucked between the terrifying lips of a monstrous beast. If these descriptions were not powerful enough to distract the patient and counter his erotic thought, confabulators could enumerate the more tangible afflictions of daily life. Here the experience and authority of the physician became extremely useful. As practitioner of a profession that constantly witnessed the disintegration of the body along with the accompanying pains and sufferings, the physician, acting

as the confabulator, could no doubt terrify the patient by recounting the illnesses of others or by simply enumerating the ailments associated with sexual activities. Not only could he point to the theological arguments of civil chaos, demonic intervention, and divine punishments, he could also tell the patient how sexual activity weakened the body, disrupted and undermined the capacity to reason, and destroyed the ability to smell, to taste, and to hear; he could describe how it led to dehydration, insomnia, depression, blindness, gout, and accelerated aging; he could warn the patient that it caused headaches, kidney failure, stomach cramps, pulmonary disorders, genital ulcers, fevers, infections, flatu-

: lence, baldness, arthritis, and abscesses; and he could tell the sufferer how sexual disorder manifests itself in leprous, maimed, deformed, and monstrous children.?/ The intense longing, inordinate desire, and tenacious fixation on the figure and image of the beloved was often thought to be too powerful to make possible the healing of the patient by merely distracting him or frightening him with warnings of pain and eternal suffering. In this case, theorists suggested that the confabulator attempt to alter the pathological image of the beloved, transforming it from an object of desire to

one of revulsion. Peter of Spain suggested verbal denigration of the woman as a beneficial form of therapy because “it withdraws the mind or thought of the patient from the beloved object” (Questiones super Viaticum, in Wack, Lovesickness 224). Thus a rhetorical therapy devel-

oped in which the confabulator attempted to displace the pleasing images of the loved one with abjective visions of a corrupt female body.

Bernard of Gordon offers some specific suggestions about things that

can be told to the patient about the beloved: “tell him that she is a

drunkard, that she urinates in bed, that her hands and feet are deformed, that she stinks, that she is dirty” (Lilio 108). This form of therapy, already fully articulated in the works of Lucretius and Ovid, was

SEXUAL PATHOLOGY AND LOVESICKNESS 63

perhaps the most common prescription for treating inappropriate sexual desire in the Middle Ages and the Renaissance. It appears in the works of Boccaccio, Juan de Mena, Eiximenis, and Juan Luis Vives, to name but a few. Ovid described the therapy best: If she has full round breasts, call her fat as a pig; if she’s slender, thin as a rail; if she’s dark, black as the ace of spades. If she has city ways, label her stuck-

up and bitchy; if she is simple and good, call her a hick from the farm. Whatever talent she lacks, coax and cajole her to use it; if she hasn’t a voice, try to persuade her to sing; if she trips over her feet, make her dance; if her accent’s atrocious, get her to talk; all thumbs? — call for the zither or lyre. If

she waddles or limps, be sure to take her out walking. If she has bulging breasts, don’t let her wear a brassiere. If her teeth aren’t too straight, tell her a comical story. (The Remedies for Love, 191)

To intensify the therapeutic efficacy of this remedy, theorists recommended that the interlocutor replicate in body, gesture, dress, and facial expression the very quality of abjection that was to be verbally conjectured in the patient’s mind. Gerard of Berry tells us that “the counsel of old women is very useful” because they can “relate many disparagements

and the stinking dispositions of the desired thing” (Glosses on the Viaticum, in Wack, Lovesickness 202). The concept of employing an old woman to confabulate with the patient predates Avicenna, who acknowl-

edged the procedure in his Canon.°8 Bernard of Gordon, elaborating on this tactic, specifies that you should look for an ugly woman of disagreeable appearance, one with big teeth, whiskers, and vile clothing (Lilio 108). The idea was to strengthen the verbal description of the denigrated beloved by representing her in the disgusting appearance of

the confabulator: “ugly women are contrary to the beloved of the lovesick patient, since she is beautiful in his estimation. Therefore the sight of ugly women is beneficial” (Peter of Spain, Questiones super Viaticum A, in Wack, Lovesickness 224).

It was in the therapy for acute cases of lovesickness that medieval medical theory’s misogynist tendency arose. Therapies that attempted to denigrate and abjectify women were originally highly specialized treatments for the very specific pathological conditions associated with amor hereos. As such it would seem that they would not have been applicable to more general sexual ailments. But in medical practice the move

from etiology to therapeutics often entails a blurring of causes and a collapsing of disease categories. Consequently the therapies developed for amor hereos were clinically prescribed for virtually all sex-related dis-

64 DISEASE AND THE MEDIEVAL CLINIC orders and were recommended as preventative measures for sexual and moral well-being. In the late medieval clinic the pathological nature of love, lust, passion, and coitus came to be etiologically focused on the ill effects of women. From a therapeutic standpoint, the most simple and effective method of preserving men’s bodies and saving their souls was to identify women as the cause of disease. In this way clinical healers hoped to encourage men to flee from women as they would flee from any disorder that threatened to destroy their bodies with the pain, dis-

ability, and stigma of disease. As Lopez de Villalobos warned, men should flee from the object of their desire, “como en pestilencia se apartan los hombres del ayre danado” [the way men flee from bad air during times of pestilence] (Sumario 324).

PART TWO The Arcipreste de Talavera

and the Spill

BLANK PAGE

3 The poetics of infection

To act, it is necessary at least to localize. For example, how do we take action against an earthquake or hurricane? The

impetus behind every ontological theory of disease undoubtedly derives from therapeutic need. When we see in every sick man someone whose being has been augmented or diminished, we are somewhat reassured, for what a man has lost can be restored to him, and what has entered him can also leave. Georges Canguilhem, The Normal and the Pathological (39)

When Hieronymus Fracastorius, the Italian polymath, published his treatise De contagione in 1546, he claimed to be the first theorist to inves-

tigate the nature and mechanics of contagion. For medical historians, the publication of the De contagione, with its systematic classification of

infectious diseases, generally marks the moment when the concept of illness as an imbalance in the physiological complexion turned decisively toward the notion that disease is caused by menacing entities that enter the body from the outside. This latter theory, with its emphasis on external causation, is known to modern medical historians as the “ontological theory of disease.” Although we can admire Fracastorius’s focused and detailed exposi-

tion, his claims of originality were highly exaggerated. Vivian Nutton has recently argued that an ontological notion of certain diseases was already implied in the Hippocratic corpus, as well as in the works of Galen, Lucretius, Avicenna, and other lesser-known medical theorists and natural philosophers. Ancient and medieval thinkers identified various communicable diseases such as leprosy, scabies, smallpox, and measles, and they pointed to specific places, conditions, and things, such as swamps, corpse-strewn battlefields, and clothing soiled with excreta, that emanated particles of disease.! Even though they left no complete theory of contagion, they presented several underdeveloped expla-

07

68 THE ARCIPRESTE DE TALAVERA AND THE SPILL

nations to account for the transfer of disease from one person or one thing to another human being. For example, in antiquity Galen and Lucretius mentioned the idea of “seeds” that caused the plague. The Roman scholar Varro (116-27 B.c.) spoke of little animals, too small to be seen, “which by mouth and nose through the air enter the body and cause severe diseases.”2 Later, St. Isidore, following the suggestion of Galen and Lucretius, argued that plague-bearing seeds “were carried into the air and borne upwards to be transported by wind or clouds to the farthest parts of the earth,” where they “were taken in with the air which we breathe and were thus absorbed into the body.”3 One medieval author suggested that it was by means of devils and demons that disease spread to human beings.4 The idea of infection, as seen in the etymology of the Latin infectio, is related to the marking, coloring, or dyeing of an object.> Hence contagious diseases consisted of things that infected or pathologically “marked” an otherwise healthy human being and that, like dyes, could spread: “Hii sunt morbi contagiosi, id est inficientes alios.”6 From a hygienic and therapeutic standpoint, this ontological concept of disease had several advan-

tages ve the longstanding physiological notions. Once healers and

patients could single out a concrete and identifiable object that was diseased or was thought to contain particles of disease (later specified as germs, bacteria, and viruses) they could take the necessary steps to attack, counteract, or, what was most often the case, instruct the patient to avoid this entity and thus preserve his health or cure his illness. This was often easier than trying to limit or increase the patient’s intake of foods, herbs, and drugs, or to cause the patient to retain or expel bodily fluids in an attempt to adjust a humoral imbalance. Moreover, in times of pestilence, those repeated occasions during the fourteenth and fifteenth centuries in Castile and Valencia when illness struck citizens indiscriminately and regardless of their physiological makeup, an ontological notion of disease, one that pointed to an alien entity that attacked the body, was no doubt more etiologically satisfying than the concept of a distempered body. It is important to emphasize that contagion was a broadly drawn concept in its early stage of development. Any deviation from what was perceived as a normal, healthy state could be considered a communicable disease, including lovesickness and sexual activity. Prior to the syphilis epidemic in the late fifteenth century, sex-related disorders were almost always thought to be the result of a physiological imbalance. When Alfonso Martinez warned his readers in the Arcipreste that amor desordenado causes blindness, destroys the ability to taste and

|

THE POETICS OF INFECTION 69 smell, makes the bodily members tremble, and accelerates the aging process (73, 98), he drew from a longstanding medical theory that identified these symptoms as the result of an excessive depletion of heat, moisture, and bodily fluids through immoderate sexual intercourse. But since Martinez’s intention was not merely to inform the reader of the body’s pathology, but rather to reform the patient’s behavior therapeutically, it was more effective to point to a malevolent object as the origin or essence of these ailments, and then try to persuade the reader to flee from it. For Martinez and Roig, the primary therapeutic and hygienic strategy

codified in their compendiums was to displace the etiology of sexrelated ailments by shifting the focus of disease away from a physiolog-

ical imbalance in the male body and toward the infectious and contagious nature of women. Martinez’s and Roig’s intention was to convince men that what seemed to be an object of desire was in reality a diseased object capable of infecting their bodies and destroying their souls. From anecdote to antidote: Etiological fabulation in medieval Spain

The idea that women were a source of disease and physical disorder had a long tradition in Western thought. In the patristic period, Tertullian, a

man fully instructed in Galenic medical theory, bitterly attacked the contemporary practice of allowing celibate young women to stand in churches with their faces unveiled and their heads uncovered upon being baptized. According to Tertullian baptism could not eliminate the biological fact that deep within the female body was a natural, unalterable condition able to inspire illicit sexual feelings in men, regardless of the woman’s moral disposition (Brown 76-82). In homilies, sermons, and hagiographical narratives, the same idea was reiterated throughout the Middle Ages. In the popular legend surrounding the life of St. Mary

of Egypt, medieval people saw the way the uncontrolled and uncontained female body could destroy the bodies and souls of men. In the Spanish translation of the metrical French version, the attraction to

Maria’s body is so powerful that in her days as a young harlot in Alexandria it inspires men to fight over her, resulting in so many wounds and deaths that the streets run with blood: Los mancebos de la cibdat / tanto les plaze de la beltat, / que cada dia la van veyer / que no se / pueden d’ella toller / Tantas hi van de conpanyas, / que

70 THE ARCIPRESTE DE TALAVERA AND THE SPILL

los juegos tornan a sanyas; / ante las puertas, en las entradas, / dabanse grandes espadadas: / la sangre que d’ellos sallia / por medio de la cal corria. (Vida de Santa Maria Egipciaca 54)

[The young men of the city found so much pleasure in her beauty that they went to see her every day, unable to tear themselves away from her. She had so many companions that the games turned into fights. At the doors and in the entrance ways they gave one another great sword thrusts: the blood that they shed ran down the middle of the street. |

Even the pilgrims en route by ship to the Holy Land are incapable of resisting the influence of her body; once the ship embarks she immediately begins to seduce passengers, and by the end of the night there is not a man, young or old, who has not sinned with her. The legend tells of how Maria repents of her sins, and as penance wanders naked for forty years in the wilderness, eating only herbs, stepping on

every thorn in her path, and sleeping on the rocky ground. When a monk by the name of Gozimas (Z6zimas) spots her in the desert, he chases her, thinking she is an apparition. Maria flees, and when he gets close enough to speak with her, she begs him not to look at her body. In one of the prose versions of the legend, Maria pleads with the abbot,

saying:

“Perdoname por Dios, abbad Zozimas, ca no te puedo esperar nin demostrarme a ti. Porque so muger, e non tengo vestidura alguna, e estan las partes vergonosas syn alguna cobertura. E sy quieres que te espere a orar por esta pecadora de muger, alcanca aca ese manto que traes cobijado, por que pueda cobrir la mi enfermedat mugeril e tornar a ti, e rrescebir tu bendicion.” (Paul the Deacon 10-11; emphasis added)

[“Forgive me in God’s name, Abbot Zdézimas, I can neither tarry nor show myself to you because I am a woman and do not have any clothing, and my private parts are not covered. If you want me to wait for you so that you may pray for this sinful woman, lend me that cloak you wear so I can cover my womanly disease and turn towards you, and receive your blessing.” |

Maria, having destroyed so many men already, fears that the very “sickness” of her female body will contaminate or infect Z6zimas. By warning the abbot of her “womanly disease,” she is taking, as it were, the necessary hygienic measures to protect him from its contagious effects. Both the prose and verse versions of the Vida de Santa Maria Egipciaca

THE POETICS OF INFECTION 71 illustrate the pathological hazards of the female body and their therapeutic defenses in late medieval antifeminist treatises. For Martinez and Roig a woman’s body posed a serious threat to masculine well-being.

Nevertheless, this danger could be mitigated, if not eradicated, by clothing women in a discourse that at once concealed the pleasures of the female body and revealed to men the pain brought on by contact with women. The difficulty facing preachers and physicians was how to formulate and circulate this hygienic information to the male public most effectively.

Popular medieval narratives often provided a powerful way to dissem-

inate notions of etiology and physiology while delineating patterns of infection, methods of therapy, and strategies for keeping well. According to Danielle Jacquart and Claude Thomasset, the Middle Ages were a time when “anatomical or physiological explanation was a melting-pot in which scientific knowledge was amalgamated with the exempla’” (5).’ Hence, one of the most powerful antidotes for lust and sexual misconduct was simply

a good anecdote. For example, Juan Ruiz’s well-known fable of the “Garcon que queria casar con tres mugeres” [The Young Man who Wanted

to Marry Three Women] illustrated the repeated warning that excessive intercourse weakened the body. To fulfill his inordinate desire, the ardent young man in the fable announced that he would marry three women. Persuaded by his family, he agreed to marry one woman and then a month later to wed another. It so happened that the young man’s father owned a mill with a big millstone. Before marrying he could easily stop the stone with his foot. After a month of marriage, the young man had lost so much strength that the millstone knocked him off his feet when he tried to stop it. Having fallen in love with his first wife and recognizing the toll this

union had taken on his body, the young man decided not to follow through with his original plan to marry three women.8

Although this fable ignored the more technical aspects of sexual pathology — the loss of semen, heat, moisture, and pneuma that led to debilitation — it offered the reader a demonstration of the effects of coitus on the body. Moreover, it encouraged readers to imagine what kind of physical shape the young man’s body (and by extension their own) would have been in had he followed the impulses of his desires and married three women. In this way the fable not only functioned medically, by informing the reader of the pathological risks of immod-

erate coitus, but also medicinally, by discouraging the reader from engaging in excessive sexual intercourse. The ability of such fables to

72 THE ARCIPRESTE DE TALAVERA AND THE SPILL

inform the reader about his body was closely related to their ability to reform the reader’s unhealthy habits and desires. In the fable “Of the Husband and His Two Wives,” which appears in a fifteenth-century version of the Esopete ystoriado, the author advises the

reader that there is no better way for older men to stay healthy than avoiding relations with women, especially younger ones. To illustrate his point he tells of a man who in the spring — the season, we are told, when the reproductive members begin to awaken — marries two women at the

same time, one old and the other young. The husband being middleaged, half of his hair has turned gray. The older wife, to encourage her husband to identify more with her, and thus win more of his affection, approaches him while he is sleeping and pulls out all of his dark hairs. Likewise, the younger wife, moved by the same desire, plucks out the man’s gray hairs. The man is left bald and consequently becomes an object of laughter and ridicule throughout the town (Esopete ystoriado 112).

Medical authorities clearly identified loss of hair as one of the most common ailments suffered by those who engaged in excessive sexual

intercourse. Immoderate coitus was thought to deplete the heat, humidity, and bodily fluids (semen) in the brain. Since theorists believed that hair was essentially a form of coagulated vapor, closely related in

substance to sweat, they concluded that drying in the cerebral cavity caused by excessive intercourse made men bald; this same drying of the

brain also explained other sex-related ailments such as loss of sight, smell, and hearing.’ Here again the pathology of this disease is inscribed in the fable. We are told that the husband is accustomed to experiencing the pleasures of the body (“criado e usado en plazeres e deleytes”), and

therefore decides to double his enjoyment by marrying two women. Although the assumed result of such excess is appropriately depicted in the fable, the etiological assumptions are displaced. For medieval medical authorities, it was the drying from the inside that caused hair loss, not extraction from the outside by the ruses of women.!° Nevertheless, what the fable loses in medical accuracy it gains in medicinal (therapeutic) power. By displacing or shifting the etiology of this disease to circumstances outside the body, the fable encourages men to see women as the root of their disorder. In effect, the fable reminds men that in order to be free from disease (and the social stigma that accompanies it) they must see women as the cause of their disorder.!! While fables such as “The Husband and His Two Wives” focus on the etiological danger of women, other narratives exemplify salutary

THE POETICS OF INFECTION 73 strategies for keeping well. In the popular ballad La gentil dama y el rustico pastor, a shepherd successfully resists the discursive advances of a beautiful woman: Fstase la gentil dama passeando en su vergel los pies tenia descalcos que era maravilla ver hablarame desde lexos, no le quise responder. Respondile con gran sana: “:Qué mandays, gentil mujer?” Con una boz amorosa comenco de responder: “Ben aca, el pastoricico, si quieres tomar plazer; siesta es de medio dia que ya es hora de comer, si querras tomar posada todo es a tu plazer.” “Que no era tiempo, senora, que me aya de detener, que tengo muger y hiyos y casa de mantener e mi ganado en la sierra que se me yva a perder, e aquellos que lo guardan no tenian que comer.” “Vete con Dios, pastorcillo, no te sabes entender, hermosuras de mi cuerpo yo te las hiziera ver: delgadica en la cintura, blanca so como el papel, la color tengo mezclada como rosa en el rosel, las teticas agudicas qu’el brial quieren hender, pues lo que tengo encubierto maravilla es de lo ver.” “Ni aunque mas tengays, senora, no me puedo detener.” (Catalan

40-1) [A gentle lady was strolling barefoot through her garden. What a marvel to see! She spoke to me from afar but I did not want to respond. Irritatedly I answered, “What is it you want, gentlewoman?” With an amorous voice she began to reply: “Come here, little shepherd, if you want to take some pleasure. It is midday, time to eat. If you want to rest all is at your command.” “I have no time to tarry dear lady. I have a wife and children and a home to maintain, and my livestock in the mountains, which would surely get lost. And the men that watch them would have nothing to eat.” “God be with you, little shepherd, you do not understand. The beauties of my body, I would have you see: my waist is thin and I am white as paper, my complexion is as varied as that of the rose on the bush, my pointed nipples want to burst out of my gown. What I have covered up is, indeed, a marvel to see.” “Dear lady, even if you have still more to offer, I cannot tarry.” |

Despite its playful tone, the ballad establishes an agonistic relation between the shepherd and the lady, turning the countryside into a bat-

74. THE ARCIPRESTE DE TALAVERA AND THE SPILL

tlefield. Interestingly, the weapons and armor are discursive rather than material. The lady hurls an invitation to participate in the pleasures of her body. The shepherd defends himself by deflecting the attack with a

verbal reflection on the practical consequences of corporeal indulgence. The invitation to pleasure is countered by the discursive articulation of collective illness. In his defense the shepherd creates images of hunger and chaos as a means to counter his surging desire for pleasure. The lady attacks for a second time, presenting a description of her own

body. Again, the shepherd successfully guards himself, this time by simply reaffirming his dedication to his responsibilities.

There is a pattern of epidemiology inscribed in this ballad. We are clearly told that the woman stands at a distance in relation to the shepherd. Therefore, her ability to “infect” the shepherd depends on her voice. Medieval theories of contagion and infection identified the air as the medium through which disease was transferred from one person to

the next. In popular iconography, such as in the depictions of St. Sebastian, protector against the plague, infection is represented by images of archers shooting arrows through the air which end up piercing the body of the saint. Although few theorists would have suggested that the female speech corrupted the air itself, they would have agreed that the corrupt images transmitted by means of the pneumatic quality of speech could have a psychosomatic effect on the recipient, which, like the plague itself, would end up destroying the man’s household and livestock. The ballad, therefore, not only illustrated a passive strategy by which men could defend their well-being against the attacks of women, but also identified women as dangerous agents of contagion. To the degree that they seriously reflected on the ballad, men would be encouraged to avoid women entirely, thus preserving their health and the well-being of their domain. The therapeutic power of a particular fable or anecdote lies in its ability

to naturalize biomedical and philosophical notions of well-being. By serving the reader as a mirror of life itself rather than as an arcane discussion about life — as in the case of natural philosophical writing — exem-

plary discourse powerfully reinforces the behavioral norms implied in medical notions of therapeutics and epidemiology. Medieval exempla, like Roland Barthes’s concept of myth, transform history into nature, forcing the reader to interpret human beings and their actions as signifiers that constantly point to a transcendent and indisputable biological order.!2 In the clinical appropriation of fabulistic discourse, biomedical speci-

THE POETICS OF INFECTION 76 ficity is sacrificed for the preservation and recuperation of the patient’s health. Through the use of exempla clinical healers were able to con-

dense the intricate workings of the body into a handful of hygienic guidelines. Once a clinical healer determined that excessive sexual intercourse was the cause of the patient’s disorder, the patient need not understand how excessive intercourse destroyed the brain, he need not be able to describe the way intercourse depleted the body of its moisture and heat, nor did he necessarily need to know the types of foods that would counter the drying effects of coitus. It was enough for him to know that avoiding women would keep him from going bald, keep his head from aching, and keep his eyesight intact. The medical value of

the exempla lay in their ability to present to the patient simple and incontestable therapeutic and health-preserving imperatives unencumbered by technical jargon and scientific explanation. The poetics of infection

The underlying hygienic principle in the Arcipreste de Talavera and the Spill is that men can free themselves from certain illnesses to the degree that they envision women as an infectious disease and as a contagious source of corporeal destruction. This was especially true for men whose imagination had already pathologically fixated on the form and figure of a particular woman, compelled, as the medical theorists tell us, by the promise of pleasure therein. For Martinez and Roig, therefore, the most effective therapy was to exploit the current explanatory models of disease, appeal to the patient’s knowledge, experience, and perceptions

of illness, and discursively force him to recognize that his object of desire was in truth a fountain of afflictions and a reservoir of torments. This therapy was executed first by re-presenting women as diseased, and second by illustrating how any contact with women led to physical disorder in the male body. To impress upon men the sickened and incurable nature of all women, Martinez and Roig turned to clinical etiologies, describing women as sinful, demonic, and excessive. They then proceeded to show the various ways in which these diseased women transferred their disorder to men. Sinful women and disease

Perhaps the most persistent representation in the Arcipreste and the Spill

of disease-ridden women is the repeated mention of the relation

7 6 THE ARCIPRESTE DE TALAVERA AND THE SPILL

between women and sin. If disease is the result of or punishment for sin, as many clinical healers maintained, then it stood to reason that sinful women were either extremely vulnerable to illness or already diseased. Both Martinez and Roig emphatically decry and exemplify the sinful nature of women, pointing to specific examples of homicide, infanticide, thievery, and adultery, as well as outrageous displays of greed, blasphemy, duplicity, and deceit. The entire second part of the Arcipreste, which is dedicated to “los vicios e tachas e malas condiciones

de las perversas mugeres” [the vices, defects, and evil ways of wicked

women], reiterates what Roig exemplifies throughout his treatise. Simply stated, many women are ineffably evil: “Por quanto las mugeres que malas son, viciosas e desonestas o enfamadas, non puede ser delias escripto nin dicho la meitad que dezir 0 escrebir” (145) [As for women who are evil, vice-ridden, indecent, and infamous, one cannot write or say the half of what could be said or written].

The relation between sin and disease is immediately apparent in the verse narrative Spill. Roig, the victim of three ill-fated marriages, describes each of his three wives in pathological terms. His first wife, la dozella, although outwardly young and beautiful, was, according to Roig, lazy, frivolous, and greedy, inclined only to spending his money and passing her days at jousts, bullfights, and fiestas where she shamelessly flirted with young men (lines 1953-3142; hereafter all references to Spill are to line numbers). After suffering from the incessant ridicule, endless mockery, and brutal scorn that characterized every encounter with her, and after seeing his wealth quickly dwindle away in the indulgence of her extravagant whims, he decided to take steps to rid himself of

her, because “her disease was incurable” (3036-8). To avoid the problems of his first wife, he then resolved to marry a widow, who, on account of her age and previous marriage experience would understand well her wifely duties. This woman, however, proved to be as problematic as his first wife, filling his life with torments and troubles (4305-903). Because

of her advanced age she was unable to conceive, and in her efforts to become pregnant she sought treatment from all kinds of medical subalterns — herbalists, midwives, fortunetellers, and dealers in charms — who

cost him more than two thousand sueldos in fees for remedies that only promoted ulcers and spasms in her stomach, melancholy and depression in her head, and consumption and wasting throughout her body. In the end, he tells us, “good” doctors were able to cure her of all her ailments except her natural character, for which there was no cure. Roig’s third |

THE POETICS OF INFECTION 77 wife, a young novice who had recently abandoned the convent, killed

their baby by refusing to breastfeed him and then died herself after becoming sick on bad wine (4909-6338). These specific examples of sick

and incurable women merely confirm the universal warning delivered by the interlocutor Solomon in book 3: “Even if you were able to select

among a thousand women, carefully examining each one for their fortune and qualities, you would find them equally sinful, because all women are naturally sick [mal] and are very seldom cured or are simply incurable!”!5 Demonic women and disease

If clinical practitioners held that some diseases could be caused by devils

and demons, then it followed, they reasoned, that women engaged in demonic and diabolical acts would either become diseased themselves or participate in the diseasing process. Roig tells us that Eve’s first love was Satan, and given the powerful influence of a first love, she could never part from him; consequently all those of her gender were shedevils and demons (355-71).!4 He tells us that women formulate their trickery with the help of the Devil (6990-4). Thus, a young bride in Requena who, unknown to her husband, had long before lost her virginity, feigned a demonic possession on the night of the wedding. When

exorcism was attempted, the demon explained through the mouth of the woman that he would leave only through the “most guarded orifice

of the body”; the ensuing exorcism through the vagina effectively accounted for the bride’s deflowered status (3180-267). According to Roig, atrocities of all kinds are committed by women inspired by the devil. He relates the story of a Parisian pastry maker who with the help of her two daughters killed men and baked them into succulent meat pies, suggesting that devils and demons assisted these women in carrying out their abominable deed (1718-21). Moreover, he explains that the sins of women caused the great flood in the time of Noah; at that time there were women who, offering themselves to demons, were impregnated by pilfered semen, thereby giving birth to evil creatures (7100-17).

Martinez likewise emphasizes the connection between women and the Devil, warning men to avoid the snares of both: “;Quantos enemigos tiene el mezquino del ombre? El mundo, el diablo e la muger’” (Arcipreste 220) [How many enemies does wretched man have? The world, the Devil, and woman! |.

7 8 THE ARCIPRESTE DE TALAVERA AND THE SPILL Womanly excess and disease

Drawing from medical theory, the medieval clinic recognized that anything excessive, imbalanced, or deficient could be identified as diseased. Martinez and Roig point to this etiological premise by describing women in terms of excess in their behavior as well as in their bodily functions. Martinez tells us that to expect a woman to be constant in her love “es querer agotar rio cabdal con cesta 0 espuerta o con muy rolo farnero” (Arcipreste '76) [is to wish to empty a great river with a basket or very coarse sieve (Litile Sermons 28) |. Roig corroborates this traditional image of woman as uncontainable fluidity by detailing how his first wife urinated frequently in bed and allowed her legs, feet, and stockings to be soaked with menses during her period (2376-97). This excess in bodily functions applies equally to women’s behavior and desires. Martinez and Roig warn that a woman’s insatiable desire for material

goods will drain men of all their worldly possessions. Roig tells the reader that to please his first wife he bought her “alfarda, tre¢a / llistada peca / bell drap de coll, / corda, trescoll, / bonys e polseres, / spill, orelleres, / crespina, trena / collar, cadena, / coral” (2153-61) [a handkerchief, striped pieces, beautiful shawls, belts, puffs for her dresses, collars and bracelets, mirrors, pendant earrings, hair bows, necklaces, chains, coral beads]. For Roig, this is just the tip of the iceberg. He tells us that, contrary

to his instructions, his wife invited the whole neighborhood to their wedding, costing Roig 300 libras, enough money — according to modern estimates — for an ecclesiastic to live opulently for more than a year with the help of two servants (Vidal 30, n. 44). Finally, at the moment when he is freed of her, she pillages his house: “Desamabla la casa mia del que

y habia hurta robo en quant troba” (2940) [she ransacked my house, stealing everything she could find]. Perhaps the most frequently cited form of female excess is unbridled verbosity.!5 Roig describes his first wife’s speech as desafrenada, “unbri-

dled” (4385), and concludes that she was “De molt parlar he poch obrar” (4399-400) [of much talk and little action]. Martinez generalizes these specific examples, telling us that La muger ser murmurante e detractadora, regla general es dello: que si con mill fabla, de mill fabla como van, cémo estan, qué es su estado, qué es su vida, qual es su manera. El callar le es muerte muy aspera: non podria una sola ora estar que non profacase de buenos e malos. (15,4)

THE POETICS OF INFECTION 79 [That a woman is a gossip and a backbiter may be taken as a general rule,

for if she talks with a thousand she talks about a thousand: how they were dressed, the state of their health, how much money they have, their private affairs, their way of living. Silence for her is a bitter death. Not for a sin-

gle hour could she refrain from taking everyone to pieces, good and bad alike. |

Readers familiar with the Arcipreste de Talavera know that one of its most

conspicuous characteristics is the lengthy representations of female speech. The often-quoted monologue in which a woman who has lost an egg rants on and on transgresses all the rules of rhetoric and showers the listener with expletives and blasphemous invocations; it is intended to illustrate the superfluits of female discourse (148-50).

On account of their uncontrollable speech practices, women are unable to keep a secret. Roig’s interlocutor Solomon tells us thata woman trying to hold a secret is like a basket trying to hold water, and that with her “two mouths” that lack “bolts,” not even half a day will pass before the whole town knows her secret, as if the royal crier had stood on every

corner with the trumpet of Arthur of the Algarbe (7822-48). The mention here of a woman’s “two mouths” lacking “bolts” is an allusion to the naturally disease-prone female body, as opposed to the naturally healthy

male body: for medieval physicians the architecture of the body was designed with “doors” or “mouths” through which the inner body communicated with the outside world.!6 For women, the vagina and uterus were viewed as an extra door and chamber that did not benefit from a closing mechanism such as a bolt, acommon euphemism for the penis.!7 The extra mouth accounted for an increased flow of air throughout the female body. It was through such passageways that infectious diseases, carried by contaminated and pestilential air, entered the body.!8 Women, therefore, were thought to be twice as vulnerable to epidemic and disease as men, whose lower “door” was permanently closed. Moreover, it was this excessive windiness that made women “naturally” speak more, since medieval theorists believed that loquacity was the result of inordinate pneuma or spirit in the body. “Why do women talk so much?” asks a late fifteenth-century French riddle; “because they have two tongues” (Pouchelle 183). These representations of excessive speech, like other manifestations of excess, were to be read by medieval men as another sign of a diseased body and a corrupt soul. Once these authors had established the diseased nature of women, they then proceeded to show how the ills of women could be transferred to the male body.

8oO THE ARCIPRESTE DE TALAVERA AND THE SPILL Agents of disease and the mechanics of infection

In Solomon’s account of the character and disposition of women, Roig provides a lengthy and highly nuanced description of what he claims is the diseased natural condition of the female body (9583-633). He complains that hidden beneath a woman’s clothing lies a miasmic region of putrefied humors and venomous creatures. Here, surrounded by foul vapors and the stench of decay, grotesque insects mingle with leeches, frogs, rats, and serpents. For the medieval reader, Solomon’s description would have called to mind medical notions of contagion while playing upon popular fears of transmutable illness associated with unclean and polluted substances that “corrupted” the air. Therapeutically speaking, Solomon’s description has the double function of displacing the pleasurable (and pathological) image of the beloved (or of women in general) while simultaneously warning the reader-patient of the infectiousness of the female body. Solomon’s discussion focuses on the way the processes of putrefaction and decay converged in the recesses of the female body, generating highly contagious menstrual excretions. Drawing on medical as well as popular lore, Roig describes the detrimental effect of this substance on natural phenomena: if you use cloths soaked with menses (Roig tells us)

to make a banner for the bowsprit of ships, do not expect propitious winds, for these vessels will be lost at sea. ‘Those who gather honeycombs

know that when the vapor that arises from menstrual cloths comes in contact with the beehive, half the bees immediately fall dead; the same vapor causes silkworms to become cold and stop producing silk. If you burn a menstrual cloth it will not produce a clear flame, but rather one with a bluish hue; if you use it as a bandage for a wounded man his wounds will not heal. Ifa woman happens to begin her period while she is near a doctor who is treating a man, that man will have a delayed recovery — or worse, he may simply die. If a menstruating woman walks through a forest or garden the trees dry up and the herbs die or become sickly. The saliva from a menstruating woman will cause a scorpion to

die. The wine that drips from the cup of a menstruating woman will infect and poison a man; the same is true of her soup bowl, which needs to be completely washed before eating from it. Ifa menstruating woman passes a small dog, it will begin to urinate uncontrollably (9634-721). The male anxiety over the female body was intensified by the notion that the flow of menses was capable of staining and infecting clothing, utensils, furniture, and foods, leaving these objects contaminated well

THE POETICS OF INFECTION S1 beyond the duration of the menstrual period. As we have seen, Roig tells how his first wife’s legs, thighs, and even stockings became soiled

during her period. He complains that “whenever she used menstrual rags (which stunk to high heaven), she would leave them around the house, in the corners, under the furniture, between the straw, and it didn’t matter a bit to her who might find them” (2379-98). From the point of view of epidemiology, the scattering of these cloths throughout

the house created a pestilential condition in which men could be harmed by unexpectedly touching the rags themselves or unknowingly

breathing the harmful vapors that were thought to arise from them. Thus Roig attempts to convince his readers that women were not only sources of infection but also agents in the mechanics of contagion. Throughout the Arcipreste and the Spill Martinez and Roig identify various patterns in which women, intentionally or unwittingly, were

thought to spread disease and illness to men. The general idea that women make men sick is present from the initial pages of the Spill, where Roig insinuates that his own father’s death was accelerated by his

mother, who caused the man to suffer from phthisis and finally die of a frenetic seizure (814-29). Later Solomon tries to persuade Roig not to marry for a fourth time by warning him that a new wife would only lead to strangulation and ulceration, intense pain and strong burning in the bladder when urinating, and trembling sensations in the head,

arms, and feet, followed by sudden death by lethargy or apoplexy (6811-29).19 Throughout the Arcipreste and the Spill Martinez and Roig insinuate

that women are agents in the transmission of communicable disease. The ways these disease-inflicting women hurt and kill men fall into four

general patterns: wounding and poisoning, draining and depletion, emasculation, and congenital disfiguration. Wounding and poisoning

Images of darts and arrows were often used in literature and iconography to symbolize sudden death from pestilence. Apollo, for example, inflicted the plague upon people by hitting them with arrows. As already mentioned, in the Middle Ages, St. Sebastian’s body bristling with arrows

provided a useful pictorial device for imagining the transfer of pestilence from one person to another.?9 In addition to conveying the epidemiologically accurate idea that the air carried harmful substances (arrows or germs) from one place to another, the Sebastian images

82 THE ARCIPRESTE DE TALAVERA AND THE SPILL

forcefully established the concept of an inimical disease-producing agent that initiated and orchestrated the mechanics of contagion. Working within this paradigm of infection, Martinez and Roig relate historical, mythical, and contemporary cases in which women act as the

contagious agents who, like the archers who shot their arrows into Sebastian’s flesh, bruise, lacerate, and ultimately kill men. In the Spill we read about the daughter of Ragtel, Sara, who strangled all seven of her husbands, leaving each one dead at her side the morning after the

wedding night (6782-804). We hear about the mythical Amazon women who, after hacking to death their battle-wounded husbands and sons, established a prosperous community of women who defended and extended their kingdom by sacrificing their male children “like rabbits” (9390-410). Roig recounts contemporary events that he claims to have witnessed firsthand, such as the cases of an innkeeper who robbed and killed her own father (1393) and the pastry baker who, with the help of her two daughters, killed, butchered, and either baked men into meat pies or used their entrails to make sausages (1647-1742): Mes aquel any / hun cas estrany, / en lo mon nou, / jorn de Ninou / s’ [h]i

esdevench. / Yo tingui’l rench: / ffiu convidar / tots a sopar / qui junt haviem. / Alli teniem / de tots potatges, / de carns salvatges, / volateria; / pasticeria / molt preciosa, / la pus famosa / de tot Paris. / En hun pastis, / capolat, trit, / d’ [h]om cap de dit / hi fon trobat: / ffon molt torbat / qui'l conegue; / reguonegue / que y [hi] trobaria: / mes hi havia / un cap d’orel-

la; / carn de vedella / creyem menjassem, / ans que y [hi] trobassem / lungla y el dit / tros mig partit. / Tots lo miram, / he arbitram / carn d’ [h]om cert era. / La pasticera, / ab dos aydan|[t]s / filles ja grans, / era fornera / he tavernera; / dels que y [hi] venien, / alli bevien, / alguns mataven; / carn capolaven, / ffeyen pastells, / he, dels budells, / ffeyen salsices / o llonguanices / del mon pus fines. (1647-95) [That year I saw something never before seen in the world. It was New Year's Day and I had invited all of those with me to dinner. We had all kinds of stews, succulent meats of wild animals, a variety of fowl, and a selection of the richest and most famous pastries made in Paris. In one of the pies we found the chopped-off tip of a human finger. This greatly upset the guest who found it.

Examining the pie further to see if there was anything else, he also found a piece of a human ear. We believed we had been eating veal, but after coming across a fingernail and the finger, we all inspected the meat and came to the conclusion that we had been eating human flesh. The pastry maker and her two grown daughters owned an oven and a tavern. Of those who went to the tavern to drink, she regularly killed a few, carved them up, and baked them into pastries; of their intestines she made some of the world’s finest sausages. |

THE POETICS OF INFECTION 83 Roig goes on to tell us that these women mixed calf meat and fine sauces with the human flesh so as to conceal it. The bones and other remains of these poor men were thrown into a deep pit, which according to Roig was almost full of human bones and skulls.

