Disease and Illness in Medieval Ireland
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Disease and Illness in Medieval Ireland Submitted in fulfilment of Ph D degree Supervisors: Dr Abdullahi El-Tom Dr Séamas Ó Siocháin Department of Anthropology at The National University of Ireland: Maynooth Ciara Crawford June 2011 1 Front Page 1 Table of Contents 2 Dedication 3 Acknowledgements 4 Summary 6 Chapter 1 Introduction 7 Chapter 2 Early Irish Society 24 Chapter 3 Methodology 58 Chapter 4 Anthropological Literature Review 101 Chapter 5 Hagiography 147 Chapter 6 The Annals 188 Chapter 7 The Law Texts 231 Chapter 8 Conclusion 279 Appendix: Glossary of Terms 305 Bibliography 309 I declare that the thesis presented here is my original work and has not been submitted to any other institution. ………………………………………... Ciara Crawford. 2 A Jordan Lena Chéile a Thógtar na Caisleáin 3 Acknowledgements Firstly, I must acknowledge my academic supervisors, Dr Abdullahi El- Tom and Dr Séamas Ó Síocháin; Abdullahi for giving me the opportunity, encouragement, friendship and support, Séamas for your patience, insight and guidance; I owe a debt of thanks and appreciation. My thanks to Carmel Crawford, my mother, and the person who provided never-ending encouragement and support throughout this journey; your love and support provided strength in my heart. I offer my thanks to my brother Gary Crawford who offered continual practical support and understanding; this holds a place in my heart also. A special thanks to Peter Conlon, for both your endurance and sustained patience; this was very much appreciated. Jordan, my son, who took this journey with me, I cannot find the words to express my gratitude and love for you; I dedicate this thesis to you. My many thanks to other extended family and relatives who have contributed to this journey; I cannot express my appreciation enough for allowing this to be possible. 4 To all my friends, you know who you are; I reserve a special word of thanks. Thank you for your encouragement, support (practical and otherwise), time, many cups of tea, and for the many hours of listening; I am extremely grateful. A final word of thanks to those who have indirectly given their help and support in little ways, and may not be aware; I would like to take this opportunity to offer thanks. Go raibh míle maith agaibh go léir. 5 SUMMARY This thesis explores various aspects of the medical system, and illness/disease for the medieval period (5th-12th centuries) in Ireland. On examining three archival source-types (hagiographical material, annals, medico-legal law texts), it became clear that there were different perspectives on health and healing for this period. Two distinguishing models came to light, a „Christian (religious) explanatory model‟ and a „Naturalistic Model‟. The former model centered mainly on the hagiographical material and elements related to Christian doctrine; however, aspects of this model were found in the annals also. The latter model was to be found in the annals and medico-legal law texts; both sources provided naturalistic aspects in relation to cause, cure/treatment and the legalities of illness and injury. The anthropological literature acted as a valuable interpretative tool when addressing these models and the processes of healing which took place. For example, the hagiographical material contained much religious symbolism in relation to illness causation and healing; the annals displayed symptomatic, prophylactic and naturalistic elements related to cause of illness; the medico-legal texts contained naturalistic aspects also; however, they came from a different perspective, they centred on the legalities of the medical system and took an empirical approach to cure. This thesis aims to convey how these two models, which were composed of three perspectives, when combined provided a picture of the health care system in medieval Ireland. These sources individually outline a range of illnesses, injuries and plagues; they also demonstrate the existence of healers. The anthropological literature has enabled this system to be placed in a particular cultural context; it has allowed us to see a medical system which was composed of different parts, yet function and act as one system. A second and no less important element of this thesis is the connection that is conveyed between the medical system and other institutions in society; the medical system acted as a window into the entire order of society. 