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2
William Holme, medicus
his chapter will focus on one English friar, whose career as both medical
T
practitioner and author or compiler can be explored at a greater level of
detail than any other. It will also turn out to be an exploration of the boundary
between medical practice and medical writing by friars. William Holme OFM
is the friar most frequently mentioned in the Tabula medicine as practising
medicine, and whose practice seems to have been exemplary for the compilers
of that text. He also wrote or compiled two medical texts himself. e overlap
between these two areas of Holme’s activity is not easy to see. Neither of the
texts under his name were cited as authorities in the Tabula medicine, and
the compilers probably knew William Holme only as a successful Franciscan
medical practitioner. Contrariwise, neither of Holme’s two medical works
make mention of the Tabula medicine, probably because they were written
before the Tabula medicine was compiled. One work by Holme was dated to
the year 1415, which is one year before the beginning of the compilation of
the Tabula medicine. Perhaps William Holme only turned to writing after his
practice of medicine ceased. Cases where he treated patients in the Tabula
medicine seem to belong to the end of the fourteenth rather than the fteenth
century. Because the subject of this book deals with medical practice and
medical writing by friars, Holme is a particularly intriguing case study, as he
is the only friar clearly associated with both these spheres of activity.1 In this
chapter I will consider Holme’s medical practice rst and then his writings.
Holme’s Medical Practice
We know more about Holme’s patients and his medical practice than we
do for any other English medieval practitioner, with the single exception of
omas Fayreford. Links between the two of them are worthy of consideration.
1
A previous version of this chapter appeared as P. M. Jones, ‘William Holme, medicus,
O.F.M. (. 1380–1415)’, in Testimony, Narrative and Image: Studies in Medieval and
Franciscan History, Hagiography and Art in Memory of Rosalind B. Brooke, ed. M. F.
Cusato and M. J. P. Robson (Leiden, 2022), pp. 204–28. I am grateful to Brill, the
publishers, for giving permission for that essay to be reworked here.
Fig. . Portrait of a Franciscan holding up a urine glass while clasping a book. His attendant
appears to hold a book bag. A later reader identied the friar as ‘Bachon’. Added to a medical
manuscript written in English. th cent. British Library, MS Royal C XV, fol. r.
William Holme, medicus 75
Fayreford, who seems to have ourished in the second quarter of the fteenth
century, would have been aware of William Holme’s fame as a practitioner.
Fayreford spent time at Oxford and read widely in practical medical literature.
He read and cited the Tabula medicine, in which Holme is so prominent.2
Fayreford’s own compilations on medicine and surgery survive in one fteenthcentury manuscript, British Library, MS Harley 2558. is manuscript, partly
written in Fayreford’s own hand, provides a list of people he treated for various
complaints. Like the Tabula medicine, Fayreford’s two compilations on medicine
and surgery consist of remedies organised under dierent ailment headings.
Fayreford may in fact have modelled his own work, in its close relation to
medical practice and its organisation by ailments, on the Tabula medicine. He
does not mention William Holme by name in his compilation, but Fayreford
would have hoped through his own writing to achieve the same renown as a
successful medical practitioner.
3
William Holme seems to have ourished as a medical practitioner and
author c. 1380–1415. What we know of his life comes from the Tabula
medicine alone.4 Anthony Parkinson, the early eighteenth-century historian of
the Franciscans, had this to say about him in his Collectanea Anglo-minoritica:
He retired home to his Convent [after his ‘public studies’], where he
privately spent sometime in the Study of Physick; that so he might be
qualied, not only to apply proper remedies to Mens inrm souls, but also
to their diseased Bodies; nor did he thus proceed without good Motives
for so doing, nor without good Success in his Performances. He drew his
skill in Physick from his great Knowledge of natural things; which, by a
diligent Application, he had learnt in Philosophy: And (which ought to be
chiey consider’d) it seems very plain by the Eects, that he had received
from God the Gift of curing Distempers; and therefore was wonderfully
successful in all his Practice of that kind, and very often cured Diseases
which seem’d naturally incurable. Such was his charity, that he neglected
2
BL, MS Harley 2558, fol. 148v: ut dicunt fratres minores.
3
P. M. Jones, ‘omas Fayreford: An English Fifteenth-Century Medical Practition-
er’, in Medicine from the Black Death to the French Disease, ed. R. French, A. Cunning-
ham, J. Arrizabalaga and L. García-Ballester (Aldershot, 1998), pp. 156–83.