Martinez says that he could tell about similar murders and mutilations, “pero si al mundo son tan notorios estos males, que superfluo es alegarlos” (119) [nowadays such goings-on are so well known that it would be superfluous to go into them]. He does, however, recount a case that he witnessed in which a wife bit off her husband’s tongue. She

did this by getting her husband in jest to put his tongue in her mouth; she then closed her teeth and bit it off, leaving him dumb and mutilated (119). In the Arcipreste and the Spill disease is often transmitted by women who deliver infectious or disease-causing substances to men. Roig tells us that “there are not enough words to express the types of poisons [women] offer men” (666-71). As proof he offers the example of a young wife who kills her husband with a poisonous drink that she claims

is a medicine (1512-1646). Roig relates how he encountered a group of women who offered unsuspecting men a potion that caused enormous fleshy growths, “the size of breasts,” to appear on their necks (1847-65). Defending his claim that women are damnable and venomous (“dones dampnandes, envirinades,” 352-3), he retells contemporary examples, such as that of Dona Forciana, who poisoned her husband, Pere IV of Aragon (1332-81). Martinez suggests that men who have had contact with women become themselves rabid dogs and venomous beasts who threaten to spread their poison to others: “Por ende, deste tal, ansi como de bruto animal o contrario a la humana naturaleza, deven todas personas, donde juizio ay, fuir e se apartar como de bestia venenosa e de perro ravioso, que mordiendo poncona todos los que muerde e comunican con él” (72) [From such a man, therefore, as from a brutish beast or one contrary to human nature, all persons of judgment should flee and separate themselves, as from a venomous beast or rabid dog that poisons all those it bites and who communicate with it]. In his treatment of women’s venomousness, Martinez focuses on the poisonous element of excessive female speech: “por un huevo dara bozes como loca e fenchira a todos los de su casa de poncona” (149) [Over the loss of an egg she will shout like a crazy woman and fill her entire household with poison]. The idea of the capacity of speech to infect, contaminate, or poison is more than just metaphorical thinking on the part of Martinez: Medieval epidemiology, as we have seen, rec-

ognized that speech could physically harm another human being.

84 THE ARCIPRESTE DE TALAVERA AND THE SPILL

Metaphysically speaking, the voice could carry dangerous images to the mind. To speak with a woman, according to Martinez and Roig, was to

expose oneself to her disease. It is for this reason that Martinez constantly warns his readers not to converse with women: “Fuid uso continuo e conversacion frequentada de ombre con muger, e muger con ombre, fuyendo de dir palabras ociosas, desonestas e feas” (65) [Flee from continued use and frequent conversation of man with woman, and

woman with man, fleeing from listening to idle, obscene, and ugly words|. The words of women, he tells us, can be like rocks that when flung into the air fall indiscriminately, injuring the innocent: “la palabra asi es como la piedra, que salida de la mano non guarda do fiere.... ;O, quanto dano trae a las criaturas el demasiado fablar” (167) [the word is thus like a stone thrown from the hand that cares not whom it

hurts.... Oh how much damage excessive speech brings!]. Since women, as we are told over and over again in the Arcipreste and the Spill,

are guilty of excessive speech, they are guilty too of numerous pathological eventualities. Men who insist on frequent and direct conversations and dialogues with women put themselves at great risk. Medieval theorists would agree; leprosy, for example, was thought to be transmitted by speaking with a man or woman infected with the disease.?! Draining and depletion

Martinez and Roig continually warn men that the pathological fluidity

associated with women has a draining and drying effect on men. Perhaps the most common physical ailment associated with sexual relations was the weakening of the body and the loss of sight, hearing, and

smell. Martinez advises the reader of these pathological conditions throughout the Arcipreste: E como los otros pecados de su naturaleza maten el alma, éste, empero, mata el] cuerpo e condepna el anima; por do el su cuerpo luxuriando padesce en todos sus naturales cinco sentidos: primeramente face la vista perder, e men-

gua el olor de las narizes natural, quel ombre apenas huele como solia; el gusto de la boca pierde e aun el comer del todo; casi el oir fallesce que paréscele como que oye abejones en el oreja; las manos e todo el cuerpo pierden todo su exercicio que tenian e comienc¢an de temblar. (72-3) [And as other sins by their nature kill the soul, yet this one kills the body and damns the soul as well. The body, in lechery, suffers, in all its five natural senses. First, a man loses his sight and his sense of smell, for he can no longer

THE POETICS OF INFECTION 85 smell as he used to. He loses his taste and even his power of eating entirely. His hearing so fades that it almost seems to him that he has bumblebees in his ears. His hands and his whole body lose the strength they once had and begin to tremble. |

In general Martinez draws his arguments straight from medical treatises that identify the consequence of excessive intercourse as a depletion of fluids that damages the eyes, ears, nose, and scalp; dehydrates the body; and leads to fatigue. This physiological etiology, however, is never explicitly articulated in the Arcipreste or the Spill. Rather the focus is on the way the nature of women debilitates, dehydrates, and finally destroys men. Thus Martinez suggests that lust, love, and women turn a young man’s body from a green and flourishing tree into a withered stick, fruitless, dry, and ready to be burned (83). As a therapeutic strategy, both Roig and Martinez make references to

the biblical story of Samson (Judges 14: 12-19). Martinez tells the reader: Mira a Santson como desque revel6 a su muger Dalida que tenia la fuer¢a en una vedija de la cabeca, c6mo con arte espulgandole e peinandole desque dormido ge la cortd, e asus enemigos le libr6 e quando quiso fazer armas falldse privado de fuer¢a, a asi le sacaron los ojos e le traian por los mercados, placas e bodas por escarnio, diziendo: “:Qué vos paresce?” (1'72-3)

[Take the case of Samson, how he revealed to his woman, Delilah, that his strength lay in the hair of his head, and how she, while artfully combing it and picking fleas from it, cut it off while he was asleep and delivered him up to his enemies, and how, when he tried to arm himself, he found himself

robbed of strength, and so they plucked out his eyes and dragged him through the market places and squares and wedding festivals to mock him,

saying: “How does he look to you now?” |

Likewise, Roig’s Solomon refers to Samson in connection with his warning that expecting a woman to keep a secret is like trying to hold water in a wicker basket (7832-3). He goes on to say that trusting in a woman is the same as going out of your way to find a poisonous serpent

to wrap around your neck, or like giving your knife to a madman; because he was trusting of a woman the mighty Samson was left blind, imprisoned, and hairless (7911-27). Among the various patterns of infection that Girolamo Fracastoro developed in his De contagione, he suggested that putrefaction and drying

86 THE ARCIPRESTE DE TALAVERA AND THE SPILL of fruit occurs when heat passes, by means of fomites, from one object to

another: The principle of that evaporation is always foreign heat, whether that heat be in the air or in the surrounding moisture; hence, in both fruits the principle of contagion will be the same as the principle of putrefaction, namely extraneous heat; but this heat came to the first fruit either from the air or some other source, and we may not yet speak of contagion; but the heat has passed on to the second fruit by means of those imperceptible particles that evaporate from the first fruit, and now there is contagion. ... (Fracastoro 9)

The authors of the Arcipreste and the Spill frequently allude to a similar

process of contagion. For Martinez and Roig, however, the “foreign heat” appears as women and the putrefaction (the result of foreign heat on an object or body) as a pathological condition in men. For example, Martinez illustrates how association with women can cause a man to

become melancholic and uncontrollably heated in rage. This causes him to pick fights to the death with strangers. ‘The same man will knife

to pieces dogs and other animals that come in his path. The faces of these men become twisted, they bite their lips and cheeks, grind their teeth, and shoot fire from their eyes (132). Emasculation

Theories of contagion are often based on the analogical assumption that the infected source can transfer its negative qualities to others. For men perhaps the most frightening result of contact with women was the

supposed emasculating effect of such association. It was a common medieval belief that to the degree that men associated with women they

became increasingly womanly. Roig illustrates this in his firsthand account of the son of a Catalan nobleman. He tells us that the youth, being the only child, was raised completely under the wing of his mother, who, shielding him from all danger and prohibiting him from developing the more manly arts, fed him cakes, sugar pastes, fruits, and other substances that were thought to be relished by women.?* The result according to Roig was not only that the boy became effeminate (hom fement, 1011), but because of the womanly hold on his character he became contra hominem, conspiring with his mother to kill Roig. In effect, once contaminated by women, the boy took on the female disease, and as a consequence was inclined to infect and kill other men.

THE POETICS OF INFECTION 37 A more graphic illustration of emasculation appears in the Arcipreste. Martinez tells us that he spoke in person with a swordsmith named Juan Orenga, native of Tortosa, who had his verguenzas cut off by his jealous

lover. He narrates in detail the way this woman invited Orenga to her house, explaining to the infatuated man that her husband, a merchant sailor, was en route to Barcelona; prior to the lover’s arrival she carefully

hid a knife under her pillow and prepared the doors to the stairs and to the street so they would lock behind her when she fled; upon Orenga’s arrival she stripped him of his armor and directed him to the bed where the knife lay hidden. Apparently he was too tired and too “cold” to make love with her, so the woman began playing with his member with one hand while with the other she retrieved the knife. When the moment was right she shouted, “Traitor, it will never serve you, nor me, or any other woman again!” With knife in hand she “cut it off him” (cortorgelo),

taking part of the thigh with it. She then fled down the stairs, leaving the poor man bleeding all over himself (118-19). Congenitally transmitted disorder

The idea that the sins of the parents become manifest in the deformities, ailments, and diseases of their children is illustrated in detail in the Arcipreste and the Spill. From an etiological standpoint, it is once again women who serve as the agents of congenital defects and premature death. Roig tells us, reiterating the medical arguments on the etiology of birth defects and congenital diseases, that women cause their children to be born lepers because they fail to clean themselves properly (during menstruation). Moreover, because they allow horrendous and appalling images to enter their imaginations during coitus, their children become deformed and twisted from their true nature. He tells us that since women are inclined to be impatient and because they lack a sufficient density of blood, there is a risk that the child of a white father will be born with black skin, the child of a happy and healthy father will be born melancholic, and the child of a strong man will be born weak, disfigured, and ugly. Roig warns that often a woman’s seed is malformed,

causing the child to be born without an arm or leg, with an enormous head, with the head stuck to the chest, without brains, or without hands or feet; still others for this reason are born blind and dumb (8836-88). Roig’s biologically focused argument progresses toward one based on women’s behavior. He warns that even the best-intentioned mother is incapable of properly caring for her children. Mothers are forgetful

88 THE ARCIPRESTE DE TALAVERA AND THE SPILL

and have no willpower, and consequently they can cause their children to be cross-eyed, ugly, deaf, hunchbacked, malformed, knock-kneed, and suffering from hernias and swollen bellies. Some unwittingly kill their children by letting them cry to death, others by allowing them to nurse themselves to death, and still others roll over on top of them at

night and smother them to death. They often kill their children by fixing the diapers too tight or by giving them overdoses of medicine (go20-6, 9186-203). Moreover, Roig tells the reader, there are many women who are so eager to destroy their children that they throw them — without baptism — into deep wells, rivers, and seas. Other women cut their children

into pieces and feed them to the dogs and pigs (8998-9015). In fact, some women “deliberately, with as much sanity as dementia, mutilate their own offspring, ripping out their eyes, causing lesions and abrasions on their bodies, for the sole purpose of making them better beggars”; “truly [these women] commit an enormous crime making their child, who was born healthy, deformed and disfigured” (9236-59). The willful abuse, deformation, and killing of children, for whatever motive, is, according to Roig’s interlocutor Solomon, not an isolated act, but a common crime that women have committed throughout the ages. He offers several examples: two women formed a pact with each other to eat their two sons (9294-304); on the outskirts of Jerusalem, the neighbors, responding to a delicate smell of cooked meat, discovered that a woman had split her son like a lamb and had placed half of the child in

the oven with the intention of baking and eating him (9305-23); a woman in Brittany impaled her son on a spit and roasted him over the fire; Athaliah (2 Kings 11), upon the death of her sickly child, ordered that all the king’s sons be hacked and dismembered (9345-59); and the evil queen Semiramis of Babylonia killed her son with her own hand because he refused to satiate her sexually (9260-95). Beyond these extraordinary examples of women harming or killing their offspring, Solomon warns that every attempt on the part of women to educate and raise children ends up in mutilating and wounding the progeny’s body while destroying his character and soul. Unlike a man, who according to Roig knows how to punish judiciously, a woman will beat her children over the head with clubs, break their arms, crush their bones; she will rip pieces of flesh from their buttocks and burn their stomachs and legs with coarse ropes that she uses to tie them down; in an effort to educate her children, she will mutilate noses, cut off fingers, and gouge out eyes (9518-67).

THE POETICS OF INFECTION 389 Solomon’s examples of the way women kill and mutilate their offspring serve to reconfirm Roig’s firsthand experience. According to Roig, the death of his only son was a direct result of his wife’s refusal to breastfeed the newborn: “;No pensseu begua” / — dix ab grans crits— / “lIlet dels meus pits! / Yo,

novencana, / no pellicana, / plaer vull pendre: / no’m plau despendre, / los pits nafrar, / per al fill dar / la sanch del cos; / mes ham repos: / no so serrana, / ni [h] ortolana, / ni de treball; / huy ab bon rall / sou exit abte: / |h] agau recapte / de llet estranya. / Huna ‘lamanya / yo se, tendera, / gran filanera / com les de Cilla, / [h] a parit filla; / es dona pobra, / no te que’s cobra; / per que avance, / ffare la llance / al espital; / aquesta ‘ytal, / per vos lloguada / e ben paruada, / lo us criara. / Com mamara / vos ho veureu. / Si vos volreu / yo’! alletas, / he que’m guastas / aquest meu cos, / he senta plors / tota la nit, / he chague’|Ilit, / pix’ als costats: / si tal pensats

/ eu [ho] acordau, / a mi no’m plau. / Puys sou potent, / siau content / que yo us parixcha; / mas, que us servixcha, / los fills allete, / he que’m

esplete.” (5075-126) : [“Don’t ever expect” she told me screaming, “that he will drink the milk from my breasts! I want to live the good life of a newlywed, not that of a pelican; I don’t want to lose my breasts in order to give the blood of my body to the child; I prefer to rest; I’m not a mountain girl, farmer’s wife, or a working

woman! What kind of a joke are you trying to pull on me! Make arrangements for milk from another source; I know of a German mother in Silla, a spinner, who just gave birth to a girl; she’s a poor woman who hardly has a

roof over her head; to improve her fortune you can have her send her daughter to the orphanage and then hire her, paying her well, of course, to take care of him for us. You'll see how well he sucks from her! But if you think that ’'m going to give him my breasts, and destroy my own body in the process, having to hear him cry every night, shitting in my bed, peeing on my side, if this is what you are planning or have decided to do, it doesn’t please me in the least! You are a powerful man, be satisfied that I give you children, but don’t expect me to nurse them while my body withers away!” |

Roig describes the ultimate effects of this motherly neglect with pathological specificity:

Lo pobrellet / pres-lo l’espasme: / barretes, asme, / alferecia, / epilencia / he molt alforro; / torcé lo morro, / [h]ague bocatge / he foch salvatge, / nunca dormi; / de perguami / li feu mamella. / Ella y [hi] apella / moltres madrines: / mil medicines, / meneschalies / he burleries / unten he faxen,

~ go THE ARCIPRESTE DE TALAVERA AND THE SPILL

/ sovint desfaxen, / refreden, / guasten; / suor li tasten: / ara salada, / ades gelada; / troben que bull; / ffan-li per ull, / res no profita; / prenen sospita

/ siu [ho] han fet bruxes, / en pits e cuxes, / blavo[r]s trobaven; / no’s recordaven / d’[h]aver mudades / he remudades / quaranta dides, / llets infinides / tant diferents. / Pels mudaments / e consells varis, / tant voluntaris, / ella’l mata / e’l aplata / dejus la terra. (5240-81) [The poor thing suffered attacks of spasms, jaw aches, asthma, and epilepsy. His face became twisted, his gums were swollen, and he suffered so much from St. Anthony’s fire (ergotism) that he was unable to sleep; this was caused by sending him from breast to breast. She called on the expertise of midwives

who with a thousand kinds of medicines, horse remedies, and stupidities

anointed and swaddled him, only to remove the swaddle to cool him and deprave him; they tasted his sweat, first too salty, then too cold; they warmed him up and treated him for the evil eye, but nothing worked; they found blue marks on his chest and legs, which caused them to suspect the workings of witches, yet they forgot that the poor child had been moved, and moved again, between at least forty wet nurses, tasting an infinite amount of different milks. With so many changes, so many ridiculous remedies, each

on account of her whims, she killed my son and left him buried in the

ground. | } Martinez, likewise, exemplifies the agency of women in the diseasing, deformation, and destruction of offspring; unlike Roig, he illustrates how women not only orchestrate these misfortunes but implicate men as well in their infanticidal crimes: Dentro en Tortosa yo vi fazer justicia de una muger que consintiO que su amigo matase a su fijo porque los non descubriese. Yo la vi quemar porque dixo el fijo: “Yo lo diré a mi padre, en buena fee, que dormiste con Irazon el pintor.” Dixolo la madre al amigo, e ambos determinaron que muriese el nino de diez anos; e asi lo mato el amigo, e la madre e él lo soterraron en un establo. Fue descobierto por un puerco después, e asi se sopo. (Arcipreste 117)

[In Tortosa I saw a woman executed who allowed her lover to murder her son to prevent her exposure. I saw her burned with my own eyes! All this because her son had said to her: “I’m going to tell my father that you have slept with Irazon the painter.” So the mother told her lover about it, and between them they decided that the boy, who was only ten, should die. And the lover killed

him, and he and the mother buried him in a stable. A pig dug the body up later and so the affair was discovered. | (Little Sermons 68)

THE POETICS OF INFECTION Ol It is easy to see how this story could be used to discourage contact with women by linking them to the horrors of infanticide.25 The anec-

dote also underscored the fear inherent in the medieval belief that progeny reveal the concealed sins of the parents — we have already seen how the child whose mother fantasized about her illegitimate lover while making love to her legitimate spouse was thought to bear a resemblance

to the lover rather than the father. The murder of the child, however, calls to mind the practice of killing deformed or monstrous children. In the early Middle Ages, the birth of a monster, as the Latin etymon monstrum (omen) suggests, was thought to be a divine rather than natural act, which showed, announced, or (de)monstrated the coming ofa future event.?4 St. Isidore offers several examples, such as the wife of Alexander

the Great, whose birth of a monstrous creature, half man, half beast, foretold her husband’s untimely death. Throughout the Middle Ages and Renaissance there existed the general notion that monstrous births could be read as omens of impending catastrophe and signs of heavenly disfavor. However, in the later Middle Ages and early Renaissance,

with the rise of biomedical theory, explanations of monstrous births shifted away from the divine origin of teratogenesis toward biological agents — corrupt semen, pathological imagination, improper coital posi-

tions, and excessive sexual relations (Niccoli, “‘Menstruum Quasi Monstruum’” 7). Whereas in earlier centuries the birth of a portentous human pointed to an unfortunate event in the future, in the fifteenth century it tended

to signify an improper act of the past. For theologians, the arrival of deformed children came to be increasingly perceived as a result of carnal excess and unorthodox sexual practice. The sins and excesses of the parents, particularly of the mother, manifested themselves in the

deformities of the child (Niccoli, “‘Menstruum Quasi Monstruum’” 1-6). We can understand how the birth of an abnormal or physically deformed child occasioned a great deal of grief and anxiety for the mother of the offspring. A convenient solution to such misfortune was to simply kill the child immediately after birth. The most common method was suffocation. The fact that deformed children were not expected to live more than a few days, the theological doubt over whether they were indeed human enough to necessitate baptism, and the relative difficulty involved in proving that such an infant had not died a natural death encouraged this form of infanticide. In Martinez’s anecdote the healthy child of the adulterous wife initially stands as a

O2 THE ARCIPRESTE DE TALAVERA AND THE SPILL

sign of the legitimate union between mother and father. The extramarital affair, however, forces a symbolic inversion. Like the monstrous child, who through his deformation announces the illicit sexual practices of the parents, the healthy child threatens to reveal the illicit relation between his mother and the painter Irazon. The only way to keep the illegitimate affair a secret is to silence the legitimate child.

Women as epidemic

Perhaps the most frequently used metaphor in popular and medical explanations of pestilence and epidemic was the image of a fire that started at one house and spread from neighbor to neighbor until the entire village was burned. Jacme d’Agramont begins his Regiment de preservacio de pestilencia by explaining that

Everyday experience shows us that when a dwelling catches on fire all the neighbors become afraid, and the nearer they live, the more frightened they become. Therefore, as I have heard from people deserving of faith that epidemic or pestilence and mortality of people reign and have reigned in some parts and regions neighboring ours, it is no wonder that there are doubts and fears. (Regiment, Duran-Reynals, trans., 57)

In the Spill, Solomon, speaking of the way women cause the total destruction of towns, reminds the reader of the fire of 1446 in which the Valencian neighborhoods of the Pelleria and the Trench, including the Fusteria and half of the market along with seventy houses, were burned to the ground. The fire was apparently started as an act of vengeance by Ginés Ferrer, whose wife had been convicted and hanged for homicide the day before (7533-60). Indeed one of the topics of misogynist literature is the way women cause epidemic destruction of cities and entire civilizations. “How many cities have been seen ruined and overturned on account of their pompous, vain, and hollow women!,” Solomon tells

us as he points to the destruction of Tyre, Troy, Sodom, Babylonia, Carthage, Rome, Saguntum, Siguenza, Cadiz, Valencia, and even Spain itself because of the sins and treachery of women (7118-22). Sander Gilman has suggested that the fear of collapse and the sense of dissolution that pervades the Western image of all diseases is pro-

jected onto the world in order to localize and domesticate it (Disease and Representation 1). He argues that societies create fictions about dis-

THE POETICS OF INFECTION O34 ease that are later accepted as realities about the self and the Other (5).

I suggest that the fictions of evil and diseased women found in the Arcipreste and the Spill helped to condition men to look for the origin of disorder in entities outside the body. It is no coincidence that the physician Francisco Lopez de Villalobos, who wrote that lovesick men must

learn to avoid their beloved “como en pestilencia se apartan los hombres del ayre danado” (Sumario de la medicina 3,24), also wrote one of the

earliest treatments of the contagious disease of syphilis ( Tractado sobre las pestiferas bubas). Whereas purely physiological notions of disease tended to identify an internal disordering of the patient’s body as the cause of illness, ontological etiology (theories of infection and contagion) provided an additional dimension, suggesting that the afflicted could transfer his or her misfortune to others. To be truly free from disease, a man had to learn not only to control his consumption of foods and moderate his behavior, but to regulate or avoid contact with those already diagnosed as diseased. In antifeminist discourse this hygienic principle becomes articulated in fables, anecdotes, and myths that forcefully urge readers, as Martinez and Roig recommended repeatedly, to “flee” from all contact with women. Fracastorius’s celebrated theory of contagious diseases is without a doubt a landmark in the history of medicine; it gave way to paradigms that have helped to control some of our most menacing illnesses. But there is an underside to this particular interpretation of disease that is clearly evident in the works of Martinez and Roig. The idea of ontological disease permitted men’s fear of corporeal disorder to be fixated in someone or something beyond them, establishing a distinction between the healthy male observer and the diseased female Other (Gilman 7). The problem is that all too often the scientific fight against germs and

viruses becomes a social attack against those who are perceived to threaten the social and political order. Thus the ontological concept of disease has variously fixated on the bodies of blacks, Jews, homosexuals,

madmen, Moors, Gypsies, and women, who, because of their alleged status as bearers of contagious maladies, have become at various points in history targets of the bellicose metaphors and the ensuing therapeutic strategies that accompany the “fight against disease.”

4 The poetics of the compendium and the conditions of the clinic

Traditional literary criticism, born out of romanticism, neo-Aristotelian poetics, and the precepts of formalism, identifies the literary text as a

rarefied discourse standing in opposition to more common forms of speech and writing. The problem with this notion of literature for the medieval critic is that it draws our attention away from the power inherent in more pedestrian forms of textuality and divides written language into the artistically uplifting and the functionally banal. Literature

as conceived by medieval writers was much broader than today’s orthodox assumptions and included notions that have been traditionally excluded from the canonical prerequisites of the Hispanic literary text. The decisive element that gave the medieval text its “literariness” was its ability to “do something” to “something else.” As such, the history of medieval literary composition is closely related to the more general history of medieval technology and tool production.

Medieval authors acknowledged an instrumental quality in the writing and codification of discourse. It is common to find comparisons made between the act of writing and manual activities such as farming,

sewing, and building: we “plough the sheets of parchment,” one medieval scribe tells us (Drogin 15). Writers frequently compared their works to musical instruments or farming implements. St. Augustine, for

example, suggested that the various components of sacred historical writings were like plowshares that break the soil, or like the strings on a harp that produce melodious sounds (City of God 108). Juan Ruiz presented his Libro as a musical instrument, telling the reader that “bien o mal, qual puntares tal diré ciertamente” (copla 70). For St. Isidore, the very nature of literature, as seen in its etymological morphology, was a type of road construction: the word “literature” (he claimed) is derived from littere (letter) and iter (road); thus literature is a collection of letters that shows the way, directs one’s path, or provides a road.! In the minds of many medieval authors the desire to inform was never more than one step away from the need to reform. Consequently, medieval

94

THE COMPENDIUM AND THE CLINIC QO5 writing was thought to function instrumentally by doing something to the reader, or by allowing the reader to transfigure, or alter, something beyond himself. The professional compendium, the popular handbook, and the medieval clinic

A healer’s ability to control and disseminate information was as impor-

tant to clinical practice as the ability to compound medicines and manipulate surgical tools. To the degree that it contained significant discourse, the compendium was intimately linked to the medieval clinic. Physicians and students of medicine relied on works such as Avicenna’s Canon to help them identify diseases and to develop appropriate therapies. ‘Io this end many medieval physicians carried at their waist a little medical reference guide called the vade mecum (literally, “go with me”). This handbook, normally consisting of six or more pieces of parchment, each folded across the middle and again into three sections, dedicated each section to a particular table, chart, diagram, or instruction. A surviving manuscript in the British Museum contains a calendar, canons of

the eclipses of the sun, canons of the eclipses of the moon, a table of planets, rules for phlebotomy, and descriptions of urine. The work was designed to be hung from the waist, where with a flick of the finger the appropriate table could be opened and consulted; this allowed physi-

cians to “make rapid calculations and decide within a matter of moments what was best for the patient” (Talbot 214).? During the later Middle Ages professionals such as priests, notaries,

lawyers, and physicians became increasingly dependent on compendiums to carry out the responsibilities of their office and trade. This dependence corresponded with an increasing professional need to control discrete units of information. The problem confronting these men was how to find (or create) and then use the correct words at the cor-

rect time. Working compendiums were created to help them appropriate useful discursive material. We can take as example the artes praedicandi, manuals dedicated to the art of preaching. These guidebooks for preachers not only explained the way sermons should be organized

and delivered, but also contained discursive elements (quotations, exempla, arguments) that the preacher could appropriate at a given moment to compose a sermon.* We can find this same quality of athandness in the medieval epistolary treatises, the artes dictaminis, which consisted of a theoretical discussion on the art of writing letters followed

g6 THE ARCIPRESTE DE TALAVERA AND THE SPILL

by the dictaminum, a collection of model letters (as many as one thousand) that could be copied and used.5 Guido Faba’s Dictamina rhetorica (c. 1226), for example, provides model letters addressing the needs of people from all social levels, secular and ecclesiastic. In one letter a student asks his parents for more money to pay for the high costs of food; in another a merchant invites a friend to invest money in fabrics; in still another, a wife asks her husband, absent for five years, to return.® Yet another type of professional compendium, the swmma confesorum, evolved during the thirteenth century out of the earlier penitential manuals. The summae, focusing on the importance of confession and contrition over the austerity of penances, attempted to be both practical and complete, offering the confessor concise information (most often specific questions) that he could use to help the sinner through confession and on toward forgiveness. Whereas the value of the compendium for the professional lay in its ability to keep a massive collection of information readily at hand, the user ran the risk of becoming lost in a sea of discourse if the collection grew too large and unwieldy. The inclusion of indexing devices allowed the material to be organized and reformulated in such a way that it was not only accessible, but also easily retrievable.” Throughout the Middle Ages various indexing devices and organizing mechanisms (numbered chapters, tables of contents, alphabetization) were used to make the text easy to retrieve. ‘The fifteenth-century Spanish translation of the Speculum laicorum contains 569 hagiographical anecdotes, biblical commentaries, moralistic fables, and historical narratives that are arranged under ninety-

one chapter headings, roughly in alphabetical order. Book 7 of Bernard of Gordon’s Lilio, which employs a common medical indexing device, orders the discussion of diseases and cures from head to toe.’ The need to create compendiums that allowed for easy retrieval is expressed explicitly in the prologues and introductions of many medieval handbooks. The author of the fifteenth-century Mirror of Coitus, for example, warns of the dangers of disorganized material and expresses his desire to represent this material in ways that make it easy to locate: Although Albafumet said that the books which speak of coitus are numerous,

J have never seen in them any complete treatment, but rather have found them rambling and deviating in such a way that the harm they caused outweighed their good. I, therefore, wish to speak of this matter completely and clearly so that all who desire to read this treatise, including physicians, surgeons, and many other people, may understand it and benefit from it. I will

THE COMPENDIUM AND THE CLINIC Q7 take care not to make a lengthy exposition to allow the reader to benefit from this treatise and its cures better. So that one may easily find the soughtafter information in this treatise, I have divided the work into chapters. (1)

The desire to make important works retrievable also encouraged writers to reformulate the discursive material into translations, commented versions, abridgments, and aphorisms. Avicenna’s Canon, for example,

underwent drastic alterations during the late fifteenth and sixteenth centuries, its chapters appearing as separate books or its contents reduced to summaries and lists of aphorisms. In the late fifteenth century, Francisco Lopez de Villalobos wrote a metrified version of the Canon, titled the Sumario de la medicina, that was designed to easily (ligerament) allow the uneducated reader to freely (lbremente) locate med-

ical information (307). The Arcipreste de Talavera and the Spill emerged out of the tradition of the professional compendium, whose organizing assumptions consisted

of gathering, collecting, and amassing units of significant discourse to be deposited in a single container. Discrete written discourses — like sur-

gical tools, medicines, and diagnostic instruments — demanded a controlling mechanism to assure that they were available and usable when needed.!0 Like a workbench, an operating table, or a physician’s bag, the compendium provided a place where instruments became available, usable, and “close at hand.” When texts were united within the confines of the compendium, they could be appropriated to facilitate a particular procedure, much in the way a medical assistant takes an instrument

from the operating table and hands it to the surgeon, or a physician reaches in his bag and withdraws an instrument, then replaces it and selects a stethoscope — each act of withdrawing and replacing corresponding to a preconceived diagnostic or therapeutic procedure. The foremost clinical function of the Arcipreste and the Spill was to grant textual entities this quality of at-handness.

During the fourteenth and fifteenth centuries the qualities of athandness and retrievability that had established the compendium as a useful professional instrument began to reappear in the form of concise popular handbooks. More narrowly focused than the larger professional compendiums, these manuals were often written in the vernacular and designed for use by nonprofessionals. The popular handbook attempted to provide information previously available only to the highly educated or learned professional. Perhaps nowhere is the emergence of the pop-

ular manual more evident than in the production of medical hand-

98 THE ARCIPRESTE DE TALAVERA AND THE SPILL

books. In the fifteenth century the Iberian Peninsula experienced a remarkable upsurge in the amount of practical medical advice available to readers in the vernacular. Health compendiums, herbals, treatises on the plague, and gynecological manuals provided for lay readers the basic medical principles of health preservation.!! In 1305 Arnau de Vilanova wrote an abbreviated version of his Liber de regimine sanitatis (1299) for the king of Aragon, Jaume II, which was subsequently translated into Catalan as the Regiment de sanitat at the request of the king’s wife, Queen

Blanca d’Anjou, who could not read Latin.!? The work begins by explaining that because the art of medicine is very long (an allusion to Hippocrates’ “vita brevis, ars longa”) and the discussions of it by learned physicians are very extensive, the common people (poble comu) cannot understand it. Consequently, King Jaume II of Aragon has commanded that this little treatise be written for those who want to understand medicine and put it to use. Berenguer Sariera, the translator, reminds us that since the work is in Latin, there are many who will not understand it. To this end Sariera has translated the work into romance (Catalan) and has included some marginal notes to help the reader “easily find” (leugeramente trobar) the proper discussions (100-1).

A similar preoccupation with the “popular” reader appears in the early fifteenth-century Mirror of Coitus.13 The Catalan-Valencian author complains that works on coitus, although numerous, are “rambling and

deviating,” and hence apt to be more confusing than enlightening (1). His express intention is to create a concise treatise dedicated solely to the matter of human coition. To this end the Mirror does not attempt to advance new medical theories, but rather presents a tightly focused discussion of sexual intercourse by avoiding technical jargon, theoretical explanations, and superfluous digressions. Perhaps the greatest therapeutic merit of the popular medical treatise lay in the way it allowed the sick themselves (or those in close contact, such as family and community members) to do the healing. Once medical discourse — hygienic advice, prescriptions, outlines of surgical procedures, descriptions of pathological conditions, explanations of diagnostic technologies, speculations on the cause of disease, lists of pharmaceutics — was transformed into a tangible and accessible format, its use was no longer contingent upon the presence of the physician or medical authority. Medieval medical history can point to a long tradition of texts written to be used without the aid of a doctor. For example, Constantine the African’s Viaticum (c. 1070), as the name suggests, was written as a handbook for travelers isolated from medical care. Perhaps

THE COMPENDIUM AND THE CLINIC O9 the most enduring of this type of handbook was the Thesaurus pauperum (The Treasury of Poor Men). Allegedly written by Peter of Spain (Pope John

XXI), the Thesaurus contained more than fifty chapters, each dedicated to a specific disorder such as loss of hair, nosebleed, toothache, nausea, constipation, hemorrhoids, diarrhea, fainting, and headaches. The work offered no theoretical orientation and limited itself to listing a variety of cures — sometimes as many as a hundred — for each affliction. As the title implies, the work was meant to be a treasury of medical advice for practitioners who were too poor for professional training. The Thesaurus pau-

perum was extensively copied, translated, and later printed throughout Europe from the late thirteenth to the eighteenth century.!4 The possession of this litthe work granted anyone who could read the ability to act as a doctor. When medical knowledge was disseminated through writing, as in the case of the Thesaurus pauperum, the sick or their associates could turn to medical remedies independent of the medical establishment. Works of this nature tended to proliferate in times of epidemic and disease. In 1348, on the eve of the Black Death, the town of Lérida commissioned the physician Jacme d’Agramont to write a small treatise on the plague. Jacme’s Regiment de preservacié de pestiléncia was the first of a long

series of brief treatises dedicated to informing the general public of ways to avoid the ravages of this disease. In the introduction to the Regiment, Jacme states that the treatise “was made primarily for the benefit of the people and not for the instruction of the physician.” He insists that the work “was made for the common and public good,” that it could be used without the aid of a physician, and that it should be given to anybody who desired to make a copy of it for personal use. Jacme, however, warns that treatises of this nature should be limited to advice on maintaining one’s health, and not be extended to include the methods and techniques used

in curing diseases, which is the sole domain of those who have been trained in the medicinal arts (48). Jacme’s treatise, therefore, presents both the benefits and dangers of the codification of medical knowledge. On one hand he recognizes that written discourse can aid the general public by making the basic rules of health care available to all regardless of their ability to consult a physician; on the other hand he clearly warns that a treatise for the general public should not include information on the art of curing, lest those who do not understand this art err.

Subsequent generations of medical writers did not heed Jacme’s warning against disseminating professional information on healing the body to the general public. Approximately sixty years later, Alfonso Chirino, court physician for Juan II of Castile and a contemporary of

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Roig and Martinez, compiled an extensive collection of cures, recipes, and surgical procedures touching on all aspects of medical practice. The title of the work, the Menor dano de la medicina, reflects Alfonso’s aggressive distrust of the majority of medical practitioners. The motive behind the writing of his treatise was to provide the general public with the most demonstrably efficacious forms of medical therapy and thereby to eliminate the need to consult incompetent and dangerous physicians. The Menor dano, which begins as a hygienic guide similar to the Regiment

de sanitat, describes proper diet, rest, exercise, and control of the emotions. It then offers cures for blisters, wounds, hemorrhoids, nosebleeds,

headaches, toothaches, earaches, stomach pains, and gout, and gives remedies for improving memory, eliminating scars, reducing facial wrin-

kles, and removing the odor left in the mouth after eating garlic. Chirino also provides recipes for tooth powders, burn ointments, and mouthwashes; he describes in detail the formulas for some of the most popular compound medicines: diapalma, socrocio, alcatenez, unguento amarillo, and agua ardiente. He lists and describes the medicinal value of certain plants and herbs: anise for the stomach, spinach for breast pains, onion mixed with oil for hemorrhoids. He includes a small section on female maladies, followed by a brief chapter on facial cosmetics. There

is even information on the techniques of surgeons, whom Chirino describes as “very bad men, and worse than physicians, if there can be anything worse.” !5

The diversity of medical information and the organizational apparatus in the Menor dano resemble the large medical compendiums, such

as Avicenna’s Canon, that flourished during the thirteenth and fourteenth centuries. Chirino’s work, however, differs significantly from the

treatises designed for professional consultation and university study. Chirino clearly expresses his intention to make medical information available to the general public. To this end he refuses to use arcane and technical jargon, speaking “vulgarly so that any man can understand.”!6 He also encourages his readers to disseminate the information — or the medicines compounded on the basis of this information — to others. He emphatically insists that the medical cures, advice, and drugs described

in his treatise be used independently of practicing physicians.!7 In effect, works like the Menor dano were a useful tool within the clinic, serving as a repository of therapeutic information; but to the degree that these works were used in the absence of a clinical healer, they began to function as the clinic itself.

