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Souls and Bodies 173
political subjects in a way that resembled the genre of the ‘mirror of princes’.22
I will explore this aspect of counsel further in the section on Regimen below.
Cura animarum: Confession and Healing
At the sickbed and the deathbed, the confessor and the physician or healer
meet head on. In manuscript illuminations, they are sometimes pictured in
the same scene: the patient in the bed, the confessor reading from a book,
and the physician holding up the urine glass. is reects what must also
have happened in practice at such stages in life’s journey, where both spiritual
and secular healing were called for. Canon 22 of the Fourth Lateran Council
set out to establish the priority of spiritual over secular healing, while also
recognising that spiritual healing could have benets for bodily health. e
tension between the two kinds of healing was also a staple topic for the
miracle story, where the Eucharist or the saint’s help was invoked to save
the patient’s body when secular healing had failed. Discourses about penance
made it clear that the profession of a healer was itself a source of hazard for
the penitent. Robert of Courson designated surgeons and physicians amongst
others as morally dubious professions requiring special investigation on the
part of the penitentiary.
But Canon 21 of the same Council describes confession in terms which
emphasise not conict or tension but the essential similarity of the two forms of
healing. It requires the faithful to confess their sins at least once a year to their
own parish priest or to another priest (for a good, but unspecied, reason – and
this will be the opening for the new orders of friars to act as confessors). It goes
on to say:
23
Let the priest be discreet and cautious that he may pour wine and oil into the
wounds of the one injured after the manner of a skilful physician, carefully
inquiring into the circumstances of the sinner and the sin, from the nature
of which he may understand what kind of advice to give and what remedy
to apply, making use of dierent experiments to heal the sick one
in Philosophy and eology in the Studia of the Religious Orders and at Papal and Royal
Courts, ed. E. Kent et al. (Turnhout, 2012), pp. 165–80.
22
See Smalley, English Friars.
23
J. W. Baldwin, Masters, Princes, and Merchants: e Social Views of Peter the Chanter
& His Circle, 2 vols. (Princeton, 1970), I, p. 57.
24
Decrees, ed. Tanner, I, p. 245: Sacerdos autem sit cautus et discretus, ut more periti
medici superinfundat vinum et oleum vulneribus sauciati, diligenter inquirens et
peccatoris circumstantias et peccati, per quas prudenter intelligat, quale illi consili-
um debeat exhibere et cuiusmodi remedium adhibere, diversis experimentis utendo
24
174 The Medicine of the Friars in Medieval England
So here we have confessional practice explicitly modelled on that of the
skilful physician. More is involved here than simply a convenient source of
metaphor. As has been observed in respect of the early fourteenth-century
surgeon Henri de Mondeville, ‘the doctor and the confessor are, from a
structural point of view, in exactly the same position relative to those in
their care’.25 e patient/penitent must interact with the healer/confessor
and the purpose of the encounter is to promote the health/salvation of
one, through the ministrations of the other. Each stage of the encounter
between the two enacts the parallel. ere is rst a judicious examination,
resulting in a diagnosis of the complaint or sin, a prognosis of what the
consequences will be, and a prescription of what must be done or endured
if the subject is to be saved.
But if confessors were equivalent to physicians in fullling their role,
how were they to be informed and prepared for these responsibilities?
Who was to counsel the counsellors? e Lateran Council expected the
bishops to recruit and train preachers and confessors. English bishops in
their synodal constitutions laid out their expectations as to what confessors
needed to know. University-trained men in the circle of Peter the Chanter
in Paris wrote the rst inuential texts in the new genre of confessors’
manuals. One of the best known was by the Englishman omas Chobham
(d. c. 1233), subdean of Salisbury Cathedral. His Summa de Penitentia or
Summa confessorum, probably written 1215–17, was a handbook for a priest
who needed to prepare for being a confessor. But it was the new orders
of friars who were on hand to carry through the agenda of the Council
and the bishops. ey were best equipped through their own schools to
study and digest works like those of omas Chobham, and, summoned by
Grosseteste, to train those who could act as preachers and confessors for
the bishops. As early as the 1220s, Raymond of Peñafort, OP (1175?–1275)
was working on his Summa de casibus poenitentiae (Treatise on the cases
of penance), a manual of canon law for confessors, intended for use in
determining the type and amount of penance a person should receive for a
specic crime or sinful act. To pursue the analogy with medicine outlined in
the Fasciculus morum, Raymond’s work was equivalent to a work on materia
medica, guiding the confessor as to what remedies he should prescribe.
