Foods, Diets and Medicines in the Middle English Version of Lanfranc’s Chirurgia Magna

Premise

I submit an analysis of foods contained in the Middle English version of Lanfranc Chirurgia magna, which is also known as Que dicitur ars completa totius chirurgie. In particular, I consider some aspects relating to wound care and diets that patients need to follow, considering their diseases.

Lanfranc wrote down his Chirurgia magna in Latin about in 1296 and dedicated it to the king of France Philip the Fair and young physician Bernard of Gordon [1]. Together with his previous work Chirurgia Parva [2], Chirurgia magna represents one of the first treatises about medicine written in France and is divided into five books (normally preceded by a prologue), then subdivided into several chapters.

The Middle English translation of Chirurgia Magna (second half of 14th century) came to us in two codices, eg. mss. Oxford, Bodleian Library, Ashmole 1396 (dated about 1380, uncertain origin, ff. 1a-269b which transmits Lanfranc work entirely) and London, British Library, Add. 12056 (Wiltshire, dated about 1420, ff. 31a-86b, which ends at the fourth chapter of the second book, regarding the hand bones) [3].

Chirurgia Magna Contents

Referring to my previous article (see note 1) and as above mentioned, Lanfranc’s Chirurgia magna is divided into five treatises which include books and different chapeters). In the first treatise Lanfrancs explains the general principles of surgery (eg. surgical ethics, anatomy, embryology, common and ulcerated wounds and how to cure them). The second treatise regards the body parts and related wounds. The third treatise concerns the skin diseases, treatment of abscesses, nose, ear, and breast diseases, together with kidney stones and phlebitomy. In the fourth treatise we can find the fractures and dislocations of bones. The last one is an antidotary regarding a list of remedies, which Lanfranco divides into seven groups (i.e. repercussive, resolving, maturative, regenerative, consolidative, mollifying and cauterizing ones), according to their funcitons, rathen than to their types.

Diets and Remedies in Chirurgia Magna

In all the five books of Lanfranc’s work are attested foods, plants, flowers and resins which are considered under two different aspects: as medicaments/remedies against diseases and diets for patients. The most important food products, used for medical practitioners are eggs (both ȝelke of an ey ‘yolk’ and whiƷt of an ey ‘egg white’; as their employments depended on the different kind of wounds, bruises and pathologies), honey, almonds, garlic, onions, wheat and barley flours, blueberries and winegar. On the contrary, concerning plants and flower, we can find both juices of verbena and mallow, used together with several kinds of flowers. Concerning the resins, Lanfrancs mentions the asa fetida (a resin coming from a plant growing in Persia), frankencense, sandragoun (‘sang-dragon’), mastic resin, armoniac (bole armonyac) and fenigrec. About all resins, Lanfranc specifies their compositions; except for frankencense.

Normally, Lanfranc is used to describe the pathologies, illnesses, diseases or wounds, afterwards he mentions the medicaments or remedies to be applied (including ingredients and doses); finally, he prescribes the diets that the patients must follow. Furthermore, he sometimes explains few cases relating to patients he previously treated.

Lanfranc’s Teaching About Constitutions of Human Body

In any case, Lanfranc affirms every surgeon has to consider the physical compositions of his patients; in fact, in the first treatise (book 1, chapter 2) in he informs us that there are four peculiarities of the human body: hot, cold, wet and dry. Moreover, within the human body these four qualities can be mixed among them, giving rise to the constitutions of the human body. In fact, there are people having hot and dry, hot and wet, cold and dry, cold and wet constitutions. In addition, each of them can be simple or compound; a few with matters, other without matters (and so there are sixteen). Among these sixteen, some can be natural and others unnaturals, so there are thirty-two. For all these reasons, a surgeon must be careful before prescribing diets and medicines as he has to be careful to distinguish each peculiarity. Þo qualitees from bodies þat ben foure: hoot, coold, moist & drie, & complexiouns ben bi hem, it is necessary to find in bodies þat ben medlid foure complexiouns. Complexiouns is no þing ellis but a maner qualite medlid in worchinge & suffryinge of contrarious qualitees þat ben founden in elementis, so þat þe leeste partie of ech element entre into þe leeste partie of þe oþere & for þat ilke. iiij. complexiouns hoot, moist, coold & drie, sumtyme ben y-componed, þat is to seie medlid þer comen up hem .viij., as: hoot & drie, hoot & moist, & coold & drie and coold & moist . Foure of þese ben symple and foure componed; & for þilke .viij. sumtyme ben wiþ mater & summtyme wiþoute mater þer ben. xvj. & for þilke. xvj. afitir sum consideratiun moun be naturel to summan & summan vnnaturel / þer moun be. xxxij. Neuere þe latter among alle þe complexiouns þat man mai fynde, þat is componed of dyuers qualitees þat it is necessarie a surgian to knowe complexiouns of bodies, lymes & of medicyns (ms. Oxford, Bodleian Library 1396, f. 3b).