THE COMPENDIUM AND THE CLINIC 101 The therapeutic power of tangible discourse and the compendium as the clinic

Beyond its ability to offer useful information that could be employed

independently of a clinical healer, the popular handbook was also capable of making medical discourse tangible. Writing reifies healing and gives medicinal speech a concreteness that answers a psychological need to turn therapy into palpable forms. Discrete speech such as fables, exempla, descriptions, warnings, and commands were thought to possess therapeutic qualities similar to those in ointments, laxatives, enemas, and balms. Thus, saying the right thing was thought to be analogous to

administering the right medicine. But medicines are concrete and tangible whereas spoken words are impalpable and immaterial. The lack of

concreteness that accompanies the spoken word, regardless of its authority and alleged usefulness, makes it less desirable as a medical therapy than material remedies that can be held, carried, and exchanged. When medicinal discourse is written down, it gains concreteness, making it transferable, portable, and usable in separate units. In effect, codification makes medicinal discourse a “thing” that like drugs and ointments

can be “transacted from one interpretive setting to another, retaining value but changing meaning” (van der Geest and Whyte, 348). The appeal of medicines and drugs lies in their concreteness. In developing countries anthropologists have found that without physical forms of therapy such as pills and suppositories, physicians have a difficult tme

encouraging patients to visit the clinic. From the point of view of the patients in these countries — as well as that of many health care practitioners — the ability to offer something tangible to the patient is an essential part of medical therapy (Melrose 183).!8 Doctors complain that they

stand to lose patients, credibility, and even revenue by not prescribing drugs. This results in a tendency to overprescribe medicines. Ugalde and Homedes speak of a doctor in the Dominican Republic who regularly satisfied his patients’ demands for medicines, even when they didn’t need

them, because “he did not want to give the impression that he did not care for them; many had walked an hour or more and would get upset if they knew that medicines were available and not given to them” (62). A widespread belief in popular culture is that medicines contain the power of healing in themselves. Medicines objectify the healing process and offer the patient a sense of security in the belief that within the con-

crete substance lies the power to control disease. ‘Those who possess

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these substances have access to their healing capabilities. ‘The power of

these medicines, therefore, can be used independently of doctors and pharmacists. Van der Geest and Whyte suggest that “pharmaceuticals objectify the healing art of physicians and make it into some-thing that can be used by anyone. Pharmaceuticals break the hegemony of professionals and enable people to help themselves” (348). A drug, therefore, can mediate the distance between the patient and the physician, relieve anxiety about recurring disease, and, because it is transactable, it can be

exchanged, bartered, and sold, retaining its use-value even when employed outside its original therapeutic setting. Perhaps the most valuable aspect of material medicines is their ability to liberate the sick from the social consequences of illness. ‘To the degree that healing is a collective effort, ideas of morality and social obligation are closely connected to the patient’s treatment. Anthropologists van

der Geest and Whyte argue that medicines liberate people from the shameful associations connected with certain medical conditions. ‘This is especially true for venereal diseases, disorders of the genitalia, pregnan-

cies, abortions, and other conditions that in many cultures are tightly linked to the patient’s moral conduct. “The charm of medicines is that they allow private individual treatment, diminishing dependence on biomedical practitioners” (351). They enable patients to take matters into their own hands. Although we must proceed with caution when comparing contemporary reliance on drugs with healing in the Middle Ages, there is ample

documentation to suggest that medieval people anxiously sought tangible forms of therapy and demanded that acts of healing be accompanied by palpable objects. Pilgrims who sought a cure for their ailments at the hand of a saint demanded as part of their cure objects that had been in contact with the holy personage; some willingly ate the charred wicks from the candles that burned before the shrine; others drank the water in which a splinter of the True Cross or the bodily relics of a particular saint had been immersed. A celebrated medicine of the Middle Ages was “water of St. Thomas,” which was purportedly concocted using

the blood wiped from the floor of the Canterbury cathedral after the saint’s murder (Sumption 82-3). In Santiago de Compostela people protected themselves from fevers by drinking the water from a fountain that St. James had miraculously created (Zaragoza Rubira, “La medicina” 38). In each of these cases, the belief in the healing power of the saint’s intervention was objectified in a physical artifact. It was not necessarily enough to pray at the tomb of a saint, hoping to invoke divine

THE COMPENDIUM AND THE CLINIC 103 intervention in restoring one’s health: the sick also demanded concrete forms of therapy to accompany their prayers and supplications. Even today, those who visit shrines such as Lourdes in southern France return with bottles of holy water and other objects to be used against future ailments or to offer to ailing friends and loved ones.

When words are written down, their power (real or imaginary) becomes objectified. This power not only becomes accessible to others, but it is able to “stand on its own, be kept in a cupboard, locked behind doors, handed over to others across place and time” (van der Geest and

Whyte, 349). The value of healing words increases when language appears in concrete forms. In medieval Europe it was very common to write oral conjurations and charms on scraps of paper that could be literally applied to a wound or ailing part of the body. In the Wolsthrun Manuscript we are told of a cure for menstrual problems that consisted of writing the words “By Him, and with Him, and in Him” on a piece of paper and then placing it on the afflicted woman’s head (Kieckhefer 4). Methods of “liquefying words” to create drinkable potions were not

uncommon. John of Mirfield, for example, noted in his Brevarium Bartholomei a practice of writing scriptural quotations on a piece of paper; the paper was then soaked in water until the ink was washed away; the solution could then be drunk as a medicine (Jowler and Bramall 32). Luis Garcia-Ballester has documented similar cases among

Morisco practitioners in Valencia in which religious writings (often alleged by the Inquisition to be names of devils) were written on a plate

that was soaked in water, the liquid later being administered to the patient (Historia social 1: 167-9). In one curious case, an illiterate woman from the Valencian town of Turis held a medical book up to a mirror with the intent of creating a mimetic transfer of the cures in the book to her body by means of the reflected image (168). The medicinal power of tangible discourse is documented and beautifully illustrated in a curious personal anecdote recorded by Alfonso the Wise. In cantiga 209 of the Florentine manuscript of the Cantigas de Santa Maria, Alfonso tells of how he fell ill in the city of Vitoria. So great was the pain, he tells us, that he believed the illness to be mortal.!9 The

doctors ordered hot cloths to be placed on his chest, but the king refused, asking instead for “Her Book,” the earlier version of Cantigas de

Santa Maria, to be laid on his chest.29 No sooner had the book been brought to the king than he was healed: “e poseron-mio, e logo jouv’ en paz. ... Que non braadei nen senti nulla ren / da door, mas senti-me logo mui ben” [they placed it on me and at once I lay in peace.... I

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neither cried out nor felt anything of the pain, but at once felt very well]. In this cantiga Alfonso not only points to the way the sacred book efficaciously functions in place of the medicinal cloths, but on a clinical level, he also shows us how the power of the Virgin supplants the skills of the physician. My intention, however, is not to argue that pious men

like Alfonso preferred the supernatural techniques of sacred healing over rational strategies of secular therapy, but rather to suggest that the codicological medium through which Alfonso’s healing took place effectively replicated the necessary conditions that allowed a clinical interaction between healer and patient. The Cantigas de Santa Maria is a collection of some 400-odd narra-

tives that recount a series of miraculous interventions in which the Virgin ameliorates dangerous conditions and remedies difficult circum-

stances for her devotees. The central therapeutic message of the Cantigas is that those who respect and love the Virgin Mary can expect to preserve an ongoing state of well-being. One of the primary manifestations of one’s love and respect, and as such one of the basic preconditions of the Virgin’s health-preserving intervention, was the repeated praising of the Virgin’s virtue and goodness. The Virgin’s intervention on behalf of Alfonso was predetermined by the fact that he had already piously collected, metrified, and illustrated an enormous compendium detailing her good deeds and phenomenal virtue. In fact, this is the very didactic message repeated in the estribillo of cantiga 209. Alfonso tells us that “Muito faz grand’ erro, e en torto jaz, a Deus quen lle nega o ben que lle faz” [He who denies God and His blessings commits a great error and is grievously wrong]. He continues: Mas en este torto per ren non jarei que non cont’ o ben que del racebud’ ei per ssa Madre Virgen, a que sempr’ amei. e de a loar mais d’outra ren me praz. Muito faz grand’ erro, e en torto jaz, a Deus quen lle nega o ben que lle faz

E, como non devo aver gran sabor | en loar os feitos daquesta Sennor que me val nas coitas e tolle door e faz-m’ outras mercees muitas assaz?

Poren vos direi o que passou per mi, jazend’ en Bitoria enfermo assi

THE COMPENDIUM AND THE CLINIC 105 que todos cuidavan que morress’ ali e non atendian de mi bon solaz. Muito faz grand’ erro, e en torto jaz, a Deus quen lle nega o ben que lle faz

{ However, I shall never fall into this error by failing to tell of the benefit I have received from Him through His Virgin Mother, whom I have always loved and whom it pleases me more than any other thing to praise. He who denies God and His blessings commits a great error and is grievously in the WYONG.

And how should I not take great delight in praising the works of this Lady who assists me in trouble and takes away sorrow and grants me many other blessings? He who denies God and His blessings . . .

Therefore, I shall tell you what happened to me while I lay in Vitoria, so ill that all believed I should die there and did not expect me to recover. He who denies God and His blessings . . .]

Therapeutically speaking, Alfonso’s illness is cured on account of his previous interaction with the Virgin in writing “Her Book.” Hygienically speaking, his future well-being is assured, now that he has inserted this new miracle into the compendium. The Virgin’s book, therefore, is more than just a container of tales. Effectively, it functions as a clinical locus in which salutary strategies are contained and carried out. The conditions of the clinic in the Arcipreste and the Spill

Like the medieval clinic itself, the Arcipreste and the Spill are social responses to a therapeutic imperative to remedy corporeal and spiritual illness. Specifically, Martinez and Roig wrote their compendiums with the intent of curbing, controlling, and curing certain amorous practices that they believed had disrupted fifteenth-century Spain with the force of an epidemic. In the introduction to the Arcipreste de Talavera, Martinez

justifies his composition by saying that “It will, therefore, be a useful and holy deed to remedy those things which are the greatest cause of our illness.”2! Later he writes:

106 THE ARCIPRESTE DE TALAVERA AND THE SPILL

Non dubde, por ende, ninguno, que si lo susodicho leyere e diligentemente lo examinare, sentira que fuello por el camino verdadero. Pues farto deve ser enxiemplo a los bivientes los enxiemplos de los antiguos pasados, e farto es conveniente al que en agena cabec¢a se castiga; e lo que otro con muchos dapnos e perigros paso e corporalmente provo, e vido, que en un poco de escriptura e papel, sin que se aya de poner a la muerte, ge lo demuestre e dé castigo a mal fazer e remedio a mal obrar e consejo para de los lazos del mundo, del diablo e de la muger se amparar e defender. (143) [And let no one who reads this doubt it, for if he reads and diligently examines it he will see that it was all written to put him on the true path. The example of the ancients should be a sufficient example for the living, and it is surely good to profit by the experience of others. What one man went through, with many hardships and dangers, and what he saw, need not wait until his death to be written down on a piece of paper; let him teach others and serve as a lesson against evildoing, a remedy for wickedness and a warning against the pitfalls of this world, a defense and liberation from the devil and from women. |

Roig articulates the same instrumental impulse, lamenting contemporary amorous practices and explicitly stating that his work is the result of a need to “remedy a collective error into which all young tend to fall.”22 Although he specifically dedicates the book to his young nephew, Baltasar Bou (241), whom he urges to read the work frequently and attentively, he instructs us that the work is to be used to inform “green young men who have no experience with the touch of fire” (292-6), and certain old men who lke birds run around chirping and whistling as if they were cicadas, crows, or magpies, howling like wolves to give substance to their

songs, their embroidered clothing, their gilded bridles, working the streets, moving the corners with their comings and goings, and every day fluttering around like the butterflies who do not fear the flame until they are burnt. (184-239)

Also represented and replicated in the Arcipreste and the Spill is the ideology of the clinic, including its beliefs concerning authorized and empowered healers. Martinez does this by casting himself as the clinical healer whose authoritative voice, legitimized by his ecclesiastical office, speaks to the reader-patient with the salutary weight of the holy man and the Christus medicus. Moreover, by insisting that the title of the work, Arcipreste de Talavera, refers to his ecclesiastical status, Martinez

subsumes the healing strategies of his compendium under the rubric of

THE COMPENDIUM AND THE CLINIC 107 his authority as archpriest. The imperative to heal lovesick and lustful men is, therefore, inextricably linked with the responsibilities of his ordained office. To this end, Martinez constantly suggests that the wellbeing of human beings is connected with the mechanisms of divine healing. The clinical hierarchy implied in the Arcipreste is explicitly described in the Spill. Roig, writing from the point of view of a physician, subordinates his own medical powers to those of sacred healing, and identifies Christ and the holy man as the most efficacious practitioners. In the dream encounter with Solomon (which occupies the entire book 3),

the ancient king informs the narrator-protagonist that to cure his decrepit and diseased body he need only turn to the “Irue and Divine Medicine,” Christ the Redeemer, the “Rich Physician, the herbalist, the Applier of Ointments, the Surgeon” (12007—106). The healing that Roig speaks of here is not solely metaphysical or spiritual. Through the voice of Solomon, Roig reminds the reader of the type of physical ailments that Christ healed: Ab fe sancera / sorts, muts, llebrosos, / sechs, tremolosos, / orps axi nats / tropichs inflats, / tisichs febrosos, / los puagrosos, / coxos, artetichs, / ffolls e frenetichs, / subets, litargichs / etichs, mirarchichs, / mentres vixque /

he li plague, / quants hi venien / tots obtenien / llurs sanitats: / primer peccats / los remetia, / puys los guaria / la corporal / he temporal / infirmitat. / Tal sanitat / hi trobaras / si tu vindras / ab fe, speranca / he confianca. (12034—60)

[With sincere faith the deaf, the mute, the leper, the sickly, the trembling,

the blind at birth, the swollen dropsied, the fevered phthisic, the goutinflicted, the lame, the arthritic, the mad and frenzied, the dull-witted, the lethargic, the consumptive, the melancholic, and all those who approached Him were healed; first He redeemed them of their sins, then he healed their temporal and physical infirmity. Such health you will find if you come unto Him with faith, hope, and confidence. ]

Through the voice of Solomon, Roig also lists specific supplicants whom

Christ healed (12021-82): the possessed daughter of a woman from Canaan (Matthew 15: 22-8) and a woman whom Roig calls Sofia (Matthew 9: 20-2), who was cured of twelve years of issuing blood by touching Christ’s tunic. Roig insists that Christ will heal all who come unto him, but that he wants them to understand, recognize, and confess their sins: “Deu or may pres, / ni vol grans pagues: / sols vol tes plagues

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/ li manifestes; / tes deshonestes / he praves obres / vol li descobres /

he les confesses” (12110-19) [God never asks for gold, nor asks for great payment; he only wants you to acknowledge your wounds, and confess your dishonest and wicked deeds]. In this way, Roig reaffirms the relation between sin and disease, one of the basic tenets of clinical etiology. For Roig the holy man is an extension of the Christus medicus.

He speaks of the way Elisha cured Naaman of leprosy (2 Kings: 5)

and reminds the reader of the way the bones of this same prophet revived a dead man.?3 In opposition to the power of holy men and authorized healers, Roig retells how St. Sylvester dissuaded Constantine

from using the horrible cure of washing himself in the blood of three thousand Christian babies. He further condemns empirics and medical subalterns, pointing to their demonic association and inefficacious prac-

tices: “Bel e Satan / he a quant fan, / exarmadores, / encortadores / les piromantiques / he nigromatiques” (12121-6) [Bel and Satan, and all those who practice charms, spells, piromantics, and necromantics]; likewise he disparages women practitioners, specifically those who failed

to cure his second wife of her infertility: “ella no dexa / cercar metgesses, / velles urguesses, / emprenyadores, / les banyadores / mores, madrines, / les adivines / he potecaris, / los erbolaris / e traguers, / hon que pogues / remey trobar” (4522-33) [She never stopped going to women doctors, old infernal witches, fertility quacks, Moorish bathers, midwives, fortunetellers, herbalists, spice vendors, and preparers of theriac, or wherever she thought she could find a remedy]. Perhaps the most powerful characteristic of the clinic that Roig and Martinez attempted to add to their compendiums was the quality of athandness and retrievability. Martinez tells us that he composed the Arcipreste by collecting sayings (dichos) of the learned Parisian Juan de Ausim (heretofore unidentified) that had been used to cure a tormented young man who suffered over his love for a certain woman (64). Implied here is the idea that the sayings collected by Martinez could also be used to heal any reader who found himself in a similar condition. Martinez beckons his public to “Ilerlo, e leido retenerlo, e retenido, por obra ponerlo” (61-2) [to read it and, having read it, to remember it, and, having remembered it, to put it into practice]. He tells us that he does this especially for those who have not yet trod the ways of the world, or drained its bitter cup, or tasted its sour dishes. Inscribed here is the idea that the textual components of his compendium, like a beverage or a food, can be used to supplement deficiencies and counter afflictions. Martinez

THE COMPENDIUM AND THE CLINIC 109 refers to his work as a “compendio breve” (61). I would argue that the adjective breve, “brief,” refers less to the length of the treatise — which is more than two hundred pages in the modern edition, 120 folios in manuscript — than to the nature of its design. When Martinez suggests in the

prologue that his work should be read, retained, and put into practice (62), he alludes to a type of work such as the priest’s breviary or the physician’s vade mecum that could be hand-held, carried close to the body,

and consulted frequently in the absence of larger institutional and informational apparatuses. Martinez recognized that “of men there are many kinds, and hence they are hard to know and harder to teach” (205). The multiplicity of men requires a multiplicity of regulatory strategies. Given the diversity

of bodily compositions, behavioral attributes, and educational back-

grounds, there can be no single implied reader-patient for whom Martinez could construct his compendium. On the contrary, for maximum. effectiveness the compendium had to attempt to meet the needs of diverse human beings. Martinez’s work, therefore, is essentially nonlinear. No ongoing narrative links the various parts and divisions. Upon reading a few chapters one gets the distinct impression that Martinez has gathered as many discursive fragments as possible, limiting his collecting only to the general idea of illicit sexuality. Indeed it is impossible

to speak of the work in terms of a preconceived notion of completion and closure, since works of this nature were intended to be capacious and flexible enough to embrace enormous amounts of materials. This is not to say that the discursive material in the Arcipreste has been thrown

into the compendium haphazardly. As I will discuss momentarily, the textual entities undergo various transformations that make them medicinally more powerful. My argument, however, is that the use of a given

anecdote, refrain, or proverb is not contingent upon, or inseparable from, the other textual entities in the compendium. The Arcipreste is meant to be an indexed collection of discursive tools, from which the lovesick patient can extract one, several, or many. To this end Martinez divides the work into four parts, each with up to thirty-eight chapters allowing for different subject matter to be stored in discrete areas. Part 1 contains a series of razones or arguments against “disordered love,” each chapter identified with a specific heading. As an additional indexing device, Martinez organizes the final chapters in

part 1 around the ill effects of love and their relation to the Ten Commandments, dedicating one chapter to each commandment. Part 2 focuses on women, dividing the information into categories based on a

110 THE ARCIPRESTE DE TALAVERA AND THE SPILL

particular womanly vice or “defect.” Part 3, which is the most medical in its orientation, lists in separate chapters the various bodily compositions

and astrological conditions and their amorous effects on men. Part 4, divided into three chapters, is a lengthy discussion on free will and cosmic determinism. Roig, like Martinez, is also concerned that his Spill be “at the reader’s

hand” and that the information therein be easily retrievable. Roig’s particular narrative structure, however, may seem to undermine this concern. One of the salient differences between the two works is the autobiographical frame through which Roig’s narrator progressively recounts his unfortunate encounters with women from birth to old age. The very ordering of the “graph” through the “bio” already imposes a linear structure on the text that not only links the various textual entities, but drives the reader toward a final sense of closure. Extractability

is more difficult to argue in a text of this nature. Nevertheless, Roig himself has incorporated several devices into the work so that individual parts can be selected and used independently. First of all, Roig’s title, Spill, the Catalan word for “mirror,” alerts the reader that he has in his possession a work that was created to function as a handbook of moral

or theological principles, as a professional compendium, or perhaps more commonly, as a practical manual of medicine or behavior designed for the general public.24 This means that the reader, even before glancing at the first page, is already predisposed to confront a guidebook rather than an extended narrative.25 Secondly, Roig explicitly says he intends to organize the work so as to make it easy to find and extract the information contained therein. In the beginning lines of the Spill, he tells us that he has divided the work into four books (libres). Each of

the four books is divided into four smaller parts. Roig promises the reader that if he works with these divisions, and keeps them in mind, he will be able to extract easily the “food” (vianda) that he most desires: “Fflors, fruyts o fulles, / rahels o fust, / seguons son gust / he sa sabor,

/ cascun lector / pres trobara / lo que volra” (750-6) [Flowers, fruits, or leaves, roots or bark, each reader, according to his tastes and pleasure, will be able to find in this work that which he desires]. The collection, codification, and indexing of useful therapeutic discourses, here equated with foods and pharmaceuticals, makes Roig’s Spill as well as Martinez’s Arcipreste highly usable in a clinical setting. Implied in this desire to allow the reader or the reader’s family members to locate and administer the appropriate discursive instruments is the idea that the

THE COMPENDIUM AND THE CLINIC 111 compendium can supplant the presence of a clinical healer and in effect function as the clinic itself.

The Arcipreste and the Spill as the medieval clinic The Arcipreste and the Spill are more than collections of useful informa-

tion that, in the spirit of the popular health guide, supply the reader with the knowledge necessary to stay healthy and cure disease. These works attempt to replicate the workings of the clinic by producing a clinical encounter in which the text, functioning as physician, confronts the reader, who stands in the subordinate role as patient. To this end, both Martinez and Roig employ the therapeutic strategies of confabulation, creating an interlocutor to speak directly to the reader-patient. In accordance with the medical suggestion that the confabulator for sex-related

ailments be an “hombre prudente y de autoridad” [prudent man of authority] or a “varon sabio” [wise man] (Bernard of Gordon), Martinez exploits his own authoritative persona as archpriest, presenting himself as an erudite and learned man (“bachiller en decretos”) with prominent

professional ties (“capellan de nuestro senior el Rey de Castilla don Juan”) who has seen firsthand the social and personal destruction caused by illicit sexual behavior.26 Replicating the role of medical confabulator, he directly addresses the reader, offering him hygienic guidelines, thera-

peutic imperatives, etiological descriptions, and salutary advice for keeping the body free from sex-related disorders.

Using salutations, interrogatives, interjections, invocations, and direct discourse, Martinez weaves a tight dialogical connection between

narrator and reader, never letting the expository and anecdotal material wander more than one step away from the interplay between tu and yo. Locutions such as pues amigo, pues tu que amas, te digo, cuando vieres, digote, te dixe, te demostraré, pensar puedes, non pienses, and fuye permeate

the work. Unlike the standard medical treatment of sexual disease in which pathological descriptions and therapeutic directives appear in

the impersonal third person, Martinez focuses his etiology on the reader’s body, and offers the patient direct therapeutic imperatives: E si por aventura los incentivos o estimulos de la carne dizes que los non puedes sofrir nin refrenar nin resistir, yo te daré buen consejo con que los sobraras, e sin grand costrinimiento de ti podras foir los deleites deste pecado.

112 THE ARCIPRESTE DE TALAVERA AND THE SPILL

Primeramente, si te viniere en la imaginacion temptacidn deste pecado, non te aduermas en el pensar, santiguate e fiere tus pechos, e anda luego e busca persona tercera con quien fables de algun negocio por que te salga de la imaginacion, e llama algund vezino 0 amigo, o algund moco 0 ombre de tu casa, e fabla con él, aunque lo non ayas gana, e sal de tu casa en un punto, como aquel que dize: “senores, ayudadme, que me matan o roban.” E asi salido, fabla con alguna persona de tu vezindad por mudar proposito e entinciOn. Item, fuye los desonestos logares, los tiempos e las personas que tu sabes o puedes entender que son causa de te enduzir a pecar. E si en logar estovieres donde aya mugeres o fueres dellas temptado, mudate del logar e busca otra compania. (Arcipreste 93)

[But if by chance you say that you cannot suffer, or hold in check, or resist the incentives or stimulations of the flesh, I will give you some advice by

which you will overcome them, and with no great constraint avoid the delights of this sin. First, if the temptation of this sin comes to you in your imagination, do not go to sleep with it in your mind. Cross yourself and beat your breast, and later go seek a third person with whom you can talk of some business or other, and thus you will drive such thoughts from you. Or call in a neighbor or friend, or some servant or man of your household, and talk with him, even though you have no desire to do so. Or dash out of your house like one who shouts: “Help me! I’m being murdered or robbed!” And having thus come outside, you talk with someone of the neighborhood in order to take your mind off its intention. Item: shun dishonest places, and the occasions and persons that you know are the cause of your temptation. And if you are in a place where women are and you find yourself tempted by them, leave it and seek other company.| (Little Sermons 44)

Whereas Bernard of Gordon explains that pathological sexual desire arises when algund enamorado conceives and formulates the figure of the woman in the imagination, Martinez speaks directly, telling the patient what to do when dangerous thoughts come to “you in your imagination.” Whereas Lopez de Villalobos tells the physician to get friends and noble relatives to speak with the patient, Martinez orders the patient to calla neighbor or seek a friend and talk to him. Bernard suggests that

the patient be beaten; Martinez tells the patient to beat himself. Bona Fortuna tells us to distract the patient by preoccupying him with matters of business; Martinez tell the patient to talk to a friend about business matters.?7

Through direct imperatives Martinez introduces a series of hygienic guidelines. This, for example, is in his list of seven things to avoid in order to keep the body and the mind free from developing pathological conditions:

THE COMPENDIUM AND THE CLINIC 113 1. [P]rimero, fuye comer e bever sumptuoso. [First, avoid sumptuous food and drink. | 2. Segundo, fuye vino puro 0 inmoderadamente bevido; que esto es inci-

tativo de ardor de luxuria. ... [Second, avoid pure wine or immoderate drinking; this incites the burnings of lust. . . .] 2. Lo tercero, non duermas en cama mucho mollida e delicada de savanas e ropa. [The third, don’t sleep in a very soft bed under delicate sheets in fine clothing. ]

4. Quarto, camisones en tu cuerpo delicados non uses mucho.... [Fourth, don’t use (wear) delicate garments next to your body... .] 5. Quinto, non continies do mugeres estan, aunque tus parientes sean nin

hermanas.... [Fifth, do not remain where there are women, even though they may be your relatives or sisters. ] 6. Lo sexto, como ya suso dixe, fuye dar tu oreja a palabras feas de luxuria favladas. ... |The sixth, as I already said, avoid listening to ugly words and lascivious conversations... . |

7. Sétimo e final, siempre faz alguna cosa por quitar tu pensamiento de vanas imaginaciones. ... [Seventh and finally, always do something to eliminate your thoughts of vain imaginings. . . .] (94-5) The very title of the work, Arcipreste de Talavera, strengthens its dia-

logical format. Martinez’s intention was to make a compendium that, when in the patient’s hand, would become equivalent to the physician at the patient’s bedside. To do this his compendium had to be able to do “in text” what the confabulator did “in person.” The problem, of course, was to maintain the presence of the persona once his discourse was codified in the pages and binding of the book. By using a personal title as the name of the book, Martinez employs an ingenious mechanism to foreground the confabulator and intensify the relation between text and physician.28 While it is true that many medieval works bear the name of the author, compiler, or protagonist — the Libro del Arcipreste de ita, El cancionero de Baena, El libro de Alexandre, La vida de Santo Domingo

de Silos come immediately to mind — there are very few book titles prior

to the fifteenth century that contain a personal name not preceded by the genitive de. The book held in the hand of the medieval reader was neither the “book of the Arcipreste” nor the “book about the Arcipreste” nor the “book by the Arcipreste,” but rather “the Arcipreste.” Although it is true that from the 1498 edition on the work was popularly known as the Corbacho— probably on account of the thematic relation between the Arcipreste and Boccaccio’s /l Corbaccio, and the popular connotation of the word corbacho as a whip (see Chapter 5) — the work’s title page continued to identify the work as Arcipreste de Talavera.?9

114 THE ARCIPRESTE DE TALAVERA AND THE SPILL

When the medieval reader opened Martinez’s compendium the voice

of the Archpriest immediately confronted him with a series of razones, arguments, and little sermons. The presentation of these razones in the context of treating love ailments calls to mind the advice of medical

theorists to control the patient’s falsa tmaginacion with arguments and rationales. In the first razon (chap. 1) Martinez faithfully executes Bernard of Gordon’s suggestion to counter the patient’s pathological imagination with “palabras e amonestaciones, mostrandole los peligros del mundo e del Dia de Juizio e los gozos del Paraiso” (Lilio 108) [words

and warnings, showing him the dangers of the world and the Day of Judgment, and the joys of paradise]. He begins by arguing that sexual relations outside of the bounds of matrimony are a mortal sin, a travesty

against the Almighty and his law. Using the skills he developed as a preacher, Martinez vividly impresses upon the reader the consequences of this transgression: ;Oh quanto dolor de coracgon, quanta amargura para las animas, de lo que de cada dia oimos, sabemos, leemos e veemos por fechos viles, torpes, orribles de luxuria, que de cada dia por guisas diversas se cometen, perder la gloria de paraiso por momentaneo complimiento de voluntario apetito, vil, cuzio e orrible! (67)

[Oh, how much heartache, and how much bitterness of spirit, there is in what we hear, learn, read, and see each day, that is, in vile, obscene, and horrible acts of lechery which every day are committed in sundry forms! To think of losing the glory of God for a fleeting moment of unrestrained appetite, vile, filthy, and horrible! |

After further development of his argument he asks the reader to consider the madness of forfeiting eternal life for a moment of carnal pleasure. He ends by reminding the reader that if man follows the dictates of his miserable appetite, he will surely suffer God’s justice (68). In each of the subsequent arguments in part 1, Martinez offers variations on this theme, often formulating his material in ways that help the

reader retain his advice and admonitions. Iwo of the most common techniques are the weaving of rhyming lines into the narrative and the recasting of advice in heavily alliterated utterances: “Por ende, fuye

amor de quien tales males proceden, e ama a Dios, de quien todos bienes vienen” (83) [Therefore, flee from love, from whom so many evils come, and love God from whom all good comes]; “por que aquel que ama, él mesmo se ata e se mata” (74) [because he who loves, binds

THE COMPENDIUM AND THE CLINIC 115 and kills himself]; “faciendo de si siervo pudiendo senor ser” (84) [making of himself a servant when he could be a lord]. The effect of these verbal stratagems was first to provide a mnemonic

aid for the reader, and second to enhance the material’s authority by reinforcing its resemblance to proverbial discourse.3° Michael Gerli, commenting on the Arcipreste, has noted that rhymed narrative “is a constant in homiletic literature dating back to the time of Saint Augustine” (Alfonso 94). Metrified discourse was also a common device used in medical writing, especially in those works that were intended to be used in a

practical setting. Medieval aphorisms equivalent to “an apple a day keeps the doctor away” were taken to be serious medical advice. In the middle of the sixteenth century, Juan Sorapan de Rieros, a physician

from Extremadura, collected and glossed more than fifty medical proverbs — mostly concerning dietary and hygienic advice — in his Medicina espanola contenida en proverbios vulgares de nuestra lengua. He

included these: “El mucho comer, trae poco comer” (116) [Much eating leads to less eating]; “De la nuez el higo es buen amigo” (116) [The fig is a good friend of the nut]; “Agua mala, heruida y colada” (322) [Bad water, boil it and strain it]; and “Come poco, y cena mas, duerme en alto, y viuiras” (145) [Eat a little at lunch, more at dinner, sleep up high, and you will live a long life]. For Sorapan the vulgar proverb contained the nucleus of a medical truth that offered powerful guidelines for healthy living to the uneducated.3! From a similar standpoint, Martinez recognized that by interweaving metrified locutions, he could transform weighty scientific prin-

ciples into easy-to-understand aphorisms and maxims that could be remembered and drawn upon in times of need. It is interesting to note that Martinez was not entirely comfortable with reducing erudite princi-

ples to such common forms, fearing that the popular tone of his discourse might be mistaken for the chatter of old women, or taken as merely a form of entertainment: Demas, ruego a los que este lib ro leyeren que non tomen enojo por el non ser mas fundado en cien¢cia; que esto es por dos razones: por quanto para vicios e virtudes farto bastan enxiemplos e praticas, aunque parescan consejuelas de viejas, pastranas o romances; e algunos entendidos reputarlo han a fablillas, e que non era libro para en placa. (204) [And now I beseech those who read this book not to be impatient with its not being based more on science. My reasons are two: first, examples of vice and virtue taken from experience are more effective, although they may sound

116 THE ARCIPRESTE DE TALAVERA AND THE SPILL

like old wives’ tales or ballads, and even though some scholars will say they are nothing but gossip and not fit for the public. ]

A common condition of the lovesick man was that he became despondent and melancholic, and sought solitude to languish in his sorrow. ‘To offer the patient a verbal remedy it was necessary that the confabulator keep his attention and not let him drift off into his deep and sorrowful thoughts. Martinez offers two rhetorical devices to keep the patient listening. First, he repeatedly employs throughout his compendium excla-

mations that alert the patient to the gravity of the confabulator’s discourse: “;Oh quanto dolor!” “jAy, amigo!,” “jOh malaventurado!,” “;Cuantas malas!,” “j;Oh juizio!,” “jAy triste!,” “;Oh, amigo!” ‘These exclamations function as a type of verbal smelling salts that awaken the reader

to the words of the confabulator.32 Second, Martinez often interjects rhetorical questions: E a qual daran regimiento que riga a otros sia si regir non sabe? E :qual sera por el pueblo preciado quél mesmo non se precie? E ¢quién honrara al que a si mesmo desonra? ... ¢Quién ayudara al que se quiere perder? (86) [For who will be put to govern others who cannot govern himself? And who will be esteemed by the people who does not esteem himself? Who will honor him who dishonors himself? . . . And who will help him who is bent upon his own destruction? |

This device not only helps to keep the patient’s attention, but also serves

to distract him by focusing his attention on matters other than the

beloved.

Martinez creates a single authoritative confabulator who under the auspices of the Archpriest presents the reader-patient with a series of therapeutic arguments, each one carefully composed using exclamations, rhetorical questions, and rhythmic expositions. Throughout the

book the Archpriest-confabulator addresses the patient directly, warning, distracting, informing, and reforming him, presumably to cure or preserve him from the pains and afflictions of amor desordenado. Jacme Roig likewise uses the therapeutic convention of the confabulator, as well as many of the same rhetorical devices, but he does so in a way that differs from Martinez. Roig offers the reader three confabula-

tors, each exemplifying and correcting from a different perspective. The first confabulator to appear in the Spill pretends to be Roig himself, a man whose extensive and ill-fated experience with women makes

THE COMPENDIUM AND THE CLINIC 117 him highly qualified to speak about the painful results of illicit sexual behavior. The clinical function of this narrator is to exemplify his own pains, sorrows, and sufferings so that the reader may benefit from his misfortune. Speaking to his nephew, Baltasar Bou, Roig explains: Si vols aprendre, / nabot valent, / lig-hi sovent, / mas ab repos; / en proces clos / ma negra vida, / de mals fornida, / vull recitar, / per exemplar / he document; / car molta gent, / vehent penar, / altri passar / mal e turment, / ne pren scarment. (712-26) [If you want to learn, my valiant nephew, read it often and carefully; I want to relate conclusively the events of my black life, full of misfortunes, as an example and as a document; for many who see others suffer pains, torments, and anguish take this as a warning to mend their ways. ]

The work begins with the narrator introducing himself as a sick man who is alienated, unknown, elderly, and for all practical purposes dead to the world. His bed, he tells us, is his home, and it is there that he lies afflicted with pain and consumed by disease and age (160-82). In these initial lines Roig the confabulator stresses his age, calling himself “vell jhubileu,” “prou envellit,” “antich de dies,” “vell, enllegit.” Modern critics have pointed to the expression “vell jhubieu” (old centenarian) to show that the ensuing narrative cannot be considered autobiographical, since

Roig was probably no more than fifty when he wrote the Spill.34 Overlooking the clinical function of the work, these critics fail to recognize that Roig describes himself in terms of one of the most often cited symptoms shown by men who engage in excessive intercourse. Roig the confabulator, as opposed to Roig the author, clearly presents himself as a man whose unbridled sexual activity has doubled his years. The effect of this self-description of sexual pathology no doubt had a humorous effect on the initial generation of readers, who, knowing Roig personally, would have been amused at seeing him pose as a man rapidly aged by his sexual activities. For subsequent readers, especially for those in the sixteenth

century, when the work grew in popularity, Roig’s confabulator, like Bernard of Gordon’s stinky old women in tattered clothing, cloaks himself in the guise of a sickly and aged man. The purpose of the strategy was to replicate in gesture and dress the very abject condition against which he warns the reader. Two-thirds into the Spill, in book 3, Roig recounts a dream in which King Solomon appears to him, chastising him for his sexual misconduct, his habitual relations with women, and his thoughts of taking yet another

118 THE ARCIPRESTE DE TALAVERA AND THE SPILL

wife. In this dream episode, Solomon takes over the function of the confabulator, speaking to both Roig and the reader. Much like Martinez’s Archpriest, Solomon represents a sagacious man who offers therapeutic

and hygienic advice. Rather than speaking to the reader, Roig now becomes the patient spoken to by Solomon, who describes Roig’s phys-

ical condition with detailed and clinical precision. According to Solomon, Roig’s sexual pursuits have caused him to suffer from corporeal and spiritual disorder: “Donchs, si be scoltes, / Ileva’ls ulls alt, / ffes hun gran salt, / surt ab bell tranch, / hix d’aqueix fanch / hon jaus mullat, / de sanchs sullat, / tinyes e ronya; / tu, sens verguonya, / en lo fanguag / ple d’alvarac / me par hi jagues, / ab altres plagues / prou verinoses / he doloroses, / he no les sents; / son-te plasents / perque les ames / he no te’n clames / ni te’n acuses, / ans les escuses. / Ffebra tens vera, / d’arma y cos quera / cotidiana, / gloria vana; / tens ycteric¢ia, / per avaricia / groch tot lo cos; / tens, hereos, / bestial furia / de gran luxuria / ffrenetiquea, / hira, bravea, / ffolla furor, / d’ale pudor; / tens de guolaca / tans mals a traca; / tens de enveja / hulcera

llega / he corrosiva: / de vida’t priva; / parlitiquea / tens de perea.” (11964-12006) [ “Therefore, if you listen closely, you will open your eyes, jump up, and with

an energetic stride flee from this mire in which you are stuck, soaked with blood, poverty-stricken and infected; it seems to me that you are shamelessly sinking into the mire, covered with abscesses and other plagues, filled with poison and pains, yet you feel nothing; for you these ills are pleasures because you love women and refuse to renounce them or accuse them, but rather you excuse them. Truly you have a fever and a woodworm eating your body and soul which is nothing more than common vainglory; you also suffer from jaundice, your whole body has turned yellow on account of avarice; you suffer from amor hereos, that bestial fury caused by lust; you are frenzied, irate, ferocious, furiously mad; your breath stinks, your throat needs clearing, you are suffering all kinds of ills on account of envy; this malignant and corrosive ulcer will not let you live; your laziness has paralyzed you.” |

Throughout book 3, Solomon notes the symptoms in Roig that suggest excessive sexual activity. His head is bald, “Ta testa calba” (15291), the result of excessive drying of the cerebral cavity caused by inordinate

coitus. His face and body are yellow, “Groch tot lo cos” (11992), according to theorists a common symptom of lovesick patients. He has prematurely aged, “home ja vell” (12287). He has become a slave to women, a typical effect of those suffering from amor hereos: “Deu t’ha fet franch, net e llibert; en [loch desert te fas catiu” (12237—9) [God has

THE COMPENDIUM AND THE CLINIC 119 privileged you, having made you clean and free, and you in the desert have made yourself a slave]. And finally, he suffers from the “rana/Diana syndrome”: “Lleva’t d’hon seus, / mala cadira, / surt, fuig e tira, / pus no t’hi sigues, /

éPer qué’t obligues / ab neus e pluges /a guardar truges / per les muntanyes? / Par que t’[h]i banyes / en aygua ros; / roses e flors, / clavells,

gesmir / hi creus collir, / quant, ensollat / porch engrassat, / jaus en lo fanch.” (12220-35) [“Get up from where you sit, wicked chair! Leave! Flee! Get yourself away, do

not continue here! Why do you insist on enduring the rain and snow to tend pigs in the mountains? To you it seems like you are bathing in rose water. You

think you are gathering roses, flowers, carnations, and jasmine, when in truth you are a dirty fattened pig lying in the mud.” ]

Employing many of the same rhetorical devices that Martinez uses in his

compendium, Solomon speaks directly to the patient, warning him of

the dangers of sexual relations, urging him to mend his ways, and describing for him in vivid detail the fates of those who persist in this activity. Solomon’s discourse, like that of Martinez, is punctuated by rhetorical questions, exclamations, and imperatives, each designed to hold the reader’s attention and jolt his sensibilities: “Vell ignocent, / ta mala vida / ¢tan prest t’oblida? / De tantes plagues / éjat afalagues? / De tant forts greuges / ¢tan pres t’alleuges? / Ffet than mil faltes / z:he ja te’n altes? / Ara te’n dols, / ara les vols. / Tu minyoneges.” (6538-48) [“You foolish old man! How is it that you forget so quickly your pitiful lifer Do you really feel pleasure in so many blisters? Is there not a simple cure for your vexations? They have made a thousand defects in you. Does this please your? Now you suffer for them, now you want them. You act like a little child!” ]

There are several advantages to using multiple interlocutors. First of

all, the encounter between Roig and Solomon creates an interplay between confabulators that has the double effect of allowing the reader to examine Roig from a more distanced and objective point of view,

while positioning the reader in the place of Roig as recipient of Solomon’s therapeutic discourse. Moreover, this dual perspective also allows Roig in his own voice to relate firsthand experiences from contemporary Spain and Europe, while Solomon, touted as a wise and judi-

cious man, narrates historical cases and legendary anecdotes. The

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reader thus enjoys the vision of historical hindsight from one man while receiving contemporary insights from another. In this strategy of multiple perspectives Roig includes yet a third interlocutor. This time, however, it is a woman who confronts the reader, offering him a privileged visit to one of the most exclusive sanctuaries of medieval women, the convent. Having unsuccessfully married twice, as we have seen, Roig is persuaded to take a young novice as his third wife, convinced that her edu-

cation in the convent will have fostered the character traits of a good spouse and worthy mother. The woman indeed gives birth to Roig’s son,

but she refuses to breastfeed him, passing him from wet nurse to wet nurse until the poor child dies. This reduces the young wife to a state of bitter remorse in which she confesses to Roig and informs the reader of the corruption, depravity, and wickedness of her convent. In a lengthy monologue she reveals that behind the habits and veils there is a group of women capable of every sin and vice, including blasphemy, fornication, and deceit. The function of this confabulator is similar to that of Bernard of Gordon’s dirty old woman who offers the lovesick patient a menses-soaked rag, explaining that it is that of the beloved, and thereby countering the beloved’s physical beauty with an abject spectacle of her hidden repugnance. Using the authority gained by her firsthand experience behind the walls of the convent, Roig’s third wife attempts to undermine the outward appearance of this holy institution with a repulsive vision of an inner reality, thus convincing men of the intrinsic evil that lurks in the recesses of even the most seemingly virtuous women.

