Finding the Pharmakon Within: Textual-iatrics in the Composition of Sixteenth-Century Syphilis
Into the living elements of things
I, Proteus, mingle, seeking strange disguise: I track the Sun-god on an eagle’s wings, Or look at horror thro’ a murderer’s eyes, In shape of horned beast my shadow glides
Among broad-leaved flowers that blow ‘neath Afric tides.
“Proteus; or, a Prelude” by Robert Williams Buchanan
At the nucleus of my reading of sixteenth-century Textual Healing is the written word as an anchor or point of conceptual stability, the enactment of logos.1 The text provides a constancy that allows
for the transmission of ideas across time and space, becoming a foundational element upon which to fix meaning and generate permanence. Binding is a critical component of textual healing, where the principle organizing feature of the text is that which provides a context in which the intended meaning is preserved. Without its binding, the text opens, the pages fall away, and the order – which provided the message contained therein – is nullified, annihilated. The power of the words themselves, then, depends upon a sturdy and well-imparted binding. Beyond the level of the text (i.e. the word, the sentence, the paragraph) – the binding is the overarching structure necessary to communicate the underlying meaning, and that which gives the text a functional purpose: the transmission of ideas.
The text as a means for the transfer of knowledge allows for a systematized response to external threats to the socially-generated ideological frameworks which comprise understandings of lived “reality.” Finite and fixed, the text represents a point of reference that binds or connects the wholly conceptual – i.e. meaning, signification, ideas – to the wholly physical – the page itself. The text enmeshes the physical with the intellectual, the spiritual, the moral, and embodies a form not unlike our own; comprised of
1Here I am leaving beside modern critical and theoretical work on the fluidity of verbal signification, and adopting what I hope will be
a less anachronistic vantage, from which perspective, the text (as represented in the Bible, for example) possesses certain inalienable truths. Textual interpretation is a moral undertaking, contingent upon appropriate knowledge and not subject to multiple and varied realities. One might consider here the enduring privileging of logos in classical philosophy and later Christian theology. The Oxford English Dictionary defines logos as “the Word of God, or principle of divine reason and creative order, identified in the Gospel of John with the second person of the Trinity incarnate in Jesus Christ.”
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elements of this material (perceived) world, along with those of the ineffable, the undeniable realm beyond our direct mortal perception.
The bound text represents a contract with the infinite, and reflects our human impulse to generate meaning through imposed narrative. Like the text, the human body is understood according to an
imposed and implied system of order and a hierarchy of functions. We understand our existence
according to the story that we tell ourselves about the nature of the cosmos – a narrative whose strands are indelibly inscribed upon and within our own physical form, our bodies. The human being is a text whose binding is variously ascribed, and according to which, we will differently understand our own nature, and the nature of all things. As creatures, we embody the very texts we generate – producing a reflection of perceived “reality,” at the same time that we are creating the very form we intend to reproduce.
Binding concretizes our reality, as it does our texts, as it does our physical forms. It represents an agreed upon understanding in the face of chaos and relativity, and displaces nihilism with inherent purpose. By inscribing meaning to text, and binding that meaning therein, knowledge is preserved, transmitted, diffused, and the threat of the infinite (i.e. meaninglessness) is avoided – however
temporarily. The text is our physical means for combatting the immaterial. It is our inflatable dingy in the vast sea of Being – something to cling to when the alternative is absolute conceptual dissolution.
By providing the illusion of fixed significances, the text is the means by which we generate reality at the same moment we provide the proof of its very undoing.2 The text fixes our position in time, situating
us temporally by showing us what and where we are not, while concurrently bringing us into a space outside of our own perceived time and place. “And this is writing. Wherever one enters it, there is something before and something after that makes it meaningful” (Neel 28). The text provides the human intellect with an external medium by which to reflect and replicate itself, transcending time, space and the
2The importance of binding in Textual Healing is further underscored in the upcoming discussion of Fracastoro’s Syphilis and
Derrida’s Platonic pharmakon, where the process of writing represents the creation of an unfinalizable conceptual opening. Jasper Neel describes this process for Plato:
he clearly recognized that writing is a forever-opening. Its words are open spaces always waiting to be filled yet never finally filled up; its process is the forever-incomplete antithesis of itself, as invention and arrangement constantly cancel each other; its embodiment is the Janus-faced operation of matter and style, each emerging from the other […] Plato offers to lead us out of the morass created by writing, rhetoric, sophistry, and discourse in general and into the realm of truth […] the sources of his power […] is writing. (64 – emphasis is my own)
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physical limitations of the mortal body. The text becomes the membrane through which we process the ineffable, projecting – and enacting – the illusion of conceptual stability, and transmitting that message ad infinitum over time. The content of the particular message – its specific meaning – is secondary to the fact of its existence. The text is – therefore, it contains a message; therefore, meaning is possible; therefore, there is a truth that can be known, comprehended and perceived. Through the text, the unknown and unknowable are bound, contained, and neutralized. The text renders certainty. It imposes order where none is possible.
