Farida Mukazhanova

EMOTIONS AND HEALTH: A STUDY OF “PSYCHOSOMATIC”

PATTERNS IN GERMAN MEDIEVAL REGIMINA SANITATIS

MA Thesis in Comparative History

with the specialization in Interdisciplinary Medieval Studies
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Central European University

Budapest

May 2011
 EMOTIONS AND HEALTH: A STUDY OF GERMAN MEDIEVAL
REGIMINA SANITATIS

by

Farida Mukazhanova

(Kazakhstan)

Thesis submitted to the Department of Medieval Studies,

Central European University, Budapest, in partial fulfillment of the requirements

of the Master of Arts degree in Comparative History,

with the specialization in Interdisciplinary Medieval Studies.

Accepted in conformance with the standards of the CEU

____________________________________________
Chair, Examination Committee

____________________________________________
Thesis Supervisor

____________________________________________
Examiner
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____________________________________________
Examiner

Budapest
May 2011

ii
 EMOTIONS AND HEALTH: A STUDY OF GERMAN MEDIEVAL
REGIMINA SANITATIS

by

Farida Mukazhanova

(Kazakhstan)

Thesis submitted to the Department of Medieval Studies,

Central European University, Budapest, in partial fulfillment of the requirements

of the Master of Arts degree in Comparative History,

with the specialization in Interdisciplinary Medieval Studies.

Accepted in conformance with the standards of the CEU

____________________________________________

External Examiner
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Budapest
May 2011

iii
 EMOTIONS AND HEALTH: A STUDY OF GERMAN MEDIEVAL
REGIMINA SANITATIS

by

Farida Mukazhanova

(Kazakhstan)

Thesis submitted to the Department of Medieval Studies,

Central European University, Budapest, in partial fulfillment of the requirements

of the Master of Arts degree in Comparative History,

with the specialization in Interdisciplinary Medieval Studies.

Accepted in conformance with the standards of the CEU

________________________

Supervisor

____________________________________________
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External Supervisor

Budapest
May 2011

iv
 I, the undersigned, Farida Mukazhanova, candidate for the MA degree in Comparative
History, with the specialization in Interdisciplinary Medieval Studies declare herewith that
the present thesis is exclusively my own work, based on my research and only such external
information as properly credited in notes and bibliography. I declare that no unidentified and
illegitimate use was made of the work of others, and no part of the thesis infringes on any
person’s or institution’s copyright. I also declare that no part of the thesis has been submitted
in this form to any other institution of higher education for an academic degree.

Budapest, 23 May 2011

__________________________
Signature
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 ACKNOWLEDGEMENTS

I would like to express my immense gratitude to my supervisor, Gerhard Jaritz, for all his

guidance, suggestions, and support. He always had a helpful comment or idea, knew the right

places to do research and obtain primary sources, read the multiple drafts of the thesis, helped

me with obscure German quotations, and was helpful in a hundred other ways. I would also

like to most warmly thank Katalin Szende for all her helpfulness, Judith Rasson for reviewing

this thesis, and Daniel Ziemann for his comments and suggestions. To all those who provided

me with inspiration and ideas, thank you. At the end of my two year medieval journey, I

would like to thank my dear Department, professors, coordinators and fellow students for this

enriching and pleasant experience.

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 TABLE OF CONTENTS

TITLE PAGE………………………………………………………………………………...i

ACKNOWLEDGEMENTS…………………………………………………………………vi

TABLE OF CONTENTS ....................................................................................................... vi

LIST OF FIGURES ................................................................................................................ ix

INTRODUCTION ................................................................................................................... 1
The state of the scholarship… ............................................................................................. 3
… on the genre. ..................................................................................................................... 3
… on emotional states in relationship to the body ............................................................ 6

CHAPTER ONE. “THE BALANCE OF HEALTH” – CONTEXTUALIZED ACCIDENTIA

ANIMI IN THE MEDICAL THEORY OF THE REGIMEN SANITATIS................................. 7
1.1. Humors, qualities, and the balance of health.............................................................. 7
1.1.1. The four humors ......................................................................................................... 8
1.1.2. ‘Naturals’, ‘non-naturals’ and ‘contra-naturals’. .......................................... 11

CHAPTER TWO. REGIMENS OF HEALTH. A HISTORICAL OVERVIEW…………..16

CHAPTER THREE. SITUATING THIS STUDY WITHIN THE HISTORY OF

EMOTIONS…………………………………………………………………………………..23
3.1. “A maturing field”…………………………………………………………………....23
3.2. Definition(s)?.................................................................................................................25
3.3. Approaches, pitfalls and possibilities……………………………………………….27
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3.3. Sketching a map of emotions……………………………………………….……..…30

CHAPTER FOUR. INTERPLAY OF EMOTIONS AND HEALTH………………………33

4.1. Overview of the selected regimina………………………………………………..….34
4.2. “Psychosomatic” patterns. Emotions’ influence on health………………...............39
4.2.1. In the selected regimina……………………………………………………....39
4.2.2. The comparative material……………………………………………….…...45
4.3. Other patterns…………………………………………………………………….......48
4.3.1. Emotions’ relation to bodily organs……………………………………...….48

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 4.3.2. Emotions’ relation to blood vessels and phlebotomy……………..….……..49
4.3.3. Emotions in the plague-prevention regimen………………………….…........…51
4.3.4. Complexio and temperaments………………………………………….…….53
4.3.5. Emotions and religion………………………………………………….……..55

CONCLUSION……………………………………………………………………………...59

BIBLIOGRAPHY…………………………………………………………………………...60
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 LIST OF FIGURES

Figure 1. Emotions mentioned in the selected primary sources 40

Figure 2. Occurrences of “psychosomatic” patterns in the selected primary

sources 41
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 INTRODUCTION

In a recent clinical study two Korean scientists came to the conclusion that patients

with trait of high anger had the shortest time to recurrent cardiac events;1 another study has

demonstrated the connection between anger and premature cardiovascular disease.2

The effect of emotions and psychological states on bodily health in the medieval

context is the subject of this thesis. The focus will be on accidentia animi (emotions) in their

interplay with physical health in the material of regimina sanitatis (regimens of health). The

main aim of the study is to establish the ways in which accidentia animi, or emotions, were

believed to define bodily health in the Middle Ages. How emotions affect health, which ones

are beneficial and which harmful, such are the questions which have inspired my research

interest and resulted in this thesis.

Thus, the research questions for my study are as follows:

§ Which emotions/psychological states have an effect on the body?

§ Which emotions/psychological states are beneficial and which are harmful? Or

alternatively, which “psychosomatic” pattern can be identified on the basis of

the source material?

§ Are there any other interdependencies between emotions and health or

emotion-health patterns and, if so, what are they?

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As primary sources I will use texts of a particular genre of medical literature called

regimina sanitatis. The body of selected primary sources consists of eight regimens in the

German vernacular written between the fourteenth and sixteenth centuries. The language of

1
Eun Kyeung Song, Youn-Jung Son and Terry A. Lennie, “Trait Anger, Hostility, Serum Homocysteine, and
Recurrent Cardiac Events after Percutaneous Coronary Intervention,” American Association of Critical-Care
Nurse 18, No. 6 (2009): 554-56; available at http://ajcc.aacnjournals.org/content/18/6/554.full.pdf+html (Last
accessed 26 May 2011).
2
Patricia P. Chang, MD, MHS; Daniel E. Ford, MD, MPH; Lucy A. Meoni, ScM; Nae-Yuh Wang,
PhD; Michael J. Klag, MD, MPH, “Anger in Young Men and Subsequent Premature Cardiovascular Disease,”
Archives of Internal Medicine 162, No. 8 (2002): 901-906; available at http://archinte.ama-
assn.org/cgi/content/full/162/8/901 (Last accessed 26 May 2011).

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 the compositions has been chosen as a formal criterion. These selected primary sources will

be put in a comparative framework with other similar compositions produced in other periods

and regions. The diversity of the primary source material is mainly justified by the rarity of

accidentia animi components in works of this genre.

All the regimens used here have been edited and published; in a single case the work is

available in a facsimile edition supplemented with a modern German translation. I have

worked with the original and have provided my own translation of pertinent quotations from

the source material.

The present study uses an interdisciplinary approach as it lies at the crossroads of the

field of the history of emotions and the history of medicine. Both of these two major

theoretical frameworks will be considered and the approaches used will be defined.

The theoretical frameworks define the structure of the present thesis. Thus, the study

opens with an introductory part where the main aim, methodology, and research questions

etc. are considered. A review of scholarship on the chosen genre and of research with similar

aims is also presented. The next two chapters deal with the theoretical framework of the

primary source material. Thus, in chapter 1 I outline the key concepts of medieval medical

theory which were crucial for understanding the relationship of emotions to health. The next

chapter’s goal is to present an overview of the history of the regimen sanitatis genre, where
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the historical development of the accidentia animi element is traced. Chapter 3 is dedicated to

the history of emotions; I look at the definitions, approaches and tools used in the discipline

in order to situate my own contribution to the field. In the next chapter, Chapter 4, I analyze

the primary source material, identify patterns and provide answers to research questions. In

the conclusion the outcomes of the analysis are summarized and paths for further research are

suggested.

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 The state of the scholarship…

It would be incorrect to say that the genre I work with has not been covered in

scholarship, nor is it true that nothing has been written on premodern medical concepts where

emotions’ or passions’ effects on the body are explored. There has been no study, however,

investigating the relationship of emotions and health in medieval regimina sanitatis in detail.

It is the ambition of this study to shed light on the variety of accidentia animi which are

crucially important for human health, which are an indispensable part of the medieval

regimen of health, as well as the particular “psychosomatic” and other patterns which

emotions can form in the material of selected German regimens of health.

… on the Genre.

Regimen sanitatis literature has been widely researched, which is also true for the

German representatives of the genre. Researchers of the medieval regimens of health have

brought to light various aspects of the regimen literature. Traditionally, the research focused

on the authorship of a particular regimen, sources, and parallels with other works of this

kind, dissemination, influence, etc.

As concerns the historical evolution of the genre, Marilyn Nicoud’s Les régimes de
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santé au Moyen Âge. Naissance et diffusion d’une écriture médicale (XIIIe- XVe siècle) is the

most comprehensive history of regimen literature to date. As the title of the book suggests,

especially the second part, this is a thorough investigation of the genre in its evolution and

dissemination, in great detail.3 However, the book focuses mainly on Italian and French

regimina, neglecting German compositions.

3
Marilyn Nicoud, Les régimes de santé au Moyen Âge. Naissance et diffusion d’une écriture médicale (XIIIe-
XVe siècle) (Rome: École Française de Rome, 2007).

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 At the same time, German scholarship has a long-standing tradition in Fachliteratur

research. Karl Sudhoff, Gerhard Eis, and Gundolf Keil are the leading figures who have

studied medieval medical and scientific texts. They are authors of a great number of

publications which it will be impossible to review here. Their contribution to the study of

medical literature cannot be overestimated. In my thesis, I make use of some of their edited

volumes.4

The critical editions of surviving regimina sanitatis are of great help to scholars as

they make primary sources more widely available for further research. For example, an

English translation of two of Moses Maimonides’ treatises5 allowed me to use this material

for comparison; moreover, I have also used other editions, for instance, facsimile copy of a

late Transylvanian regimen.6

The preponderance of the section on food and drink in the body of regimina puts a

stamp on the research of such literature as well. Thus, the most prominent component of

regimens – cibus et potus – has been well-researched. Melitta Weiss Adamson’s Medieval

Dietetics. Food and Drink in Regimen Sanitatis Literature from 800 to 1400 is a detailed

study of twenty-three regimina focusing on food and drink.7 In my study, I will rely on her

findings, especially those concerning accidentia animi.

Unfortunately, there is no detailed comparative study of accidentia animi in German

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or any other regimina literature. Usually mentioned last or completely lacking in the sources,
4
Gerhard Eis, “Die Gross-Schützener Gesundheitslehre. Studien zur Geschichte der deutschen Kultur im
Südosten” (Brno: R.M. Rohrer, 1943), idem, Medizinische Fachprosa des späten Mittelalters und der frühen
Neuzeit (Amsterdam: Rodopi, 1982); idem, Forschungen zur Fachprosa, Ausgewählte Beiträge (Bern: Francke
Verlag, 1971); “Ein teutsch puech machen”: Untersuchungen zur landessprachlichen Vermittlung medizinischen
Wissens, ed. Gundolf Keil (Wiesbaden: Reichert, 1993); Medizin im mittelalterlichen Abendland, ed. Gerhard
Baader and Gundolf Keil (Darmstadt: Wissenschaftliche Buchgesellschaft, 1982), Würzburger
medizinhistorische Forschungen: Festschrift zum 70. Geburtstag von Willem F. Daems, ed. Gundolf Keil,
Beiträge zur Wissenschaftgeschichte, vol. 24 (Pattensen (Han.): Horst Wellm Verlag, 1982).
5
Ariel Bar-Sela, Hebbel E. Hoff, Elias Faris, Moses Maimonides,
“Moses Maimonides' Two Treatises on the Regimen of Health: Fī Tadbīr al-Sihhah and Maqālah fi Bayān Ba'd
al-A'rād wa-al-Jawāb 'anhā,” Transactions of the American Philosophical Society NS 54, No. 4 (1964): 3-50.
6
Paulus Kyr, Die Gesundheit ist ein Köstlich Ding, 1551, ed. Robert Offner (Hermannstadt: Schiller Verlag,
2010).
7
Melitta Weiss Adamson, Medieval Dietetics. Food and Drink in Regimen Sanitatis Literature from 800 to
1400 (Frankfurt am Main: Peter Lang, 1995).

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 emotions have often been overlooked by most researchers. Even when the important role

attributed to the emotions in medical compositions has not gone unnoticed, scholars have

often confined themselves to laconic statements about their importance.8 In some cases it

might be an enumeration of typical accidentia animi: in Adamson’s summary, “the emotions

usually discussed under this heading were joy, anger, anxiety, fear, sadness, and shame.”9

A more detailed consideration than usual is given to emotions in Pedro Gil-Sotres’

article on regimens of health in the volume Western Medical Thought from Antiquity to the

Middle Ages.10 He begins by defining accidentia animi or passiones, as they are usually

called in Latin sources, mentioning that these would be called “feelings” or “emotions” rather

than “passions” in modern terminology.”11 Identifying accidentia animi as “psychosomatic

movements directly affecting the body, and indirectly affecting the soul,”12 Gil-Sotres also

speaks of “healthful” and “unhealthful passions.” Joy is the only emotion in the first category;

while sadness, anxiety, fear, and, last but not least, wrath are among the “unhealthful”

emotions of the second category.13 It is important to mention that Gil-Sotres paid adequate

attention to physiological changes which emotions were believed to produce in the body,

external symptoms, diseases, and treatment recommendations.

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Faye Getz has noted that “[i]mportant for understanding [medieval]… medical ideas is to remember that the
emotions (or passions of the soul) had an important effect on the body’s well-being.” Although here the scholar
is referring to Geoffrey Chaucer’s medical ideas, this statement holds true for much of the medieval medical
system, of which Chaucer’s views are a part. Faye Marie Getz, Medicine in the English Middle Ages (Princeton,
NJ: Princeton University Press, 1998), 88.
9
Melitta Weiss-Adamson, “Regimen sanitatis,” in Medieval Science, Technology, and Medicine: an
Encyclopedia, ed. Thomas Glick, Steven J. Livesey, Faith Wallis (New York: Routledge, 2005), 438-439, esp.
438.
10
Pedro Gil-Sotres, “The Regimens of Health,” in Western Medical Thought from Antiquity to the Middle Ages,
ed. Mirko D. Grmek and Bernardino Fantini (Harvard: Harvard University Press, 1998), 291-318.
11
Ibid., 313.
12
Ibid.
13
Ibid., 313-314.

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 … on emotional states in relationship to the body

There is also research on the premodern concepts of how health is dependent on or

interconnected with emotions. Quite a number of publications speak of psychosomatic

medicine and psychosomatic approaches in the ancient, medieval and early modern contexts.

For example, there is a study on Byzantine,14 as well as medieval psychosomatic medicine.15

Sometimes concrete cases are investigated within this framework like, for instance, heart

disease.16

Apart from this, there is a recent PhD dissertation on emotions in the medieval medical

context of which I learned in the last month of writing my own thesis. Na’ama Cohen-

Hanegbi’s doctoral dissertation deals with the conceptualization and treatment of emotions in

medicine and confession literature in late twelfth to fifteenth-century Spain and Italy,17 she is

also the author of another study of women’s emotions in medical consilia.18

The system which emotions form in medieval regimina sanitatis is still to be

researched in detail. My modest study is meant to fill this gap and explore the patterns of the

emotion-body interplay that can be found in German regimens of health. Although working

with restricted primary source material, I will make use of a systematic approach, hopefully

avoiding the danger of extrapolating from a small data set.

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14
Aristotelis Chr. Eftychiadis, “Byzantine Psychosomatic Medicine,” Medicina nei Secoli Arte e Scienza 11, No.
2 (1999): 415-421.
15
Antoinette Stettler, “Zur Psychosomatik im Mittelalter,” Gesnerus, 31, No.1 (1974): 99-106; R. W. Gutt,
“Psychosomatische und somatische Grundlagen der Wunderheilungen aus dem 13. und 14. Jahrhundert,”
Medizinische Klinik 61, No. 52 (1966): 2084-2087; Jürg A Bosshard, Psychosomatik in der Chirurgie des
Mittelalters, besonders bei Henri de Mondeville, Inaugural Diss. Univ. Zürich (Zürich: Juris-Verlag, 1963).
16
Carol E. McMahon, “The Psychosomatic Approach to Health. A Study in Premodern Medicine,” Chest 69
(1976): 531-537.
17
Personal communication via Internet; also can be found in the Program for “Learning to Feel: Emotions
Beyond Nature vs. Nurture” Conference (10-14 April 2011), 14, available at http://www.zeitgeschichte-
hamburg.de/img/download/D_142105099_em.pdf (Last accessed 26 May 2011).
18
Naama Cohen, “The Emotional Body of Women: Medical Practice between the Thirteenth and the Fifteenth
Century,” in Le sujet des émotions au Moyen Âge, ed. Piroska Nagy and Damien Boquet (Paris: Beauchesne,
2008), 465-482.