A powerful device used by all of the Spills confabulators, and to a lesser degree by Martinez’s Arcipreste, is the specific reference to cities and regions with which readers would have been familiar as a means of strengthening claims of narrative authenticity. When Roig the confabulator, for example, narrates his travels from Valencia to Paris,

and then between Catalonia and Castile, he relates incidents that he saw with his own eyes in towns that were well known to his reading public: “Passing Bunol I arrived in Requena where at dusk I witnessed a great festival... ,” “Entering the town of Lérida, Isaw... ,” “I arrived at the old ruined castle called Morvedra (Sagunto)....” Martinez uses this device also: “Moreover, I saw with my own eyes in the said city of Tortosa two things very difficult to believe, but, by God, I saw them!” Roig even

goes so far as to use this technique to reformulate aphorisms and truisms. For example, in his reworking of the notion, tirelessly reiterated in misogynist literature, that women are as insatiable as the sea or a river,

THE COMPENDIUM AND THE CLINIC 121 Roig names specific rivers from the region of Valencia: “Les dones / totes / sabs que son glotes / mes que la mar; / ffoch de cremar, / terra de ros, / d’infern cah6s, / no son pus glots; / Chuquer Iurs clots / no’ls ompliria, / ni y [hi] bastaria / Ebro tanpoc” (22270-81) [You know that all women are more voracious than the sea; neither burning fire, nor the parched earth, nor the chaos of hell are as insatiable as they are; neither the Jucar nor the Ebro is capable of filling them]. The confabulator’s claim to have witnessed the event in a city near the implied

patient had the therapeutic effect of transforming an exposition of proverbial wisdom into a description of practical reality, thus impressing upon the patient the immediacy of the confabulator’s discourse.*5 One of the most troublesome, if not enigmatic, aspects of the Spill is

the unusual meter with which the confabulators speak to the patient and narrate their therapeutic exempla: the work is written in more than 8,000 rhymed couplets (16,000 lines) of four or five syllables, which Roig identifies as “noves rimades comediandes” (681-2). Modern edi-

tors have noted that Roig’s meter quickly becomes monotonous and tends to disorient and confuse the reader (Tinena 30; Alminana Vallés 43). However, there are several explanations for this strange format that correspond with Roig’s clinical objectives. First of all, it was not unusual

for medical handbooks to be written in verse. The extraordinarily popular Regimen sanitatis salernitanum (over three hundred editions), for example, possibly written in Toledo and often attributed to Arnau de Vilanova, is a lengthy metrified treatise that addresses hygiene, materia medica, anatomy, physiology, etiology, and medical practice. In the fif-

teenth century there also appeared a number of metrified medical works in the vernacular, including Diego el Covo’s Cirugia rimada and Francisco Lopez de Villalobos’s Sumario.

In rhymed form, medical concepts became axiomatic, and were easy to remember and disseminate. Roig, in fact, suggests that this was the intended result of meter when he explains in the opening lines that his work consists of lively aphorisms (683). As is the case with Martinez’s rhymed narrative, Roig’s meter offers the reader a mnemonic aid while adding to his firsthand experiences a prosodic quality of proverbial discourse. In some cases, the metrical schema allows Roig to drive home important points. His rhymed enumerations of objects and accumulations of adjectives forcefully bear down on the reader with increasing intensity. For example, speaking of the mutilations and maladies that women inflict on their offspring through their parental neglect, he compiles an extensive list of malformations and physical defects:

122 THE ARCIPRESTE DE TALAVERA AND THE SPILL

Mes, per ser molles / de flach recort, / algu’n fan tort, / visch e guercer / lleig, esquerrer / he geperut, / contret, ventrut. . . . (9186-92) [But because they are weak and have poor memories, they make some of them one-eyed, cross-eyed, squinting, ugly, left-handed, humpback, malformed, swollen in the stomach. .. .]

In addition to the rhetorical benefits that Roig attempted to secure by

means of his “noves rimades,” there is a more compelling rationale behind his meter. By the mid-fifteenth century the growing bourgeoisie had come to expect, and indeed demand, highly stylized forms of writing for sacred as well as profane topics.36 As early as 1393 Joan I of Aragon established an official festival of the Gay Science to be held annually on the Feast of the Annunciation of the Virgin Mary. The king appointed two administrators to whom he granted the authority to judge the poems

and literary works submitted to the competition and to award prizes (Boase 127-32). The city of Valencia expanded from 40,000 inhabitants

in 1418 to more than 65,000 in 1483, and despite several epidemics,

enjoyed one of the most enviable economic situations along the Mediterranean coast (Tinena 15). Such prosperity created a growing class of learned citizens for whom poetic festivals, private tertulias, and public readings became a regular part of life. It is this Valencia that produced innovative poets such as Ausias March, Roic de Corella, and Jordi de San Jordi. Rather than being an arcane and esoteric discourse — as the Spill appears to modern readers — the tightly woven five-syllable lines of Roig’s work were designed to appeal to the refined sensibilities and sophisticated literary tastes of the fifteenth-century Valencian reader. Further evidence that Roig designed his work to be embraced by the

Valencian public is his express desire to write in the language of the people. In the preface to the Spill, where he introduces his intention to write “noves rimades” in romance, Roig also claims that his language (“parleria”) will be that of the towns of Paterna, Torrent, and Soterna (688-90). According to Alminana Vallés, “el pensament de Jacme Roig esta clar. Ell vol escriuere els seus versos en un valencia normal, corrent, pla, senzill, agoes, el que parlava la gent, tant en Valencia com en els

pobles, en les seues conversacions familiars i socials” (424) [the thoughts of Jacme Roig are clear. He wanted to write his verses in normal, everyday Valencian, plain and simple, the way the people spoke in Valencia as well as in the villages during their family and social con-

versations|. Paterna, Torrent, and Soterna were towns in close prox-

THE COMPENDIUM AND THE CLINIC 123 imity to Valencia, inhabited by laborers and common field workers (Riquer 242). Roig’s mention of the language of Paterna, Torrent, and Soterna is an innovative way of restating the introductory topic used in most popular medical handbooks (Speculum al foderi, Regiment de preservacio de pestilencia), through which the author makes explicit claims to

write in the vernacular in a way that all men, not only the learned, can understand, and from which all can profit. Roig’s Spilland Martinez’s Arcipreste are popular therapeutic handbooks

designed to help men improve their physical and spiritual health. Contained in these works are the therapeutic strategies of the medieval clinic, as well as the mechanisms of a clinical encounter between healer and patient. The size, shape, and format of these works appealed to a common human need to possess means of healing in tangible forms, and allowed the patient-reader to heal himself independently of prac-

ticing physicians. Small enough to be held in the hand, passed to a friend, and stored on a shelf, these works were also capacious enough to contain hygienic guidelines, therapeutic imperatives, etiological descriptions, salutary advice, and most of all, rhetorical remedies to address the

needs of the ailments arising from inordinate and dangerous sexual desire.

The tortured body and the abjectified voice: Additional therapeutic strategies

In Boccaccio’s Corbaccio, the Florentine author tells his readers, a shrewd doctor cannot always heal every illness or every patient with sweetsmelling ointments, since there are many illnesses and many patients who do not respond to these and who require foul-smelling remedies if they wish

to be led back to health; and if there is any sickness which one may wish to purge and cure with foul words, arguments, and demonstrations, illconceived love in man is one of them, because in a short time a foul word has

more effect on the scornful intellect than a thousand decent and pleasant persuasions poured into the deaf heart through the ears over a great length of time. (52)

Medieval medical theorists would have agreed with Boccaccio. They argued that rational arguments and pleasant diversion were often not powerful enough to treat severe or advanced cases of sexual disease. To

cure these men they recommended harsh remedies based on pain and abjection, in which the lovesick patient either witnessed a grotesque demonstration or received a severe beating. As additional strategies for curing men of their sexual ailments, Martinez and Roig included various “foul-smelling remedies” in the Arcipreste and the Spill.

The hygienics of pain and torture

There is something strangely amiss in medieval illustrations of medical

procedures. A miniature from a fourteenth-century manuscript of Rolandus Parmensis’s Chirurgia depicts an operation for the removal of bladder stones in which the patient is seated on a bench supported by two pillars. While the assistants hold the patient’s legs apart, exposing

the anus and genitalia, the physician kneels beneath wielding an unidentified surgical instrument. Drops of bodily fluid, perhaps blood 124

TORTURED BODY, ABJECTIFIED VOICE 125 or urine, fall from the instrument. In another miniature, which accompanies a thirteenth-century medical treatise, we see one patient kneeling to allow the physician to couch a cataract; in an adjacent scene another man is having his scalp incised; this image is followed by yet another in which a doctor extracts a foreign object from the patient’s forehead. Modern readers who are aware that anesthesia is a recent medical development recoil in a spontaneous act of self-defense from the images

of pointed metallic instruments piercing soft human flesh. Yet the depicted faces of these medieval patients, those who are actually suffering the penetration of the knife, remain remarkably indifferent to what must have been excruciating procedures. At worst these faces show a mild sense of anxiety. For the most part they reflect no discomfort whatsoever; often they smile placidly or gaze calmly at the surgeon and his assistants. The absence of signs of pain in these images certainly does not arise

from the absence of a tradition of graphic represention of torment and suffering. We only need examine one or two of the numerous depictions of the “Mouth of Hell” to see the twisted and distorted faces of those being engulfed by eternal damnation. For example, a fifteenthcentury woodcut accompanying Dioniso’s Cordial de las quatro cosas postrimeras shows hordes of naked humans screaming as they endure impalement, flaying, and burning. Given the longstanding ecclesiastic traditions of representing the torments of physical suffering, we may ask why is there so little representation of pain in medieval medical images. The answer is that there is little place for pain in images that illus-

trated the workings of authorized medical practitioners. Pain in the Middle Ages was a sign of disorder, a reminder of humankind’s fall from grace, and a warning of the torments awaiting those who failed to repent

of their sins in this life. For the clinical physician who associated his work and his skills with those of Christ, any representation of the doctor as an inflicter of pain conflicted with the desired image of the physician

as a benevolent healer who reordered the body and assuaged the torments of the afflicted. Even today very few images of clinical procedures

portray the patient’s discomfort. Most often the patient is simply anesthetized; frequently, medical illustrations focus only on the wounded or diseased part of the body, completely eliminating the relation between patients’ diseases and the subjective experience of their illnesses. Although there was little use for images of pain in the representation of medieval clinical practices, the infliction of pain was often deemed appropriate in clinical therapeutics, especially for the treatment of psychosomatic disorders such as lovesickness. As I mentioned earlier in this

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study, Bernard of Gordon tells us that sufferers of heroic love who are unresponsive to interlocutors’ admonitions and warnings should be forcefully and repeatedly beaten until they begin to stink.! The idea that physical pain could thwart the urges of lust had a long tradition in the Western world, one constantly mentioned by preachers and moralists. The compiler of the Espéculo de los legos, for example, included a legend in which St. Benito threw himself naked into the thorns and thistles “porque por el dolor de las llagas ¢cesase el ardor de la delectagion” [so that the pain of his sores would bring to an end the burning of pleasure]; likewise St. Macario applied a hot iron to his body, hoping that the wounds he made would destroy his desire for evil pleasures (225). The legends of the Desert Fathers are replete with the heroics of selfinflicted pain as a strategy for containing and controlling sexual desire: Pachon shut himself in a hyena’s den and then held an asp against his genital organs; Evagrius spent many nights in a frozen well; Philoromus wore irons (Rousselle 152). Yet in the medical treatment of sexual desire, the infliction of pain is more than merely a primitive form of behaviorism designed to condition men and women to act properly. When Bernard speaks of beating the patient frequently and forcefully, he recognizes that there is an agonistic relation between the workings of the imagination and the sensations of pain. As Elaine Scarry has argued, to be in pain is to be unable

to imagine. Antithetically anomalous, pain is a state that is wholly without an object, whereas the imagination is the only state that is completely contingent on its objects (Body in Pain 162). Pathological love, according to Bernard of Gordon, is a disease caused when the form or figure of the beloved is forcefully apprehended in the mind (Lilio 107). Thus, to the degree that the patient felt his own pain, he lost his ability to imagine the beloved. The envisioning and anticipation of acquiring

pleasure through the beloved and the experiencing and suffering of pain were recognized as mutually exclusive activities. Simply stated, the therapy of beating the patient was intended to destroy the image of the

beloved that had been formed and configured in the imagination by causing intense sensations of pain in the body. The problem facing Martinez and Roig was how to administer rhetorically the therapeutic blows to the patient. We have already seen how these authors offer their patients anecdotes in which men experience

various forms of pain at the hands of women. In the Arcipreste, for example, Juan Orenga suffers the violent amputation of his genitals and the slicing away of skin and muscle from his thigh; another man has his

TORTURED BODY, ABJECTIFIED VOICE 127 tongue bitten off; still others, Martinez tells us, are wounded in fights over their beloved. In the Arcipreste, Martinez intensifies these accounts of wounds and suffering through the use of various rhetorically produced images of torment. Throughout the work, Martinez attempts to create the sounds and intonations of physical anguish. In his argument against old men marrying old women, he allows the sufferers to complain of their disorders,

mentioning each ailment with the corresponding inarticulate cry of pain, “jAy!”:

[N]unca estan alegres, el uno con dolores e la otra con mas, ella diziendo: “;Ay de la madre! ;Ay de la cabega! jAy daxaqueca! j;Ay de la muela! j;Ay de la teta! ;Ay del ojo! jAy de la cadera! ;Ay del est6mago! jAy del costado! jAy del

vientre! ;Ay del ombligo! jAy del todo el cuerpo, cuitada!” El otro dice: “;Ay de la gota! jAy de la ijada! ;Ay de los lomos! j;Ay de los renones! ;Ay de ceatica! ;Ay de pasecoica! ;Ay de las muelas!” (228) [They are never happy, what with him in pain and her in more, and she says:

“Oh, my uterus! Oh, my head! Oh, my headache! Oh, my tooth! Oh, my breast! Oh, my eye! Oh, my hip! Oh, my stomach! Oh, my side! Oh, my bowels! Oh, my navel! Oh, my whole body, poor thing!” And he says: “Oh, my gout! Oh, my lumbago! Oh, my back! Oh, my kidneys! Oh, my rheumatism! Oh, my bellyache! Oh, my toothache!” ]

On a more general level, Martinez punctuates his arguments with reminders of physical torment and suffering: “;Oh quanto dolor! . . . las penas infernales” (67); “;Qué dolor, qué tribulacion! . . . alli es el dolor” (78); “que amor su naturaleza es penar el cuerpo en la vida. ... su vida fue dolor e enojo” (79); “con tormentos dapnado” (88); “penas e tor-

mentos. ...crueles penas. ...morir e penar” (89) [“Oh, what pain! ... the infernal torments!”; “What pain, what tribulation! .. . there is the pain”; “that the nature of love is to inflict pain on the body in this life. ... their life was pain and annoyance”; “damaged by torments”; “punishments and torments. ... cruel punishments... . die and suffer” ].

Another strategy designed to fill the would-be lover’s mind with images of pain and suffering was the comparison of the ailments of the body with the future pains of purgatory brought on by illicit love in this life:

Pues, amigo, abre los ojos espirituales e corporales; mira e vee quantos danos de locamente amar provienen, por donde non solamente el tal pierde la vida perdurable, mas cobra las penas infernales. ;Ay del triste que espera pasar

128 THE ARCIPRESTE DE TALAVERA AND THE SPILL

por sus deméritos tantas e tan crueles e perpetuas penas! Que si considerase en como un dolorcillo de cabeca, o axaqueca, o de ijada, de lomos, de vientre, de rinones o de costado, 0 una calentura, 0 terciana, o quartana o otra qualquier dolencia 0 pasion, e quando le dura algund tiempo, como le saca de entendimiento e le faze desesperar, maldiziendo su ventura e aun el dia en que nascid; 0 una espina chiquilla que en el pie, o mano o dedo le entre, como le faze raviar; o un dolor de muelas, o dientes, o de ojos, o de orejas, 0 dolor de gota, o de ceatica, o torgedura de pierna o braco, o de otras muchas enfermedades que a las personas vienen. Pues :qué deve fazer aquel que sufre o ha de sofrir aquellas terribles penas e tormentos crueles, mas sensibles sin comparacion en millares de vezes que las que aca padecen? Y en los de aca ay remedios de fisicos, iervas e melezinas; en los de aculla no ay remedio nin esperang¢a, salvo en los de purgatorio. . . . EK asi penado e atormentado, como desesperado, se acomienda a todos los diablos, pensando que sus penas avrian fin; e biviendo morra, e muriendo, en nuevas penas, tormentos e dolores bivira de cada dia por siempre jamas. (141-2)

(Therefore, my friend, open your spiritual and corporeal eyes; look about you and see the many evils that spring from madly loving, because of which you not only will lose eternal life, but will suffer infernal torment. Woe to the wretch who is waiting, through his sins, to suffer so many and such cruel and perpetual punishments! Ah, if he would only reflect on how a little head pain, or a big headache, or pain in the side, or in the hip, or belly, or back, or kidneys, or a fever, either tertian or quartan, or any other pain or affliction, if it lasts any time at all, drives him to madness and despair, cursing his fate and even the day he was born, or how even a little thorn in his foot or hand or finger makes him howl with pain, or a toothache, or an eyeache, or earache, or gout, or sciatica, or a sprained leg or arm or finger, or any one of the thousand ills that people suffer - Well, then, what is he to do who suffers or will have to suffer those terrible pains and torments, beyond comparison, thousands of times more painful than those he suffers here in life? And for those here there are the remedies of physicians, and herbs and medicines, but in the other world there is no remedy nor hope, save for the souls in purgatory.... Thus, suffering and tormented, like a desperate person, he will commend himself to all his devils, thinking his pains would have an end. And living he will die, and dying, new pains, torments, and sufferings, he will live every day, world without end! ]

In addition to such comparisons, Martinez often includes references to the acts of inflicting pain: “palos, acotes, e punadas” (192) [thrashings, whippings, and punches]; “cuchilladas, palos e coces” (219) [knifings, clubbings, and hoofings]. In fact, it is interesting to note that the secondary title of the work, El corbacho, adopted near the end of the fif-

TORTURED BODY, ABJECTIFIED VOICE 129 teenth century, was interpreted to mean “the whip,” a punishing instrument. Thus for many of Martinez’s readers his entire compendium was envisioned as a device for inflicting pain. The references to pain and the tormented body that reappear page after page in the Arcipreste were, no doubt, most efficacious in the hygienic

context of encouraging healthy men, especially young men who lacked

experience, to avoid immoderate and illicit sexual behavior. Indeed, Martinez believed that he could use images of pain to frighten men from

thinking about women and from dwelling on the pleasure of a sexual encounter. From a therapeutic standpoint, however, these images must have had a minimal effect on the lovesick patient. The problem is that the verbal or graphic representation of pain is always at least once removed from the experience of pain itself. Thus, it was possible for men to think

about pain, and even identify their desires and anxieties as pain, while maintaining the memory of the beloved in their minds. Indeed, one of the most tedious conceits of fifteenth-century vernacular poetry is the representation of love as pain: “Las cuitas e dolores / con que soy penado / son males d’amores / que me avéis causado” (Juan de Mena, Obra lirica 70) [The worries and pains that I am suffering are the afflictions of love

that you have caused me]. But this “pain” in which the lover languishes — and that the lover often seeks — is a far cry from the raw and immediate experience of pain that Bernard of Gordon had in mind when he suggested that a patient be beaten forcefully and frequently until he began to stink, presumably having emptied the contents of his bowels into his pants. Hence, pain as a therapy for lovesickness was only effective to the degree to which the overwhelming presence of corporeal anguish

displaced the mental fixation on the beloved. This type of pain is extremely difficult, if not impossible, to elicit rhetorically. Consequently, Martinez’s verbal representation of physical pain was probably most effective as a preventative or hygienic measure.

Despite the difficulties of employing verbally generated images of pain in a therapeutic setting, Jacme Roig promoted a technique involving images of physical torment that could be used to facilitate the healing process of men who were recovering from lovesickness. This strategy consisted not of presenting the possibility of pain in the male subject, but rather of showing the ailing male patient the spectacle

of a suffering female other. Throughout the Spill, Roig describes in detail the punishments handed out to women evildoers. The nobleman’s wife who plotted to kill Roig is severely flogged, punched, whipped, and locked in a tower (1058-66). Dona Forciana, the woman

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who poisoned her husband, is placed on the wheel and tortured while many of her servants are burned alive (1377-82). The daughter of an innkeeper who robbed and killed her own father is placed naked in a barrel with a snake, a monkey, and a rooster; the barrel is sealed and thrown into a river (1417-26). The young woman who offered her husband poison claiming it was medicine is first buried alive with her dead husband on top of her, then dug up and hung from a tree, under which a fire burns her to ashes (1512-1646). The pastry baker and her two daughters who killed, cut up, and baked men into meat pies are quar-

tered and have their house burned to the ground (1647-1742). A woman described as a witch who would sneak around in the night trying to extract dead men’s teeth to use in illicit potions is skinned alive and

hung from a tree (1757-97). And a woman who prostituted her own

son by forcing him to lie with her clients is drawn and quartered (1866-80). In Paris, Roig tells us, so many evil women were condemned

and hanged that they looked like clusters of grapes dangling from the vines (1741-56).2 These descriptions of tortured and executed women belong to a medical practice that was designed to re-empower love-debilitated men. We have already seen how one of the most often warned-against effects of excessive sexual intercourse was the sapping of strength. This weakening was thought to leave men extremely susceptible to external powers. The

concern was that in such a debilitated condition, men easily became captive, enslaved, and disempowered. In the case of amor hereos, the obsessive fixation on a particular woman was thought to weaken not only the body but to captivate the patient’s imagination and enslave him

to the image of his beloved. Arnau de Vilanova explained that heroic love is called dominalis because it tends to master the soul and make the lover treat his beloved as his master.3 The intention behind Roig’s spectacles of torture and excruciating pain was to reverse this pathological inversion, empowering the male patient through his witnessing of acts

that neutralized the agent of his diseases. For the most threatening aspect of many sexual diseases was not the immediate suffering of the lovesick man, but rather the way his ailment inverted what was thought to be the natural order. Sempronio, in Rojas’s Celestina, expresses this preoccupation when he reproves the ailing Calisto for having submitted the “dinidad del ombre a la imperfecién de la flaca mujer” (24) [dignity of man to the imperfection of weak woman]. It is significant that all the women tortured and executed in the Spill have transgressed and undermined the natural and social order; they are guilty of homicide,

TORTURED BODY, ABJECTIFIED VOICE 131 patricide, larceny, cannibalism, prostitution, grave robbery, and adultery. The spectacle Roig describes in the Spill of women having their limbs torn from their torso, their skin flayed from their bodies, and their flesh consumed in flames — not to mention the psychological torture of being drowned with savage animals in the darkness of a sealed barrel — was intended to reaffirm triumphantly the proper and natural relation between men and women. The torture involved in these punishments of women, as Michel Foucault explains about torture in general, was to “brand the victim with infamy” and trace around or on the body of the condemned the signs that must not be effaced (Discipline and Punish 24). At stake in the healing of the love-stricken patient, as is the case in all

acts of healing, was the reestablishment of order. Significantly, the pathological fixation on the beloved thought to cause heroic love was

described by medical theorists as a “falsa opinion o imaginacion” (Bernard of Gordon, Lilzo 108). The medieval etiology of lovesickness explained how the disease undermined the ability to reason correctly, causing the patient to see beauty in homeliness and to anticipate pleasure in pain. The representation of torture in the Spill was designed to counter this erroneous vision by serving as the parchment upon which truth could be reinscribed.4 Hence we read how the woman who poisoned her husband is punished by being buried alive with her dead husband positioned above her. Sexually and socially, the spectacle of this

punishment acts to reaffirm the true hierarchical order between the genders.° The punishment of the husband poisoner points to the very heart of Roig’s theological argument on the origin of pain, as well as to his ultimate strategy for eradicating the sexually induced suffering of men. In Roig’s discussion of the events in the Garden of Eden, he explains that

“Eve,” the name God gave woman, means false joy, curse, perdition, weeping, and cruncher of bones (10344-9). In a similar etymology, Francesc Eiximenis makes the relation between pain and women even clearer: los angleses apellen la fembra “aman” qui vol dir en nostra llengua “dolor de

hom,” car dien que no es pot fer que l’hom sia ab fembra que puixa ésser sens dolor e desplaer a la fi. (Lo Crestia 73) [the Angles call women “aman,” which means in our language “pain of man,”

because they say that a man cannot be with a woman without there being pain and displeasure in the end. |

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For Roig, Eve was not only the cause of Adam’s fall, but in the extended sense, she was also the primeval source of all of men’s sufferings. Thus

the acquisition of long-term health was thought to be contingent on inverting the image of “Eve” so as to fixate on “Ave.” Indeed, a secondary

theme of the Spill, one that doubles as a general hygienic principle, is that men should praise and pray to the Virgin Mary every day. Solomon advises the diseased Roig, “Mentres temps tins, de roba muda, he la saluda tots temps ab Ave, preguant te lIlave los teus delictes” (14984-9) [While you still have time, change your ways and hail her at all times with “Ave,” pleading for her to cleanse your sins]. Fixation on the Virgin rather than on the daughters of Eve, according to Roig, will keep men healthy and free from pain. By extension Roig suggests that men should also praise the lives of saintly women such as Catalina, Marina, Tecla, Anastasia, Inés, and Lucia as well as study the heroics of women such as Esther, Rebecca, and Sarah (15204-69). Roig warns, however, that men should read about the lives

of dead women only: “Solicituts / de dones vives / te prech esquives; / sols te deportes / de semblants mortes / llegint Ilur vida” (15270-5) [I tell you to avoid the solicitudes of living women and implore you to read only about the lives of dead ones]. Roig recommends the example of dead women not only because the images of these women, when codified in books, are cemented and unchanging and therefore unequivocally legible, but because they are also contained and controllable. For Roig the options are simple: preserve your health by thinking only about virtuous dead women like the Virgin Mary, or live in pain and die condemned by courting in thought and deed the living descendants of Eve: “Llexa disputes / he no refutes / los consells meus; / cert, si no’ls creus, / viuras penat, / morras dampnat” (15285-9) [Stop arguing and quit refuting my counsels; it is certain that if you don’t believe them, you will live in pain and die damned]. In the final pages of the Spzll, Roig the narrator presents himself to his readers as a man “cured” of his sexual and woman-related ailments. At this moment the entire Spill reveals itself as a detailed case study in which the reader has witnessed the etiology of one man’s ailment, its epidemiology, its therapy, and finally its cure. Roig, taking on the role of the recovered victim, explains that fifty to sixty of his better years were consumed by pains and afflictions. Thanks to the advice of Solomon, delivered in the form of a dream (book 3), his remaining years have been relatively peaceful. ‘To stay healthy he exercises by working in his garden, and he takes a short walk before eating. Three days a week he

TORTURED BODY, ABJECTIFIED VOICE 133 eats lean meat, three days he eats only fish, and one day a week he limits

himself to bread and water. He regularly visits the imprisoned and attends to the needs of the sick. His door, we are told, is always open to the poor, whom he feeds and clothes. Above all, he avoids any contact with women, even the most blameless hospitality and goodwill: “Giving your hospitality to women is like throwing it down a hole,” he tells us. “Those who overlook the flaws of women are sinful.” In fact, it “was an enormous error on the part of Asuero that he didn’t flay his wife Vasti”

(she refused to attend a banquet prepared by her husband). He continues:

Dina should have been killed. ... Fineas acted more prudently when he thrust a knife in his wife Madianita.... Ramon, count of Tolosa, wisely hanged his wife. . .. Remember that certain duke who correctly had his own daughter burned naked. . . . It was with great art that the ancient traveler had his wife cut into twelve pieces, one for each of the twelve tribes of Israel... . The king Jehu: nobly had his cruel wife killed and set out for the dogs (they devoured all but her hands and feet)... . The ruler Moisés had the throats

cut of an infinite number of them... . Julian the Apostate had more than nine thousand of them hung alive by their breasts... . And Hercules left forty thousand of them wounded and decapitated. .. . (15611-923) The narrator’s description of his later years reads like an exemplified account of a medieval hygienic handbook in which we find counsel on diet, sleep, clothing, exercise, and sexual relations. What is terrifying in this littke memoir, however, is the way that Roig’s health — indeed the health of all men — is not solely contingent on light exercise, proper diet, and pious deeds. According to Roig, for men to be truly well, to eliminate all pain and suffering from their life, and to regain and main-

tain their strength, they must engage in an ongoing reaffirmation of their own power by focusing on images of beaten, tortured, and executed women. Appropriating the voice

In Constantine the African’s treatise on coitus we find the following formula designed to stimulate desire for sexual intercourse: Take the brains of thirty male sparrows and let them age in a glass receptacle; take an equal amount of tallow that surrounds the kidneys of a recently slaughtered ram; melt the tallow over the fire and add the sparrow brains

134 THE ARCIPRESTE DE TALAVERA AND THE SPILL with a desired amount of honey; mix all the ingredients in a bowl and let the mixture cook until it solidifies; from the substance make pills the shape of a hazelnut; take one of these prior to coitus. (De coitu 174)

To imagine the process of making this remedy, we would have to envision the apothecary retrieving a bird from a pile of dead sparrows. He

would have to press his forefinger against the bird’s neck, holding it firmly on the table so that he could crack or cut the cranium with an appropriate instrument. He would then extract the brain of the bird and drop it into the prescribed glass receptacle. Later he would toss the car-

cass onto the floor and reach for another bird, repeating the process thirty times until he filled the glass jar with the required amount of brains.

Although the efficacy of such a remedy may seem questionable and its formulation primitive, the modern reader should not be shocked by the harvesting of animal organs for medicinal purposes. The practice of using animal parts in the compounding of drugs has a long and ongoing tradition in Western pharmacology. Nevertheless, there is something disconcerting about the extraction of organs from living or recently deceased human beings. Perhaps in this case it is the violent excess combined with the promise of tenuous results that strikes the sensibilities of the modern reader. Or perhaps it is that the line between the human subject and the animal other is thin and often fades in the way bodily parts of birds and beasts resemble their human counterparts. Indeed any serious consideration by contemporary readers of the appropriation of living organs for medicinal purposes eventually leads to the current controversy, perhaps more frightening in its implications, over utilizing human materials for therapeutic practices. The experimenting with fetal tissue to develop a cure for Alzheimer’s or Parkinson’s disease, or the transplanting of kidneys, eyes, livers, and hearts from donor to patient, cannot help but stir up troubling social questions concerning the corporeal integrity of the individual in relation to a more general economy of well-being. Medieval medical practice, like all medicine, was inextricably linked

to the economic conventions that regulated the distribution of goods and services at large. Consequently, the medieval clinic identified certain human beings whose well-being could be sacrificed for the sake of the more powerful. Not surprisingly, these were often determined on the basis of class, race, and gender. Bernard of Gordon, for example, recommended that noblemen have their food tested by peasants to assure that it was digestible. The medical rationale behind this practice

TORTURED BODY, ABJECTIFIED VOICE 135 was that the stomachs of peasants were accustomed to coarser foods; bad foods that would prove fatal for the delicate stomachs of the nobility would only cause nausea and discomfort in the peasant. In the medieval economy of well-being, the peasant’s digestive tract was quite literally appropriated for the benefit of a nobleman’s digestive process.® This economy of well-being was inscribed in all forms of medieval

representation, sacred and profane. A powerful case in point is the images of Sts. Cosmas and Damian, patron saints of medicine and physicians. These brother saints were born in Arabia and schooled in Syria

during the second half of the third century. They became well known throughout the Middle Ages for their skills in the healing arts. Medieval hagiographies such as Jacobo de Voragine’s Legenda aurea tell of how the brother physicians spent their lives healing men and beasts without

payment or recompense. In medieval iconography the two are almost always depicted wearing physician’s gowns, often holding an instrument or an object related to medical practice. In one medieval miniature they are shown receiving a surgical instrument from the heavens.’ Soon after

their death as martyrs, cults began to emerge throughout Eastern and Western Europe that gave rise to various posthumous accounts in which the saints interceded therapeutically on behalf of their ailing followers (Linage Conde 17).

In Spain there is evidence of devotion to Sts. Cosmas and Damien dating back to as early as the eighth century. Throughout the Middle Ages their presence can be documented in virtually all parts of the Iberian Peninsula — Castile, Galicia, Portugal, La Rioja, Andalusia, and Catalonia. In the fifteenth century the legendary healing powers of the two saints became the inspiration for altarpieces and statues. One anecdote of the saints’ posthumous healing became extraordinarily popular

in the Iberian Peninsula. According to the Golden Legend, a devoted Roman nobleman whose leg had been consumed with cancer pleaded with the physician saints for relief from his suffering: While he was asleep, the two saints appeared to their devoted servant, bringing salves and surgical instruments. One of them said to the other: “Where can we get flesh to fill in where we cut away the rotted leg?” The other said: “Just today an Ethiopian was buried in the cemetery of Saint Peter in Chains. Go and take his leg, and we’ll put it in place of the bad one.” So he sped to the cemetery and brought back the Moor’s leg, and the two saints cut off the sick man’s leg and inserted the Moor’s in its place, carefully anointing the

wound. Finally they took the amputated leg and attached it to the body of the dead Moor. (Jacobus de Voragine 198).

136 THE ARCIPRESTE DE TALAVERA AND THE SPILL

From the mid-fifteenth century on, representations of this miracle proliferated in altarpieces and reliefs in Barcelona, ‘Tarrasa (Barcelona), Vich (Gerona), Burgos, Covarrubias (Burgos), Valladolid, and Palencia.® The miracle is generally depicted with the two saints grafting the Moor’s

black leg onto the nobleman’s white thigh. In the background the painters often created a second scene that either illustrated the Moor with the infected white leg attached to his body or, as is the case in Jaime Huguet’s representation in the church of Santa Maria in Tarrasa (1462), portrayed the two physicians amputating the Moor’s leg with an instru-

ment resembling a hacksaw. Some art historians have argued that the depiction of a black leg was clearly intended to create a contrast of colors, thus making the miracle more apparent for the medieval public. But the question of race cannot be so easily elided. The corporeal well-being of the white noble is clearly contingent upon the illness, or corporeal nonbeing, of the black Moor.

