Lovesickness in The Middle Ages - Mary Frances Wack

PART ONE
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Lovesickness
in the Middle Ages
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§§ 1 §§
PATHOLOGY A N D PASSION
Lovesickness in Antiquity and the
Early Middle Ages
Passionate love . . . [is] a fragile crest where death and regeneration

vie for dominance.
Julia Kristeva'
A s antiquity gave way to the Middle Ages, an unknown poet in fifth-

century Vandal Africa told the story o f a young man named Perdica. Sent
to study in Athens as a boy, Perdica made offerings to all the gods except
Venus and Cupid when, years later, he set out for home. T h e journey
was exhausting, and he and his companions turned off the road into a
shady grove cooled by a stream to rest during the midday heat. After
they had eaten, Perdica fell asleep. Piqued, the neglected Cupid pierced
"the youth's breast with a savage dart." With that an image appeared to
Perdica in a dream; he fell in love with it. T h e next day, as he crossed
the threshold o f home, he saw in the figure who greeted him the woman
o f his dreams—his mother.
Perdica spent that night tormented by incestuous desire. Unable to
sleep, fearful, racked with sighs, he begged Love for peace. Should he
reveal his love to his mother? Oedipus at least had entered his mother's
bed unknowingly. B y daybreak his limbs were weakened, and he refused
food. His worried mother called in the city's physicians, but they could
find nothing. The oldest and most experienced o f them, Hippocrates,
was also puzzled by the symptoms. Yet he too found no physical cause
for Perdica's malady. But as he took the youth's pulse, his mother entered
the room. His pulse, which had been slow and regular, suddenly raced;
Hippocrates had discovered Perdica's secret. " T h e cause is near, mother;
the gifts o f medicine reach an end. Here there is suffering o f the mind; I
am useless. May the gods grant the rest." With that Hippocrates relin-
quished the case.
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Figure 1.1. B r o n z e statuette o f an emaciateci m a n ( R o m a n , 1st c. C . E . ) . " P e r d i k " is
inscribed o n t h e b o t t o m o f the r o b e , b e t w e e n t h e legs. T h e left w r i s t is held u p f o r
t h e physician t o check t h e pulse. B y z a n t i n e Visual Resources, © 1988, D u m b a r t o n
O a k s , W a s h i n g t o n , D . C . (47.22).

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Pathology and Passion § 5
T h e m o t h e r ' s a t t e m p t s to c o m f o r t her son w e r e in vain; t o r n b y love

and shame, he sickened even f u r t h e r . Pallor suffused his body. H i s e m a -
ciation progressed so far that his eyes w e r e hollow, his n o s e s t o o d o u t
sharply, his wasted a r m s revealed their t e n d o n s , and his ribs p r o t r u d e d
(Figure 1.1). Searching for a quicker way t o die than this s l o w w a s t i n g ,
he resolved on death b y h a n g i n g .
T h e m i n i a t u r e epic entitled Perdica's Malady (Aegritudo Perdicae) at once
chronicles the youth's fatal passion f o r his m o t h e r and e p i t o m i z e s a n u m b e r
of t h e m e s implicit in the lover's m a l a d y in t h e E u r o p e a n M i d d l e A g e s . 2 At
the r o o t of lovesickness lies an unfulfilled, s o m e t i m e s u n s p e a k a b l e desire
that m a y be incestuous o r o t h e r w i s e socially unacceptable. Yet t h e m i n d a n d
b o d y are such close partners that bodily s y m p t o m s reveal w h a t the patient
represses. Sighing, sleeplessness, and w a s t i n g f r o m refusal to eat betray t h e
mind's effort to master its o v e r w h e l m i n g passion. T h e clever physician can
interpret these signs and penetrate to the cause of the malady. Medicine,
h o w e v e r , treats the b o d y , a c o m m i x t u r e of elements. Its remedies c a n n o t
transgress so far against social n o r m s as t o prescribe incestuous love.
Ancient literature and medicine agreed in their descriptions, if n o t their
evaluations, of eros experienced as illness. 3 Like o t h e r aspects of classical
culture, t h e concept of an erotic m a l a d y passed into the E u r o p e a n M i d d l e
Ages, b u t it did so by a d o u b l e r o u t e . A f e w G r e e k medical w o r k s s u r v i v e d
the cultural b r e a k u p o f the R o m a n e m p i r e to be translated i n t o Latin, read,
and recopied in E u r o p e b e t w e e n the sixth and eleventh centuries. T h o u g h
these texts were carefully preserved b y t h e efforts o f m o n a s t i c scribes, they
did n o t generate f u r t h e r medical discussion in the West on the lover's
malady. In contrast, a greater n u m b e r of Greek medical w o r k s was t r a n s -
lated into Arabic and stimulated extensive discussion o f t h e disease o f love
in A r a b i c medicine. W h e n the e l e v e n t h - c e n t u r y African m e r c h a n t C o n s t a n -
tine shipped a c a r g o of Arabic medical w o r k s to Italy, he b r o u g h t w i t h h i m
a richer stock o f medical ideas a b o u t love than w e r e h i t h e r t o available. T h e
first part o f this chapter surveys ancient and B y z a n t i n e discussions of love-
sickness that w e r e available in the West b e f o r e C o n s t a n t i n e ' s arrival in o r d e r
to s h o w that the Viaticum's teaching o n lovesickness represented a n e w ,
fuller way of conceptualizing the lover's m a l a d y and of i n t e r p r e t i n g a n d c o n -
trolling erotic behavior. 4
Medical views of love w e r e n o t the o n l y source, h o w e v e r , of t h e E u -
ropean u n d e r s t a n d i n g of lovesickness. Ideas a b o u t passionate love f r o m t h e
Bible and Biblical c o m m e n t a r y , and f r o m classical and vernacular literature
f o r m e d a " h o r i z o n of e x p e c t a t i o n s " for C o n s t a n t i n e ' s first readers. T h e f o l -
l o w i n g sections o f the chapter trace the representations of lovesickness
t h r o u g h these sources in o r d e r to account f o r the eager reception given to
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6 § Lovesickness in the Middle Ages
the Viaticum's chapter on love. The Biblical notion of "love languor" and
stories that recounted episodes of lovesickness, such as those of A m n o n and
Thamar, and Antiochus and Stratonice, helped prepare the way for the
medical doctrines of passionate love reintroduced in the eleventh and twelfth
centuries.
Although some of the texts discussed below have been studied by spe-
cialists in the history of lovesickness, to m y knowledge no one has yet
examined the ensemble to explain w h y Christian Europe was able to incor-
porate Greco-Roman and Arabic doctrines on the lover's malady and its
cures into high medieval culture. N o r have these sources been fully explored
for what they can tell us about the social and interpersonal relationships
underlying pathological love, about the lived experience behind the doctors'
dispassionate prose. 5
Medical Texts of Antiquity

Despite the encomiums to Eros in Plato's Symposium, the Greeks and
Romans mistrusted passionate love. Cultural ideals of rationality and self-
control were threatened by erotic love, which overthrew reasonable gover-
nance of the body and the mind and challenged the basic structures of
society. The poetry of Sappho and Ovid describes love's physical and psy-
chological disruptions, while the tragic stories of Medea, Hippolytus, and
Phaedra dramatize the threat love poses to social order. " W h e n desire is
doubled it becomes love; when love is doubled it turns into madness." T h e
Greek saying characterizes love intensified beyond proper measure as a f o r m
of madness. 6 It was the madness of love that drove Sappho to leap to her
death, and love that robbed Lucretius of reason—so, at least, went the
legends.
Ancient medicine, however, offers little systematic discussion of love,
and what there is comes relatively late. 7 N o t until the fourth century of the
c o m m o n era does love appear as a separate classification of mental disease.
Before then it is associated with mania, melancholy, phrenesis (frenzy), and
other mental illnesses. Nonetheless, the ancient tradition is important for
the lover's malady in the Middle Ages for several reasons. In Arabic and
European medical works f r o m the eleventh century onwards, lovesickness
remained associated with melancholy and mania, either as a subtype of the
former, or as a precursor to both conditions. Chaucer's Arcite, for example,
fares in his changeable moods " N a t oonly lik the loveris maladye / O f her-
eos, but rather lyk manye, / Engendred of h u m o u r malencolik." 8 In addi-
tion, the symptoms and therapies for lovesickness were largely drawn f r o m
ancient recommendations for mania and melancholy.
Moreover, mania and melancholy
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lematic that w e have seen in Perdica's Malady and that resurfaced in t h e

Christian M i d d l e Ages. M a n i a and m e l a n c h o l y pose f u n d a m e n t a l q u e s t i o n s
a b o u t t h e relations of soul and b o d y and a b o u t the d o m a i n s o f medicine a n d
ethics. T h e s e maladies, w h i c h affect b o d y and soul alike, w e r e the foci f o r
medical and philosophical discussion of "diseases of the s o u l . " C a n there
be, p r o p e r l y speaking, any such thing, o r are diseases o n l y o f the b o d y ?
W h a t is t h e role of m o r a l suasion o r logotherapy, the ancient c o u n t e r p a r t to
Freud's " t a l k i n g c u r e , " in c u r i n g a patient o f t h e fixed ideas o r o f the " p r o -
f o u n d a n g e r " of melancholy? W h a t is the patient's responsibility f o r d i s o r -
ders of his soul? W h a t can t h e physician treat, and w h a t m u s t he cede t o the
m o r a l philosopher?
Ancient writers gave a variety o f answers to these questions, as can be
seen in the detailed recent studies of J. Pigeaud. 9 H i s conclusion, that ancient
medicine and p h i l o s o p h y defined their respective d o m a i n s of c o m p e t e n c e in
d y n a m i c interchange w i t h o n e a n o t h e r , f o r e s h a d o w s medieval d e v e l o p -
m e n t s . T h e disease of love, w h i c h afflicts b o t h t h e b o d y and the spirit of
a patient c a u g h t in a m a t r i x o f social and ethical relationships, lay in a cul-
tural zone intersected by the discourses of medicine, literature, natural
philosophy, m y s t i c i s m , pastoral theology, and didactic literature. When
Christian E u r o p e began to s t u d y the Aristotelianized science of Islam first
i n t r o d u c e d t h r o u g h C o n s t a n t i n e ' s medical translations, the b o u n d a r i e s of
medicine, p h i l o s o p h y , and n o w m o r a l t h e o l o g y had to be r e d r a w n . 1 0 In this
site o f contestation priest and physician vied f o r professional territory, a n d
that struggle left its m a r k o n medieval attitudes t o w a r d the lover's malady.
Lovesickness first b e c o m e s a significant part of medical tradition in t h e

w r i t i n g s o f Galen (ca. 1 3 0 - 2 0 0 ) . " His detailed accounts o f h i s medical p r a c -
tice in R o m e d o c u m e n t cases in w h i c h he detected love t h r o u g h its s y m p -
t o m s and cured those suffering f r o m this "passion of the s o u l . " T h e s e
descriptions were later codified b y B y z a n t i n e and A r a b i c medical w r i t e r s
b e f o r e being r e i n t r o d u c e d to Italy in the eleventh c e n t u r y b y C o n s t a n t i n e
the African. M o r e o v e r , Galen's l e n g t h y r e p o r t o f the lovesickness of J u s t u s '
w i f e gives us the earliest medical account of w o m a n ' s psychological and
somatic responses to love.
Galen's references to love (he has n o specialized t e r m f o r m o r b i d love)
suggest that its diagnosis and t r e a t m e n t were controversial in the medical
c o m m u n i t y o f his time. In a c o m m e n t a r y on H i p p o c r a t e s ' Prognostics,
w h i c h was translated into Latin by C o n s t a n t i n e the African f r o m an A r a b i c
version, Galen disputes the n o t i o n held by s o m e that love is a d i v i n e ill-
ness. 1 2 Rather, he argues, those w h o g r o w sick or pale, w h o are sleepless o r
fevered f r o m love, are stricken w i t h the h u m a n e m o t i o n of s o r r o w a n d n o t
b y a n y t h i n g divine. His clear distinction b eby
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views of lovesickness characterizes the medical tradition as a whole. T h a t

does n o t mean, however, that the Platonic inclination to view love b o r n of
the sight of beauty as a divine madness ceased to influence the d e v e l o p m e n t
of medical tradition, or failed to shape Islamic and Christian understandings
of passionate love. As w e shall see, the somatic perspective of medieval
physicians and the transcendent view of the theologians engaged each other
in varying ways t h r o u g h o u t the high and late Middle Ages.
Galen's appraisal of lovesickness steers a middle course between the
transcendent view of love as a divine illness held by his rivals and a crudely
somatic understanding of the malady. A c o m m e n t a r y on Hippocrates' Epi-
demics gives h i m the o p p o r t u n i t y to describe his treatment of the lovesick in
detail, and is w o r t h s u m m a r i z i n g at s o m e length:
I know men and women who burned in hot love. Depression and lack of
sleep overcame them. Then, one day, as a result of their love-sorrows they
became fevered. The physicians who were treating them sought to heal
their bodies by forbidding them to bathe, by ordering rest and a good
regimen. But as we took over their treatment and recognized that their
suffering consisted of love-sorrow, then we applied ourselves to their cure
without revealing to them, much less to others, what we had discovered.
We ordered them to take frequent baths, to drink wine, to ride, and to see
and hear everything pleasurable. Thus we directed their thoughts toward
these things. . . . For if continual love-sorrow oppresses someone, his con-
dition then assumes forms that are difficult to cure. For many it is also
good to stimulate anger over an injustice, or to rouse love of competing
and of achieving victory over another, according to the inclination of each
for a particular sport. . . . One must call forth excitement, wake joy in
competition, and counter the desire to quarrel and fight with others by
saying to them that these diversions will comfort and heal them. They
should imagine that the hounds and the hunt or the horses or the wrestling
boys or the quails or the cocks or other things that interest them and that
they love are their own. Preoccupation with such things is best for them.
After I had explored the conditions of many mentally ill people ("seelisch
Kranken") and healed them of their illnesses, so that they were completely
healthy again, my friends requested me to write a book containing the
prognoses I had learned to recognize in these patients.13
This account makes it clear that Galen classified love not as an affliction of
the body, as did his unsuccessful rivals, b u t as a passion of the soul. It should
be noted, however, that in Galenic medicine the operations of the soul are a
function of the body's h u m o r a l composition, so that his view of love is
ultimately somatic. 1 4 But even t h o u g h he codified Hippocratic h u m o r a l
theory into a f o r m that provided the basic f r a m e w o r k for Byzantine, A r a -
bic, and medieval European medicine, Galen does not specify the h u m o r a l
basis of lovesickness; that w o u l d be a medieval contribution to the disease.
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In addition to d e n y i n g that love is a divine illness or an affliction of the