Þo qualities from bodes-ben foure: hot, colde, moyst & drye, & complexiouns ben by ham, yt ys necessarie to fynden in bodyes þat ben medlyde, foure complexiouns; Complexioun ys noþynge ellys but a manere qualite medlyde in worchynge & suffrynge of contruriose qualite þat buþ founden in Elementis, so þat þe leste partye or eche elemente entre in to þe leste partye or þe oþere partye. And for þat þilke foure complexiouns: hot, colde, moiste & drye, sumtyme nen y-componyd, þat ys to sugge medlyde þere comen of hem VIII, as hote & drye, hote & moiste, colde & drye, colde & moiste; ffoure of þese ben symple, & foure ben componyd And for þilke VIII sumtyme ben with mater, sumtyme withoute mater, þere ben XVI & for þylke XVI, after sum consideracioun mowe ben to naturełł to sum Man & to sum man vnnaturełł, þere mowe ben XXXII. Nevere þe lattere amonge alle þe complexiouns þat man may finde, þat is componyd of dyuerse qualitees & … Y may preve in þis manere þat yt is necessarye a surgyne to knowe complexiouns of bodyes, lymes & of medycynes (ms. London, British Library Add 12056, f. 34b).

Lanfranc’s Teaching: Diets and Remedies for Wounded Patients

Diets for Wounded Patients

In the first treatise (book 1, chapter 2) Lanfranc mentions the diets for wounded people in general, informing us they are forbidden to consume wine, milk, eggs and fish.

We forbade him wine, mylk & eggs & fish... but he schal ete for his mete growel maad or otemele, eiþer or barli mele wiþ almaundis; & he schal use a streit dietynge, til þat he be sikir þat he schaue noon enpostym (ms. Oxford, Bodleian Library, Ashmole 1396, f. 3a).

We forbid him wine, milk & eggs & fysch… but he schal ete for his mete grueƚƚ y-made of ote mele, oþere barly mele with Almaundes. & he schal vsen a streit doynge tyl þan be sykere þat he schal haue non emposteme (ms. London, British Library, Add. 12056, f. 33b).

This topic is repeated in the first treatise (book 3, chapter 10) in which Lanfranc quotes the various diets to be prescribed to wounded patients in more detail.

The. x. chapitle of þe þridde techinge is of gouernance & diete of men þat ben woundid (ms. Oxford, Bodleian Library 1396, f. 37a): The x Chapitle of þe þridde techynge is of men that beth y-woundyde (ms. London, Add. 12056, f. 57v)

‘The tenth chapter of the third treatise is about treatments and diets suitable for wounded men’ Regarding diets to be prescribed to wounded patients, Lanfranc explains that some doctors are of different opinions. In fact, some physicians think that patients are allowed to eat hearty food, like capons and hens besides drinking wines, in order that they can recover faster. In the opinion of these doctors, wounded patients should avoid drinking water, as it can cause corruption of the injured body part. On the contrary, other physicians are of the opinion that patients should avoid hearty foods and eat just broad, cooked apples and drink water in the first ten days of their disease: Þer ben manye men þat discorden of dietynge of men þat ben woundid, for sum men ȝeuen to alle men þat ben woundid, wheþir þat it be in þe heed ot in ony oþere place, good wiyn & strong fleisch of capouns & of hennes : & þei affermen þat bi sich a maner wey sike woundid men ben sumere heelid / for þei seien þat water putrifieth lymes þat ben woundid & engendriþ enpostymes & corrupiþ & febliþ complexciouns & makiþ harmys. & sumere oþere men gouernen alle maner of sike men þat ben woundid wiþ breed & watir & applis soden til ten daies ben goon. (ms. Oxford, Bodleian Library 1396, ff. 37a-b); Many men discorden of dietynge of men þat ben woundyde, for sum men ȝeuen to alle men þat ben woundyde, wheþer þat it be in þe hed oþer in enye oþere place, gode wyn & stronge flesch of capouns & of hennys; and þey affermen þat by swyche a manere weye seke woundyde men somere ben y-helyde, ffor þey siggen þat watyre putrefyedþ lymes þat beþ woundyde & engendriþ Apostemys & corrumpyth & flebith complexiouns & makyth many harmys Sum oþere men gouernen alle manere of syke men þat beþ woundyde with brede & water & Applys y-sodyn, tyl x dayes ben passyde (ms. London, Add. 12056, f. 57b).