One could argue that according to the legend the Moor was already dead, and thus concerns over his health or illness become irrelevant. But fifteenth-century representations, especially in Castile (Burgos, Palencia, Valladolid) tend to conceal this detail, and often even suggest that the Moor was still living when the amputation and grafting took place. Unique to the Iberian Peninsula are paintings in which the Moor appears in the foreground, usually lying on the floor in front of the operating table. In these depictions it becomes increasingly difficult to affirm conclusively that the Moor is dead (Devisse and Mollat 2:205).9

In a striking sixteenth-century relief from the monastery of San Francisco in Valladolid —- now housed in the National Museum of Sculptures — the representation of the Moor moves one step further in this direction. Here the Moor is depicted lying on the floor, completely conscious of the events taking place above him. His face is contorted with pain and his left hand reaches toward the stump. The two physician saints are indifferent to the Moor’s suffering, each absorbed in the

particulars of the operation, one grafting the leg, the other checking the pulse while examining a flask of urine. Limb grafting was not recognized as a feasible surgical practice in

fifteenth-century Europe. Hence, the successful leg transplant could only be explained as the result of divine intervention. Nevertheless, these representations forcefully linked miraculous healing with the work

of clinical practitioners. In the various paintings and reliefs the two saints stand laboring over the patient, checking the pulse, wielding the bone saw, manually fitting the black leg onto the white stump, and applying herbs and balms to the wounds. Rather than suggesting that

TORTURED BODY, ABJECTIFIED VOICE 137 the transplant occurred mysteriously through the incomprehensible workings of holy mediation, these representations compellingly suggest that the miraculous healing came about as a result of an ordered surgical procedure. Significantly, the procedures and instruments depicted

in images of Cosmas and Damian represent those used in standard fifteenth-century medical and surgical practice. The complicity between medical practice and racial inequality that we see in the legends and images of the two saints takes a gendered turn in the depiction of the lives of several female saints. Like the Moor’s leg, the body parts of women were presented as being instrumental in curing the diseases of men.

As we have seen, the general technique of Galenic medicine for restoring the body to a state of health consisted of increasing, varying, or decreasing the patient’s foods, beverages, and activities. For the outspoken fifteenth-century physician Alfonso Chirino, the most proven medicines were not surgical remedies, but rather “viandas, dietas, tristeles e v6mitos” (Menor dano de la medicina 5) (foods, diets, clysters, and vomits]. Thus the material basis of medieval clinical therapy was formed of meats, vegetables, fruits, herbs, and flowers. Interestingly, metaphors

derived from food, flora, and fauna were commonly used in Western representations of women. For example, in Spain, in both popular and

erudite descriptions, women were represented as bread bakers (panaderas) whose bodies by extension became the desired white bread. Often their breasts appear as apples (manzanas), the color of their skin as white goat’s milk, their cheeks as roses and pomegranates, and their genitalia as a rabbit (congo). A traditional verse reads: “De las frutas, la

manzana, / de las aves, la perdiz, / de las colores, la grana, / de las damas, la Beatriz” (Elbers 93) [Of all the fruits, the apple, of all the birds, the quail, of all the colors, scarlet, of noble women, my Beatriz]. In a less flattering way, Roig often refers to women as animals, insects, birds, and fish: son alimanyes, / serp tortuosa / son, e rebosa, / mona, gineta, / talp, orone-

ta, / mucol, putput, / guall, cutibut, / aranya’b tela, / tava, mustela, / vespa, alacra, / he robios cha, / la sanguonera, / he vermenera, / mosca e grill; / llebre, conill, / drach, calcatric, / tir basalis, / vibra parida, / he cantarida, / la onsa parda / he leoparda, / lloba, lleona, / la escurcona; / son llop de mar, / lo pexa mular, / drach e balena, / polp e serena. (7692-718) [they are animals: the winding serpent they are, and vixen, monkey, mare, mole, swallow, red owl, hoopoe, rooster, cuckoo, spider with her web, horsefly, weasel, wasp, scorpion, the rabid dog, the leech, fly, and cricket; hare, rab-

1 38 THE ARCIPRESTE DE TALAVERA AND THE SPILL bit, dragon, crocodile, basilisk, snake, cantharides, brown bear, leopard, shewolf, seawolf, lioness, cetacean, whale, octopus, mermaid. |]

The comparing of a woman to a flower, a piece of fruit, or an animal

might indeed be an innocent gesture that attempts to connect the object of sexual desire with the beauties and pleasures of the sensible world. But when these images are institutionalized and transferred into a therapeutic discourse, metaphorical language becomes transformed into practical paradigms. If women are likened to foods, herbs,

and plants, and these substances can be used to cure disease, then women can also be used in a medicinal setting. Thus, for example, Peter

of Spain tells us that “in the cure of lovesickness plasters or women are applied to the testicles.” In the original Latin, “women” and “plasters” appear in the same case, thus pointing to women’s objectified Status as medical material: “Sed in cura amoris hereos applicantur emplastra vel mulieres ad testiculos” (Questiones super Viaticum, in Wack, Lovesickness 218-19). Moreover, the standard therapy for both lovesick-

ness and sexual superfluidity (excess semen in the body) was to have the patient engage in sexual intercourse. In describing this cure medical theories often employed the phrase usar de la mujer. The same is true of hygienic treatises that speak of “using women” with moderation. In fact, a sixteenth-century treatise by Francisco Nunez bears the title El tratado del uso de la mujer.

The idea that the bodies of women can be converted into things for the use of men is quite evident in the Spill. Roig narrates the case of a

woman who was caught pilfering from the graves of dead men. He describes this woman as a hog whose flayed skin (a reference to the pun-

ishment for grave robbing) could be used to make wine bags: “la pell lexa / per fer-ne bots” (1796-7). In another instance, Solomon, while

urging Roig to flee from women, makes the analogy between the Israelites’ escape from Egypt and a sick man’s escape from the hold of women. In extending the analogy, Roig likens women to pleasurable foods — cooked meats, squashes, fruits, and figs, “carns cuytes, / cohonbros, fruytes, / ffigues” (12353-5). Although here Roig encourages his

reader to avoid the consumption of these foods/women, the idea of women as a usable and consumable substance within the pathological therapeutic paradigms of humoral medicine remains fully intact; the

use or avoidance, consumption, or rejection of any substance was thought to be purely contingent on the nature of the substance in relation to the temperament of the body.

TORTURED BODY, ABJECTIFIED VOICE 139 This medically authorized objectification and use of the female body in therapeutic practice also appeared in narrative accounts and visual representations of the lives of women saints. Two of the most popular female saints in late medieval Spain were St. Lucy and St. Agatha. The

representation of these women in medieval altarpieces often shows them together, holding their respective iconographic body parts on a salver. Lucy stands next to Agatha, holding her two eyes, while Agatha likewise supports a platter bearing her two shorn breasts. As might be expected, these bodily images point directly to heroic and miraculous moments in the saints’ lives. Significantly, they also point to a therapeutic moment in which Lucy’s eyes and Agatha’s shorn breasts were used to control or assuage the pathological male libido.

The legendary St. Agatha lived on the island of Sicily in the third century a.p. during the reign of the Roman emperor Decius. Born into a noble family, Agatha was renowned for her great beauty, captivating charm, and remarkable piety. Quintianus, the governor of Sicily, became infatuated with the young Agatha and under the pretext of persecuting

the Christians had her brought before him. When she spurned his advances and rebuked him for persecuting the Christians, Quintianus had her imprisoned in a local brothel. A month later he once again brought her before his tribunal. Agatha continued to resist his advances, remaining steadfast in her faith. Frustrated, Quintianus became enraged

and decreed that Agatha be bound to a pillar and her breasts cut off | with iron shears. Agatha’s courageous defense of her chastity foreshadows the practice of medieval women who mutilated themselves to ward off sexual assault. The life of Dona Maria Fernandez Coronel (Maria Coronel) gave rise to a legend that exemplified female self-mutilation as a strategy for masculine well-being. The nucleus of the legend tells of how King Pedro I of Castile (the Cruel) fell in love with Dona Maria because of her exceptional beauty and began to pursue her relentlessly. ‘To thwart his illicit advances, and thereby preserve her virginity as well as the king’s chastity, Maria poured hot oil on her face, producing horrible burns. Her disfiguration forced Pedro to refigure his libidinal and political ambitions. In admiration of her heroic defense of her virginity the king financed and offered protection for a monastery in which Maria spent the rest of her days. The legend contains echoes of an earlier and no less frightening

account of an incident that took place in a monastery outside the Andalusian city of Ejica during the Islamic invasions of the early eighth

century: three hundred nuns allegedly lacerated their faces with the

140 THE ARCIPRESTE DE TALAVERA AND THE SPILL

intent of making themselves so ugly and repugnant that the invaders

would not rob them of their virginity.!° In other similar episodes, described by Jane Tibbets Schulenburg as heroic responses to preserve virginity, pious medieval women cut off their noses and lips, gouged out

their eyes, and lacerated their faces to extinguish the passions of invading infidels (“The Heroics of Virginity”) .1! This economy, in which the health of a man or the well-being of the state were in direct relation to the physical illness of a woman, appears more explicitly in the legends surrounding St. Agatha’s counterpart, St.

Lucy. Born in Syracuse around the latter part of the third century to wealthy Christian parents, Lucy resolved early in her life to preserve her chastity, devote herself to God, and dispose of her material wealth to the poor. Upon her father’s death, Lucy’s Greek mother, who held control of the family property, resisted her noble intentions to help the poor. It was only after her mother was cured of chronic vaginal bleeding while

praying at the shrine of St. Agatha — where she had been taken by Lucy — that Lucy was permitted to give freely to the indigent. While Lucy was praying to St. Agatha to intercede for her mother, the saint appeared

and told her that she had the power herself to petition God for her mother’s health. After Lucy’s mother regained her health, the pagan youth to whom the girl had been unwillingly betrothed complained of her generosity and denounced her to the governor Paschasius, who found her guilty of being a Christian. After miraculously resisting several

of the governor’s tortures, she died when a sword was driven through her throat (Koch 162-2). The legend that accounts for the loss of Lucy’s eyes appeared several centuries after her martyrdom. A young man from Syracuse, captivated

by her beautiful eyes, fell deeply and obsessively in love with her. Concerned about the well-being of her suitor, and following the admonition of Christ, “If a member offendeth thee, cut it off,” she removed her eyes and presented them to the young man on a plate.!* The young man converted to Christianity and likewise vowed to remain chaste for the rest of his days. The presence of her eyes, often depicted promi-

nently on large altarpieces in chapels and cathedrals throughout Europe, served as a powerful reminder of the sexual economy of masculine well-being. Lucy’s suitor, blinded by his love for her, was not only

cured but gained spiritual sight, at the precise moment Lucy lost her corporeal sight. Although representations of Sts. Agatha and Lucy existed in Spain from as early as the twelfth century, the abundance of images from the

TORTURED BODY, ABJECTIFIED VOICE 141 fifteenth and sixteenth centuries suggests an increase in popularity during the late Middle Ages and Renaissance. My contention is that for the fifteenth-century public, these images of women and their body parts pointed directly to fifteenth-century medical practice, to its economy of well-being, and to a clinically authorized therapy for pathological sexual desire. In these paintings and sculptures the two saints are almost invariably depicted holding their body parts on a platter. On a pharmacological level, the way that the saints present their respective parts suggests that they are offering a form of food — loaves of bread or fruits — that can

be consumed. It is common even today throughout Europe to bless or eat bread on St. Agatha’s day, a practice that developed from mistaking the two breasts on a salver for loaves of bread (Lewison 419). Moreover, if we examine the food icons and symbols associated with other female saints, the link between edible substances and body parts becomes even more conspicuous. Images of St. Mary the Egyptian, for example, have her stand in a similar posture holding the three loaves of bread that she

used to sustain herself miraculously in the desert. When we consider that in the Middle Ages bodily relics of saints were often eaten or compounded for healing purposes, the relation between human flesh, food, and healing practices becomes even clearer. David Schechter and Henry Swan have shown that Renaissance rep-

resentations of the shearing of Agatha’s breasts depicted the ancient torturers using sixteenth- and seventeenth-century surgical instruments such as shears, pincers, and sharpened tongs. According to Schechter and Swan, it is unlikely that the selection of the appliances represented was only casual

or unpremeditated. It is more plausible that, being deprived of concrete knowledge from canonical recitals with regard to the actual manner of breast

ablation, the illustrators sought contemporary instruments as models. (695-6)

In these representations we see, therefore, a shift of focus away from Agatha as a torture victim toward Agatha as a source of healing. The presence of these surgical instruments, no doubt, alerted the viewer to

the medicinal underpinnings of Agatha’s breast amputations, even though analogously speaking, such representations should have linked the ancient torturers with the Renaissance physicians and surgeons. It is clear that in the telling of Agatha’s miraculous healings as patron saint of diseased breasts, the focus shifted away from the brutal destruction of her body toward her body as a medium of therapeutic restoration.

142 THE ARCIPRESTE DE TALAVERA AND THE SPILL

In a sense, Martinez and Roig, with their therapeutic and hygienic project of mediating the pathological male libido, likewise extracted and administered to the patient a female body part: her tongue. As

critics have often recognized, Martinez and Roig offer the reader lengthy extracts of female speech. In the Arcipreste, for example, we have extensive monologues in which women whine incessantly over the loss

of insignificant property, ridicule the physical attributes of other women, or simply badger their male companions. These alleged representations of female speech are the lengthiest in Spanish literature until

the late fifteenth century. Prior to this period, direct discourse by women in literary texts was extremely limited. It is true that Dona Jimena, the dutiful wife of the mighty Cid, offers a prayer for his safe

return, and that the prostitute-turned-saint Santa Maria Egipciaca attempts to seduce men with her words. But these portrayals of speaking

women merely serve to point to an exemplary character trait or vice, and for the most part are nothing more than a formulaic discourse used in a particular setting to teach the public how a good woman should or should not act. The representations of female speech in the Arcipreste and the Spill differ from these earlier manifestations in that they are presented primarily as speech itself, and only secondarily as indicators of female nature. Like plasters, syrups, enemas, and ointments, these discrete units of speech were designed to be applied, consumed, and digested by the reader-patient. In the Middle Ages the voice, which is primarily thought of today in nonphysical terms, was never completely detached from its

material components, including the biological organs that created the intonations and inflections of speech. It was common for authors to play with the concepts of tongue as language and as food. Boccaccio, speaking of the nature of female speech, conflates the tongue as a food with the tongue as a medium of discourse: Certainly if it is true what those physicians say, that the member which the brute animals, birds, and fish exercise most, is most pleasing to the taste and most healthful to the stomach, no mouthful should ever be more tasty and better than her tongue, which never leaves off chattering, never slackens, and never stops: yak, yak, yak from dawn to dusk! Even at night, I declare, when she is sleeping it cannot cease. (The Corbaccio 51)

In the Spill Roig mentions that God, immediately after creating Eve from Adam ’s rib, took the tail of a goat, made a tongue out of it, and

gave it to Eve (10333-5). Francesc Eiximenis narrates this story in greater detail:

TORTURED BODY, ABJECTIFIED VOICE 143 La fembra continuamente mouria la lengua a parlar, si trobaba qui li tingués corda. Per acop digueren alguns poetes que Nostre Senyor crea la fembra sens llengua; e com Adam fos trist can ella no li podia parlar, dien que suplica al Senyor que li faés lengua. E dien que lo Senyor dix: “Adam, Ileixa-la estar, car si l’ha, mala parlara a tos obs.” E com Adam no cessas encara de suplicar a Nostre Senyor Déu que li creas llengua, dien que Nostro Senyor veés aqui una cabra, e pres-li la coa e féu-ne llengua a la fembra. E de continent parla ab la serp; pus enclina Adam ab son parlar a pecat.!3

[The Woman (Eve), if she could find someone to listen to her, would continuously move her tongue to speak. For this reason some poets say that Our Lord created her without a tongue. But because Adam was sad, not being able to speak with her, they say that he pleaded with the Lord to make her a tongue. And they say that the Lord said: “Adam, leave things as they are! If I do as you ask, she will speak ill of all your deeds.” And since Adam did not cease to plead with Our Lord to make a tongue, they say that Our Lord saw a goat, and taking its tail, made a tongue for the woman. Thereupon she spoke with the serpent and with her speech moved Adam to sin. |

The anecdote reveals several medieval assumptions about the nature of female speech. Unlike her body, which originates from Adam’s rib, a woman ’s tongue is a beastly and monstrous appendage that distorts her godly design. Her tongue is both the result of Adam’s ignorance and the cause of his fall. Female speech is, therefore, animal, illicit, superfluous, and ultimately dangerous. For Martinez and Roig, a successful therapeutic strategy to keep men from being seduced by women — sim-

ilar to Bernard of Gordon’s recommendation to treat the lovesick patient by showing him a cloth soaked with menses — is to extract the voice from the body and display it for the patient in a way that reveals its primordial nature. In the lengthy monologue of a woman who claims to have had her hen egg stolen, Martinez demonstrates the beastly quality of the female voice: éQueé se fizo este huevo? :quién lo tomo? ¢quién lo levé? :A do le este huevo?

Aunque vedes que es blanco, quicas negro sera oy este huevo. Puta, fija de puta, dime: :quién tomo este huevo? ;Quién comidé este huevo comida sea de mala ravia: camaras de sangre, correncia mala le venga, amén! ;Ay huevo mio de dos yemas, que para echar vos guardava yo! ;Ay huevo mio, qué gallo

e qué gallina salieran de vos! Del gallo fiziera cap6n que me valiera venite maravedises, e la gallina catorze; o quica la echara e me sacara tantos pollos e pollas con que pudiera tanto multiplicar, que fuera causa de me sacar el pie del lodo. Agora estarme he como desaventurada, pobre como solia. j;Ay huevo mio, de la meajuela redonda, de la cascara tan gruesa! ¢Quién me vos

144 THE ARCIPRESTE DE TALAVERA AND THE SPILL

comid? jAy, puta Marica, rostros de golosa, que tu me as lancado por puertas! Yo te juro que los rostros te queme, dona vil, suzia, golosa! ;Ay huevo mio! Y ¢qué sera de mi? jAy triste, desconsolada! ;Ihus, amiga! y gcOmo non me fino agora? jAy, Virgen Maria! (149)

[What became of my egg? Who took it? Who stole it? Where is that egg? Although it was white, it is black today! Whore and daughter of a whore, tell me, who took my egg? Who ate that egg? I hope she gets bitten by a mad dog; or gets hit by the bloody squirts or bad flow; amen! Oh my egg of double yolk,

I was saving thee for hatching! Alas, my egg! What a cock and what a hen would have issued from thee! Of the cock ’'d have made a canon worth twenty farthings, and the hen would have brought fourteen! Or perhaps I should have set her and she would have hatched out so many cockerels and pullets, and they would have so multiplied that they would have got my feet out of the mud! But now I am luckless and poor as I was. Alas, my lovely egg of the round tread and shell so thick! Who has eaten thee? Marica, you whore, you glutton, you have driven me out of my house! I swear I'll blister your cheeks for you, you vile, dirty, gluttonous woman! Alas, my egg! What will become of me now, pitiful forlorn wretch that Iam! Jesus, my friend, why don’t I die and get it over with? Alas, Virgin Mary! ]/4

Martinez creates the image of a ranting hen that cackles around the barnyard, infuriated over her pilfered egg.!5 This monologue, which is twice as long as the excerpt quoted, is followed by another, even more lengthy, in which a woman goes from house to house disrupting the entire neighborhood over the loss of a hen (150-2). Like the previous outburst, this one is full of complaints, curses, and expletives: “; Triste de mi, que tres dias ha entre las manos me lo llevaron! jlhus, quanto robo, quanta sinrazon, quanta injusticia! ... jRayo del cielo mortal e pestilencia venga sobre tales personas!” (Arcipreste 150) [Woe is me, only three days ago she was stolen from me! Dear Jesus, how much robbery

there is, how much injustice, how much wrong! ... Maya bolt from heaven and a mortal pestilence strike such people! (Little Sermons 105-6) ]. In both monologues women transgress all the established norms of medieval rhetoric, failing to formulate their complaints and discontents into an ordered discourse. There is no exordium, no narratio, no confirmatio or refutatio, only an incessant flipping — here, there, back,

forth — that suggests the twitching of a goat’s tail. The result is an uncomfortable, even painful condition for the man who is forced to endure her rambling, cacophonous babble — motivated, as Martinez says, by next to nothing: “Y en esta manera dan bozes e gritos por una nada” (150).

TORTURED BODY, ABJECTIFIED VOICE 145 When the female voices do attempt to develop a particular argument, it is to malign other women. In the longest monologues in the Arcipreste women berate other women from top to bottom, describing every detail from their dirty hair to soiled undergarments: Fallan las gentes que Fulana es fermosa. jOh Senor, y qué cosa es favor! Non la han visto desnuda como yo el otro dia en el bano: mas negra es que un diablo; flaca que non paresce sinon a la muerte; sus cabellos negros como la pez e bien crispillos; la cabega gruesa, el cuello gordo e corto como de toro; los pechos todos huesos, las tetas luengas como de cabra; toda uniza, equal, non tiene faccidn de cuerpo; las piernas, muy delgadas, parescen de ciguena; los pies tiene galindos. De gargajos nos farto la suzia, vil, podrida el otro dia en el bano; asco nos tom6 a las que ai estavamos, que rendir nos cuido fazer a las mas de nosotras. (161) [They think What’s-her-name is beautiful! Oh, Lord, what a fine thing it is to have friends! But they haven’t seen her as I did the other day, naked in the bath! Why she’s blacker than a devil, and so skinny that she looks like nothing if not death itself! Her hair is black as tar and completely frazzled, her

head huge, her neck short and thick as a bull’s, her bosom all bone! Her breasts dangle like a goat’s! She’s straight up and down — no figure at all, flat!

Her legs are spindly as a stork’s, her feet lumpish. At the bath the other day the filthy thing hawked and spat until most of us were sick! ]

For Martinez, monologues such as this one have a double therapeutic function. First, they characterize the excessive nature of female speech. Second, they fulfill the traditional medical practice for curing men of sexual desire by displacing pleasing images of women with abjective visions of a corrupt female body. Since it is a woman who does the abjec-

tifying, the monologues have a recursive effect on the reader that not only reflects the imperfections of a particular woman, but those of women in general, including the speaker. Through her own speech, Martinez shows men how women are doubly defective: corporeally and verbally.

Roig also provides the reader with discrete doses of female speech as part of his overall therapy for sexual well-being. In recounting episodes from his married life, Roig tells how his first wife (1953-3142) refused

to speak to him except to ridicule him. He presents, in her voice, a lengthy tirade in which she calls him an old man who urinates in his boots; she says he would not know the difference between a country girl and a noblewoman, and that he is worn out and useless; she constantly pelts him with insulting images of sexual impotence, calling him a used

146 THE ARCIPRESTE DE TALAVERA AND THE SPILL

needle that can no longer sew (2724-89). According to Roig, she maligned him in this way day in and day out: “De tals licons ab agres sons sovents n’ohia he soferia” (2789-93). His second wife likewise pestered him with her cursing and bedroom whining: Deya’n lo llit: / “Seguons que veig / cert, mal e leig / vos me tractau, / car

retractau / tot quant yo man; / si res deman, / may se’n fa res; / vostres dine[r]s / he quant teniu / de miu [ho] cobriu; / res no’m fiau, / ni confiau / sabes guardar; / veig-vos tardar / que res no’m feu; / del que sabeu / may me’n parlau, / ni’m revelau / vostres secrets.” / Cent mil retrets / semblants me deya. (4352-74) [In bed she used to say to me: “As far as I can certainly see you are treating me poorly and inappropriately because you retract all that I order; if I ask for something, you never give me anything! You hide your money and everything you have from me! You don’t trust me! You don’t believe I can safeguard your things. I think you’re dull-witted, since you do nothing for me. You never tell me the things you know or let me in on your secrets.” She gave me a hundred thousand reprimands of this type. ]

The representations of female speech in the Arcipreste and the Spill fulfill the therapeutic and hygienic imperatives of late medieval sexual pathology. By administering the voices of women to men, Roig and Martinez hoped to spare men from suffering what they believed would ensue inevitably from any intimate contact with women. Martinez’s and Roig’s strategy was to transform female speech into an endless stream of empty signifiers that, while appearing to say something, in reality said nothing at all. For Martinez and Roig the words of women were nothing

more than the chirping of birds, the cackle of hens, or the incessant wiggle of a goat’s tail. Detached from the body and displayed as beastly excess, the female voice becomes impotent, abject, and ultimately silent.

In the medieval economy of sexual well-being, there is only room for one tongue. As Martinez clearly illustrates with his account of the wife who bit off her husband’s tongue, leaving him dumb and mutilated,

either men must learn to silence women or they will ultimately be silenced by them.

PART THREE The triumph of the clinic

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6 Women, the power to disease, and the fictions of the Counter-Clinic

In the earlier Middle Ages learned practitioners operated in relative harmony, or at least in harmonious indifference, alongside of and in conjunction with empirics, quasi-professional practitioners, and folk healers who regularly attended to the needs of the sick and afflicted.1 Documents point to a variety of healers from different social, ethnic, and educational backgrounds. Some of these were general practitioners, while others specialized in a particular medicinal craft.2 Tornabracos or algebristas were called on to set bones. The sacador de piedra removed bladder stones. And saludadores and ensalmistas attempted to cure with

' blessings and conjurations. Typical was a group of dental hygienists called caxalers who worked in the cities and courts of Aragon. Using herbal powders and metal instruments (called tenalles or ferrors), the caxaler removed plaque and decay from some teeth, extracted others, and generally attempted to mitigate oral discomfort. Although the caxalers focused on odontological ailments and dental hygiene, their activities often extended into areas well beyond modern dentistry, including administering enemas, letting blood, and, strangely enough, removing the testicles of men whom judicial authorities had sentenced to be castrated (Rahola i Sastre). Women played a vital role in caring for the sick.’ The Catalan exarmadora, usually a woman, left work each spring to treat patients suffering from gout (Donate Sebastia 806-7), and comadres and madrinas treated gynecological disorders and assisted women giving birth.4 Moorish and Jewish women were in great demand at the court of Aragon at the end of

the fourteenth and beginning of the fifteenth century; the city of Castellon, for example, solicited the services of Moorish metgessas in 1391 on account of their great success in curing eye diseases (Garcia-Ballester, Historia social 42).° According to Garcia-Ballester, McVaugh, and Rubio

Vela, there is “continuing documentation of this practice [the practice of women | in Valencia from 1332, when a woman named Cahud is found

149

150 TRIUMPH OF THE CLINIC practicing surgery in the royal household, until 1436, when the king granted a license to Peregrina, wife of Marti Navarro of Morella.... [T]he practice of women [in Valencia] included activity in virtually all aspects of medicine: as midwives; as specialists in, for example, eye ail-

ments; and as practitioners of general medicine and surgery treating men as well as women” (Medical Licensing 30).

Although not trained in traditional medical practices, other men and women specialized in curing specific diseases — such as headaches, sore throats, eye disorders, breathlessness, gout, and a painful cutaneous affliction known as the “savage fire” (foc salvatge) — using prayers, chants,

and conjurations. The records of a pastoral visit made by De Na Benviguda de Mallnovell in 1310 describe in detail the way this woman

treated headaches, sore throats, breathlessness, and skin diseases by reciting Paternosters and Ave Marias in combination with a special

conjuration. For breathlessness, she instructed the afflicted to repeat the following: “Ascla e malura / tot ne vaja a pastura”; for a headache the sufferer was asked to repeat a dialogue between Jesus and the Virgin Mary in which the son complains to his mother of a headache

. (Perarnau i Espelt 70-1). Several years later, a man by the name of Francesc Oller confessed that he regularly treated patients suffering from desfeta (an inflammation of the cornea) and mal de ventre (a generic term for stomach disorders). In treating mal de ventre he made the sign of the cross, evoked the power of God and the Holy Virgin, said at least

three Paternosters and Ave Marias, and finished by reciting the following verses: “Mala hosta, bona hosta; / qui acuy, bona hosta; féu-li lit

de oliverdola / e cobri | ab flacada nova” (Perarnau i Espelt 73-4). Although such practices were condemned by the ecclesiastic authorities and the practitioners were asked to make public penance, the bishops taking confessions openly acknowledged that many had been cured by these treatments. Not only did the dissemination of biomedical information through

popular sources make it much easier for the semi-educated to adopt therapeutic principles of Galenic medicine. Morisco and Jewish healers maintained an ongoing system of medical education that was completely independent of the Christian universities. According to Garcia-Ballester, the Morisco practitioners “personified the mixture of Christian and Arab cultures; the former because they spoke Castilian and read medical texts written in Castilian and also in Latin, the latter because Arab medicine was passed on by an oral tradition” (“Academicism” 248).6 Jewish physicians also drew on material from both Jewish and non-Jewish sources,

WOMEN AND THE POWER TO DISEASE 151 notably those from learned Arab culture in Spain. Although the extent of their book learning varied, “it is evident that their medical ideas and techniques were, like those of the Christians, permeated by the influence of Greco-Arabic medical culture” (Siraisi, Medieval and Early Renaissance Medicine 31). The fact that there are over one hundred extant Hebrew translations of Avicenna’s Canon (most of them from Spain) illustrates the quality of medical education afforded to Jewish physicians.’

During the early fifteenth century the university-educated Christian physician could no longer unequivocally distinguish himself from his subaltern counterparts solely on the basis of his knowledge of principles

of Galenic medicine. Thus the factor that differentiated the learned healer from the uneducated subalterns shifted irreversibly from one based solely on the acquisition of medical knowledge to one based on absolute control over medical practice. This is not to say that the erudite component lost its importance in medical training, but rather that the official recognition of learned physicians (which gave them the

authority to read the signs of the body and declare the presence or absence of disease) began to take on greater importance. This included the advent of two powerful controlling mechanisms: (1) a system of evaluation and licensing of medical practitioners; and (2) the creation of a specific place where authorized healing could be enacted, the hospital. 1. Medical licensing. From the beginning of the twelfth century, ecclesiastic and courtly mechanisms were put into place in Europe to evaluate

and limit medical practitioners. The earliest recorded attempts to regulate medical practice were those of King Roger II (1130-54) of Sicily and

his grandson, Frederick II, who required all those wishing to practice medicine to be examined.’ Under the guise of acting in the public’s best

interest, the medical faculty at Paris in the twelfth century began a series , of attempts to eliminate all “charlatanism” and medical practice by empir-

ics, and to evaluate and license all “legitimate” medical personnel (Kibre). Mandated medical licensing reached the Iberian Peninsula in subse-

quent years. In Castile there are regulations from as early as the late twelfth century requiring medical practitioners to be examined and authorized. The Fuero real of Alfonso II of Leon (1188-1230) states under the rubric “De los fisicos y maestros de Ilagas” that “Ningun ome no obre fisica, si no fuere ante aprovado por buen fisico o fisicos de la villa do obiere de obrar e por otorgamiento de alcades e€ so esto aya acta

152 TRIUMPH OF THE CLINIC testimonial del Consejo” [No man is allowed to practice medicine unless he has been approved to do so by a competent physician or by the physicians of the village in which he plans to practice, and has been authorized by the mayor] (libro 4, titulo 16; Parrilla Hermida 477). Likewise, Alfons II of Aragon created a provisional framework for the regulation

of physicians through legislation enacted by the cortes of Manzon (1289); the fuero required physicians and lawyers to be examined by a town council before practicing medicine or law; they were also required to take an oath promising to carry out their professional duties in good faith (Garcia-Ballester, McVaugh, and Rubio Vela, Medical Licensing 2).

From the beginning of the thirteenth century, this type of legislation also attempted to limit medical practice based on ethnicity and gender. The Valencian cort of 1239 promulgated a fur proscribing women from practicing medicine “under penalty of being whipped through the town” (Garcia-Ballester, McVaugh, and Rubio Vela 59). Similar prohibitions arose against Jewish and Morisco practitioners. For example the Castilian provincial council of 1313 prohibited Jewish physicians from treating

Christians: “que no usen la fisica con los christianos, por letrados y provados que sean” [they should not practice medicine on Christians no matter how learned and experienced they may be]; likewise in a papal bull of 1415, Pedro de Luna prohibited Jews from practicing medicine (Rius Serra). In 1335 the bishops of Salamanca complained that Jewish (and Arab) healers maliciously took advantage of sick Christians, leaving their bodies even more debilitated (Granjel 100). It wasn’t until the fifteenth century, however, that restrictive legislation was expanded and rig-

orously enforced. In 1429 Juan II, acting on the advice of his physician Alfonso Chirino, established a tribunal to examine physicians. In 1477 the monarchs Isabel and Fernando established the first of a series of laws that developed into the Real Protomedicato, a centralized organization designed to guard the public health by examining healers and impeding and penalizing unorthodox practitioners (Parrilla Hermida 475).

2. The hospital. Before 1500, the hospital was only one of several places where clinical healers practiced their medicine; for the most part the clinic was still very much at the patient’s bedside — for less serious ail-

ments, in the streets and in the public squares. Hospitals were essentially institutions for the ailing poor. Even when their ills were extremely serious, rich patients regularly received clinical care in their homes. One

of the reasons this was possible was that medieval clinical practice depended more on the manipulation of theoretical principles than on

WOMEN AND THE POWER TO DISEASE 153 the application of medical technology. Today very little clinical healing takes place outside of institutions like the hospital. The ambulatory physician who treated the patient in the home during the first half of the twen-

tieth century has become obsolete. This is in part due to the rise of a medical technology that is too expensive, too cumbersome, and too sophisticated (meaning it can only be properly operated by specialists) to fit into the proverbial black bag.9 But it is also related to the authorized physician’s desire to maintain complete control over all conditions pertaining to the health of the patient. The imperative was already present in the second part of Hippocrates’ first aphorism, which states, “The physician must be prepared not only to do what is right himself, but also to make the patient, the attendants, and the externals cooperate.” The rise of the hospital during the later Middle Ages marks the beginning of one of the most powerful conventions of clinical control. By

locating the encounter between physician and patient in a specific place, practitioners were better able to manipulate all of the factors thought to affect the body — including the “patient, the attendants, and the externals.” The entire history of the hospital, from the Middle Ages to the present, can be plotted as the continuous imposition of increas-

ingly complex apparatuses of control. During the thirteenth century the authorities began to incorporate into the physical and administrative structure of the hospital mechanisms to categorize and quarantine patients.!0 Certain hospitals were established to specialize in treating one ailment, such as leprosy or St. Anthony’s fire.!! Physical division within the hospital building separated the women from the men and the infected from the wounded. The idea that corrupt air transmitted infectious illnesses encouraged the building of hospitals in places where “healthy winds” could expedite healing.!* Toward the sixteenth century

pharmacies were built into the hospital to allow quick retrieval of the appropriate medicines. In general the modern hospital has grown out of this late medieval desire to create conditions in which the physician has at his disposal the services, medicines, and instruments necessary to carry out the prescribed therapy.

The licensing procedures of the late medieval tribunals and the controlling mechanisms of the hospital were not initially powerful enough to curtail the practice of those health care practitioners who did not hold a university degree and could not pass the required examination. There were simply not enough university-trained physicians to meet the needs of the sick. In the years following the Valencian statute of 1329, the towns

154 TRIUMPH OF THE CLINIC of Nulles, Ribagorg¢a, Jérica, Morella, and Castellon complained bitterly

of the lack of physicians and urged the king to make exceptions to the law (Garcia-Ballester, McVaugh, and Rubio Vela 20). The onset of plague

epidemics from the mid-fourteenth century onward further diminished the number of licensed physicians, leaving many small towns, such as

Alzira and Jativa, with “no one to cure the ill and take care of their needs.”!3 A final reason for the failure of medical regulators to control unlicensed practitioners was that, economically, the poor simply could not afford to pay for the skills of a licensed physician.!4 In this regard many unlicensed caretakers were praised because “they attend the sick poor and incapacitated who lack the means to pay.”!5 Perhaps the greatest impediment to controlling unauthorized practi-

tioners was that university-trained and licensed physicians had no monopoly on curing disease and easing pain, nor were they able to demonstrate consistently that their skills were more efficacious than those of other healers. Modern medicine has evolved into a highly specialized enterprise that rigorously distinguishes its technology and practitioners from alternative healers and nonmedical personnel. Although it draws its initial authority from the privileged epistemological status of

science — which pretends to be an accurate reading of the Book of Nature —it also makes powerful claims of therapeutic efficacy.!® Medieval physicians, regardless of their number of years of university training, could not demonstrably make the same assertions. Complaints of the inefficacy of medical treatment were so common during the late Middle Ages and the Renaissance that they emerged as a literary trope in the sixteenth century. In defense of nonlicensed medical personnel, many pointed to the effectiveness of their cures. In Paris during the early fourteenth century (1322), Jacqueline Félicie de Almania was cited for illegal practice of

medicine (practicing without a license) and duly excommunicated. John of Padua, surgeon to the king of France, Philip IV, insisted that empirics, like Jacqueline, practiced in ignorance of the art of medicine and in so doing could easily kill a patient by incorrectly applying clysters and potions. Countering these arguments, Jacqueline’s defense counsel

produced witnesses who had been successfully treated by Jacqueline. During the course of her trial, testimony from former patients expressed overwhelming confidence in her ability to cure their ailments. Many of the witnesses emphatically described the way licensed physicians had failed to cure them, listing by name those professionals who had unsuccessfully treated them.!” The defense counsel reiterated the ineffective-

WOMEN AND THE POWER TO DISEASE 155 ness of licensed professionals, adding that unlike many licensed physi-

cians Jacqueline “cared for her patients assiduously until they were cured.” As a final argument her defender asserted that the judgment of the faculty of medicine could not be binding, since the witnesses had shown the faculty’s judgment to be contrary to the public good (Kibre 8-11). The defense counsel’s arguments fell upon deaf ears; Jacqueline was found guilty and punished. Fictions of the counter-clinic

The strength of any institutional mechanism of control such as a system of hospitals or a process of licensing depends on conjuring up an imaginary otherness malevolently opposed to the institution’s objectives and ideology. In the later Middle Ages the burgeoning body of clinical practitioners began to define itself in antithesis to a body of practitioners whose goals and techniques were shown to resist those of authorized healers. If clinical authorities could not clearly and consistently demonstrate that their methods or their learning were effective, they could at least fortify their claims to legitimacy by casting a shadow on the activities of subalterns. If they were unable to stop the sick from seeking the help of unauthorized healers, they could at least discourage this prac-

tice by creating or retelling stories and anecdotes that impugned the

character and methods of these healers, forcefully drawing a line between the legitimate healer and the sinister other. We know from his professional activities that Jacme Roig was well aware of the distinction between authorized and illegitimate healers. As we have seen, he was repeatedly appointed by the Consell de la Ciutat to be the official Examiner of Physicians of Valencia until his death in 1478.18 He was also the appointed physician for the Valencian hospitals of En Clapers and En Bou, and held the administrative position of desospitador in the Hospital d’Inocents, the hospital often celebrated as the first mental institution in the West (Alminana Vallés 910-16). In these official capacities, Roig not only fully participated in the institutional mechanism of the clinic, but was also called upon repeatedly to differentiate between clinical healers and “illegitimate” practitioners. Throughout the Spzll Roig establishes a firm distinction between the

authorized physician and the antithetical subaltern, describing the former as good and competent while denouncing the latter as evil and inept. For example, he tells us that his second wife, in her frustrated efforts to conceive a child, often turned to “metgesses” [female doc-

156 TRIUMPH OF THE CLINIC ~ tors], “velles urquesses” [old she-devils], “emprenyadores” [women who

help women get pregnant], “banyadores mores” [Moorish bathers], “madrines” [midwives], adivines [diviners], “potecaris” [apothecaries],

“erbolaris” [herbalists], “triaguers” [compounders of antidotes], and “estrolechs” [astrologers] (4523-33, 4607). Not only did these healers, who cost Roig more than two thousand sueldos, fail to heal his wife, but their treatments actually made her sick:

a tots arreu / recorregue, / tots los cregue: / huns calda deyen, / altres la feyen / ffreda y humida / 0 adormida; / tots variaven / hi la ‘nguanaven; / d’ells ser liguada / enfitillada / li feyen creure; / fferen-li beure / mil beu-

ratjades / prou mal forjades / en banys, huntures / he faxadures, / perfums, e cales; / ulcers males / li concriaren, / he li causaren / salt de ventrell, / en lo cervell / malencolia / he mirarchia; / molt la guastaren, / he

la cremaren. / Tota secada, / prop heticada, / per lo parir cuyda perir. (4014-44) [she turned to all of them, believing each one. Some said she needed warmth; others wanted to treat her with cold, humidity, and sleep; they all disagreed, each one denying the treatment of the other. Some made her believe that she was bewitched. They made her drink a thousand poorly mixed potions. With their baths, ointments, bandages, perfumes, and suppositories, they produced terrible ulcers and spasms in her stomach, and melancholy and hysteria. With these remedies they depleted and consumed her, leaving her dehydrated and consumptive. In her attempts to give birth she almost lost her life. |

In opposition to these inept practitioners and their detrimental therapies, Roig tells how a “valent metge” [worthy physician] finally cured her of consumption, debilitation, liver problems, and stomach spasms. In the Spill these illicit and incompetent healers are conspicuously gender-specific. In contrast to the benevolent healing Christ, Solomon points to Satan and his spurious doctors. Curiously, Satan’s counterpractitioners are all women: “abrenuncies Bel e Satan, he a quant fan, exarmadores, encortadores, les piromantiques, he nigromantiques” (12120-6) [Renounce Bel and Satan, and all the works of charmers, witches, pyromantics, and necromancers]. Throughout the Arcipreste and the Spill, Martinez and Roig remind the reader that women are ill disposed and disinclined to act as proper clinical healers. If the etiology of disease could be explained by the intervention of devils, demons, and wicked spirits, then it stood to reason that

women, who according to Roig have been “friends of the Devil” (10438-9) from the beginning, were more likely to make men sick than

WOMEN AND THE POWER TO DISEASE 157 to cure their ailments. Likewise, if ancient and medieval deontologists were correct when they claimed that the efficacy of the physician was contingent on his moral character and great virtue, then women, who according to Martinez are greedy, dishonest, envious, unscrupulous, manipulative, disobedient, and deceitful, have no place wielding surgical instruments, compounding medicines, and checking pulses. To illustrate this point, Roig recounts in the early pages of the Spill

how the women in the hospital of En Claper had mistreated him. Abandoned by his mother after his father’s death, he had hoped to find refuge from the elements and relief from his ailments in the institution where Christian charity and medical practice converged. The spitalera (hospitaler) and her servants, however, provided him neither with material necessities nor with spiritual encouragement to cure his disorder.

