Meeting “reinvented our understanding of medical manuscripts” in the High Middle Ages

An international team of medieval scholars from the United States, Australia, the Netherlands, Finland, Germany, and Canada have made several important discoveries related to medical texts during a meeting held at the National Humanities Center in North Carolina. The gathering, entitled “Excavating Medicine in a Digital Age: Paleography and the Medical Book in the Twelfth-Century Renaissance,” examined the evidence for medical thought and writing in late eleventh– and twelfth–century Europe.

The meeting, which was held from September 30th to October  3rd, was organized by Monica Green, professor of history at Arizona State University, and Eliza Glaze, associate professor of history at Coastal Carolina University. They and their colleagues have successfully dated and localized more precisely dozens of landmark manuscripts preserving eleventh– and twelfth–century medicine. One key was to combine the skills of historians with those of paleographers, specialized scholars who study the history of book hands and the production of manuscript books. The other was to use the new digital technologies of image production and transfer to bring together a large enough set of data (more than 450 medical manuscripts of the period survive) to allow systematic comparison of a wide body of material manuscript evidence.


The late 11th and 12th centuries were a pivotal moment in the history of Western medicine: the point when learned medical practitioners in Europe first began systematically to retrieve earlier Greek writings on medicine and to adopt the sophisticated medical theories and practices from the Islamic world. This period laid the foundations for what would become scientific medicine in the West.

That this transition happened has long been known. But its precise details—explaining which texts were most important, and which ones circulated where—have been opaque to scholars for one principal reason. Almost none of the hundreds of manuscripts of medicine that survive from this period are dated.


The combined skills of the researchers allowed the group, over a three-day period, to:

  • document the extraordinary investment that scribes, practitioners, and patrons made, beginning in the eleventh century, to organize the inherited corpus of information on practical medicine and pharmaceutics; that process, in turn, allowed the quick adoption in the twelfth century of “new” elements of Arabic medical practices and pharmaceutical substances, like sugar, tamarind, and other spices imported into the Mediterranean
  • trace the incredibly rapid spread of new works on medicine from southern Italy, where they were composed or translated, all the way to monastic and cathedral centers in England
  • identify the oldest known copy of the Pantegni, a major medical work by the tenth-century Persian writer al-Majusi, which was translated into Latin before the year 1085 by a North African merchant-turned-monk, Constantine the African; indeed, the team came to the conclusion that this manuscript seems to have been produced at the Abbey of Monte Cassino under Constantine the African’s direct supervision
  • examine another copy of the Pantegni held at the Duke University Medical Center and determine that it was in fact 100 years older than previously estimated; this means the Duke manuscript is now a very important early witness to this tremendously influential text.

As the weekend wrapped up, one participant, Outi Merisalo, professor of Romance philology at the University of Jyväskylä, Finland, asserted that the group’s approach has “reinvented our understanding of medical manuscripts.” Consuelo Dutschke, a cofounder of Digital Scriptorium who joined the team from Columbia University, said “It’s astonishing at this point in my career to be a student again.” “I am speechless . . . this is just wonderful,” noted Francis Newton, emeritus professor of classics at Duke University, and the world’s leading authority on the manuscripts of Monte Cassino from this period. “The archive of high-quality digital images the group assembled in advance, studied individually, and then assessed collectively here at the Center is a tremendous resource that truly demands a more public airing. I look forward to seeing the publications to follow,” claims Glaze.

Another participant, Alison Beach, professor of medieval studies at the University of Cologne, said to,  “The medical historians had identified key manuscripts critical to the spread and development of medical science in the Latin West. For the paleographers, these manuscripts were puzzles to solve! Where were they made? Was it possible that some were produced in the eleventh century? Could a translation of a key text really have made it that quickly into a manuscript copied in France, England, or even Germany? It was exciting for all of us to see how many of these puzzles we could ‘solve’ working together. Paleographers don’t often get to see colleagues get so excited about our opinions regarding scribal identity, date, and provenance! It was rewarding to be reminded of how important the art-science of paleography is. Because the organizers had done a great job of circulating (via Blackboard) background readings, the paleographers had a good and growing sense of the significance of some of our findings. The ‘conversation’ was one of the most exciting intellectual experiences of my career.”

This gathering was part of the National Humanities Center’s “Conversations and Symposia” initiative, a new funding program to allow former fellows of the Center to re-engage with the intellectual life of the Center and launch new research projects that require collaborative thinking. Green, an NHC fellow in 1996-97, and Glaze, an NHC fellow in 2010-11, are the first two recipients of this support, which totaled $10,500. “This impressively erudite group brought the passion for learning we hoped this new program would attract,” said Kent Mullikin, deputy director of the Center.

Professor Beach, who is interested in the practice of the medical arts in women’s religious communities, said she “got involved in the project when a few of my students in Cologne got excited about a text that we read in one of my courses: Monica Green’s work on the Trotula.  I got in touch with Monica with a few student questions, and before I knew it, I was drawn into the whole topic. Because I live in Germany, I was able to do two on-site manuscript examinations for the group in preparation for the meeting at the National Humanities Center.”


Other scholars who attended the “Excavating Medicine” gathering included Consuelo Wager Dutschke, curator of medieval and Renaissance manuscripts, Columbia University, and cofounder of Digital Scriptorium; Nicholas Everett, associate professor of history and religion, University of Toronto; Jean Givens, professor of art history, University of Connecticut; Erik Kwakkel, lecturer in medieval studies and paleography from the Institute for Cultural Disciplines, University of Leiden (who joined the group via teleconferencing); Francis Newton, emeritus professor of classics, Duke University; Michael McVaugh, emeritus professor of history at the University of North Carolina at Chapel Hill; Outi Merisalo, professor of Romance philology at the University of Jyväskylä, Finland, and maître de conférences in Latin and Romance philology at the University of Helsinki; and Rodney Thomson, emeritus professor of history, School of History and Classics, University of Tasmania.

Green notes that she now knows how the geologists and archaeologists of the 1940s felt when carbon-14 dating was first discovered: having a method to situate major historical developments in time and place radically transforms our knowledge. “We have known far too little of this critical period when Arabic, Greek, and Latin thinking fused in extraordinarily productive ways. Our new digital age is an excellent moment to revisit this period and attempt to understand what happens when cultural traditions intersect. Our field has been propelled fifty years forward in one short weekend.”

For further information: some of the manuscripts discussed at the “Excavating Medicine” gathering are already available to the public online, including:


a beautifully illustrated herbal from England at the end of the eleventh century,

also, from the twelfth century, an herbal and bestiary written either in the southern Low Countries or England,

and another herbal from the late twelfth century,

Sources: National Humanities Center, Arizona State University, Carolina Live