Death and Dying in the Middle Ages (review)

Edelgard E. DuBruck and Barbara I. Gusick, eds. Death and Dying in the Middle Ages. Studies in the Humanities: Literature--Politics--Society, vol. 45. New York: Peter Lang, 1999. xi + 515 pp. Ill. $70.95.

Sweeping and simplified associations of the later Middle Ages with death, graphically reinforced by Johan Huizinga in the wake of World War I, persist in much historical discourse. Their dramatic appeal seems impervious to the accumulation and growing sophistication of studies on medieval mortality and mentalité, which are inventoried by Edelgard E. DuBruck in her introduction to this multidisciplinary collection of eighteen papers. Although most of the essays are based on religious and literary sources, the discussions cover a broad range. Some of the authors make noteworthy contributions to our understanding of attitudes and practices. Christine Guidera sheds light on hitherto overlooked--and indeed sparsely documented--activities in Beguine life, particularly caring for the sick, preparing corpses for burial, and escorting the dead to the cemetery. The preeminent authority on illuminated books of hours, Roger S. Wieck, surveys the iconography of the end of life that, often heralded by a physician performing uroscopy, proceeds from last rites to interment. In his examination of "Journeys to the Otherworld," Peter De Wilde cites several cases of persons who awoke from a coma, and whose stories seem detailed enough to have at least indirect medical relevance.

Of immediate interest to readers of the Bulletin is the subject of the opening article, "The Doctor and Death in the Middle Ages and Renaissance," by Yves Ferroul. The author touches on crucial issues, such as iatrogenic mortality, diagnostic certification, the concern with prognostication, and the treatment of desperate cases. The essay's usefulness, however, is greatly diminished by an idiosyncratic formulation of theses, blurred arguments, and unreliable citations. The first "theme," titled "the physician who provokes death," contains the insinuation ("we can . . . imagine," p. 33) that medieval practitioners knew "guidelines" for eliminating enemies and ending the misery of patients; the only evidence cited is an anecdote whose only intent, actually, was to compare surgery to torture. A second section, on distinguishing "the living from the dead," devotes an entire page to a different topic entirely--namely, the claim that the reality of cruentation (bleeding by a victim's corpse in the presence of the murderer) was "not doubted by the medieval doctor" (p. 39). Ferroul's conclusion, while justly underscoring the emergence of a "professional conscience," betrays a limited familiarity with the sources by deploring "the lack of theoretic reflection on the part of medieval doctors about the nature of death" (p. 46).

Uneven as they may be in quality, the essays share certain themes that should stimulate further thinking and inquiry. Macabre poetry about cadavers and putrefaction holds clues to medieval attitudes toward dissection, and even to notions of life. Dances of death contain stinging criticism of medical practitioners that warrants closer scrutiny. Lay lore as well as sermons leave no doubt that the physician's highly publicized obligation to send the patient to confession before treatment was not merely an ecclesiastical injunction, but a deeply ingrained cultural imperative, part of ars bene moriendi, "the art of dying well." While obviously fueled by the fear of eternal damnation, the recourse to confession was also inspired by the more earthly wish to die with peace of mind. In fact, hoping for a blissful hereafter clearly did not preclude longing for the moment of release. Another impression, conveyed by both secular and devotional literature, is that medieval people feared a sudden death more than anything else, with an intensity that can perhaps be contrasted with the modern abhorrence of lingering agony. On the whole, however, this volume suggests that the religious nature of so much documentation accounts for a disproportionate prominence of death and dying in our image of the Middle Ages.

Luke Demaitre
University of Virginia, Charlottesville

...