On the contrary, they ransacked his bag and the lining of his shirt searching for money; when they found none they told him they had no room for an indigent patient, insisting that he would have to beg on the streets for his food and wine (924). For Roig, women are simply too incompetent to participate in the healing arts, and are naturally inclined to invert the therapeutic structure by misdiagnosing diseases and misapplying medicines. Solomon explains in book 3: Qui [h]aver vol / d’elles costol, / quant es malalt, / ffara bon salt / del llit al vas: / mostrant solas / he gran amor / he sots color / de molta cura, / sense

mesura, / de brous premsats / he destillats / en ampolletes, / solsits d’olletes, / celiandrats / he molts picats, / l’enbotiran / he fassiran / com al porcell. / May lo consell / del metge tenen: / elles s’entenen; / la malaltia /

no’l mataria: / ffer 1’ [h]a morir / sols l’enbotir / he ffassiment. / Honestament, / cert, infinits / han mort marits. (8079-116) [He who being sick wants the assistance of women makes a big leap from the bed to the tomb. Appearing to be loving and affectionate, and using the pretext of employing a wonderful cure, they stuff and gorge the sick man with

broths pressed and distilled in flasks, with platters of sausages, and with coriander ragout, as if he were a pig! They never follow the physician’s orders, believing they understand the situation better. By stuffing and gorging him, they are the ones to blame, not the sickness, for killing the patient. An infinite number of husbands have certainly died this way! ]

According to Solomon, women in a therapeutic context will insist that their sick husbands lie on the worst bed in the house; they constantly will order him to get up and move from bed to bed. They will also dispute the doctor’s diagnosis: “no febrejau, ni sera res, de fredor es” [you

158 TRIUMPH OF THE CLINIC don’t have a fever, if anything you’re too cold]; and they will offer all kinds of counterproductive remedies and advice (8154-76). For Martinez and Roig the most dangerous characteristic of women is their tendency to stockpile enormous quantities of materials, benign and harmful. Martinez complains that “infinidas cosas fallaras [en] sus arcas e cofres atestados” (159) [you will find infinite things in their chests and coffers], which if spread out would stock a large shop. As examples he offers an enormous inventory that includes rings, earrings, bracelets, scarves, kerchiefs, cambrics, toques, headdresses, hair nets, beads, linen, blouses, purses, belts, combs, sponges, mucilages, tweezers, mirrors, rags, ointments, and cosmetic waters. Likewise Roig complains that his first wife fastidiously guarded under lock and key a small chest in which she

kept medical compounds, pastes, powders, oils, dyes, and unguents (2515-35). The collection and possession of diverse things were seen by men like Martinez and Roig as a source of power through which women could deceive men, destroy their health, and undermine their social wellbeing. The ritual denunciation in antifeminist literature of the “cosas” that women hoard in their boxes and bags reflects an anxiety over the relation between the possession of things and the power to disease. Roig’s suspicion of the things that women keep in their coffers is only equal to his fear of women’s activities behind closed doors. In places such as bath houses, brothels, and convents — places to which men’s access is prohibited or limited — women develop their counter-clinical skills. These are the places where women display their unbridled behavior, where they learn how to concoct medicines and how to feign the signs of disease, and

where they practice their arts of deceiving and destroying men. Roig describes his first wife’s frequent visits to the baths of Ganou and Suau.

Here she and her friends reportedly undressed and danced naked on beautiful tapestries, jumping and screaming like wild women; they overindulged themselves with fowl, meats, and wines; they received plas-

ters made from expensive ingredients such as amber, musk, and whale fat; and they returned home well after midnight accompanied by dancers and musicians (2646-703). The troubling excesses of the bathhouse, however, are mild compared to what goes on in the convent. For Roig the convent serves as a training ground where women not only learn to collect and concoct the materials for their coffers, but also learn to use these substances in the art of diseasing. Roig’s wife explains that the abbess carefully taught her the strategies of feigning illness, as well as how to use the powders, dyes, and ointments to simulate the symptoms of disease:

WOMEN AND THE POWER TO DISEASE 159 Mas l’abadessa / me doctrina, / consell dona / que’m fes malalta / he qualque falta / en ma persona / alguna stona, / 0 pus sovent / seguons lo vent, / ffingis tenir: / no prou hoyyr, / al cap dolor, / he baticor, / esmortiments, / afollaments, / mal de neulella; / en la mamella, / no hulcerat / mas comencat, / cancer tenir. / “Molt pots fingir / ab gentil art: / secret, apart, / metenl’orina / cendra, farina, / oli, calc, llet, / algun ququet chich / del forment / ffes cautament / metge sabut, / practich, astut, / vell, no la vega: / si la menega, / conexeria, / divulgaria / ton artifici. / Metge novici

/ \laguotegat / he ben paguat / te planyera; / he complaura / per son jovent, / no prou sabent / s’enquanara: / publicara / que ten grans mals; / mil cordials, / confits, aloses, / he quantes coses / desigaras, / atenyeras.” (6016-66) [The abbess also indoctrinated me and counseled me as to how to make myself ill, and how to fake momentarily and capriciously some kind of personal defect such as hearing problems, headaches, heart tremors, dizziness, miscarriages, back pains, breast abscesses (not yet ulcerated, but only in the initial stages). “With subtle artistry, you can simulate many things. In secret in your urine cinders, flour, oil, lime, milk, or one of those wheat worms; be careful not to be examined by an experienced or wise physician, because he will see through your scheme; rather pick a young doctor whom you can flatter; he will have compassion and will comply; on account of his youth and lack of experience, he will fall for the trick, making your great disease known in public, by which you will be able to get tonics and confections, or whatever

you want.” | | Roig’s wife confesses that with the abbess she learned how to put blisters on her skin using a garlic; how to discolor the skin with mustard; how to

produce ulcers with ground pepper; how to prick her palate with a needle so as to cough and spit up blood; how to produce the symptoms of consumption. According to the abbess:

D’enmallatir / o del guarir, / quant son mester, / la qui u [ho] sab fer / molt se’n ajuda, / lo que’s vol muda: / hun “no u [ho] hoy, / lo mal [h]agui, / jaso guarida, / ja so ferida,” / la scusara / del que volra. (6097-102) [She who learns to disease or to cure, whichever be necessary, will greatly further her cause: an “I couldn’t hear,” an “I was sick,” an “I am cured,” or an “I am wounded,” will get you what you want!

In addition to the teachings of the abbess, Roig’s wife received training from an older nun who taught her how to give the evil eye, to put on spells and charms, to abort babies and fake virginity, and to administer sleeping potions.

160 TRIUMPH OF THE CLINIC As Roig vividly illustrates throughout the Spill, a woman’s art of diseasing is not only practiced and taught in the convent; it also manifests

itself in the bedroom, on the streets, and in the residences of women. Roig recounts how his second wife, motivated by her efforts to conceive

a child, sought the services of a “metgessa stranya” from Bigorra. According to Roig, this old practitioner who specialized in fertility therapy had tricked the entire kingdom of Aragon, from Valencia to Rosellon, with her unorthodox remedies. When barren women came to her for treatment, she would offer them cloves and ginger, explaining that their cold bodies, combined with the impure semen of their husbands, made it impossible for them to conceive. To remedy the situation, she kept several well-endowed young men in the back rooms of her house; with three or four thrusts, she claimed, they could make any woman pregnant (4334-602).

For Roig, this female practitioner threatened the patriarchal order

of the entire kingdom of Aragon. Rather than curing disease and mitigating disorder, she literally helped plant the seeds of personal and social chaos. Thus Roig, upon learning of this woman and her unorthodox therapy, denounced her to the local authorities. The particular nature of her practice required a double moratorium on her activities. Not only did she have to stop administering drugs and supplying illicit semen, she also had to be kept from revealing the } true circumstances of her clients’ pregnancy in order to “evitar scandelizar tan[t] trist marit” (4591-2) [avoid scandalizing so many pitiful husbands]. The solution was to ignore the normal judicial process and permanently silence her. Roig tells us that she was discreetly strangled

one night in her own house. He adds, “;Quant bort secret resta ledesme!” (4600-1) [How many bastards in this way were made legitimate! |.

These tales of women who know how to fabricate the symptoms of disease for their own profit, who hoard pharmaceutical and other materials to be used against men, who administer remedies that undermine the social order, and who occasionally turn to witchcraft and black magic to further their evil designs, were invented to stand in opposition to the authorized physician who selflessly treated the true signs of illness, who

benevolently prescribed the medicines that strengthened the temperament, and who combined the care of the body with the preservation of the soul. These fictions forcefully warned of the dangers that arise when women obtain the power to disease.

WOMEN AND THE POWER TO DISEASE 101 Women and the power to disease

Works like the Spill probably reflect the anxiety of many learned physicians during the late fifteenth century over the practice of medicine by women, Jews, Moors, and empirics, as well as by the uneducated and the inexperienced. It was not loss of revenue that university-educated prac-

titioners feared, as might be expected. At the beginning of the fourteenth century there were only nineteen physicians and eight surgeons available for the thirty thousand citizens of Valencia. According to Garcia-Ballester, this ratio (roughly six physicians for every ten thousand citizens) was one of the highest in the Iberian Peninsula (Histona social 145).19 Rather, the deep-seated fear over biomedical intervention by subaltern healers was that both the innocent and the nefarious would

acquire the power to disease. I use the verb “to disease” here in two ways. First, in its most literal sense of making someone sick, or infecting someone with, inflicting someone with, or disposing someone to an illness. The concern of medical professionals, a concern that fully moti-

vates today’s rigorous control over drugs and medical technology, derives from the fear that the ignorant and misinformed can do more harm than good by misapplying or misusing pharmaceutical and medical instruments. By misadministering a drug or incorrectly prescribing a therapeutic strategy, one can actually harm another human being. The second meaning of “to disease” relies on the distinction established at the beginning of this study between disease and illness. In this sense to disease a patient is to impose a pathologically significant meaning on his or her biological being, conferring on that person all the privileges and limitations of this socially defined status. Socially speaking, the power to disease can be an instrument of both oppression and liberation. Feminists, for example, have argued convincingly that the medical profession, through its power to pathologize, has historically attempted to control women’s desires by casting their discontents into pathological molds. But this power, since it functions in direct correlation to the rights and privileges that society grants the sick and the afflicted, can be a source of liberation, freeing the individual from diffi-

cult yet “normal” situations; exemption from military service, release from work, monetary compensation, and deferral of debt are only a few of the privileges conceded to those who have been officially diagnosed as

suffering from a biological disorder. It is for this reason that today the power to disease is closely guarded by authorized healers.2°

162 TRIUMPH OF THE CLINIC Individuals who diagnose their own ailments and prescribe their own therapy are often deemed to be suspect. It is not enough for a worker to tell her employer that she is suffering from muscle pains and to spend a

few weeks recuperating at a health spa. It is not enough for an airline passenger to say that he was too sick to fly and therefore must be reimbursed for his “nonrefundable” ticket. These ailments, real or feigned, require the legitimizing confirmation of an authorized physician if the patient is to be fully liberated from his or her normal responsibilities. The same is true of the diagnoses and therapies of subaltern healers. This reliance on the word of the orthodox physician over the impressions of the patient and the claims of the subaltern healer clearly points to the successful struggle of Western medicine during the past five hundred years to limit the practice of medicine to a select group of healers.

The origin of this opposition between authorized physicians and unorthodox practitioners lies in institutional conventions and discursive practices that arose in the later Middle Ages as an attempt to control the power to disease.

Prior to the fourteenth century in Spain, the physician’s ability to classify biological phenomena as disease was closely related to his acquisition and control of learned discourse. But the open circulation

in the fourteenth and fifteenth centuries of popular medical handbooks — works like Bernard of Gordon’s Lilio, Juan de Avinon’s Sevillana

medicina, Alfonso Chirino’s Menor dano de la medicina, Johannes de Ketham’s Compendio de la humana salud, and anonymous works such as

the Tratado de la phisonomia and the Tratado de la generacion de la criatura — had the effect of empowering the non-specialists, allowing the

empirics, as well as the sick themselves, to keep important concepts about the body and its disorders at hand, where they could be retrieved and used in the appropriate hygienic or therapeutic moment. Lacking reliable institutional restraints to limit and control the dissemination of medical theory, learned healers became increasingly anxious over the falling of this power to disease into the hands of women and other subalterns. In the Spill, we find the story of a woman who makes a poisonous

drink that she calls a medicine and serves to her husband: “Beveu Senyor, / dix, ’[h]ipocras” (1548-9) [I say drink, my lord, this medicine]. After he dies she offers a perfectly acceptable clinical explanation

for her husband’s death: “D’un gras porcell / e vi novell / [h]a molt traguat, / es s ofeguat de poplexia” (1573-7) [From having swallowed much fatty pork and new wine, he suffocated from apoplexy]. According

WOMEN AND THE POWER TO DISEASE 1623 to Bernard of Gordon, apoplexy (stroke) was thought to be caused by the excessive consumption of food and drink, and by a life of idleness and leisure (Lilio 119). In effect, the woman’s ability to disease offers her a double liberation: first, she is able to free herself from her husband by persuading him to drink a poison; second, she frees herself from the legal implications of her misdeed by convincing friends, family,

and judicial authorities that her husband’s death was caused by a medically recognized corporeal disorder. In his introduction to the Spill, Roig presents the idea that women manipulate the signs and symptoms of disease to camouflage their true objectives:

[C]riden que’s moren / quant son pus sanes, / si han tercanes / llur mal no

colen; / e fingir solen / tenir dolor, / per dar color / a ses empreses. (448-55) [They complain that they are dying when they are very healthy. If they suffer from the tertian fever, they don’t treat their illness; they usually feign pains to disguise their schemes. |

Accounts of women feigning ailments and complaining of maladies for their own sexual gain were common during the later Middle Ages and early Renaissance. Miguel Pere, in his biography (1510) of St. Vicent Ferrer, relates the story of a woman who, being enamored of the saint, repeatedly called him to her bedside, “fengint tenir mal de costat tan

gran que la sua vida perillava” (Cerver6 135) [feigning a pain in her side so great it put her life in peril]. Roig’s third wife tells a similar anecdote of a nun who, feigning visible signs of illness, beckoned her confessor to her room:

Lo pro[ho]m segut / lo cap se cobre / ella’s descobre / dient molt sua; / mostrant-se nua, / diu que’s descobra / he faran obra / ... “No vull del mon / sino sols vos; / puys som abdos, / [h]agam plaer / ab bon voler / he fina’ mor.” (5744-57)

[Seated, the good man covered his head. She took off her clothes, complaining that she was sweating; presenting herself naked to him, she told him to get undressed and get to work ... “I don’t want anyone in the world but you; here we are together, let’s take pleasure with good will and jin amour. |

Likewise, Roig’s wife tells how the nuns in her convent feigned illness to

bring a young doctor to their bedside (5805-8). One nun frequently complained to the young doctor, saying, “Tinch gran vent / en lo ven-

104 TRIUMPH OF THE CLINIC trell” (5837-8) [I have excessive gas in my stomach]. On another occa-

sion we are told that this same nun began troubling the doctor with concerns about her breasts and nipples and other questions. The doctor,

understanding the true nature of the questions, turned to leave the room. The nun, imploring him not to go so quickly, ran to embrace him as he headed toward the stairs; entangled in her embrace, the doctor tripped and rolled down the stairs with her; the fall caused a severe laceration on her cheek and, according to the narrator, left her “vera malalta” (5882) [truly ill]. Roig’s wives are women who have learned to assume the signs of biological disorder to liberate themselves from work and to enjoy the privileges of illness. His first wife, for example, always feigns sickness during the week so she can stay in bed and avoid her work (2503-8). His second wife learns how to simulate pregnancy, going through all the motions of the condition and changing her body to imitate the symptoms; she pads

her breasts with cotton, colors her nipples with henna, and pretends cravings for pastries and meats. Interestingly, the signs that she cannot feign physically, she fabricates verbally, articulating the complaints of a pregnant woman: “Sent-me llassa / hun mes me passa, / ja ma camisa / de bona guisa / he prou purgui / deu draps n’ [h]agui; / com so dolenta

/ trop-me calenta, / si no vomite / tantost m’enfite” (4733-42) [A month has passed, I am worn out, my shirt is already a good size, I just purged myself and it took ten rags; I ache all over and suffer from heat flashes; if I don’t vomit, I suffer indigestion]. Martinez also offers an example of a woman who feigned biological disorder to liberate herself from difficult situations. In the “escaping lover” tale — of which Martinez tells us that there are thousands — typically an adulterous wife engineers a distraction to help her lover flee unnoticed from the house or bedroom when the husband returns home unexpectedly. In one of Martinez’s versions the wife tells her husband that she does not feel well. When he sits on a bench near the bed and

orders her to bring him something to eat, the wife moves toward the lover, who is hiding behind a curtain, and secretly explains to him that when she shows her husband her breast, he should flee from the house. The wife then complains to the husband, “Marido, non sabes cémo se ha fichado mi teta, e ravio con la mucha leche” (188) [Husband, you’ve

no idea how my breast is swollen. I’m in pain with so much milk]. Concerned over his wife’s affliction the husband commands the wife to show it to him. Martinez then explains:

WOMEN AND THE POWER TO DISEASE 165 Saco la teta e diole un rayo de leche por los ojos que lo cegoé del todo, e en

tanto el otro salio. E dixo: “jO fija de puta, como me escuece la leche!” Respondio el otro que se iva: “sQué deve fazer el cuerno?” (146-7) [She took out her breast and shot a stream of milk into his eyes, completely blinding him, while the other escaped. And the husband said: “You daughter of a whore, how your milk burns!” And the other who was making his escape said: “What can the poor cuckold do about it?” |

A double diseasing takes place in the anecdote. First the wife feigns the malady of excessive breast milk. We should bear in mind that this was a

pathological condition recognized by medical theorists. Bernard of Gordon, for example, in book 4, chapter 13 of the Lilio, “De las passiones de la teta” [Of the Diseases of the Breast], explains that an abundance of breast milk results if a woman has not recently conceived or

given birth, from the retention of menses or from a growing tumor (208). He explains, “Pues agora como pujar la leche en las tetas trae dolor e finchazon e dureza e congesti6n e quaseacio6n” [And now as the milk pushes into the breasts, it causes pain, swelling, hardness, congestion, and coagulation]. A second diseasing occurs in the story when the wife squirts milk into her husband’s eyes, at least temporarily blinding

him. Thus both physically, through her body fluids, and verbally, through her description of her biomedical disorder, she employs the art of diseasing to escape from what would surely have been a tragic situa-

tion for herself and her lover. } For men such as Martinez and Roig, these narratives of feigned disease Or misappropriated medical discourse illustrated more than just the particular travesties of deceiving women. They formed part of a larger body of anecdotes and counterexamples designed not only to show men the dangers of allowing women to acquire medical knowledge and employ medicinal materials, but also to convince men that

women, operating in what seemed to be a medical context, were in reality directly opposed to the goals of the clinical healer. Celestina’s counter-clinic

The clinical anxiety expressed in the Arcipreste and the Spill reappears in

other late fifteenth-century works, notably in Fernando de Rojas’s acclaimed novel-in-dialogue, Celestina. Rojas’s work, which describes the

disastrous results of unabated amorous pursuits, can be read as a case

166 TRIUMPH OF THE CLINIC study of Martinez’s and Roig’s worst clinical nightmare: destruction, chaos, disorder, and death wrought by pathological sexual desire that is improperly and incompetently treated. Moreover, Celestina is a work pro-

foundly concerned with the nature of disease, and like the Spull, it is a work that attempts to reaffirm the relation between healing and clinical authority.

In the opening section we encounter an ailing and love-stricken Calisto, who, having been rejected by Melibea, moans, cries, and seeks the solitude of his darkened room (Rojas, Celestina 2:22). The youth’s symptoms, including his evident obsession with Melibea, clearly indi-

cate that he is suffering from the disease of heroic love.?! Calisto’s behavior forces his servant Sempronio to undertake the difficult task of doctoring his master’s ailment. Confused by Calisto’s actions and concerned with his own well-being, Sempronio reluctantly ponders his role as physician and contemplates the possible therapeutic directives.22 He reasons that it may be better to leave his master alone: “oido é dezir que es peligro abrir o apremiar las postemas duras, porque mas se enconan.

Est€é un poco; dexemos llorar al que dolor tiene, que las lagrimas y sospiros mucho desenconan el coragé6n dolorido” (2:20-1) [I have

: heard that it’s dangerous to open or press hard boils while they are green, for they only get more inflamed. I'll leave him alone for a bit. Let him weep who’s in pain, for tears and sighs greatly relieve the troubled heart].23 But he also recognizes that “por otra parte, dizen los sabios que es grande descanso a los afligidos tener con quien puedan sus cuitas llorar, y que la llaga interimor mas empece” (2:21) [On the other hand, wise men Say it’s a great comfort to the afflicted to have someone to share their troubles, and that a hidden wound is more dangerous|. Sempronio, who is admittedly bewildered and who lacks any formal medical training, opts to treat Calisto actively: “Porque si possible es sanar sin arte ni aparejo, mas ligero es guarecer por arte y por cura” (2:21) [Although it is possible to cure without method or apparatus, it is quicker to heal with them]. He promises Calisto that he will cure him: “bien sé de qué pie coxqueas. Yo te sanaré” (2:22) [I know what’s ailing you. I'll cure you].

We can assume that in order to make such a promise, Sempronio must have some kind of diagnostic and therapy in mind. Judiciously, Sempronio states that healing begins by recognizing the patient’s disorder: “el comienco de la salud es conocer ombre la dolencia del enfermo” (2:23) [The beginning of a cure is to recognize the afflicted’s disease |.*4 He then accurately identifies Calisto’s illness as a captured

WOMEN AND THE POWER TO DISEASE 167 will, snared by his love of Melibea (2:23). Quite competently, Sempronio

proceeds to employ the standard discursive treatment for heroic love, warning Calisto of the dangers and inconveniences of women. He begins by suggesting that it is wrong for men to surrender masculine dignity to the imperfection of women, and offers Calisto a lengthy diatribe against women: Lee los istoriales, estudia los fil6sofos, mira los poetas. Llenos estan los libros de sus viles y malos enxemplos y de las caidas que levaron los que en algo,

como tu, las reputaron. Oye a Salomon do dize que las mugeres y el vino hazen a los ombres renegar. Conséjate con Séneca y veras en que las tiene. Escucha al Aristoteles, mira a Bernardo. Gentiles, judios, cristianos y moros, todos en esta concordia estan... . ¢quién te contaria sus mentiras, sus trafagos, sus cambios, su liviandad, sus lagrimillas, sus alteraciones, sus osadias, sus dissimulaciones, su mala lengua, su engano, su olvido, su desamor, su ingratitud, su incostancia, su testimoniar, su negar, su rebolver, su presuncidn, su vanagloria, su abatimiento, su locura, su desdén, su sobervia, su sugecion, su parleria, su golosina, su luxuria, su suziedad. . . . (2:25-6)

[Read your histories; study your philosophers; read your poets. Their books are full of stories of wicked women who destroyed men, men who like yourself held them in high esteem. Listen to Solomon where he says that women and wine make men deny God. Take counsel with Seneca and you'll see what

he thinks of them. Consult Aristotle, look at St. Bernard. Gentiles, Jews, Christians, and Moors all agree with this. ... Who could tell you their lies, their tricks, their changes, their fickleness, their sniveling, their bad temper, their impudence, their deceits, their gossiping, their disaffection, their neglect, their ingratitude, their inconstancy, their false witness, their denial, their disarray, their presumption, their boastfulness, their false humility, their folly, their scorn, their pride, their servility, their loquacity, their gluttony, their lust, their filth... .]

Although properly orchestrated according to the principles of medieval

medical theory, Sempronio’s attempt to treat Calisto’s ailment is doomed to fail because Sempronio lacks the proper authority to diagnose disease, organize a therapeutic strategy, and administer a cure. He is not even qualified to carry out the verbal therapy of berating the beloved, because, according to most medical theorists, the interlocutor must be a learned and wise man of great authority (Bernard of Gordon, Lilio, 108). Sempronio has no real authority over Calisto. Consequently, Calisto does not respond to Sempronio’s therapy and even contests his diagnosis.

168 TRIUMPH OF THE CLINIC Calisto’s resistance to Sempronio’s treatment begins after Sempronio identifies the root of his master’s illness as his love for Melibea. Calisto asks, “iQué te parece de mi mal?” [What do you think of this sickness of

mine?]. Sempronio responds, “Que amas a Melibea” [You’re in love with Melibea]. Calisto then challenges Sempronio’s diagnosis by asking

“iY no otra cosa?” (2:23) [And nothing else?] From this point on Sempronio’s new role as Calisto’s physician will become increasingly tenuous: by challenging Sempronio’s diagnosis, Calisto likewise chal-

lenges his servant’s medical authority. With his allusion to the ambiguous “otra cosa,” Calisto begins to invert the physician—patient configuration in an effort to treat his own disease. Point by point Calisto attempts to offset Sempronio’s arguments. In response to Sempronio’s list of female vices, he counters with the individual virtues of Melibea: Miras la nobleza y antiguedad de su linaje, el grandissimo patrimonio, el ecelentissimo ingenio, las resplandecientes virtudes, la altitud y inefable gracia,

la soberana hermosura. ... (2:27-8) [Consider the nobility and antiquity of her lineage, her great patrimony, her excellent wit, her shining virtue, her high and ineffable grace, her sovereign beauty. .. .]

As the debate continues these virtues become decidedly more physical: Comienco por los cabellos. :Vees tu las madexas del oro delgado que hilan en Arabia? Mas lindos son y no resplandecen menos. Su longura hasta el postrero assiento de sus pies; después crinados y atados con la delgada cuerda, como ella se los pone, no a4 mas menester para convertir los ombres en piedras. . . . Los ojos verdes, rasgados; las pestanas luengas; las cejas delgadas y alcadas; la nariz, mediana; la boca, pequena; los dientes, menudos y blancos; los labrios, colorados y grossezuelos; el torno de rostro, poco mas luengo que redondo; el pecho, alto; la redondeza y forma de las pequenas tetas, equién te la podria figurar? (2:28-9)

[Pll begin with the hairs of her head. Have you ever by chance seen the skeins of golden threads they spin in Araby? Hers are more beautiful and shine no less. They reach to the very soles of her feet. And then, when they’re

curled and tied with a fine ribbon, as she wears them, nothing is lacking to turn men into stones. ... Her eyes, green and wide; her lashes, long; her brows, dainty and high; her nose, neither too large nor too small; her mouth, little; her teeth, small and white; her lips, red and plump; her face, somewhat

WOMEN AND THE POWER TO DISEASE 169 longer than it is round; her bosom, high; her small breasts, so full and firm, who can describe them! |

Implied in Sempronio’s therapy is that Calisto will be distracted sufficiently to lose interest in Melibea. Calisto, however, has no desire to forget Melibea; on the contrary he associates the end of his suffering with that moment when he acquires Melibea’s love. As the debate continues, this fact becomes increasingly obvious to Sempronio, who once again reconsiders the relation between Calisto’s malady and his own well-being — the dominating motive behind helping Calisto in the first place. Eventually Sempronio gives in: “Y por que no te desesperes, yo quiero tomar esta empresa de complir tu desseo” (2:30) [However, to keep you from despair, I want to undertake this scheme to satiate your desire |.

Recognizing that his master is in no imminent danger of death, Sempronio inaugurates an alternative form of therapy that consists of sexually uniting Calisto and Melibea: “traérgela é€ hasta la cama” (2:30)

[Pll bring her to his bed]. Sempronio knows that this new treatment will not only fulfill his master’s desire, but may also prove to be financially beneficial for himself as well. He tells Calisto that he knows of an old woman, “una vieja barbuda que se dize Celestina; hechizera, astuta, sagaz en cuantas maldades ay. ... A las duras penas promovera y provocara a luxuria, si quiere” (2:30) [a bewhiskered old beldame who calls herself Celestina, a witch, astute and wise in all evil things. ... She can move the very stones to lechery if she sets her mind to it]. Calisto, who

has heretofore rejected Sempronio’s therapeutic suggestion that he forget Melibea, now, without a moment’s hesitation, demands to speak with Celestina. We have seen how Sempronio’s advice is not completely detached from the medical context of curing men from sex-related ailments. Old women such as Celestina were recommended in medieval medical treatises to help men find a willing female companion with whom they could

copulate and thus alleviate the discomfort of superfluity (Mirror of Coitus, chap. 8). Theorists such as Avicenna, Bernard of Gordon, and Lopez de Villalobos recommended that in the treatment of heroic love, old women dressed in tattered clothing should displace the pleasurable

image of the beloved with an abject description. Thus women like Celestina were used in both therapeutic traditions: to facilitate coitus for humoral superfluity and to discourage men from having contact

1770 TRIUMPH OF THE CLINIC with the beloved for heroic love. Sempronio, however, allows his therapy to slip from the latter diagnostic assumption to the former. Calisto, who

is Clearly suffering from heroic love, will be treated in the tradition of humoral superfluity. Sempronio’s attempt to engage the skills of Celestina meets with opposition. Parmeno, Calisto’s other servant, resists this form of therapy at first, questioning Celestina’s moral and ethical integrity, accusing her

of witchcraft, and denouncing her as a prostitute and a procuress. Curiously, his most lengthy argument against Celestina concerns the nature of her enormous laboratory. Parmeno lists more than one hundred different types of herbs, roots, ointments, concoctions, and animal parts (2:36-8). When we modern readers hear of ointments made from snake, whale, and wildcat fat, of the warehousing of teeth and other body parts, or of

the variety of concoctions compounded using quail heads and mule brains, our thoughts immediately turn to the workings of subaltern healers such as chiropractors, midwives, shamans, herbalists, folk healers, charlatans, and medicine men who practice their arts outside of the orthodox medical profession. Interestingly, the majority of ingredients listed by Parmeno were legitimate pharmaceutical materials that were frequently prescribed, individually or in compounded forms, by

medical theorists. In fact, when we compare Parmeno’s list with the inventories of medieval pharmacies, we find that the substances in Celestina’s laboratory form one of the richest depositories of materia medicae in the literature of the later Middle Ages. Ingredients such as agraz, agua rosada, alfocigos, almizcle, altramuces, ambar, azahar, azafran, canfora, centeno, ciervo, conejo, culantrillo, culebra, erizo, espliego, flor de sauco,

gamo, hieles, jazmin, laurel blanco, limones, and manzanilla — to mention but a few — all have documented medical uses and appear repeatedly in pharmaceutical treatises.2°

In addition to her enormous collection of medical materials, Celestina possesses a skill that makes her eminently qualified to practice medicine. Not only does she have at hand and under her control a host

of pharmaceuticals, she is also capable of manipulating an arsenal of discursive fragments. One of Celestina’s acknowledged assets is her skill in appropriating erudite as well as popular speech. Whereas in her lab-

oratory she stockpiles some of the most potent herbs and fragrances known to medieval medicine, in her memory she stores the most effective words in Western medical discourse. For example, to overcome Parmeno’s opposition to Sempronio’s strategy of bringing Calisto and

WOMEN AND THE POWER TO DISEASE 171 Melibea together in bed, Celestina takes from her repertoire a medical , rationale for joining men and women sexually: [D]os conclusiones son verdaderas: la primera, que es forgoso el ombre amar a la muger y la muger al ombre; la segunda, que el que verdaderamente ama es necessario que se turbe con la dulcura del soberano deleite, que por el hazedor de las cosas fue puesto, por que el linage de los ombres se perpetuasse, sin lo cual pereceria. (2:43)

[Iwo propositions are true: first, it is necessary that man love woman, and woman, man; second, that he who truly loves is necessarily troubled by the sweetness of that sovereign delight that was ordained by the Maker of all things in order to perpetuate mankind, and without which mankind would perish from the earth. ]

Her justification is a close paraphrasing of one of the standard medical arguments in favor of moderate sexual intercourse established, elabo-

rated, and widely disseminated throughout the Middle Ages. Constantine the African, for example, begins his treatise De coitu by explaining:

Creator volens animalium genus firmiter ac stabiliter permanere et non perire, por coitum illud ac per generacionem disposuir renovari, ut renovatum interitum ex toto non haberet. Ideoque complasmavit animalibus naturalia membra que ad hoc opus apta forent et propria, eisque tam irabilem vitutem et amabilem delectationem inservit ut nullum sit animalium quod no pernimium delectetur coitu. (77)

[The Creator desiring that the animal kingdom persist in a stable and sure form, and so not perish, He established its renovation by means of coitus and

reproduction, so that through this renovation, the human race would not suffer complete destruction. For this reason He incorporated into the nature of animals the necessary and appropriate members for this function, and He infused in them such a disposition and such an agreeable pleasure that there is not an animal alive who does not delight exceedingly in coitus. |

Despite her subaltern status, Celestina manipulates the same discourse that educated practitioners do. But as the readers of Celestina learn, neither these words from the lips of Celestina nor the drugs from her laboratory ever produces a clinically approved cure for Calisto’s ailment. Rather, they lead him to his downfall and his ultimate death. What

is clearly suggested in Celestina is that unauthorized practitioners,

172 TRIUMPH OF THE CLINIC despite their ability to speak like physicians and administer drugs like an apothecary, are so intrinsically flawed that their therapy can only

result in pain and destruction. According to Rojas, once subaltern healers such as Celestina possess the “power to disease,” these practitioners will use this power to mislead the male patient for their own profit rather than cure his disease. Rojas’s Celestina, like Roig’s Spill and Martinez’s Arcipreste, forcefully discouraged men from using the services of women healers.

For modern critics, the misogynist rhetoric of the late fifteenth century is laden with so much hyperbole that it is difficult to read works such as the Arcipreste and the Spillas anything more than distant and now harmless parodies from a bygone age. Indeed, one could make the argument that Martinez and Roig become as excessive as the very womanly excess they denounce. A similar observation has been made by Howard Bloch, who contends that the medieval misogynist author seeks to do to his reader “precisely that of which he accuses women: to deceive with words,

to provoke contradiction, and to seduce with what is defined as the essence of the feminine: the ruses of rhetoric” (“Medieval Misogyny” 19). Reading the works of Walter Map, Andreas Capellanus, and Jehan le Févre, Bloch suggests that “[i]f a woman is defined as verbal transgression, indiscretion, and contradiction, then Walter Map, indeed any writer, can only be defined as a woman, and the discourse of misogyny then becomes a plaint against the self or against writing itself” (19). For Bloch a reader has no choice but to mistrust the writer of the text and to acknowledge that the danger of women is that of literature itself. Although Bloch’s point is well taken, his analysis focuses solely on the claim of writing to inform the reader rather than on its ability to reform

him. From a therapeutic standpoint, to say that the Spill and the Arcipreste undermine themselves because they replicate the very object that they denounce is like saying that the vaccine for polio is less effective because it contains the same virus that the vaccine is intended to combat. If the Arcipreste and the Spill have relevance for the contemporary reader beyond their literary value, it is in observing the way these works helped to foster deep-seated suspicions about a woman’s ability to function as healer. Beneath the outrageous anecdotes and patently ridiculous descriptions of women who pester, trick, mutilate, and even kill their husbands and lovers lies a formidable argument against accepting women into the ranks of orthodox medical practice. Medical historians

WOMEN AND THE POWER TO DISEASE 173 have noted that from the fifteenth century on there was an increasing marginalization of women in the authorized system of health care. This is notably true in the area of obstetrics and gynecology, which for many centuries had been controlled almost exclusively by women.?6 Today the

tensions between midwives and licensed obstetricians and the complaints about gender indifference and sexual harassment within the domain of orthodox medical education acknowledge the persistence of Martinez’s and Roig’s belief that it is risky business to allow the materials of medicine and the authority to diagnose disease to fall into the hands of women.