4
Jones, ‘Mediating’. For manuscripts containing the Tabula medicine, see P. M. Jones,
‘e Tabula Medicine: An Evolving Encyclopedia’, English Manuscript Studies 1100–
1700, vol. 14, Regional Manuscripts 1200–1700, ed. A. S. G. Edwards, 14 (2008),
60–85. William Holme is not the same man as the William Holm who was a royal
surgeon in the 1370s. See Talbot and Hammond, Medical Practitioners, p. 403: our
Franciscan Holme is credited there as M.D: ‘It is not known where Holme took his
medical degree, but it was probably abroad’, for reasons which are unclear.
76 The Medicine of the Friars in Medieval England
not any person, even of the meanest Circumstances; Poor and Rich, High
and Low were indierently admitted by him; he was equally solicitous for
all Ranks, and used his utmost Care to cure all, without any Expectation of
temporal Prot to himself; for his Endeavours were perform’d gratis; and on
this Account he was both admired and beloved by the common people, and
also greatly esteem’d by persons of quality, and those of even the rst Rank.
He composed and publish’d A compleat Volume of Simple Medicines;
which work, as Leland says, is in St Peter’s College at Cambridge. Of his
other writings I nd nothing.
5
But there are no surviving records of his residence in a convent, or of his
ordination, his licensing to preach or hear confessions, or of his death. His
own writings on medicine reveal nothing except his name and order and the
date of his writing of one work (1415).
Holme’s Patients
In the Tabula medicine, Holme is mentioned more than one hundred times,
almost invariably in the form ‘per fratrem W. Holm’ at the beginning or end of a
particular remedy. He is referenced more than any other practitioner. Although
we do not know to which Franciscan house or houses Holme belonged it is
clear that much of his practice centred on London. One of his patients was the
Franciscan minister provincial for England, Nicholas Fakenham, whom he
treated for Colica (Colic). is was during Fakenham’s term as minister (tunc
ministro); it must have occurred during the years 1395 to 1402.6 As minister
provincial, Fakenham was the most important man in the English order, and
in fact he is the only Franciscan known by name that Holme treated. London
was the normal residence of the minister provincial, who moved from friary to
friary, discharging business and conducting visitations. It is conceivable that
William met and treated him outside London, but more likely that it was at
5
A. Parkinson, Collectanea Anglo-minoritica: Or, A Collection of the Antiquities of the
English Franciscans… (London, 1726), pp. 194–5. Parkinson says that Holme was
an Observant Franciscan, but this is unlikely even if he had travelled in Italy, where
some Observant houses were permitted from 1415 (there was no English Observant house until 1480–1). Parkinson’s sources for what he has to say about William
Holms (sic) are unknown.
6
For Fakenham as minister provincial, see A. G. Little, Franciscan Papers, Lists and
Documents (Manchester, 1943), p. 198. I thank Dr Michael Robson for assistance in
making this identication. e Colica case is found in University College, MS Lat.
11, fol. 38r.
William Holme, medicus 77
the London Greyfriars. Holme’s practice was not limited to London, however,
and his distinguished patients came mostly from outside his Order.
Under two closely related headings, Dissinteria (Dysentery) and Fluxus
(Flux), we nd that Holme tried (probatum) on Lady Trussell in London a
remedy employing the expensive and legendary myrobalans (a kind of Indian
dried plum).7 His patient is likely to have been the second wife of Sir Alfred
(or Avery) Trussell, a landholder, an MP between 1399 and 1407, and sheri
of Warwickshire and Leicestershire 1402–3.8 Her rst name is not known.
e Trussell family held the manor of Billesley in Warwickshire; and omas,
rector of Billesley, is cited as a source for other remedies in the Tabula medicine,
under the headings of Malum mortuum and Vulnus (Wound). It seems likely
then that William Holme acted as medical practitioner for the Trussell family
of Billesley and possibly served them as their confessor, too.9 He may have been
the person who passed on the rector’s remedies to the compilers of the Tabula
medicine. His contact with the Trussells extended probably to Warwickshire
as well as London.
If the Trussell connection puts Holme as medical advisor to a prominent
gentry family, then other entries in the Tabula medicine suggest that his
expertise was valued in royal circles. Under the entry for Pedes (feet), we nd
that Holme tried out a remedy for swollen legs and feet on the duke of York,
that is, Edmund of Langley, rst duke of York, fourth surviving son of Edward
III, who died in 1402. Holme also used an ointment to heal the injured and
putrid testicles of a knight in the household of the queen (Anne of Bohemia
or Isabella of France). Both queens had Franciscan confessors, and that may
have been a point of initial contact or recommendation for Holme. ese
entries put Holme at court – as prominent a medical practitioner perhaps
as William Appleton, who was retained by John of Gaunt (see Chapter 1).