Moreover, in Lanfranc’s opinion several doctors are wrong, as they do not consider the physical characteristics of wounded people, as above mentioned. On the contrary, in prescribing diets, all physicians should consider the constitution of each patient. In this occurrence, we can read Lanfranc’s references to his sources. In fact, he affirms he prefers to follow his ancestors’ teaching, such as Galien (129-201)[4], Avicen (980-1036) [5] and Rhazes (850- 903 o 923) [6]. In fact, he thinks it is wrong to rely only on his own experience, which can be useful, but it is not enough. On the contrary, it is right to refer to the teachings of the great doctors of the past. Finally, regarding wounded people, Lanfranc thinks it is correct to avoid wine and meat just during the first phase of disease and in case of head or nerve wounds. And if god wole eende þis book, it scha be remeuynge erroris & declaring duties. I seie þat þese boþe sectis erren in her opynyouns, for þei taken here only to ther experimentis not considerynge resoun of complexioun of him þat is woundid.

Ʒif þat god wyl ende þis bok, yt schal be remeffynge awey Errores & declarynge & opynge Dowtous. Y sigge, þat boþe þese sectis erren in here opyniouns, ffor þey taken hede onlyche to here experiments noƷt considerynge resoun of þe complexioun of hym þat is y-woundyde. ȝe schulen vndirstonde þat boþe þese sectis ben nouȝt ; & þerefore I folowynge þe doctrine of rasis, auicen, & galion & of oþere doctouris; & also experimentis þat I haue longe preued; I seie þat it is nedeful þat a woundid man in þe begynnynge absteyne him from wiyn & namely if þat þe wounde be in þe heed eiþir in ony partie of a senewe (ms. Oxford, Bodleian Library 1396, ff. 37b); Þe vnderstandyge pat þe boþe sectes bys noȝt comendable and þerefore y folowynge þe doctryne of rasys, Avence, galien & of oþer doctoris & also experymentis, þat y haue longe y-preuede, sigge þat it is nedefull in þe bygynnynge þat a woundyde man Absteyne hym from wyn & namlye ȝif þat þe wounde be in þe hed oþere in eny partye of a synwe (ms. London, British Library, Add. 12056, f. 58a).

Remedies for Wounded Patients

In the first treatise (book 3, chapter 3) Lanfranc points out the foods used to heal wounds. For instance, to heal nerve injuries, he starts specifying the different kind of them; in fact he asserts that lengthwise wounds (called fissura) are less dangerous than widthwise ones (called sissura), because lengthwise wounds are easier to stitch up: Þe woundis þat ben maad in lenkþe of þe senewe ben lesse perillous þan þo þat ben maad in brede of þe senewe ben most perilous. If þat a senewe were wændid in lenþe, he mai wel & liƷtliche sandide togedere (ms. Oxford, Bodleian Library, Ashmole 1396, f. 19b); The woundes þat be þy mad in lengthe of þe synne beþ lasse perilous & þo þat beþ in brede of þe synwe beþ more perilous. Gif þat a synwe were woundede in lengþe he may be wel & lyƷtlyche y-sandyde togedire (ms. London, British Library, Add. 12056, f. 47a). In any case, to disinfect both wounds, he recommends to use mondificatives, consisting in boiling flour of barley together with rose honey: A mundificatijf medicine of senewis wounded is maad of þis maner: take mel roset colat Ʒ. iii. smel flour of barly & medle hem togidere & boile hem slili (ms. Oxford, Bodleian Library, Ashmole 1396, f. 23a); A mundificatyff medicine of symwes y-wandyde ys y-made in þis manere: R. mel rosat colat Ʒ.iii. smel floure of barly Ʒ medle hem togedre & bolyle hem slily (ms. London, British Library, Add. 12056, f. 48a). Afterwards, to treat the wounds after suturing, Lanfrancs recommends spreading egg-white onto the wounds: Bynde togiþeris þilke wounde with a boond þat closiþ þe wounde togiþeris & keep þilke wounde from swellynge wiþ þe whiƷt of an ey leid aboue þe wounde & lete þe wounde be in reste (ms. Oxford, Bodleian Library 1396, f. 16b); Bynde togedyre þilke wounde with a bound þat close þe wounde to gedire & keep þe wounde from swellynge wiþ þe whyte of an eyƷe y-lede aboue þe wounde & lete þat wounde ben in reste (ms. London, British Library, Add. 12056, f. 44b)

