Sores of the Realm | Marybeth Ruether-Wu | The Hypocrite Reader


Marybeth Ruether-Wu

Sores of the Realm


ISSUE 95 | SYMPTOMS | JUL 2020

An Egyptian plague of boils in the Toggenburg Bible


What do “bad apples” have to do with the Black Death?

The answer is closely connected to the meaning of “corruption,” commonly used today to indicate (per the New Oxford American Dictionary) “dishonest or fraudulent conduct by those in power” or “the process by which something...is debased.” In the Middle Ages, however, corruption usually meant something less abstract: the deterioration of physical matter, particularly bodies; “pus, rot.” For late medieval authors, it was impossible not to associate this type of corruption with the vivid horrors of the Plague, which killed between 40-60% of the population in England between 1348-1351 and another 20% when it recurred in 1361-2. In his allegorical poem Piers Plowman, popular poet (and unintentional revolutionary1) William Langland describes nature striking down humanity “with many sharp sores, / Like pox and pestilence… / So Nature through corruption killed so many” [with many kene sores, / As pokkes and pestilences… / So kynde þorw corupciouns kulled ful manye]. The corrupt bodies of plague victims continued to haunt discussions of power and change for centuries, reinforced by subsequent outbreaks of plague, smallpox, and other infectious diseases.

In order to understand the moral, social, and political dimensions of “corruption” in medieval texts, we have to understand what “corruption”—of the body—meant to medieval readers. Popular culture has perpetuated a wholly negative view of medieval medicine: one in which ignorant victims were viciously bled to death by unsanitary barber-surgeons, birdlike plague doctors, and outright witches. Most people would be shocked to hear 14th century writers describe the way diseases spread through contact, methods of disinfecting, the phenomenon of acquired immunity, or the importance of 14-day quarantines. It is true, however, that even as they shared certain basic wisdoms and used similar tools to prevent the spread of pandemic, medieval Europeans conceptualized the body in profoundly different ways to our own, with implications that touched every aspect of daily life, particularly where “corruption” is concerned.

Certain aspects of humoral medicine, in fact, are worth embracing: Whereas modern medicine imagines our immune systems engaged at all times in a paranoid, militaristic fight against “invaders,” humoral medicine asked practitioners to look inward for sources of corruption and inequity; to root out the “bad apples” that presage and promote rot. We might rightfully take a more cautious approach to the cures central to humoral medicine, which focused on purging “excess humors” from the body through e.g. emetics, diuretics, and bleeding. However, if we are determined to reject their cures, we must also reexamine the institutions that they influenced, not the least of which is our system of Common Law, which originated and developed in a thought-world which considered it necessary to “purge” and “bleed” disruptive members from the polity.

Humoral Medicine and Corruption

The medical system practiced in the European Middle Ages is often called “humoral,” for its focus on the body’s four “humors,” or “Galenic,” for the Greek physician Galen (d. ca. 200 C.E.), but much of the medicine practiced in the later middle ages was inherited from Islamic physician-scholars. By the twelfth century universities were opening across Europe and teaching a medical curriculum which taught the works of Muhammad ibn Zakariyyā al-Rāzī (known to Western readers as “Rhazes”), Alī b. Al-Abbas Al-Majūsī (“Haly Abbas”), al-Ḥusain b. Abdallāh Ibn Sīnā (“Avicenna”), and Ibn Rušd (“Averroes”) as much as they did Galen. When John of Gaddesden, an Oxford-educated physician cited by Chaucer, described smallpox, for example, he contextualized his discussion of corruption and excess within a Eurasian history of innovation: “According to Haly in his commentary on part 2 of Galen’s Art of Medicine [the passage beginning] ‘Unnatural swellings…’, these diseases come about because in a person in whom there is residual menstrual blood or corrupt blood which is in a state of ebullition, nature expels all the superfluity of a bloody fever or a continuous choleric fever to the surface of the body.”