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 CHAPTER ONE

“THE BALANCE OF HEALTH” – CONTEXTUALIZED ACCIDENTIA ANIMI IN

THE MEDICAL THEORY OF THE REGIMEN SANITATIS

The concept of emotions playing an important role in health matters is embedded in

the theoretical basis of the sources under consideration. A regimen of health is meant to

regulate human health through six crucial factors, including accidentia animi, or emotions. In

this respect, all compositions of the genre are quite similar, both in structure and content. This

fact is also due to the established medical tradition inherited from ancient Greece. Here, I will

focus on the medical theory of the medieval regimen sanitatis, which is the natural context

for emotions in relationship to bodily health. I will consider the humoral theory – the

theoretical basis underlying the medical regimen literature – along with its main components,

the sex res non naturales.

Due to the limitations of a study of this scale, I will only deal with the medieval

medical concepts from the viewpoint of preservation of health in this genre. Only the dietetic

or hygienic aspect of the medieval medical system will be considered here. The religious and

philosophical dimensions of medieval medicine, as well as therapy, surgery, or

pharmaceutical practices, lie outside the scope of the study and will not be treated.

1.1. Humors, Qualities, and the Balance of Health

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For a better understanding of the medical system of the sources I will consider its

evolution from Classical Greek and Byzantine medicine, through the contribution of Arab

physicians and scholars to its assimilation by the medieval West. I will start by tracing the

gradual development of the theoretical system, focusing on the essential components and

terminology. I will then discuss the main components of this medical system in detail,

essentially the res naturales, sex res non naturales, and res contra naturam. Not aiming to

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 present an exhaustive account of the evolution or system, I will instead highlight the aspects

related to the emotional component.

1.1.1. The Four Humors

As has been pointed out by numerous scholars, medieval medicine, including

dietetics, is rooted in humoral theory.19 The origins of humoral theory go back as early as the

sixth century BC, with the theory of four elements – fire, water, air and earth – attributed to

Empedocles (504-443 BC)20, and later Zeno (fifth century BC), introducing the four basic

qualities – hot, cold, wet, and dry – into the system.

What Melitta Weiss Adamson terms “the prototype of a humoral pathology”21 can be

found as early as around 400 BC. In what is now called the Corpus Hippocraticum, or

Hippocratic writings, the four qualities were linked to four bodily fluids: black bile, phlegm,

bile, and blood. The Nature of Man contains the most systematic humoral theory of the whole

Corpus Hippocraticum.22 Other scholars, however, maintain that Alcmaeon of Croton (fifth

century BC) was the first figure to whom the concept of health as a balance of opposing

factors in the body can be attributed.23

The four cardinal elements were linked to the four qualities only in the fourth century

BC.24 This system, in which fire is associated with the hot, air with the cold, water with the
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19
Adamson, Medieval Dietetics, 10; László András Magyar, “Stellenwert des Sanitatis studium im
medizinischen Schrifttum seiner Zeit,” in Paulus Kyr, Die Gesundheit, 21.
20
For a good survey of the evolution of the theory and a summary of research into it, see Adamson, Medieval
Dietetics, 10-18.
21
Ibid., 11.
22
The text, written ca. 400 BC, was ascribed by Aristotle to Polybius, who might have been Hippocrates’ son-
in-law. The text not only lists the four bodily fluids for the first time, but establishes that the four main qualities
must be in the right proportion to one another for health to be preserved, Ibid.
23
Alcmaeon defines health using political metaphors: The equality (isonomia) of the opposing powers which
make up the body (e.g., the wet, the dry, the hot, the cold, the sweet, the bitter, etc.) preserves health, whereas
the monarchy of any one of them produces disease; The Stanford Encyclopedia of Philosophy, available at
http://plato.stanford.edu/entries/alcmaeon/#Health (Last accessed 26 February 2011). Also see Christa
Hagenmeyer, “Die 'Ordnung der Gesundheit' für Rudolf von Hohenberg: Untersuchungen zur diätetischen
Fachprosa des Spätmittelalters mit kritischer Textausgabe, ” Dissertation, University of Heidelberg, 1972, 96-
97.
24
Adamson, Medieval Dietetics, 12.

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 wet, and earth with the dry, was later developed by Aristotle.25 The idea of the four

temperaments was also introduced by Aristotle, and was elaborated by medieval writers.26

Another significant development of the system was connected with the Pneumatic school of

medicine,27 which added more factors to the system.28

Yet the system only acquired its more or less final shape in the writings of Galen (129

– 216/217 AD). He combined the existing elements of theory found in Plato, Aristotle, and

the Pneumatic school with the Hippocratic system, in particular as found in The Nature of

Man.29 The system, elaborated on and enriched by Galen, features the four elements

connected to the four qualities and fluids; it also encompasses both the micro- and

macrocosm, four qualities of taste, and nine temperaments.30 The balance of the cardinal

qualities is mentioned by Galen as eukrasia or symmetria, while the imbalance is called

dyskrasia.31

This idea is of great importance for understanding medieval medicine, therapy, and

prophylaxis. The key to health was believed to be the balance or harmony of the humors

(eukrasia), while the imbalance of bodily fluids (dyskrasia) was seen as the cause of disease.

In this manner, the art of preserving health consisted in removing the excessive humors from

the body and restoring the ones that were in deficit. Activities such as bloodletting, exercise,

and baths were supposed to help to dispose of superfluous fluids. The compositions of the
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regimen sanitatis genre discuss the ways in which one can maintain this healthy balance in

everyday life.

25
Ibid.
26
Ibid.
27
This school, founded in Rome by Athenaeus of Cilicia in the 1st century AD, adopted an active principle of
immaterial nature, pneuma or the spirit of the Stoics. This principle was the cause of health and disease.
28
For example, the male/female principle was introduced; the elements and the qualities were also linked to the
senses: taste, smell, and hearing. See Adamson, Medieval Dietetics, 13.
29
Ibid.
30
Ibid.
31
Ibid. See also Gil-Sotres, “The Regimens of Health,” 294.

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 The division of the four main qualities into four levels of intensity (gradus) – with the

fourth being the strongest – is also attributed to Galen, but might have been in existence

before him.32 Foodstuffs were believed to possess the quality of being either cold or hot, dry

or moist, on a four-degree scale.33 Therefore, any food or drink could be used as medicine to

keep the balance of the qualities within the body; however, when taken without due attention

to the composition of humors and qualities, food and drink could be a source of harm to the

body.34

Galen’s authority in matters of health marked medieval medical writing throughout

many centuries, as late as the mid-sixteenth century. By way of an example, in one of the late

sources under consideration here, Die Gesundheit ist ein Köstlich Ding, Galen is mentioned

twice already in the introduction!35 Due to their huge importance and influence, the works of

Galen have received wide scholarly attention that focused on various aspects of the issue of

health and disease, from reconciling pagan elements of Galenic writings with Christianity to

the so-called Arabic Galenism on etiology.36

Later, starting from the early eighth century,37 Greek medical lore found its way into

the Arab learned world. Ali ibn Abbas al-Majusi, or Haly Abbas (d. 994) is famous for his

32
See Adamson, Medieval Dietetics, 16.
33
For instance, aniseed is hot and dry in the third degree in this system, while an apple is moist and cold in the
first degree. See Magyar, “Stellenwert des Sanitatis studium im medizinischen Schrifttum seiner Zeit,” 24-25.
34
Melitta Weiss Adamson mentions that in Galen’s system the division between foodstuffs and drugs is blurred,
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still it is important that “[l]ike Hippocrates, Galen distinguishes between pharmacopoeia which is capable of
altering the physis, and foodstuffs which merely increase the substance of the body. See eadem, Medieval
Dietetics, 16. The author traces the texts in which the gradus-system is described as well as Greek and Latin
terms used to refer to it, see ibid., 16-17.
35
Paulus Kyr, Die Gesundheit ist ein Köstlich Ding, 45-46.
36
There is a rich literature on Galen’s teachings and its further assimilation by Arabic and Western writers. See,
for instance, Vivian Nutton, “God, Galen, and the Depaganization of Ancient Medicine,” in Religion and
Medicine in the Middle Ages, ed. Peter Biller and Joseph Ziegler (Woodbridge: York Medieval Press, 2001), 15-
32; Danielle Jacquart, “The Introduction of Arabic Medicine into the West. The Question of Etiology,” in
Health, Disease and Healing in Medieval Culture, ed. Sheila Campbell, Bert Hall, and David Klausner
(Toronto: Centre for Medieval Studies, University of Toronto, 1992), 186-195; Danielle Jacquart, “Moses,
Galen, and Jacques Despars,” in Religion and Medicine in the Middle Ages, ed. Peter Biller and Joseph Ziegler
(Woodbridge: York Medieval Press, 2001), 33-46; Daniel J. Boorstin, The Discoverers (New York: Vintage
Books, 1985), esp. the chapter “The Tyranny of Galen,” 344-350.
37
The beginning of the translation activity has not been precisely identified; see George Saliba, “Islamic
Translation and Translators,” in Dictionary of the Middle Ages, vol. 12, ed. Joseph R. Strayer (New York: Simon
and Schuster Macmillan, 1989), 127-133, esp. 127-128.

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 medical compendium, Kāmil al-SDinā’ah al-Tibbiyyah. The importance of this critical

systematization of Galen’s heritage can hardly be overestimated. In the late eleventh century

Kāmil al-SDinā’ah al-Tibbiyyah was translated into Latin, and became known under the Latin

name Liber pantegni. Constantinus Africanus (Constantine the African; c. 1020 – 1087) also

translated other no less important treatises: for instance, Johannitius’ Isagoge or Introduction

to Galen and the Viaticum of Ibn Al-Jazzar.38

Constantine’s translations represent an important milestone; once the medical theory

of the ancients and Arab physicians was assimilated, the Western medical tradition entered a

new prolific stage. Medical theory and practice developed steadily, and new treatises

(although rooted in the old tradition) were produced. Among the plethora of medical texts

were numerous regimens of health meant to help their readers maintain good health.

1.1.2. ‘Naturals’, ‘non-naturals’ and ‘contra-naturals’.

A few words need to be said about the key concepts of medieval medical theory: res

naturales, sex res non naturales, and res contra naturam. As emotions, which are the main

subject of my investigation, are part of the sex res non naturales, it seems logical to start with

them. The terms res non naturales and ‘non-naturals’ are used interchangeably as is common

in English-language scholarship.
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The six non-naturals are key to the genre of regimen sanitatis. These factors,

fundamental for health, have long been believed to be Galen’s own terms. This issue of the

origin of non-naturals and Galen’s authorship of the term is discussed by Adamson.39

‘Naturals’, ‘non-naturals’ and ‘contra-naturals’ appear to have been first systematized in the

38
“Introduction,” in Practical Medicine from Salerno to the Black Death, ed. Luis García-Ballester and Roger
French (Cambridge: CUP, 1994), 1-29, esp. 10.
39
Reviewing the research done by scholars such as Lelland Rather, Saul Jarcho, Jerome Bylebyl, Peter Niebyl,
and Luis García-Ballester, Melitta Weiss Adamson summarizes it as follows: the concepts of the key factors for
health that can be found in Galenic texts were later systemized as the six non-naturals by Alexandrian Galenism
and subsequently taken over by Arab authors. Adamson, Medieval Dietetics, 18-20.

11
 work of Johannitius, or more precisely, in the Latin translation of his Introduction, executed

by Constantinus Africanus in the second half of the eleventh century. It is here that one comes

across res naturales, res non naturales, and res contra naturam.40 As one can see, it is in this

Latin translation of the Isagoge that the six non-natural factors influencing health become

associated with the term res non naturales, “as they were known throughout the Middle

Ages.”41

Johannitius’ order of non-naturals is the following: 1. aer, 2. motus et quies, 3. cibus

et potus, 4. somnus et vigilia, 5. repletio et evacuatio, and 6. accidentia animi. The same

order is found in Haly Abbas’ composition, where these factors are linked to the number

six.42 These six non-naturals, with a slight difference in names, appear in yet another

important text, which reached the Latin world in the first half of the twelfth century. The

Secretum secretorum, believed to be a series of letters between Aristotle and his student,

Alexander the Great, was written by an unknown Islamic author in the tenth century. This

composition was one of the most read in the Middle Ages, by scholars and lay readers alike.43

The Secretum secretorum teaches: “With this should be observed the quality of the regimen

in six non-natural things: in air, exercise and rest, food and drink, sleep and walking, coitus,

and passions and emotions.”44

If the non-naturals represented the factors which had an impact on the body and could
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be regulated, then the naturals were natural, organic factors that could be affected. The four

humors and four qualities, discussed above, constituted the fundamental element of res

40
Ibid., 20; “Introduction” to Practical Medicine from Salerno to the Black Death, 10-11; Peregrine Horden,
“Religion as Medicine: Music in Medieval Hospitals,” in Religion and Medicine in the Middle Ages, ed. Peter
Biller and Joseph Ziegler (Woodbridge: York Medieval Press, 2001), 135-153, esp. 142-143.
41
Adamson, Medieval Dietetics, 20.
42
Ibid.
43
Faye Getz calls this work “the most powerful example of medical Arabism in medieval England,” but its
influence was not limited to this area. Roger Bacon is one of the English intellectuals of the thirteenth century
who elaborated on pseudo-Aristotelian ideas. For more detailed information, see Getz, Medicine in the English
Middle Ages, 53-63.
44
repletio et evacuatio is reduced to coitus here. Observetur cum hoc regiminis bonitas in sex rebus non
naturalibus: aere, exercicio et ocio, cibo et potu, somno et vigilia, coitu et accidentibus anime; English and
Latin text quoted from Adamson, Medieval Dietetics, 20.

12
 naturales.45 Besides, there were also res contra naturam, or diseases, which were to be

analyzed externally through their symptoms.46 External signs such as swellings or fevers, as

well as the pulse, along with body’s excretions, primarily urine, were used for diagnosis.

The concept of the six non-naturals is key to understanding the bulk of compositions

like the ones I am exploring. The possibility of regulating non-natural factors in order to

preserve good health became the axis around which prophylactic medical texts centered. The

emphasis on the preventive qualities of the sex res non naturales is strong in the regimens and

has been noted by scholars.47 Their ambivalent nature was described by Avicenna, in the

early eleventh century: non-naturals, in balance and moderation, have a beneficial effect on

the health and prevent sickness, while excessive and unbalanced use of the same non-naturals

can cause sickness. This other aspect of the nature of the six non-naturals did not become

very popular, and neither did the terminology which Avicenna used for this concept.48

The following is an overview of the six factors:

1. aer – not only the quality of air – its temperature, humidity, smell, purity – but also

influence of environmental factors, such as geographical location, climatic conditions, winds,

seasons, winter and summer habitation, clothes, perfumes, etc.; also as the carrier of disease

such as plague;
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45
In its elaborated form the system of res naturales consists of seven groups: elementa – the four elements fire,
air, water, earth, with their qualities warm, cold, moist, and dry; commixtiones/complexiones – various
proportions of elements and qualities characterizing a person; compositiones (humores) – the four bodily fluids:
blood, yellow bile, black bile, and phlegm in their interplay; membra (partes) – the organs and parts of the body;
virtutes (facultates) – the powers operating in the body, comprising virtus animalis, virtus spiritualis and virtus
naturalis; operationes (actiones) – the physiological processes which are brought about by virtutes, e.g.,
digestion or excretion; spiritus – the breathlike substance which is thought to be the carrier of powers and
functions. For more information, see Ferenc Némethy, “Zum Regimen Sanitatis in Deutscher Sprache,”
Orvostörténeti közlemények 30, No. 3-4 (1984): 11-23, esp.14.
46
These can be subdivided into morbus or morbi (aegritudines) – illnesses; causa morbi – causes of illness;
accidentia morbum sequentia (signa, significationes) – symptoms of illness, Ibid., 14.
47
Adamson, Medieval Dietetics, 21.
48
In Avicenna’s writing, non-naturals are called causae efficientes when they harm the body and causae
necessariae when they help preserve health. In the first case, they appear to be closer to res contra naturam. See
Adamson, Medieval Dietetics, 20-21, 66, and 73.

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 2. motus et quies49 – exercise and rest, where the necessity of physical exercise for a

healthy organism is emphasized. Describes the type, quality, quantity, speed, and intensity of

physical activity, the effects of excessive and moderate exercise on the body, the rhythm of

physical activity and rest periods. Establishes the difference between “sport” and other types

of movement (active and passive movement, movement while working), sometimes also

includes baths and massage;

3. cibus et potus – regarded as the most important and thus, the most elaborated

component of healthcare; contains advice on appetite, quantity, quality, amounts, order and

time of food consumption, dietetic lists of foodstuffs and their humoral qualities, culinary

recipes, etc.;

4. somnus et vigilia – regulation of phases of sleep and wakefulness, duration of

sleep, relation to food consumption (for instance, recommended foodstuffs before going to

bed), digestion, and emotional well-being, etc.;

5. repletio et evacuatio50 – on the whole, regulates purging the body of harmful

excesses, which could be blood, urine, stool, menstrual blood, mucus, saliva, semen, vomit,

etc; usually contains detailed recommendations for phlebotomy; sometimes includes coitus,

baths, massages; may also discuss haematoscopy, clysters, etc.;

6. accidentia animi51 – emotions and states of the mind and their effect on the body.
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***

To sum up, the medical system of the medieval regimen sanitatis is preventive as it is

concerned with the preservation of health. This form of medieval dietetics is rooted in the

four-humor theory and centers around the six non-naturals. The dietetic focus, in its broad

49
Can appear as exercitium et otium, or just exercitium.
50
Could be also called inanitio et repletio, or secreta et excreta, laxatio et constrictio humorum.
51
Other names can be accidentia animae, motus animi, affectus animi or animi affectiones.