‘Suture the flaps of the wounds and then rejoin them together and spread the egg white on to preventing it from rotting. After words bandage the wound and let it rest’. However, we can find the employment of winegar together with a resin, the so-called bole of armoniac, both used as a disinfectant medicine, called medycin defensiv by the Middle English translator: & þanne worche aboute þe wounde… leie a medycin defensiv of bole armonyac, oile of rosis & a lytil vynegre so þat þe medicyn touche þe brynkis of þe wounde þat humoris moun not haue her cours to renne to þe wounde (ms. Oxford, Bodleian Library f. 5a); And þenne worche aboute þe wounde… leye a Medycine definsiue of bol Armonyac, oyle of rosys & a litel vynegre so þat þe medycine touche þe sydes of þe woundes þat humours mowe noʒt hauen here cours to renne to þe wounde (ms. Londra, British Library, Add. 12056, f. 35b). In addition, the oil of roses is quoted for the first time in this occurrence, although it is mentioned again in the first treatise (book 3, chapter 3), in which Lanfranc explains how it is prepared, (eg. using the oil obtained from the unripe olives), adding the explicative gloss: Oile of rosis , þat is maad of olie de oliue þat is nouȝt ripe (ms. Oxford, Bodleian Library 1396, f. 20a); Oyle of roses , þat ys y-made of olye of olyffe, þat is nouȝt rype (ms. London, Add. 12056, f. 47v). ‘Oil of roses, that is prepared with oil from olives that are still riping’ [7]. On the contrary, concerning deep wounds, going down to the bones, Lanfranc recommends to use frankencense powder, mastic and sangdragoun [8] (all mixed together), in order to obtain a purifying compound to be smeared onto the wounds: … and putte in þe same medicyn a litil poudre of frankencense, mastik & sandragoun medle hem togidere & leie aboue þe wounde till it be hool (ms. Oxford, Bodleian Library, f. 23b); ---þenne putte in þe same medycine a lite smal poudre of franke ensence, mastike & sank dragoun & medle hem to gedre, & leye aboue þe wounde tyl it be al hol. (ms. London, Add. 12056, f. 49a).