Al-Majūsī’s contribution here illustrates not only the way that physicians continued to contribute case studies, theories, and cures over the centuries, making “Galenic” medicine far more dynamic and multicultural than its name suggests, but also the constants that tied these diverse practices together: the belief that 1) the body is composed of four humors: blood, bile, phlegm, and choler; 2) that any excess accumulation and/or change in state (hot, cold, wet, or dry) of one humor endangers the whole body; and 3) that symptoms like fever and bloody flux are the body’s attempt to purge the corrupt humors. The physician’s job is to help the body purge excess and/or corrupt humors and restore balance to the whole. Notably, unlike modern germ theory, Al-Majūsī asserts that a particular disease (smallpox) can have multiple root causes, depending on the patient. Are they female? It might be retained menses. Are they male? Perhaps he ingested or inhaled something which corrupted his blood; perhaps his diet was too rich and encouraged the overproduction of blood and heat. Diagnosis and treatment require biographical work and an exact understanding of how an individual lives and moves in the world.

For medieval practitioners, looking at the “whole” rather than the particular was central to diagnosing and treating disease. Humoral medicine perceives the human body as a kind of microcosm, a balancing act that repeats itself in progressively larger orders throughout the cosmos, and which responds to changes and imbalances within the larger system. As the cosmos is constituted from fire, water, earth, and air, the body is composed of choler, phlegm, black bile, and blood. Each body has a unique complexion, or balance of the humors, and hence a unique relationship with their environment, determined by variables like age, gender, heredity, diet, astrological signs, and location. Physicians must also take into account the remedies’ complexions, because their composition worked in sympathy with the body, such that “against a hot cause a cold medicine is required” [agayns a hote cause nedys colde medicyn] and so on. The physician’s work was to take these holistic influences into account and balance the many ways the world acted on each individual body.

Negative environmental factors, from planetary movements to dietary choices, could throw the balance of the humors out of harmony with each other and with the cosmos. Corruption was one of the many possible consequences—or causes—of change to a body or environment, but it was the one most favored by physicians who attempted to account for the sudden, devastating emergence of the bubonic plague in the mid-fourteenth century.2 As Dr. Nancy G. Siraisi explains,

The experience of plague was sufficiently novel and terrifying to generate a new variety of medical literature, the plague tractate; 281 of these treatises giving explanations for the causes of plague and recommending treatment or precautions are known to have been composed between the mid-fourteenth century and 1500…. The spread of plague was accordingly explained as a result of corruption or infection of the air that altered for the worse the complexion of those who breathed it; the precipitating cause of the bad air was often, but not always, said to be astrological.

Treatise on the Epidemic, one of the most popular plague tractates of the fourteenth century, situated the epidemic within this universal macrocosm, explaining that “everything below the moon, the elements and the things compounded of the elements, is ruled by things above, and the highest bodies are believed to give being, nature, substance, growth, and death to everything below their spheres.” As these higher bodies moved obliviously on, the air below was “corrupted and made pestilential.” Breathing in corrupt air, some argued, had a disastrous effect on the balance of humors; as John Lydgate’s English translation of the wildly popular, and somewhat ironically named, Secretum Secretorum (“The Secret of Secrets”), explains, “Great excess follows corruption” [Of mekil excesse folwyth Corrupcioun]. In the minds of these physicians, the corruption of a pervasive, necessary, and constantly-circulating element made profound change nearly inescapable.

