Feminae: Medieval Women and Gender Index

In this picture a woman cares for a leper. She wears white (dress and headpiece) with a dark gray cloak. Medical care in the Middle Ages was often associated with religious communities. While she indeed may be a nun—the Augustinian hospitaller sisters wore white garments under their cloaks, and Poor Clares wore gray—her hair is long and uncovered beneath her headdress. She might instead be a laywoman committed to religion without formal vows involving a cloistered life. A mulier religiosa like this included beguines and Franciscan tertiaries.

Here, the woman hands her patient a fish. Giving food to the hungry and drink to the thirsty were two of the biblical acts of mercy. The patient sits in bed and has red spots evenly spaced across his upper body. This is a standard representation of leprosy in medieval art. The illness was mentioned frequently in both the Old and New Testaments, in accounts which addressed disease, sin, social rejection, mercy, concern, and healing. Medieval responses tended to share the same complicated set of ideas. It is to be noted, however, that Salmon identified the disease as syphilis in her book published in 2022.

The image is an historiated letter D in DIXI for the initial word in Psalm 38 (Vulgate and Douay-Rheims) in which David regrets the brevity of life but puts his hope in God. An excerpt from Matthew 25:40, "Quod uni ex minimis fecistis" (What you did for the least of these, you did for me) is inscribed within the scene, itself set within the circle of the letter.The painter uses mainly five colors: a bright red; a pink for accents; light, vivid blue; a bluish-gray; and a yellow-gold tone for the background and part of the border. The figures' skin is a different color, emphasizing the woman's health in contrast to her patient.

The letter D is formed with four creatures biting each other. The two smaller animals on the left have their tails intertwined, forming the left, vertical side of the letter. Depictions of hybrid animals appear in many illuminated manuscripts. The two smaller creatures each swallow the tail of a larger, fish-like animal; the larger red animal bites the head of the gray one. Fish held particular significance: Jonah’s encounter with a big fish had parallels to Christ’s death and resurrection, the Gospels mentioned “fishers of men,” and early Christians adopted the fish symbol as an anagram for Christ (IXTHYS: Iesous Xristos Theou Yios Soter). In addition, fish and eggs were a staple of the medieval diet, particularly on fast days and other days of restraint (e.g. Lent); very ill patients, while occasionally exempt from certain religious dietary restrictions, still ate fish regularly as part of their diet.

This image comes from a psalter created in the Benedictine Abbey in Engelberg, Switzerland, in the last quarter of the thirteenth century. Other pages in the psalter use the same colors; besides historiated initials, the psalter contains zodiac signs. Secular imagery was used regularly enough that some religious leaders voiced open objection. This manuscript may have been made for use in a Dominican women's monastery.

In the sixth century, Saint Benedict of Nursia founded a monastery in Italy and established a written Rule governing monastic life that spread throughout Europe. In particular, part of the Benedictine Rule called for regular reading of the entire psalter—all one hundred fifty psalms—within the week. This requirement drives the liturgical divisions and order of psalms common to psalters. In addition, Benedict’s desire for all—religious or lay communities—to chant the psalter promoted the popularity of psalters among the laity as well as the vocationally religious. The books' small size made them portable.

Although leprosy affected a minority of individuals during the Middle Ages, it figured prominently in sermons and literature, which revealed a dramatic tension in how the disease was viewed. Leprosy itself was associated with sin, including promiscuity—many believed it to be a sexually transmitted disease—but lepers themselves were thought to have been specially selected by God for salvation due to their earthly suffering. Their physical condition was often associated with Christ’s suffering on the cross, and preacher Jacques de Vitry equated lepers with the laity most valued by God: the poor, pilgrims, mourners, and crusaders. The Third Lateran Council, while assuming the separation of lepers from the broader community, made provisions for their religious needs and repeatedly emphasized their continued membership in the broader Christian community. It seems that lepers still had regular ties to healthy family and friends and even continued to own land. Hospitals for lepers, although located outside city walls, were not far from the archbishop’s palace and major churches.

To care for the sick, special hospitals, known as leprosaria, were founded, particularly during a wave of charitable donations and building during the thirteenth century. Care was complicated. Contemporaries knew that leprosy could not be cured by medical intervention and focused on alleviating suffering and saving souls. Leprosaria were generally located outside city walls, possibly in response to the Levitical injunction to put lepers "outside the camp" due to the contagious nature of the disease. In addition, medieval people understood that the body’s gradual deterioration from leprosy required long-term attention. Caregivers ensured that the sick ate carefully balanced diets, with some institutions specifically choosing softer foods (eggs, fresh bread) to accommodate the sick who had suffered so much physical, sensory, and nerve damage they could not eat solid foods. The leprosaria residents had to exercise and bathe frequently. Clothing was supplied and washed (separate from the clothing of the healthy). The nurses also performed the requisite bloodletting and dressed patients’ sores, providing needed care. In addition, in order to nourish the souls of the afflicted, leprosaria followed the basic monastic model and lived according to the monastic rule, regulating day time hours for prayer to benefit the soul.

Medical caregivers did include secular physicians later in the medieval era, but the primary caretakers were from religious communities. Nuns from orders geared towards care (Augustinian hospitaller sisters, Cistercians, Poor Clares), female beguines and male beghards, and Franciscan tertiaries all provided care. Some tertiaries were married couples; others were social elites who either chose not to take vows or were sometimes actively discouraged by religious leaders from doing so. Instead they were often urged to use their power and their wealth to maintain peace and stability and to aid the poor and the Church, rather than renounce it all through separation from the world and a vow of poverty.

In particular, beguines performed all the major forms of medical care, from nursing and midwifery to giving medicines and regulating diet, as well as prayer and meditation. Many beguines worked in monastic hospitals or in beguinages which included hospitals. Medical knowledge, born from experience, was transmitted within the community. Ritchey posits that some knowledge was written and passed via texts that religious women carried with them at all times including psalters.