How to Heal Wounds and Burns: In the first treatise (third book chapter 5) the author considers those wounds caused after falling from a horse or in case of being struck by stones and similar wounds:Þe fifþe chapitle of þe þridde techinge of woundis þat ben maad wiþ smytynge of staf or stoon or fallynge or smytynge of an hors or wiþ ony oþir þing semblable (ms. Oxford, Bodleian Library 1396, f. 25b); Þe ffye Chapitle of of þe þridde techinge is of woundis at that beth y-mad with smytynge (ms. London, British Library, Add. 12056, f. 10v). In case there is a burn next to a wound, the author advises to sprinkle the burn with oil of roses and blueberry powder and then put yolk, together with oil of roses, using a dab or a little linen cloth. After that, the doctor has to smear a compound on the wound, prepared with four parts of water, one part of olive and four of wheat, leaving it on the wound until it is closed; then he has to clean again and let it heal: if þat a brusour were wiþ a wounde, anoynte aboute þe wounde or eille þe place þat is brusid wiþ þe oile of rosis & poudre of mirtilles for it fastneþ be place. Wiþinne þe wounde leie þe Ʒelk of an ey, wiþ oile of rosis with stupis, ellis wiþ lint. Leie aboue þe wounde a potage maad of .iiij. parties [9] of watir & oon partie of oile de olyue & four of wheete þat sufficiþ to þe medicyn & leie þis medicyn to þe wounde, til þat þe akþe be aswagid, & til þat þe quytture be engendrid, aftirward clense þe wounde, aftir þe clensynge regenerer & at þe lawounde te cicatrice (ms. Oxford, Bodleian Library 1396, f. 26b-27a); Ʒif þe brosure were wiþ a wounde, anoynte about þe wounde oþere ellys þe place is y-brusyde, wiþ oyle or roses, & ræste aboue þe forseyde poudre of mirtillyes, for þis medycine fastnyth þe place þat is y-brusyde… Wiþynne þe wounde leye þe Ʒolke of an eye with oyle of roses, with stupes oþere ellys wiþ lynte, & leye aboue þe wounde a potage y-madde off foure partyes of water & o partye of oyle d’Olyve & floure off Whete þat suffyseþ to þe meductbe & leie þis medycine to þe wounde, aftere þe clensynge regenere, & at þe laste cicatryce (ms. London, British Library, Add. 12056, f. 51v).

Remedies for Virulent Wounds and Ulcers: In the first treatise (book 3, chapter 11) Lanfranc mentions several substances to be applied to those patients suffering from virulent wounds and ulcers:The .xj. chapitle of þe þridde techinge of þe firste tretis (ms. Oxford, Bodleian Library 1396, f. 39v); The xi. Chapitle of chapitle of þe þridde techynge of þe firste tretys is of olde woundes (ms. London, British Library Add. 12056, f. 59r). About virulent ulcers, we can find also an explicative gloss and we are informed the physician must observe what type of matter comes out of the wound; then he has to disinfect the wound with a compound prepared by boiling rose water, lamp, balaustrade, lentis and honey. Finally, he has to cleanse with water or wine, together with asbinthe, Bulgarian marrubium, sage, burnet and honey: If þe vlcus be virulent þat is to seie venemi loke if þat þe venym þat goiþ out be redisch or ȝelowisch & if þat þe lyme haue any maner heete; þanne waische it wiþ water of rosis and barlich, alim (aluminis), balaustia & lentiles wiþ hony ben soden yn & lete þis watir persee to þe deppe of þe wounde & waische it wiþ watir or wiyn þat mirre wormode (ie. absinthium), horhone (cfr. lat. marraubium vulgare), sauge, pimpernelle, hony symple or compouned ben soden yn (ms. Oxford, Bodleian Library 1396, f. 41v); Ȝif þat þe Vlcus be Virulente þat to sigge Venym þat goþ out be reddysch oþere ȝolwe, & ȝif þat þe lyme haue enye manere hete ; & þenne wasche it wiþ water þat rosys / barlyche Alum & balaustia & lentilis with honye symple oþere componed ben sodyn In . And lete þis watere percen to þe depthe of þe wounde. And ȝif þe Virus be withouten hete & þe membre haue non lete, wassche it with water oþere wyþ wyn, þat Mirre, wermot horhowne, sauge, pympirnel, honye symple oþer componed ben sodyn In (ms. London, British Library, Add. 12056, f. 60r).

Diets for Patients Suffering from Gancrene: In the first treatise (book 3, chapter 13) the author deals with the gangrene referring to the diets suitable for these patients. In this case, they have to eat fine foods, as mutton, capoun, pheasant, partridge, chicken and little birds. Instead, they have to avoid beef, donkey, geese and big birds (living in water), salty and overly soaked foods (i.e. garlic, onions and winegar), red and thick wine, if they intend to live long on earth. Instead they can drink ‘clear’ wine [10].

