Symptomatic Subjects

In the period just prior to medicine's modernity, England saw a remarkable upsurge in medical writing. Julie Orlemanski's Symptomatic Subjects shows how late medieval English writers drew on the discourse of medicine to narrate anew the crossings—and the conflicts—between physiology and personhood.

Symptomatic Subjects
Bodies, Medicine, and Causation in the Literature of Late Medieval England

Julie Orlemanski

2019 | 344 pages | Cloth $69.95
Literature / History / Medicine
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Table of Contents

List of Abbreviationsix

Chapter 1. Imagining Etiology
Chapter 2. Cause, Authority, Sign, and Book

Chapter 3. Satire and Medical Materialism
Chapter 4. Embodying Causation in Exempla

Chapter 5. The Metaphysics of Phisik in the "Knight's Tale"
Chapter 6. Desire and Defacement in the Testament of Cresseid

Chapter 7. Symptoms and the Signifying Condition in Hoccleve's Series
Chapter 8. From Noise to Narration in the Book of Margery Kempe


Works Cited

Excerpt [uncorrected, not for citation]


Early in Geoffrey Chaucer's romance Troilus and Criseyde, the officious matchmaker Pandarus advises Troilus on how to write a love letter. He warns against jumbling "discordant thyng yfeere [together], / As thus, to usen termes of phisik / In loves termes [for example, to use terms of medicine among love's terms]." Mixing medicine's lexicon with lovespeak, he admonishes, would make Troilus comparable to a painter who depicts a fish "With asses feet, and hedde[s] it as an ape [with donkey's feet, and gives it the head of an ape]." Different conceptual idioms, Pandarus seems to think, have different bodies that go with them; combining them "cordeth naught [does not accord]." And yet, in spite of Pandarus's advice, Chaucer and many other late medieval writers show themselves to have been great jumblers of "termes of phisik." Their writings mingle medical vocabulary with the generic stylings of romance, consolation, satire, exemplum, miracle story, and devotional meditation, among others. The physiological descriptions of lovesickness woven through Troilus and Criseyde are enough to suggest that Pandarus's poetics are not, in fact, Chaucer's own. But Pandarus's stylistic injunction nevertheless does imply that the distinction of "termes of phisik" from their putative others—the terms' at least imaginary cordoning off from other conceptual vocabularies—was a comprehensible one, perhaps as clear as the difference between a fish and an ape.

This study investigates what late medieval writers were up to in using "termes of phisik" in their compositions, which is to say, what notions of embodiment, subjectivity, and causality medicine made available and what writers did with them. Phisik in fourteenth- and fifteenth-century England was a discourse in ascent. In this era just prior to what we think of as medicine's dawning modernity—before Renaissance anatomy, before the centralized regulation of medical professions, before the rise of empiricism or the rationalist division of mental from physical substance—England was the scene of a remarkable upsurge in medical writing. Between the arrival of the Black Death in 1348 and the start of English printing in 1476, thousands of discrete medical texts were copied, translated, or composed, the large majority for readers without university degrees. These sundry texts shared a model of the universe crisscrossed with physical forces and a picture of the human body as a changeable, composite thing, tuned materially to the world's vicissitudes. This book tells the story of how embodied subjectivity was narrated in its entangled relation to the world in the era of medicine's unprecedented textual vitality. In that, it offers one approach to the phenomenology of medieval selfhood, or what it was like, within the era's mix of discourses, to reflect on both having and being a body.

The period was one of intellectual ferment for lay and vernacular readers. By the later fourteenth century, it had been more than two hundred years since new Latin translations of Galenic medicine, Aristotelian natural philosophy, and their Arabic commentators began circulating in western Christendom, offering distinctive accounts of why the physical world was as it was. Medicine was where the inquiry into nature scaled itself to the human form, and one effect of its widespread textualization was to render the material body, it seemed, less human. Phisik showed persons strafed with the impersonal systems of life—elements, mixtures of qualities, humors, members, powers, faculties, and spirits. They were vulnerable to a volatile economy of physical forces. Such ideas reached new audiences in formats like encyclopedias, mirrors for princes, plague tracts, physiognomies, surgical compendia, gynecological treatises, sermons, devotional literature, and many others. The play of unsystematized authorities and the wrangling over explanations without a solidified framework to order them characterized intellectual inquiry outside university walls, where scientia and skill, Latin and Middle English, and speculation and pragmatics each had its part to play.