This holistic theory of the body, disseminated for centuries in classrooms, hospitals, private visits, pamphlets, Latin treatises and English rhyming poems, shaped the way the larger medieval public viewed their bodies and their world. Today, for instance, the metaphorical trap set by our current understanding of biomedical immunity naturalizes state violence and xenophobia. As Donna Haraway has observed, modern descriptions of biomedical immunity are “obsessed with the notion of contagion and hostile penetration of the healthy body, as well as of terrorism and mutiny from within.” For anthropologist Emily Martin, when “the body is depicted in contemporary popular publications as the scene of total war between ruthless invaders and determined defenders,” it ensures that “violent destruction seem[s] ordinary and part of the necessity of daily life.” Imbalances did not “invade” or “attack” the medieval body, as we now imagine germs and even cancers to; instead, the matter which made bodies resonated with all other matter, both inside and outside the apparent boundaries of the body. Medieval ways of thinking are fundamentally “fluid”; bodies, which we conceptualize as solid and inviolable, are made exclusively from the humors and are thus radically porous and constantly making exchanges with the world around them. Finding the line between a medieval body and the world is like trying to find the line between the ocean and the bay. One flows constantly into the other. To continue the metaphor, conservationists concerned with the health of a bay's ecosystem might try to mitigate and repair damage to it, but they fundamentally can't stop the ocean from reintroducing the same/new problems. Rather than seeking to “fight” germs or “battle” cancer, medieval medical regimens sought to regulate humoral bodies by compensating internally for shifts in the environment. One could not change the movement of the spheres, but if, say, Venus in retrograde was causing a patient’s complexion to become cold and melancholic, a physician could recommend a diet that produced the opposite effects. One did not necessarily need to—and often frankly couldn’t—address the causes of disease, but it was possible to compensate for them. Some causes were untouchable and eternal, and some interactions unavoidable.

Pustules on the Body Politic

As visible evidence of internal corruption, abscesses preoccupied both the communal imagination and reality. Famous medieval physicians from Guy de Chauliac to Lanfrac of Milan dedicated entire books to the subject of lesions like boils and ulcers.3 From pox to buboes, infected wounds to tumors, abscesses were a horrifying yet pervasive motif of late medieval life.4 Physicians explained that abscesses and ulcers differed from surgical incisions or healing wounds in that their contents have become corrupt. John of Mirfield explains,

In a manner of speaking, an ulcer is a solution of continuity already putrefied or inveterate. Similarly, every old wound having putrefaction, or poison ... is no longer a wound, but will be called an ulcer. The laudible sanies of wounds is white, even-textured, smooth and without bad odor. For every wound, after it has passed through two or three months of treatment, is no wound, but is named an ulcer, a cancer or a fistula.

Hence ulcers are a sign not just of physical trauma but of an invisible, longstanding distemper of the interior.

When the bubonic plague5 first ravaged Europe in the mid-fourteenth century, medieval physicians interpreted its eponymous buboes as a derangement of the whole body, “down to the very marrow of their bones.” Pamphlets produced by contemporary physicians promise that the best protection from the pandemic was internal integrity, achieved through a regimen centered around the proper intake and expulsion of nutriment. Early in the crisis the medical faculty at Paris released a pamphlet in which they warned that at the greatest risk of infection were

bodies that are full and obstructed with evil humors, in which waste matter is not consumed or expelled as is necessary; that live by a bad regimen.... But those who have bodies that are dry and free of impurities, who govern [their bodies] well and in accordance with a suitable regimen, are more resistant to the pestilence.

The Paris faculty’s report recommends regular bleeding as a preventative measure and further bleeding at the first sign of disease, before “gruesome symptoms appear.” Most physicians theorized that these “gruesome symptoms,” the swollen buboes, were the result of the body’s attempts to expel corrupt humors through its usual “drainage points” at the head, armpits, and groin.

Guy de Chauliac, perhaps the most famous surgeon of his day, made a compelling case for draining the corrupt matter from boils in 1348, when he caught—and survived—the Black Death. His acquired immunity allowed him to remain with his patients in Avignon long after his terrified colleagues had fled the city, cataloguing the pandemic’s progress and writing strikingly detailed descriptions of both the disease and of his varied attempts to treat it. Over time, de Chauliac came to realize that, though few survived the Black Death, those that did always exhibited a secondary phase in which the buboes burst and evacuated their pus: “for all who got sick died, except for a few toward the end, who escaped when their buboes ripened.” In Guy de Chauliac’s plague journals, boils burst like ripe fruit, moving from stigmatic to salubrious as if, in evacuating the body, they nourished it.