… þe pacient use a good gouvernaile: as drinke good wiyn & cleer & lithe & he muste leeue reed wiyn & troublid & þicke wyn & he may ete good fleisch, as moutun of a weþer, kide fleisch sowkynge, capouns, hennes, chickenes, partrichis (pernix), fesautis & smalke briddis… & he muste leeue: beeues fleisch & gotis fleisch, hertis fleisch & haris fleisch, goos, dockis, & alle grete briddis þat lyuen in watri placis & al salt þing & acute þing as garleek, oynyons & vynegre et cetera [þat] þe sike man may lyue þe lengere vpon erþe (ms. Oxford, Bodleian Library 1396, f. 49b); … þe pacient vse a gode gouernaylle : as drynkinge gode wyn & clere & lyȝt & he mote leuen red wyn and troblyde & þykke wyn ; & he may eten gode flesch, as motoun of a weþire kyde fflesch sokkynge, Capouns, hennys, Chykenys, partryches, ffesauntes, & smale briddes, & he moste leuyn beffys flesch, gotys fflesch, hertys fflesch, harys fflesch, goses, dokys & alle grete briddys þat lyuen in watrye places, & alle salt þynge : garlyke, Oynouns, vynegre, &c., þat syke men mowe lyuen þe lengere vpon erthe (ms. London, British Library Add. 12056, f. 65b).

Remedies for Gancrene:First, Lanfranc explains that a cancer [11] must either be left untouched or entirely removed from its roots. Regarding the medicament, Lanfranc advises to clean the wound having gangrene, drie it and anoint with an ointment used to employ, together with unguentum tute [12], cherry to be mixed with oil of roses, portulaca or some other cold herbs [13] … This ointment is very effective medicament: Waische þe wounde of þe cancre wiþ gotis whey, & drie it softly, & anoynte þe wounde wiþoute with þis oynement of rasi & tuti / take ceruse, tutie, I-waische & medle hem wiþ oyle of rosis & wiþ ius of purcelane or of sum oþere cold eerbe, putte ynne sum of þe toon & now sum of þat oþer, til þe oynement be weel I-maad / þis oynement is myche worþ for to defende þat þe malice of þe cancre schal not wexen (ms. Oxford, Bodleian Library 1396, f. 49b); Wassche þe wounde of þe cancre with gotys wheyƷ, & drye yt softlyche & anoynt þe wounde withinne & without, with þis oygnement of rasts of tutye. R. ceruse, tuthye, y-sasschyn and medle hem wiþ oyle of rosis & wiþ jus of poslane oþere of sum oþere colde erbe, now puttynge in sum of þe on & now sum of þe oþere tyl þe be ful mad. Þis oygnement ys myche worth forto diffendem, þat þe malys of cancre þat is y-woundyde schal noƷt waxen (ms. London, British Library Add. 12056, f. 65b).

Healing of Different Diseases

Remedies for Cough

In the third treatise (book 2, chapter 8), entitled Apostym wiþoutforþ aboute þe spaudis and þe gibbositees Apostym wiþoutforþ aboute þe spaudis and þe gibbositees, Lanfranc refers to the cough in children, teaching us he is used to cure this disease with almonds, previously diluted in a decoction of fennel, together with almonds, tarragon, quince, in order to obtain a kind of soup as thick as honey is. As soon as the cough gets better, the patients can take a bath in marshmallow rose, almond leaves and flax seeds boiled in water: Also it bifalliþ þat children han grete bocchis in her brest & þat comeþ of cowȝinge þat puttiþ out þe matere, & also it comeþ of greet wynd þat puttiþ out þe matere . Þe cure herof in þe firste bigynnyng is in þis maner for to aswage cowȝing as almaundis temperid with a decouccioun of fenel. Also take swete almaundis .ij. partis, dragaganti [14] semen, citoniorum [15] ana, oon parti, Iulip [16] quod sufficit & make herof a souping medicyn þat it be as þicke as hony. whanne þe cowȝinge is aswagid, þan make him a baþ wiþ rotis altea & leues of malue & fenigrec & lyne seed soden in watir & þis schal be cast vpon þe enpostym wiþ a vessel holden an hiȝe þere from þanne aftirward þou schalt dissolue þe matere & make it neische with medycyns þat ben forseid in hard enpostyms, & þan cure it vp as it is aforseid in þe enpostyms of wijnd. (ms. Oxford, Bodleian Library 1396, f. 147a-b). However, in this case, Lanfranc does not quote any diets for this disease