Perhaps the most detailed Dominican treatise on confession is by John
of Freiburg (c. 1250–1314). His Summa confessorum was completed before
ad sanandum aegrotum. See A. Murray, Conscience and Authority in the Medieval
Church (Oxford, 2015), p. 66.
25
M.-C. Pouchelle, e Body and Surgery in the Middle Ages, trans. R. Morris (Cam-
bridge, 1990), pp. 55 and 227, notes 43 and 45.
Souls and Bodies 175
1298 and draws on Raymond de Peñafort’s Summa de casibus penitentiae and
the moral theology of omas Aquinas. John’s penitential manual aimed to
instruct confessors on how to use the canon law and moral theology of the
Church in their task of carrying out the sacrament of penance. Both these
works enjoyed wide circulation in England.
ere was not much call for English mendicant authors of guides to
confessors, thanks to the success of the works of Raymond de Peñafort
and John of Freiburg. However, the Franciscan Peter Quesnel (or Quesuel)
wrote a Directorium iuris in foro conscientiae (Guide to law in the forum of
conscience) around 1320.26 Nothing more is known about him, although his
work was popular in continental Europe as well as in England. His prologue
announces he has organised his work so that poor clerics can nd the part
most useful for their immediate needs. e rst chapter discusses the Trinity,
faith and the seven sacraments, the second is a guide for those who are
required to administer the sacraments, the third deals with transgressions
that can be an impediment to receiving the sacraments, and the fourth with a
series of issues in canon and civil law. Its highly practical character as a guide
to confessors is enhanced by the tables of contents and indices providing
an alphabetical entry to the work, often found with it. Although Quesnel
does not make much of the medicinal analogy, a work by the French papal
penitentiary Jean Rigaud OFM of the early fourteenth century, the Formula
confessionis, presses this home:
Understand therefore my son that confession is a kind of medicine. Medicine
can be summed up in four things. First, setting aside, gathering, and
digesting corrupted and harmful humours. Second, purging evil humours,
present and past. ird, preserving against the evil humours in case they are
generated in the body. Fourth, compounding merits and virtues.
27
e language of purgation had resonance in advice to confessors. Once
diagnosed, sins could be purged by confession. In the case of Rigaud and
26
Roest, Franciscan Literature, pp. 333–5.
27
A. Teetaert, ‘La formula confessionis du frère mineur Jean Rigaud’, Miscellanea
historica in honorem Alberti de Meyer, Recueil de travaux d’histoire et de
philologie, Sér. 3.22 (Louvain, 1946), pp. 651–76 (p. 662): Vide igitur, li,
quod confessio est quedam medicina. Medicina autem sumitur ad quatuor.
Primo ad separationem, collectionem et digestionem humorum corruptorum
et nocivorum. Secunda ad purgationem malorum humorum presentium et
preteritorum. Tertio ad preservationem malorum humorum, ne in corpore
generentur. Quarto ad confectionem meritorum et virtutum. Also A. Teetaert,
‘Quesvel, Pierre’, Dictionnaire de théologie catholique, ed. A. Vacant and others
(Paris, 1903–72), vol. XIII.
176 The Medicine of the Friars in Medieval England
other authorities on penance, the purging of evil may be followed by the
acquiring of good. is is medicine by contraries. It is not concerned with
the idea of restoring a complexional balance appropriate to the individual
as expounded by scholastic physicians, but in expelling and replacing bad
things with good.