It occurred to more than one medieval author that the methods used to cure physical corruption might (symbolically, at least) also cure moral corruption. One medieval poem, Mum and the Sothsegger (“Silence and the Truth-teller”), imagines Parliament gathering to address the problem of a corrupt judiciary by exposing “the sores of the realm / … [and] burst all the boils and abscesses of the heart / And let the rancor run out in a rush all at once, / Lest the false felon fester within” [the sores of the royaulme /… [and] berste oute alle the boicches and blaynes of the hert / And lete the rancune renne oute arusshe al at oones, / Leste the fals felon festre withynne]. The knights of Parliament seem to be alternately both physician and patient, not only tasked with inspecting and healing the body politic, but also enfeebled by the disease and afraid of the treatment. The language here is delicately calibrated to acknowledge the violence of the cure. It is “better” that the boils “were to breste oute” [burst out], because this might allow the body politic to heal, though the operation sounds both painful and repugnant.

Mum and the Sothsegger stages a debate between the virtues of prudent silence (keeping “mum”) and speaking truth to power in times of injustice and unrest. In Mum, the truth itself becomes surgical tools, and the judicial system’s repugnant “boils” rupture under the painful pressure of exposure. The Sothsegger (truth-teller) asserts that his society’s disease comes from within; the rancor is made of native “felon[s]” rather than an infectious invasion of external agents. Treatment therefore requires autobiographical work; the confrontation of the boils is thus central to the maintenance of society’s health: “For as I have heard, they heal well instead / When the anger and the poison all runs out” [For as I herde have, thay helen wel the rather / Whanne th'anger and th'attre is al oute yrenne].

Sothsegger acknowledges that the toxic accumulation of anger in the body politic threatens the body politic, but importantly, he argues that the people’s anger is justifiable, an inevitable symptom of political corruption and exploitation. The poem warns that it is better for the corruption “to breste oute” [burst out] than wait for their patient to “rise agayne regalie and the royaulme trouble” [to rise against regality and trouble the realm]. Confronting corruption is unpleasant and painful work, but allowing the sickness to fester presents an existential threat to the entire body politic. Sothsegger prescribes regular meetings of Parliament, apparently with the expectation that more “boicches” will occur as a matter of course. Mum and the Sothsegger takes what we might consider a cynical view: corruption is inevitable. But it makes sense from a society unified by the belief that all people are born into sin and death, and better still, the poet’s attitude avoids the fallacies contingent on belief in a “perfect union.” If one begins from the premise that the body politic is in need of constant re-examination, maintenance, and confrontation, progression is a necessity.

Unfortunately, the abscess/corruption metaphor was too effective, and too obvious to anyone with a passing understanding of humoral and political theories, to ever belong entirely to critics and reformers. In the second century CE, Roman emperor Marcus Aurelius wrote that “he who raises sedition in the city” due to personal grievances is “a pustule of the world” [abscessus mundi]. Like excesses of heated, corrupt humors in the body, some medieval authors reasoned that excess agitation must be bled from the state.

Medieval physicians warned against excessive bleeding, which could itself become pathological. Guy de Chauliac fumed that “many idiots,” taken in by the spectacle of healing, will praise surgeons for making a “deep cutting,” not realizing until too late that the grievous new wound would fester and create a much more dangerous problem. In the political realm, however, physicians’ calls for moderation were often disregarded. Instead, their contemporaries deployed medical metaphors to justify state violence. In Policraticus, twelfth-century bishop John of Salisbury argued that it is the sovereign’s duty to bleed, even to maim, the body of which he is the head:

It is the practice of physicians when they cannot heal a disease with poultices and mild medicines to apply stronger remedies such as fire or steel…[T]he ruling power when it cannot avail by mild measures to heal the vices of its subjects, rightly resorts, though with grief, to the infliction of sharp punishments, and with pious cruelty vents its rage against wrong-doers to the end that good men may be preserved uninjured.

The state’s “pious cruelty” saves the body politic from further, possibly terminal, corruption. If the sovereign himself is the source of morbid imbalance in the state, the cure still lies with salubrious violence, though John of Salisbury stops short of explicitly encouraging “bleeding” the king. Instead, he turns to a familiar arboreal metaphor: “the origin of tyranny is iniquity, and springing from a poisonous root, it is a tree which grows and sprouts into a baleful pestilent growth, and to which the axe must by all means be laid.” Forget throwing out one bad apple, he seems to say: in times of pestilence, cut down the whole tree.