Cure of Apostema at the Stomach, Liver and Spleen

In the third treatise (book 2, chapter 10) Lanfranc explains the diseases at the stomach, liver and spleen, prescribing his patients to sprinkle te part with different types of oils (mastic and lily ones), together with oinments of roses and absinthes, squinting, cypress, barley and other things that he does not specify: Whanne þere schewiþ an enpostym in þe mouþ of þe sstomac & aboute þe regioun of þe lyuer & of þe splene, it is good & profitable to comforte þe place wiþ oyle of mastic, & oyle of spica & ile of lilie & wiþ cold enplastris of rosis & of absinthio, squinanto, cipero, citonijs wiþ mele of barli & oþere þingis (ms. Oxford, Bodleian Library 1396, f. 148b). However, a physician should beware of repellents, but he can apply resolving medicines: & þou schalt be wel war of repercussiuis, whanne þe enpostym is nyƷt ony principal lyme, saue þou schat leie þerto resoluyng & maturatif þingis & loke þat þei be not medlid wiþ no þingis þat bn repercussif, for if þou ledist ewpwexuaaiuia vpon þe stomak or þe lyuere or þe splene þei wolde be enfeblid þerwiþ & to al þe accioun of þe bodi wolde be enperid : for þese lymes seureþ principaly for to norische al þe bodi (ms. Oxford, Bodleian Library 1396, f. 148b).

Remedies for Patients Suffering from Eye Diseases

Lanfranc starts to write there are a few eye-diseases and some of them can be contagious. One is ophthalmia, consisting of a white (or red) point in the eye [17]. it is important to distinguish three different degrees of ophthalmia (i.e. light, strong and severe) Þere comeþ manye sijknessis in þe iȝen & summe comeþ of causis wiþoutforþ & summe of causis wiþinneforþ, and þere ben oþer maner sijknes of þe iȝe & þat ben seid contagious : as obtolmia … obtolmia is clepid a whit welke or a reed poynt. In þe maner obtalmia is clepid enpostym of þe iȝe & þere en .iij. maners of obtalmia : as liȝt & strenger & alþer strong (ms. Oxford, Bodleian Library 1396, ff. 162b-163a). Subsequently, the author mentions the treatments for this disease, including two remedies that Galien and Rhazes were used to prepare. Galien’s remedies were both a compress (obtained from

yolk of one egg, oil of roses, verbena juice, saffron and opium all mixed together, in order to obtain an ointment, then to be closed in a piece of linen cloth and placed ob the eye) and eye-drops (obtained from breast milk) [18] : R. a ȝelke of an eij, & as miche of oile of rosis, & as miche of iuys of verueine & . ϶ j. of saffron & ϶ of opij; medle togidere & make þerof an enplastre & leie it vpon a sotil lynnen cloþ & leie it on þe iȝe & in his iȝe leie collirium album with wommans milk Þat noryschiþ a maide child ; for .G. made þis medicyn. (ms. Oxford, Bodleian Library 1396, f. 164a). The other concerns Rhazes who was used to treat ophtalmia with the eyedrops (called collirium album), to be applied threefold a day, which Lanfranc himself had the opportunity to try on his patients. This remedy was prepared by cherries, astragalus sarcocolla, starch and tarragon and opium pound all mixed together and diluted in pure water, until it gets thick. Afterwards, the mixture had to be closed in a piece of linen cloth and placed on the eyes, as well: Rasis made collirium album in þis maner & it is good þing for I haue preued it ofte tyme . Take ceruse waisch .x. partis, sarcocolle greet .iij. partis amidi .ij. partis, tarracon (Lat. dragaganti) .j. parti, opij j. grinde alle þese togidere & tempere hem wiþ rein water & make þerof pelottis as gret as it were a pese & kepe hem & whanne þou wolt worche þerwiþ tempere oon þerof wiþ wommans milk þat it be as þicke as it were must (Lat. mustum) & leie þerof in hise iȝen þre sidis in þe dai (ms. Oxford, Bodleian Library 1396, f. 164v).

Diets for Patients Suffering from Eye Diseases

Next Lanfranc describes the diet for patients suffering from ophthalmia, consisting in eating no meat and drinking no wine, although the patient is allowed to eat a colaturee [19] of almond milk: & whanne þe reednes & swellyng of his iȝe is aweie he mote be war of his dieting, for he mai ete no fleisch ne drinke no wijn, saue he mote ete colature of almaunde milk (ms. Oxford, Bodleian Library 1396, f. 165b).