Holme’s remedy for Malum mortuum tells us that the knight he treated for this
condition paid 100 shillings for the ointment concerned, and so it was called
the sanativum punchardonum, that is ‘Punchardon’s remedy’. is knight must
7
See E. Lev and Z. Amar, Practical Materia Medica of the Medieval Eastern Med-
iterranean according to the Cairo Genizah (Leiden, 2008), p. 71; R. Yoeli-Tlalim,
‘Myrobalans: e making of a Eurasian Panacea’, in R. Yoeli-Tlalim, ReOrienting
Histories of Medicine: Encounters along the Silk Roads (London, 2021), pp. 63–84.
8
L. S. Woodger, ‘Trussell, Sir Alfred (or Avery) (b. bef. 1349), of Nuthurst, War-
ws.’, e History of Parliament, http://www.historyofparliamentonline.org/vol-
ume/1386-1421/member/trussell-sir-alfred-(or-avery)-1349#biography.html/,
accessed 20 April 2023.
9
See ‘Parishes: Billesley’, in A History of the County of Warwick: Volume 3, Barlichway
Hundred, ed. P. Styles (London, 1945), pp. 58–61.
78 The Medicine of the Friars in Medieval England
have been one of the Punchardon family, originally from Pont-Chardon in
Calvados, Normandy; perhaps the suering knight was the son or grandson
of Sir Richard de Punchardon, who held land at Little Bovey in Devon and
was given high military oce in the reign of Edward III.10 is 100-shilling
remedy was very expensive, and it may seem remarkable that a friar should
ask and receive such a large sum.11 Holme’s various remedies for his patients
suggest a medical practitioner with a reputation in royal and aristocratic circles,
able to command the highest fees for one-o treatments, and the deviser of a
prestigious remedy with its own brand name.
Other patients mentioned, but not by name, range across the social
spectrum. ey include a cardinal (under Urina) and someone identied as
a cotus, perhaps a grounds-keeper (suering from Glandule, glossed as ‘a wen’
in English). In one case, the patient was himself a distinguished medical
practitioner. e medicus of the bishop of Winchester was at death’s door
suering from violent diarrhoea (Colerica passio) when Holme treated him
successfully. Holme’s expertise must have been such that even the best medical
practitioners needed his services. Where the text mentions patient names, their
social position must sometimes be guessed from the kind of treatment oered.
An ointment for Fluxus (ux) was prescribed by Holme for Cliord: to judge
by the expensive spices among the ingredients, this Cliord was somebody of
high status. However, like many other medieval practitioners, Holme reserved
some remedies for the poor, who could not aord expensive ingredients. Several
of his remedies for Fluxus involved the use of spices, suitable only for the rich,
like Cliord, but one is specically for poorer patients (pro pauperibus). is
treatment involved a combination of herbs and no spices. Whether for rich
or poor, Holme’s remedies stood the test of experience. Many of them are
probatum (tested) in general or on a particular patient.
Holme’s clientele was not exclusively male, as we saw in the case of Lady
Trussell. Nor did he avoid gynaecology, even though he was a friar. He
recommended a diet and a plaster for pain in the side suered by a pregnant
10
E. G. Punchard, ‘Punchard of Heanton Punchard, County Devon’, Report and
Transactions of the Devonshire Association 25 (1893), 382–8; L. C. Loyd, e Origins
of Some Anglo-Norman Families, ed. C. T. Clay and D. C. Douglas, Harleian Society
Publications 103 (Leeds, 1951), p. 83.
11
For similarly large sums charged for medical cures, see Rawclie, ‘Prots of Prac-
tice’; the contemporary surgeon, John Arderne, claimed never to have operated on
stula in ano for less than 100 shillings: P. M. Jones, ‘John of Arderne and the Med-
iterranean Tradition of Scholastic Surgery’, in Practical Medicine from Salerno to the
Black Death, ed. L. García-Ballester, R. French, J. Arrizabalaga and A. Cunningham
(Cambridge, 1994), pp. 289–321 (p. 298). A Dominican friar was paid 40s for a
cure at York in the late 1420s: Getz, ‘Archives’, p. 256.
William Holme, medicus 79
woman. Where suocation of the womb is the problem – that is to say, when
the womb itself or vapours emanating from it move up towards the heart and
make it hard for the woman to breathe – Holme prescribed a combination of
oils for applying with the ngers inside the vulva, and for the womb itself to
be pushed back into position where possible. Perhaps he meant this hands-on
treatment to be carried out by a midwife acting under his direction – although
the Tabula medicine text does not say so, instead simply crediting Holme with
the necessary expertise.12 Monica Green has argued that there was a steady
advance in male authority over, and practice of, gynaecology in Europe in the
thirteenth and fourteenth centuries. Perhaps the role of friars as gynaecologists
should not come as too much of a surprise, despite inhibitions about contact
with women expressed so ercely in the Franciscan Rule and constitutions.13
Certainly Holme was not the only English friar with an interest in gynaecology.