Bad Apples / Deadly Apples

We’re all painfully familiar with how defenders of our justice system dismiss evidence of corruption as “a few bad apples.” Like “corruption,” however, “bad apples” originated within a medieval socio-medical discourse, and they serve as a useful example of the ways that medieval authors saw corruption as systemic, fluid, and internal. The “bad apples” of medieval texts are not infecting outsiders, a perverse Other, a “cancer on society”; they are evidence of a profound imbalance within society itself. Indeed, they suggest a radical critique of the entire “barrel,” since corruption is both a symptom and a cause, endlessly expressing and reintroducing disorder into a fundamentally disordered system.

The phrase “a few bad apples” itself has its proverbial roots in the late fourteenth century, a period characterized by pandemic and civil unrest. It appears in Geoffrey Chaucer’s Canterbury Tales, a collection of stories ostensibly shared by a group of pilgrims on their way to Thomas Becket’s shrine in Canterbury, England. Chaucer took his inspiration for the frame narrative from another fourteenth-century author, the Italian poet Giovanni Boccaccio. Pandemic lives at the heart of the tales collected in Boccaccio's Decameron, which begins with a group of youths determined to comfort one another through a two-week quarantine after they flee their plague-ridden city. Like Boccaccio, Chaucer’s poem is profoundly shaped by the trauma of the plague and the social imbalances and disorders it engendered.

As recent debates about the reopening of restaurants and bars prove, shared meals exist at the charged intersection between social practices and fear of contagion. Although not necessarily any more dangerous than any other gathering, food service materializes the fear of ingesting and absorbing a disease that spreads invisibly—the same way that rot spreads from apple to apple. Appropriately, then, the “bad apple” adage appears in a tale told by the pilgrims’ Cook, who in turn puts it in the mouth of another food service professional, a master victualler. Infuriated by his riotous apprentice, Perkyn, the master victualler reasons: “Much better is a rotten apple out of the hoard / Than that it rot all the rest” [[w]el bet is roten appul out of hoord / Than that it rotie al the remenaunt] (I.4406-4407). Rather than address Perkyn’s behavior, the master victualler ejects the youth from his household. To the consternation of many of Chaucer’s readers and scholars, the tale cuts off abruptly after Perkyn finds lodging with a thief and a prostitute.

Prior to the Cook’s Tale and his proclamations about “rotten apples,” Chaucer sketches out a short biography for the Cook. He is one Hogge of Ware, and his specialty is blancmange, a chunky off-white paste made from shredded poultry or fish mixed with soft rice and almond milk.6 In the same breath, Chaucer reveals that the Cook is afflicted with a “mormal”:

But greet harm was it, as it thoughte me,
That on his shyne a mormal hadde he.
For blankmanger, that made he with the beste.

On a first reading, the last line appears as a bizarre non-sequitur. Sadly, it is not. “Mormal,” a uniquely medieval diagnosis, is a contraction of the Latin malum mortuum by way of Old French mort male, “bad death.” In Treatises of Fistula, John Ardene describes it as an abscess or tumor filled with “brownish, clayish” pus. Chaucer’s abrupt pivot from mormal to blancmange is in fact a grotesque joke; Hogge’s food and his pustules do not look as dissimilar as one would hope.