6 Chapter 1 Introduction The topic of this thesis is „disease and illness in medieval Ireland‟. Before I proceed, it is important that I clarify specific elements reflected in the title of this thesis. Let us begin with the two terms „illness‟ and „disease‟. There have been many definitions given and distinctions made between these two terms; however, it is easy to get lost in the semantics of these words. Nonetheless, I will briefly outline some definitions given to these two terms by various authors. Following this, I will provide a common-sense interpretation of these terms in relation to the context of this thesis. Emson (1987) points to Jennings‟s interpretations of these two terms; Jennings stated that “illness is experience and that only disease can be investigated by the methods of biomedicine” (Jennings quoted in Emson 1987: 812). Johnson and Sargent (1990) tell us that the concept of culture has led to a generally accepted distinction between disease and illness. Illness refers to the culturally defined feelings and perceptions of physical and/or mental ailment and disability in the minds of people in specific communities. Disease is the formally thought definition of physical and mental pathology from the point of view of the medical profession (Johnson and Sargent 1990: 275). Kleinman (1988) sees „illness‟ as the way in which the sick person and the members of the family or wider social network perceive, live with, and respond to symptoms and disability. He invokes the term „Illness‟ to conjure up the human experience of illness and suffering. He sees it as the lived experience of monitoring bodily processes. Kleinman points out that the illness experience includes categorising and explaining, in common-sense ways accessible to all lay persons in the social group, the forms of distress caused by those 7 pathophysiological processes. In Kleinman‟s view, illness behaviour consists of initiating treatment and deciding when to seek care from professionals or alternative practitioners. Kleinman interprets „disease‟ as being a health problem interpreted within a particular nomenclature and taxonomy; he sees the doctor or practitioner interpreting the health problem within a particular nomenclature and taxonomy, a disease nosology that creates a new diagnostic entity, an “it”-the disease (Kleinman 1988: 3-5). I have applied the terms „illness‟ and „disease‟ interchangeably and concurrently many times throughout this thesis; I have done so for two reasons: (1) It was impossible to elucidate the patient perspective on these two terms, I did not have the luxury of observing first-hand usage of these two terms; also, I did not have the opportunity of conducting a qualitative investigation. As such, it is impossible to know how these two terms may have been interpreted or understood. My fieldwork is archival, it belongs to a specific historical period and social context; if I were to provide specific definitions for these terms, I risk being culturally insensitive to both their value and meanings; (2) the three source-types which I have used as part of my research are written in Old Irish, Latin and a combination of both. In looking at these sources, I have noticed that there is an overlap of meaning amongst some of these terms. For example, the Old Irish term galar translates as „sickness, disease, physical pain‟ (Dictionary of the Irish Language, DIL hereafter); the term teidm translates as „disease, sickness, pestilence‟, also „a fit, or attack of illness or anger‟, or „affliction‟ (DIL). The term esláinte is a variant of eslán and translates as „unsoundness, disease, illness‟ (DIL). Another term is trebhlaid which is a variant of the word treblait; this translates as „tribulation, illness, suffering‟. As we can see, these 8 varying meanings create confusion where the illness-disease distinction is concerned; for this reason I have applied both. The important thing to remember is that both states are undesirable; they cause discomfort, pain and interfere with a state of well-being. Reference to „Medieval Ireland‟ in this context, refers to the period of time dating from the 5th century through to the 12th century. Nevertheless, a more accurate dating of these individual sources and the occurrence of illness and disease found therein is possible. I address the issue of dating in chapter 3 „Methodology‟. I chose to research this area initially as (1) I was interested to find out what the prevalent illnesses and diseases were in medieval Ireland for this period; also, I wondered what kind of medical treatment was available, (2) I looked to unearth the connections between this medical system and wider society of this time, and what information was reflected through it, if any, and (3) I wanted to place this system in an anthropological context. The written evidence for this period, let alone medical manuscripts containing this information, was scant. Literacy was newly acquired at the beginning of this period, with few people having access to these skills; writing was initially confined to the clergy or the elite of society; it was up to these people to record this body of information. They did record this information, but unfortunately it did not survive in its entirety down through the centuries. Nevertheless, on examining the literature closely, I did find a comprehensive body of information, in fact too much for one thesis. After scrutinising this information, I chose to use three different archival sources; these were not all 9 medical manuscripts, but they all provided information on different aspects of illness and healing for this period.