The intellectual salvation of sixteenth-century existence, Textual Healing also occurs on the physical level – text as medicine – and as a tool for social bonding – through the circulation of texts. I explore these additional properties of textual healing more in depth in Chapters 2 and 3, where I discuss the Cinquecento Epic as a genre deployed in part as a response to emergent French Pox; and then examine literature and art at the court of Federico II, first duke of Mantua, which serves as a micro-history or case study, in the application of text as medical treatment, and as a tool for establishing social bonds.
The concept of sixteenth-century Textual Healing demands the question: What can a text do? The answer is to be found in its binding – physical as well as intellectual; in the physical and emotional effect that the act of reading has on a person; and in the way that texts can influence and shape the social networks in which they occur. Before stepping into specific examples of Textual Healing at work in the literature of the period, I return first to the medical context in which sixteenth-century French Pox was understood – or rather – not understood.
Towards an Institutionalized Model
As the early modern world scrambled to mount an organized campaign to combat the Pox, the ideological framework by which society understood physical disorder underwent a major shift, and communities were forced to develop new forms of social response to disease. Still centuries before the Enlightenment and the formal establishment of institutionalized medicine, medical colleges and boards were only beginning to take shape in the sixteenth century, and healing was largely a practice tied to local tradition, custom, and disposition. The authority granted physicians was a rarity, and treatment by a physician would have been a distinct luxury, enjoyed by only the privileged few in society. Hospitals as we
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know them today had not yet come into existence3 and the vast majority of individuals – were they so
lucky as to be solvent enough to pay for care from a third-party – would not have had the resources to pay for treatment from anyone other than a surgeon (again, not in the modern usage), barber, quack or other lay healer, most likely from within their own community. Unsurprisingly, men and women were treated differently by medicine, and men were far more likely to receive treatment than were women. The use of simples and botanical concoctions was common, and served as a further marker for wealth and status (the best cures coming from the costliest and most exotic ingredients available).
These points illustrate the utility in distinguishing between modern and early modern medical “institutions,” where the former indicates a distinct and well-defined system, with specific rules and guidelines for how medicine may be practiced and by whom, whereas the latter refers more broadly to a loosely interrelated network of methods and practices, geographically and politically variant, and tied to power and status. For those in power, access to the newest trend in medicine, i.e. university-trained physicians, provided a novel means for the conspicuous consumption of wealth. As a result, it is during this period that we see a shift in the way in which medical authority was understood and conveyed, and the re-imagining of a distinct medical institution removed from the public sphere, within the exclusive purview of the social and intellectual elite. While early modern medicine was a social institution, it was not institutionalized in the modern sense, and should convey a somewhat fluid and composite system, rather than the more-or-less neat and categorical one we know today.
3Issues of social class come to the forefront here. We recall that the pre-modern world operated within a market-based treatment
model, where medical expertise was provided at a premium, and occurred within a particular, rarified and elite context. Altho ugh different forms of sanitorium existed at the time, they were largely purposed for the segregation of socially unacceptable persons (lepers, for example), rather than in the interest of public health. To address the practical and moral/ethical (i.e. theolog ical) issues presented in providing medical care to suffering members of the indigent class, the sixteenth century developed new forms of philanthropy and founded religious confraternities, such as the Companies of Divine Love, dedicated to social redemption and salvation through charitable acts (Arrizabalaga et al. 153).
Beginning around 1530, and continuing through the end of the century, the chronic wasting nature of French Pox and its high visibility and prevalence across all strata of society contributed to the formation of hospitals for the incurables (spedali degli incurabili) throughout the Italian peninsula. These institutions emerged in urban centers, where the afflicted among the urban poor – the largest and most visible social group – blighted the social landscape. The connection between pox and the poor became institutionalized as:
[t]he very founding of these institutions to deal with this specific threat led to growing public awareness and to a sharper definition of the problem. Now [that] the threat of Mal Francese […] had come to be institutionalized, its victims could be isolated temporarily from society. (170)
By the middle of the sixteenth century, French Pox had come “to be seen as the incurable disease [once leprosy’s dubious honor]” (ibid).
For more on the influence of early syphilis on the development of modern public health and the modern hospital, see Arrizabalaga et al., especially chapters 7 and 8.