Worse, his oozing abscess evokes an image all too familiar with fourteenth century readers: the Plague’s eponymous buboes. In doing so, it viscerally bridges the threat posed by pandemic and bad apples—because in Middle English, the mormal was also known as a “deadly apple.” Hogge of Ware invokes and embodies the “bad apple,” and his position as the pilgrim’s Cook vividly reinforces the proverb’s warning. Hogge, like his hero Perkyn, is a disruptive creature of excess. Fragment IX of The Canterbury Tales finds the Cook not only too drunk to speak coherently or stay on his horse, but foul-breathed and ill. The miasma of his halitosis compounds the impression that the Cook’s mere presence corrupts those who associate with him. As the group pauses to heave a combative Cook back on his horse, the Manciple opines, “thy breeth ful soure stynketh: / … / The devel of helle sette his foot therin!” and concludes, in a chilling echo of plague tractates, “Thy cursed breeth infecte wole us alle.” One fourteenth-century chronicle of the plague describes “the breath of infection spreading equally among [those talking together], until one infected the other so that nearly the entire body succumbed to this woeful disease.” Plague can spread in the same way as other forms of corruption, from simple vulgarity to outright sedition: through talk, contact, and exchange. For Chaucer as for many of his contemporaries, the greatest dangers to a community could be found within itself—in its own impulses, excesses, vices, iniquities, and deprivations.

Chaucer’s medieval audiences would have immediately understood Hogge’s “deadly apple” as a disturbing symptom of a larger dysfunction and a harbinger of a deeper corruption of the whole “bunch.” Before the Cook even begins his story, the pilgrims’ host Harry Bailey wryly warns him that it had better be good enough to make up for the food poisoning he gave them all earlier. Within only hours of joining them, the Cook has already made them sick. Hogge of Ware is no outside (or outlier) infecting agent, but an active and central participant in an entire community’s digestion, both as a producer and as a consumer: “Wel koude he knowe a draughte of londoun ale.” His mormal is, in a way, a warning for the distemper that he could cause even without dripping pus in his customers’ blancmange. Common medical wisdom held that the cause of mormals was the consumption of “evyll meates and drynkes, whiche engendre corrupt humours.” The wider consumption of Hogge of Ware’s garbage-stuffed fast food and his constant company in London’s taverns suggest that his deadly affliction will inevitably spread throughout his community, if it hasn’t already.

For Chaucer, the Cook himself presents an excellent example of the ways that “bleeding” the marks of corruption might only superficially address systemic problems. Chunky white paste is not Hogge’s only culinary specialty. Back in London, the Cook sells savory hand pies as fast food. He evidently fills them with garbage-fed goose, which went against London’s inaugural food safety ordinance, the 1379 “Ordinance of the Pastelers.” The ordinance, which attempted to head off another public health crisis in a city already struggling to recover from successive waves of plague, singled out cooks who “have heretofore baked in pasties rabbits, geese, and garbage, not befitting, and sometimes stinking, in deceit of the people.” London’s geese were known to scavenge from the city’s garbage heaps, and were therefore considered unfit for consumption; logically, if the geese consumed corrupt, rotten material, then their humors would in turn be corrupted, and this corruption would be passed on to unwitting consumers. Hogge attempts to disguise the smell of rot by packing his pies with parsley, infuriating his nauseated fellow pilgrims.

Despite having no access to refrigeration, Hogge flogs unsold meat-and-garbage pies the next day after reheating them in his fly-infested shop. Harry Bailey accuses the Cook of “letting [the pies’] blood,” the juices and gases which accumulated in them overnight, in order to disguise the fact that they are (and perhaps always have been) spoiled. Though the language used to describe Hogge’s cooking is medical, it does not ‘cure’ anything. Hogge has “laten blood” from pasties; in an echo of humoral theory, the pasties oscillate under his tender mercies between “twice hot and twice cold” [twies hoot and twies coold]. Nothing can change the fact, however, that the material he packed them with was corrupt to begin with. The Cook’s perfidious habit of “bleeding” the juices from old pies so he can continue to sell them works because it superficially changes the pasties’ appearance—though not the fact that they spread disease.

It seems as though Chaucer intended to reinforce and resolve this question in the Cook’s Tale, beginning with the master victualler’s ejection of Perkyn, which superficially spares his own household but in reality transfers Perkyn’s unmitigated mischief to London’s streets. But ultimately, Chaucer offered his readers no resolution for the problem of managing pathological excess or systemic corruption. The Cook’s Tale abruptly breaks off, unresolved, after just 58 lines. In spite of several medieval editors’ attempts to stitch up this unsatisfactory rupture themselves, one scribe’s concluding note reflects all we really know about Chaucer’s intentions: “Of this cokes tale maked Chaucer na moore.”