28
It is not always clear whether it is confession itself that is purgative, or
penance as a remedy applied by the confessor. Robert Grosseteste, the lector to
the Franciscans, used a dierent form of purgative analogy in his Templum dei:
In this table there is all the duty of the pastoral oce, that the twisting
snake is to be taken out by the hand of the obstetrician with wine and oil
against wounds and illnesses, and a purgative medicine is to be given during
the preliminary preparations, a medicine which induces health, and once
induced it conserves it until gifts and blessings are brought about instead of
illnesses and wounds.
29
is extraordinary analogy has the confessor playing an obstetric role in
delivering not a child but a snake or worm, suggesting both intestinal parasite
and Satan himself. e wine and oil are sacramental as well as medicinal.
e purgative itself must be the act of confession, which cleanses, but also
then goes on to allow the introduction of inner joys and blessings instead
of the illnesses and wounds of sin. What is envisaged as the business of the
confessor not only takes away what causes harm from the patient but provides
positive benets.
Works like those of Grosseteste and Rigaud counselled those who took on
the responsibility as confessors to the penitent sinner. eir priestly readers
were counselled to provide, through confession, the means to allow the sinner
to purge himself of sin and acquire blessings. e same kind of advice could
be oered to the penitent sinner directly. Writing for literate lay people, friars
could advise on the importance of contrition, the necessity of confession and
28
N. Cohen-Hanegbi, Caring for the Living Soul: Emotions, Medicine and Penance in
the Late Medieval Mediterranean (Leiden, 2017), pp. 104–6; P. M. Jones, ‘Complex-
io and Experimentum: Tensions in Late Medieval English Practice’, in e Body in
Balance: Humoral Medicines in Practice, ed. P. Horden and E. Hsu (London, 2013),
pp. 107–28, explores the limits of the complexional model.
29
Robert Grosseteste, Templum Dei: Edited from MS. 27 of Emmanuel College, Cam-
bridge, ed. J. Goering and F. A. C. Mantello (Toronto, 1984), p. 38: In hac tabula
est tota cura ocii pastoralis, ut obstetricante manu per vinum et oleum contra
vulnera et inrmitates educatur coluber tortuosus, et preambulis preparationibus
detur medicina purgativa inducens sanitatem, et inductam conservet quousque pro
inrmitatibus dotes et pro vulneribus beatitudines inducantur; trans. McCann,
Soul-Health, p. 54.
Souls and Bodies 177
the acceptance of penitential practices. e seven penitential psalms were
an important part of the liturgy and were readily adaptable as devotional
reading for this purpose. e Carmelite Richard Maidstone (d.1396) wrote
a translation of the penitential psalms into English in the 1380s. Maidstone
himself became confessor to John of Gaunt, duke of Lancaster, in the 1390s,
and was a celebrated preacher. e poem is in eight-line ballade stanzas. Each
stanza of the poem starts with the Latin text of the psalm, follows it with an
English literal paraphrase and then ends with a rhetorical amplication. e
purpose of the Penitential psalms is articulated in medical terms:
Mercy, lord, for I am seke;
Hele me, forbrused beþ all my bones
30
Christ is addressed as the ‘lowly leche’ (l.131). Penitence is envisaged by
Maidstone not so much as purgative but as a therapeutic bath in which the
lth of sin can be washed away. is is elaborated so that the sinner washes in
their own tears in order to heal their soul. Each penitential psalm in turn is
given a place in a devotional progress to full contrition. Psalm 6 dwells on the
acknowledgement of sin; Psalm 31 on the penitent’s need of a clear conscience
and true confession; Psalm 37 on the nature of confession itself; Psalm 50 on
a prayer for grace; Psalm 101 on a dramatic dialogue between Christ and the
sinner, assuring them of Christ’s atoning action at the crucixion; Psalm 129
on a contemplation of nal judgement; Psalm 142 on a direct prayer to Christ
for grace to resist further temptation.
