The Art of Healing: Painting for the Sick and the Sinner in a Medieval Town (review)

Marcia Kupfer is an art historian, and her subject is a cycle of frescoes executed around 1200 in the crypt of the Romanesque collegiate church of Saint-Aignan-sur-Cher in north-central France. Nonetheless, her book is important to historians of medieval medicine, because it illustrates how disease experiences and ideas about healing were structured by Christian ritual and religious imagery. Kupfer highlights the dynamic and contested nature of these interactions, their local character, their social implications, and their cultural embeddedness. The result is a practical demonstration of how scholars of medieval medicine can, and should, go beyond rigid dichotomies of "sacred" versus "secular" healing, or "natural" versus "spiritual" disease.

The central image in the crypt shows Christ delivering to St. James a scroll inscribed with a verse from his Epistle, "Confess your sins" (James 5:16)—a phrase lifted from a longer passage advising the sick to seek anointing at the hands of the church, and to confess their sins. At the bottom of the scene, pilgrims approach the saints with supplication and offerings, while a cripple drags himself along with the aid of hand-crutches. This linking of penance, pilgrimage, almsgiving, and healing is played out in the other two scenes. One contains episodes from the life of St. Giles, including his healing miracles, and the mass through which he obtained pardon for Charlemagne's secret sin. The other shows scenes from the lives of Mary Magdalen, her sister Martha, and her brother Lazarus. Lazarus is raised from the dead; Martha becomes the "woman with the issue of blood" healed by Jesus; Mary anoints Christ's feet in the house of Simon the Leper.

Kupfer's exegesis of these images moves along two lines. First, she shows how the Church of Saint-Aignan functioned as the "mother church" within a landscape thickly strewn with chapels and hospitals dedicated to the saints depicted in the crypt. A nearby leprosarium was consecrated to Lazarus, and the town's maison-dieu for travelers and the disabled poor was consecrated to Saints Giles and Lupus. In the neighboring village of Noyers was a porticus (shelter) for sufferers from the "disease of St. Silvanus," modeled on the saint's principal cult site at Levroux. Kupfer argues persuasively that this "disease" was ergotism (ignis sacer or mal des ardents), an ailment with a profound symbolic charge, since it entailed destruction of the flesh (erysipelas, gangrene), loss of mobility (spontaneous amputation, muscle spasms), and neurological damage (convulsions). She posits that the symbolism of ignis sacer underpinned many of the dedications of chapels and hospitals in Saint-Aignan: St. Lawrence protected against gangrenous ergotism; St. Andrew against the convulsive type; St. Lupus healed seizures, as well as ulcerative erysipelas; and St. Giles, like Lazarus, was the patron of lepers, also victims of a mutilating disease. Second, the iconographic program of the crypt announced the clergy's claim to control these diffused locations of healing. In part, this control was juridical, administrative, pastoral, and financial; but it was also driven by the church's larger goal of identifying physical healing with sacramental penance, and vice versa.

It is difficult in this brief review to summarize the richness of Kupfer's argument, or its many illuminating observations. Two, however, deserve special mention. The account of how the canons of Levroux, impresarios of St. Silvanus, prosecuted the wife of André de Breuil for treating "their" disease, is the centerpiece of a careful analysis of the competition between clergy and women in the labile zone of "healing." The discussion of changing attitudes to leprosy is cautious and nuanced. The book's weaknesses (e.g., some misreadings of medieval medical theory) are minor; its harvest of insights and its value as a model are great.