It might be that Chaucer (unlike Mum and the Sothsegger’s anonymous poet) ultimately balked at “purging” the corruption he so vividly evoked. These qualms were not shared by his editors, who took it upon themselves to violently bleed off Perkyn’s potential for corruption. For modern readers, the collaborative, fluid nature of medieval manuscripts allows us the unique opportunity to witness a public caught between multiple points of view. Two continuators summarily isolate and execute the tale’s “bad apple,” Perkyn, for his presumed crimes. A third of extant manuscripts pivot to a new story and a different unruly hero, Gamelyn. Like the continuations, Gamelyn’s tale concludes with judgment and execution. But Gamelyn subverts the fate other continuators intended for Perkyn by hijacking his own trial and “sentencing” instead his guardian, a corrupt royal justice, and the jury that wrongfully convicted him to be hanged in his place. For the continuators, the justice system is a tool for expelling corruption; for the Gamelyn-poet, the excessive violence of the justice system requires equally violent change.

Despite their differences, all of Chaucer’s continuators maintain the need to violently rupture the metaphorical pustule they see in their society, even when they can’t agree where or what the pustule is or what deeper corruption it reveals. Unintentionally, by blithely incorporating their own literary “matter” to the text, these continuators demonstrated the way medieval thinkers saw the world: as profoundly porous, open to and and in need of constant, collective examination and adjustment. Whether “bad apples” required violent expulsion or systemic change depends on who you ask, and their stomach for radical action; but all were painfully aware of what could happen to a society in which corruption spread, unchecked and festering, deadly.

1 The titular character of Piers Plowman, a lengthy allegorical poem about a dreamer’s search for “Do-Best,” became an unlikely rallying point during the Peasants’ Revolt in 1381. According to contemporary sources, a number of rebels named “Piers Plowman” as their leader. There is also evidence that the revolt’s leaders used rhyming poems and coded messages inspired by Piers Plowman to secretly organize and coordinate the uprising, e.g. “John Shep[herd]...bids Piers Plowman to go to his work...and take with you John Trueman...”

2 It’s important to note that it is impossible to identify any kind of consensus on the proper cause or treatment of any given disease among medieval medical practitioners. Opinions could, and did, differ widely between regions, universities, traditions, centuries, and even individual practitioners in the same city at the same time. Surviving university lectures and case studies preserve well-known physicians’ accounts of saving a patient at the critical moment from a foolish rival medical practitioner, a formula that remains popular in medical dramas today.

3 The Middle English translation of Guy de Chauliac’s treatise on ulcers distinguishes carefully between many different types of ulcers, including “virulent & corrosive & serpiginous, sordid & putrid, cavernous & profound” types; ulcers that were painful or festering; those that had been caused in an accident; those caused by a bad combination of humors; and those under the skin.

4 Compare the evocative dimensions of “finding a lump” today, or the stigma of skin lesions associated with HIV/AIDS. In AIDS and Its Metaphors, Susan Sontag compares cultural perception of the “disabling, disfiguring, and humiliating” symptoms of AIDS to depictions of rabies, cholera, syphilis, and smallpox, reflecting, “Being deadly is not in itself enough to produce terror. It is not even necessary, as in the puzzling case of leprosy, perhaps the most stigmatized of all diseases, although rarely fatal and extremely difficult to transmit…. The most terrifying illnesses are those perceived as not just lethal but as dehumanizing, literally so.”

5 The plague (Y. pestis) also spread in pneumonic, septicemic, and gastrointestinal forms, and recent research suggests that the pneumonic form was responsible for much of the plague's spread -- hence the fear of "breath." Despite this, the bubonic plague acquired a unique metaphorical resonance in medieval writing and art, due in part to the buboes' visible cycle of accumulation and rupture.

6 Unlike the modern dessert of the same name, medieval blancmange recipes were savory. See, for example, this 14th century recipe for “blawmanger”