The Physician’s Almanac: Accessory as Authority

During the fall semester I wrote a paper focussing on the use of physician’s almanacs for an Art History seminar about the Medieval and Renaissance body. Medicine and astrology during this time were closely linked. There were much larger medical texts that doctors referred to, but there were also smaller, portable documents that were used during a house call. Since these almanacs are SO COOL, and since not much scholarship has been written on them, I thought that I would share some of my research here.

Medieval and modern scholars agree on the central importance of astrology for a full understanding of Medieval medicine. Citing Hippocrates, medieval authors argued that whoever called himself a doctor, yet knew no astrology, was like a blind man. We have twenty-nine surviving examples of a tiny class of manuscripts, many of which were probably designed and produced to meet the needs of medical practitioners and service their traveling practice of medical astrology. These tools are called physicians’ almanacs and have a distinctive appearance as books, even though they are quite different from what we think of in the usual codex form. They were written and illuminated on parchment leaves which were subsequently folded into an oblong shape, sewn together at one end and connected to a cord from which it hung at the physician’s belt. The images in the calendars of the fourteenth and fifteenth centuries typically include tables with eclipse diagrams, coloured urine glasses, a bloodletting man, and a zodiac man. For each of these kinds of images, there are accompanying sets of rules used to interpret and explain how to use the image. They were used to determine when and where to let blood or to apply medicines, in conjunction with the calendrical data. The relationship between the images and the text in these almanacs is interesting in that the images are given priority, and the text is there in order to explain how the image it to be used.

However, the information provided in these almanacs would have been rather elementary knowledge to an educated physician, therefore the almanacs may have had a more social construct built around their use: the actual encounter between the physician and patient. Perhaps the function of these almanacs was more to do with marking the physician as an authoritative figure, as he no doubt would have been seen as educated and knowledgeable whenever he donned his almanac. I argue that physicians’ almanacs work to perform the body by being symbols of identity, status, and authority.

In terms of physical construction, the almanacs are relatively simple, yet strong and easy to construct. They are made up of at least six small pieces of parchment folded together across the middle, then folded again into sections. Sewn together at the bottom, the sections are then gathered into an oblong shape. Each section is identified on the outside by a title so that the relevant section can be quickly found and unfolded.

One of the most common and important picture elements in these almanacs is the zodiac man [as seen in the cover image]. Usually, the signs of the zodiac are represented on the different parts of the body over which they hold influence (Aries — the head; Pisces — the feet, etc.). The use of these zodiac men, which are found in hundreds of codex manuscripts, as well as the almanacs, primarily work to tell the physician that when the moon was in a particular sign, it would be inauspicious to let blood or operate on the part of the body associated with that sign. The medium through which these astrological influences operated was of course the movement of the four humours.

From the thirteenth-century onwards, the university teaching of medicine became increasingly structured, with lectures, curricula, examinations, and degrees. This structure was both a result of, and a stimulus for, the idea that the highest learning made the best doctor or physician. Literacy, which had long since been viewed as an asset in medicine, now rose to prominence in distinguishing the elite healer. This rise coincided with the growing appreciation of books, which peaked in Medieval and Renaissance Europe. Books were prominent among Medieval physicians, and were often some of their most treasured possessions attributing to their social status. Manuscripts, even small almanacs, were expensive to make and were valued repositories of information. The book clearly signified that learning was the highest asset, and literacy the minimum qualification, for a practicing physician.

These almanacs may have had a social, performative function as well as an instrumental use. It seems likely that the almanacs had a role to play in the interaction between the doctor and the patient, perhaps meant to impress and reassure the patient as much as to enable the doctors to make diagnostic decisions. As mentioned above, the rather elementary information found in the medical images and accompanying texts might easily, in fact, have been memorized by the owner, who would have had little need for such a guide. Some scholars have pointed out frequent mistakes in these almanacs in the execution of the images and text, which could hint at more concern for display and embellishment than accuracy. It is not uncommon to find urine flasks wrongly coloured, or indication lines running to the wrong captions. Perhaps the calendars were badges of authority and opening up the leaves was an impressive part of the ritual of medical consultation. It would have also given the physician much greater professional mobility, in that he had no need to bring the patients to books or his books to his patients, but had the ability to make house-calls.

One of the greatest reasons for the almanacs being texts of authority is their placement in the tradition of medical texts. The greatest authors were those who were seen as the heirs to Hippocrates. Their teachings made such an impression of learnedness that they exercised the highest authority, sometimes at the expense of observation and reason. Moreover, they were quoted so universally, and so often without attribution, that the modern reader can hardly ever be sure that an idea or experience reported in a Medieval text originated with its writer. However, this should not lead one to underestimate the originality of the writer’s selection, interpretation, and application. Writers who projected an authoritative aura throughout history were Hippocrates, Galen, Avicenna, and Constantine the African. By harkening back to the foundational texts and teachings of these men, Medieval physicians furthered their authority and status by upholding and adding to these early texts. Wearing these almanacs on their body physically marked them as medical authorities and keepers of an ancient medical tradition.

Further reading:

Hilary M. Carey, “What Is a Folded Almanac? The Form and Function of a Key Manuscript Source for Astro-medical Practice in Later Medieval England.” Social History of Medicine 16, no. 3 (Winter 2003): 481-509; Medieval Medicine: The Art of Healing From Head to Toe. Luke E. Demaitre. Santa Barbara, CA: Praeger, 2013; Medieval Medicine in Illuminated Manuscripts. Peter Murray Jones. Revised ed. London: British Library, 1998.

Cordially, etc. etc.

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5 thoughts on “The Physician’s Almanac: Accessory as Authority

  1. Excellent post I hadn’t come across the use of these Medical almanac’s before very interesting thanks for the Posting gives me a real insight into this aspect of art History. well done . Laurencex

    Liked by 1 person

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