body, Galen also rejects the existence of a characteristic "lover's p u l s e . " In a
story in the Prognostics, he recounts in circumstantial detail h o w he, like the
physician Erasistratos, diagnosed a case of m o r b i d love. 15 T h e w i f e of J u s t u s
( w h o may have been a senator or a wealthy R o m a n or Pergamene) suffered
f r o m insomnia w i t h o u t fever, and refused to answer the physician's ques-
tions. Galen decided that she was suffering either f r o m a melancholic d e -
pression o r f r o m a secret w o r r y . Further inquiry revealed that there was n o
bodily illness, and that her trouble was psychological. By means of the pulse
t e s t — n o t i n g under w h a t circumstances her pulse became disturbed and ir-
regular—Galen was able to detect her secret passion for the dancer Pylades.
Unfortunately, Galen o m i t s to tell w h a t cure he prescribed.
T h i s story has been t e r m e d "a great first in the history of m e d i c i n e "
because a woman suffers f r o m the sickness of love. 16 It is even m o r e n o t e -
w o r t h y because surviving sources indicate that it was a t h o u s a n d years
before the medical c o m m u n i t y again pursued the question of w o m e n ' s love-
sickness. N o literary persona such as Phaedra or Medea, she is a female
patient w h o requires Galen's diagnostic skill as m u c h as any m a n in the grip
of lovesickness. Gourevitch suggests that a w o m a n figures in Galen's story
because the gradual emancipation of w o m e n in R o m e granted t h e m a n e w
erotic equality: they could take the initiative in love. A l t h o u g h the a p p e a r -
ance in history of w o m a n as a loving subject is significant, Galen's story
points less to her emancipation than to its precariousness. T h o u g h Galen
gives n o explicit etiology, the narrative itself, in its emphasis o n the w o m -
an's embarrassment and secrecy, implies that a socially problematic relation-
ship is involved. In fact, it is d o u b l y problematic because it involves b o t h
the threat of female adultery and the crossing of very s t r o n g class barriers,
especially if her husband was of senatorial rank. 1 7 A liaison between a free-
b o r n w o m a n and a d a n c e r / p a n t o m i m e , w h o was p r o b a b l y either a f r e e d m a n
or a slave, was liable to legal penalties and was in any case disreputable. T h e
lovesickness of Justus' wife signifies that her erotic emancipation had n o t
g o n e so far that she could express her desire, which threatened domestic
and social order, w i t h o u t encoding it in somatic illness. H e r " l i b e r t y " to
suffer f r o m love expresses itself in the repressive f o r m of illness.
For Galen, then, love is n o t a distinct disease, but one of a n u m b e r of
psychological conditions that can powerfully affect the body. As s h o w n b y
the pulse story, e m b e d d e d in a w o r k on prognostics, his interest in love is
primarily semeiological and diagnostic. Love is a practical, n o t a theoretical
p r o b l e m . Indeed, his reports of curing patients of the lover's malady u n d e r -
score that it was a p r o b l e m that called for medical intervention.
T h o u g h physicians in the following centuries organized their remarks
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on love under a separate heading, implying its status as a distinct disease,

they offered no real advances over Galen. Oribasius' chapter on love, to-
gether with those of Caelius Aurelianus and Paul of Aegina, may be taken
as examples of the most sophisticated teaching on the disease of love avail-
able in Europe when Constantine arrived. Oribasius (326-403), physician
to Julian the Apostate, devotes a chapter to lovers in his medical compila-
tion, the Synopsis (or Conspectus ad Eustathum), but like Galen he offers no
specific etiology. 18 In the eighth book, on diseases of the nervous system,
he catalogues symptoms and cures that were to become standard items in
Islamic and European medical treatises for those " w h o are consumed by
love." T h e physician may recognize such patients because they are s o r r o w -
ful and suffer f r o m insomnia. Their eyes are hollow and they do not weep;
they are like those w h o are filled with toil. 19 Their eyelids move m o r e fre-
quently than any other part of the body.
Oribasius protests, as Galen did, against those physicians w h o fail to
recognize the nature of the malady, and w h o forbid the patients to take
therapeutic baths or w h o restrict their diets. Rather, the physician should
prescribe just the opposite: baths, wine, listening to amusing stories or
speeches, and striving against adversaries all have their use in curing lovers.
Although Oribasius, drawing upon the work of Rufus of Ephesus (b. after
50 C.E.), the greatest physician of the late Empire next to Galen, r e c o m -
mends therapeutic intercourse for melancholy, he fails to mention it in his
chapter on lovers. As we shall see, however, once this cure entered discourse
on morbid love, it became controversial and served as a test case for c o m -
peting professional and cultural values.
The Synopsis proved influential in both western and eastern medical
traditions. In the West, our concern here, it was translated into Latin twice
around the sixth century, and is preserved in a dozen or so early manuscripts
and fragments. 2 0 Given that some of the surviving manuscripts are in a
script used at Montecassino and surrounding areas in the eleventh century,
perhaps the incomparable library under Desiderius (abbot 1058-87) con-
tained an Oribasius manuscript that Constantine might have consulted. 21
In order to understand European developments of lovesickness after
Oribasius, we must briefly trace its course in the East. As we have seen,
there was no consensus in ancient medicine on love's nature or status as a
disease; Galen and Oribasius speak of lovers, not of a disease called "love."
Galen's works indicate that the medical c o m m u n i t y considered illness-
producing love to be related to both mania (the "divine madness" of Plato)
and melancholy. When Arabic physicians translated and synthesized ancient
and Byzantine medicine, they reorganized the discussions of love. Lovesick-
ness became a separate diagnostic category with s y m p t o m s drawn f r o m
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mania and melancholy, as well as from Oribasius' and Paul of Aegina's

chapters on lovers. Therapeutic intercourse, which Rufus of Ephesus had
advocated for melancholy, became a prominent cure for love. We find in
al-Râzî (b. 865), for example, that "the cure for love is frequent coitus." 2 2
The earliest of the better k n o w n medical works to complete this synthesis
of symptoms and therapies was the Zad al-musäfir of ibn al-Jazzär, which
served as the source for Constantine s Viaticum.23
This integration did not occur in the West. In contrast, a major work
available to the early Middle Ages differed significantly both f r o m Galen's
views on love and f r o m the Arabic synthesis introduced by Constantine.
On Acute and Chronic Diseases, a translation of Soranus' (2nd c. C.E.) lost
treatise by Caelius Aurelianus (5th c. C.E.), was recommended by Cassio-
dorus (ca. 490-ca. 583) as basic medical reading. 24 Caelius Aurelianus' de-
parture from the classical and Arabic tradition on the question of therapeutic
intercourse underscores the significance of Christian Europe's later accep-
tance of the cure. His discussion of melancholy, however, elucidates in part
the psychological dynamics underlying lovesickness.
In the section of his compendium on chronic diseases Caelius Aureli-
anus quotes Plato on the types of mania, among which is one called eroticon.
Mania may result from, among other things, love (amor nimia) or the drink-
ing of love philters (potions intended to make the drinker fall in love), and
is most frequent in young and middle-aged men. T h e s y m p t o m s of mania
include many of those that reappear in Byzantine and Islamic accounts of
lovesickness: unhappiness, mental anxiety, tossing in sleep, frequent blink-
ing of the eyes, and disturbances of the pulse. " W h e n mania lays hold of the
mind, it manifests itself n o w in anger, n o w in merriment, n o w in sadness
or futility, and now, as some relate, in an overpowering fear of things which
are quite harmless" (539).
Although Caelius Aurelianus' s y m p t o m s for mania correspond to the
later discussions of the signs of lovesickness, his therapies are much at vari-
ance with what later came to be the standard remedies for love. He rejects
purgatives because they injure the body, and dismisses drunkenness, music,
and love, on the grounds that they all increase madness rather than allay it.
T h o u g h his rejection of therapeutic intercourse is based on medical rather
than moral grounds, it foreshadows the split between medieval physicians
and priests on this issue. 25
Some physicians hold that love is a proper remedy for insanity, on the
grounds that it frees the patient's mind from the agitation caused by mad-
ness and thus purifies it. They are not aware of the obvious truth that in
many cases love is the very cause of madness. . . . Nor should we disdain
the view o f those w h o have actually called love a form o f insanity because

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of the similarity of the symptoms which the victims show. And surely it is
absurd and wrong to recommend, of all remedies for the disease, the very
thing that you are trying to treat; not to mention the fact that it is impos-
sible to get an insane person to fall in love, for, since he is bereft of reason,
he cannot properly appreciate beauty. . . . Moreover, even if the patient
falls in love, there is considerable doubt as to which course is preferable,
to forbid coitus or to permit it. When the patient sees the object of his
desire, he will become even madder if venery is forbidden him. On the
other hand, if permitted, it will harm him; for it not only deprives the body
of strength but also agitates the soul (557-59).
In Caelius Aurelianus' Platonic f o r m u l a t i o n , an insane person cannot fall in

love because he cannot f o r m a rational appreciation of beauty. In the Viati-
cum and other medieval medical texts on love, in contrast, it is precisely the
sight of beauty that drives the soul m a d and plunges it into lovesickness.
A n d since the divine is absolute beauty, this cause was a meeting g r o u n d
for medical and theological views of passionate o r ecstatic love. O n the
other hand, Caelius' rejection of therapeutic coitus, evidence of the ascetic
strain in late antique culture that early medieval Christianity n u r t u r e d into
h y p e r t r o p h i c f o r m s , prefigures the later ecclesiastical c o n d e m n a t i o n s of
the cure. 2 6
A l t h o u g h Caelius Aurelianus rejects one of the m o s t f a m o u s cures f o r
mania and melancholy, his discussion of the latter disease is i m p o r t a n t for
its observations of melancholies' behavior. H e notes that " C i c e r o speaks of
black bile in the sense of p r o f o u n d anger; and w h e n Hercules is stirred to
m i g h t y w r a t h , Virgil says 'and t h e r e u p o n the w r a t h of Hercules b u r n e d
furiously w i t h black bile'; for those suffering f r o m melancholy seem always
to be downcast and p r o n e to anger and are practically never cheerful and
relaxed" (561). 27 In focusing o n the s y m p t o m a t i c c o m p l e x of black bile/
melancholy and w r a t h , Caelius Aurelianus touches u p o n a c o n t e m p o r a r y
natural philosophical p r o b l e m of i m p o r t a n c e for the interpretation of love-
sickness.
T h e pseudo-Aristotelian Problem 30, part of a series of medical and
natural philosophical questions assembled in Alexandria between the f o u r t h
and seventh centuries, explains that melancholic men, w h o may, despite the
debilitating effects of the h u m o r , attain great accomplishments ( " m e l a n -
cholic genius"), are nonetheless "easily m o v e d to anger and desire." 2 8 T h e
medieval scholar David of D i n a n t copied a Latin s u m m a r y of Problem 30
into his n o t e b o o k s (Quatemuli) s o m e t i m e before 1210, w h e n they were c o n -
d e m n e d by the Bishop of Paris as containing heretical matter. H e explains
that black bile, colera nigra, is " s m o k y , " fitmosa, and its effects are similar to
those of wine. A n d j u s t as wine stimulates lechery (luxuria), so m a n y melan-
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cholici are luxuriosi because lechery arises f r o m " f u m o s i t y " or smokiness.

T h o s e w h o are e n d o w e d f r o m birth w i t h a great quantity of hot black bile
b e c o m e mad (maniaci), intellectually o u t s t a n d i n g (boni ingenti ad discendum),
a m o r o u s , and quickly m o v e d to anger or other e m o t i o n s (anime affectus).29
In Problem 30, then, we have the same c o m p l e x of s y m p t o m s as in Caelius
Aurelianus, w i t h this difference, that in the pseudo-Aristotelian p r o b l e m
they are given a h u m o r a l origin. T h e trio of depression, love, and anger
evident in these t w o w o r k s emerges so often in descriptions of melancholy
and lovesickness (in b o t h medical and literary sources) that it will b e c o m e a
central issue in m y interpretation of the disease's social context.
T h e fate of Caelius Aurelianus' treatise is emblematic of the general
f r a g m e n t a t i o n of late antique culture as it passed into the early M i d d l e Ages.
Despite Cassiodorus' endorsement, the parts on acute and chronic disease
were separated and epitomized, and were p r o b a b l y scarce at all times. 3 0 T h e
section on acute diseases circulated under the title Aurelius and that o n
chronic diseases, w h e r e mania is listed, under the title Esculapius.31 M u c h of
the theoretical discussion was excised, leaving mainly practical i n f o r m a t i o n .
T h e sections on love in the mania chapter appear not to have survived this
reorganization.
T h u s we can explain the silence of the seventh-century encyclopedist
Isidore of Seville on the topic of the lover's malady in his f o u r t h b o o k , o n
medicine. T h o u g h he d r e w f r o m Caelius Aurelianus for m a n y of his e t y -
mologies, he did so b y way of the Esculapius, w h i c h seems n o t to have
contained any statements a b o u t love. 32 Nonetheless, in another part of the
Etymologies, the m o s t influential encyclopedia of learning until it was s u p e r -
seded in the thirteenth century, Isidore says that "love b e y o n d all measure
a m o n g the ancients was called w o m a n l y love" (femineus amor; XI.2.24). 3 3
This c o m m e n t , coupled w i t h the silence on love in the medical chapter, well
illustrates the c o m p l e x inheritance of medieval views of passionate love;
ancient ideas on eros were transmitted t h r o u g h encyclopedias and literary
and philosophical w o r k s , as well as t h r o u g h medical texts o n love. E v e n
m o r e i m p o r t a n t , Isidore's r e m a r k underscores the puzzling paradox, to
w h i c h I return in the last chapter, of medicine's silence a b o u t w o m e n ' s love-
sickness. For passionate love to be " w o m a n l y love" m e a n t that ancient and
medieval culture saw excessive love as characteristic of w o m e n , yet w o m e n
are w i t h f e w exceptions absent f r o m medical accounts of love. " W o m a n l y
love" befell men, w h o were the subjects of medical discourse. Nevertheless,
t h o u g h w o m e n by and large remained outside medical discussions o f love-
sickness, the notion of " w o m a n l y love" held by the masculine w o r l d of
learning (clerical culture in its broadest sense) significantly influenced the
lover's malady in the later M i d d l e Ages.

