Historians have often derided the medical cures found in medieval texts as not effective and being just “mere placebo.” However, a new study points out that the ‘Placebo Effect’, being a real thing, could provide relief to patients, even in the Middle Ages. Moreover, medieval physicians understood how to help their patients achieve these benefits.
The study, “It Will Help Him Wonderfully”: Placebo and Meaning Responses in Early Medieval English Medicine,” by Rebecca Brackmann, appears in the latest issue of Speculum. Brackmann, an Associate Professor of English at Lincoln Memorial University, re-examined three texts from early medieval England: Bald’s Leechbook, Leechbook III, and the Old English Herbal, which give prescriptions for various ailments and health issues.
In recent years, medical experts have been looking into these medieval texts to see if the cures they offer can be of use in modern medicine. In 2015, researchers found that a remedy for eye infections could be useful in combatting the superbug MRSA. However, Brackmann was interested in how these texts were written in ways to promote a patient’s response to treatment.
A typical example from these texts would be this treatment involving the plant known as Betony. The Old English Herbal offers over two dozen remedies with this plant. One example states: “For stomach pain, take two coins’ weight of the same plant, boil gently in water, then give it warm to the person to drink. The stomach pain will diminish and be soothed, so that soon there will not be any pain.”
Many of the prescriptions in these works have language similar to this one, where it notes that the medicine will provide relief to the patient. They can range from “it will help him wonderfully” to “soon it is well.” Brackmann writes:
The compilers believed that these periodic reminders that remedies worked had a purpose in medical writing. To modern readers, however, these statements appear at first to be largely redundant. After all, surely the supposition of the medical texts is that their remedies work; otherwise, why write them? Nonetheless, the Old English and Latin medical texts repeatedly assert that the patient will soon improve, or maintain that salves or drinks are “good medicine.”
While various clinical studies have shown that the ‘Placebo Effect’ has been seen to have a somatic improvement in patients, this efficacy can depend on a number of factors, including an expectation that the cure will help them. Being able to talk with your physician and have them understand your pains or illness can even help alleviate symptoms.
While medieval physicians may not have heard of the term ‘Placebo Effect’, these texts point to ways they understood the importance of making their patients feel that they are getting better. Brackmann explains:
From the patient’s perspective, an early medieval physician telling his or her patient, “You’ve got an excess of bad humors in your stomach,” and proposing a course of dietary adjustments and herbal drinks, would be no less meaningful than the twenty-first-century doctor telling his or her patient, “You have acid reflux,” and prescribing a course of dietary adjustments and a proton-pump inhibitor. Texts remaining from early medieval England indicate that some professional healers were aware of the therapeutic value of disease explanations. Again, we need not assume these doctors knew exactly how such statements worked, only grant that the doctors could have been observant enough to notice that they did. In any case, the texts contain, and probably the physician conveyed, enough of a structural understanding of the body to help articulate and give meaning to somatic experiences, and thereby augment therapeutic interventions. Patient-physician encounters, then, as we glimpse them in the Old English medical texts, followed several patterns that probably would have enhanced meaning and therefore somatic response from the sufferer.
It would not just be with words that physicians could encourage this. Medieval people perhaps saw some colours as having more efficacy than others. In Leechbook III, for example, when dealing with head pain, the text advises they wrap their head with a red bandage. While the choice of such a colour could not seemingly make a difference, perhaps at an unconscious level the patient believed that red would work better, just “as modern American patients “know” that red pills work better than white ones for pain.”
Some of the prescriptions offered in these early medieval texts are very detailed, having the patient do and say things. Leechbook III offers this remedy:
For pain in the stomach and abdominal pain. When you see a dung beetle in the ground throwing [dirt], grasp him with both hands along with his flung-up [dirt], wave with your hands vehemently and say three times, “Remedium facio ad ventris dolorum.” Then throw the beetle over your back on the road. Be careful not to look after it. When a man’s stomach or abdomen has pain, grasp the stomach with your hands; it will soon be well with him. You can do this for twelve months after [you have caught] the beetle.
While a modern reader could just think that is just some kind of ‘magic’ being talked about, one can also see it as a way for the patient to do something complex to help themselves – the very act, if the patient believes that it can help them, can lead to a meaningful response in their wellbeing.
Brackman’s research focuses only on medical texts from early medieval England, but she notes that similar wording can be seen in the works from other cultures around the medieval world. She encourages other researchers to make use of this study as a model to further understand how medicine worked in the Middle Ages
“I found Rebecca Brackmann’s article very appealing in that it took early English medicine on its own terms and showed that the efficacy of medieval medicine–like modern medicine–may have been activated by the “meaning response” (or placebo effect) as much as anything else,” comments Katherine L. Jansen, editor of Speculum. ”I think her use of modern “meaning response” theory helps us to see medieval medicine in a new more positive light.”
Rebecca Brackmann’s article “It Will Help Him Wonderfully”: Placebo and Meaning Responses in Early Medieval English Medicine,” appears in Speculum: A Journal of Medieval Studies, Vol: 97:4. The article can be accessed through the University of Chicago Press.
Top Image: A 13th-century image of a medieval physician with a scroll. British Library MS Harley 1585 fol. 13r