14
 sense,52 describes a healthy way of life, in which a balanced emotional state plays an

important role. The preventive aspect of δίαιτα is more prominent than the therapeutic one. In

this matter, the right diet – in the modern sense of the word – played a particularly important

role throughout the whole tradition.

In this system, just as the world was believed to be composed of four elements (earth,

water, fire, air), so the body was thought to consist of four humors, corresponding to each

element – black bile (melaina cholé), phlegm (phlegma), bile (cholé), and blood (haima or

sanguis), respectively. Similar to the core elements, humors possessed their qualities, being

warm or cold, dry or moist, where, for instance, earth is cold and dry, water is cold and moist,

fire is warm and dry, and air is warm and moist. The art of maintaining human health

consisted of preserving the balance of these four humors and their qualities.

Therapy and prophylaxis could be achieved through the agency of these principle

qualities of warm/cold, dry/moist. For instance, if cold humors like phlegm and black bile

produced cold diseases, or similarly warm diseases were produced by warm humors, the

ailment could be treated by applying substances with opposite qualities. Thus, according to

the principle contraria contrariis curantur, cold diseases are to be cured by warm substances

and warm diseases by cold. The full variety of food and drink, as well as other non-naturals,

served to achieve this end: air and environment, repletion and excretion53/elimination and

retention54, exercise and rest, sleep and wakefulness, emotions or affects.

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52
The Greek word δίαιτα – “way of living, mode of life” – denotes a regulated way of life, a healthy mode of
life.
53
In the terminology of Melitta Weiss-Adamson; see eadem, “Regimen sanitatis,” in Medieval Science,
Technology, and Medicine: an Encyclopedia, 438.
54
In the terminology of Faith Wallis; see eadem, “Theoretical Medicine,” in Medieval Science, Technology, and
Medicine, 336-340, esp. 338.

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 CHAPTER TWO

REGIMENS OF HEALTH. A HISTORICAL OVERVIEW.

Before venturing into the exploration of emotion-health patterns in the selected

primary sources, it is necessary to consider what this genre represents. The preventive nature

of the genre was discussed in the previous chapter. Here I will concentrate on the historical

development of the genre, highlighting the main stages of its evolution and variations in the

types of compositions. The history of the emotional component in regimen of health literature

will also be traced.

***

The main stages in the development of the genre can be summarized as follows:

1. Pre-Arabist period – The “European period of limited knowledge before the

translation from Arabic flooded the continent;”55

2. Arabist period – “the assimilation-period of Greco-Roman science mainly by

the Arabs and the Latin translations of the Arabic texts;”56

3. Westernization period – “the age of scientific literature produced in Europe

from Pre-Arabist and Arabist sources in Latin and in the vernacular.”57

Regimens of health have a long history and their origins can be traced back to as early

as 400 BC, to the Corpus Hippocraticum.58 The next important stage in the development of
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the genre was connected with Arabic medicine. Greek medical books were translated into

55
Adamson, Medieval Dietetics, 22.
56
Ibid.
57
Ibid.
58
Three Hippocratic writings are particularly concerned with dietetic aspects: Regimen (or Dreams), A Regimen
for Health, Regimen in Acute Diseases, in Nicoud, 3. The Greek titles of the works are: περὶ ἐνύπνιον (peri
enupniôn); περὶ διαίτης (peri diaitès), περὶ διαίτης ὀξέον (peri diaitès oxeôn).

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 Syriac/Arabic, resulting in a “blending [of] the knowledge of Greece with the wisdom of the

East.”59 As was mentioned above, the main figure of the translation activity was Johannitius.

This prominent Nestorian scholar understood and underscored the necessity to take

care of passions of the soul:

Sundry affections of the mind produce an effect within the body, such as those
which bring the natural heat from the interior of the body to the outer parts or
the surface of the skin. Sometimes this happens suddenly, as with anger;
sometimes gently and slowly, as with delight and joy… some affections
disturb the natural energy both internal and external, as, for instance, with
grief.60

Sunt quaedam accidentia animae quae faciunt intra corpus, sicut ea, quae
commovent calorem ab interiori parte ad superficiem cutis, aut impetuose ut
ira, aut leniter cum sauvitate ut deliciae. Sunt etiam quae ad se caliditatem
contrahunt et celant, aut impetuose ut terror vel timor, aut leniter ut angustia.
Et sunt quae commovent naturalem virtutem intus et extra ut est tristitia…61

Muslim scholars did not ignore the importance of emotions and passions for the

physical wellbeing of a person. Rhazes (ca. 865 – 925), for instance, wrote a chapter on this

topic.62 Ibn Butlan’s (d. ca. 1066) famous Tacuinum Sanitatis also contains a section

dedicated to accidentia animi.63 Haly Abbas also dealt with the interdependence of emotional

and physical health, as has been pointed out by researchers.64 In contrast, accidentia animi are

59
“Moses Maimonides’ Two Treatises on the Regimen of Health,” 3.
60
Johannitius, Isagoge, here quoted from Horden, “A Non-natural Environment,” 143.
61
Isagoge Iohannitii, ed. Maurach, here quoted from Danielle Jacquart, “The Introduction of Arabic Medicine
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into the West,” 195. Also compare Hugh of St. Victor, Didascalicon 2.26, ed. Buttimer: Accidentia animae ideo
dicuntur occasio sanitatis vel infirmitatis, quia aliquando commovent calorem impetuose, ut ira, vel leniter, ut
delectationes, vel attrahunt et celant aut impetuose, ut terror et timor, aut leniter, ut angustia. Et sunt quae
commovent naturalem virtutem intus et extra, ut est tristitia (“Accidents of the soul ... sometimes move the
natural heat impetously, as anger, or gently, as delight ; sometimes they withdraw and conceal it impetuously, as
fear or terror, or gently, as anguish. And there are some that move the natural virtue from the interior and
exterior, as grief.”) Latin text and English translation by Jacquart in eadem, 194 and 191, respectively.
62
In Liber de medicina ad Almansorem (Liber Almansoris) there is a chapter called “De cogitationibus anime.”
In Adamson, Medieval Dietetics, 59.
63
It discusses uerecondia, ira, cantus, organare cantum uel sonare, sonare et balare, gaudia (Adamson,
Medieval Dietetics, 87), of which only uerecondia (shame), ira (anger), and gaudia (sic!) (joy) appear to be
emotions proper. Apart from these three, fear, anxiety, and sadness are mentioned in the Tacuinum Sanitatis
entry of Medieval Science, Technology, and Medicine: An Encyclopedia, 469.
64
Nurdeen Deuraseh and Mansor Abu Talib explore this issue in the Islamic medical tradition. They mention
joy and contentment among the positive/beneficial emotions, in contrast to harmful anger, sadness, worry, fear
and anxiety. In Nurdeen Deuraseh and Mansor Abu Talib, “Mental Health in Islamic Medical Tradition,” The
International Medical Journal 4, No. 2 (2000): 76-79, esp. 77.

17
 absent from Avicenna’s (ca. 980 – 1037) Canon of Medicinae and Cantica, although his list

of causae efficientes (non-naturals) includes all six factors.65

Beginning in the second half of the eleventh century, this body of medical knowledge,

elaborated and systemized by Arab as well as Byzantine authors, was taken over in the West.

This translation activity is believed to be one of the factors that led to the creation of the

school of Salerno.66 Other medical schools emerged after the twelfth century, such as those in

Paris, Montpellier, Bologna, and Padua.67

In connection with the famous medical school of Salerno a particularly influential

medical treatise needs to be mentioned. The widely known Regimen sanitatis Salernitanum,

or Flos medicinae, is believed to have been produced in Salerno between 1260 and 1300.68

This composition, written in verse, bears a dedication to Robert, Duke of Normandy, the

eldest son of William the Conqueror. The language of the poem is quite plain, while the

significance of this handbook of health was great. It enjoyed enormous popularity, was

translated into vernacular languages (including German),69 and there are numerous

manuscripts, incunabula, and early prints (more than 250 printed editions, including at least

40 incunabula).70

The importance of emotions in the matters of health was not overlooked in this

illustrious regimen of health:

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si tibi deficiant medici, medici tibi fiant

hæc tria – mens læta – requies – moderata diæta.71

65
Ibid., 67, 74.
66
Alain Touwaide, “The Legacy of Classical Antiquity,” in Health and Healing from the Medieval Garden, ed.
Peter Dendle and Alain Touwaide (Woodbridge: The Boydell Press, 2008), 15-28, 22.
67
Magyar, “Stellenwert des Sanitatis Studiums im medizinischen Schrifttum seiner Zeit,” 22.
68
Adamson, Medieval Dietetics, 97.
69
An example of bilingual version of the Regimen sanitatis Salernitanum will be considered in Chapter 5 of the
present thesis.
70
Adamson, Medieval Dietetics, 98.
71
“Shouldst Doctors need? be these in Doctors’ stead–/ Rest, cheerfulness, and table thinly-spread.” In addition
to this, in the very first verse of the regimen, one is reminded: Si vis incolumem, si vis te reddere sanum,/ Curas
tolle graves, irasci crede profanum; (“If thou to health and vigor wouldst attain, /Shun weighty cares–all anger
deem profane”). For Latin text and English translation, see Regimen sanitatis Salernitanum, ed. John Ordronaux
(Philadelphia: J. B. Lippincott, 1871), 46, 47.

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 Popularization was a significant stage in the development of the regimen of health

genre. It was possible after another important step was achieved – the main characteristics of

the genre being fixed. These include: compositions centering on the six non-natural factors, a

new title for works of this kind, and also practical orientation of the texts.72 This important

development is associated with the Regimen sanitatis ad inclytum regem Aragonum, by

Arnold de Villanova (Arnaldus de Villa Nova, Arnaldus de Villanueva, Arnaldus

Villanovanus, Arnaud de Ville-Neuve or Arnau de Vilanova), known by several versions of

his name.73 This physician of Catalan origin, who lived between 1235/1240 – 1311, wrote

works on medicine, alchemy, and astrology, and he is also famous for his commentary of

Regimen sanitatis Salernitanum.74

It can be argued that it is incorrect to treat works, such as Villanova’s Regimen

sanitatis ad inclytum regem Aragonum, as regimina sanitatis, they are rather consilia. “… [A]

text drawn up at someone’s request which expounded a medical treatment for a particular

illness suffered by a specific patient,” stresses Sebastià Giralt, constitutes a consilium.75 At

the same time, not all researchers draw such a sharp dividing line between more general

regimens and more personalized consilia. Nicoud and Adamson consider such texts among

the regimina sanitatis. I would like to emphasize that for my study demarcating the

boundaries between the two genres is not relevant, and I include consilia in the body of
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regimens to be analyzed. The focus of my study is on how emotions affect the human body,

whether it is a specific addressee of a consilium, or a general reader of a regimen sanitatis.

72
Nicoud, Les Régimes de Santé, 154.
73
Ibid.
74
Adamson, Medieval Dietetics, 97; Regimen sanitatis Salernitanum, 40-43. Also compare Villanova’s
commentary on joyfulness; in Regimen sanitatis Salernitanum, 41.
75
Sebasti (sic! Sebastià) Giralt, “The “Consitia” (sic! Consilia) Attributed to Arnau de Vilanova,” Early Science
and Medicine 7, No. 4 (2002): 311-356, esp. 311. In the analyzed consilia, Giralt mentions the following
emotions: worries, anger, and alarm in the Cura febris ethice; cheerfulness in the Regimen quartane; eadem, 331
and 338 respectively.

19
 Starting in the thirteenth century, the genre of maintaining health entered its most

popular period. Numerous compositions appeared all over Europe, both in Latin and the

vernaculars. It would be impossible to cover the historical evolution of the whole regimen

literature, thus I will focus on the German representatives of the genre.

Regimens in the German vernacular can be found from as early as the twelfth

century. The Breslauer Arzneibuch, by an unknown compiler, is one of the earliest Middle

High German regimens known. Its dating is problematic; although the manuscript has been

dated to the thirteenth century, large portions of its content can be found in compositions of

the twelfth century.76 Another early regimen of health, Spegel der naturen, was produced in

1325, authored by Everhard von Wampen in Low German verse.77 One of the most influential

regimens was composed around 1300 by Konrad von Eichstätt. Melitta Weiss Adamson

emphasizes the fact that his Sanitatis Conservator had an impact on most of late-medieval

German dietetic writing.78 Unfortunately, Konrad leaves out emotions and passions of the

soul from the discussion: “The non-natural missing in Konrad’s regimen, as in so many other

European regimina, is De accidentia animi.”79

Although in many cases regimens of health are difficult to categorize and separate

from other medical writings, it can be said that after 1348 the genre of regimen sanitatis had

its aim fixed as the preservation of health of those to whom it was addressed, leaving therapy
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76
Adamson, Medieval Dietetics, 23, 103.
77
Ibid., 138.
78
Ibid., 142, 149.
79
Ibid., 144. However, Adamson researched two regimens in the tradition of Konrad’s composition which do
discuss emotions; these are the Tractatus de regimine sanitatis of Arnold von Bamberg (beginning of the
fourteenth century; I will consider this composition in Chapter 5 in more detail) and Regel der Gesundheit
(fifteenth century); see ibid., 152, 182 respectively. In another regimen, contained in the composite manuscript
Haubuch by Michael de Leone (mid-fourteenth century), Adamson mentions anger, sadness, and deep distress;
see eadem, “Preventive Medicine in Fourteenth-Century Würzburg: The Evidence in Michael de Leone’s
Hausbuch,” in Ir sult sprechen willekomen. Grenzenlose Mediävistik. Festschrift für Helmut Birkhan zum 60.
Geburtstag, ed. Christa Tuczay, Ulrike Hirhager, Karin Lichtblau (Bern: Lang, 1998), 501-520, esp. 513.

20
 to related genres such as consilia.80 Apart from this consilium/regimen contradistinction,

other differentiations are also made within the genre.81

In print, the earliest German medical incunabula go back to 1470s. Two were noted by

Thomas E. Keys in his research on the earliest medical books printed with movable type: the

Ordnung der Gesundheit82 (which will be considered later among the selected primary

sources) and Bartholomaeus Metlinger’s Ein Regiment der jungen Kinder.83 Influenced by the

trends of the medical school which they belonged to,84 regimens of health were produced

everywhere in Europe by the fifteenth and sixteenth centuries. The genre enjoyed great

popularity, by this time written for and read by a wide audience, not only medical specialists.
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80
Nicoud, Les régimes de santé au Moyen Âge, 279.
81
Pedro Gil-Sotres, for instance, distinguished two large groups: regimens tailor-made for individuals of high
social rank (i.e. consilia) and “university” regimens (frequently linked to the teaching activity of their authors).
In Gil-Sotres, “The Regimens of Health,” 300.
82
First printed April 23, 1472, at Augsburg. See Thomas E. Keys, “The Earliest Medical Books Printed with
Movable Type: A Review,” The Library Quarterly, 10, No. 2 (1940): 220-230, esp. 225. Christa Hagenmeyer
mentions it as the first of the German medical books to go to print, with as many as twelve prints between 1472
and 1495. See Christa Hagenmeyer, “Die 'Ordnung der Gesundheit',” 10.
83
First printed in 1473, at Augsburg. See Keys, “The Earliest Medical Books,” 225.
84
The moving away from the gradus-system, for example, was connected with Montpellier becoming the center
of medical learning over Salerno; in Adamson, Medieval Dietetics, 200. The introduction of rules, regulae,
which make the contents more memorable, is connected with the French school of dietetics; ibid., 201.

21
 The regimen’s development also meant diversification of the genre. Apart from the

conservative regimen proper – the one designed for adults – there are a range of regimens

aimed at other groups – pregnant women, children, the elderly, and convalescents. Moreover,

another group of texts form the so-called travel-regimina. Furthermore, some of the texts are

general in nature, intended for a wide audience, while others are addressed to certain

individuals and personalized. For instance, such tailor-made regimens, or rather consilia,

might aim at gout.85 In addition to all this, the whole picture is made even more complicated

by a number of related genres or subgenres, for instance, the regimen duodecim mensium,

regimens for the months of the year, or pestregimina, prophylactic plague regimens.86

***

It is hardly possible to review the historical development of a genre as diverse and rich

as regimen sanitatis in the few pages of this chapter. It has just been my aim to point out the

principle milestones in the evolution of this genre from its origins in the Corpus

Hippocraticum and Galen’s work to the diverse regimen literature of the late Middle Ages, as

well as different types of regimen literature. In the later period, when a huge number of

compositions were produced, I have narrowed the view down to the German regimina in

accordance with the selected primary material.