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While Isidore c o m p o s e d the m o s t widely-read encyclopedia of the early

M i d d l e Ages in Visigothic Spain, in Alexandria a y o u n g e r c o n t e m p o r a r y ,
Paul of Aegina (fl. ca. 640), compiled an epitome of Greek medicine for
physicians w h o w o u l d not read the prolix ancient writers like Galen. Trans-
lated into Latin in the tenth century (one manuscript in Beneventan script,
n o w at Montecassino, dates f r o m the late eleventh century) Paul gives the
fullest and m o s t systematic account of love a m o n g those w o r k s available to
the West before Constantine's arrival. 34 T h e Latin translation begins: " T h e r e
is nothing inconsistent in adding cupidities to the diseases (passionibus) of the
brain, since they are certain cares," w h i c h are then defined as a passion of
the soul {passio anime). T h e s y m p t o m s and therapies follow Oribasius and
Galen. For all its relative fullness, however, Paul's chapter on lovers seems
meager c o m p a r e d to the Arabic discussions translated in the eleventh and
twelfth centuries. H e offers n o h u m o r a l causality; his interest centers instead
on semeiology and therapy.
Before Constantine began to translate, then, E u r o p e a n s had access to
only a f e w medical treatises that discussed the disease of love. If the medical
w o r k s surveyed above are theoretically unsophisticated in their exposition
of love c o m p a r e d to later w o r k s , they do tell us one i m p o r t a n t thing a b o u t
lovesickness in antiquity and the early M i d d l e Ages, namely, that it was seen
as a practical p r o b l e m requiring diagnosis and therapy, b u t n o t necessarily
elaborate theoretical explanation. Nonetheless, it is d o u b t f u l that the m e d i -
cal view of the lover's malady was a c o m m o n p l a c e even in the circles of
monastic culture w i t h the best access to ancient texts. Indeed, the corpus of
pre-Salernitan medicine shows a strikingly reduced coverage of mental ill-
nesses c o m p a r e d to earlier and later periods. When the care of the soul
passed into the hands of the clergy, mental disturbances became a less i m -
portant part of secular medicine than they had in antiquity.
Lovesickness in Classical Literature

If Galen o m i t t e d to record his remedies for Justus' wife, O v i d , in contrast,
offered a panoply of cures for love. In the M i d d l e Ages his poetry was read
and memorized in g r a m m a r schools and quoted f r o m Provence to Iceland.
Alexander N e c k h a m (d. 1217), for example, enjoined scholars w h o aspired
to liberal education to be especially familiar w i t h O v i d ' s "little b o o k on the
r e m e d y for love." 3 5 ( T h o u g h Sappho, w h o was considered the p r e - e m i n e n t
diagnostician of the s y m p t o m s of m o r b i d love in the ancient w o r l d , "takes
f r o m the attendant circumstances of life and f r o m truth itself the emotional
experiences which a c c o m p a n y erotically passionate m a d n e s s , " according to
Longinus, her poetry was u n k n o w n in the Middle Ages.) 3 6
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T h e magister amoris O v i d taught that sickness could be an artful strategy

in the game of love, and that u n w a n t e d love could be cured by his remedies.
T h e twelfth-century resurgence of interest in his p o e t r y — a n aetas Ovidi-
ana—meant that the medical views of love j u s t beginning to circulate in the
translations of C o n s t a n t i n e and Gerard of C r e m o n a (d. 1187) could d r a w
u p o n his poetic authority for acceptance. In fact, readers of Constantine's
chapter on lovesickness sometimes j o t t e d d o w n lines f r o m O v i d in the m a r -
gins of their manuscripts. O n e such early thirteenth-century reader noted:
" O v i d gives the cure for this sort of disease in the Remedies for Loue w h e n
he says: 'Sunt fora sunt leges q u o d tuearis a m o r e ' " (a m i s r e m e m b e r e d q u o -
tation of line 151: " T h e r e are courts, there are laws, there are friends for
you to protect"). 3 7 T h e m u t u a l reinforcement of the R o m a n d o c t o r of love
and the medieval physicians continued into the thirteenth century w h e n the
Viaticum c o m m e n t a t o r s Egidius and Peter of Spain (d. 1277 as Pope J o h n
X X I ) q u o t e d O v i d in their analyses of lovesickness. 3 8
In a reciprocal development, the early thirteenth-century O l d French
translator of O v i d ' s Art of Love (Ars amatoria) glossed his ancient a u t h o r in
light of c o n t e m p o r a r y behavior of the lovesick. H e justifies the utility of his
w o r k for y o u n g lovers w h o out of despair " h a n g themselves . . . kill t h e m -
selves by the s w o r d , or by fire or by w a t e r " or w h o " g o m a d " because of
love. " N o one can k n o w the sickness of love as well as the one w h o has
tried it." 3 9 In his view, O v i d offers a h o w - t o manual for those w h o w a n t to
play the g a m e of love—and win. M o r e o v e r , the translator's naturalism is a
match for that of c o n t e m p o r a r y physicians w h o were r e c o m m e n d i n g thera-
peutic intercourse despite its prohibition by the C h u r c h : " H e wants to prove
that it is not a sin for a man and a w o m a n to g o to bed w i t h each other, for
it is a natural thing, and nature bestows it, nor is it an artificial t h i n g . " 4 0
O v i d ' s erotic poetry thus proved a locus for interchange between medical
and literary views of love, and its authority n o d o u b t contributed to the
swift acceptance of the Arabic medical tradition.
O v i d ' s poetry bequeathed a grab-bag of s y m p t o m s , strategies, and
cures to medieval readers; ancient narratives, in contrast, depicted s o m e -
thing closer to case histories of lovesickness. O f the narrative depictions of
languishing lovers inherited by the Middle Ages, the story of A n t i o c h u s
and Stratonice, recounted by Valerius M a x i m u s (fl. early 1st c. C . E . ) , Plu-
tarch (d. ca. 126 C . E . ) and others, enjoyed great popularity d o w n to m o d -
ern times. 4 1 If w e see in the youth's passion for his s t e p m o t h e r a desire for a
maternal figure, the story becomes, in effect, an Oedipal comedy, the c o u n -
terpart to the tragic o u t c o m e of Perdica's Malady. T h e story's main lines run
as follows. Antiochus, son of king Seleucis, is "seized by infinite love" for
his s t e p m o t h e r Stratonice. Because he refuses to reveal his passion, he falls
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deathly ill. O n e day as the physician Erasistratus sits by the patient, Stra-
tonice enters. T h e doctor notices h o w Antiochus blushes, h o w his breathing
quickens, and h o w his pulse races. W h e n she leaves, he pales, his breathing
and pulse slow. In Figure 1.2 the pulse test is depicted at the far left of the
first panel. O n the right side of the same panel, just as in the literary ver-
sions, Erasistratus announces the youth's malady to the king. Seleucis' love
for his son is so great that he hands over "his m o s t dear w i f e " to h i m . T h e
second panel shows the w e d d i n g festivities and the recovered A n t i o c h u s
dancing exuberantly in the central scene.
H o w congenial such a story was to the Western i m a g i n a t i o n — i n c o m -
pensation for the daily tragedy of renounced desire for the m o t h e r ? — i s
s h o w n by the theme's i m m e n s e popularity in art, in rhetorical exercises, and
in literature. 4 2 N o r did its popularity wane in the Christian M i d d l e Ages.
R o d u l p h u s Tortarius (d. ca. 1122), a m o n k of Fleury, c o m p o s e d a poetic
version of Valerius M a x i m u s ' Facta et dicta memorabilium that contains an
account of Antiochus' lovesickness. 4 3 T h e signs of l o v e — w a s t i n g , blushing,
pallor, and erratic breathing—as well as the pulse test figure p r o m i n e n t l y in
his swift retelling of the classical tale. T h e n u m b e r of f o u r t e e n t h - c e n t u r y
commentaries on Valerius M a x i m u s indicates that he was studied inten-
sively in the later Middle Ages. 4 4 Boccaccio's teacher, for example, the
m o n k Dionigi da B o r g o San Sepulcro (d. 1340), explains in his c o m m e n -
tary the physiological reasons for the accuracy of the pulse t e s t — a n o t h e r
example of the crossover between the medical and literary traditions of
lovesickness. 4 5
This fantasy of Oedipal desire, w h o s e detection and cure lay in the p h y -
sician's hands, thus f o r m e d part of the E u r o p e a n matrix of ideas soon to
receive the n e w medical teachings on lovesickness. As w e have seen, Per-
dica's Malady does n o t disguise the incestuous yearning at all, and, signifi-
cantly, has a tragic o u t c o m e . T h o u g h the circulation of the p o e m in the
Middle Ages was limited (only one manuscript survives), the story itself
was k n o w n . Fulgentius and all three Vatican M y t h o g r a p h e r s m e n t i o n P e r -
dica's incestuous lovesickness, but allegorize it as a story of agriculture: Per-
dica's m o t h e r is the earth, and he a farmer. 4 6 T h e m o t i f appears to have been
familiar f r o m art as well as f r o m literary sources. T h e bronze statuette in
Figure 1.1 was recovered near Soissons, France, suggesting that represen-
tations of the t h e m e travelled w i t h imperial culture.
Lovesickness in Christian Sources

To a far greater degree than secular literature, Biblical texts permeated the
minds and imaginations of medieval people. As Leclercq says: " T h e w o r d s
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of the sacred text never failed to p r o d u c e a strong impression o n the m i n d .

T h e biblical w o r d s did not b e c o m e trite; people never got used to t h e m . " 4 7
Biblical passages on lovesickness are thus of the u t m o s t i m p o r t a n c e for u n -
derstanding the medieval views of passionate love that conditioned the re-
ception and use of the medical discussions of lovesickness. T h e t w o key
texts in this development were the story of A m n o n and T h a m a r in 2 Samuel
13 (2 Kings in the Vulgate) and the refrain in Canticles, " f o r I a m sick w i t h
love" (Cant. 2.5, 5.8).
T h e biblical episode of A m n o n ' s love for his sister T h a m a r b o t h p o r -
trayed the reality of lovesickness and, in its narrative details, offered a vision
of the disease that overlapped w i t h those of medicine and secular literature.
Like Valerius M a x i m u s and the a u t h o r of the Aegritudo Perdicae, the biblical
writer dramatizes h o w unsatisfied desire expresses itself somatically in the
s y m p t o m s of lovesickness. T h e resolution of the story, however, differs
significantly f r o m the secular narratives.
And it came to pass after this, that Amnon the son of David loved the sister
of Absalom son of David, who was very beautiful, and her name was
Thamar.
2 And he was exceedingly fond of her, so that he fell sick for the love
of her: for as she was a virgin, he thought it hard to do any thing dishon-
estly with her.
3 N o w Amnon had a friend, named Jonadab the son of Semmaa the
brother of David, a very wise man:
4 And he said to him: "Why dost thou grow so lean from day to day,
O son of the king? why dost thou not tell me the reason of it? And Amnon
said to him: I am in love with Thamar the sister of my brother Absalom.
5 And Jonadab said to him: Lie down upon thy bed, and feign thyself
sick: and when thy father shall come to visit thee, say to him: Let my sister
Thamar, I pray thee, come to me, to give me to eat, and to make me a
mess, that I may eat it at her hand.
6 So Amnon lay down, and made as if he were sick . . .
(2 Kings 13.1-6; RSV 2 Samuel)
T h a m a r comes to minister to her sick brother. " A n d w h e n she had p r e -

sented h i m the meat, he took hold of her, and said: C o m e lie w i t h me, m y
sister. She answered him: D o n o t so, m y brother, do n o t force me: for n o
such thing must be d o n e in Israel. D o n o t thou this folly." T h a m a r pleads
in vain. " B u t he w o u l d not hearken to her prayers, but being stronger over-
powered her and lay w i t h h e r " (Figure 1.3). 48
Then Amnon hated her with an exceeding great hatred: so that the
hatred wherewith he hated her was greater than the love with which he
had loved her before. And Amnon said to her: Arise, and get thee gone.
(13.15)

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Figure 1.3. A m n o n and Thamar. London, British Library, MS Royal 2 Β. VII, fol. 58.
Amnon's lovesickness is both real and feigned. It is real enough to cause

his friend to remark on his loss of weight; Amnon's body involuntarily be-
trays him. At the same time, he uses his illness as a ploy to obtain his desires.
For monastic readers who, as Leclercq says, imaginatively recreated what
they read or heard, "giving very sharp relief to images and feelings," A m -
non's illness gave an ambiguous picture of lovesickness, as both the physical
consequence of immense thwarted desire, and as the deceptive pretext—as
in Ovid—to accomplish illicit desire.49
The most striking element of the story is Amnon's sudden hate for the
woman he loved to the point of sickness. In the terse style of much biblical
narrative, the writer does not explain why the reversal occurred, only re-
ports it. In portraying the sudden shift of Amnon's love to hate, did the
author perceive a psychological pattern similar to the melancholic anger
noted above in Caelius Aurelianus? A medieval interpretation of the pas-
sage, at any rate, indicates that it was understood to represent a common
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pattern of behavior. T h e illustrated Bible moralisée declares that A m n o n r e p -

