Depictions of Physical Order: A Brief Look at Diagrams in Late Medieval English Medical Manuscripts

1000 Worte Forschung: Dissertation, History of Art, University of Glasgow, completed in January 2015

In my thesis, I positioned diagrams – such as uroscopy charts, humoral rotae, volvelles, the spheres of the universe, mappae mundi, lunation diagrams, Zodiac Man, Phlebotomy Man, Wound Man and Disease Woman – included in medical manuscripts, within a larger visual and cultural framework. When considering devotional or religious art, scholars often study the multiple reasons for its creation, reproduction and distribution.1 Conversely, when discussing scientific diagrams and illustrations, many historians consider their ubiquitous presence as evidence primarily of their practical function.2 I argue that the diagrams included in medical manuscripts can provide insights into late medieval social beliefs and medical practices. I argue that artists and compilers chose and reproduced diagrams for multiple reasons well beyond the practical.

But what is a diagram? And how are they different from other illustrations? Well, there are no formal features or characteristics that apply to all medieval diagrams. Symmetry, however, is the most common characteristic and is central to most types of diagrammatic renderings.3 In some examples, the intellectual content is expressed through the human form while other diagrams are based on geometric shapes. Diagrams describing Christian theological ideas have been examined by modern art historians.4 For example, Ann Esmeijer considers the intersection between diagrammatic representations and Scripture during the medieval period. She argues that the use of harmonious and continual cosmological diagrams may have arisen within Christian writing to express Christian theological concerns.5 I believe that this kind of consideration and crucial appraisal of diagrams included in medical sources can yield insights into complex medical, theological and social discourses. The definition of diagram originates not within the formal features of the schema, but within its function.6 An illustration of a plant can be either life-like or abstract, whereas a diagram of the same organism must necessarily explain a feature or purpose.

To undertake a meaningful discussion it was necessary to establish a somewhat representative corpus and to structure this diverse material in meaningful ways. The manuscripts included in this thesis were chosen based on their audiences. Because illustrated manuscripts from the Middle Ages originate primarily within the higher echelons society, it is not possible to claim that the audiences of these schemas include the entire spectrum of medical practitioners. I nevertheless attempted to include manuscripts owned and used by educated laypersons, university educated practitioners, surgeons, and barber surgeons. This allowed me to compare the diagrams and illustrations included in the Guild Book of the Barber Surgeons of York to the schemas included in a codex used by a practicing uroscoper, and investigate their varied appearance in relationship to the social functions the diagrams fulfilled.7

The intellectual content of these medical diagrams, rather than their formal features, influenced the structure of the thesis. By grouping material according to their function or content, visually distinct diagrams were positioned within the same categories, allowing for closer consideration of schemas produced for different audiences. Humoral theory, while perhaps not as influential to medical practice as previously believed, was frequently illustrated in medical treatises. The very notion of health was closely connected to the perceived balance within the human body.8

These medical theories provide the framework for organising this expansive field of visual material and the content of this thesis, which was structured according to contemporary humoral conventions. The first chapter considered diagrams describing the humoral balance of the human body. Schemas that explain the external influences on this physical equilibrium were discussed in the second section. Lastly, in the final chapter I discussed depictions of cosmic influences on the internal microcosm as mapped on the human body.

Through text-image analysis, by considering the diagrams in relationship to the texts that immediately surround them and the other texts included within the same codex, I have shown that diagrams, through different means, emphasised or legitimized the surrounding texts and medical practices. Additional analysis was interpictorial: the visual motifs are considered in relationship to similar and related pictorial subjects, familiar from other manuscripts and artistic contexts. Through consideration of the intervisual references to devotional art and other scientific schemas, the multiple meanings of the medical diagrams were further elucidated. Another feature of the codices studied is their status as physical objects, how they were held, used, leafed through and transported. Lastly, by situating the codices and their diagrams within a late medieval English social, ideological and religious milieu, a deeper understanding of their function was achieved. Rather than being simple tools used in medical practice or representations of medical theories, diagrams included in medical manuscripts functioned in multiple, prescriptive and descriptive, ways to define theological, civic and gendered ideas around social order.

Suggested citation: Sara Öberg Strådal: Depictions of Physical Order: A Brief Look at Diagrams in Late Medieval English Medical Manuscripts, in: Mittelalter. Interdisziplinäre Forschung und Rezeptionsgeschichte, 28. September 2015,

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  1. See, for example: New Perspectives on the Man of Sorrows, ed. by Catherine R. Puglisi and William L. Barcham Studies in Iconography (Kalamazoo 2013).[]
  2. See, for example, discussion on uroscopy charts and phlebotomy diagrams in: Loren MacKinney, Medical Illustrations in Medieval Manuscripts (London 1965), 11-12, 55-58.[]
  3. On symmetry in medieval art, see:Madeline Caviness, ‘Images of Divine Order and the Third Mode of Seeing,’ Gesta 22 (1983), 99-120.[]
  4. Transmission of theological diagrams, see: Kathleen Scott, Tradition and Innovation in Later Medieval English Manuscripts (Hong Kong 2007), 1-32. Bianca Kühnel argues, regarding diagrams within the Carolingian tradition, that they contained many additional meanings beyond their primary scientific ones. See The End of Time in the Order of Things: Science and Eschatology in Early Medieval Art (Regensburg 2003), 255.[]
  5. Anna C. Esmeijer, Divina Quaternitas: A Preliminary Study in the Method and Application of Visual Exegesis (Amsterdam 1978), 33-34.[]
  6. Bert S. Hall, ‘The Didactic and the Elegant: Some Thoughts on Scientific and Technological Illustrations in the Middle Ages and Renaissance,’ in Picturing Knowledge: Historical and Philosophical Problems Concerning the Use of Art in Science, ed. by Brian S. Baigrie (London 1996), 9; James Franklin, ‘Diagrammatic Reasoning and Modelling in the Imagination: The Secret Weapons of the Scientific Revolution,’ in 1543 and All That: Image and Word, Change and Continuity in the Proto-Scientific Revolution, ed. by Guy Freeland, Anthony Corones (London 2000), 55-56; John North, ‘Diagram and Thought in Medieval Science,’ in: Villard’s Legacy: Studies in Medieval Technology, Science and Art. In Memory of Jean Gimpel, ed. by Marie-Thérèse Zenner (Aldershot 2004), 278; Philipa Semper, Diagrams in English Medieval Manuscripts (PhD Thesis, University of Exeter, 1994), 6.[]
  7. London, British Library, Egerton MS 2752 and Oxford, Bodleian Library, Ashmole MS 1413.[]
  8. On health and responses to illness, see: Carole Rawcliffe, ‘The Concept of Health in Late Medieval Society,’ in Economic and Biological Interactions in Pre-Industrial Europe from the 13th to the 18th Centuries, ed. by Simonetta Cavalicchi (Prato 2010), 319-334.[]

Sara Öberg Strådal

Sara studied Art History at the University of Glasgow and submitted her PhD thesis on diagrams in late medieval English medical manuscripts in October 2014. She is interested in text image relationships, representations of scientific knowledge, authority and intervisual references to Christian imagery. In her PhD she also studied the use and social function of medical manuscripts and the diagrams that they contained.

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