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85
One such text will be considered in the practical part of this thesis, namely, Regimen editum contra arteticam
siue podegram per Erhardum Knab, artium et medicine doctorem.
86
Different scholars differentiate different types of regimina. The types distinguished by Ferenc Némethy, for
instance, include: Seasonal regimen (Regimen temporum), monthly regimen (R. duodecim mensium), movement
regimen (R. motus, exercitii et quietis), travel and sea regimen (R. iter agentium, R. mare intrantium), food
regimen, regimen of excreta and vomiting, regimen for pregnant women and women in labor, regimen for
newborn babies, children, adolescents, old people, etc. See Ferenc Némethy, “Zum Regimen Sanitatis in
Deutscher Sprache,” 12.

22
 CHAPTER THREE

SITUATING THIS STUDY WITHIN THE HISTORY OF EMOTIONS

With the relevant aspects of the history of medicine covered, it is imperative to cover

the history of emotions for the second major theoretical framework of the present study. I

chose to concentrate on the field in general, its approaches and historiography, as this will

serve better to situate my own contribution. The main questions posed to a medievalist

interested in the emotions of late medieval German medical texts are: “What are (medieval)

emotions? How can one study them? What is the state of research for the emotions I have

identified and examined?”

To answer these questions adequately, I begin by addressing the problem of the

definition(s). Attention will be given to the approaches to studying emotions in historical

perspective. The history of emotions has often been criticized on various grounds, for this

reason I will also consider problems and pitfalls, along with the approaches which allow

overcoming these difficulties. Only the aspects relevant to a medievalist’s perspective on the

history of emotions will be treated, leaving psychological, neurological, philosophical, and

anthropological dimensions to more specialized studies.

3.1. “A Maturing Field”87

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Feelings and mental states have never been neglected or forgotten. From philosophers

of ancient Greece and Rome to medieval theologians to thinkers and intellectuals of the

(early) Modern Age, emotions and related phenomena have attracted close attention. In

scholarship, emotions can be and have become the object of study from different

perspectives: psychology, psychiatry, neurology, anthropology, sociology, etc. They are also
87
To describe the present state of the research I am using the collocation which Peter N. Stearns used a decade
ago; see Peter N. Stearns, “History of Emotions: Issues of Change and Impact,” in Handbook of Emotions, ed.
Michael Lewis and Jeannette M. Haviland-Jones (New York: The Guilford Press, 2000), 16-29, esp. 19

23
 a fruitful research topic for practitioners of the history of emotions, where the best insights

are gained with interdisciplinary approaches.

The rise in the study of emotions did not happen until recent decades. Back in 1941 a

history of emotions was called for by Lucien Febvre;88 now research into all things emotional

is on the upturn. “Emotional turn,” a “burgeoning field,” “a new narrative,” “a rich seam for

study” … such phrases reflect the importance of recent research into emotions and passions.

Since the term “emotional turn” was used in 2006 for the first time,89 it has become natural to

view it as such.90 Indeed, the nuanced and careful investigation of emotions, as well as their

expression, representation, and contextualization, has lived up to the “turn.”

Quite a number of scholars have embarked on this path, with the result of more and

more publications with more and more approaches. In this regard, the history of emotions

does represent a burgeoning field, as Jan Plamper has referred to it.91 A new narrative for the

study of emotions in the past is something Barbara Rosenwein called for back in 2002.92

Nowadays, the tantalizing framework of the old narrative has been left behind; no one sees

the emotional life of the Middle Ages as childlike and ungoverned, as Johan Huizinga and

Norbert Elias treated it.93 The hydraulic model (irrational emotions as opposed to the rational

88
See Barbara Rosenwein, “Worrying about Emotions in History,” The American Historical Review 107, No. 3
(2002): 821-845, esp. 821; also Peter Burke, “Is There a Cultural History of the Emotions?” in Representing
Emotions. New Connections in the Histories of Art, Music and Medicine, ed. Penelope Gouk and Helen Hills
(Aldershot: Ashgate, 2005), 35-47, esp. 35.
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89
Thomas Anz, “Emotional Turn? Beobachtungen zur Gefühlsforschung,” literaturkritik.de 12 (2006),
available at http://literaturkritik.de/public/rezension.php?rez_id=10267 (Last accessed: 4 May 2011).
90
It is mentioned in two recent publications which nicely summarize the historiography of emotions. See Ute
Frevert, “Was haben Gefühle in der Geschichte zu suchen?” Geschichte und Gesellschaft 35, No. 2 (2009): 183-
208, esp. 184-187; Jan Plamper, “The History of Emotions: An Interview with William Reddy, Barbara
Rosenwein, and Peter Stearns,” History and Theory 49 (2010): 237-265, esp. 237.
91
Plamper, “The History of Emotions,” 237.
92
Barbara Rosenwein, “Worrying about Emotions in History,” 821-845.
93
Huizinga spoke of “… a tone of excitement and of passion to everyday life and … that perpetual oscillation
between despair and distracted joy, between cruelty and pious tenderness which characterize life in the Middle
Ages;” in Johan Huizinga, The Waning of the Middle Ages: A Study of the Forms of Life, Thought and Art in
France and the Netherlands in the XIVth and XV Centuries, tr. Frederik J. Hopman (New York: Anchor Books,
1924), 9; here quoted from Rosenwein, “Worrying about Emotions,” 822. Elias believed that “People [in the
Middle Ages] are wild, cruel, prone to violent outbreaks and abandoned to the joy of the moment;” in Norbert
Elias, The Civilizing Process (Oxford: Blackwell, 1994), 319; here quoted from Rosenwein, “Worrying about
Emotions,” 823. For a critique besides Rosenwein’s see Frevert, “Was haben Gefühle in der Geschichte zu
suchen?” 195, 196.

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 reasonable mind) has been overcome, as well as the flaw of a sweeping generalizing

treatment of emotional experiences.

The new trend is a history of emotions which pays due attention to contexts, aspects,

and details. Cross-cultural comparisons are encouraged by some,94 while it is emphasized that

any emotion (as well as its expression) is culture- and period-specific.95 It is indeed a rich

seam for study, in Catherine Cubitt’s words,96 when emotions are studied on an

interdisciplinary foundation, offering new insights into aspects of history otherwise

incomplete.

3.2. Definition(s)?

What does the history of emotions investigate? In spite of the seeming obviousness of

the answer to this question the matter is not that simple. The main notion of the history of

emotions is fraught with difficulties. Is there a universal definition for “emotion”? Is there

one single “right” approach to studying, analyzing, defining, etc. the so-called emotions?

Furthermore, what can be done with the problem of terminology, adequately rendering

psychological experiences from one language into another?

We all have an idea of what is felt or experienced as an emotion; but the problem

begins when one tries to define it clearly in scientific terms for scholarly purposes.97 As
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elusive as it is, this notion might also be referred to as passions, feelings, sentiments,
94
“… there is another recourse to assist the study of medieval peoples’ emotions: the judicial use of
comparisons,” see Mary Garrison, “The Study of Emotions in Early Medieval History: Some Starting Points,”
Early Medieval Europe 10, No. 2 (2001): 243-250, esp. 247.
95
“… ‘the emotions’, unchanging within human nature, transcending historical conditions, do not exist. Rather,
‘emotions’ are brought into being socially and historically, and recognized, encouraged, controlled, particularly
in relation to race and colour, social class and gender.” See Penelope Gouk and Helen Hills, “Towards Histories
of Emotions,” in Representing Emotions. New Connections in the Histories of Art, Music and Medicine, ed.
Penelope Gouk and Helen Hills (Aldershot: Ashgate, 2005), 15-34, esp. 15.
96
Catherine Cubitt, “The History of the Emotions,” Early Medieval Europe 10, No. 2 (2001): 225-227, esp. 225.
97
The OED, for example, defines emotion as “A mental ‘feeling’ or ‘affection’ (e.g. of pleasure or pain, desire
or aversion, surprise, hope or fear, etc.), as distinguished from cognitive or volitional states of consciousness.”
See OED, http://www.oed.com/view/Entry/61249?redirectedFrom=emotion#eid (Last accessed 27 March 2011).
However, such a definition is highly ambiguous, and makes use of notions that are often used as synonyms in
the history of emotions research, where “emotions,” “feelings,” “affections,” and “passions” are sometimes used
interchangeably.

25
 sensibility, affections, affectivity, desires, drives or instincts.98 Scientific definitions, suitable

for the domain of psychology, do not necessarily simplify the task of the historians of

emotions.99

It has been demonstrated that defining emotions entails drawing further distinctions,

sometimes even splitting hairs; thus, some would differentiate between emotions and

episodes of emotional experience,100 others draw a sharp dividing line between “passions and

affections” or “sentiments and affections” and “emotions.”101 Such differentiation might be

suited to philosophical theorizing or psychological categorization, but it is barely helpful for

the medievalists and historians who want to deal with representations or manifestations of

emotional life and experiences. For this reason devising technical definitions of emotions

does not seem to solve the problems of the history of emotions, furthermore, these definitions

are liable to criticism, too.

The fact that all emotions are culture-dependent makes any attempt to formulate the

“best” definition futile. It is indeed not possible to devise an overarching definition of

emotions which would apply to all periods and all places, or one that could not be argued

against. It has become a consensus among historians of emotions that there cannot be a

definition or an approach which would be universally valid.102

98
Peter Burke, “Is There a Cultural History of the Emotions?” in Representing Emotions, 35-47, esp. 38.
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99
For instance, William James (1842-1910) and William McDougall (1871-1938) saw emotions as
psychological concomitants of instinctive behavioral categories, generally occurring either when the behavioral
implementation of such instincts was frustrated or as a result of the behavior itself rather than its motivation.
This definition has been argued by psychologists as well as scholars such as Graham Richards, for its limited
applicability. See Graham Richards, “Emotions into Words?” in Representing Emotions, 49-65, esp. 51-52.
100
Peter Goldie, The Emotions: a Philosophical Exploration (Oxford: Clarendon Press, 2000), 11.
101
Thomas Dixon, From Passions to Emotions: the Creation of a Secular Psychological Category (Cambridge:
Cambridge University Press, 2003), 18-19.
102
See Penelope Gouk and Helen Hills, “Towards Histories of Emotions,” in Representing Emotions, 17;
Damien Boquet and Piroska Nagy, “L’historien et les émotions en politique: entre science et citoyenneté,” in
Politiques des émotions au Moyen Âge, ed. Damien Boquet and Piroska Nagy (Florence: Sismel – Edizione del
Galuzzo, 2010), 5-30, 15. However, the psychologist Bernard Rimé, the author of the concluding essay in the
same volume, disagrees. He insists that there is an established prototype definition of emotion (“Pour l’émotion,
les prototypes comportent notamment des traits tels que la modification abrupte de la situation, les réponses
expressives, les modifications de la conscience, et les tendances d’action. Ainsi, selon cette logique, plus l‘état
d’un individu donné rassemble de telles caractéristiques à un moment, plus cet état sera considéré comme une
emotion.” See Bernard Rimé, “Les émotions médiévales. Réflexions psychologiques,” in Politiques des

26
 A more inclusive term may indeed be better suited to this type of study, as for

example, French histoire d’affectivité.103 Accounting for the diversity of emotional and

psychological phenomena that become the focus of scholarly investigation, such a term might

also offer an alternative to the definition-of-emotion issue.

3. 3. Approaches, Pitfalls and Possibilities

A more constructive way to formulate the theoretical tenets of a field such as the

history of emotions is looking at the approaches used rather than definitions. The category of

“all things emotional” is broad, thus, the arsenal of possible approaches is broad and needs to

be suited to the nature and aims of a particular study.

I have chosen to focus on the approaches of the three leading historians of emotions

(in Anglophone scholarship), who have discussed the history of emotions in a recent

interview.104 This interview represents not only one of the most current views on this study,

but it is also a good summary of key concepts, analytical tools, challenges, and

possibilities.105

William Reddy embarked on emotional history with the view that emotion is a

structure through which all different complex meanings and nuances of social history become

personal,106 and in his investigation introduced the concept of “emotives.”107 These are
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expressions about what one feels (i.e., emotions) which are both managerial and explanatory.

In the scholar’s own words, “[a]n emotional expression is an attempt to call up the emotion

émotions au Moyen Âge, ed. Damien Boquet and Piroska Nagy (Florence: Sismel – Edizione del Galuzzo,
2010), 309-332, 312.
103
Boquet and Nagy, “L’historien et les émotions en politique: entre science et citoyenneté,” 5-30; Damien
Boquet and Piroska Nagy, “Pour une histoire des emotions. L’historien face aux questions contemporaines,” in
Le sujet des émotions au Moyen Âge, ed. Piroska Nagy and Damien Boquet (Paris: Beauchesne, 2008), 15-51.
104
Plamper, “The History of Emotions.”
105
There is also a strong French school of the history of emotions. For a detailed summary of the discipline, see
Boquet and Nagy, “Pour une histoire des emotions,” 15-51.
106
Reddy, in Plamper, “The History of Emotions: An Interview,” 238.
107
See Reddy, The Navigation of Feeling (Cambridge: CUP, 2001), 104.

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 that is expressed; it is an attempt to feel what one says one feels.”108 One of the key points for

Reddy is the political significance of emotions, as well as the normative nature of “emotional

regimes.”109

Barbara Rosenwein, in her turn, emphasizes the culture-specific nature of emotions;

they are “the result [of] our values and our assessments.”110 That is why emotions differ from

culture to culture, from society to society, from one “emotional community”111 to another.

Moreover, in this scholar’s view, assuming that our emotions are identical to those of the past

is absolutely unhistorical, with the very “emotion” category being a recent construct.112

Always tied to emotions are how they are expressed – by words, gestures, mimicry, body

language, and so on. Investigating emotions in historical perspective, Rosenwein employs the

method of association.113

In the same interview, Peter N. Stearns stressed that research along the history-of-

emotions guidelines allows gaining insights into psychological and historical issues as they

are interdependent, with more attention to social contexts and consequences.114 At the same

time, he differentiates between emotions proper, as psychological experiences, and

emotionology, as emotional norms and cultural standards.115 Stearns maintains that research

should concentrate mainly on emotionology because, firstly, this aspect is more accessible

than personal experiences themselves, and, secondly, because norms influence behaviors,
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attitudes, and evaluations.

One of the difficulties linked with the study of how people felt about something in the

faraway past – a flaw of which the history of emotions has been accused – is the lack of direct

108
Reddy, in Plamper, “The History of Emotions: An Interview,” 240.
109
To put it in a nutshell, “every community deploys emotional ideals and norms, and inculcates norms through
emotional rituals, formulas, prayers, oaths, and so on.” Ibid., 240.
110
Rosenwein, in Plamper, “The History of Emotions: An Interview,” 251.
111
See Rosenwein, Emotional Communities in the Early Middle Ages (Ithaca: Cornell University Press, 2006).
112
Rosenwein, in Plamper, “The History of Emotions: An Interview,” 253.
113
Ibid., 254.
114
Stearns, in Plamper, “The History of Emotions: An Interview,” 262.
115
Ibid.

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 access to the feelings and emotions of the informants. Scholars nonetheless have

demonstrated how this problem can be overcome. One of the possible approaches is focusing

on norms of emotion and patterns of behavior characterizing a certain “emotional

community” or a certain society, class, stratum, etc.116 Alternatively, one can deal with

representations of emotions which are as insightful; if not the mental states themselves than

the ways in which they were to be expressed can say a great deal about a society’s values,

attitudes, norms, and customs. The representation of emotions in visual material has now

become a popular topic;117 feelings and passions have never been neglected in literary

studies.118

It is salutary to remember that the study of such subject matter as passions, emotions,

and mental states, is not hard science. Emotional experiences are always embedded in culture,

within the borders of the respective society (or some section of it), and time period; also, they

are handed down through the intermediary of the source, written, visual or otherwise. In this

context, “approaches” appears to be the key word, as the source material of love letters or

paintings depicting individuals overcome by grief or spiritual affect can be truly illuminating

but will probably require different approaches. In the case of written material, scholars have

warned against unjustified dismissal of topoi (or what one may consider as such) as

stereotypical clichés of little scholarly value.119

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The extent to which the idea of joy, anger or, say, fear in the Middle Ages or antiquity

is shaped by modern concepts and attitudes to such emotions is another criticism of the

history of emotions. Similarly, one can question whether these are completely different from

what is now called by these names (not to speak of how to approach them from this

116
Stearns’ “emotionology.” See above.
117
The most recent publication on this topic is “Geschichte, Emotionen und visuelle Medien,” Geschichte und
Gesellschaft 37, No. 1 (2011): 1-129.
118
Patrick Colm Hogan, What Literature Teaches Us about Emotion. Studies in Emotion and Social
Interaction (Cambridge: CUP, 2011).
119
See Garrison, “The Study of Emotions in Early Medieval History,” 245-247.

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 perspective). To skeptics, the historians of emotions respond by showing that different

chronological frameworks are not necessarily hostile to one another. “To study the emotions

of medieval people on their terms as well as ours, it may be helpful or necessary to juxtapose

these two perspectives, the modern psychological and medieval theological,” states Mary

Garrison.120

The challenges in the study of feelings and emotions of the past are numerous,

from definitions to the danger of particularism (focusing on specific emotions rather than

psychology)121 or constructionism (treating emotions as social or discursive constructs).122

The ways to overcome such pitfalls depend on the specificity of the study design, the aims,

and the nature of sources. As for the directions in which the history of emotions should

develop, the views of scholars are influenced by their research interests and preferred

methods or time period. Some suggestions and guidelines can be compared in the interview

conducted by Jan Plamper.123

3. 4. Sketching a Map of Emotions

No less easy or straightforward than the problem of definition is answering the

question: “Which emotions make up the history of emotions?” Demarcating the boundaries

of the domain cannot be achieved by drawing up lists of emotions. The attempts to single out

fundamental emotions have been harshly criticized,124 mainly on the grounds that emotions
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are not being universal. It is not the case that the emotions which have been identified and

examined by scholars establish the subject and borderlines of the field. Nevertheless, specific

120
Ibid, 245.
121
Ibid., 250.
122
Burke, “Is There a Cultural History of the Emotions?” 43.
123
Plamper, “The History of Emotions: An Interview.”
124
The ten fundamental emotions identified by Carroll Izard and S. Buechler include interest, joy, surprise,
sadness, anger, disgust, contempt, fear, shame/shyness, and guilt; this view was argued against by Anna
Wierzbicka, “Human Emotions: Universal or Culture-Specific?” American Anthropologist 88, No. 3 (1986):
584-594, esp. 584-585. Alternatively, Paul Ekman distinguished six universal emotions (happiness, sadness,
disgust, surprise, anger and fear), arguing that facial expressions of these are constant and universal in all
cultures; for a critique see Rosenwein, in Plamper “The History of Emotions: An Interview,” 260.