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Notes

Introduction: The preacher and the physician

1. An overview of this criticism appears in Gerli, Alfonso Martinez (35-8). 2. “Hiha homens que naixen predestinats per a conquistar el cim de la gloria.

Tal es el cas de l’escritor que nos ocupa en esta obra, Jacme Roig, que destaca ab llum propia entre els astres del cel valencia” (Alminana Vallés, 810). 3. Roig was named examiner in 1436, 1439, 1440, 1450, 1460, 1466, 1468, 1474, 1477, and 1478 (Alminana Vallés, 860-1). For a discussion on medical licensing in Valencia during the later Middle Ages, see Garcia-Ballester, McVaugh, and Rubio Vela’s Medical Licensing and Learning in FourteenthCentury Valencia, and Chapter 6 of this work.

4. On Roig’s affiliation with these hospitals, as well as transcriptions of pertinent documentation, see Alminana Vallés (go6—13). A brief history of these institutions appears in Rubio Vela, Pobreza, enfermedad y asistencia hospitalana en la Valencia del siglo XIV.

5. Alminana Vallés includes a transcription of this inventory, which appears in the “Manuals de consells” (A-41, fol. 95, housed in the Archiu Municipal de Valencia), along with the collection of documents in vol. 3 of his edition and study of the Spill (doc. 99, 1119-22). 6. All citations from the Spill are taken from Alminana Vallés’s 1990 edition, giving line rather than page numbers.

7. There is currently no translation of the Spill available in English. I have paraphrased the text in English to help the reader unfamiliar with medieval Valencian. Since the Spill, with its extensive vocabulary and peculiar meter,

is a highly nuanced work, readers should keep in mind the provisional nature of my translations. When possible they should compare the English with the original. The Castilian translation by Miquel y Planas (reedited by Jaume Vidal in 1987) and the modernized Catalan prose version by Jordi Tinena may also prove useful. 8. My translations of the Regiment de preservacié are based loosely on Duran-

Reynals and Winslow’s 1949 translation. I would like to thank Donna Rogers for her assistance with difficult passages. g. Biographical studies of Martinez include: Verardo Garcia Rey’s brief biography “El Arcipreste de Talavera”; there is some biographical information in Cristobal Pérez Pastor’s introduction to his edition of the Arcipreste de Talavera (xx—xxi); and a short biography in Michael Gerli’s monograph,

175

176 NOTES TO PP. 7—9 Alfonso Martinez de Toledo (chap. 1: “Life and Times of Alfonso Martinez de

Toledo,” 13-25). 10. Gerli, Alfonso Martinez de Toledo (23); on the medical dispute, see Pérez Pastor (XxXiv).

11. All citations of the Arcipreste de Talavera are taken from Michael Gerli’s edition (Catedra, 1981). 12. Translations of the Arcipreste are largely taken from Lesley Byrd Simpson's

1955 English translation, but I have altered his wording where it seemed necessary. Eric Naylor and Jerry Rank are currently preparing the first complete translation of the Arcipreste. 13. Ramon Miquel y Planas introduced his Spanish translation of the Spill with a detailed examination of the thematic and biographical similarities between the works and lives of Jacme Roig and Alfonso Martinez (xii-lxviil). 14. Traditional assumptions hold that disease entities are natural objects rather than social (linguistic) constructs. For studies that argue otherwise, see H.

Tristram Engelhardt, Jr., “The Disease of Masturbation: Values and the Concept of Disease”; Ilza Veith, “Historical Reflections on the Changing Concepts of Disease”; and L. Fleck’s study of syphilis, Genesis and Development of a Scientific Fact.

Chapter 1: Disease, discourse, and illness

1. For an overview of recent attempts to define disease see Merskey’s “Variable Meaning for the Definition of Disease” (216-19).

2. On the difficulty in defining a transhistorical concept of disease, see Temkin, “Health and Disease,” and the accompanying bibliography; also Veith, “Historical Reflections on the Changing Concepts of Disease.” 3. See Eisenberg, “Disease and Illness”; Young, “The Anthropologies of Illness and Sickness” (264); Kleinman and Sung, “Why Do Indigenous Practitioners

Successfully Heal?” (8); Kleinman, The Illness Narratives (3-8); and Engelhardt, “Ideology and Etiology” (257).

4. See, for example, Michéle Barret and Helen Roberts, “Doctors and Their Patients”; Sue Fisher, Jn the Patient’s Best Interest; and Elaine Showalter, The Female Malady.

5. Fora truly frightening example of the way medical authorities mapped the physiology, behavior, and pathology of African-Americans in a way that reinforced the ideological underpinnings of slavery, see Dr. Samuel Cartwright’s 1851 “Report on the Disease and Physical Peculiarities of the Negro Race.” 6. Masturbation was associated with a number of ailments including dyspepsia,

constrictions of the urethra, epilepsy, blindness, vertigo, loss of hearing, headaches, weakness, impotence, loss of memory, rickets, and leucorrhea. See Engelhardt, “The Disease of Masturbation”; and Hare, “Masturbatory Insanity: The History of an Idea.”

7. See Waitzkin, “A Critical Theory of Medical Discourse; Conrad and Schneider, Deviance and Medicalization; Zola, “Medicine as an Institution of Social Control”; and Comaroff, “Medicine: Symbol and Ideology,” “Healing and Cultural Transformation,” and “Healing and the Cultural Order.”

NOTES TO PP. 20-3 177 8. For further discussion on clinical baptism (baptismus clinicorum) see cliniques in the Dictionnaire d’archéologie crétienne et de liturgie (cols. 1942-4).

9g. This attitude was expressed much earlier by the Hebrew physician Isaac Jubaeus (880-932) in his Guide for Physicians: “Since the science of medicine is very extensive and the life of man is too short to compass it all, experienced physicians are tested and tried and cleansed from fools, in that the

former are always occupied in studying literature and meditating upon it day and night. For this purpose the physician isolates himself from other men whenever his services are not needed. . . . The best physician is he who busies himself in reading attentively most of the writings of the ancient physicians, especially the works of Galen, the prince of physicians, whose presentation is most extensive and who concerned himself most ardently with the treatment of disease. And they are wrong who say ‘Go not to the physician but to the practitioner.’ For the fool does not know what he is doing and will kill a thousand before he will cure one. And if he says, ‘Rely on me because I have experience,’ do not listen to him, because life is too short to test out even one disease or the nature of one plant. Therefore we should busy ourselves with that which the ancient physicians found out in the thousands of years which have elapsed; in the great kindness of their hearts and in compassion for us they have written and preserved for us all that they discovered” (182-3). 10. This is not to say that there were no empirical aspects to medical clinical medicine. See Shaw, “Scientific Empiricism in the Middle Ages: Albertus Magnus on Sexual Anatomy and Physiology.” 11. Massengill, A Sketch of Medicine and Pharmacy and a View of Its Progress by the Massengill Family from the Fifteenth to the Twentieth Century (55). 12. See Temkin, Hippocrates in a World of Pagans and Chnistians; and Amundsen

and Ferngren, “Medicine and Religion: Early Christianity Through the Middle Ages.” 13. Hippocrates (4:423); also cited by Temkin, Hippocrates in a World of Pagans and Christians (84).

14. For a discussion on the origin and use of these terms, see Temkin, The Double Face of Janus (187-8).

15. Alfonso Chirino reiterated this idea in the fifteenth century: “E digo, que él que non es buen omne puede ser fisico, mas non buen fisico; e sera buen fisico seyendo primero buen omne virtuoso” (Espejo 425) [And I say that he who is not a good man can be a physician, but not a good physician; he will be a good physician, being first a good, virtuous man. |

16. On Peter of Spain see Maria Helena Da Rocha Pereira’s edition and Portuguese translation of Thesaurus pauperum (Obras médicas de Pedro Hispano). Thomas of Chobham: “For many fall into insane love such that they can hardly be turned from their error. This love is moreover a disease not only of the mind but also of the body, since the marrows are swollen, the veins disordered, [and] every bodily sense weakened” (cited by Wack, Lovesickness in the Middle Ages 29).

17. Nancy Siraisi points out that of 342 medical students and masters at French universities before 1500, 214 were either regular clergy (monks, canons, or

178 NOTES TO PP. 24—9 friars) or secular clergy (nonmonastic) (Medieval and Early Renaissance Medicine 25).

18. For a discussion on speculation concerning Martinez’s academic affiliation with Salamanca, Toledo, or perhaps a foreign university, see Gerli, Alfonso Martinez (18).

19. The Jsagoge of Johannitius (Hunain ibn Ishaq) provided a concise introduction to Galenic medicine that was widely used as a standard text even after European physicians had access to the Greco-Arabic medical corpus. It was translated into Latin during the first half of the twelfth century by Marcos de Toledo. See the introduction to Gracia and Vidal’s edition and Spanish translation; an English translation of the /sagoge appears in Edward Grant’s A Source Book of Medieval Science (705-15). AS a concise systematiza-

tion of Galenic medicine, it served as a basic outline of medieval medical theory. It was, for example, the basis of Arnald de Villanova’s most extensive work, the Speculum (Garcia-Ballester, Historia social 3,4).

20. For a history of medicine in the Crown of Aragon during the late Middle Ages, see Garcia-Ballester, La medicina a la Valencia medieval; Antoni Cardoner i Planas, Historia de la medicina a la corona d’Arago (1162-1479); and Michael McVaugh, Medicine before the Plague.

21. See Siraisi, Medieval and Early Renaissance Medicine (25); and Humphreys, “The Medical Books of the Medieval Friars.” 22. Lain Entralgo notes that many of the epithets of the Greek gods — akesios, epikouros, alexikakos — allude to their physician-like character. Likewise, the Romans often made reference to the Apollo medicus, which, according to

Lain Entralgo, encouraged Clement of Alexander to call Christ the “paeonic Physician,” Paiéon being the god who on Olympus cured Hades and Ares (Therapy of the Word 56).

23. Centuries later, the French surgeon Henri de Mondeville (d. 1320) explained that “God himself practiced as a surgeon when He made the first man out of clay, and from his ribs made Eve; and again when from the dust He made a plaster with which He rubbed the eyes of the blind man and so restored his sight” (Pouchelle 43). 24. Estéfano, the author of the late fourteenth-century Visita y consejo de medicos,

likens the archbishop Pedro Gomez Barroso to the “verdadero médico” (fol. 1v).

25. “La ssalut corporal non puede sin la spiritual sser bien avida” (4or).

26. For more examples, see Amundsen and Ferngren’s “Medicine and Religion” (106). 27. Temkin makes this point about the Hippocratic physicians and their relations to the cult of Asclepius (Hippocrates in a World 85). 28. Translation by Schroeder, Disciplinary Decrees of the General Councils (201); also cited by Amundsen, “Medieval Canon Law” (28-9).

29. A similar expression appeared in the early Apostolic Constitutions, written in the late fourth century, which told the bishop “as a compassionate physician [to] heal all that have sinned, using of saving methods of cure; not only cutting and searing, or using corrosives, but binding up and putting in

NOTES TO PP. 30—4 179 tents, and using gentle medicines, and sprinkling comfortable words” (Apostolic Constitutions 70).

30. See Gy, “Le précepte de la confession annuelle et la nécessité de la confession.”

31. The English translation of the text is cited by Tentler (“The Summa” 104) and McNeill and Gamer (414). 32. “E prec los legidors d’aquest que, si per ventura en o romance ho en la sentencia del libre torbaven muyta cosa qui.ls sembras no raonable, que ans que ho reprenguesen, que ho corregisen ab aquel de lati, per ¢o cor moltz

vocables e [en]tenimentz ha en los libres de medicina, que a penes se poden metre en romanc¢” (100-1). 33. See Amundsen, “The Medieval Catholic Tradition” (88-9); and Amundsen and Ferngren, “Medicine and Religion” (125). 34. In 1329 King Alfons IV established provisions in the Cortes of Valencia that governed the examination and supervision of medical practitioners. The ordinance obligated physicians and surgeons to swear each year before the justiciar that they would not treat anyone seriously ill or wounded who had not first made confession. See Garcia-Ballester et al., Medical Licensing (59-01). 35. “Moralment, que quam lo metge deu prendre en cura hun hom, primo lo deu confessar; e s6n-o tenguts fer, car axi.u diu la decretal Mandamos, etc., e per ¢o pecque mortalment si fa lo contrari” [Morally, when a physician takes a man under his care, he must first get him to confess; he is required to do this by the decretal “Mandamus etc.,” and sins mortally if he does not

do so.] (Sermons I: 209; also Garcia-Ballester, La medicina 68). | 36. Literature on this point is extensive: Kiev, Magic, Faith and Healing (8); Kleinman and Sung, “Why Do Indigenous Practitioners Successfully Heal?”

(7-8); Young, “Some Implications” (13); McGuire, “Words of Power”; Berliner, “Medical Modes of Production.” 37. Kleinman and Sung, in their seminal article on indigenous practitioners in

Taiwan, argue that traditional healers satisfy many of their patients not because their methods and technologies are necessarily more efficacious than those of modern professional health care, but because traditional healers offer patients explanations for their health problems that are personally oriented and meaningfully grounded in a social and religious context (“Why Do Indigenous Practitioners Successfully Heal?”). Kleinman and Sung harshly criticize modern physicians and health professionals who provide only technical information that is neither personally nor socially

meaningful, accusing them of being blind to their responsibilities as healers. In support of his argument he points out that in Taiwan only modern doctors are sued for malpractice (at the highest rate in the world), while indigenous practitioners are virtually never sued (8). 38. Nancy G. Siraisi argues that while “physicians considered the patient’s narrative valuable, they also felt obliged to mistrust it because of the medical

ignorance they imputed to those not trained in their own learning and craft” (Medieval and Early Renaissance Medicine 124).

180 NOTES TO PP. 34-8 39. Archimatthaeus (first half of twelfth century), General Instructions for the Practitioner (in Grant 743). A treatise on bedside manners that exists in five manuscripts from the tenth to the fifteenth century instructs the physician to ask the patient “if he has any pain. If he says he has, then ask if the pain is severe and constant. ... Ask if the pain comes when he is cold... . If the ailment is acute inquire as to the beginning of the illness. . . . After this ask what former physicians said when they visited him. . .. Inquire concerning the condition of the body... having made the inquiries you will easily recognize the causes of the illness and the cure will not be difficult” (trans. MacKinney 196). For an example of the actual type of methods used in medical practice, including the discursive aspect, see Lockwood’s publication of the consilia of Ugo Benzi (Hugh of Siena) (1376-1439). A consilium

| was a type of doctor’s report in which the attending physician described the patient’s case and prescribed the appropriate therapy; an example appears in Grant (760-1). 40. See Temkin, The Falling Sickness (105). John of Gaddesden recommended that the physician utter the words, “Depart demon and go forth,” in the ear of the suspect; a patient possessed by a demon was thought to go into a coma while the epileptic would remain unaffected (106). 41. “The Symptoms of Lepers” (in Grant 755). 42. On the versions of this diagnostic procedure in Erasistratos, Galen, and Avicenna, see Mesulam and Perry, “The Diagnosis of Love-Sickness.” The procedure, attributed to Galen, also appears in Bernard of Gordon’s Lulzo (108). 43. On the penile abscess, see Bernard of Gordon (Lilio 308); on dizziness, see Alfonso Chirino (Menor dano de la medicina 136); on impotence, see Mirror of Coitus (21).

44. Lain Entralgo identifies three uses of the spoken word to achieve the cure of a patient: the “prayer” (euche), the “charm” (epode), and the “persuasive” or “cheering” speech (terpnos, thelkterios logos) (Therapy of the Word 32). 45. Vatican lat. 4/797, fol. 191r (cited in Perarnau i Espelt 48, n. 1).

46. For an explanation of the way ritual speech functions in healing, see McGuire.

47. For example, Johann Weyer in his De praestigiis daemonum (translated as Witches, Devils, and Doctors in the Renaissance) denounces those who would

misuse sacred scripture for the magical curing of diseases. Among the examples he cites is the following: “In the year 1568, when the Spaniards and the Italians were waging war in Flanders, some of them boasted that they would be preserved from plague and from all evils, and that they would be protected by the following formula and words, on the authority of the Roman Pontiff: ‘He took up the Cross for us, and while upon the Cross, Jesus thirsted, His sacred hands and feet pierced by iron nails. Jesus, Jesus, Jesus! Lord deliver us from this evil and from this plague.’ They then recited three Our Father’s and three Hail Mary’s” (373-80). 48. John of Ardern offered a similar remedy, instructing the physician to write the names of the three wise men — Caspar, Melchior, and Balthazar — with blood drawn from the little finger, after which the patient should say three

NOTES TO PP. 38—42 181 Paternosters and three Ave Marias daily. Gilbertus Anglicus advises the application of an ointment while saying “Christ has conquered” into the right ear of the patient, “Christ governs” into the left ear, and “Christ commands” into the patient’s face (Temkin, The Falling Sickness 105-13).

49. The sixteenth-century Spanish theorist Francisco Valles later summarized this position, saying that a good physician should not limit himself to the proper use of medicine and medicinal instruments, but should also take great care in everything he says in the presence of the patient: “Pues no es propio de un buen médico limitarse a usar rectamente los medicamentos y todos los instrumentos medicinales, e instituir regimen en los que concierne al comer y beber; sino también, cuidar de todo cuanto haya que decir o hacer en presencia del enfermo, y de la habitacion, casa, lecho y todas las cosas esternas; y disponer todo de manera que resulten al enfermo lo mas gratas y Utiles que sea posible” (Francisct Vallesii in libros Hippocratis de morbis popularibus, commentaria magna, Madrid, 1577; trans. Peset 5).

50. See Ell, “Concepts of Disease”; and Amundsen and Ferngren, “Medicine and Religion.” 51. On Basil the Great, see Amundsen and Ferngren, “Medicine and Religion” (99); on St. Isidore, see Zaragoza Rubira, “El concepto de la enfermedad en la obra de Isidoro.”

52. For the legends of the withered hand and the man struck blind see Sumption (78); for the envious bishop, see Temkin, The Falling Sickness (100). 53. See Peake, The Problem of Suffering in the Old Testament.

54. The New Testament is full of examples in which pathological symptoms were identified and treated as a demonic possession: a man who wandered day and night in the mountains crying out and cutting himself with stones was healed when Jesus cast the legion of unclean spirits besetting him into a herd of swine (Mark 5:2-10); a father brought his son to Christ complaining that an evil spirit “teareth him and he foameth, and gnasheth with his teeth, and pineth away,” and pleaded with Christ to heal him (Mark 9:17—-27). See the discussion by Amundsen and Ferngren in “Medicine and Religion” (97).

55. St. Isidore, for example, explains that the Devil acts on the human body “because it is beneficial that some sinners are corporeally handed over to Satan in order to save their souls, so that in the future they are afraid to sin, frightened of the future judgment by the present punishment” (Sentencias en tres libros 723; Zaragoza Rubira, “El concepto de la enfermedad” 436). Among the six causes of disease, Basil the Great of Caesarea explains that the fourth cause is at the Evil One’s instigation, as in the case of Job, whose heroic patience confounded Satan (Amundsen and Ferngren, “Medicine and Religion” 99). 56. The idea of the wily Devil who would insinuate himself into the mind under the pretense of being the will of God extends well beyond the Middle Ages. See Porter, A Social History of Madness (83); Neaman, Suggestion of the Devil: The Origin of Madness; and Walker, Unclean Spirits: Possession and Exorcism in France and England in the late Sixteenth and Early Seventeenth Centuries.

182 NOTES TO PP. 43—50 57. For a complete discussion on Galen’s understanding of the complexion, see Siegel (196-357). For a historical overview of Greek physiological thought, see Lain Entralgo, El cuerpo humano (63-208). 58. On the origin of the idea of the non-naturals see Rather, “The ‘Six Things Non-Natural’”; Bylebyl, “Galen on the Non-Natural Causes of Variation in the Pulse”; Jarcho, “Galen’s Six Non-Naturals:”; Niebyl, “The Non-Naturals.”

59. Medical historians have identified more than 150 treatises on astrological medicine (Helen Rodnite Lemay, “Sexuality” 188-9). By the thirteenth century astrological works held a solid place in the curricula of medieval medical faculties. For further discussion, see Richard Lemay, “The Teaching of Astronomy in the Universities of the 14—15 Century, Principally in Paris.”

60. Conflict, for example, could have occurred if the physician recommended coital therapy for treating disorders such as headaches, depression, and loss of appetite (Mirror of Coitus 13). Bernard of Gordon sidestepped the problem by insisting that therapeutic intercourse, when necessary, should only be carried out between husband and wife. Also see Elsasser, “Ausfall des Coitus als Krankheitsursache in der Medizin des Mittelalters.” 61. Alcohol, for example, is not a disease, but a person diagnosed as an alcoholic may benefit from associating the ill effects of alcoholism with the physical substance. 62. Byron Good (“The Heart of What’s the Matter” 40) uses the term semantic illness network to label the “network of words, situations, symptoms and feel-

ings which are associated with an illness and give it meaning for the sufferer”; see also Young’s summary in “Anthropologies of Illness.” Young offers a more refined model consisting of prototypes and chain complexes, by

which he attempts to account for the instability and ambiguity that often accompany patients’ statements about their illness (“Anthropologies of Illness” 272-4). 63. A number of recent studies examine clinical interactions between physicians and patients. Sue Fisher, for example, has examined the way language is used in medical interactions to manipulate treatment decisions in the cases involving hysterectomies (In the Patient's Best Interest: Women and the Politics of Medical Decisions).

64. See McVaugh’s introduction (“The Development of Medieval Pharmaceutical Theory”) to Arnau de Vilanova’s Aphorismi de gradibus, especially

3-11. Chapter 2: Sexual pathology and the etiology of lovesickness

1. In Jean Charlier de Gerson, Opusculum tripartitum (Paris, 1510); Tentler, Sin and Confession on the Eve of the Reformation (188).

2. Conversely, the salutary value of corporeal afflictions was often seen in the way God helped the faithful resist the pitfalls of sexual desire and lust. St.

Isidore, for example, identified disease as useful in undermining illicit sexual desires: “for those who are robust and healthy it is useful to become sick so as not to sin, since on account of the trials of illness they do not soil themselves with the illegitimate desires and the urges of lust”; “It is useful

NOTES TO PP. 50—2 183 for those who endure the ills of this life to be burdened with these temporal afflictions so that while they are troubled by pain they do not yearn for the excesses of ambition and lust” (Sentencias 683 and 1120, in Zaragoza Rubira, “El concepto de la enfermedad” 437). 3. See Ell, “Blood and Sexuality” (153-4); and Brody, The Disease of the Sout: Leprosy in Medieval Literature. Bernard of Gordon tells of a leprosy-stricken countess who while under his care made love with one of Bernard’s under-

studies; he immediately contracted the disease: “Qualquiera se deve guardar de no se echar con leprosa e dezirvos hé de una condesa leprosa que vino a mi a Mompesler a estar en mi cura. E un bachiller en medicina la administrava e durmio con ella, e emprenola e perfectamente fue fecho leproso. Pues malaventurado es el que faze esto” (Lilio 47). 4. Increasingly from the thirteenth century on, the chronicles and ballads that narrate the downfall of Spain in 711 focus on the sexual misconduct of King Rodrigo and the complicity of Count Julian’s daughter as the leading cause of the Islamic conquest. The rape of La Cava, which is foreshadowed in the chronicles by Rodrigo’s illicit penetration of Hercules’ cave, replicated the very conditions in which Adam partook of the for_ bidden fruit and thereby precipitated generations of disease, disorder, and human suffering. 5. For a detailed introduction to medical concepts of human sexuality in the Middle Ages, see Jacquart and Thomasset, Sexuality and Medicine in the Middle Ages. Other useful discussions can be found in Lemay’s “William of

Saliceto on Human Sexuality” and her “Human Sexuality in TwelfthThrough Fifteenth-Century Scientific Writings.” 6. Avicenna’s treatment of sexuality in the Canon appears in Book 3. On the

use of the Canon in the thirteenth-century university, see Siraisi, “The Changing Fortunes of a Traditional Text” (19), and her recent monograph Avicenna in Renaissance Italy: The Canon and Medieval Teaching in Italian Universities after 1500.

7. For the most part the Speculum al foderi is a reworking of the Latin Liber minor de coitu. Remarkable exceptions, however, are the chapter on coital positions (chap. 10), the discussion on the ways of women (chap. 8), and

the instructions for proper foreplay (chap. 9). These discussions, uncommon in Western treatment of sexuality, were no doubt taken from Arabic works on sexual hygiene. Despite the implications of the title word fodert (from the Latin futwo, which in contemporary Catalan usage corresponds to the English word “fuck”), the treatise is a straightforward treatment of sexuality, written without jocular or obscene intent. See the introduction to my edition and translation, The Mirror of Coitus (xvii-xx1).

8. “Porque el templado ayuntamiento es pruechoso?” (Johannes de Ketham 119).

9g. For example: “E carnal ajustamén, qui a profit de natura és hordonat, se deu fer aprés dormir, con lor cors és atemprat” (Regiment de sanitat 131). 10. “Tria vero sunt in coitu: appetitus ex cogitacione fantastica” (Constantine, De coitu 80). Mary Wack adduces substantial evidence that in medieval literature cogitation and imagination were synonymous.

184 NOTES TO PP. 53—4 11. To cure impotence, the author of the Libro del cuidado de la salud suggests

that the patient imagine extensively the act of coitus until the organs of sexual appetite begin to obey: “Y entre lo que mueve a la reflexion y despierta a la imaginaciOn, se enumeran la prolijidad del coito y el pensar en él y en sus situaciones, la variedad de sus formas, como las distintas formas de refinamientos, el bienestar, las hermosuras del lujo, las estatuas de las camaras privadas, y de los vestibulos con pechos rellenos y meyjillas acicaladas. ... Se imagina el goce y la perfeccion del coito, hasta el punto de que las disposiciones naturales se concentran, se expulsan las substancias y se ponen en movimiento los 6rganos del apetito sexual por obedtencia a la imaginaciOn” (154). 12. For an introduction to these types of works in the Iberian Peninsula see Marquez Villanueva, “Las lecturas del Dean de Cadiz.” More recently, Luce

Lopez-Baralt has published a number of important studies on the “Kama Sutra” tradition in Spain: see “Un ‘Kama Sutra Catalan’ del siglo XIV” and “Un Kama Sutra espanol: El primer tratado erotico de nuestra lengua.” Her edition and detailed introduction to the aljamiada Kama Sutra (M GS-2 of the Biblioteca de la Real Academia de la Historia in Madrid) is certainly the most exhaustive study on oriental erotica in Spain during the Middle Ages and Renaissance. 13. See Wack, “Imagination, Medicine, and Rhetoric” (106). 14. Theorists were ambiguous and inconsistent with the names given to the different types of bodily spirits. See Bono, “Medical Spirits”; and Jacquart and Thomasset, Sexuality and Medicine (79).

15. The relation between this type of pneuma and flatulence appears clearly articulated in Albert the Great’s De animalibus: “For one must not forget that in every ejection of sperm, flatulence is involved; the ejection occurs in

several movements, for the flatulence ejects first one part, then another. The situation is the same as in vomiting, which is caused by the force of what is vomited: the number of these spasms of vomiting corresponds to the number of climaxes experienced in coitus” (book 9, tract 1, chap. 7; quoted by Jacquart and Thomasset, Sexuality and Medicine 79). 16. The origin of seminal fluids was a question that drew ambiguous responses

from early medical theorists (Jacquart and Thomasset, Sexuality and Medicine 52). The idea of the brain as the point of seminal origin (encephalomyelic theory) dates back to prehistoric times, pointing no doubt to the analogous relation between seed and its shell and semen and the cranium. For an historical and cross-cultural survey of semen and its location in the head or in the marrow of the bones, see La Barre’s Muelos: A Stone Age Superstition about Sexuality. In contrast to the encephalomyelic

notions of semen, some theorists, notably Arabs, offered a hematogenic theory in which blood was thought to be concocted in the testicles; through a process of dealbation it became whiter and whiter until transformed into sperm (milk in women). An often-repeated proof for the encephalomyelic theory was Hippocrates’ assertion that men whose veins behind their ears were cut could not produce offspring or ejaculate semen: see Constantine, De coitu (80); Albert the Great, De animalibus 22.1.4 (64). A third theory,

NOTES TO PP. 54—6 185 which helped explain congenital similarities between parent and offspring, suggested that semen passed through all members of the body, drawing

qualities from the entire body. This theory blended well with encephaloymelic concepts. No doubt a rigid distinction between the two was hard to maintain, and we can often find in medical treatises a synthesis of the two: “La materia dela simiente viene de todos los miembros del cuerpo. Y por esta razon parece la criatura al padre y a la madre en todos los miembros: pero la mayor parte viene del meollo. Y por esta razon el que mas enflaquece y se siente menguado del llegamiento delas mugeres es el

meollo. E por esta razon quando cortan las venas detras de las orejas pierden el engendrar: ca del meollo deciende la simiente a aquellas venas detras de las orejas: y dende va al filo del espinazo y dende a los rinones y dende alas venas que van alos genetiuos. Y assi se cuezen y dende ala verga” (Juan de Avinon, Sevillana medicina 108r). 17. “Item Galenus in libro de cura membrorum: semen est epiritus et humor spumosus. Spumosus autem fit humor per motum, sicut est videre in tempestate maris” (De coitu 86). In his treatise On the Usefulness of the Parts, Galen

states that “semen itself is a pneuma and like foam, so that if ever it is emitted into the outer air, there soon appears to be much less of it than when it was first emitted” (641).

18. The standard advice is to copulate when the body is tempered and balanced. See, for example, Constantine, De coitu (114). 19. Albert cited by Johannes de Ketham: “La luxuria no es sino vna expulsion pura de humidad la qual consume el cerebro” (Compendio de la humana salud 1QV).

20. “E esto contece de grant flema en el estomogo o de vsar mucho de mugeres” (Menor dano 136). [And this is caused by great phlegm in the stomach or by frequent use of women.] 21. Albert relates the story of a passionate monk who copulated with a beautiful lady seventy times in one night and consequently died; the ensuing autopsy revealed that his brain had dried and shriveled to the size of a pomegranate and that the eyes had been completely destroyed (Jacquart and Thomasset, Sexuality and Medicine 55-6). See also the Liber minor de cottu (56). 22. See Liber minor de coitu (57-9).

23. See Mirror of Coitus (3), Liber minor de coitu (57), Arnau de Vilanova’s Regiment de sanitat (131), Andreas Capellanus’s On Love (305), and Juan de Avinon’s Sevillana medicina (108r).

24. The author of the late fifteenth-century Compendio de salud humana cites Albert the Great’s example of the sparrows whose alleged inordinate sexual practices reduced their lives to a mere three years: “[E como dize] alberto magno que aquestos paxaros llamados gorriones que andan por los tejados por el muy continuo e desmesurado ayuntamiento no viuen mas de tres anos” (19QV).

25. “e los que usan mucho coitu, no engendran, 0 pocas vezes, o sale fedionda su generacion” (Lilio 302). Johannas de Ketham: “Porque nascen algunas criaturas gibosas 0 contrechas. Responde que esto acahesce por el ayun-

186 NOTES TO PP. 56-8 tamiento desordenado del hombre” (Compendio de la humana salud 251). This idea gained even greater force in the sixteenth century, when women were condemned for an inordinate sexual desire that was believed to man-

ifest itself in the deformities and diseases of their children (Niccoli, “*“Menstruum Quasi Monstruum’” 1-2).

26. “La lepra en dos maneras se cobra: o del vientre de su madre o después que es nascido. Si del vientre de su madre, porque fue engendrado en el tiempo del menstruo” (Bernard of Gordon, Lilio 46). 27. A longstanding tradition explained monstrous births as signs of God’s anger. See St. Isidore, Etimologias (book 11, chap. 3); also Kappler, Monstruos, demonios y maravillas (266).

28. Albert the Great, quoting Avicenna (De animalibus 65). In an often-repeated demonstration of the power of the imagination to affect the body, a man would walk on a plank lying on the ground; the man then tried to walk on the same plank elevated high in the air: “Avicenna also suggests, although he does not put this opinion forward as irrefutable, that the power of the imagination can actually change or seem to change extraneous bodies, in cases where the power of the imagination is too unrestrained; and hence we gather that the power of the imagination is not to be considered as distinct from a man’s other sensible powers, since it is common to them all,

but to some extent it includes all those other powers. And this is true, because such a power of the imagination can change adjacent bodies, as for example, when a man is able to walk along some narrow beam which is stretched down the middle of a street. But yet if this beam were suspended over deep water he would not dare to walk along it, because his imagina-

tion would most strongly impress upon his mind the idea of falling, and therefore his body and the power of his limbs would obey his imagination, and they would not obey the contrary thereto, that is to say, walking directly and without hesitation” (Malleus maleficarum 12).

29. Recently a great deal of work has appeared on this disorder. See Mary Frances Wack’s Lovesickness in the Middle Ages: The Viaticum and Iis Commentaries (this work includes editions and translations of some of the most important medieval commentaries on Constantine the African’s early discussion of the disease in his Viaticum) as well as her earlier articles on the same; Michael McVaugh’s introduction to Arnau de Vilanova’s Tractatus de amore heroico is lucid and informative; also see Massimo Ciavolella’s La ‘malattia d’amore’ dall’antichita al medioevo. For a discussion on the way the disease was theorized in late medieval academic circles in Spain (especially in Salamanca), see Pedro Catedra’s Amor y pedagogia en la edad media, notably

chap. 3, “Aegritudo amoris y determinismo astrologico”; also of interest is Donald Beecher and Massimo Ciavolella’s introduction to and translation of the sixteenth-century Treatise on Lovesickness by Jacques Ferrand; and still

worth mentioning is John Lowes’s ground-breaking article, “Ihe Loveres Maladye of Hereos,” published in 1914. 30. The expression was widely circulated in the Middle Ages; see Catedra (57). 31. Arnau de Vilanova, for example, explains “quod amor talis (videlicet qui dic-

NOTES TO PP. 58-67 187 itur hereos) est vehemens et assidua cogitatio supra rem desideratam cum confidentia obtinendi delectabile apprehensum ex ea” (Tractatus de amore heroico 40).

32. See, for example, The Mirror of Coitus (49).

33. See The Mirror of Coitus (55-6); Juan de Avinoén, Sevillana (fol. 110r); Johannes de Ketham, Compendio de la humana salud (fol. gor). Since anger, like coitus, was thought to heat and dry the body, the combination of coitus and anger was thought to be dangerous, especially for the brain (Arnau de Vilanova, Regiment de sanitat 132). The author of the Liber minor de coitu warns against copulation after experiencing sadness or worry (77).

34. Following the advice of Ovid, Bernard of Gordon suggests: “E después llévenlo a luengas regiones por que vea cosas varias e diversas, como dize Ovidio: “Vé por lugares fermosos respandescientes e fallaras mill colores de las cosas”’ (Lilto 108). [And later, take him to distant regions so that he sees various and diverse things; as Ovid says: “Go to beautiful and magnificent places and you will find things in a thousand colors.| Bona Fortuna tells of a particular patient whom (with the consent of his relatives) he accused of

homicide, so that he was forced to flee the district; accordingly he was healed. Tractatus super Viaticum, in Wack, Lovesickness 263.

35. The most frequently cited example of this strategy is the one found in Bernard of Gordon’s Lilio (109). 36. Johannitius in the /sagoge explains: “Sundry affections of the mind produce an effect within the body, such as those which bring the natural heat from

the interior of the body to the outer parts or the surface of the skin. Sometimes this happens suddenly, as with anger; sometimes gently and slowly, as with delight and joy. Some affections, again, withdraw the natural heat and conceal it either suddenly, as with fear and terror, or again gradually, as poverty. And again some affections disturb the natural energy both

internal and external, as for instance, grief” (709).

37. It is through the use of biomedical discourse that Andreas Capellanus attempted to persuade his friend and patient Walter to avoid sexual activities. Capellanus not only details the biomedical arguments against excessive intercourse (debilitation, shortening of lifespan, sleeplessness), but also grounds these arguments in medical authority: “We have it from physicians”; “Johannitius [author of the Isagoge] says .. .”; “I remember once reading in a medical treatise that sexual activity makes men senile earlier. That is why I hasten to beg you not to indulge in love” (On Love 305). 38. Avicenna, Canon I/fen. 1, tract 4, chap. 25; in Wack, Lovesickness 302, n. 15. Chapter 3: The poetics of infection

1. See Nutton, “The Seeds of Disease: an Explanation of Contagion and Infection from the Greeks to the Renaissance.” Nutton argues that even though medical theorists speculated on the cause of contagion, the conceptual framework inherited from Galen hampered them from inquiring too deeply (34).

188 NOTES TO PP. 68—72 2. See Temkin, “Health and Disease” (426). 3. On the Nature of Things, quoted and translated in Nutton, “The Seeds of Disease” (20). 4. See The Book of St. Gilbert, ed. Raymonde Foréville and Gillian Keir.

5. Temkin points to a chapter in Theodorus Priscianus’s medical textbook (written during the sixth century a.p.) that bears the title De infectionibus capillorum [On the Dyeing of Hair]. He suggests that the modern-day notion of infection evolved from the connotation of poisonous substances used in

dyes. He notes that the English word “stain” still maintains the double meaning of dyeing and of polluting, tainting, and spoiling. Temkin also points to the “analogy with a tincture where a small drop of dye-stuff suffices to color a large amount of fluid,” arguing that it “played an important role in medieval alchemy and medicine. It helped to explain how the whole

body could become sick from mere contact or inhaled breath” (“An Historical Analysis of the Concept of Infection” 457, 461). 6. The aphorism comes from a ninth-century Latin list of contagious diseases (Temkin, “An Historical Analysis” 460). 7. Ilza Veith argues that ancient and medieval “medical nomenclature developed slowly and so long as medical knowledge was restricted, a narrative, descriptive style was used to evoke a picture of disease, where nowadays one word, a simple disease name, would suffice” (221). 8. Juan Ruiz, Libro de buen amor (coplas 189-98). The anecdote is based on the same story as the French fabliau “Le valet aux douze femmes” (Michael, “The Function of the Popular Tale” 191; Lecoy, Recherches 157-8). g. Bernard of Gordon, for example, began his second book of the Lilio, “de todas las enfermedades del celebro fasta las enfermedades de los ojos,” with a discussion on the causes and cures of hair loss (73-6). Among the various

causes of hair loss, Bernard, reiterating the words of numerous medical authorities before him, listed excessive coitus: “Ay otra calva que es acidental en la qual se salen los cabellos como se faze en los convalescientes e en los fambrientos e en los encarcelados e en los que acostumbran mucho coyto” (Lilio 75). See also Mirror of Coitus (3) and the Liber minor de coitu

: (56).

10. The biblical story of Samson (Judges 16) illustrates how a woman deprived a man of his hair, which led to the loss of his physical strength and eyesight, deprivation also associated with excessive intercourse by medieval theorists.