31
e only other poetical translation into Middle English of the penitential
psalms was also the work of a friar, omas Brampton OFM. All that is known
of him is from manuscripts of the work which state that he is a confessor and
a theologie sacre doctor (Doctor of sacred theology), and that his translation
dates from 1412. His translation is much more literal than that of Maidstone,
providing a close paraphrase of the psalms. But the rst six stanzas that set the
scene before the translation begins place the speaker explicitly in the context
of the examination of his conscience. e speaker is sick in his bed:
As I lay in my bed
And sikenes Revid me of my rest
What maner life þt I had led
30
Richard Maidstone’s Penitential Psalms: Edited from Bodleian MS Rawlinson
A.389, ed. V. Edden (Heidelberg, 1990), ll. 17–18, as quoted by McCann, Soul-
Health, p. 59.
31
Penitential Psalms, ed. Edden, p. 79.
178 The Medicine of the Friars in Medieval England
For to thynke me thoughte it best
…
As a consequence of this train of thought, the speaker sends for a ‘brodir ful
dere’ and makes confession to him. In Psalm 31 verse 5, the ‘Tu es refugium
meum a tribulatione que circumdedit me’ of the Latin psalmist is rendered as
ou are myne help in all diseas
Whan I am wounded in any wo
is interpretation of aiction, tribulation or woe as a sickness or wound
in the speaker is carried through the poem. What Brampton calls ‘unwise
gouernaunce’ is responsible for the wounds that ‘be Rotyn and festererith wt
in’ (l. 35). is is governance as spiritual regimen of the individual, but unlike
Maidstone, Brampton sometimes envisages the solution by addressing the
educative role of the clergy within society:
Preestys perfyte in ther leuyng
Shulden telle þe peple þe ryght waye
And teche knyghtys commonns and kyng
How þey shulde serue god to paye (l. 96)
32
e Franciscan author of Dives and Pauper, a dialogue written c. 1405,
puts Pauper (evidently a well-read mendicant preacher) in the position of a
confessor or counsellor advising Dives (a rich layman) on how to lead a virtuous
life in accordance with the Ten Commandments. e author was very likely
employed on the household sta of an English magnate, to whose patronage
he was indebted. It sets out a vision of the ‘mixed life’, in which the layman
can practice the art of contemplation within the setting of an active way of life.
e text is full of exempla, poems and miscellaneous lore, and in that respect
is more of a colloquy for laymen to read and gain spiritual guidance than
a straightforward dialogue between antagonistic points of view.33 e work
32
J. R. Kreuzer, ‘omas Brampton’s Metrical Paraphrase of the Seven Penitential
Psalms: A Diplomatic Edition of the Version in MS Pepys 1584 and MS Cam-
bridge University Ff 2.38 with Variant Readings from All Known Manuscripts’,
Traditio 7 (1951), 359–403; M. P. Kuczynski, Prophetic Song: e Psalms as Moral
Discourse in Late Medieval England (Philadelphia, 1995), pp. 124–35; V. Gillespie,
‘Moral and Penitential Lyrics’, in A Companion to the Middle English Lyric, ed. T. G.
Duncan (Cambridge, 2005), pp. 81–3.
33
Dives and Pauper, ed. P. H. Barnum, 2 vols. (Oxford, 1976–2004); J. Boey, ‘Some
Middle English Sermon Verse and Its Transmission in Manuscript and Print’, in
Preaching the Word in Manuscript and Print in Late Medieval England: Essays in
Honour of Susan Powell, ed. M. W. Driver and V. O’Mara (Turnhout, 2013), pp.
259–75.
Fig. . Dominican friar, servant and patient. From Isaac Israeli, Dietae particulares.
University of Pennsylvania, Kislak Center for Special Collections, LJS MS , fol.
r, Paris, c. . e servant holds a bowl containing foods, appropriately for a text
on diet.
180 The Medicine of the Friars in Medieval England
could serve as a mine of materials for use in sermon-making too. e author
himself wrote a cycle of sermons now found in Bath, Longleat MS 4, which
refers to Dives and Pauper. ese sermons are critical of ‘somme prelatis’ who
have attempted to prevent the author teaching the Gospel in English, just as
Dives and Pauper criticises secular clergy who fail to observe canon law and
seek prot for themselves. e work is both a guide to lay spirituality and a
resource for the mendicant preacher. It was evidently successful in this dual
role, circulating extensively in manuscript and nding its way into print.