Entries for female ailments feature prominently in the Tabula medicine, and
other friars are cited as sources for remedies.
14
What ailments did Holme treat?
When we look at the range of conditions treated by Holme, we see that his
practice covered most areas of physic and surgery, as understood in his time. In
all, he intervened in sixty dierent areas of illness. Beyond these, there are ve
other headings in the Tabula medicine where Holme is mentioned for specic
medicines (balsam, and a draget or dredge, a sweet preparation), or for kinds
of medicine that achieve particular eects on the body (for example medicines
which are restorative, laxative or constraining under Strictorium).
Among the illnesses he treated, Holme was particularly expert in fevers, uxes,
various kinds of swellings on the body, pestilence, sexual problems and urinary
complaints. is is reected in the number of remedies he has ‘proved’ under these
headings. Surgery fell within his province too, as shown by his treatment of the
legs of the duke of York and use of the sanativum punchardonum. ese surgical
remedies did not explicitly involve ‘burning or cutting’, so Holme might have
avoided the censure of the Church expressed in canon 18 of the Fourth Lateran
Council (and after) on those clerics in major orders who practised manual surgery
and cautery.15 On the other hand, the entry for Tisis (Phthisis) or consumption,
tells us that Holme tried out on himself Avicenna’s remedy of applying cauteries
12
All these cases are cited under the heading ‘Matrix’.
13
M. H. Green, Making Women’s Medicine Masculine: e Rise of Male Authority in
Pre-Modern Gynaecology (Oxford, 2008).
14
Jones, ‘Mediating’, pp. 302–4.
15
Amundsen, ‘Medieval Canon Law’, pp. 41–3.
80 The Medicine of the Friars in Medieval England
(with heated irons) to the chest to dry out material in the lungs and evacuate it.
Holme applied very small cautery irons to his own chest in ve dierent places,
then washed the wounds with honey water and applied healing agents. Perhaps
he tried this remedy on other consumptive patients too.
16
University-trained physicians prided themselves on their skill in diagnosis
and prognosis. is was the standard of rationality in medicine, and thus they
set themselves apart from other kinds of healers who relied on experience
alone. e Tabula medicine makes it hard to judge whether mendicant
practitioners attached the same importance to diagnosis and prognosis as did
secular physicians. e Tabula medicine prioritises therapeutics, and only a brief
introduction to each entry discusses the nature and development of an ailment
in the patient. ere is seldom discussion of signs and symptoms. Because of
this textual bias, we cannot be certain whether Holme knew and followed
the recommendations of diagnostic and prognostic texts written by university
physicians. e Dominican friar Henry Daniel certainly knew these well, as
he wrote a long and comprehensive guide to uroscopy in Middle English.17
Daniel references a wide range of academic medical authorities. He did much
more than just translate his Latin authorities into Middle English. He made
an authoritative interpretation of these texts, resolving disagreements between
authors. Henry Daniel’s enterprise suggests that friars were as well read in
diagnosis as in other areas of medical science and attached just as much
importance to its techniques as lay physicians did.
Another feature of university medicine was its emphasis upon diet and
regimen. By knowing how to control the six non-naturals (air; motion or
exercise, and rest; sleeping and waking; food and drink; excretion; and passions
of the soul, or emotions), the physician could keep the body near to its proper
balance of qualities and humours and avoid disease – this was reckoned a
16
Cf. Avicenna, Liber canonis, Lib. 3, fen 10, tract. 5, cap. 5 (Venice, 1507), sig. mm4
recto: tunc necessarium est cauterium eri cum cauterio minuto quo perforetur
pectus ut exiccetur materia & trahatur paulatim (en it is necessary for there to be
cautery, using a little cautery iron with which the chest is to be penetrated so that
the matter may be drained and drawn out slowly).
17
Daniel, Liber Uricrisiarum. See also ‘e Liber Uricrisiarum’, e Henry Daniel Pro-
ject, accessed 14 April 2023, http://henrydaniel.utoronto.ca/urines/; R. Hanna, ‘Henry
Daniel’s Liber Uricrisiarum (Excerpt)’, in Popular and Practical Science in Medieval Eng-
land, ed. L. M. Matheson (East Lansing, 1994), pp. 185–218; J. Jasin, ‘A Critical Edition
of the Middle English Liber Uricrisiarum in Wellcome MS 225’ (unpublished PhD
dissertation, Tulane University, 1983); T. A. Johannessen, ‘e Liber Uricrisiarum in
Gonville and Caius College, Cambridge, MS 336/725’ (unpublished MA dissertation,
University of Oslo, 2005), https://www.duo.uio.no/handle/10852/25409/, accessed 23
January 2023. Henry Daniel will be treated at more length in Chapters 3 and 4.