Learned readings of this story in the fifteenth century, such as Alfonso Fernandez de Madrigal (E] Tostado), identified Samson’s attraction to Delilah as an example of amor hereos caused by an inordinate fixation on the Philistine woman’s form. See Pedro Catedra’s Amor y pedagogia (57); El Tostado’s commentary on Judges 16, “Quomodo Sampson semper amabat mulieres philistinas,” appears in the appendix (189-90). 11. Several years ago an anecdote circulated among college students in North America and Europe. A young man picked up a woman in a local bar. After a night of vigorous lovemaking, the student awoke the following morning to find that the woman had already left. As he stumbled to the dresser he

noticed something written on the mirror. Moving closer he could see a

NOTES TO PP. 74-91 189 large heart drawn in red lipstick which contained the words, “Welcome to the Wonderful World of AIDS.” In Spain the weekly magazine Interview pub-

lished a two-page color photo of a mirror with a heart and the words “Bienvenido al mundo del SIDA”; the accompanying story retold the same anecdote, which purportedly took place in Madrid. 12. See Barthes’s essay “Myth Today” in Mythologies (109-29). On the idea of humans as signifiers in a divine narrative, see Stephen Nichols’s Romanesque Signs (3).

13. “Si mil mudaves / he le triaves / be d’una’n huna, / per llur fortuna / he calitat, / per llur peccat / serien tals, / car tots sos mals / son, per natura, / de rarra cura / o incurables” (6979-89). 14. “ab llur antich / primer amich, / Eva de mort, / dins aquell hort / hon fon formada. / Per llur errada / lexa llavor / de frau, error / e gran malea / a sa ginea, / hi, quantes son / ara’n lo mon, / son diablesses, / dimoniesses; / car les primeres / amors son veres / he tostemps duren” (355-71). 15. For a discussion of the medieval notion of female speech as excess, as well as a discussion on the relation between women and language in the Middle Ages, see Edith Joyce Benkov’s article “Language and Women: From Silence to Speech.” 16. The idea of the mouth as a door was omnipresent in medieval representations of the body (Pouchelle, 147). 17. The French surgeon and theorist Henri of Mondeville described a type of physiological symmetry between the womb and the mouth, suggesting that the clitoris changes the air that enters the womb as the uvula tempers the air entering the mouth (Pouchelle 182). 18. According to Marie-Christine Pouchelle, at the beginning of the fifteenth century in France, a children’s play rhyme pointed to the relation between

disease, the vagina, and the mouth: “What a cough you’ve caught in the cunt, old girl / What a cough, what a cough in the cunt” (189). 19. For a medieval definition of apoplexy (apoplesia), see Bernard of Gordon (Lilio 119-21); on lethargy (ltargia), see Lilio 94-6.

20. Images such as arrows no doubt served as the conceptual precursor for Fracastoro’s insistence on, and subsequent explanation of, the material bases of contagion over supernatural explanations (see “How the Germs of Contagions are Carried to a Distant Object and in a Circle,” chap. 7 of De contagione 29-38).

21. “E viene esso mismo [la lepra] por mucha fabla e comarcanca con los leprosos” [And this occurs from much speaking and association with lepers] (Bernard of Gordon, Lilio 47). 22. Vegetables, fruits, cakes, and candies have been traditionally thought of as “women’s food,” in opposition to the more manly consumption of meats. For an interesting analysis of the inscription of gender in certain foods, see Carol J. Adams, The Sexual Politics of Meat.

293. Fora historical survey of infanticide, including the Middle Ages, see Langer,

“Infanticide.” Helmholz, “Infanticide in the Province of Canterbury,” and Kellum, “Infanticide,” treat the topic in England during the Middle Ages.

190 NOOTES TO PP. 91-6 24. For the reception of monsters as signs in the early Renaissance, see Niccoh,

“Profezie in Piazza: Note sul profetismo popolare nell’Italia del primo Cinquecento.” —-" "Chapter 4: The poetics of the compendium and the conditions of the clinic

1. “Littere, en latin, que son ‘letras,’ quiere tanto dezir como Legiiere, porque dan carrera alos que leen” (Etimologias romanceadas 100).

2. It is curious that the size and shape of this little book, and especially the way it was carried near the hip, is like a bag or pouch. One medical historian suggests that what seems to be a money pouch hanging from the belts of physicians in medieval illuminations was probably one of these small medical books that helped the physician “make a quick decision about the treatment to be given to a patient.” See Talbot, “A Mediaeval Physician’s Vade Mecum.” The physical format of the vade mecum manuscripts imitated the breviaries that priests, monks, and friars carried at their waists while on

journeys or outside the library or cathedral. With these little manuscripts hanging from their hips, the pious could pause and read the appropriate holy texts at the hours dictated by their order. 3. For a general overview of the ars praedicandi in Spain, see Faulhaber, “Retoricas clasicas y medievales en bibliotecas castellanas,” 197-8. 4. Alan of Lille’s The Art of Preaching is divided into chapters that treat a particular vice or theme. Alan initiates each chapter by encouraging the preacher to make use of the discursive instruments (variously called texts, authorities, and reasons) as ameans of arming the listener against the vice or sin in ques-

tion. For example, chapter 10, “Against Pride,” states that “if he [the preacher] intends to inspire his listeners to flee from pride, let him use these texts: [1] “Everyone who exalts himself shall be brought low’ [Luke 14:11]. [2] And ‘What is valued highly among men is an abomination in the sight of God’ [Luke 16:15]. [3] And Paul: ‘Have no taste for self-aggrandisement, but be meek’ [Romans 11:20]. [4] Jesus son of Sirach: ‘Pride is the beginning of every sin.’ [5] Again ‘He has put down princes from their throne, and he has exalted those of lowly birth’ [Luke 1:52]. [6] Peter says: “God resists the proud but gives his grace to the humble’ [1 Peter 5:5]” (52). 5. Fora review of the history of the ars dictandi, see James J. Murphy, Rhetoric in the Middle Ages (194-268).

6. See Faulhaber’s “The Letter-Writer’s Rhetoric.” 7. One of the great technological advances of the early Middle Ages was the introduction and regular use of the codex in place of the rolled papyrus. The early Christians discovered the advantages of being able to locate quickly a pertinent passage and to compare easily one passage with another by turning pages rather than unrolling lengthy scrolls. Secular professionals, such as physicians, also found that the durability, compactness (the pages can be written on both sides), and accessibility of the codex allowed them to manage the discursive material of their trade successfully. See Roberts, “The Codex”; Sirat, “Du rouleau au codex”; and Escolar, Historia del libro (1'79—-98).

NOTES TO PP. Q6—100 191 8. “Tracta de las passiones de los miembros de la generaciOn en qualquier sexu o linaje, e de los antidotos que valen desde la cabeca fasta los pies” (301). 9. For example, in 1508 there appeared in Lyons a small volume titled Flores Avicennae that was designed to allow the Avicenna corpus to be committed easily to memory. See Nancy G. Siraisi’s fascinating article, “The Changing Fortunes of a Traditional Text: Goals and Strategies in Sixteenth-Century Latin Editions of the Canon of Avicenna.” 10. The compendium served as the textual equivalent of the proverbial physi-

cian’s black bag, its clinical usefulness being similar to that of cases, pouches, boxes, and other storing devices in that it gave practitioners (who

circulated through the streets and marketplaces, most often treating patients outside the confines of hospitals and clinics) the power to effectively control the tools they needed to treat a variety of ailments and disorders. For example, an inventory of the goods owned by a prominent practitioner in the Valencian court, Ramon Johan, lists a bag of herbs, a box of

instruments to clean and pull teeth, a trunk containing a banner announcing his profession, and a linen sack containing nine metal instruments used to castrate men (Rahola i Sastre, 295). 11. A similar upsurge, which Faye Marie Getz calls “nothing less than explosive,” took place in England during the same period; she estimates that the number of vernacular medical manuscripts multiplied sixfold (1). Studies : by Bennett and Voigts confirm her observations. 12. See Miguel Batllori’s “Noticia preliminar: Les obres médiques catalanes d’Arnau de Vilanova” in the introduction to his edition of Arnau’s Regement de sanitat (53-91).

12. Jacquart and Thomasset suggest that perhaps the Mirror inaugurated “a long series of practical treatises, thanks to which people may gain better control over their bodies” (224 n. 120). 14. Today more than seventy manuscripts and fifteen printed editions of the treatise survive (Siraisi, Medieval and Early Renaissance Medicine 132). For further discussion, see the introduction to Maria Helena Da Rocha Pereira’s edition and Portuguese translation (Obras médicas de Pedro Hispano). For the popular use of this treatise among medical subalterns during the sixteenth and seventeenth centuries, see Munoz Calvo’s Inquitsicién y ciencia en la Espana moderna (111). With regard to the sexual aspects (aphrodisiacs, contraceptives) of the Thesaurus, see Jacquart and Thomasset, Sexuality and

Medicine (91-2); these authors claim that there are 116 prescriptions related to fertility and sexuality: 34 for aphrodisiacs, 26 for contraceptives, and 56 for fertility. 15. Under the rubric “Que deue escussar el onbre a los cirugianos en quanto

pudiere,” Chirino explains: “En la cerugia que conuiene saber segunt la entencion deste tratado, lo primero es que vos guardedes quanto pudierdes de la maldat de cerugianos que son muy malos omnes e peores que fisicos, Si peores se puede aver” (103). 16. “que todo lo que aqui fallardes escripto non sera por vocablos de medecina nin por palabras escuras saluo fablando bulgarmente que qualquier omne

puede entender” (6).

192 NOTES TO PP. 100-13 17. Chirino’s compendium is not an isolated work. His contemporary, Gomez de Salamanca, wrote a similar treatise, the Compendio de medicina, for the Alvaro de Luna. Although not nearly as complete as the Menor dano, it contains cures for all the typical maladies, including gout, toothaches, kidney pains, liver ailments, and sores in the mouth. 18. Van der Geest, while doing fieldwork in Cameroon, found that drug shortages in public health institutions brought these services to a standstill and caused the sick to look for therapies that did include medicines. A clinic without medicine, according to van der Geest and Whyte, is a like a “bar without beer” (346). 1g. A transcription of the cantiga with English translation by Kathleen KulpHill and a color reproduction of the accompanying miniatures appears in John Keller and Richard Kinkade’s article, “Iconography and Literature: Alfonso Himself in Cantiga 209.” 20. Mary Wack has observed how “the craft of bookmaking also provided material for the practical exercise of medicine. Bona Fortuna advises his students to construct casts for broken bones using cloths prepared as in bookmaking” (Lovesickness in the Middle Ages 128).

21. “por tanto seria utile cosa e santa dar causa conveniente de remedio a aquellas cosas que mas son causa de nuestro mal” (63). Some translators render mal as “evildoing.” Unfortunately there is no single expression in English that expresses adequately the physical and moral connotations of mal. By translating this term as “illness” I do not want to elide the moral and spiritual connotations of the word, since there was no rigid separation between the two in the Middle Ages.

22. “Del que so spert, / de Deu rebut / he clar hagut / l’esperiment, / sera’l present / mon ensenyar: / sols remeyar / error publica, / en que’s implica / comunament / tot lo jovent, / no sens pecat” (110-20). 293. “Axi salut / prest cobraras / he reviuras / ressucitat / com lo tocat / per Eliseu” (12206-11) [This health, you will quickly regain, and you will be revitalized and resuscitated as if you had been touched by Elisha]. 24. Although Roig specifically names his work the Spill (“est doctrinal memorial: haura nom spill,” 237-9, also 41-5 and 793-5), from the first edition of 1531 the work was titled in full Libre dels consells los quals son molt profitosos y saludables axi per al regiment y orde de ben viure com per a augmentar la devocio ala puritat y concepcio de la sacratissima verge Maria. The third edition of 1651 bears the title Libre de les dones, més verament dit de consells. The various titles

reinforce the didactic nature of the work. 25. For a general discussion on mirror imagery in medieval book titles, see Herbert Grabes, The Mutable Glass: Mirror-Imagery in Titles and Texts of the Middle Ages and the English Renaissance.

26. Lépez de Villalobos, Sumario (324); Bernard of Gordon, Lilio (108). 27. Bernard of Gordon (Lilio 108); Lopez de Villalobos (Sumario 324); Bona Fortuna (Tractatus super Viaticum, in Wack, Lovesickness, 203).

28. The title of the work derives from the epigraph to the Escorial manuscript: “Libro compuesto por Alfonso Martinez de Toledo arcipreste de Talavera

NOTES TO PP. 113-22 193 en hedat suya de quarenta annos, acababo quinze de marco anno del nascimiento del nuestro Salvador [hesu Christo de mil e quatrocientos e treinta e ocho annos. Sin bautismo sea por nombre llamado Arcipreste de Talavera donde quier que fuere levado” (61). 29. See Gerli’s introduction to his edition of the Arcipreste (19-21). The full titles of the extant editions are El arcipreste de Talavera que fabla de los vicios de las malas mugeres : complexiones de los hombres (Sevilla, 1498); Tratado contra las mugeres que con poco saber mezclado con malicia dicen e facen cosas no debidas

(Toledo, 1499); El arcipreste de Talavera que fabla de los vicios de las malas mugeres (Toledo, 1500); Arcipreste de Talavera que habla de los vicios de las malas mugeres e complexiones de los ombres en espanol (Sevilla, 1512); Arcipreste de Talavera que fabla de los vicios de las malas mugeres E complexiones de los hombres, nuevamente anadido. Y con su tabla (Toledo, 1518); Siguese un compendio breve y muy provechoso para informacion de los que no tienen experiencia de los males y danos que causan las malas mugeres a los locos amadores: y de otras cosas anexas a este proposito (Logrono, 1529); Arcipreste de Talavera que habla de los vicios de las malas mugeres: y complexiones de los hombres (Sevilla, 1547).

30. See Gerli, Alfonso Martinez (94); von Richthofen (520); Pérez Pastor, ed., Arcipreste de Talavera (vi).

31. “...los refranes, no son materia debil, y sin artificio, y forma: antes que engendran en los entendimientos de los hombres, por suauidad, y gracia, admirable sabiduria, y ciencia” (84). 32. Gerli, pointing to the Ars praedicandi of Eiximenis, Henry of Hesse, and Martin of Cordova, suggests that the use of exclamations was a common device of preachers who likewise attempted to capture favor and attention and elicit an emotional response from their public (Alfonso Martinez go). 32. For the relation between Martinez’s use of the rhetorical question and the preaching tradition, see Gerli, Alfonso Martinez (go-1).

34. The autobiographical aspect of the Spill remains an unexplored area of inquiry. Unfortunately, modern critics have only approached the work using extremely underdeveloped notions of autobiography. Recent works, such as Janet Varner Gunn’s Autobiography: Toward a Poetics of Experience, sug-

gest that autobiographical writings are less an attempt to document life than a ritualistic act of self-placing and self-understanding. In the case of Roig’s Spill, such a theory would help us to understand the way Roig’s narrative of his life, fictitious or based on historical events, provides a medium of self-affirmation. 35. This is also a common device used by tellers of “urban legends” to authenticate their narratives. In Jan Harold Brunvand’s collection of variations on the “Vanishing Hitchhiker” legend, each version conventionally begins by announcing that “this really happened to a friend of a friend,” or “one of my sister's best friends... ,” followed by the mention of a toponym that locates the narrative in the general proximity of the listener — “in Spartanburg,” “in a Durant Avenue boarding house,” “in downtown Los Angeles” (The Vanishing Hitchhiker: American Urban Legends and Their Meanings 24-41). 36. See Joan Fuster, “Lectors i escriptors en la Valéncia del siglo XV.”

194 NOTES TO PP. 126—40 Chapter 5: The tortured body and the abjectified voice

1. “sea castigado muchas vezes fasta que comience a feder” (Lilio 108). 2. Similar allusions are often attributed to Diogenes: Covarrubias, writing in the early seventeenth century, tells us that Diogenes, upon seeing a group of condemned women hanging from an olive tree, exclaimed, “Oh that all trees should bear such fruit!”: “Vio Diogenes pendientes infamemente de un olivo a unas que la justicia avia castigado con aquel suplicio y dixo: jOjala todos los arboles del mundo llevaran este fruto!” (Tesoro de la lengua castellana o espanola 818).

3. See McVaugh, “Introduction” (26); and Arnau de Vilanova, Tractatus de amore heroico (50-1).

4. See Page DuBois’s fascinating study on truth, torture, and enslavement in antiquity, Torture and Truth.

5. For a study of spectacles of sexual inversion in the late Middle Ages and Renaissance, see Davis, “Women on Top.”

6. Amore extreme example is documented in the chronicles of the early conquest of Mexico. Hernan Cortés reportedly opened the bodies of plump Indians to get fat to heal the wounds of fifteen soldiers. Hernando de Soto was also reported to have used the fat of slain Indians to heal wounds (Taussig, Shamanism, Colonialism, and the Wild Man 237).

7. The miniature appears in the Menology of Basil II (Vatican Library); it is reproduced in-the New Catholic Encyclopedia under “Saints Cosmas and Damian.” 8. Barcelona: altarpiece by Miguel Nadal. Tarrasa: altarpiece by Jaime Huguet in the church of Santa Maria. Vich: anonymous panel, Museo Arqueoldégico

Artistico Episcopal. Burgos: painting by Leon Picardo, Museo Diocesano. Covarrubias: painting by Pedro Berruguete, “Miracle of the Black Leg,” Museo Diocesano. Valladolid: relief from the Monasery of San Francisco, Museo Nacional de Esculturas. Palencia: cathedral, chapel of St. Gregory. See David-Danel, /conographie des saints médecins (45-50).

g. Such is the case in the painting on one of the panels of the altarpiece of the chapel of St. Gregory in the cathedral of Palencia. 10. The anecdote appears in Fray Antonio de Yepes, Crénica general de la Orden de San Benito (1: 137-8). 11. As examples Schulenburg cites the case of St. Eusebia and her companions at the monastery of St. Cyr, near Marseille (c. 738); St. Ebba and the nuns of Coldingham during the Danish invasions around 870; the blessed Oda

of Hainault (d. 1158), who cut off her nose to avoid marriage; and St. Margaret of Hungary, who did likewise to avoid marrying the duke of Poland (46-9). 12. In fifteenth-century Spain this legend was often attributed to the Blessed Lucia la Casta, a French Dominican who came to Spain with Vicente Ferrer

in 1420 and is venerated even today in Jerez de la Frontera. As Miguel Capdevila points out, however, there are representations in Spain of St. Lucy holding her eyes on a platter three centuries before the birth of Lucia la Casta (Q).

NOTES TO PP. 143-9 195 13. ‘Tere del Crestia (chap. 1948); anthologized in Contes 7 faules (67-8).

14. Iam grateful to Eric Naylor for his assistance in translating difficult portions of this passage. 15. The analogy between women and hens is made more explicit several chapters later when Martinez suggests that women, trying to extract secrets from men, “escarvan en ellos, como faze la gallina por gusano” (173) [scratch for them as a hen does for a worm].

Chapter 6: Women, the power to disease, and the fictions of the counter-clinic

1. Monica Green makes the following distinction between the categories of healers: “physicians, who could often boast of a university training, claimed as their province the general business of diagnosis and treatment of internal diseases; surgeons carried out most of the manual aspects of the medical art (bone setting, amputations, etc.), while barber-surgeons were largely confined to more minor surgical procedures, particularly bloodletting. Apothecaries would be responsible for dispensing medications, though this

role took on real medical import when advice was dispensed as well. ‘Empiric’ is a generic term used loosely to signify all those individuals who took up medical practice on their own, independent of university sanction, state licensure, or guild regulation. It should be emphasized, however, that these categories were much more fluid and subjectively defined than in the

modern, highly regulated medical industry of Westernized societies” (“Women’s Medical Practice” 439, n. 9). 2. For discussions on health care practitioners in Spain during the late Middle Ages and Renaissance, see the following: Luis Garcia-Ballester, “Academicism versus Empiricism in Practical Medicine in Sixteenth-Century Spain with Regard to Morisco Practitioners”; Guenter B. Risse, “Medicine in New Spain’; Josep Rahola i Sastre, “Els odontolegs dels segles XIV 1 XV a Barcelona”; José

Maria Donate Sebastia, “Saludadores y médicos en la baja edad media’; Rafael Munoz Garrido, “Empiricos sanitarios espanoles de los siglos XVI y XVII"; Miguel Herrero, “Tipologia social del siglo XVII.” On the type of training these practitioners received, see Vern Bullough’s “Training of the Non-University Educated Medieval Practitioners.”

3. Monica Green provides an excellent overview of female practitioners in medieval Europe in her article “Women’s Medical Practice and Health Care in Medieval Europe.” 4. For a discussion on women healers in Spain, see C. Fernandez Ruiz’s “La

comadrona en la historia de la obstetricia.” A more general treatment appears in Towler and Bramall’s Midwives in History and Society.

5. Documents show that five Jewish midwives received permission to practice in the Crown of Aragon during the last part of the fourteenth century (A. Lopez de Meneses, “Cinco catalanas licenciadas en medicina por Pedro el Ceremonioso.” Antonio Cardoner; Planas documents six women healers

working in the fourteenth century (“Seis mujeres hebreas practicando la

196 NOTES TO PP. 150—4 medicina en el reino de Aragon”); see also Garcia-Ballester, Historia social

(42-5); Cardoner; Planas, Historia de la medicina (103-4); and Harry Friedenwald, “Jewish Doctoresses in the Middle Ages.” 6. Luis Garcia-Ballester has carefully studied the role of the Morisco physician in late medieval and early Renaissance Spain. See Historia social, Los moriscos, and “Academicism versus Empiricism.” 7. See Roth, “The Qualification of Jewish Physicians in the Middle Ages.” 8. See Siraisi, Medieval and Early Renaissance Medicine (17-23). g. Economic factors have also encouraged the restricting of the clinic to a par-

ticular place. In their offices, doctors can treat many patients, and hence reap the financial rewards of a larger clientele, whereas in the home-visit practice the time spent traveling severely limits the number of patient—physician visits.

10. The history of the hospital, even during the medieval period, is far beyond the scope of this study. For specific studies on hospitals in the Crown of Aragon see Rubio Vela, Pobreza, enfermedad y asistencia hospitalaria en la Valencia del siglo XIV; and Burns, “Los hospitales del reino de Valencia en el siglo XII.”

11. For example, the hospital of Sant Antoni in Valencia specialized in the treatment of fuego infernal or St. Anthony’s fire, a type of ergotism (Rubio Vela, Pobreza 35).

12. Conversely, it was reasoned that the unhealthy air arising from the hospitals could carry infections into the adjacent urban centers (Rubio Vela, Pobreza 17).

13. “quod non est aliquis qui en eorum infirmitatibus et necessitatibus curet eosdem” (Achivo de la Corona de Aragon, Cancilleria, reg. 1893, fol. 1741; quoted by Garcia-Ballester, McVaugh, and Rubio Vela, Medical Licensing 22). Three years after the outbreak of the plague, the inhabitants of Jativa complained: “Attamen quia nobis constat, tam occasione temporum preter-

itorum sterilitatis quam racione mortalitatum que per universum orbem dudum permittente. Altissimo, viguerunt, copiam fisicorum et sirurgicorum qui in civitate Xative et aliis notabilibus locis esse solebant, in tantum fore

diminutam quod vix aliquem sirurgicum invernire posterit in eadem” (Achivo de la Corona de Aragon, Cancilleria, reg. 893, fol. 84r; quoted and translated by Garcia-Ballester, McVaugh, and Rubio Vela, Medical Licensing 21) [By reason of the sterility of times past, as well as of the deaths which the Almighty has allowed to flourish in the world, that abundance of physicians and surgeons which used to be found in the city of Xativa and other large cities is now so diminished that it is scarcely possible to find a single surgeon here]. 14. For the salaries and fees charged by physicians in medieval England, see Carol Rawcliffe, “The Profits of Practice: The Wealth and Status of Medical Men in Later Medieval England.” 15. “quamque aliguibus pauperibus et egenis pacientibus, qui non habent unde medicis salaria ende valeant ministrare” (Archivo de la Corona de Aragon,

NOTES TO PP. 154—66 197 Cancilleria, reg. 683, fols. g9gv-100r; quoted and translated by GarciaBallester, McVaugh, and Rubio Vela, Medical Licensing 22).

16. A “frequent strategy of professions, such as medicine, has been to claim that their activities and knowledge are not simply specialized segments of what is available to all - common sense, morality, art, “know-how,’ and so on — but rather have a special, technical status which sets them apart from everyday life. They are forms of reasoning that claim authority on the grounds that they demonstrate the means (e.g. particular therapies) to desired ends (e.g. restorations of ‘health’)” (Wright and Treacher 6). 17. Similar arguments concerning the practitioner's efficacy proved equally unsuccessful in gaining the release of a midwife from prison. The defense

argued that through her expertise seven children had been born Caesarean, each child and mother remaining alive and healthy (Feis; Nemec 29). 18. See discussion and accompanying documentation in Vol. 3 of Alminana Vallés’s edition of the Spill (842-56). 19. In other urban areas the number of trained practitioners was much lower.

For example, in Barcelona during the fourteenth and fifteenth centuries, there were on average fewer than two doctors for every ten thousand inhabitants, about the same proportion as in the most depressed regions of modern-day Ethiopia or Vietnam (Garcia-Ballester, “Academicism” 247). 20. For a recent study of the social implications of “diseasing,” see Nelkin and Tancredi, Dangerous Diagnostics: The Social Power of Biological Information.

21. Calisto’s mention of Erasistratus — “;O! jsi biviesses agora Erasistrato, médico, isentirias de mi mal?” (2:19) — would also draw a physician’s attention toward a diagnosis of amor hereos. ‘There is little doubt that the mention

of this ancient doctor alludes to the story of Antiochus and Stratonica, although an error in the initial printing of 1499, which transformed “Erasistrato” to “Eras y Crato” (later “Crato y Galieno”), has caused some confusion (Marciales 329). For an alternative reading that still supports the diagnosis of amor hereos, see Castels’s “El mal de amores de Calisto.” 22. Although Sempronio ridicules the nature of Calisto’s disease — “;Ha, ha, ha! ¢Este es el fuego de Calisto?” (2:23) — as well as the rhetorical means by which Calisto attempts to express his illness — “que por la boca le sale a borbollones” (2:22) — we should remember that the possibility of his master’s death from his illness is compelling enough to cause Sempronio to intervene actively. 293. My translations of Celestina are based on Lesley Byrd Simpson's 1955 translation.

24. Here Sempronio summarizes a well-known medical aphorism: “Todo esto se sigue de lo que dixo Avicena e otros munchos que, conoscida la enfermedat, ligera es la cura” (Alfonso Chirino, Espejo 366) [AI of this follows what Avicenna and many others said, once the disease is known, the cure is

easy]. ,

198 NOTES TO PP. 170—3 25. For a complete list and commentary, see the glossary of Modesto Laza Palacios’s El laboratorio de Celestina.

26. See Blumenfeld-Kosinski, “The Marginalization of Women in Obstetrics,” in Not of Woman Born: Representations of Caesarean Birth in Medieval and Renaissance Culture (91-119); Jeanne Achterberg, Woman as Healer; and Greilsammer, “The Midwife, the Priest, and the Physician.”

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Index

abjection, 62 Arbesmann, Rudolph, 24-5, 29 abscesses, 56 Arnau de Vilanova, 3, 52, 98, 130 adjurations, 36 ars dictaminis, 48, 95-6

Agatha, St., 139-40 ars praedicandi, 48, 95

air, 80 Asclepius, 22, 24 Albert the Great, 52, 55 Augustine, St., 3, 25, 26, 27, 94 Alfonso X, 44, 103-5; Cantigas, 103-5 Avicenna, 24, 34, 43, 51, 56, 61,

amor hereos, 9, 57; symptoms, 9, 58; 63, 67, 95, 97, 100; Canon,

treatment of, 10, 35, 58, 63 191NQ.

Amundsen, Darrel, 22, 28 anecdotes, as antidotes for sexual ail- Barthes, Roland, 74

ments, 69-75, 74 Benedek, Thomas, 24

Andreas Capellanus, 52 Benedictine Rule, 24 Andrew Treacher, 11 Berceo, Gonzalo de, 27, 42

Antifeminist writing, 2-3, 8 Bernard of Gordon. 4, 9-10, 35,

aphrodisiacs, 53 38-39, 43, 55-8, 61, 63, 96, 112,

Arcipreste de Talavera: antifeminism in, 117, 120, 126, 129, 134, 143, 163,

10; critical views on, 2-3; concept 188ng of “amor desordenado” in, 8, 13, Black Death, 6 68; treatment of the human body Bloch, Howard, 3, 172 in, 7, 23-4; descriptions of women Boccaccio, 63, 113, 124, 142

as agents of infection, 75-93; Bona Fortuna, 39, 58-9, 61, 112 women as the demonic, 77; Bonaventure, St., 50, 56 description of women as excess, Brownlee, Marina Scordilis, 3 78-9; female speech, 79, 83-4;

sexual pathology 84; examples of cannibalism, 82, 88 emasculation, 87; infanticide, 90; Canguilhem, Georges, 67 organizing mechanism in, 97; con- Celestina, 165-72 ditions of the medical clinic in, Chirino, Alfonso, 30, 32, 47, 55,

105-11; concept and presence of 99-100, 137, 152, 177N15 confaulatio in, 111-21; title of, 113, | Christ: as healer, 24-6

128-9; alliteration in, 114; repre- Christine de Pizan, 1, 12 sentation of pain in, 126-8; appro- clergymen: and physicians, 22-32;

144-5. cine, 28

priations of female speech in, discouraged from practicing medi217

218 INDEX , clinic, 19-21; clinical healers, 21-2; emasculation, 86-7

definition, 19-20 empirics and folk healers, 149, 150

coitus: ailments caused by excessive Engelhardt, Tristram H., 17 use of, 55-6; necessary for good epidemic: women as, 91-2 health, 35; pleasure in, 50, trea- epilepsy, 34, 43

tises on, 51, frequency of, 55, Erasistratus, 22, 34 harmful aspects of, 55—6 Esopete ystoriado, 72

Comaroff, Jean, 33 Espéculo de los legos, 49, 96, 126 Compendio de la humana salud, 51, 57 Estéfano, 26, 38

confabulatio, 59-62 Eve, 77

confabulator, 60-63; in the Arcipreste

and the Spill, 111-21 fables: of infection and contagion,

confession, 29-30, 32; summa confe- 71-2; “Garcon que queria Casat

sorum, 96 con tres mugeres, 713 Of the

congenital defects, 56-57, 87-92 Husband and His Two Wives, Constantine the African, 34, 39, 43, 72; therapeutic power in,

51, 52, 54, 58, 61, 98, 133, 171 74 ;

contagion, 67-8, 70, 85-6; represen- flatulence: as a result of excessive

tation of, 74 coitus, 50

Coronel, Maria, 139-40 Flint, Valerie J., 27 . Cosmas and Damian, 135; “Miracle of Fourth Lateran Council (1215), 30

the Black Leg,” 135-7 Fracastorius, Hieronymus, 67, 85-6,

Council of Tortosa (1429), 32 93

courtly love, 11 Galen, 7, 22, 34, 35, 54, 67-8 Gentil dama y el rustico pastor, 73-4

demons, as cause of disease, 42 Garcia-Ballester, Luis, 24, 103, 149

deontology. » 23, 38, 39 Gerard Cremona, 24

Devil, 77, 181n56; as cause of disease, Gerard of Berry, 39, 63 42; sexual intercourse invented by Gerli, Michael, 2, 1751

the, 50 Getz, Faye Marie, 31

Diego el Covo, 12 t Gilman, Sander, 92

disease, g—10; and ideology, 19; astfO- Guibert of No gent, 42 logical explanations of, 44; caused Gyjigo Lanfran C, 41 by Adam’s fall, 41; caused by

demons, 42; caused by excess or hagiography, 27 deficiency, 43; caused by sin, 41; hair, 55, 72; loss as a result of exces-

descriptions used as cure for sive intercourse, 72; related to lovesickness, 62; definitions of, 11, strength, 85 17; medieval explanatory models healing: and ideology, i8—19; and of, 40-5; the patient’s sense of, 46; order, 33; discursive strategies of, ontological notions of disease, 67; 32-40; Charms, incantations, and

“seeds of,” 68; adjurations, 36—7, 103

Dominicans, Dominican order, 29 heart, 53-4 drugs: quality of concretness, 101 Hospital, 152-3

Henri de Mondeville, 27-8, 178n23

Eisenberg, Leon, 17-18 Hippocrates, 20—2, 67; first aphoEiximenis, Francesc, 29, 63, 131, 142 rism, 20-2, 98

INDEX 219 Huguet, Jaime, 136 Lucy, St., 139-40

Humbert of Romans, 29, 46 Luis de Lucena, 2 lust, 50 illness, 17

imagination, 38, 53, 56-9; as cause of Maimonides, 20-1

birth defects, 56-7, 186n28, in Martinez de Toledo, Alfonso, 60, 71;

producing lovesickness, 58 ecclesiastic life, ‘7; medical

incantations, 36 training 7, 23-4, views of fifindexing: in medieval handbooks, 96 teenth-century Spain, 13 infanticide, 88 Mary of Egypt, St., 69—70 infection, 68; etymology of, 68, repre- = masturbation, 18, 176n6

sentation of, 74; women and, 80 Matulka, Barbara, 2

Innocent III, Pope, 32 McVaugh, Michael, 149 Isidore, St., 41, 42, 68, 91, 94, measles, 67

181n55, 182n2 medical handbooks and treatises, 95,

Issac Israeli, 21, 38-9 162

99 80

medical licensing, 151-4

Jacquart, Danielle, 71 melancholy, 58

Jacme d’Agramont, 6~8; Regiment de Mena, Juan de, 63 preservacio de pestilencia, 6, 31, 92, menstruation, 56, 80-1, 91; menses,

Jacobo de Voragine, 135 Merskey, Harold, 17

Jerome, 24 Michael Savonarola, 53 Jewish healers, 150 midwives, 149

Johannes de Ketham, 51 misogyny, 1-4, 63, 172; in treatment Johannitius (Hunain ibn Ishaq), 7, of lovesickness, 63

24, 43, 178n10, Mirror of Coitus, see Speculum al

John of Gaddensen, 53, 180n40, foderi,

John of Turre, 34 monastic medicine, 24 Juan de Avinon, 52 moorish healers, 149 morisco healers, 103, 150 Kibre, Pearl, 24

Kleinman, Arthur, 40 Naylor, Eric, 195n15. Nutton, Vivian, 67

Lain Entralgo, Pedro, 29, 36 naturals, 43 leprosy, 50, 56, 67, 84, 87, 183n3 non-naturals, 43

Liber minor de coitus, 51 Nunez, Francisco, 138 liver, 54 Nykrog, Per, 2 literature: medieval definition of, 94

Llull, Ramon, 29 ointments, 53

Lopez de Villalobos, Francisco, 61, Olson, Glending, 7, 60

64, 93, 97, 112, 121 Ornstein, Jacob. 2

logotherapy, 29, 36-40, 103 Ovid, 62-623 lovesickness, 9; definitions of, 11;

pathology of, 9; treatment of, 10, pain, 18; as a cure for lovesickness,

29 59, 124-33; representation of in

Lucretius, 49, 62, 67-8 medieval medical treatises, 125

220 INDEX Paracelsus, 56-7 semen, 11, 54, 184n16

Paul, St., 42 sevillana medicina, 52

Pere IV of Aragon, 83 sexual ailments, 11; seminal super-

Perfumed Garden, 53, fluity, 11; ailments related to pestilence, 5-6, 64, 68, 81; in excessive coitus, 55-6; see also Valencia 5-6, 68; pestilential con- lovesickness and amor hereos;

ditions in women, 81 dehydration, 84 Peter Wright, 11 sexual desire, the formulation of, Petrus Hispanus (Peter of Spain), 23, 2-2

62, 99, 138 sexual physiology, 51

physicians: and clergymen, 22-32; Siraisi, Nancy, 23

doctor-patient relation, 19; smallpox, 67 morisco physicians, 32 Sodom and Gomorrah, 50

plague treatises, 6 Solomon, 80

plague, 6, 68; see also pestilence Sorapan de Rieros, Juan, 115

Plato, 37 Speculum al fodert, 4, 34, 51, 53, 54;

Plutarch, 9 96, 98, 183n7

course, 54 legos

pneuma: necessary for sexual inter- Speculum laicorum, see Espéculo de los

poison, 83 Spill: antifeminism, 10; medical con-

potions, 83 cepts, 5; description of women as Pouchelle, Marie-Christine, 28 infection, 75-93; women as disprayers, 37 ease, 76—7; women as demonic, preaching, 29, 47-8 77; narrator’s first wife, 76, 78; punitive miracles, 41 second wife, 76; third wife, 76-7; description of women as excess,

Requena, 77 a Roig, Jacme, 69, 71; professional aaa development, 5; library, 5; writing

S—Q;ofles of lation, Real Protomedicato, 152 70-9; infanticide, examples emasculalion . 86—7; 88; organizing mechanism in, 97; conditions of

the medical clinic in, 105-1; con-

. cept and presence of confaulatio of the .Spill, 7; description ofin, 111-21; meter, 121; represen-

women as infection, 75-93; . _— , .. tation of pain in, 129-33. Examiner of Physicians, 155 oe ; story telling: as medical remedy, 60;

Rojas, Fernando de, 130 as hvoienic practice. 71

Rubio Vela, Agustin, 149 8 P 7 syphilis, 68 Ruiz, Juan, 71, 94

Taussig, Michael, 18-19

Samson, 85 Tacuiunum sanitatis, 60

Sariera, Berenguer, 31, 98 Temkin, Owsei, 22-3 Satan, 77; see also Devil temperaments: proper for coitus, 55 Santiago de Compostela, 101 teratology, 91

scabies, 67 Tertullian, 24, 28, 69

Scarry, Elaine, 126 Thomasset, Claude, 71 Schulenburg, Jane Tibbets, 140 toothaches, 36 Sebastian, St., 74, 81-2 torture, 124-33

Second Lateran Council, 28 translatio imperil, 44

INDEX 221 translation; of medical texts from Virgin Mary, 132

Latin, 31 Vives, Juan Luis, 63

Tratado de la generaci6n de creatura, 57

Whyte, Susan Reynolds, 102

Ugalde, Antonio, 101 William of Saliceto, 51

women: as the cause or agent of dis-

vade mecum, 19gOn2 ease, 64, 80-1; as infectious and

vagina: as “extra door,” 79 contagious, 69, 75, as excess, 78; van der Geest, Sjaak, 102 as uncontainable fluidity, 78;

Varro, 68 speech of, 78-9, 83-4, 133; as

Valles, Francisco, 60, 181n49, man-eaters, 82, 88; who poison Valencia, 6; plague in, 5—6, 68 men, 83; and the power to dis-

Vicent Ferrer, St., 29, 32 ease, 161-5; feigning disease, Vida de Santa Maria Egipciaca, 70 163-4

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