Regimen sanitatis
English friars helped to shape discourses of princely advice, which included
keeping the subject in good health. e most inuential text of princely
advice from the thirteenth century onwards was the Secretum secretorum.
is is an extended letter purportedly written by Aristotle and addressed
to his former pupil Alexander the Great, who was on campaign in Persia.
It is strongly in favour of the prince’s acquiring knowledge of the sciences,
including medicine and some ‘occult’ sciences like physiognomy. e text
had been translated from Arabic into Latin by John of Seville c. 1130 but
only in a partial version. e full text in ten books became available once
translated by Philip of Tripoli, and this second translation was circulating
in Paris by the 1240s. Roger Bacon was in Paris by 1245, teaching courses
in Aristotelian philosophy, and he certainly came to know the Secretum
secretorum there, and believed it to be a genuine work of Aristotle. However,
it was not until after he became a Franciscan in 1257, indeed probably not
until the second half of the 1270s, that Bacon put together his own edition
of the Secretum secretorum. is was written for an unknown prince, quite
possibly King Edward I, though there is no dedication in the text itself. He
does address the reader directly as ‘you’ and most of the extant manuscripts
are English. Bacon took great care to produce an accurate text, complaining
of the gaps and false readings in the manuscripts he had seen. He collated
at least four dierent copies to produce his edition. It is still the most useful
edition of the Secretum secretorum and the most accurate. e original tenbook format was reorganised into four books: on rulership, maintenance of
health, the marvels of science and physiognomy, respectively. Bacon added
other features to make the text more usable: diagrams, but also a chart,
notes and chapter headings. He wrote a substantial introduction, primarily
intended to help the reader with the astronomical references, especially in
Souls and Bodies 181
the chapters on talismans and bloodletting.34 Bacon’s notes to the text are
scattered and somewhat perfunctory in the section on rulership, much more
prominent on astrology, physiognomy and, above all, medicine.
Bacon considered himself an authority on regimen and medicine and
is happy to intervene in the Aristotle text to correct, explain, elaborate
or advocate, as Steven J. Williams observes.35 Bacon considered that the
failure to observe a proper regimen of health, meaning control of the six
non-naturals, caused by human sin and passed on from fathers to sons,
was primarily responsible for the shortened lives, and liability to disease, of
modern humans. But these failures were not imposed by the limits of human
nature itself, and therefore could be remedied by art.36 Bacon is particularly
keen in his edition of the Secretum secretorum on powerful medical remedies,
including an antidote to poison especially useful for kings and nobles. Bacon’s
note refers to its successful use on a man whose imperial blood was that of
noble kings, and he gives a detailed recipe for its preparation.37 An extended
note amplies Aristotle’s commendation of rhubarb – Bacon claims nothing
is better for the human body and gives detailed instructions for its use.38
His enthusiasm for rhubarb may have been red by the account of friar
William of Rubruck’s mission to the court of the Great Khan in Qaraqorum
in 1253–5. William saw the wondrous results rhubarb achieved in saving an
ailing woman at court, but also saw it dangerously misapplied to a Christian
patient. Bacon relied extensively on this Franciscan brother’s account of his
travels in the Opus maius, as well as in the Secretum secretorum. He also had
conversations with William in Paris after his return from the journey to the
Mongols.39 ere is also added advice in the Secretum secretorum on matters
34
Roger Bacon, Secretum secretorum cum glossis et notulis, ed. R. Steele, in Opera hac-
tenus inedita Rogeri Baconi (Oxford, 1920), pp. 108–12; Secretum Secretorum: Nine
English Versions, ed. M. A. Manzalaoui, EETS OS 276 (Oxford, 1977), has a val-
uable discussion in the Introduction of the complicated textual history in Latin,
including Bacon’s editorial work, as well as the proliferation of versions in Middle
English translation.