resents the lecherous rich (divites luxuriosi) w h o w i s h to accomplish their
every will and desire w i t h w o m e n . 5 0 In explaining A m n o n ' s sudden hate,
however, the moralized Bible's message is less clear; its ambiguities can be
read as projections of cultural fears about w o m e n and sexuality. According
to the textual gloss, w h e n the lecherous rich cannot have their way w i t h
w o m e n , they resort to gifts or blandishments (dono vel simulatione verborum).
T h e a c c o m p a n y i n g illustration, however, suggests violence rather than suc-
cessful seduction, as a w o m a n raises her a r m s in self-defense against the m a n
pressing himself u p o n her. H e r right hand pushes his head away while her
left is d r a w n back as t h o u g h to strike h i m . In the next scene, A m n o n , " w h o
hated and despised [ T h a m a r ] , " casts her f r o m his bed; she leaves " c r y i n g
and h o w l i n g " (ftendo et ululando). A m n o n , according to the gloss, signifies
the lecherous rich man, w h o , after he has taken his pleasure w i t h a w o m a n ,
casts her f r o m h i m , unaware u p to this point that she was intent o n gulling
him (illam a se mox expellit se ignorans adhuc per illam esse decipiendum).
A m n o n ' s a n g e r — o r that of the lecherous r i c h — b e c o m e s righteous anger,
and in a stunning reversal of the literal m e a n i n g of the Biblical story, T h a -
mar emerges as the evildoer and A m n o n the victim. T h e medieval reading
of the story thus reverses the agency of sexuality and p o w e r : male anger is
motivated and justified b y the threat of female deceit. B l a m i n g the victim
is one way of lessening the tension of ambivalent feelings, w h e t h e r A m n o n ' s
or those of any m a n w i t h the means to achieve his desires.
A l t h o u g h the medieval moralized Bible ignores the question of family
relations, it may be significant that A m n o n ' s violent ambivalence directs
itself toward his half-sister. As a sibling, she figures the self, b u t as a w o m a n
and potential w i f e (see v. 13) she figures the m o t h e r . His pathological love
suggests the narcissistic, ambivalent feelings that Freud claims are at the
root of melancholia. 5 1
T h e story of A m n o n and T h a m a r , says Baldwin, bishop of C a n t e r b u r y
(d. 1190), exemplifies incestuous or shameful love, w h i c h brings w i t h it
suffering and the anxiety of sorrow. T h i s vain love, this s h a m e f u l love is n o t
only a languor, but a vice of the soul and death. 5 2 But, he continues, there
is a holy love that is languor itself. It suffers anxiously—amore langueo—but
this languor is a virtue, health, and medicine. Baldwin's contrast between
the m o r t i f e r o u s love of A m n o n and T h a m a r and salvific l a n g u o r introduces
the second i m p o r t a n t biblical tradition for lovesickness in the M i d d l e Ages,
exegesis on the Song of Songs.
T h e m o s t frequently c o m m e n t e d b o o k of the Bible in the early M i d d l e
Ages, the Song of Songs attracted great interest in the eleventh and twelfth
centuries. 5 3 Desiderius of Montecassino, Constantine's abbot, had a m a n u -
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script copied for the library which contained commentaries on that book by
Origen, Gregory, "the doctor of desire," and Berengar. 5 4 Constantine's
chapter on love thus entered European intellectual life and attracted its o w n
commentaries when interest in the spiritual languor ("for I am sick with
love") of the Song of Songs was at its height.
Exegetes, following Origen, interpreted the Song of Songs as an alle-
gory of the soul's desire for God, the absent Beloved (Figure 1.4). T h e
tropological reading insists on the real experience of love-suffering, and
provides a language for the subjective experience of unsatisfiable desire. If
the physicians describe lovers' suffering f r o m the outside, so to speak, in
the categories of learned discourse, the commentaries in the Song of Songs
give us a glimpse into the lived reality of the love Baldwin calls "languor
and the passion of an unwell m i n d . " 5 5 Because the vocabulary of love and
lovesickness f r o m the Song was a prime resource for the development of
medieval love lyric, 56 it too served as a meeting point for sacred, secular,
and medical ideas about love.
Origen sets forth what remained a central interpretative problem not
only with the Song, but with the vernacular literature of love as well: the
essential ambiguity of love. 57 Just as Scripture uses the same terms for the
members of the outer man and the inner man, so too the same words may
be used for carnal and spiritual love. "Just as there is one love, k n o w n as
carnal and also k n o w n as Cupid by the poets, according to which the lover
sows in the flesh; so also is there another, a spiritual love, by which the
inner man w h o loves sows in the spirit." 5 8 T h e soul is moved by spiritual
love " w h e n , having clearly beheld the beauty and fairness of the Word of
God, it falls deeply in love with His loveliness and receives f r o m the Word
Himself a certain dart and w o u n d of love" (199).
T h e ambiguity of the word "love" is compounded by the reversal of
value given to the " w o u n d of love" or love-languor. As Origen says, this
wound is not deadly, but rather "health-bestowing"; the w o u n d of love is
the " w o u n d of salvation" (199-200). Just as Christ's passion led to the
triumph of the resurrection, so in this interpretation of Canticles, love-
suffering becomes salvific. But as salutary as the love w o u n d may be, a m -
biguity nonetheless persists. Origen continues: the wicked one can inflict
wounds of cupidity with his darts, wounds so subtle that the "soul scarcely
perceives that she has been pierced and wounded by t h e m " (198-99). H o w
then can one distinguish between health-giving and death-dealing love?
T h e signs of love that Origen lists are n o clear guide, because they apply
equally well to spiritual and carnal lovers. The lover yearns and longs by
day and night, can speak of nothing but the beloved, will hear of nothing
else, and can think of nothing else. He desires and hopes for the beloved
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Figure 1.4. T h e B r i d e o f C a n -
ticles languishes w i t h love.
Bible moralisée. Paris, B i b l i o -
t h è q u e N a t i o n a l e , M S lat.
11560, fol. 72r.
alone (198). A n a n o n y m o u s t w e l f t h - c e n t u r y c o m m e n t a t o r c o m p a r e s t h e
manifestations o f l a n g u o r o u s desire to " i m p a t i e n t l o v e , " w h i c h day and
n i g h t beats at the d o o r s of prostitutes. 5 9 In fact, the parallelism b e t w e e n
sacred and secular love was felt so s t r o n g l y that the medical signa amoris
came to be applied to mystical love. For e x a m p l e , Richard of St. Victor
(d. 1173) describes identical s y m p t o m s f o r successive stages of b o t h carnal
and spiritual passionate love. 6 0
T w e l f t h - c e n t u r y c o m m e n t a t o r s on the S o n g of Songs a t t e m p t e d to
clarify h o w physical illness could signify spiritual love. In the early t h i r -
teenth century, w h e n C o n s t a n t i n e ' s Viaticum, a c c o m p a n i e d b y G e r a r d of
Berry's gloss, was readily available in t h e universities, Parisian t h e o l o g i a n s
a d o p t e d the new, m o r e technical medical discussions o f Iovesickness to il-
l u m i n a t e the w o r k i n g s of mystical rapture. William of A u v e r g n e , b i s h o p of
Paris ( 1 2 2 8 - 4 9 ) and theologian at the university, r e m a r k s to his s t u d e n t s in
an explanation of rapture: " Y o u o u g h t to r e m e m b e r s o m e things w h i c h y o u
experience continually. You see that love is a certain raptus, j u s t like that
w h i c h is called morbus eros, w h i c h is a violent and m o s t intense illness, in
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which s o m e o n e w h o loves is in such rapture that it barely permits h i m to

think of anyone besides the w o m a n he loves in this way." 6 1 T h e r e m a r k
suggests that love as a medically defined illness was b o t h c o m m o n k n o w l -
edge and c o m m o n experience. Indeed, William's colleague, William of
Auxerre, noted that m a n y are driven m a d by amor morbus w h e n they cannot
obtain w h a t they love. 62 B y the time of H u g h of St. Cher's p o p u l a r De
doctrina cordis (around 1235), the semiotics of lovesickness had so penetrated
mystical writing that H u g h was able to b o r r o w the signs of love wholesale
f r o m the medical chapters on lovesickness by C o n s t a n t i n e the African and
Gerard of Berry. 6 3 Later writers continued to b o r r o w f r o m the medical
tradition to elaborate the signs of spiritual love. Medical teachings on
lovesickness were thus easily assimilated to religious discourse a b o u t pas-
sionate love, w h i c h powerfully validated the accuracy of the physicians'
descriptions. 6 4
The Crucified Christ, Model of Love and Suffering

Christ, the B r i d e g r o o m of tropological readings of the Song, suffers the
sickness of love as m u c h as the Bride herself does. T h e era in w h i c h the
African merchant C o n s t a n t i n e entered the m o n a s t e r y of Montecassino w i t -
nessed a n e w emphasis on Christ as a loving savior. M o r e than a J u d g e and
King, Christ was seen rather as " t h e sweet lover of m a n k i n d . " 6 5 H e t o o k o n
and suffered in m o r t a l h u m a n flesh out of his great love for h u m a n k i n d .
With this shift in theological emphasis, affective attachment to the C r o s s
and Passion also grew. T h e C r o s s became an object of intensely e m o t i o n a l
devotion, as worshippers reciprocated the loving sacrifice of the Passion
w i t h their o w n compassion. Like the tropological reading of the Song, the
Cross mediates between the eternal and the historic, transcendent divinity
and subjective individual experience. 6 6
Loving compassion for the w o u n d e d , suffering b o d y of Christ, u n d e r
the guidance of the active religious imagination described b y Leclercq,
could express itself in images of unabashed eroticism. R u p e r t of D e u t z
(d. 1129) reports a dream in w h i c h he worshiped the Cross. T h e crucified
Christ seemed to return his gaze and accept his salutation. Yet he w a n t e d
closer union w i t h his Savior. Rushing to the altar, he embraced and kissed
the image. "I held h i m , I embraced him, I kissed h i m for a long time. I
sensed h o w seriously he accepted this gesture of love w h e n , while kissing,
he himself opened his m o u t h that I m i g h t kiss m o r e deeply." 6 7 Clearly,
Rupert says, this signified the fulfillment of w h a t the beloved of the Song
says: " W h o shall give thee to m e for m y brother (i.e., husband), sucking
the breasts of m y m o t h e r , that I m i g h t find thee w i t h o u t , and kiss thee, and
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n o w no m a n may despise m e ? " (8.1) T h e r e is m u c h to dwell on in the

passage: the remarkable flexibility of gender i d e n t i t y — b o t h R u p e r t and
Christ simultaneously occupy male and female roles; the overt eroticism of
their union; Rupert's interpretation of his passionate experience t h r o u g h the
Song; and the association of eros and n u r t u r i n g suggested by the verse f r o m
the Song.
Rupert's vision, t h o u g h perhaps m o r e vividly represented than others,
is part of a medieval tradition of affective piety in w h i c h experiences of
spiritual union were represented t h r o u g h images and gestures of loving b e -
havior. 6 8 Figure 1.5, which has a n u m b e r of analogues in medieval art,
shows h o w the C r o s s could unite divine and h u m a n passions of love. T h e
h u m a n witnesses depicted in Crucifixion scenes serve as sources of affective
identification for the audience. 6 9 M a r y Magdalen, the m o s t carnal of lovers,
here passionately embraces the C r o s s and kisses Christ's w o u n d e d feet at the
center of the composition. " T h e power of a visual image to evoke love in
the viewer is at its height in the figure of the M a g d a l e n . " 7 0 We may assume
that scenes and experiences like this had i m p o r t a n t implications for the fate
of the lover's malady in the M i d d l e Ages. Veneration of the the C r o s s and
identification w i t h Christ's Passion—imitatio Christi—forged a b o n d , in m e -
dieval consciousness, between love and suffering. Suffering, m o r e o v e r , was
n o t weakness, but the ultimate act of love. Since Christ's Passion was taken
as a m o d e l for affective experience, this strain of affective piety deliberately
cultivated "lovesickness." We find, for example, that in the thirteenth cen-
tury a D o m i n i c a n friar, contemplating the R e d e m p t i o n , was " r a p t in love
of G o d . . . and languished for love, lying for three days w i t h o u t eating
or d r i n k i n g . " A n d in imitation of the bride of the Song o f Songs, the
thirteenth-century mystic Julian o f M t . Cornillon suffered the sickness of
love, w h i c h her sisters m i s t o o k for physical illness. 71 Given the a m b i g u i t y
of the s y m p t o m s of lovesickness, is it farfetched to think that the t h e o l o -
gians' analogy between the t w o loves, earthly and spiritual, was partially
responsible for the ennobling of lovesickness f o u n d in vernacular literature?
In any event, the potential for confusion between morbus eros and passio
caritatis was an uncertainty ripe for exploration by vernacular poets of love
f r o m Gottfried to Chaucer. G o t t f r i e d von Strassburg (d. ca. 1210) boldly
melds Christian and erotic suffering into a "eucharistic poetics" in the p r o -
logue to his story of Tristan and Isolde: "Today we still love to hear of their
tender devotion, sweet and ever fresh, their joy, their sorrow, their anguish,
and their ecstasy. . . . Their life, their death are our bread. T h u s lives their
life, thus lives their death. T h u s they live still and yet are dead, and their
death is the bread of the living." 7 2 By the fourteenth century this d e v e l o p -
m e n t came full circle. T h e parallel between sacred and secular lovesickness
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Figure 1.5. T h e C r u c i f i x i o n . M i n i a t u r e f r o m a missal b y N i c c o l ò da B o l o g n a ,
active ca. 1 3 6 9 - c a . 1402. E m b r a c i n g a n d / o r kissing t h e C r o s s o c c u r s in n u m e r o u s
d e v o t i o n a l paintings. T h e C l e v e l a n d M u s e u m o f A r t , G i f t o f J. H . Wade, C M A
24.1013.

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then lay so ready to hand that a s e r m o n on the text quia amore latigueo d e -
scribes Christ's passion " u n d e r the seven secular signs of l o v e - l o n g i n g . " 7 3
Popular Lore
T h e Tristan story reminds us that there were other, less easily traceable,
European notions of lovesickness to which the n e w medical learning could
be assimilated. Love potions and love magic were part of the stock in trade
of unrequited lovers in the earlier Middle Ages, as we k n o w f r o m peniten-
tials, canon law, saints' lives, and literature. Guibert of N o g e n t ' s (d. ca.
1125) parents were unspelled by an enchantress, and a love p o t i o n figures
p r o m i n e n t l y in the Life of Christina of Markyate, a t w e l f t h - c e n t u r y re-
cluse. 74 It was c o m m o n l y t h o u g h t that t h r o u g h natural or supernatural
m e a n s — h e r b s and charms or diabolic a i d — o n e could " t u r n men's m i n d s to
love or h a t e , " states that were sometimes so extreme that they seemed to be
diseased. 75 As we shall see, this magically-caused love came to be viewed as
a f o r m of amor hereos or lovesickness in the later Middle Ages. In the late
eleventh and twelfth centuries, however, indigenous tales of love magic and
love madness offered material that could be elaborated t h r o u g h the medical
doctrines on lovesickness.
T h e story of the "wasting sickness" of the Irish h e r o C ú Chulainn is a
case in point that is w o r t h closer examination for its similarity to the c o n -
stellation of anger, love, and sickness that w e have seen in the story of A m -
non and T h a m a r and in the ancient discussions of melancholy. Preserved in
a manuscript of the twelfth century, it is a native story of love-madness
dating f r o m the ninth or tenth century o n t o which was grafted the learned
tradition of lovesickness. 7 6 A l t h o u g h the narrative suffers f r o m interpola-
tions and dislocations, it nonetheless yields a coherent vision of the d y n a m -
ics a m o n g love, anger, and p o w e r in the Middle Ages.
D u r i n g an assembly of the U l s t e r m e n , d u r i n g w h i c h each m a n was
assigned "his t r i u m p h and his p r o w e s s , " a w o n d r o u s l y beautiful flock of
birds settled on the lake; every w o m a n coveted a pair. E t h n e Ingubai, w i f e
of C ú Chulainn, claimed t h e m if they were to be caught. A n g e r e d by the
" w h o r e s of the U l a i d " (Ulstermen), as he calls the w o m e n w h o requested
h i m to get the birds, the hero C ú Chulainn nonetheless killed the birds and
distributed t h e m to every w o m a n except his wife. C ú Chulainn perceived
his wife's anger, t h o u g h she denied it; he told her not to be angry and p r o m -
ised her the m o s t beautiful birds. When t w o birds appeared, w h i c h his wife
counseled h i m n o t to touch, he shot anyway and for the first time in his life
missed his mark. Downcast, C ú Chulainn sat against a stone. T w o w o m e n
came toward him, laughed at him, and h o r s e w h i p p e d h i m . " A n d they c o n -
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tinued for a long time, each of them in turn coming still to him to beat him,
so that he was almost dead."
Cú Chulainn took to his bed, where he remained for a year "in sickness
and in weakness," without speaking to anyone. O n e day an emissary from
the Otherworld arrived with the message that Cú Chulainn was desired
there both as the lover of Fand and as a warrior. The prospect of adventure
having restored his spirits, he sent for his wife (now called Emer), saying:
"They are fairy women w h o have visited and destroyed me." His friend
Loeg recited a poem to restore him: "It is great idleness for a warrior to lie
in sleep of wasting sickness, for it shows demons (gloss: women), folk f r o m
Tenmag Trogaige (gloss: from Mag Meli), and they have injured (?) thee,
they have confined thee, they tortured thee in the toils of women's wanton-
ness."When his wife Emer arrived, she reproached h i m : ' " S h a m e for thee,'
said she, 'to lie for love of a woman, for long lying will make thee sick.'"
The story continues, narrating the jealousy of his wife and how she
finally triumphed over Fand, Cú Chulainn's madness at the loss of Fand,
and the draughts of forgetfulness finally given to the hero of Ulster and his
wife. Let us return, however, to the opening episode with Cú Chulainn and
his wife. His anger has a number of objects—the women of Ulster, the fact
that he missed his cast at a feast where all were "assigned their prowess"—
but his wife's anger plays an important part in his eventual lovesickness.
Though she denies anger, she has been slighted before all Ulster, and
Cú Chulainn's repeated enjoinders not to be angry indicate her real e m o -
tion. When the pair of birds arrives, he then disregards her advice not to
touch them.
Though only his despondency after missing his cast is mentioned, we
may suspect that his state is more complex than that. His emotion is c o m -
pounded of humiliation, anger, and knowledge of his wife's own anger,
shame, and accurate prediction regarding the birds. The Otherworldly vi-
sion thus arrives at a moment of great emotional turmoil.
The women w h o beat him nearly to death and cause his long wasting
may be seen as doubles for his wife: they punish him as he fears or imagines
she would, should she give vent to her wrath. 7 7 His sickness embodies fear
of his wife's vengeance, distanced and enacted by the women of the Sidhe.
Later in the story she shows exactly how capable she is of violent revenge
for an insult to her honor, so that Cú Chulainn has good reason to fear her
as well as love her. And since a hero like Cú Chulainn cannot show fear, he
experiences it somatically as external punishment and sickness. Loeg's poem
attributes Cú Chulainn's sickness to the "toils of women's wantonness."
Recalling Cú Chulainn's epithet "whores of the Ulaid," does Loeg refer to
the otherworldly Fand or to his wife? If we accept that Fand may function
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psychologically as a double for C ú Chulainn's wife, then his passionate affair