Cure of Kidney Stones

In the third treatise (book 3, chapter 8) Lanfranc illustrates that a stone in the bladder or the reins arises from a superfluity of the hynmours and great heat, a stile get hard in the fire: A stoon n a man is engendrid of plente of grete humoris wiþinne a man, as we moun se an ensample wiþoutforþ of oþere þingis, in þe maner þat men brennen tilis in a furneis (ms. Oxford, Bodleian Library 1396, f. 190v). Later he mentions the foods that a patient must avoid and those that he can eat, together with treatment to be adopted and medicines to be taken, including a syrup that Avicen was used to prepare. However, in his diet, the patient should absstain from beef, geese, water fowl, offal, sweet bread, dairy productys (unless whey), salty foods, apples and pears. Moreover, he must abstain form drinking new wine, water that is too cold and from any substance increasing humors: Now I wole teche in what maner a man schal kepe him þat is disposid to haue þe stoon, he schal ete no metis þat ben viscous ne to scharpe, & tofore alle þingis hard chese gaderiþ viscous mater & hard & he schal ete no beef, ne no fleisch of a goos ne no grete briddis þat swymmeþ in þe water & he schal ete no fleisc of an hert & he schal ete no swete bread [20] & al maner mete þat is maad od swete past & he schal ete no whete soden & he schal ete no maner þing þat is maad of milk saue þe whey & he schal drinke no coold watir, & he schal ete no fruitis þat ben of greet substaunce as applis, peris & he schal drinke no newe wijn, ne no wijn of greet substaunce & he schal ete no þingis þat ys to myche salt & he schalt absteyne him fro alle þingis þat engendriþ scharpe humoris & grete & he schal not ete to greet sauly [21] (ms. Oxford, Bodleian Library 1396, ff. 191r). On the contrary, the patient can eat well-leavened bread, possibly with fenel of parsley seeds; drink light wine, preferably mixed with water. In addition, he may eat capon meat, hens, chicks and partridges, as well as all the meat of birds living in the fields, but he cannot eat the meat of waterfowl. Furthermore, he can eat pork, veal and mutton; boneless fish and hard-boiled eggs.

Finally, the he can drink a diuretic sirup (called oximel diureticum and squillitic) [22] or another one that Avicenna used to prepare, consisting in water, winegar, fennel roots boiled all together; afterwards the sirup has to be mixed with sugar and it is ready to be drunk: In þis maner he schal diete him silf, he schal ete breed þat is wel leueyned & his breed wole be þe bettir for him if it be medlid wiþ poudre maad of fenel –seed & persil & he schal drinke sutil wijn & cleer medlid wiþ fair cleer water. And if his reynes & his bowels weren hote þan he mai drinke coold water þat be clair & clene & he mai ete fleisch of capouns & hennes & chilkenes & partrichis & of alle oþere maner of briddis þat mouen in feeldis & of hem þat woneþ in watir he schal no ete. & he mai ete pork & motoun & principali of beestis þat ben gildid & he mai ete fleisch of .iij. daies poudringe & he mai ete veel & he mai ete eiren þat ben meische soden, fisch þat haþ no schellis & þer substaunce to him be greet & hard, he schal not ete þerof alle maner fisch þat haþ manie schellis, is better þan he þat haþ no schellis.

He schal vse sirupis duretikis as oximel diureticum & squilliticum, or he schal vse a sirup þat auicen made R. Aquae lī x. aceti lī medle hem togidere & boile hem wiþ iij. of rotis of ache & rotis of fenel ȝ .iij. and fenel seed & ache ana & .j. seþe hem alle togidere til þe .iij. part be consumed awei & þas cole hem & do þerto lī .x. of sugre & þan clarifie it & seþe it & kepe it for þin vss (ms. Oxford, Bodleian Library 1396, f. 192a).

Dermatological Diseases

Hair Loss

In the third treatise (book 3, chapter 2) Lanfranc points out how to heal hair loss. In all these cases, it is necessary to use a compound, obtained from one part of laudanum, diluted in fourth parts of cranberry oil and spread it on the hair roots: If þou wolt kepe heeris þat þei schulen not falle awei R. ladani (lat. laudanum) ʒ .j. & resolue it in ʒ .iiij. of oile of mirtilles & herewiþ anoynte þe rootis of þe heeris (ms. Oxford, Bodleian Library 1396, f. 105r).