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 examples of emotions, passions or affections that have been studied can provide a good

understanding of the discipline. So, which passions are on the agenda of researchers?125

Anger is perhaps the emotion with the richest history, occupying a special place in the

history of emotions. A number of studies have explored what anger was about in antiquity,126

in the Middle Ages, and in later periods.127 There is no special history of sadness, but related

phenomena have been studied. For instance, quite a lot is written on melancholy128 and on

representations of grief in medieval literature.129

A number of publications are dedicated to fear, beginning with the studies of Jean

Delumeau to more recent ones.130 As for the experience and expression of worry, in Jewish

tradition at least attitudes and contexts have been studied by Michele Klein.131 Insights into

belligerence during the medieval period can be gained from Norbert Elias’ article.132 Other

emotions still await having their histories written, for instance, surprise or obstinacy.

125
Below I would like to focus on the emotions which I am dealing with. The emotions enumerated by no means
exhaust the subject matter of the field, nor present the trends in the research.
126
Ancient Anger: Perspectives from Homer to Galen, Yale Classical Studies, vol. 32, ed. Susanna
Braund, Glenn W. Most (Cambridge: CUP, 2007); William Vernon Harris, Restraining Rage: The Ideology of
Anger Control in Classical Antiquity (Cambridge: Harvard University Press, 2001), Simon Kemp and K. T.
Strongman, “Anger History and Management: A Historical Analysis,” American Journal of Psychology 108,
No.3 (1995): 397-417.
127
Anger’s Past. The Social Uses of an Emotion in the Middle Ages, ed. Barbara H. Rosenwein (Ithaca: Cornell
University Press, 1998); Paul R. Hyams, Rancor and Reconciliation in Medieval England. Conjunctions of
Religion and Power in the Medieval Past (Ithaca: Cornell University Press, 2003); Carol Zisowitz Stearns and
Peter N. Stearns, The Struggle for Emotional Control in America’s History (Chicago: University Of Chicago
Press, 1986); Maureen Flynn, “Taming Anger’s Daughters: New Treatment for Emotional Problems in
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Renaissance Spain,” Renaissance Quarterly 51 (1998): 864-886; Kate McGrath, “Medieval Anger: Rage and
Outrage in Eleventh- and Twelfth-Century Anglo-Norman and Northern French Historical Narratives,” PhD.
Diss. (Atlanta: Emory University, 2007), Joëlle Rollo-Koster and Alizah Holstein, “Anger and Spectacle in Late
Medieval Rome: Gauging Emotion in Urban Topography,” in Cities, Texts, and Social Networks 400 - 1500,
ed. Caroline Goodson, Anne E. Lester, Carol Symes (Ashgate: Ashgate Publishing, 2010), 149-176, and others.
128
Some of the recent publications on manifestations of melancholy include: Eric Gidal, “Civic Melancholy:
English Gloom and French Enlightenment,” Eighteenth-Century Studies 37, No. 1 (2003): 23-45; Marion Wells,
The Secret Wound: Love-Melancholy and Early Modern Romance (Stanford: Stanford University Press, 2006);
Peter G. Toohey, Melancholy, Love, and Time: Boundaries of the Self in Ancient Literature (Ann Arbor:
University of Michigan Press, 2004).
129
Elke Koch, Trauer und Identitat: Inszenierungen von Emotionen in der deutschen Literatur des Mittelalters
(Berlin: Walter de Gruyter, 2006).
130
Jean Delumeau, La Peur en Occident, XVI-XVIIIe sièles: Une Cité assiégée (Paris: Fayard, 1978); Fear and
Its Representations in the Middle Ages and Renaissance, ed. Anne Scott and Cynthia Kosso (New York: Brepols
Publishers, 2002).
131
Michele Klein, Not to Worry: Jewish Wisdom and Folklore (Philadelphia: Jewish Publication Society, 2003).
132
Norbert Elias, “On Transformations of Aggressiveness,” Theory and Society 5, No. 2 (1978): 229-242.

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 Summing up, it should be noted that the approaches and methods chosen need to be

defined by the nature and aims of the particular research goals. In my study, I understand

emotions in the modern state of the word, making use of Rosenwein’s method of association.

I also share Mary Garrison’s view that approaching medieval emotions with modern concepts

does not mean anachronism, but can be helpful and illuminating. I treat the analyzed

emotions in the primary sources as the products of their own time, however, as components of

the medieval medical system, rooted in a different worldview and (pre)scientific concepts. I

proceed by exploring what role in human health was ascribed to emotions in the preventive

medical literature of the later Middle Ages.

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 CHAPTER FOUR

INTERPLAY OF EMOTIONS AND HEALTH

His quoque; corpora nostra

Aut suauiter afficiuntur,
Aut moleste læduntur.

De animi affectibvs,
Paulus Kyr, Sanitatis studium133

In this present chapter I will proceed to the analysis of the selected primary sources.

Eight medieval regimina sanitatis from the broad region of German-speaking Europe will be

the main material. In addition to these, a number of other compositions from other areas or

time periods will be examined as comparative material. The diversity of these sources, in

terms of both the area and time of their production, as well as their form or context, is

explained and justified by the rarity of the emotional component in sources of this kind. This

comparative study of the genre, both chronologically and geographically, will serve the

purpose of establishing certain recurrent patterns (common to all or the majority of

compositions irrespective of time or place of production), as well as identifying peculiarities

in the selected regimina.

The primary sources under scrutiny are the following:

1. Büchelin wye der mensch bewar das leben sein (1460);134

Die Gross-Schützener Gesundheitslehre (early sixteenth century);135

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2.

3. Villingen manuscript (end of the fourteenth century);136

4. Erhard Knab, Gichtregimen (1469);137

133
Sanitatis studium ad imitationem aphorismorum compositum. Item, Alimentorum uires breuiter et ordine
Alphabetico positae. Autore Paulo Kyr medico. Impressum in Inclyta Transylvaniae Corona Anno 1551. Here
quoted from facsimile copy in Paulus Kyr, Die Gesundheit ist ein Köstlich Ding, ed. Robert Offner
(Hermannstadt: Schiller Verlag, 2010), 43-126.
134
Büchelin wye der mensch bewar das leben sein. Facsimile aus der Handschrift D 692/XV 3 der
Kirchenbibliothek zu Michelstadt um 1460, ed. Dietrich Kurze (Hürtgenwald: Guido Pressler, 1980), 25-117.
135
Gerhard Eis, Die Gross-Schützener Gesundheitslehre. Studien zur Geschichte der deutschen Kultur im
Südosten (Bnrno: R.M. Rohrer, 1943), 90-172.
136
Gerhard Eis, “Eine altdeutsche Sammelhandschrift aus Villingen,” in Medizinische Fachprosa des späten
Mittelalters und der frühen Neuzeit, ed. Gerhard Eis (Amsterdam: Rodopi, 1982);

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 5. Heinrich Münsinger, Regimen sanitatis in fluxu catarrhali ad pectus (second

half of the fifteenth century);138

6. Meister Alexander, Monatsregeln (fifteenth century);139

7. Ordnung der Gesundheit (ca. 1400);140

8. Ortolf von Baierland, Arzneibuch (fourteenth century);141

Hereafter the sources will be referred to in this manner. The dates refer to the

composition of the original.

4.1. Overview of the Selected Regimina

The corpus of the primary sources under scrutiny consists of eight texts from the

fourteenth through the sixteenth centuries. All the regimens are in the German vernacular,

while one of the texts (Büchelin wye der mensch bewar das leben sein) combines German and

Latin verses, and was heavily influenced by the Regimen sanitatis Salernitatum.142 The

Meister Alexander, Monatsregeln is in fact an expanded vernacular translation of the Latin

original.143

As for the form of the texts, they are not homogeneous; a few of the works are in fact

consilia like those dealing with gout or bronchial catarrh, whereas Meister Alexander’s

137
Regimen editum contra arteticam siue podegram per Erhardum Knab, atrium et medicine doctorem. Incipit
feliciter 1469. See Gerhard Eis, “Erhard Knabs Gichtregimen,” in Forschungen zur Fachprosa. Ausgewälte
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Geiträge, ed. Gerhard Eis (Bern: Francke Verlag: 1971), 91-100.

138
Regimen sanitatis editum pro Friderico palatino Rheni per doctorem Minsinger in fluxu catarrali ad pectus.
See Gerhard Eis, “Heinrich Münsingers “Regimen sanitatis in fluxu catarrhali ad pectus,” in Forschungen zur
Fachprosa. Ausgewälte Geiträge, ed. Gerhard Eis (Bern: Francke Verlag: 1971), 81-90.
139
Meister Alexander, Monatsregeln, Würzburger medizinhistorische Forschungen 30 (Hannover: Horst Wellm
Verlag, 1985).
140
Christa Hagenmeyer, “Die 'Ordnung der Gesundheit' für Rudolf von Hohenberg: Untersuchungen zur
diätetischen Fachprosa des Spätmittelalters mit kritischer Textausgabe, ” Dissertation, University of Heidelberg,
1972.
141
Das Arzneibuch Ortolfs von Baierland nach der ältesten Handschrift (14. Jhdt) (Stadtarchiv Köln W 4° 24*),
ed. James Follan (Stuttgart: Wissenschaftliche Verlagsgesellschaft, 1963).
142
Büchelin wye der mensch bewar das leben sein.
143
Compare, for instance, the Latin versions edited by Gerhard Baader and Gundolf Keil (Cod. germ. mon. 398)
and Ortrun Riha (Cod. 8769 of Madrid National Library); see Gundolf Keil, “Eine lateinische Fassung von
Meister Alexanders Monatsregeln,” in Medizin im mittelalterlichen Abendland, ed. Gerhard Baader and Gundolf
Keil (Darmstadt: Wissenschaftliche Buchgesellschaft, 1982), 228-259, esp. 247-256; Meister Alexander,
Monatsregeln, 79-130.

34
 composition is a regimen duodecim mensium. In a single case I had to rely on an excerpt from

a medical text where the topic is regulating bloodletting and measures after the procedure.144

The range of topics discussed (bloodletting, plague prevention, etc.) goes beyond the six non-

naturals, which means that some of the sources are medical compendia rather than regimina

sanitatis proper.

The Büchelin wye der mensch bewar das leben sein comes from Codex Michelstadt D

692/ XV 3, from the town church library of Michelstadt in the Odenwald.145 The composition,

based on the Regimen sanitatis Salernitanum, contains 375 Latin and 699 German verses.146

Although there is no direct reference to the author, Dietrich Kurze maintains that the work

was written by Nicolaus Matz (1440 - 1513), the founder of the town church library.147 As for

the dating of the Büchelin, Kurze suggests that Nicolaus Matz wrote the original text during

his studies in Vienna, sometime between 1455 and 1469.148

Two of the sources under consideration were produced in Heidelberg by learned

physicians about whose personality and practice some facts are known: Gichtregimen and

Regimen sanitatis in fluxu catarrali ad pectus. The first text gives both the date of production

and the name of the author, stated in the title of the work (Regimen editum contra arteticam

siue podegram per Erhardum Knab, atrium et medicine doctorem. Incipit feliciter 1469).149

Knab came from Zwiefalten (in modern Baden-Württemberg) and was educated in Bologna

and Heidelberg.150 The addressee of the regimen, in fact a consilium, is not known; in all
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likelihood it was a high-ranking individual to whom doctor atrium et medicine Erhard Knab

was a personal physician.151

144
Eis, Eine altdeutsche Sammelhandschrift aus Villingen.
145
Büchelin wye der mensch bewar das leben sein, 9.
146
Late Middle High German of Swabian dialect. Ibid., 9,13.
147
Ibid., 10.
148
Ibid., 10, 11.
149
From Heidelberg codex Pal. Germ. 226 (ff. 264r-267r). See Eis, “Erhard Knabs Gichtregimen,” 91.
150
Ibid.
151
Ibid.

35
 As for Heinrich Münsinger (Mynsinger, Minsinger; d. 1472), the author of Regimen

sanitatis in fluxu catarrali ad pectus,152 it is known that he worked as both a physicus and a

surgeon.153 In his service as a personal physician to Count Palatine Frederick II (1451 - 1476)

he composed the consilium designed to relieve the consequences of the right side bronchial

catarrh of his patron.154 The work is written in plain language and personalized.155

In the case of Meister Alexander’s regimen duodecim mensium, I have worked with

the German vernacular version of the composition. The Latin original – a part of a

compendium – was written sometime between the beginning of the thirteenth and the

beginning of the fourteenth century by a certain magister Alexander Hispanus.156 The identity

of the author has not been established with precision; Riha demonstrates that he was in all

likelihood a physician of clerical background157 active in the German area.158 On the basis of

this Latin original a number of German vernacular month regimens were composed; Ortrun

Riha identified fourteen such versions in 1985.159

The version I use – a version close to the original (die textnahe Bearbeitung)160 –

comes from Austrian territory of the fifteenth century.161 It was completed by an anonymous

educated author, with a clerical background.162 The author not only translated from Latin

freely, but also inserted elements from other sources. For these reasons this version contains

references to anger and obstinacy, unlike other more verbatim translations and the Latin
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original itself.

152
From Cod. lat. 244 (ff. 212r-217r) in Bavarian State Library, Munich. See Eis, “Heinrich Münsingers
“Regimen sanitatis in fluxu catarrhali ad pectus,” 81.
153
Ibid.
154
Ibid. 83.
155
The dialect used is Alemannic with a slight influence of Swabian dialect. Ibid., 85.
156
Meister Alexander, Monatsregeln, 33.
157
Ibid., 34.
158
Ibid., 33.
159
Ibid., 53.
160
Based on the Codex XI D 10 of the National Library of the Czech Republic in Prague (ff. 43r-45v). In Meister
Alexander, Monatsregeln, 156-173.
161
Ibid., 52.
162
Ibid., 55.

36
 Die Gross-Schützener Gesundheitslehre comes from a manuscript in the library of

Count Charles Kollonitz in the castle Veľké Leváre (Gross-Schützen; near Bratislava); in

1937 it was acquired by Gerhard Eis who provided a critical edition.163 The dating of the

manuscript, in accordance with a source analysis, is no earlier than 1520.164 It appears that the

text from Veľké Leváre manuscript is the only known version of this regimen of health.165

Neither the author’s identity nor the place of production can be established with precision.166

It can be inferred from the text that the author was probably a physician.167

Ortolf von Baierland’s Arzneibuch is one of the oldest medical works in German,

dating back to the second half of the thirteenth century. Hartmut Broszinski and Gundolf

Keil’s dating of the original is between 1250 and 1300,168 Ortrun Riha places it around

1290.169 Not much is known about the author who is believed to have worked in Würzburg.170

Although the Arzneibuch and its parts were widely copied and used, the oldest extant texts are

not the original version. I have used the edition by James Follan, based on the manuscript

from 1348.171

The Ordnung der Gesundheit is another important medical composition that circulated

widely in various forms in manuscripts, incunabula, and early prints. It has been mentioned

earlier that it was the first medical book in German to be printed.172 As has been argued by

163
Described as Hs. 21 of Eis’ personal collection. See Eis, Die Gross-Schützener Gesundheitslehre, 13.
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164
Ibid., 14.
165
Ibid.
166
Ibid., 16.
167
Ibid., 38.
168
See Hartmut Broszinski and Gundolf Keil, “Ein niederdeutsches Ortolf-Exzerpt aus den Jahren um 1400,” in
Fachprosa-Studien. Beiträge zur mittelalterlichen Wissenschafts- und Geistesgeschichte, ed. Gundolf Keil
(Berlin: Erich Schmidt Verlag, 1982), 291-304, esp. 291.
169
See Ortrun Riha, Ortolf von Baierland und seine lateinische Quellen. Hochschulmedizin in der Volkssprache
(Wiesbaden: Dr. Ludwig Reichert Verlag, 1992), 7.
170
Broszinski and Keil, “Ein niederdeutsches Ortolf-Exzerpt, ” 291; Das Arzneibuch Ortolfs von Baierland nach
der ältesten Handschrift, 58.
171
The oldest manuscripts identified by him in 1963 and used for the edition: the Würzburg Manuscript M. ch. f.
79 (1398), held at the Würzburg University Library, and the Cologne Manuscript W. 4º 24*, held at the Cologne
City Archives (1398). See Das Arzneibuch Ortolfs von Baierland nach der ältesten Handschrift, 20, 24, 38-39.
In 1982 Broszinski and Keil published a critical edition of an excerpt from the Arzneibuch in Low German,
stemming from around 1400; see Broszinski and Keil, “Ein niederdeutsches Ortolf-Exzerpt,” 295.
172
Supra note 60.