w i t h Fand in the O t h e r w o r l d can be seen as a fantasy of reconciliation w i t h
his wife.
Δ story f r o m O d o of Cluny's (d. 944) Collations, in w h i c h a m a n is
w h i p p e d by d e m o n i c w o m e n , suggests the plausibility of this interpretation
of C ú Chulainn's wasting sickness. A certain H u k b e r t of Sens, given to the
sin of luxury, saw t w o w o m e n standing by h i m o n e night w h o were n o t the
ones w h o usually came to h i m . H e realized that they were phantasms.
O t h e r people rushed up, b u t he alone saw the w o m e n . H e t o o k r e f u g e in
the church, but it too was full of phantasmic w o m e n , a m o n g w h o m sat o n e
as queen. She ordered t h e m to seize h i m and w h i p h i m . His repentance
came t o o late, and he was given into their power. H e fell to the g r o u n d ,
w h e r e they w h i p p e d h i m as he screamed out w h a t he saw and felt. A f t e r
this went on for a time, the w o m e n disappeared and those outside saw the
t r o o p cross over the bridge. T h e m a n died a short time later. 7 8
W h e t h e r the story reflects H u k b e r t ' s experience of madness or O d o ' s
fictional skills, in either case it is the combination of transgression against
w o m e n w i t h their fearsome vengeance that parallels the psychological d y -
namic of C ú Chulainn's story. In b o t h stories anxiety over relationships
w i t h w o m e n unleashes fantasies of their revenge so p o w e r f u l that they result
in illness or death. Such fantasies are collective; in t h e m w o m e n tend to
b e c o m e demonized, and love madness becomes the result of love magic.
T h a t lovesickness can be a somaticized f o r m of fear and of anger t o w a r d
w o m e n will be discussed at greater length in chapter eight. For the present,
the story of C ú Chulainn s h o w s that early European vernacular traditions
of lovesickness offered parallels to the poetry of O v i d and to the learned
doctrines of the physicians. Like the other f o r m s o f literary and medical
discourse surveyed in this chapter, such native stories b o t h conditioned the
reception of the n e w teachings on lovesickness and were themselves e n -
riched by it.
In addition to vernacular literature, penitentials, legal codes, witchcraft
treatises and s e r m o n s partially d o c u m e n t popular as well as learned beliefs
in the debilitating powers of love. 7 9 T h o m a s of C h o b h a m (fl. 1200-33), for
example, lists a n u m b e r of remedies for "insane love" in his penitential
manual for confessors. " F o r m a n y fall into insane love such that they can
hardly be turned f r o m their error. This love is m o r e o v e r a disease (morbus)
not only of the m i n d but also of the body, since the m a r r o w s are swollen,
the veins disordered, [and] every bodily sense w e a k e n e d . " 8 0
Popular lore by its nature is nonetheless difficult to d o c u m e n t ; the p o l y -
m o r p h o u s variations on the t h e m e of "insane love" in non-learned tradition
cannot be fully traced in a study such as this. In contrast, as the d o c u m e n t s
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surveyed in this chapter have shown, the more stable written tradition of
learned medicine enjoyed a continuous but limited presence in Europe be-
tween the fall of the Roman empire and the revival of scientific learning in
the eleventh century. These medical works, however, offer only sketchy
analyses of the disease of love, and their limitations suggest w h y Constan-
tine's chapter on love enjoyed the success it did. Having been granted the
status of a separate disease in Islamic medical handbooks, lovesickness re-
entered the West in the Cassinese monk's latinized version accompanied by
a comparatively full theoretical and practical discussion of its causes, s y m p -
toms, consequences, and cures.
Yet the success of the medical view of the lover's malady, as shown by
the adoption of Constantine's description of lovesickness in a variety of dis-
ciplines, rested on a broader basis than that of developments in medical
writing alone. T h e Bible, exegetical and mystical writings, classical litera-
ture, vernacular stories, and popular beliefs all agreed with the doctors'
diagnosis that passion could breed sickness of body and mind. Such una-
nimity was a powerful argument for the disease's reality and hastened the
acceptance of the Arabic doctrines on lovesickness. " T h e discovery of love"
has been used to characterize the revolution in sensibility that swept t h r o u g h
European culture in the late eleventh and twelfth centuries. In this super-
saturated mix of texts, ideas, and behaviors, the conception of love in the
Viaticum and other medical texts, couched in a more precise technical v o -
cabulary, crystallized new ways of interpreting and controlling erotic be-
havior. 81 If we see the conventions of courtliness as ideals for controlling
erotic and aggressive behavior, then it is easy to understand w h y there was
such an affinity between lovesickness and "courtly love" in vernacular lit-
erature of the high and late Middle Ages. Both offered techniques for con-
straining and yet indulging in potentially disruptive erotic impulses.

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§§ 2 §§
CONSTANTINE'S VIATICUM
And Palladius the physician was asked about love and said: "Love is
a disease which is generated in the brain, when the thoughts are al-
lowed to dwell on one subject and the loved person is constantly
brought to mind and the gaze is continually fixed on him."'
T h e generations on either side of 1100 found themselves in a rapidly

changing world that for us, in retrospect, marks the watershed between
the early and the high Middle Ages. Agricultural improvements trans-
formed the material basis of society. Population expanded and its m o -
bility increased. N o r m a n conquests in the Mediterranean and the first
Crusade opened new lands for travel and production. N e w trade routes
and improved communications followed. In short, the social world w i d -
ened dramatically and its relation to the natural world altered in significant
ways. T h e twelfth century witnessed not just altered physical relations
with the natural world, but the emergence of the idea of nature. 2
Several generations of scholars have n o w documented h o w nature
and human nature were rethought in light of the newly-available Arabic
texts f r o m Montecassino and Toledo and how this new understanding
found expression in, for example, philosophical and literary works associ-
ated with Chartres. 3 The Arabic medical texts that Constantine translated
stimulated a new emphasis on the materiality of the human organism, its
mutable composition f r o m the elements. In Nemesius' On the Nature of
Man, which Constantine's patron Alphanus (d. 1085) translated, we learn:
"Since man consists of a body, and since every body is composed of the
four elements, it is necessary that the affections, which parallel the ele-
ments, undergo in man the division, mutation, and flux which belong to
the body alone." O r , as the Archpoet says: "Factus de materia levis ele-
ment! / Folio sum similis de quo ludunt venti" (Made of matter of a light
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element, I am like a leaf the winds play with). 4 T h e materiality of the

h u m a n organism raised new questions about the relations between b o d y
and soul, for which people turned to treatises such as Qustä ibn Lüqä's De
anima et spiritu discrimine ( " O n the Distinction between Soul and Spirit,"
often attributed to Constantine) or the works on the soul (De anima) of
Aristotle and Avicenna. 5
At the same time, the rise of literacy changed intellectual and religious
life. T h e reform movements of the late eleventh and twelfth centuries, the
emphasis on affective, interior experience and its need for reformation, the
rise of the universities and the spread of heresies all grew out of (as well as
contributed to) new conceptual vocabularies introduced and spread by
scribal culture. 6
T h e discovery of the self together with the perception of the need for
interior, spiritual reform lent new importance to love in religious and intel-
lectual life. H u m a n nature increasingly came to be seen as a loving nature. 7
Love impelled the quest for perfection and the ascent to God, as Bernard
continually and movingly proclaimed in his sermons on Canticles. Vernacu-
lar poetry offered a secular counterpart: a vision of a love that promised a
heightened sense of self in both joy and sorrow, and the occasion and means
for moral improvement. At this time, too, the Church p r o m o t e d an ideal
of marriage that on the one hand emphasized equality between men and
women, but on the other portrayed women's subjugation. 8
Constantine the African and his translations are poised at the beginning
of this cultural shift. Quickly carried to nearby Salerno, and across Europe
to Chartres, Germany and England, these texts provided one of the f o u n -
dations for the renewal of intellectual life in the twelfth century. T h e influx
of Arabic medicine, derived in large part f r o m the works of Hippocrates
and Galen, formed the core of medical instruction for centuries and offered
a critical impetus for the development of both practical and theoretical
medicine in Europe. T h r o u g h the Viaticum Constantine gave Western
physicians, patients, and readers a theoretical framework and a .technical
vocabulary with which to discuss passionate love. This vocabulary and ac-
companying theory were admittedly not well developed, yet nonetheless
were far more accessible than earlier translations of Greek medical works on
lovesickness.
We k n o w for certain little m o r e about Constantine than that he was

born in Africa and entered the abbey of Montecassino while Desiderius was
abbot (1058-87); 1087 is conventionally accepted as his date of death (Fig-
ure 2.1). Peter the Deacon's Illustrious Men of Montecassino (De viris illustris
cassinensis, after 1144) and the Chronicle of Montecassino are the earliest and
9
best sources for Constantine's life and writings.
Brought T w o other
to you by | Cambridge legendsLibrary
University survive,
Authenticated
Constantine's Viaticum § 33
Figure 2.1. Portrait of a physician, perhaps meant to be Constantine

the African, in the opening initial of the Viaticum. Vatican, Biblio-
teca Apostolica, MS Pal. lat. 1149, fol. 125r..
one apparently f r o m thirteenth-century Salerno, the other f r o m f o u r t e e n t h -

century Montpellier, b o t h f r o m centers of medical learning in active e n -
gagement w i t h his w o r k . 1 0
According to Peter the Deacon, C o n s t a n t i n e was b o r n in C a r t h a g e . H e
traveled to Babylon, w h e r e he learned all the arts and sciences, as well as
the medicine of the Chaldees, Arabs, Persians, and Saracens. H e left B a b y -
lon for India, and after acquiring the arts of the Indians, travelled to Ethiopia
and E g y p t . W h e n he returned to Africa after spending thirty-nine years in
study, his c o u n t r y m e n , envious of his accomplishments, tried to kill h i m .
H e fled secretly to Salerno, w h e r e he disguised himself as a p o o r m a n . T h e
brother of the King of Babylon recognized h i m and led him before D u k e
Robert Guiscard, the N o r m a n Brought ruler to
of you
Salerno, w h o received
by | Cambridge University hLibrary
im with
Authenticated
great honor. Constantine then went to Montecassino, where Abbot Desi-