Medicine's model of the strange and symptomatic body tangled in skeins of cause and effect called forth answering paradigms. Personal agency and its theological counterpart, free will, remained crucial to medieval conceptions of the person. Penitential discipline recoded the body's sufferings; spiritual analogy made medicine the repository of metaphor; and courtly idealization conscripted bodily harm into spectacles of social cohesion. As naturalistic models of causation mingled with penitential, miraculous, and socially symbolic ones, their juxtaposition demanded that a growing number of readers negotiate the divided claims of material forces, willful action, and divine power. Partly as a result, the later Middle Ages became a period of what I will call etiological imagination—an era broadly fascinated with projects of explanatory invention and the tasks of envisioning, arbitrating among, and emplotting intricate causal chains. Why did one patient recover and a second worsen? Why did a husband contract leprosy when his wife did not? Was it on account of the man's melancholic disposition, the miasmatic air, or his sinfulness? Case by case, medieval men and women pieced together distinctive causal explanations, often drawing on divergent intellectual traditions, and so acted as bricoleurs of etiology. At the center of this book's investigations is the claim that when we attend to the language of phisik, both in the intricacy of its conceptual system and in its promiscuous uptake, we discover previously unremarked experiments in combining causation and selfhood in the texts of late medieval England. These experiments transpire, I will show, in the space of a stubborn phenomenological gap between one's materiality and one's experience, or between having and being a body.

Literary narratives played a distinctive role in the endeavors of etiological imagination. Authors like Geoffrey Chaucer, Robert Henryson, Thomas Hoccleve, Margery Kempe, and the playwright of the Croxton Play of the Sacrament adopted the rich terminology of the body and its ailments to depict characters struggling to control their bodies and to control the interpretations that gave their bodies meaning. These writers tell the stories of symptomatic subjects, figures marked with leprous pustules, or the pallor of lovesickness, or lunacy's rolling eyes—who try to gloss and construe their own bodily conditions. Such figures inhabit a contentious hermeneutic circle that churns between competing systems of explanation, in the interchange of symptoms and speech acts, flesh and rhetoric.

Because poetic narratives could encompass multiple kinds of causation in their plots and could orchestrate competing discourses within their polyvocal bounds ("termes of phisik," "loves termes," and many more besides), they came to act as meta-etiological forms, or arenas for commenting on the relations among causal and explanatory models. Stories like Chaucer's "Knight's Tale" and Henryson's Testament of Cresseid gather together and then tangle the etiological categories that determine bodies. They draw into a single plot powers as varied as the pagan gods, the planets, humoral physiology, erotic compulsion, political history, chance, fate, a benevolent monotheistic deity, and metafictional determination. Such a dizzying array renders the ultimate significance of stories like these difficult to decide, and such interpretive resistance, I will argue, acts to thematize the workings of etiological imagination. Extended self-narrations, like the Book of Margery Kempe and Thomas Hoccleve's Series, give such meta-etiology a further twist. The portrayal of the author's wildly symptomatic body directs readers' etiological scrutiny to the text's narrating voice. As interpreters try to parse the balance of external impingement and narrative design, the text threatens to become itself a symptom—a possibility to which Margery Kempe's Book and Hoccleve's Series show themselves keenly alert.