37
 Christa Hagenmeyer, the book was compiled around 1400 at the court of Count Rudolf VI of

Hohenberg173 and bears a dedication to Rudolf and his consort, Margarete von Tierstein.174

The name of the author is not known; it is reasonable to assume that he was either the

personal physician of the count or a clergyman at the court.175 The treatise was widely used in

monastic circles and later by educated clergymen, in the practices of physicians and barber-

surgeons and among educated members of the bourgeoisie.176 The earliest full version of the

Ordnung comes from a manuscript from around 1450, which has been critically edited by

Hagenmeyer; this edition is used in this study.177

The Villingen manuscript is a composite manuscript which was compiled in the

Benedictine monastery of St. Georg in Villingen (Schwarzwald).178 It consists of two

originally independent parts which were bound together sometime around 1500 or later.179

The first part is a compilation of medical and veterinary texts,180 in the second part more

medical composition are found. The phlebotomy text under scrutiny is found in the second

part of the codex, which goes back to the end of the fourteenth century.181

It is worth mentioning that emotions are not necessarily discussed only in the section

dedicated to accidentia animi of all the six non-naturals, but in other parts of the regimens.

Indeed, only two of the eight sources give this section a relevant heading (Die Gross-

Schützener Gesundheitslehre, Heinrich Münsinger’s regimen). Interestingly enough, one

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encounters emotions, among other things, in the section on good new wine in the Ordnung

der Gesundheit.182

173
Hagenmeyer, “Die 'Ordnung der Gesundheit' für Rudolf von Hohenberg,” 82.
174
Ibid., 281.
175
Ibid., 84.
176
Ibid., 90-91. Also see Adamson, Medieval Dietetics, 162.
177
Cod. Sal. 9,53 of the University Library Heidelberg. See Hagenmeyer, “Die 'Ordnung der Gesundheit' für
Rudolf von Hohenberg,” 12, 277.
178
Eis, “Eine altdeutsche Sammelhandschrift aus Villingen,” 1.
179
Ibid.
180
Ibid., 2.
181
There is a record on f. 242v with the date 1394. See Ibid., 5-6.
182
Von guºtem newem wein, ibid. in 335.

38
 A close reading of the source material shows that even in the case of absence of the

accidentia animi component among the non-naturals – discussed in its own right – references

to emotions and psychological states can still be found and used for research purposes. Thus,

I will analyze texts like the Ordnung der Gesundheit which have been described in

scholarship as lacking accidentia animi or mention of emotion.183

4.2. “Psychosomatic” Patterns. Emotions’ Influence on Health

4.2.1. In the Selected Regimina

Below I will consider in detail “psychosomatic” patterns, by which I mean particular

patterns of an emotion or a psychological state having an effect on human health, either

beneficial or harmful.184 I have introduced the distinction between beneficial/positive and

harmful/negative for purposes of systematization; none of the sources classifies emotions into

these categories, which are, however, implied.

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183
Compare, for instance, Hagenmeyer “… allein das Diätetikum “accidentia seu motus animi” wird nicht
dargeboten,” in Hagenmeyer, Die 'Ordnung der Gesundheit' für Rudolf von Hohenberg, 52. Also see Adamson,
Medieval Dietetics, 163.
184
The term “psychosomatic” is understood as “caused or aggravated by psychological factors,” when refers to a
physical disorder, as defined in OED. See OED,
http://www.oed.com/view/Entry/153938?redirectedFrom=psychosomatic#eid (Last accessed: 23 May 2011).

39
 The overview of specific emotions is presented in the following chart:

Particular Emotion Ratio of the mentions in The regimen (see the list
the selected sources (out of above)
total of 8)
(Zorn)185 [anger] 87.5 % (7/8) 1, 2, 4, 5, 6, 7, 8
186
(Traurigkeit) [sadness] 75 % (6/8) 1, 2, 4, 5, 7, 8
187
(Freude) [joy] 75 % (6/8) 1, 2, 3, 4, 5, 8
188
(Sorge) [worry] 50 % (4/8) 1, 3, 5, 8
(kurtzwil) [pleasure] 12.5% (1/8) 3
189
(Kummer) [worry] 12.5% (1/8) 3
(kriegen)190 [belligerence] 12.5% (1/8) 4
(Wunder)191 [surprise] 12.5% (1/8) 4
(vnmut) [displeasure] 12.5% (1/8) 2
(hertmuetikait) [obstinacy] 12.5% (1/8) 6
(Furcht)192 [fear] 12.5% (1/8) 5

Figure 1.

Emotions mentioned in the

selected primary sources

In this chart the emotions are given in the original language, in standardized form, in

order to keep as close to the original as possible and to avoid the danger of inadequate

rendering of the emotions from one language into another; this problem is inherent in the
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history of emotions as has been mentioned in the previous chapter. The English equivalents

have been provided for orientation/reference only.

185
In the sources: zorn, czorn, zurn, zoren, zorne, czornne, tornne, torne.
186
Trurigkeit, traurigkait, traurikait.
187
Freude, frod, froude, frad, froeud.
188
Sorg, sorgveltigkeyt, sorgfelligkeit.
189
kumber
190
I have translated kriegen as an emotion as “belligerence.”
191
wunder may also be translated as “anger” or “wrathful excitement”; see Grimm, Deutsches Wörterbuch, vol.
30, col. 1784. http://germazope.uni-trier.de:8080/Projekte/WBB2009/DWB/wbgui_py?lemid=GK13703 (Last
accessed 26 May 2011).
192
Forcht.

40
 Apart from specific emotions, it is necessary to consider all the patterns of emotional

states which have an impact on the health. In figure 2, I summarize the results of the analysis

of psychosomatic patterns, of both harmful and beneficial effects. The number of mentions is

shown by the symbol +; the results are based on both particular emotions mentioned (as

above) and more general descriptions. Due to the restrictions of space, the works are referred

to according to the numbers in the list above.

Regimen

Emotion 1 2 3 4 5 6 7 8
Negative Influence on Health
Anger ++ + + + ++ ++ +++
Sadness +++ ++ + + + ++
Worry + + ++ + ++
Belligerence +
Obstinacy +
Fear +
Surprise +
Displeasure +
Positive Influence on Health
Joy ++ + ++ + + +++
Pleasure + +
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Figure 2.

Occurrences of “psychosomatic” patterns

in the selected primary sources

41
 From the chart it can be seen clearly that negative emotions are more numerous than

their positive counterparts, “joy,” and similar to it, “pleasure.” It is worth examining each of

these emotions on its own.

Anger (zorn), as can be seen from the sources, is the most frequently mentioned

emotion. Moreover, it can be said that its relationship with the body is depicted in a more

elaborate fashion than that of other emotions. For instance, in several sources an explanation

is provided as to why anger is harmful for human health. This is best illustrated in the

Monatsregeln, which explain the way in which the body becomes heated by anger and thus

loses strength. This work warns against getting angry in both hot and cold months, for

example, in August193 and January,194 which testifies to the fact that the negative effect of this

emotion was not thought to be restricted to the warm season.195

The month regimen section in the Ordnung der Gesundheit also contains a warning

against anger in May. Here, however, it is not the workings of the emotion that are discussed,

but rather its consequence: gout/paralysis.196

It can be said that anger is the emotion whose unhealthy nature is associated with

gout. Thus, in two regimens under consideration anger is listed among the possible causes of

gout (gicht, gycht), in the above mentioned Ordnung der Gesundheit and in Ortolf’s von
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193
“Vnd da von sol man sich auch dann huetten vor / hicz der sunnen… vnd auch vor czorn, / wann da von wird
ain mensch auch erhiczt vnd / wesward an seiner kraft” (“And one should also protect oneself from the heat of
the sun... and also from anger, because from it one becomes hot too and loses one’s strength”), in Meister
Alexander, Monatsregeln, 168Here and below translation mine, unless otherwise noted; the emotions have been
underlined.
194
“Der mensch huet sich / vor czorn, hertmuetikait” (“One protects oneself from anger and obstinacy”), Ibid
157.
195
For a brief overview of ancient and medieval views on anger, including its effect on the body, see Simon
Kemp and K. T. Strongman, “Anger History and Management,” esp. 397-403. For a detailed discussion of anger
and other emotions in ancient and medieval philosophy consult Simo Knuuttila, Emotions in Ancient and
Medieval Philosophy (Oxford: Clarendon Press, 2004).
196
“Man sol nit zurnen, wan da von den wirt gegycht” (“One should not be angry, as one gets gout/paralysis
from that”). In Hagenmeyer, Die 'Ordnung der Gesundheit’, 285.

42
 Baiernland Arzneibuch.197 As for the special gout consilium by Erhard Knab, it warns against

anger and a number of other harmful emotions and recommends joy.198

More than one disease is ascribed to the effects of anger. For example, the case of

emotoyca passio, or blood spitting (Blutauswurf), is considered in the Arzneibuch; and the

first measure of how to deal with/cure the disease is to protect oneself from anger.199

Anger, just like excessive sadness, can also be the cause of madness (mania,

vnsynicheyt, vnsynnicheyt), teaches the Arzneibuch.200

Occasionally the specific nature of negative emotions is explained. A few

compositions consider several emotions together, and provide physiological explanations of

their effect on the body. For instance, Heinrich Münsinger’s regimen offers a physiological

account of anger, worry, sadness, and fear in common: “…Your Grace should avoid worry,

sadness, fear and especially anger, as it moves the fluid and blood and vapor in the head and

makes the fluid in the head to flow even more.”201 Similarly, Die Gross-Schützener

Gesundheitslehre links the harm done by displeasure, anger, sadness, and excessive worry

with the perturbation of the blood and humors and changes in the natural complexion of a

197
“Paralisis het dy gycht; dat kumt gerne van calden eder von czornne eder ouerigeme etene vnde drynkende
eder van unkuschet...” (“Paralysis, also called gout, comes often from the cold or anger or excessive eating and
drinking or from unchastity…”). In Das Arzneibuch Ortolfs von Baierland, 125.
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198
“Item ir sollent vch huten vor zorn vnd wunder, vor trurigkeit, vor kriegen, besonder sollent ir suchen zimlich
froude, wa mit die gesin mag; die bringt vch besonder crafft vnd sterck” (“Besides, you have to protect yourself
from anger and rage, from sadness and from belligerence, especially you should seek enough joy, which you
enjoy with your mind, this brings you particular strength and power”). In Knab, Gichtregimen, 99.
199
“Emotoyca passio is eyn suke, daz deme menschen blot get vs deme munde .... Me sal eme alzo helfen: se
sollen sich huten vor torne, vor vasten ...” (“Emotoyca passio [Blood spitting] is a disease, when the blood
comes out a person’s mouth … One should help him like this: they should beware from anger, from fasting …”).
In Das Arzneibuch Ortolfs von Baierland, 137, 138.
200
“Mania is in duscheme eyn vnsynicheyt vnde wert itwanne von boseme etende ... eder von tornne, eder von
ouerigher trorichet. Jtwanne kumt de suke van oberiger hitte vnde van oueriger vuchtichet alse van deme blode,
so synt se allewege vrolich vnde vnderwylen trorich.” (“Mania is called insanity in German and comes
sometimes from bad food ... or from anger, or excessive sadness. Sometimes the disease comes from excessive
heat and from excessive wetness, and also from the blood, this way the people are always joyful and from time
to time sad”). Ibid., 126.
201
“…Vwer gnad sol vermyden sorgveltigkeyt, trurigkeit, forcht vnd besunder zorn bewegt die fluss vnd das
gebluett vnd die dempff im hopt vnd macht den fluss im hopt noch mer fliessen,” in Münsinger, Regimen
sanitatis in fluxu catarrhali ad pectus, 89.

43
 person.202 According to the Ordnung der Gesundheit, anger and sadness, just like a lack of

chastity and much work, increase the temperature of the body in an unhealthy way.203

The number of emotions mentioned in the Büchelin wye der mensch bewar das leben

sein is limited to anger, sadness, worry, and joy; however, they are discussed in three verses

in different combinations but with the same idea in mind. Thus, the first of the verses

suggests restraining oneself from harmful anger and worry, and recommends being joyful;204

in the next verse, the dangers of sadness and frequent anger are explained (not only do they

affect the body but even precipitate death);205 and finally, the positive effect of joy is

contrasted with the negative effect of sadness.206 Thus, the importance of emotions for the

balance of health is strongly emphasized in this regimen.

Obstinacy (hertmuetikait) appears in only one regimen – Meister Alexander’s

Monatregeln, where it is mentioned together with the only other emotion noted, anger.207 It is

possible that these two emotions were associated in view of their effects, at least by the author

of the work.

202
“In den czu fällen ewers gemütes sölt ir euch hüten vor vnmut, czorn vnd traurigkait vnd vor vil
sorgfelligkeit, wan die dingk seyn bewegen das blut vnd feuchtigkeit des leybs vnd verandern die natürlichen
complexion des menschen” (“As for your mood, you should beware of displeasure, anger and sadness and of
much worry, because these ailing things stir up/disturb the blood and the moisture of the body and change the
natural complexion of the human”). In Eis, Die Gross-Schützener Gesundheitslehre, 91.
203
“Man sol sich hueten vor unkeusch, vor zoren und traurikait und vor grosser arbait, wann sie den leichnam
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enzündent und schickent zue empfengnuβ diβ gepresten” (“One should protect himself from unchastity, from
anger and sadness and a lot of work when they heat up the body and lead to this disease”). In Hagenmeyer, Die
'Ordnung der Gesundheit', 335.
204
“...So bis frolich vnd loβ zorn hin gan, / Auch grosses sorg soltu laussen anston” (“... so be joyful and leave
anger behind and do not worry a lot”). In Büchelin wye der mensch bewar das Leben sein, 25. Also, compare the
corresponding Latin verse with the first lines of the Regimen sanitatis Salernitatum, 46, which was used as its
source.
205
“Das betrubt hercz, stetter zoren / Und das gemütt, das dy frad hot verloren, / Dy drew ding verczerent den lib
behendt, / Das der mensch gewint ain kurcz endt” (“A sorrowful heart, frequent anger and the mood which has
lost its joy, these three things consume the body swiftly, so that the man meets a short end”). In Büchelin wye
der mensch bewar das leben sein, 25. Here, I have considered “das betrubt hercz” and “das gemütt, das dy frad
hot verloren” synonymous with sadness.
206
“Das betrubt hercz zwinget offt vn(d) vill/ Den menschen zu des todes zill; / Aber frolicher mut zu aller
stundt / Wirkt offt, das das alter grünt” (“A sorrowful heart often brings people to the end, but the joyful mind
always makes the life’s age blossom”). Ibid.
207
“Der mensch huet sich / vor czorn, hertmuetikait” (“One protects oneself from anger and obstinacy”). In
Meister Alexander, Monatsregeln, 157.

44
 There are not many positive/healthy emotions; only joy (with the related pleasure)

appears in the sources. Nonetheless, the beneficial effect of joy is strongly affirmed by the

authors and it stands in contrast to all the unhealthy and harmful emotions. Joyfulness is

“prescribed” for the maintenance of health and prophylaxis of illness in six regimens out of

the eight examined.208

4.2.2. The Comparative Material

A similar picture can be found in a regimen quite distant from the selected primary

material both geographically and chronologically. The regimen of health written by Moses

Maimonides (1135 – 1204) sometime between 1193 and 1198209 takes a strong stand on the

crucial role of emotional well-being in health:

On this account, the physicians have directed that concern and care should
always be given to the movements of the psyche; these should be kept in
balance in the state of health as well as in disease, and no other regimen
should be given precedence in any wise. The physician should make every
effort that the sick, and all the healthy, should be most cheerful of soul at all
times, and that they should be relieved of the passions of the psyche that cause
anxiety. Thereby the health of the healthy will persist.210

208
“So bis frolich…” (“... So be joyful”); “…Aber frolicher mut zu aller stundt / Wirkt offt, das das alter grünt”
(“...A sorrowful heart often brings people to the end, but the joyful mind always makes the life’s age blossom”);
in Büchelin wye der mensch bewar das leben sein, 25; “Darumb sölt ir frölichen seyn vnd nit betrüben yn ewrem
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gemüte, wollt ir euch ewer gesuntheit brauchen” (“That is why you should be joyful and not gloomy in your
spirits, if you wish to enjoy good health”); in Eis, Die Gross-Schützener Gesundheitslehre, 91; “… vnd sol man
… alle arbait fliehen vnd allen kumber vnd sorg lan ligen ... vnd froeud vnd kurtzwil sůchen. vnd sol ain mensch
zů den lúten siczen vnd gan bi den er gern sitzet, von den sin gemůt mug erfrowet werden” (“... and one should
... escape all work and put away all worry and trouble ... and seek joy and pleasure. And one should spend time
with the people one likes, from which one’s mood may become joyful”); in Eis, Eine altdeutsche
Sammelhandschrift aus Villingen, 7; “…besonder sollent ir suchen zimlich froude, wa mit die gesin mag; die
bringt vch besonder crafft vnd sterck” (“... especially you should seek enough joy, which you enjoy with your
mind, this brings you particular strength and power”); in Knab, Gichtregimen, 99; “Dar vmb soll úwer gnad
sůchen zimlich frod, wa sie mag” (“That is why Your Grace should seek enough joy, which You enjoy”); in
Münsinger, Regimen sanitatis in fluxu catarrhali ad pectus, 89; “Men sal en so helfen: sint se von troren vnde
von trobenisze vnngesunt worden, so sal man se vrolich machen vnde sal en vyl geloben gutes dingez” (“One
should help them like this: in case they became ill from sadness and gloom, then one should make them joyful
and should promise them a lot of good things”); in Das Arzneibuch Ortolfs von Baierland, 127.
209
Ariel Bar-Sela, Hebbel E. Hoff, Elias Faris, Moses Maimonides,
“Moses Maimonides’ Two Treatises on the Regimen of Health,” 38.
210
Ibid., 25.