derius received him into the community, and where he completed his many
translations of Arabic medical texts into Latin.
In the Salernitan legend, Constantine is a merchant w h o , u p o n learning
of the paucity of European medical works, determined to make good that
lack. As he sailed f r o m N o r t h Africa to Salerno, laden with books, a storm
off Cape Palinuro damaged some of the precious cargo. However, C o n s t a n -
tine made it safely to Salerno and there, after converting to Christianity,
began his program of translation. 11 In these legends Constantine is figured
as a culture hero, transferring the advanced medical science of Islam to a
relatively backward Europe—a translatio studii in the most literal sense.
Whatever the truth behind the circumstantial narratives of the leg-
ends—they tell us more about h o w later generations saw Constantine than
about the man himself—we k n o w that Constantine was at first befriended
by Alphanus, the archbishop of Salerno (1058-85) to w h o m Constantine
dedicated his De stomacho.n Alphanus at some point sent him to his friend
Desiderius, Abbot of Montecassino, to w h o m in turn Constantine dedi-
cated his translation of c AlI ibn al-Abbäs al-Majüsí's (d. 994) Kitâb al-Malakï
k n o w n as the Pantechne or Pantegni. If he was not a Christian already, his
conversion probably dates f r o m this time. 13
Montecassino was then in its golden age. Situated at the crossroads of
European, Islamic, and Greek cultures, pivotal in both papal and imperial
politics, the abbey was an ideal place for bringing the N o r t h African's gifts
to the West to fullest fruition. T h e scriptorium was flourishing, and C o n -
stantine had pupils w h o stimulated his translations and compositions. 1 4 His
prologues and dedications portray him as a man for w h o m knowledge was
always part of a living dialogue. We k n o w most about his students Johannes
Afflacius and Atto, both of w h o m continued his translation project. Atto
was chaplain to the Empress Agnes, wife of Henry III and mother of H e n r y
IV, and reworked Constantine's texts, though whether f r o m Latin into the
vernacular or in the f o r m of Latin paraphrases is not entirely clear. 15 J o -
hannes Afflacius Saracenus finished Constantine's version of c Alï ibn al-
c
Abbâs' Kitâb al-Malakï (Pantegni) as well as composed several treatises of
his own. 1 6 In addition, he may have been the one to retranslate the Viaticum's
chapter on lovesickness f r o m the Arabic, in effect creating a second edition
that circulated under the name of Liber de héros morbo.17
Arabic Sources
The Viaticum is an adaptation of the popular medical handbook of A b u j a ' f a r
Ahmad ibn Ibrahim ibn ab! Khälid al-jazzär (d. 979), Kitäb Zäd al-musäfir
Authenticated
wa-qüt al-hä4ir (Provisions for the Traveler and the Nourishment of the Settled).18
Ibn al-Jazzâr, a student of the physician and philosopher Ishäq ibn Sulaymän
al-Isrâ'ïlï (Isaac Judaeus, ca. 855-955), himself the pupil of Ishäq ibn
c
I m r a n , practiced medicine in the N o r t h African city of Q a y r a w a n , the m e -
dieval capital of Tunisia. All three physicians considerably influenced the
development of medieval medicine in the West t h r o u g h Constantine's Latin
translations.
T h e treatise is divided into seven b o o k s w i t h the diseases themselves
arranged f r o m head to toe (a capite ad calcem). cIshk, or passionate love, is
the subject of the twentieth chapter of the first b o o k , immediately preceded
by insomnia, frenzy, and drunkenness, and followed by sneezing, epilepsy,
and apoplexy. 1 9 Since the Zäd al-musäfir was intended as a small b o o k for
traveling in case n o doctor were available (some of the earliest Latin m a n u -
scripts are the size of a paperback), the presence of a chapter on passionate
or excessive love reveals h o w widespread the notion of love as a serious
disease requiring treatment was in Islamic culture (Figure 2.2). 2 0
In c o m p o s i n g the chapter on c ishk, Ibn al-Jazzàr d r e w on sources that
include Galen, Z e n o , al-Kindi, and R u f u s of Ephesus. His use of his teacher
Ishäq ibn c Imran's treatise on melancholy (another Constantinian transla-
tion) 2 1 underscores the close relationship between love and melancholy in
Arabic medical thinking: al-Râzï, c Alï ibn al- Abbäs, and Avicenna m a k e the
same connection. Nonetheless, Ibn al-Jazzär, like his Byzantine predecessors
Oribasius and Paul of Aegina, categorizes love and melancholy as distinct
diseases in separate chapters. T h o u g h the disease of love never severed its
ties f r o m melancholy, its separate treatment in the Zäd al-musäfir granted
the idea of m o r b i d love an a u t o n o m y that helps account for its ready a d o p -
tion in the West. 22
c
Ishk
Before analyzing Constantine's chapter on love m o r e closely, it will be use-
ful to note the range of meaning for c ishk in medieval Islamic culture. T h e
t e r m was widely u n d e r s t o o d as an "irresistible desire . . . to obtain posses-
sion of a loved object or being . . . It betrays, therefore, in one w h o e x p e -
riences it a deficiency, a want, w h i c h he m u s t supply at any cost in order to
reach perfection." 2 3 As a m o t i o n toward perfection, it admits of hierarchical
degrees, and as an aspiration t o w a r d beauty it can b e c o m e a passionate quest
for G o d . " W h a t e v e r the differences in opinion about its content, cishk is one
of the characteristics of medieval self awareness, obsessed w i t h the quest for
the eternal, the transcendent, and the sacred." 2 4
A wide variety of sources, including n o t only poetry and adab literature
Authenticated
Figure 2.2. D o c t o r treating a patient. F r o m t h e Maqämät o f a l - H a r i r i (1122). V i -

enna, B i l d a r c h i v , O s t e r r e i c h i s c h e N a t i o n a l b i b l i o t h e k , C o d . A . F . 9, fol. 64v.
b u t also theology, j u r i s p r u d e n c e , p h i l o s o p h y , and medicine analyzed, d e -

bated, extolled a n d excoriated 'ishk. T h e scholar Ibn al-Jawzi (d. 1200) d e -
clares that cishk is " t h e acute inclination o f t h e soul ( n a f i ) t o w a r d s a f o r m
(sura) w h i c h c o n f o r m s to its n a t u r e ( tabc ). If the soul thinks intensely o n this
f o r m , it imagines the possibility of o b t a i n i n g it and begins to h o p e that it
may. F r o m this intense t h o u g h t is b o r n the malady [of l o v e ] . " 2 5 T h e c o n -
ception of a certain affinity b e t w e e n lovers has its roots in N e o p l a t o n i c and
Platonic traditions inherited by Islamic culture. 2 6
A m o n g Arabic physicians w h o w r i t e o n cishk, Ibn al-Jazzàr gives m o s t
p r o m i n e n c e to this " d o c t r i n e o f a f f i n i t y " w h e n he writes in his chapter o n
love that " w h e n the soul sees w i t h i n itself a consimilar f o r m , it goes m a d ,
as it were, in o r d e r to fulfill its desire." Like the a u t h o r of the p s e u d o -
Aristotelian Problem 30, then, he fuses a Platonic conception o f f r e n z y w i t h
a medical v i e w of madness. 2 7 T h i s Platonic t h e m e in the chapter o n c
ishk
offered a p o i n t of contact in the West, t h r o u g h C o n s t a n t i n e ' s translation,
b e t w e e n medical views of love a n d those o f o t h e r disciplines influenced b y
P l a t o n i s m , such as p h i l o s o p h y and literature.
If, on the o n e h a n d , cishk was assimilated t o divine love in Islamic cui-
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ture, o n the o t h e r it p e r m e a t e d literary depictions of passionate love. " I t is

a state of spiritual servitude to an idealised female figure, u p o n w h i c h t h e
' c o u r t l y ' sentiments of a soul in ebullition . . . crystallize." 2 8 Since t h e t e r m
c
ishk carried significant cultural resonances that strikingly parallel the i n t e r -
play of mystical m a d n e s s (alienatio mentis), lovesickness, and " c o u r t l y " love
in the West, to w h a t degree, if any, was their c o n j u n c t i o n i m p o r t e d ? O r are
w e dealing instead w i t h parallel manifestations in t w o cultures equally heirs
to the legacy of antiquity? Recently loan C o u l i a n o has a r g u e d that " t h e
p h e n o m e n o n o f courtly love has . . . m o r e in c o m m o n w i t h A r a b m e d i c i n e
and m y s t i c i s m [than w i t h C a t h a r i s m ] . " 2 9 H e points out that idealization o f
the f e m i n i n e p e r v a d e d A r a b mystical p o e t r y and was r o o t e d in the Platonic
a s s u m p t i o n o f a c o n t i n u u m b e t w e e n sensory and intelligential beauty. C o u -
liano locates the genesis of courtly love in this strain of Platonizing m y s t i -
cism (Sufism) a n d the concept of lishk. H e argues that it e m e r g e d f r o m a
shift in the idea of health: " T h r o u g h this Umwertung, the g l o o m y equi-
librium o f psychic forces r e c o m m e n d e d b y learned treatises was t r a n s -
f o r m e d into a sickness o f the intellect [i.e., the medical idea of lovesickness],
whereas, o n the contrary, t h e spiritual sickness induced by love e n d e d by
being extolled as t h e real health of b o d y and s o u l . " 3 0
T h o u g h he argues for t h e priority of Islam in the d e v e l o p m e n t o f
courtly love, C o u l i a n o does n o t take u p t h e question o f w h e t h e r a n d h o w
Islam influenced the West o n this score. In her re-evaluation o f the Arabic,
specifically Andalusian, influence o n medieval E u r o p e a n literary history,
Maria Rosa M e n o c a l makes a s t r o n g case that the poetic f o r m called t h e
muwashshaha m e d i a t e d b e t w e e n the t w o cultures. 3 1 O r i g i n a t i n g in A n d a l u -
sia, this t y p e of p o e m contained a n u m b e r of stanzas in classical Arabic and
a refrain (kharja) in the M o z a r a b i c vernacular. Several passages in t h e e x -
amples she prints s h o w that lovesickness was a s t a n d a r d t h e m e :
M e u 1-habib e n f e r m o de m c u amar.
Q u e n o ha d'estar?
N o n ves a m i b e q u e s'ha d o n o llegar?
[My beloved is sick for love of me. How can he not be so? Do you not see
that he is not allowed near me?]
O h you, m y sickness and m y healer, in b u t a w o r d f r o m y o u lies the cure

of m y illness. A n d yet, because of you, I have melted away t o n o t h i n g .
(93-95)
T h e Islamic n o t i o n of cishk in all its c o m p l e x i t y , then, m a y have p e n e t r a t e d

E u r o p e f r o m t w o directions: f r o m N o r t h Africa (by way of Italy) t h r o u g h
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Constantine s medical translations and at about the same time (1050-1150)

f r o m Spain in Andalusian poetry. T h e Spanish route was then later rein-
forced by Gerard of Cremona's (d. 1187) Toledan translations of other Ara-
bic medical works dealing with the disease of love. 32
Viaticum 1.20
Constantine translated the Zäd al-musäfir into Latin with the title Viaticum
peregrinantis. Since his translation is actually a paraphrase that expands and
omits where necessary in order to present Islamic medicine to an unedu-
cated Western audience—those w h o found the Pantegni hard going, as he
says in the preface to the Viaticum33—I will henceforth refer to the Latin
version as "Constantine's" Viaticum to distinguish it f r o m its Arabic source,
the Zäd al-musäfir.
T h e chapter on " a m o r qui et eros dicitur" (love that is also called eros)
closely follows the structure of its source, beginning with a definition of
love, followed by its causes, symptoms and cures. In reworking Ibn al-
Jazzär's chapter, he abridges the definition of love and the catalogue of p o -
tential love objects. He also cuts out Arabic names in the attribution of
quotations while leaving those of Galen and Rufus. 3 4 Finally, he omits ma-
terial at the end of the chapter—an explanation of the type of basil to be
used, and an invocation to Allah. O n e interesting result of Constantine's
alterations is the implication that excessive love is directed solely at people.
T h e Arabic and Greek versions indicate that the lovesick patient may desire
objects as well as people. T h o u g h later Western physicians occasionally use
amor hereos, as they called it, in reference to horses or other objects—
Richard de Bury even uses it of a passion for b o o k s — t h e most c o m m o n
understanding of the disease in the Latin Middle Ages restricted it to sexual
passion for a person of the opposite sex. 35
Eros and Pleasure

T h e particular type of love that is also called eros,36 begins Constantine,
is. a disease (morbus) of the brain involving desire and "affliction of the
thoughts." T h e definition follows Galenic tradition in localizing sensation
and passions in the brain rather than in the heart, where Aristotle puts
them. 3 7 Constantine then refers to certain philosophers w h o claim that eros
is the word designating the greatest pleasure. Just as fidelity is the ultimate
form of affection, so eros is the extreme f o r m of pleasure.
The definition of love as a pleasurable disease (morbus) suggests the
paradoxical inversion of the concept of health found in "courtly" love in
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medieval Islam a n d C h r i s t i a n E u r o p e (that is, it is salutary to be sick w i t h

love). T h e parallel makes the definition a locus w h e r e w e can o b s e r v e w h a t
C o u l i a n o calls the "selective w i l l " of the Viaticum c o m m e n t a t o r s , by w h i c h
they read their a u t h o r t h r o u g h a " h e r m e n e u t i c filter," an " i n t e r p r e t i v e
grille," w h i c h reveals structures and e m p h a s e s of the a p p r o p r i a t i n g cul-
ture. 3 8 If w e accept this hypothesis, the c o m m e n t a r i e s o u g h t to tell us as
m u c h a b o u t medieval conceptions of pleasure as they d o a b o u t love and
disease. For C o n s t a n t i n e ' s first s u r v i v i n g c o m m e n t a t o r , G e r a r d of B e r r y
(late t w e l f t h century), wealth and l e i s u r e — t h a t is, pleasure in daily l i f e — a r e
the prerogatives o f the nobility, a n d it is they w h o suffer t h e disease o f love.
To this localizing of lovesickness in the c o u r t s he adds a n o t h e r element g e n -
erally associated w i t h courtly literature: the c o u p l i n g of pleasure w i t h in-
tense love f o r a single individual. 3 9 For Peter of Spain, as w e shall see in
detail in chapter six, pleasure is a f u n c t i o n of t h e p s y c h o p h y s i o l o g y of g e n -
der, and g e n d e r affects w h e t h e r and h o w intensely o n e suffers f r o m love-
sickness. Viewed as a f o r m o f e x t r e m e pleasure, m o r b i d love thus e v o k e d
cultural a s s u m p t i o n s a b o u t pleasure in the b o d y politic and in the i n t i m a t e
recesses o f the g e n d e r e d body. T h e s e in t u r n b e c a m e avenues (among
others) f o r the passage of lovesickness into particular locales of cultural t o -
p o g r a p h y — t h e literature of " n o b l e love" and scientific discourse o n sexual
pleasure.
Causes
E r o t i c love can arise f r o m the b o d y ' s need to expel excess h u m o r , f o r w h i c h
R u f u s (says C o n s t a n t i n e ) r e c o m m e n d s intercourse as the best r e m e d y .
E r o t i c love can also arise f r o m the perception of a beautiful f o r m , w h e n t h e
soul goes m a d w i t h desire to fulfill its pleasures. A l t h o u g h this N e o p l a t o n i c
strain is underplayed by Viaticum c o m m e n t a t o r s , G e r a r d of B e r r y does
briefly gloss it as the cause of true love. M i n d and b o d y interact closely in
this disease: the balance b e t w e e n s o m a t i c and psychological causes is also
paralleled in s y m p t o m a t o l o g y and therapy. C o m p a r e d w i t h his s y m p t o m -
atology and therapy, h o w e v e r , C o n s t a n t i n e ' s etiology is the least satisfac-
tory part of the chapter and t h e section that was to be m o s t amplified b y
c o m m e n t a t o r s , as will be detailed in the f o l l o w i n g chapters.
As C o n s t a n t i n e presents it, it is difficult to decide w h e t h e r amor eros is
m o r e akin to N e o p l a t o n i c striving f o r b e a u t y or to an attack o f sexual need.
T h e chapter as a w h o l e e m b o d i e s the Galenic p r e m i s e that " m a n ' s b e h a v i o r
d e p e n d s on his somatic c o n s t i t u t i o n and d i s p o s i t i o n . " 4 0 T h i s medical m a t e -
rialism implies a kind of m o r a l d e t e r m i n i s m , a consequence that Galen h i m -
self was n o t fully prepared to draw. H e maintained that free will was n o t
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thereby infringed; dietetic medicine, study, and p h i l o s o p h y could amelio-