The aim of the extended close readings that make up the latter half of Symptomatic Subjects is not primarily to contextualize the literary works, for instance by demonstrating which contemporary practices of phisik informed them (though some of this will be necessary). It is rather to reveal these works' speaking back to phisik, in part by speaking through it. Poetry and imaginative narrative, I will contend, participated in the late medieval project of remapping the self's causal impingements, a project at once broadly shared and fractured into distinctive and sometimes conflicting idioms like medicine, natural philosophy, pastoralia, theology, and mythography. Symptomatic Subjects tracks this remapping as it unfolds across several genres and scenes, with an eye to the shifting domains, the mobile and unrationalized patterns of continuity and discontinuity, that characterize the etiological imagination in the later Middle Ages.

The structure of this book follows a trajectory from "termes of phisik" to those terms' reinvention in literary narrative. It arcs from accounting for medicine as a distinctive if heterogeneous discourse in fourteenth- and fifteenth-century England, through medicine's uptake in the registers of satire and exemplum, and onward to the frictional interface of causation and embodied agency in some of the most important works of Middle English writing. These topics constitute a series of overlapping investigations that cumulatively show how and why phisik mattered in late medieval England. The book falls into four parts. Part I, "Thinking with Phisik," introduces medicine as medieval people practiced and articulated it. The first chapter, "Imagining Etiology," serves as an introduction to the study as a whole. It describes the historical conditions of medicine's textual efflorescence in England and maps out the crucial tensions defining phisik's cultural role—tensions between theory and practice, science and art, generality and particularity, symptom and expression, and causation and agency. Chapter 2, "Cause, Authority, Sign, and Book," explores phisik from four angles—how it grappled with causal understanding, how the authority to heal was negotiated, what the semiotics of the medical body looked like, and what bookish forms medicine assumed.

In Part II, "Playing with Phisik," I turn to medicine's implication in two literary modes. Chapter 3, "Satire and Medical Materialism," shows how medicine's jargon and its focus on the materiality of the body acted as the stimulus to satirical invective, particularly in Chaucer's "Nun's Priest's Tale," Henryson's "Sum Practysis of Medecyne," and the East Anglican miracle play the Croxton Play of the Sacrament. The fourth chapter, "Embodying Causation in Exempla," argues that exemplary stories operate in ways that are parallel to medicine's own modes of understanding: both seek to recognize a more general realm of governing principles in the fate of particular bodies. I trace the growing role of narrative in the medical writings of the later Middle Ages as well as the place of medicine and disease in homiletic literature, including the Gesta Romanorum and Piers Plowman.

Part III, "Emplotting Phisik," tracks how medical terminology, the impingements of the material body, and etiological complexity come to be incorporated into the plots of two vernacular poems. "The Metaphysics of Phisik in the 'Knight's Tale'" focuses on the seemingly gratuitous medical language used to describe Arcite shortly before his death. I argue that Theseus's final speech of consolation allows us to recognize phisik's role in the tale's imagination of alternatives to the monotheistic order of the Prime Mover. Chapter 6, "Desire and Defacement in the Testament of Cresseid," shows how Henryson's decision to strike Cresseid with leprosy effects a shift from the romance conventions of Chaucer's Troilus and Criseyde to those of the exemplum. However, an incoherence in the exemplary plot creates uncertainty about what kind of justice is served. The would-be story of punitive disease is haunted by another tradition of leprosy's medieval representation, that of affective devotion.

In the last part of Symptomatic Subjects, "Personalizing Phisik," narrative voice, rather than plot, becomes the central object of literary analysis. The seventh chapter, "Symptoms and the Signifying Condition in Hoccleve's Series," explores the symptomatic self-loss that Hoccleve's narratorial persona undergoes during his madness. I argue that Hoccleve knits together accounts of symptomatic and textual expression to offer a new embodiment of the signifying condition. Chapter 8, "From Noise to Narration in the Book of Margery Kempe," reads Margery's paramystical crying as a symptom. Her involuntary vocalizations, I argue, allow the Book to construct its own textual voice through iterative circuits of symptom and explanation, noise and narration. Finally, in the coda, I remark on Symptomatic Subjects in light of the scholarly subfield of the history of the body and issues of historical periodization.