45
 From this quotation, as well as the two paragraphs preceding it, one can clearly see

how important Maimonides deemed passions of the psyche211 for bodily health. The pattern

of the beneficial effect of joy as contrasted to the negative effect of sadness or anxiety can be

discerned in both On the Regimen of Health212 and in A Treatise in Elucidation of Some

Accidents and the Response to it written by Maimonides at the behest of Sultan Al-Malik Al-

Afḍal.213 It is emphasized that first harmful passions should be removed to rectify the psyche

(regain emotional equilibrium), which in turn will help restore physical health.214

As for specific “psychosomatic” patterns, Maimonides does not specify particular

emotions which lead to particular health disorders. He does, however, mention the states

which need to be removed in order to regain mental equilibrium: “grief and obsession,”

“terror of what is unnatural to fear,” and “diminution of satisfaction.”215 As one can see,

emotional balance is given a major role in the matter of curing certain states and regaining

health.

The Sanitatis studium composed by Transylvanian physician, Paulus Kyr, contains the

most casual treatment of animi affectus and at the same time is the richest in “psychosomatic”

patterns. The author, educated in Vienna, Padua, and Ferrara,216 enjoyed a good reputation as

a physician and worked as the town doctor (physicus) in his home town Braşov (Kronstadt,

Stephanopolis, Corona, Krunen, Brassó).217 His Sanitatis studium went into print in 1551 and

was intended for students of the Braşov Gymnasium.218

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211
As pointed out by the authors of the article and of the English translation, passions of the soul (Arabic al-
infa'alāt al-nafsaniyyah) connote more that emotional excitement or agitation. See ibid., footnote 94, 23.
212
Full name: Fī Tadbīr al-Ṣiḥḥah [The Treatise Sent to the King al-Afḍal, son of Saladin, concerning the
Regimen of Health].
213
Full name: Maqālah fī Bayān Ba'ḍ A'rāḍ wa-al-Jawāb 'anhā [The Response to the Letter of al-Af al in
which He Elucidated all those Accidents which have Befallen Him].
214
Ibid., 22,25,38,
215
ibid., 25.
216
Robert Offner, “Kronstadt, der Stadtarzt Paulus Kyr und Ferrara,” in Paulus Kyr, Die Gesundheit ist ein
Köstlich Ding, 12.
217
Ibid., 13.
218
Ibid., 19.

46
 Paulus Kyr starts the chapter about emotions by stating their possible effects on health

– used as an epigraph to this present chapter – and discusses animi affectus at some length.

Nine such emotions or affects are discussed: gaudium (joy), timor (fear), maestitia (sorrow),

cura (worry), animi angor (distress), cogitationes graviores (grave thoughts, pensiveness),

terror (great fear), pudor (shame), ira (anger); all of these have been underlined in the book

by a careful reader.219

Kyr’s manner is different from all the other authors; not only does he bring in the

names of four authorities (Aristotle, Valerius Maximus, Hippocrates, and Pliny) incorporating

material from various sources, but he also enumerates quite a good number of states and

illnesses that can be caused by the animi affectus. Some of these patterns are original and

have no parallels in the material investigated.

Interestingly enough, this is the only source in which joy can have a negative, even

lethal, effect: “Aristotle reports that as a result of unexpected joy one has exhaled one’s life;

besides Valerius Maximus tells that several fainthearted had died by reason of joy.”220

Similarly, excessive shame221 or sudden fear can be the reason for death.222 In addition

to this, fear – just as sadness – may lead to an excess of black bile.223 The impact on the

bodily health of such emotions and states as sorrow, worry, distress, and particularly

pensiveness, is negative through other states that they produce: restlessness and

sleeplessness.224
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219
The facsimile copy in the edition used here comes from the book now kept in the archives of the Lutheran
Church at Braşov (shelf mark: HB 510, old: 0941/3). See Robert Offner, “Vorwort,” in Paulus Kyr, Die
Gesundheit ist ein Köstlich Ding, 8.
220
Gaudio subito allato animam expirasse refert Aristoteles, Valerius deniq; maximus, præ gaudio non nulli
admodum pusillanimes mortui sunt. Ibid., 71.
221
Pudore immenso nonnullos mortuos esse, Plinius author est. Ibid.
222
Timore subitaneo nonnulli morte perierunt præsertim pusillanimes admodum. Ibid.
223
.// Si autem timor et mæstitia longo tempore habentes perseuerent Hippoc. autore, ex eo atra bilis
significatur; ibid.
224
Mæstitia, curæ, animi angor et cogitationes præsertim grauiores non modicam uim corporibus faciunt:
inducunt enim inquietudinem ac uigilias, unde sensuum lesio est, et totius corporis robur minuitur; ibid.

47
 With regard to anger, Paulus Kyr provides more than general statements of its

harmfulness; he mentions that it can lead to apoplexy or palsy or quivering of the whole

body.225 It is interesting to mention that according to the Transylvanian author, great fear is

the possible cause of epilepsy, but it may be beneficial in some kinds of insanity.226

4.3. Other Patterns.

The investigation of the selected primary material shows that an interdependence of

emotions and body is expressed not only through the pattern “emotion causes disease/harm,”

but also through other patterns. These need to be considered in some detail.

4.3.1. Emotions’ Relation to Bodily Organs

The verse 139 of the Büchelin wye der mensch bewar das leben sein links emotions to

particular bodily parts. Thus, anger is said to be produced in the heart, the spleen is

responsible for laughter, and love is located in the liver.227

It is hardly surprising that in a system where bodily health and emotional states are

perceived as tightly interconnected, such patterns can be found.228 The tight connection

between psychology and physiology works both ways, so that a specific emotion causes a

physical reaction in the body, but physiological processes can themselves result in a specific
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emotional state. For instance, sadness produces a constriction of the heart that leads to a

diminution of blood and spirits diffused to the internal and external members, and thereby

chilling and drying the whole body, so that it can no longer digest food, and so, wastes away.

225
Ira deniq, cui quanta uis est, uel inde palam fit, quod quosdam ira concitatos, quasi attonitos, ac extra se
positos uidemus, inde sunt aliquando grauissimi morbi apoplexia, paralysis, articulorum maxime, ac totius
corporis tremor. ibid., 71-72.
226
Terrore aliquibus animi deliquium ac morbum comitialme accidisse compertum habemus: sicut contra in
quibusdam insaniæ speciebus perterreri ac expauesære prodest. Ibid., 71.
227
… cor excitat iram, [s]plen ridere facit, cogit amare iecur…; …[d]as hercz auch tüt den zurn machen, [v]nd
das milcz machete lichen, [d]ie leber ist der liben schin… (“The heart also produces anger, the spleen produces
laughter, and the liver is the shrine of love.”) Ibid., 103.
228
Compare Gil-Sotres on the heart as the central organ that generates passions, or emotions; see Gil-Sotres,
“The Regimens of Health,” 313.

48
 At the same time, a sickly state or wasting away can also produce sadness.229 This is what

Arnald de Villanova was warning Jaume II in his Regimen sanitatis ad inclytum regem

Aragonum, as Michael R. McVaugh underscores, that anger and sadness should be avoided as

the first overheats the body, whereas the second chills and dries.230

4.3.2. Emotions’ Relation to Blood Vessels and Phlebotomy

As for the blood vessels, Ortolf’s Arzneibuch states that a large and strong blood

vessel can be a sign not only of a health but of a mild and joyful disposition;231 a sad heart

goes with small vessels;232 whereas a person who is often cross has a small blood vessel that

beats fast.233

The same vascular-psycho-physiological account can be found in at least two other

medical compositions which I have analyzed: the Ordnung der Gesundheit and a medical text

from manuscript B.V. 3, now kept in the Archdiocese Library of Eger.234 The striking

similarities between the blood vessel-human temperament patterns in these two works and

Ortolf’s von Baierland Arzneibuch are explained by the fact that the latter was used as the

source for the former. The Arzneibuch, compiled sometime in the second half of the thirteenth

century, was one of the most famous and most copied, with a sharp increase in its influence

229
Michael R. McVaugh, Medicine Before the Plague. Practitioners and their patients in the Crown of Aragon,
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1285-1345 (Cambridge: CUP, 1993), 147.

230
Ibid.
231
“Egidius sprichit, is de adere groz vnde stark an eyme gesunde mensche, dat bedudet eyn gesund vnde eyn
milde mensche vnde eynen vrolichen menschen, vnde de lyde vnde nature gesund syn;” (ch. 60) “Aegidius
teaches that when a blood vessel is large and strong in a healthy person that means a healthy and a mild person
and a joyful person, and that the limbs and nature are healthy;” Das Arzneibuch Ortolfs von Baierland, 106.
232
“Eyn cleyne adere an eyme gesunden menschen bedudet eyne kalde nature vnde eynen krancken menschen,
vnde eyne afnemynge an deme liue vnde trorich herte;” (ch. 61) “A small vein means a healthy person, a cold
nature and that the person is of a sick nature and a decrease in the body and a sad heart;” ibid.
233
“Slet eyn adere snel an eyme gesunden menschen vnde is cleyne, dat bedudet eyne hitte vnde eyne dorre
nature vnde gar tornich mensche, dez torn schire hyn is;” (ch. 62) “When a blood vessel beats fast in a healthy
person and is small, that shows a hot and dry nature and a quick-tempered person whose anger goes away fast;”
ibid., 107.
234
Marion Ónodi, “Die deutschen medizinischen Texte in der Handschrift B.V.3 der Erzdiözesanbibliotek Erlau
(Eger),” in “‘Ein teutsch puech machen’:” Untersuchungen zur landessprachlichen Vermittlung medizinischen
Wissens [im Sonderforschungsbereich 226 entstanden], ed. Gundolf Keil (Wiesbaden: Reichert, 1993), 402-
442.

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 and dissemination from the onset of the fifteenth century.235 There was a whole tradition of

texts and compilations which copied Ortolf’s work, sometimes only in the form of

excerpts.236

In the case of the Eger manuscript, chapters 60, 61 and 62 echo the respective chapters

of the Arzneibuch.237 The so-called Pulstraktat (written in the German vernacular)238 is one of

the medical treatises in the second part of this manuscript.239 This part is shorter than the first

one, containing theological texts, and dates back to the end of the fifteenth century.240 As for

the Ordnung der Gesundheit, the fourth book is also based on the Arzneibuch, chiefly

uroscopy and pulse excerpts.241 The information about the veins and what they are signs of is

practically identical with the original.242

Not only were emotions believed to be in close interconnection with the complexion

of a person, but they were also central to a conservative regime following bloodletting. For

235
Broszinski and Keil, “Ein niederdeutsches Ortolf-Exzerpt aus den Jahren um 1400,” 291.
236
Ónodi, “Die deutschen medizinischen Texte in der Handschrift B.V.3 der Erzdiözesanbibliotek Erlau (Eger),”
408-411; Broszinski and Keil, “Ein niederdeutsches Ortolf-Exzerpt aus den Jahren um 1400,” 293.
237
“Jst dÿ ader gros vnd starkh an ainem gesundten menschen, das pedewttet ain gesundten an dem herczen vnd
ein mitterss hercze vnd einenn frolichen menschen vnd das auch dÿ gelider vnd dÿ natur gesundt seindt;” “When
a blood vessel is large and strong in a healthy person that means a healthy in heart, of a moderate heart and a
joyful person, and that the limbs and nature are healthy;” “Item ain klaÿne ader an ainem gesůndten menschen,
das bedewottet ain khaltew natůr vnd einen khranchen menschen vnd einen abnementen an dem leyb vnd auch
aines trawrigen herczen;” “A small vein in a healthy person shows cold nature and a sick person and a decrease
in the body and also a sad heart;” ibid., 412. “Schlecht dÿ ader dratt ann ainem gesůndten menschen vnd ist
chlain, das pedewt haysse vnd durrew natůr vnd einen zarnigen menschen, des czoren aber schier verget;”
“When a blood vessel beats fast in a healthy person and is small, that shows a hot and dry nature and a quick-
tempered person whose anger goes away fast;” ibid., 413.
238
Ibid.
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239
The Pulstraktat in Ortolf’s Arzneibuch, in its turn, had Aegidius Corboliensis’ Carmen de pulsibus as the
source, which the author elaborated and modified to a great extent. See Ortrun Riha, Ortolf von Baierland und
seine lateinische Quellen, 8,10.
240
Ónodi, “Die deutschen medizinischen Texte in der Handschrift B.V.3,” 404.
241
Hagenmeyer, Die 'Ordnung der Gesundheit' für Rudolf von Hohenberg, 55, 58. also see Adamson, Medieval
Dietetics, 162-163.
242
“Es spricht Egidius: Ist die ader groβ und starck an ainem gesunden menschen, das bedeut auch gesunthait an
dem hertzen und ain miltes hertz und ain froelichen menschen und das seine gelider von natur starck sind;” (ch.
42) “Aegidius teaches that when a blood vessel is large and strong in a healthy person that
also means healthy of the heart and a mild heart and a joyful person, and that his limbs are healthy by
nature;”“Ain claine ader bedeut an ainem gesunden menschen ain kalt natur und das der mensch krancker natur
ist und ain abnemung am leib und ain traurigs hertz;” (ch. 43) “A small vein means a healthy person, a cold
nature and that the person is of a sick nature and a decrease in the body and a sad heart;” “Schlecht die ader
drat an ainem gesunden menschen und ist clain, das bedeutt ain hayβ und dirr natur und ain gech zornigen
menschen, des zoren doch schier hin ist;” (ch. 44) “When a vein beats fast in a healthy person and is small, that
shows a hot and dry nature and a quick-tempered person whose anger goes away fast;” in Hagenmeyer, Die
'Ordnung der Gesundheit' für Rudolf von Hohenberg, 365.

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 instance, the bloodletting treatise in the Villingen manuscript gives recommendations for the

first day of phlebotomy. It is noteworthy that, again, emotional wellbeing is essential to a

phlebotomy regime; thus, one is recommended to put away all worries and troubles and to

seek joy and pleasure.243

4.3.3. Emotions in the Plague-Prevention Regimen

From the body of the selected primary sources as well as comparative material a large

area emerges in which emotions seem to play a particularly crucial role: plague-prevention

measures. Among the primary sources investigated, the Ordnung der Gesundheit contains

recommendations concerning emotions in a special part dedicated to plague prevention (Book

III; Das drittail diss buchs sagt von der pestilentz).244 Although corrupt air was usually

believed to be the source of infection, the medical texts kept reminding their reader of the

necessity of maintaining emotional health in such perilous times. “One should protect oneself

from unchastity, from anger and sadness and a great deal of exertion when they heat up the

body and lead to this disease,” warns the Ordnung der Gesundheit.245

For illustration of this recurrent model, I will look at other texts from different

contexts which support this link between plague prophylaxis and psychological equilibrium.

The first of such comparative sources, the Leeuwarden manuscript, contains a short plague

treatise. It was composed around 1470, in the Middle Dutch vernacular

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(mittelniederländisch).246 The anonymous author, who drew from other similar

243
“… vnd sol man … alle arbait fliehen vnd allen kumber vnd sorg lan ligen ... vnd froeud vnd kurtzwil sůchen.
vnd sol ain mensch zů den lúten siczen vnd gan bi den er gern sitzet, von den sin gemůt mug erfrowet werden”
(“... and one should ... escape all work and put away all worry and trouble ... and seek joy and pleasure. And one
should spend time with the people one likes, from which one’s mood may become joyful”); in Eis, Eine
altdeutsche Sammelhandschrift aus Villingen, 7.
244
Hagenmeyer, Die ‘Ordnung der Gesundheit’, 332.
245
“Man sol sich hueten vor unkeusch, vor zoren und traurikait und vor grosser arbait, wann sie den leichnam
enzündent und schickent zue empfengnuβ diβ gepresten.” Ibid., 335.
246
Willy L. Braekman and G. Dogaer, “Spätmittel niederländische Pestvorschriften,” in Medizin im
mittelalterlichen Abendland, ed. Gerhard Baader and Gundolf Keil, (Darmstadt: Wissenschaftliche
Buchgesellschaft, 1982), 443-475.

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 compilations,247 advises his readers to avoid anger, unhappiness and sadness, and besides, to

be joyful and not too fearful.248

Another interesting source to consider is a plague poem (Pestgedicht) edited by B. D.