rate the effects of one's bodily composition, allowing moral behavior to
overcome the dictates of somatic t e m p e r a m e n t .
Constantine takes no overt stand on the issue. T h e allusions to Galen
and their application to untreated lovesickness, however, i m p l y a d e t e r m i n -
istic view, one that also surfaces in his conception of etiology. T h e a d v e n -
titious sight of a beautiful object and the presence of excessive or c o r r u p t
h u m o r s involve chance and the material composition of the b o d y ; free will
or domination of matter t h r o u g h one's philosophical attitude are passed
over in silence. T h e ambiguity of the Viaticum's causality enabled lovesick-
ness to be idealized in poetry, to be c o m p a r e d w i t h mystical love, and to be
c o n d e m n e d as cupidity.
Symptoms; Melancholy
T h e s y m p t o m s of lovesickness, in contrast, proved far less problematic.
T h o s e that can be traced back to Greek and R o m a n literature t h r o u g h the
intermediaries of Arabic and Byzantine medical w o r k s include the alteration
of appearance (sunken eyes, jaundiced color) and of behavior (insomnia,
anorexia, depressed t h o u g h t s [profondatici cogitationum]).41 T h e consequences
of untreated lovesickness are even m o r e dire. As Galen says, " t h e p o w e r of
the soul follows the c o m p l e x i o n of the b o d y " ; f u r t h e r m o r e , " t h e b o d y fol-
lows the soul in its action, and the soul accompanies the b o d y in its suffer-
i n g . " This d y n a m i c interaction of b o d y and m i n d increases the lover's
bodily suffering while the disturbed balance of his physical c o m p l e x i o n f u r -
ther unbalances h i m psychologically. H e may lapse into a melancholy
passion.
Whereas the Viaticum considers love a forerunner of melancholy, in a n -
other Constantinian translation, the Pantegni theorica, love is a type of m e l -
ancholy. 4 2 A n d in Constantine's translation of Ishaq ibn c Imran's treatise on
melancholy, those w h o lose a beloved, scholars w h o suddenly lose their
books, those w h o are exceedingly religious, indeed, anyone w h o suffers
f r o m excessive t h o u g h t , w h i c h is "labor of the soul" according to H i p p o c -
rates, may fall prey to melancholy. T h e s y m p t o m s of lovesickness corre-
spond to those listed in De melancholia, and in fact the Viaticum's chapter
on love parallels De melancholia in a n u m b e r of places. 43 T h e kinship b e t w e e n
love and melancholy in the Constantinian corpus reinforced the n o t i o n
that love could b e c o m e a disease; it provided an authoritative medical back-
g r o u n d for the figure of the "melancholy lover" in E u r o p e a n literature; and
it suggests that the p s y c h o d y n a m i c s of melancholy may illuminate the gene-
sis of lovesickness, a point to be taken up in the last chapter.
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Cures
The longest section of the chapter, embellished with frequent quotations
f r o m medical authorities, deals with therapy. In keeping with the dual cau-
sality, the cures—intercourse, wine, baths, conversation, music, and p o -
etry—are directed at both body and mind. Therapeutic intercourse, a cure
that ancient medicine particularly recommended for melancholy and mania,
was a therapy whose aim was to restore proper humoral balance. It was
considered one of the six "non-naturals" (air, food and drink, waking and
sleeping, motion and quiet, evacuation and repletion, and the emotions),
whose regulation was essential to health (Figure 2.3). Constantine's De
coitu, for example, sets forth the circumstances in which intercourse is
healthful or harmful and describes how it best may be accomplished. N o t
only does coitus expel superfluous humors, but in addition, according to
the widely-quoted Rufus of Ephesus, it also chases out fixed ideas, which is
particularly valuable for the melancholic. A m o n g its benefits he also reck-
ons that of "dissolving love." 4 4
Therapeutic intercourse seems to have posed no ethical dilemma to
most of the doctors w h o wrote on lovesickness, most likely because it fit
lay European sexual morality: men's sexual activity outside marriage, espe-
cially with prostitutes, seems not to have been viewed very seriously, since
it posed no threat to "household order or the purity of the lineage." 4 5 T h e
easy availability of prostitutes, at least in the larger urban centers where
academic physicians, medical students, and their well-to-do patients con-
gregated, suggests that there would have been little practical difficulty in
carrying out this particular cure. 46 T h o u g h Constan tine and his c o m m e n -
tators never address the topic explicitly, it seems clear that " h o n e s t " w o m e n
were excluded f r o m the enjoyment of this therapeutic practice.
O t h e r physical cures, drinking wine and bathing, were also calculated
to restore the proper balance of humors. At the same time, they helped the
patient regain a more cheerful disposition by counteracting his tendency to
isolation and depression. O f all the cures, wine elicits the most fulsome
praise. Three ancient authorities in turn endorse its powerful benefits. Ac-
cording to Rufus, it is a strong medicine for the timid, the sad, and lovers.
Galen reckons the first winemaker a m o n g the wisest men, and Z e n o de-
scribes its ability to leach discontent f r o m the soul. T h e benefits of wine are
at their best, says Constantine, if the drinking is a m o n g friends w h o are
outstanding in beauty, knowledge or morals. 4 7 T h e physical and moral ex-
cellence of the lover's drinking companions redirects his fixation toward
more worthy objects. If this relaxing but not somniferous conversation can
take place in gardens, so much the better. It will be most pleasant if they
Authenticated
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Figure 2.3. Coitus, one o f the "non-naturals" upon whose regulation .health de-
pends, is illustrated in the health handbook Tacuinum sanitatis. Bibliothèque géné-
rale, Université de Liège, M S 1041, fol. 69v.

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^ u i m n j i b u r n Aiouit.opVo.cx.ntic u u . c i c c t ò . t t u a ^ . i t r i t ì i i c i u i u . i n i icAir f.iiiic.ucrtmi.
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wgiomb» .nifi ñicniir ctcfffluc « V i t i n j
Figure 2.4. D r i n k i n g w i n e w i t h a g o o d - l o o k i n g c o m p a n i o n in a f r u i t - b e a r i n g g a r -
d e n . Vienna, B i l d a r c h i v , O s t e r r e i c h i s c h e N a t i o n a l b i b l i o t h e k , C o d . ser. n o v . 2644,
fol. 86r.

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Figure 2.5. B a t h i n g w a s o f t e n a social activity in t h e M i d d l e A g e s , o f f e r i n g d i s t r a c -
tion f r o m p r e o c c u p a t i o n as well as physical t h e r a p y . B a t h o f Iuncara, f r o m P i e t r o
da Eboli's De balneis Puteoianis. N e w York, T h e P i e r p o n t M o r g a n Library, G 74,
fol. 6.

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Figure 2.6. According

to the Tacuinum sanita-
tis, sleep is a suitable
cure for, a m o n g others,
the melancholic. T h e
power of music to
soothe is also implied
in the illustration.
Vienna, Bildarchiv,
SWftv.&inmiAüra« Stilili« iJfftor-Uu¿ar.*.m>jarr lÌKtòa>anitc i W í «'l'ilnu*«— Österreichische
imrtrn íntjtílj. c n t a t o R i irWiur noitre-t nunc Ita ujajôciitr. Nationalbibliothek,
h«c«irol!>.<Jiiciiiri!U¡¡ «¡unafjl'.mttórtinr t m d ù r m y i S r i t η Ο - ι ^ ι ο ί ' C o d . ser. nov. 2644,
fol. lOOr.
are bright, sweet-smelling, and fruit-bearing (Figure 2.4). If this is not pos-
sible, the rooms where the people are to sit should be strewn with salutary
herbs like roses ("good for inflamed brains" according to the Tacuinum san-
itatis), myrtle, willow, and basil.
Bathing, like wine drinking, was supposed to alter the humoral balance
as well as to restore equanimity. Constantine recommends that bathing fol-
low sleep, and that the water and air be bright and temperate. Some patients
are so heartened when they enter the baths, he notes, that they begin to
sing. Since bathing in the Middle Ages was a social activity (Figure 2.5), 48
Constantine cautions that the patient should be shielded f r o m repugnant
people while bathing, and reinforces the point with a brief anecdote. Phi-
losophers once asked someone w h y a horrible man is worse than any bur-
den (pondus). He replied that while other weights are borne by body and
soul together, a horrible man is a burden to the soul alone.
Music too is a therapy with both physical and psychological benefits.
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Some philosophers even claim a kind of synergy for music and wine: sound,
they say, is like spirit, and w i n e like the body, each of w h i c h aids the other.
B o t h ancient and medieval medicine prescribed music for its therapeutic
effects. 49 Constantine quotes " O r p h e u s " to reveal music's power to alter
m o o d s . T h o u g h e m p e r o r s invite h i m to p e r f o r m for their pleasure, he
in turn takes pleasure in t h e m because he can change their souls as he
p l e a s e s — f r o m anger to mildness, f r o m sadness to joy, f r o m avarice to g e n -
erosity, f r o m fear to boldness (Figure 2.6).
"Recitation of verses" was also supposed to alleviate the patient's obses-
sion w i t h a particular w o m a n . 5 0 As Avicenna recognized, s o m e t i m e s this
strategy only served to reinforce the lover's preoccupation, especially w h e n
the songs were about unsuccessful love. Constantine, in contrast, t h o u g h
giving the cure only the briefest mention, introduces n o d o u b t s as to its
efficacy. This particular cure provided a fertile point of convergence b e -
tween the medical tradition of lovesickness and literary representations of
passionate love. F r o m the t w e l f t h century onwards, fictional characters or
lyric personae claim to c o m p o s e or sing in order to relieve love-sorrow,
and in the hands of Dante, Boccaccio, and Chaucer, the lovesick poet or
poetic lover was variously reinterpreted according to medical ideas a b o u t
lovesickness.
Johannes Ajflacius and the " Liber de héros morbo"

T h e study of Constantine's chapter on love and the Western u n d e r s t a n d i n g
of lovesickness has been b o t h enriched and complicated by the discovery of
a "second edition" of Ibn al-Jazzär's chapter on c ishk. As I have argued else-
where, its a u t h o r may have been Constantine's pupil Johannes Afflacius,
w h o used b o t h the Arabic version and the Viaticum to p r o d u c e a s m o o t h e r ,
less a m b i g u o u s text which circulated under the manuscript rubric Liber de
héros morbo.51 T h a t the Viaticum's chapter on lovesickness enjoyed a second
edition as an independent treatise suggests that E u r o p e a n readers were suf-
ficiently interested in this n e w technical discourse on passionate love to j u s -
tify the effort of retranslation.
A p p e n d e d to the text is the explicit: "Finit liber heroice passionis" (here
ends the b o o k of the disease heros); t h r o u g h o u t , f o r m s of the w o r d heroicus
replace Constantine's eriosis and eriosos as designations of the patients. In the
context of the Liber de heros morbo, heroicus means " t h o s e w h o suffer f r o m
the disease heros"—a n e w and unique meaning. T h e previously attested se-
mantic range of heroicus includes the obvious " b e l o n g i n g to a h e r o " as well
as a peculiar medieval sense " b e l o n g i n g to a lord or n o b l e m a n , " d o c u -
m e n t e d as early as the sixth century. Just as C o n s t a n t i n e introduced the
Authenticated
n e o l o g i s m eriosis, so J o h a n n e s (or w h o e v e r was the a u t h o r of the Liber)

r e f o r g e d heroicus as a technical medical t e r m f o r passionate lovers. W h e t h e r
heros was a d o p t e d f r o m a Viaticum m a n u s c r i p t or w h e t h e r it w a s i n t e n d e d
as a deliberate contrast to eros finds n o easy a n s w e r in the evidence at h a n d .
W h a t e v e r its origin, does the translation of cishk as heros testify to a nascent
concept of love as a " n o b l e passion"? O n e c h a n g e m a d e in t h e Latin d e f i n i -
tion of cishk suggests that s o m e of t h e usual m e a n i n g s of heros consciously
o r unconsciously shaped the explanation. Whereas C o n s t a n t i n e says that
j u s t as loyalty is t h e m o s t e x t r e m e f o r m of affection, so eros is the m o s t
intense f o r m of pleasure, the Liber alters t h e t e r m s of t h e contrast. Instead
of distinguishing b e t w e e n the qualities of love (affection, pleasure), it does
so b e t w e e n the objects o f love: "Just as fidelity is i m m o d e r a t e love f o r a lord,
so h e r o s is i m m o d e r a t e love f o r t h o s e t o be possessed (sexually)." B y c o m -
paring intense sexual love to loyalty t o a lord, the Liber de heros morbo col-
locates passion and service as early as 1100 in a way that w a s t o b e c o m e
conventional in certain t w e l f t h - c e n t u r y literary traditions. T h o u g h there is
"a l o n g a n d large d i f f e r e n c e , " as Chaucer's M e r c h a n t w o u l d say, b e t w e e n
heros morbus and t h e erotic suffering of stylized love service in later medieval
literature, the Liber heroice passionis is nonetheless a h a r b i n g e r o f the cultural
transvaluations of b o t h amor a n d passio in the t w e l f t h and thirteenth c e n t u -
ries, w h e n idealized love-suffering gradually shifted f r o m cultural fantasy t o
social reality. 5 2
The V i a t i c u m ' s Popularity and Influence