35
Williams, Secret of Secrets, pp. 175–81; S. J. Williams, ‘Roger Bacon and the Secret
of Secrets’, in Roger Bacon and the Sciences: Commemorative Essays, ed. J. Hackett
(Leiden, 1997), pp. 365–93 (p. 385).
36
Allen, Roger Bacon, pp. 24–9, 106–8.
37
Secretum secretorum, ed. Steele, speculates this might be Henry III’s brother Rich-
ard, earl of Cornwall, or Charles of Anjou, pp. xlv, 88.
38
Ibid, p. 70. Rhubarb was one of the few medicines Bacon claimed to have tried on
himself (Allen, Roger Bacon, p. 111).
39
e Mission of Friar William of Rubruck: His Journey to the Court of the Great Khan
Möngke 1253–1255, ed. P. Jackson and D. Morgan (London, 1990), pp. 197–9, 217;
182 The Medicine of the Friars in Medieval England
such as drinking, sleeping and tooth cleaning. Bacon emphasises the value
of astrology for medicine. Medicines should be exposed to astral inuences,
and there is a great deal of guidance on when best to employ bloodletting,
with helpful tables and gures attached. Bacon is particularly interested in
the employment of medical panaceas, most notably the gloria inestimabilis.
It employs many rare and expensive ingredients, but Bacon claims to have
seen it used successfully to treat the greatest French prince after the king,
identiable as his brother Alphonse of Poitiers, who fell seriously ill in
1252 but recovered by the next year.40 Aristotle’s supposed championing of
alchemy in the Secretum as a source of precious metals and elixirs is also fully
endorsed and, indeed, expanded by Bacon. With the help of such elixirs,
human life could be extended beyond the limit customary in modern people,
so that those who took such an elixir could, by halting corruption of the
body, live to the years of the patriarchs in the Old Testament. ese were
themes taken up elsewhere in Roger Bacon’s writings and in many of the
pseudo-Bacon texts which circulated in England through into the fteenth
century. Bacon’s ideas on prolongevity and on the power of extraordinary
remedies gave a distinctive spin to the advice to princes genre in England.
41
e thirteenth-century encyclopedias on natural history and medicine
compiled by friars embraced the regimen of health. e one that enjoyed
most success in England was De proprietatibus rerum, compiled by
Bartholomaeus Anglicus, c. 1240 (see Chapter 3 above).42 A series of
chapters in book six deal with regimen, particularly chapters 20–9. ese
chapters eectively survey three of the six non-naturals, that is, eating and
drinking, sleeping and waking, and exercise and rest. e eleventh book
deals with air, a fourth of the non-naturals. Bartholomaeus cites his sources:
Avicenna, Galen, Hippocrates, Isaac Israeli, Aristotle and Augustine, as
the inuence of William on Roger Bacon, potentially as a source of ideas on alche-
my and prolongevity as well as rhubarb, is discussed in Yoeli-Tlalim, ReOrienting,
pp. 117–20.
40
Ibid, p. 105. See Chapter 4, p. 130 for this panacea.
41
See also the section on Alchemy in Chapter 4.
42
M. Twomey, ‘Bartholomaeus Anglicus’, Oxford Bibliographies Online, https://
www.oxfordbibliographies.com/view/document/obo-9780195396584/obo-
9780195396584-0225.xml#obo-9780195396584-0225-bibItem-0038, accessed
17 April 2023, calls De proprietatibus rerum the most widely copied, adapted
and translated medieval encyclopedia. Bartholomaeus declares his encyclopedia’s
purpose was to be a guide to the world aimed specically at students of the Bi-
ble. For his biography, see J. Lidaka, ‘Bartholomaeus Anglicus in the irteenth
Century’, in Pre-modern Encyclopaedic Texts: Proceedings of the Second COMERS
Congress, Groningen, 1–4 July 1996, ed. P. Binkley (Leiden, 1997), pp. 393–406.