Care and Cure: Diseases, disabilities and therapies
Conference report – by Elma Brenner, Liz Herbert McAvoy and Patricia Skinner
How have disease, disability and medical care historically been represented in texts and images? This was the focus of a conference held at Swansea University in June 2012.
‘Care and Cure: Diseases, disabilities and therapies’ brought together postgraduates, early-career researchers and leading experts to explore diverse aspects of medical history in the medieval and early modern periods. The British, German and American participants were encouraged to think about distinctions between disability, disease and medicine. In particular, they discussed how to work on more recent historical periods by incorporating the findings of scientists studying diseases of the past, and to what extent these can inform studies of the medieval and early modern eras. The conference examined themes in pre-modern healthcare and medicine (c.600–c.1800), with a particular emphasis on research methods and different disciplinary approaches to the history of medicine.
The meeting began with two interactive workshops, which brought methodological issues to the fore. Irina Metzler (Swansea) and David Turner (Swansea) discussed ‘Working with Images as Medical Source Material’, addressing disability in the Middle Ages and the 18th century respectively. While Metzler highlighted the difficulty of finding medieval images depicting disability, Turner examined self-portraits by disabled artists. In the second workshop, Julia Boffey (Queen Mary, London) discussed Middle English manuscript anthologies containing medical recipes, focusing on the National Library of Wales MS Brogyntyn II.1. She showed that medical material circulated very flexibly, often being incorporated in manuscripts containing a variety of material intended for household use. As is common with such texts, there were questions of provenance, choices of texts and their likely readership. The medical receipts in this manuscript gave rise to questions about the context for practical medical care, use and availability of ingredients, and the purpose of texts that on the face of it seem deliberately parodic.
Papers by Bianca Frohne (Bremen) and Ivette Nuckel (Bremen) explored the social context of disability in late medieval and early modern Germany, in terms of the experiences of the deaf-mute sons of high-status families, and the extent to which disabled artisans received support from guilds and other sources. Metzler and Turner presented research papers that added further dimensions to our discussion of disability. Metzler examined materialist approaches to the subject, noting that the care available to disabled people principally took the form of charity, and that in the late Middle Ages there was increasing concern about artificial disability, when beggars feigned bodily impairment in order to elicit alms. Turner discussed the marginal status of disabled people in early modern England, where suspicion about fraudulent ‘disabled’ beggars persisted. He challenged assumptions about the vulnerability of those with congenital disabilities in the past, but also highlighted the blurring between care of the disabled and cure of the sick. A survey of ‘The Changing Face of Disability History’ by Anne Borsay (Swansea) placed these analyses in a broader chronological perspective, addressing methodological approaches to studying disability in more recent centuries, which have ranged from biographical studies of disabled individuals to institutional studies and the social and cultural contextualisation of disability.
Patricia Skinner (Swansea) encouraged us to think about the visibility of medical practitioners, a theme that was also developed in a keynote address by Peter Biller (York). In her preliminary work for a Wellcome Trust-funded project on facial disfigurement in the early Middle Ages, Skinner has noted the “relative invisibility” of surgeons in the early medieval West, partly because surgery was not then recognised as a formal profession. She raised questions about who administered highly specialised treatments, such as those for head injuries. Biller surveyed the medical practitioners and activities revealed in the Inquisition Registers of Languedoc between the 1230s and 1320s. Although the Inquisition did not specifically inquire into the occupations of the individuals who were questioned, these registers incidentally shed light on ordinary medical practice in this region, and on the access that people had to practitioners and treatment.
Theresa Tyers (Nottingham) and Alison Williams (Swansea) both explored issues relating to botany and pharmacology. Focusing on a 14th- century Anglo-French manuscript (Yale, Beinecke MS 492), Tyers examined the transmission history of a botanical cure for infertility. Williams addressed the interest in medical botany of François Rabelais (1494–1553), the French humanist and physician. Rabelais took a more moderate, positive stance than many of his contemporaries on the pharmaceutical use of plants. In both cases the use of remedies was seen to have moral and ethical implications, illustrated by omissions or censorship in later medieval recipe collections (Tyers) and by very real dangers presented in fictional parodies (Williams). These papers, like those by Metzler and Turner on disability, highlighted the continuity of key themes in the history of medicine, disease and disability between the medieval and early modern eras, and the usefulness of bringing together scholars working on both periods.
A striking feature of the conference was the way that many of the papers, as well as the workshops, highlighted the metaphorical use of sickness and healthcare to engage in wider social or political commentary. While most obvious in pictorial representations of the sick and disabled, this theme was also evident in discussions of the changing status of the disabled poor (Metzler), the rhetoric surrounding permanent incapacity in medieval court cases (Skinner), and the tension within guilds when called upon to support their infirm members (Nuckel). There was a strongly reflective element to the two days: how we study pre-modern medicine is as important as what we study, and this requires the collaborative expertise of not only historians and those working in literary fields, but also art historians, biologists, social scientists, archaeologists and clinicians.
The conference concluded with a plenary lecture by Monica Green (Arizona State) surveying exciting recent developments in the scientific study of diseases of the past, particularly by bioarchaeologists and microbiologists, and assessing how these developments intersect with the work of historians and researchers in other humanities disciplines. While in 2001 scientists were able to sequence the genomes of plague (Yersinia pestis) and leprosy (Mycobacterium leprae), this approach involves retrospective diagnosis, a form of analysis that historians are keen to avoid. Nonetheless, Green argued, the combination of scientific findings with the light that historians can shed on past responses to disease is “contributing to a global history of health”. Her lecture highlighted the broader relevance of studies of medieval and early modern European diseases, disabilities and therapies to our understanding of the history of health throughout the world.
The conference was convened at the Centre for Medieval and Early Modern Research, in association with the Research Group for Health, History and Culture, Swansea University. It was supported financially by the Wellcome Trust with additional contributions from the Royal Historical Society, Medium Aevum, and the Universities of Swansea, Bangor and Aberystwyth. The authors of this report were the co-organisers.
Elma Brenner is a specialist in Medieval and Early Modern Medicine based at the Wellcome Library (firstname.lastname@example.org). Liz Herbert McAvoy is a Reader in Gender Studies and Medieval Literature at Swansea University (email@example.com). Patricia Skinner is a Wellcome Trust Research Fellow at Swansea University (firstname.lastname@example.org).
Conference attendees Bianca Frohne, Irina Metzler and Ivette Nuckel are members of the Homo Debilis research group at the University of Bremen, which studies social integration and challenges of daily life for impaired persons in historical perspective.