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In her work on sixteenth-century physician and polymath, Girolamo Cardano, Nancy Siraisi employs the term “Renaissance medicine” as a strictly temporal/chronological grouping, rather than one intended to signify “its characteristic features.” She writes:
For Italy, at any rate, the term "Renaissance medicine" certainly should not be read to imply a complete rupture, either intellectual or organizational, with the preceding period; yet the sixteenth- century practitioner functioned in a very different cultural and social world from that of his
fourteenth- or fifteenth-century predecessor. (The Clock and the Mirror 3, 4)
From the identification of French Pox in the late fifteenth century, until the early seventeenth century, western medicine had become unsettled and destabilized, clearing the way for new modes of thinking and performing (what would later become) science. At a point of liminal reckoning, the sixteenth-century medical practitioner – whether they be a lay, “learned,” or occult healer – operated in an untested social and cultural context characterized by the commingling of novelty (French Pox, etc.) and continuity (established models and Greco-Arabic sources of authority, etc.).4
Shifting away from a unifying understanding of Renaissance medicine, opens the door to new ways of considering individual texts and authors (whether medical or aesthetic) from the period. To this end, Siraisi does not equivocate:
At this point, to attempt a general definition of "Renaissance" scientific culture in medicine and related fields is perhaps not very useful. It appears more profitable to examine how physicians actually deployed the intellectual resources available to them in the context of specific social and professional pressures. (4 – emphasis my own)
Contemporary texts dealing with medical subject matter, such as the French Pox, can then be examined as projections of the individual contexts in which they were produced – revealing the latent influence of underlying ideological forces. Whether aesthetic, political, theological or philosophical (to the modern mind),5 sixteenth-century medical writings “hold up a mirror—sometimes, to be sure, a distorting mirror—
to many aspects of a complex medical world” (ibid) and allow present-day scholars to peer deeper into the sixteenth-century cosmos, approaching a closer sense of the historical moment and a more accurate reading of its traces.
4The blending of old and new – novelty and continuity – is a characteristic that overlaps with the genre of the Epic Poem, and is
further explored under the section subheading, “The Epic Significance of Form.”As we see with medical literature and theorizing at the time, the Epic Poem is an excellent source for exploring the latent expression of various ideologies through the
inclusion/exclusion and adoption/adaptation of established models.
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With the reckoning that Renaissance medicine was a composite system, rather than a codified “institution,” it is the seventeenth century, that Michel Foucault identifies as the critical turning point in the evolution of the “institution” – in form and function – in western society. As others have pointed out as well, this development can be tied directly to changing cultural perceptions of madness and affliction, and to early public health initiatives resulting in the first hospitals. Having originated in the expulsion and displacement of lepers following the Crusades (not only a Holy War, but an event of cultural – and perhaps pathological – transmission which is thought to have been the source for leprosy in Western Europe), and carried forward in the social exclusion of persons suffering from illness or madness, it is in the seventeenth century that the early-modern hospital emerges.
From exclusion/expulsion of the critically sick, to their confinement/concealment and eventual quarantine, the “hospital” as a place for the restoration of health only comes into being after the close of the Renaissance. In the dreamily poetic tone that Foucault has adopted for his text on delirium and the social history of mental “disorder,” the critic drives home the oneirically literal metaphor of the Ship of Fools (literal because these ships were a historical phenomenon of the late middle ages – the historical source for the popular imagery) as the holding place for society’s throwaways during the late medieval and early Renaissance. It is a transition which occurs on multiple levels, expressed by Foucault’s evocative admonition: “Behold it moored now, made fast among things and men. Retained and maintained. No longer a ship but a hospital” (35).
While Foucault’s work specifically focuses on mental disorder and its social and institutional consequences, his critical and literary deployment of the Ship of Fools provides a metaphor that is readily applied to sixteenth-century French Pox as well. We should recall, then, that the conceptual vessel with its characteristic cargo of the miserable and unwanted, is still far from solid land. Removed from the stable structures that might hold it in place, the problem – displaced and lacking a specific directional orientation from which to grasp it – persists.
Returning to our period, we find our Ship of Fools has not yet docked, and bobs uncertainly in the dense fog of misapprehension. Pox sufferers and lepers, the mad and the physically deformed – through literature and art we begin to see the castoffs of sixteenth-century society as the proverbial tip of the iceberg, beneath which something far more sinister and intractable lurks. Through Textual Healing the
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sixteenth century begins to re-order its ideological frameworks, attempting to gain authority and control over an unknown and unknowable adversary – epidemic and chronically wasting disease. We leave the port, now, and take our first foray into the literary restoration of physical health.
Syphilis: A Poem and A Concept
At the center of my discussion of the literary response to sixteenth-century French Pox is Girolamo Fracastoro’s epic poem, Syphilis Sive Morbus Gallicus (1530). In an 1842 edition to the poem, Filippo Scolari likens the work to the Aeneid, that heroic poem considered emblematic of the height of Roman cultural achievement, and describes the work as containing all of the taste and exceptionality characteristic to sixteenth-century science, literature and arts (Scolari 7).6 A hybrid text with an explicit
didactic function, the work provides a fictionalized etiology for French Pox, along with symptomology, prognosis and a description of treatments and remedies employed by contemporary physicians. Entirely foreign to medical literature of our own day, the poem occurs as an artistic medium adapted to the practical function of repairing a damaged intellectual framework. In this context, poetic invention is understood as the product of divine inspiration, thereby rendering the text “truthful” exposition and efficacious medicine (contrary to and despite the superabundance of elements of “fantasy,” so apparent for a modern readership).
The Epic Significance of Form
Fracastoro’s deployment of epic poetry as the means by which to provide an invented genesis for the new malady is both emblematic of the sixteenth-century affinity for the epic form, at the same time that it represents an important departure from associated literary tendencies. In his work, the poet
constructs a fictionalized history blending myth and legend with contemporary events and figures, in order to give form to a coherent concept of syphilis – an ideologically laden social construct with implicit and