Haage. The earliest known version of this rhymed composition with recommendations on

plague prevention appears in a manuscript which was produced before 1424 in the Alsatian

region.249 As for the source, Haage argues that it must date to around 1400 or earlier.250 Later

versions of the poem survive in various other manuscripts, in some cases the authorship is

ascribed to a certain Hans Andree.251 This short plague poem makes further references to

emotions and psychological states. First, quite traditionally, it warns against the negative

sadness, anger and despondence, as contrasted to positive joy;252 and later it also underscores

that everything should be done with love and (good) sense, as well as by living in peace.253

Even as late as in the second half of the seventeenth century the role of emotional

balance can be found in preventive treatises on the plague. To illustrate this, I quote a plague

treatise written by English anatomist and physician Thomas Willis (1621-1675), entitled A

Plain and Easie Method for Preserving [by God’s Blessing] those that are Well from the

Infection of the Plague, and for Curing such as are Infected with it. Written in the Year

1666.254 An excerpt from this medical treatise illustrates well the extent to which the sex res

247
Ibid., 475.
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248
“Toern, onghenoecht, bedructheit van herten … alle dese salmen scuwen daer men can ende mach, ende men
sel vrolic wesen ende ymmer niet seer verueert.” (“Zorn, Unzufriedenheit, Traurigkeit des Herzen ...: all das soll
man vermeiden, soweit man das kann und vermag, und man soll fröhlich sein und niemals allzu ängstlich”);
Middle Dutch text and German translation in ibid., 460.
249
Bernhard Dietrich Haage, “Zur Überlieferung eines altdeutschen Pestgedichts,” in Würzburger
Medizinhistorische Forschungen. Beiträge zur Wissenschaftgeschichte. Band 24. Festschrift zum 70. Geburtstag
von Willem F. Daems, ed. Gundolf Keil (Pattensen (Han.): Horst Wellm Verlag, 1982), 323-335.
250
Around the same time as the plague part was added to the Ordnung der Gesundheit, ibid., 326.
251
Ibid., 323.
252
“Truren, zorn und och unmůt/ Soltu lossen, sie sint nit gůt./ Bis in dime můte zů mossen froelich,/ Dz entpfil
ich dir sunderlich.” (“Of Sadness, anger and also displeasure/ You should get rid of, they are not good./ Be in
moderately joyful mood, / This I recommend you particularly.”) Ibid., 334.
253
“Du solt och allewegent ettewz begynnen / Zů tůnde mit libe und och mit synnen. / Einig mit freden sin in
huse, / Frůge und spote wesen in siner kluse / Ist och usser mossen vaste gůt, / Ist er do inne mit frŏlichem můte.
” Ibid., 335.
254
The printed edition from 1691 of this work is available at http://www.med.yale.edu/library/historical-
old/willis/will1.htm (Last accessed: 15 May 2011).

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 non naturales, and the accidentia animi among them, were influential in the domain of

preventive medicine well into the mid-seventeenth century in continental Europe and in

England.

Now because the Spirits are commonly the first that receive Infection; We
must fortifie them, that they may not easily admit the approaches of their
Enemy, which when they are in full vigor and expansion, they will repel, and
as it were keep off at a distance. Therefore Wine and Confidence are a good
Preservative against the Plague: But when the Spirits, through fear, or want
of supply, do recede, and are forc’d to give back, the Enemy enters, and first
seizeth them, and thence gets into the Blood and Humors; Therefore much
Fasting and Emptiness are bad: But every one should Eat and Drink at
convenient Hours, in such manner and measure, as may always keep the
Spirits lively and chearful, and endeavour to compose his Mind and Affection
against fear and sadness.255

Some scholars have argued that compositions such as the English treatise should be

considered as a distinct type of medical text, different from regimina sanitatis.256 Irrespective

of details of classification, A Plain and Easie Method takes a stand on emotions as they are

related to bodily health which is in accordance with earlier regimens of health.

4.3.4. Complexio and Temperaments

Complexion theory is yet another way in which the psychological and somatic were

linked.257 In this system, human dispositions – the temperament – and character were defined

by the composition of the main qualities (complexio or crasis).258 Some of the sources under
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consideration here elaborate on this theory and make reference to the relation between the

body’s complexion and emotional states.

255
Ibid., 7-8. http://www.med.yale.edu/library/historical-old/willis/Willis06-07.jpg, http://www.med.yale.edu/
library/historical-old/willis/Willis08-09.jpg Boldface original, underlining mine.
256
“Plague tractates have been usually grouped within the larger genre of regimina sanitatis … Yet this
grouping ignores the fact that a proportion of the plague tractates that appeared during the period also included a
curative regime along with the traditional preventive one.” See Jon Arrizabalaga, “Plague Tractates,” in
Medieval Science, Technology, and Medicine: an Encyclopedia, ed. Thomas Glick, Steven J. Livesey, Faith
Wallis (New York: Routledge, 2005), 405-409, esp. 406.
257
For a brief overview see Nancy G. Siraisi, Medieval and Early Renaissance Medicine. An Introduction to
Knowledge and Practice (Chicago: The University of Chicago Press, 1990), 101-106.
258
Ibid., 101.

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 The Ordnung der Gesundheit suggests that one can recognize a healthy person not

only by the color and consistency of his urine or other physical symptoms, but also by his

mild and joyful disposition (“How to recognize a healthy person. If he has more blood, which

means heat and moisture, so the person is joyful and sings eagerly and is mild.”)259 The

prevalence of heat and dryness over cold and moisture explains a quick temper (“If he has

more heat and dryness than cold and moisture, then he gets angry easily and his anger goes

away quickly and he is unstable… and is faint-hearted”).260 Prevalent cold and dryness result

in a predisposition to sadness and fear (“But if he has more cold and dryness than heat and

moisture he is often sad and very fearful”).261 This passage of the Ordnung der Gesundheit is

based on material in the Arzneibuch where the same system can be found.262 In yet another

place in the Ordnung der Gesundheit temperaments proper are discussed. Here the author

discusses in detail how the body’s prevailing humor with its qualities defines someone’s

temperament (“sanguine,” “melancholic,” “choleric” or “phlegmatic”), and with it, the

predisposition to certain emotions or psychological states. Below, I will focus on the

emotions which are defined by each particular temperament.

Thus, the regimen ascribes joyfulness and bravery to the sanguine temperament,263 as

contrasted to sadness and fearfulness, common to the melancholic complexio.264 A person of a

259
“Wie man ain gesunden menschen erkennen sol. Hatt er des plůtz mer, das ist der wirm und feuchtikayt, so
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ist der mensch froelich und singt geren und ist milt;” ibid., 345.
260
“Hatt er der hitz und dirrin mer, denn der keltin oder der feuchtin, so ist er geren zornig und der zoren ist im
schier hin und ist an seinen dingen unstet ... und ist claines mutes;” ibid.
261
“Hatt er aber der kelltin und dirrin mer, dann der hitz und feuchtin, so ist er geren traurig, er fürcht im ser;”
ibid.
262
“Nů wyl ich sagen, wo man eynen gesunden menschen sal erkennen ; wat natůre he an eme hebbe, dat he dez
blůdez mer, dat yst der wermede vnde der fuchtekeyt, so yst he (warm und fewcht und ist froleich) vnde synget
gerne vnde yst milde, vnde syn harne yst goltfar vnde to mate dycke;” (“Now I would like to say how to
recognize a healthy person and what nature he represents: he has more blood, that is heat and wetness, he is
warm and wet and joyful and he sings eagerly and is mild nd his urine is golden and thick”); “Hat her auer der
hytte vnde der dorde me, so yst he gar tornyg vnde der torn yst schyr vorgan; her yst vnstete ... (“But if he has
more heat and dryness, then he is often anger and his anger goes away fast; he is unstable…”); “Hat her auer der
kelde vnde dorde me, so yst he gerne truryg vnde worthtig sych sere…;” (“But if he has more coldness and
dryness, then he is often sad and very fearful…”), Das Arzneibuch Ortolfs von Baierland, 82-83.
263
“Er ist milt zue erlichen dingen, er ist froelich, zimlich. Er ist kuen und muetig zue gueten dingen, er ist
e
gu tig...;” (Sangwineus, ch. 21) (“He is mild in serious matters, he is joyful, honest. He is bold and courageous
in good things, he is amicable…”); Hagenmeyer, Die 'Ordnung der Gesundheit' für Rudolf von Hohenberg, 290.

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 choleric temperament is described as brave and prone to anger which, however, soon

passes,265 unlike people of a phlegmatic temperament.266 The author of the Ordnung names

Aristotle as his source.267 It is interesting to observe that the emotions mentioned in

connection with temperaments correspond to the ones which have been identified as the most

frequently listed among accidentia animi of the preventive regimen. Thus, the four emotions

with which the Ordnung der Gesundheit operates (joyfulness, sadness, anger, fear) receive

another degree of interdependence with human body.

4.3.5. Emotions and Religion

In general, the system of emotions in the bulk of the medical compositions of this

genre has no religious or ethical component. As has been demonstrated, the harmfulness of

certain emotions and passions is explained by changes in the body and physiology attributed

to them, in the terms of Galenic medicine rather than in theological terms. However, there is

an exception to this rule in the Tractatus de Regimine sanitatis, written by Arnold von

Bamberg.268 In this case a Christian dimension has been added to the system.

This regimen is particularly curious to consider, not only because it explains how

important it is to begin with the accidentia animi in the matters of health,269 but because it

discusses these within a religious framework. The author advocates restraining such emotions
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264
“ Ain mensch der selben natur ist geren karg, geytig, traurig ... und ist forchtsam... ;” (Melancolicus, ch. 22)
(“A man of this complexion is quite thrifty, greedy, sad and ... fearful... ”); ibid., 290-291.
265
“Er ist ... schnellen zorns, der ist im doch schier hin. ... Er ist unforchtsam ...;” (Colericus, ch. 23) (“He is
quick-tempered, but his anger goes away soon... he is not fearful…”); ibid., 291.
266
“Der mensch ... ist nit zornig;” (Flegmaticus, ch. 24) (“The person is not prone to anger”); ibid.
267
Ibid., 288.
268
Tractatus de Regimine sanitatis (Incipit tractatus de Regimine sanitatis magistri Arnoldi praeposits Jacobi in
Babenberech. See Latin text with a German translation in Karin Figala, Mainfränkische Zeitgenossen “Ortolfs
von Baierland”: Ein Beitrag zum frühesten Gesundheitswesen in den Bistümern Würzburg und Bamberg,
Pharm. Diss. (Munich: Ludwig-Maximilians-University, 1969), 160-190, 190-220, respectively.
269
Et quia inter sex res non naturales circa quarum commensurationem et ordinationem debitam versatur totum
regimen sanitatis, accidentia animae turbant (turbantur) ut in pluribus aliqualiter intellectum, quo turbato
cuiuslibet regiminis executio pariter conturbatur, et cum hoc etiam corpus non modicum alterant (alteratur), cui
alterato non iam debetur regimen sanativum sed potius curativum ideo ut videtur in dicto regimine merito est ab
ipsis incipiendum. Ibid., 161. Figala bases the Latin edition of the regimen on the oldest manuscript (Ms. 434
Erlangen) from 1317, using another codex (Clm 7755 Munich) from 1318 for comparison (in brackets).

55
 as anger, worry, and sadness for the sake of the morals and philosophy of Christ; he is also

concerned about the fact that anger and worry separate one from God, apart from affecting

the mind and body.270

The Christian moralistic element can be explained by the fact that the author was both

a physician and a member of the clergy, the provost of the St. Jakob secular canonicate

monastery in Bamberg.271 Probably educated at Bologna,272 Arnold wrote the regimen upon

the request of Augustinus Gazotti, bishop of Agram273 (Zagreb) in 1317.274

The reference to Christianity notwithstanding, the emotions of Arnold’s regimen are

in compliance with the traditional system and support the common pattern.275 The author

explains the harmful nature of negative emotions from positions of Christian morals;

however, the perturbation caused by emotions is framed in traditional Galenic medical terms.

As far as Christian elements are concerned, Arnold von Bamberg’s regimen is the sole

work which makes such ideas explicit. Significantly, in other compositions produced in

monastic circles, emotions and states of the mind are not given a moral value and their impact

on the body is drawn in medical, not Christian or philosophical, terms. One of these texts –

the Villingen manuscript – describes a bloodletting regime without elaborating on issues of

piety or morality.276
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270
Sed quia prohibere huius scilicet irasci, sollicitari, tristari, etcetera ad moralem et Christi (ipsum)
philosophum qui considerando dispositionem et ordinem universi novit omnia mala et bona mundi propter quae
et in pluribus sollicitari et irasci contingit esse mala et bona fantastica et omnino non duratura nec irascendum
penitus nec solummodo (solomodo) propter illa quae separant nos a deo potius quam ad medicum pertinere
videtur. Ibid.
271
“Propst des Säkularkanonikatsstiftes St. Jakob in der Bischofsstadt Bamberg,” ibid., 78. Also see Adamson,
Medieval Dietetics, 150.
272
The closing of the regimen suggests: Super hoc tamen specialiter poteritis habere consilium cum domino et
magistro meo G. archidiacono bononiensi, 189. See Figala, Mainfränkische Zeitgenossen “Ortolfs von
Baierland,” 79; also see Adamson, Medieval Dietetics, 150.
273
Figala, Mainfränkische Zeitgenossen “Ortolfs von Baierland,” 80; also Adamson, Medieval Dietetics, 150.
274
Figala, Mainfränkische Zeitgenossen “Ortolfs von Baierland,” 80, 84.
275
Compare Figala’s commentary on the accidentia animae section: Figala, Mainfränkische Zeitgenossen
“Ortolfs von Baierland,” 90.
276
Supra note 217.

56
 The Liber de Conservanda Sanitate is another text which comes from the Benedictine

monastery The Small Garden in Walcourt, Belgium.277 Neither the identity of its author nor

the exact date of composition is known. L. Elaut has suggested that, in all likelihood, the

regimen was written by a friar.278 As for the date, although the colophon on page 179 r°

mentions the year 1444, the Liber and other texts in the same bundle might go back to an

earlier epoch.279 The Liber de Conservanda Sanitate teaches “[item] summe cavendum est ab

ira, tristicia, timore, solicitudine et cogitatione rerum melancolium inducentium, et servanda

est tunc castitas.”280 Here, only the mention of chastity might be seen as an indication of the

monastic context of the regimen; which, all the same, can be found in compositions designed

for a less pious readership.281 The sentence following the one regulating emotional life might

also have been influenced by a monastic way of life, as it warns about “things warming and

heating up.”282

In spite of all this, it seems to me that the patterns of emotions in this manuscript

should be considered as a part of the larger plague-prevention model rather than as mere

monastic moralizing guidelines. The location of the sentence with the mention of emotional

states – in the section entitled De modo preservationis de epidemia – places it in the anti-

plague (or any other epidemic) emotional regime framework. The two examples demonstrate,

however, that a religious dimension was compatible with the system and could easily be
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added. The concept of emotions as an integral part of physical wellbeing was, nonetheless,

defined in Galenic terms.

***

277
L. Elaut, “The Walcourt Manuscript: A Hygienic Vade-Mecum for Monks,” Osiris 13 (1958): 184-209, 184.
278
Ibid., 185-186.
279
Ibid., 185.
280
“And one is to beware in the highest degree of anger, sadness, fear, excessive worry and contemplation about
the things bringing black bile, and then chastity is to be preserved.” Ibid., 206.
281
See, for instance, the Ordnung der Gesundheit or Arzneibuch, which “prescribes” chastity: supra note 27, 33.
282
Elaut, “The Walcourt Manuscript,” 206.

57
 Summing up, the ways in which emotions and psychological states relate to the body

and health are numerous, as is demonstrated in the selected primary sources and comparative

material. First and foremost, there are a number of emotions and states which disturb the

balance of health and thus cause harm to the body; these have been referred to as negative in

the present study. The most frequently mentioned among these are anger, sadness, and worry.

In contrast, the positive or salubrious emotions are few; however, practically every regimen

of health which discusses accidentia animi underscores the beneficial effect of joy on human

health.

Apart from the models in which emotions can cause or trigger certain unhealthy states

or diseases – considered “psychosomatic” patterns – emotions form other patterns. For

instance, a number of sources make emotional wellbeing an important constituent part of a

plague-prevention regime. Similarly, evidence can be found about the important role that

emotions play in a phlebotomy regime; a correlation between the size of blood vessels and

emotional characteristics of an individual has also been identified. In addition to the interplay

of the vascular system and emotional states, emotional dispositions (temperaments) are said

to be explained by physical factors.

Certain emotions are mentioned more frequently than others and certain patterns are

recurrent. On the whole, the diverse texts under consideration form a consistent system in
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regard to emotions and psychological states. In the case of Arnold von Bamberg’s Tractatus

de Regimine sanitatis, accidentia animi are placed in a theological framework, which is

uncommon for regimen-literature. The later in time a regimen of health is written the more

diverse the patterns of emotion-body relationship seem to be. Paulus Kyr’s Sanitatis studium,

written in the mid-sixteenth century, on the one hand, contains a few models which have no

parallel in other investigated sources, and on the other hand, pictures some of the emotions as

both harmful and beneficial in different situations.

58
 CONCLUSION

Drew Leder wrote in 1998:

The lethal diseases of the modern industrial age, most prominently

cardiovascular disease and cancer, have been shown to be intimately bound up
with sociocultural and personal intentionalities; that is, life-style, emotions,
environmental agents, habits of diet, drug use and exercise.283

Fascinatingly, the six non-natural factors do not seem to have lost their topicality up to

the present day. In the light of modern scientific research, accidentia animi deserve special

attention. This thesis has demonstrated that new insights can be gained from a detailed

investigation of the emotions and psychological states mentioned in German regimina

sanitatis.

Certain psychosomatic patterns could be identified in the selected primary sources

material, in which particular emotions were believed to result in particular diseases and

unhealthy states. At this point a disclaimer should be made as the primary material used here

was only a small sample and further comparative study is required.

Evidence has been found for other patterns of interaction between the body and

emotions. It has been shown that a number of sources include emotions among the necessary

components of a plague prevention regime. The other patterns which accidentia animi seem

to form have also been considered, including their relation to blood vessels and phlebotomy,
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as well as to temperaments. The question as to whether emotions should be considered a part

of medieval religious discourse has also been considered.

This study has demonstrated that the accounts of psychosomatic relationships are

varied in the selected primary source material and deserve further research. A more

exhaustive comparative study of regimina sanitatis with a focus on emotions would be

283
Drew Leder, “A Tale of Two Bodies: The Cartesian Corpse and the Lived Body,” in Body and Flesh. A
Philosophical Reader, ed. Donn Welton, (Malden, MA: Blackwell Publishers, 1998), 117-129, 127.

59
 necessary to deepen the understanding of their considered role in the matters of medieval

health.
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60
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