William Holme, medicus 81
Fig. . Diagram of quaternities, from Henry Daniel OP, Liber uricrisiarum, th cent.
Cambridge University Library, MS Ff.., fol. r. Homo (man) is at the centre. He is
surrounded by names of elements, qualities, seasons, humours, ages, and winds – all but
the last in fours. ey are all understood to act on man’s health.
superior skill to that involved in treating illness once it was diagnosed.18 Again,
since the Tabula medicine was compiled as a collection of therapeutic remedies,
it did not set out to explain how best to control the non-naturals. But one
entry at least suggests William Holme did attach importance to this area of
18
On the academic importance of regimen, see M. Nicoud, Les régimes de santé au
Moyen Âge: naissance et diusion d’une écriture médicale (XIIe–XVe siècle), 2 vols.
(Rome, 2007). See also P. Gil-Sotres, ‘e Regimens of Health’, in Western Medical
ought from Antiquity to the Middle Ages, ed. M. D. Grmek (Cambridge, MA,
1998), pp. 291–318.
82 The Medicine of the Friars in Medieval England
physic. Under Febris quartana (quartan fever), Holme recommends a diet for
patients liable to its periodic attacks. On the day when an attack is expected,
the patient can eat for ve hours beforehand, but should not drink wine at
all, only weak beer. His food should be a light collation of chicken. Once
the attack has started, he should not sleep or eat if he can help it but take a
medicine instead to assuage his thirst. Afterwards, he should avoid certain
meats including hare, venison and beef, and sweat it out as long as he can,
liable as he is to a dry mouth and perspiration. In the days following the attack,
he must avoid dangerous meats and in particular waterfowl. Holme goes on
to give a very specic list of the sh with scales the patient can eat. Holme
uses the English words for perch, roach, pike, gudgeon, stickleback, crabs and
freshwater craysh; he must avoid oysters, shellsh, loach, eels, tench or any
sh where the scales might stick to the ngers.19 is preference for sh with
scales is found in a number of the more common late medieval regimens of
health; most relevantly, it is applied to quartan fever in book one on fevers of
the Compendium medicine of Gilbertus Anglicus, an author denitely known
to Holme.20 Specicity about the distinct kinds of sh, and the use of English
terms in Holme’s fever diet, suggest strongly that he devised this regimen for a
particular patient, elaborating on the basic idea of the Gilbertus Anglicus text.
Holme’s relationship with his clients, particularly the high-born ones, must
have involved giving them advice on regimen and diet alongside the kind of
spiritual advice he would give them as their confessor.
Holme sometimes devised entire courses of treatment for his patients,
rather than just suggesting or applying single remedies for their illnesses. In
19
University College, MS Lat. 11, fols. 88v–9r: Dieta quartanarii secundum fratrem
W holm est ut in die accessionis comedat per v horas ante accessionem sed non
bibat vinum illo die sed ceruiciam tenuem nec nouam nec nimis antiquam comedat
carnes pullorum & collaticiam de eis & in tempore accessionis nullo modo dormiat
nec bibat si poteris abstinere & si non poterit bibat modicum vel habeat medicinam
sitim extinguentem // Post accessionem bibat comedat & dormiat si voluerit sed
prohibentur in quartana carnes ferine leporine bouine acetum & olera caulium et si
contingat quod sudet & os non desiccatur per horam nec corpus debilitatur sudet
quam diu poterit pati et si debilitatur amoueantur paulatim successiue // In diebus
vero quietis comedat bibat quidcumque & quando voluerit sed abstineat a carnibus
& ferinis ut predictum est at ab auibus aquaticis de piscibus comedat squamas
habentes scilicet perche roche pik gogones stikelyng crabbes creuers stripes sed
nullo modo ostrias uel conchilia neque loches anguillas neque tenches neque pelles
piscium que adherent digitis.
20
Gilbertus Anglicus, Compendium medicine, Liber 1, cap. 25 de quartana vera in-
terpollata (Lyons, 1510), fol. 49 (written originally c. 1250). See M. R. McVaugh,
‘Who was Gilbert the Englishman?’ in e Study of Medieval Manuscripts of Eng-
land, ed. G. H. Brown and L. E. Voigts (Turnhout, 2010), pp. 295–324.