With its flourishing s c r i p t o r i u m and its p r o x i m i t y to the medical school at
Salerno, M o n t e c a s s i n o was well-placed f o r t h e diffusion of C o n s t a n t i n e ' s
translations. A l t h o u g h the d e g r e e of C o n s t a n t i n e ' s i m m e d i a t e i m p a c t o n
Salernitan medicine has been controversial, recent scholarship has a f f i r m e d
his early influence on Salernitan writers. 5 3 J o h a n n e s Afflacius m a y have been
i n s t r u m e n t a l in i n t r o d u c i n g his m e n t o r ' s w o r k s to the Salernitans. 5 4 C o n -
stantine's o t h e r student, Atto, w h o was chaplain to e m p r e s s A g n e s , also
helped the diffusion of his master's w o r k s by either p a r a p h r a s i n g t h e m
in Latin o r translating t h e m into t h e vernacular. T h o u g h n o n e o f these
versions appears t o have survived (unless the Liber de heros morbo is the
j o i n t w o r k of J o h a n n e s and Atto), they suggest an i m m e d i a t e interest in
the n e w l y available medical learning on the part o f lay readers as well as
physicians.
T h r o u g h imperial courtiers like Atto and t h r o u g h M o n t e c a s s i n o ' s w i d e -
r a n g i n g ties in E u r o p e the n e w C o n s t a n t i n i a n c o r p u s spread relatively
quickly t h r o u g h o u t the West. His w o r k s are f o u n d as early as the 1130s in
Authenticated
Chartres, 1161 in Hildesheim, and appear in twelfth-century library cata-

logues in St. A m a n d and Durham. 5 5 In the first half of the thirteenth century
Richard de Fournival listed the liber passionarius quem Viaticum vocat in his
library catalogue, and in the fourteenth Simon Bredon, a physician and Fel-
low of M e r t o n College (d. 1372), bequeathed a glossed copy to Roger As-
wardby, asking him to return it to the owner; if the owner could not be
found, he was to give it to any physician w h o lacked it, which suggests that
many doctors were expected to o w n a copy. 56 T h e German physician A m -
plonius Ratinck (d. ca. 1434), whose library is n o w at Erfurt, owned five
glossed copies of the Viaticum.57 Private owners of the w o r k are well attested
in England, where they have been traced through donations to libraries. 58
With the rise of more formal medical education at the medieval univer-
sities, the Viaticum entered the standard medical curriculum. Alexander
Neckham's list of textbooks shows that the Viaticum was read at Paris by
the end of the twelfth century, and in the statutes of 1270—74, the bachelor
of medicine was required to hear it in order to be licensed. 59 T h o u g h docu-
mentary evidence is not as abundant for the medical school at O x f o r d as it
is for Paris, O x f o r d seems to have followed Parisian practice; thus it is likely
that the Viaticum was read there as well. 60 Constantine's work may have been
k n o w n to an even wider audience than the candidates for medical degrees,
since many students at O x f o r d studied medicine without receiving a degree
in it. 61 T h e statutes for the medical school at Cambridge date f r o m the late
fourteenth century (a fire in 1381 wiped out earlier records) and were based
on those at O x f o r d . Since the Viaticum was among the required texts there,
we may infer its use at O x f o r d as well. 62
T h o u g h legend attributes the foundation of the medical school at M o n t -
pellier to a student of Constantine the African, the Viaticum seems not to
have been intensively studied there in the middle of the thirteenth century.
By the early fourteenth century, however, Montpellier physicians quoted it
in their o w n works. 6 3
Concordantiae, which were general medical dictionaries arranged alpha-
betically, attest to the particular importance of the Viaticum's chapter on
love. Entries were usually brief and referred the reader to the standard au-
thorities on the subject. 6 4 Jean de St. Amand (Johannes de Sancto Amando),
a professor of medicine at Paris in the late thirteenth century (d. before
1312), drew u p a concordance, or as Sarton calls it, "a dictionary of internal
pathology," based primarily on the works of Galen and Avicenna. 65 T h e
Viaticum is occasionally cited and appears in the entry for amor hereos. T h e
reader of this entry in Jean's concordance, after learning of Galen's famous
diagnosis of lovesickness by alterations of the pulse, is referred to Constan-
tine and Avicenna: " D e ista materia habes Γ (primo) viatici et IIIo (tertio)
Authenticated
Avicennae" (Concerning this material see the first book of the Viaticum and
the third book of Avicenna). 66 Jean's concordance was revised by Pierre de
St. Flour (Petrus de Sancto Floro), w h o received his degree as bachelor of
medicine at Paris in 1349. 67 Under the entry amor hereos Pierre lists al-Râzï,
Averroes and Constantine as authorities, and he also quotes Avicenna's defi-
nition of ilisci Çishk) f r o m the Canon. These concordances testify that C o n -
stantine and Avicenna were considered the standard authorities on the
subject of lovesickness in the thirteenth and fourteenth centuries. T h e final
f o r m of medical writing that allows us to j u d g e the importance and influ-
ence of the Viaticum in the Middle Ages, glosses and commentaries, is the
subject of the following chapters.
T h e Viaticum s division of the causes of passionate love into physical

and psychological paralleled the growing dualism of twelfth-century habits
of mind, with their tendency to see reality in terms of matter and spirit,
outer surface and inner reality. As a disease caused by humoral imbalance,
amor eros reminded the medievals of their materiality, their subjection to
environmental forces and to time. Perhaps medicine even gave them license
to enjoy that materiality a bit, by prescribing actual pleasures—women,
wine, and baths—to replace the anticipated pleasure of union with the
beloved.
T h e historical record has left no details on patients treated by practi-
tioners w h o consulted the Viaticum. Using recent investigations of the i m -
plications of literacy, we can, however, sketch the probable effect of the
Viaticum and the Liber de héros morbo on medieval society. A m o n g the con-
sequences of the spread of literacy, Stock argues, are the formation of " n e w
rituals of everyday life." 6 8 In the eleventh and twelfth centuries, new texts
and changed methods of interpreting old ones introduced new values that
in turn reshaped social behavior. This" was likely to happen with medicine,
which is by its very nature a pragmatic social interchange a m o n g healer,
patient, and family. 69 N e w ideas f r o m Arabic medicine— c ishk and amor
eros—had the potential for transforming the social practices associated with
love. While it is true, as I have argued in the first chapter, that Biblical and
classical literary conceptions of lovesickness, as well as folk ideas about love
madness, aided the reception of Arabic medical ideas, the new medicine
gave the West a different sort of model of erotic action and passion.
As medical texts, they had scientific authority and were viewed as e m -
pirical descriptions of reality, that is, of the social reality of humans in
health, disease, and states in between. T h e y had to be seen as empirical
descriptions if medicine was to have any practical effect—and we need to
recall that the Viaticum was above all else intended as a practical handbook.
Authenticated
T h e love that was the subject of the physician's concerns was neither literary
fable nor spiritual allegory, but a psychosomatic disorder requiring treat-
ment. -The disease of love, as we may gather f r o m the commentaries on
Constantine and Avicenna, f r o m medical texts and vernacular literature,
gradually rooted itself in medieval mentalities, shaping both intellect and
affect. By the late Middle Ages, lovesickness had become an effective ploy
in the amorous intrigues of the nobility. 70 T h e medical texts also confirmed
the "reality" of the disease in a second way, by granting the physician the
authority to intervene in the patient's emotional life. His power to diagnose
a certain pattern of behavior as love turned disease and to prescribe cures
for it also gave him the power to reshape perceptions of love. In other
words, medicine offered a new interpretive model for explaining certain
symptoms of appearance and behavior.
T h e shift f r o m oral to scribal culture enabled people to pattern their
lives on texts to a new degree; as Stock claims, interpretive models influ-
enced experience. With the diffusion of Viaticum manuscripts and their
assimilation into intellectual life, Constantine's description of intense, de-
bilitating love was available for conscious or unconscious imitation. It p o -
tentially generated both a particular experience of love and the means for
reflecting upon or classifying that experience. Finally, the description of
love as illness lent a powerful and ongoing presumption of reality to the
evolving love conventions of the literature emanating f r o m courts and ur-
ban centers of medieval Europe. T h e growing body of medical discourse on
love made it possible for the literary representations of erotic passion to be
interpreted mimetically or realistically, as reflections of real life. T h e cul-
tural authority of medicine may have in part enabled the poetic fantasies of
the troubadours to become the social realities of the late Middle Ages and
early modernity.

Authenticated
§§ 3 §§
" N O B L E " LOVE
Gerard of Berry s
Glosses on the Viaticum
Ecstatic love is taken in another way, for love that alienates the
mind . . . w h i c h indeed is called a m o n g physicians amor ereos. For
amor ereos is a great desire w i t h excessive concupiscence and affliction
o f the thoughts. Ereos are said to be noble m e n w h o , because o f s o f t -
ness and pleasures o f life are subject to this sort o f passion.
H u g h o f St. Cher 1
I n the century after Constantine had renewed the vigor of European

medicine, the discipline itself and its relations to medieval culture under-
went profound transformations. T h e Constantinian translations awakened
medicine's philosophical aspirations, which were strengthened by encoun-
ter with the new translations of Aristotle and Arabic science issuing f r o m
Spain. Institutionally, medicine became associated with the newly-formed
universities, where it entered into dialogue with other disciplines, par-
ticularly in the arts faculty. Increasingly professionalized and secularized,
medicine in the late twelfth and early thirteenth centuries began to
achieve recognition both as an intellectual discipline and as a socially i m -
portant profession. 2
Between Constantine and Gerard of Berry, w h o w r o t e the earliest
surviving commentary on the Viaticum, also lies the first flourishing of
vernacular courtly literature, in which the European nobility fashioned its
dream of romantic love. Lyric poems, lais, and romances depicted the
passions of "noble hearts." Drawing upon O v i d and perhaps the Viaticum
and/or the Liber de héros morbo, vernacular poets explored the process of
falling in love and noted its tell-tale signs. 3 By the end of the century
love in imaginative literature had become so conventionalized that A n -
dreas Capellanus (d. after 1191) could codify and spoof the rules for lov-
ing in De amore (ca. 1181-86), a treatise with which Gerard's chapter on
love shows a number of similarities. 4
Authenticated
Gerard's commentary on amor (h)eros, marked by the Aristotelianism

of Salerno and the Arabism of Montpellier, reveals the complex crosscur-
rents of medical, literary, and religious languages on the subject of passion-
ate love around 1200. T h e importance of his contribution to technical
medical discourse on love can be gauged by the large n u m b e r of surviving
manuscripts of his Glosses on the Viaticum and by the frequency with which
he was quoted by other medical writers on lovesickness. Amplonius Ra-
tinck, a fifteenth-century physician and bibliophile, collected no fewer than
five copies of Gerard of Berry's commentary on the Viaticum.5 T h e medical
c o m m u n i t y of the thirteenth and fourteenth centuries shared Amplonius'
high appraisal of Gerard's work: at least seventy-five manuscripts of the
Glosule super Viaticum (Glosses on the Viaticum) have survived into the t w e n -
tieth century. His work was so influential because, as we shall see, he gave
physicians a language for analyzing the pathology of love, for tying e m o -
tional states to material conditions in the body. 6
Calling himself "Magister Gerardus Bituricensis, professione phisicus,"

Gerard says in the prologue that he compiled his commentary at the request
of his Parisian colleagues in order to remedy the excessive brevity of the
Viaticum's discussions of causes, signs, and cures, and to supplement what
was ignored by his predecessors. 7 H e also says that he will omit experimenta,
that is, empirical formulations that cannot be theorized, f r o m Salerno and
Montpellier, except for a few that have been well-tested by experience. We
may infer, then, that he taught medicine, and that his commentary, like the
others in this volume, grew out of classroom instruction (Figure 3.1).
Gerard's work may be provisionally placed in the last decades of the
twelfth century. At the latest it must have been composed by 1236, the date
of the earliest manuscript, a date also supported by H u g h of St. Cher's q u o -
tation of Gerard on amor hereos around 1235. 8 However, another citation of
Gerard points to an earlier date. T h e Salernitan master Bernardus Provin-
cialis explicitly attributes to Gerard a discussion of monstrous afterbirths
called "brother of the Lombards" in a commentary on the Tables of Saler-
nus.9 De Renzi argues that Bernard's commentary should be dated around
1150—60, based on his failure to quote Salernitan authors f r o m the second
half of the century. 10 T h e one citation that would cast doubt on the date, he
says, is of Gerard on the Viaticum. De Renzi's solution was to see in a certain
Gerard, nobleman and physician, whose activities are attested near Salerno
in 1184, the author of the commentary on the Viaticum.11 There are p r o b -
lems with this solution. First, Gerard explicitly says that he w r o t e at the
instigation of his Parisian colleagues. Given the relatively backward state of
Parisian medicine before Gilles de Corbeil's (ca. 1140—ca. 1224) arrival
Authenticated
Gerard of Berry's Glosses on the V i a t i c u m § 53
Figure 3.1. A m a s t e r o f m e d i c i n e a p p a r e n t l y teaches t o t h e back o f t h e

r o o m w h i l e a d i s g r u n t l e d s t u d e n t p o i n t s t o the t e x t " L i f e is s h o r t " (the
o p e n i n g w o r d s o f t h e first H i p p o c r a t i c A p h o r i s m ) . V i e n n a , B i l d a r c h i v ,
O s t e r r e i c h i s c h e N a t i o n a l b i b l i o t h e k , C o d . 2315, fol. I r .
a r o u n d 1194, it is difficult to i m a g i n e that G e r a r d w r o t e the c o m m e n t a r y in

Paris b e f o r e 1160 and then m o v e d to the p r e e m i n e n t medical center of
E u r o p e , Salerno, to c o n t i n u e his activities. 1 2 Second, G e r a r d uses Avicenna's
Liber de anima a n d Canon medicinae. T h e Canon was translated b e f o r e 1187
(the death o f G e r a r d of C r e m o n a ) , the De anima b e t w e e n 1152 and 1166. 13
A date as early as 1 1 5 0 - 6 0 t h e r e f o r e seems unlikely for either B e r n a r d u s
Provincialis o r G e r a r d .
Several o t h e r discussions of arpia or frater lombardorum d o h o w e v e r s u g -
gest a general date o f 1 1 8 0 - 1 2 0 0 for Gerard's activity, as well as c o r r o b o r a t e
his Salernitan and Parisian connections. T h e a n o n y m o u s Salernitan c o m -
m e n t a t o r of a b o u t m i d - c e n t u r y and t h e Salernitan master B a r t h o l o m a e u s ,
active in the third q u a r t e r of the t w e l f t h century, b o t h m e n t i o n the u n u s u a l
condition. 1 4 It also appears in a Prose Salernitan Question a t t r i b u t e d to " m a s -
ter A l a n , " w h o m a y be identical w i t h Alain de Lille (d. 1203), in a m a n u -
script that originated in Paris in the late t w e l f t h c e n t u r y ; Gilles de C o r b e i l
also m e n t i o n s it. 1 5 G e r a r d thus seems to have b o r r o w e d f r o m a n d c o n t r i b -
uted to this tradition, w h i c h w o u l d place his activity in r o u g h l y the last
quarter o f the t w e l f t h century.
Authenticated
Although Gerard drew together his glosses on amor hereos in Paris in

the age of Philip Augustus (1165-1223), the case of the jrater lombardorum
suggests a Salernitan background or strong Salernitan connections. As we
have seen, the Salernitan author Bernardus Provincialis was familiar with
Gerard's commentary not long after it was written, which suggests close
ties to that center. Gerard's treatise also shows affinities with the works of
Maurus (d. 1214) and U r s o (d. 1225), Salernitan authors of the late twelfth
century, and indeed, the commentary f o r m itself is in line with the c o m -
mentary tradition of twelfth-century Salerno. 16 Furthermore, his choice of
the Viaticum as an authoritative text on which to c o m m e n t again suggests
connections with Salerno rather than with Montpellier, since the Viaticum
had little impact at the latter school before the middle of the thirteenth
century. 17
Yet Gerard's relatively early use of Avicenna points to the influence of
Montpellier, first of the medical centers to come to terms with the Toledan
translations. 18 It is possible that Gerard's refusal to discuss the experimenta of
Salerno and Montpellier is a response to his Parisian colleagues' expecta-
tions that he bring them up to date on the practices of those leading medical
centers of the time based on his experiences there. Travel a m o n g medical
schools was not u n c o m m o n : Gilles de Corbeil (ca. 1140-1224), for ex-
ample, in whose Parisian medical circle Gerard may have been active, stud-
ied at Salerno, stayed briefly in Montpellier, and then settled in Paris. 19
However, in the absence of any direct evidence for Gerard's peregrinations
a m o n g the medical schools, one can say at the m i n i m u m that the major
currents of latö-twelfth-century medicine (Salernitan Aristotelianism and the
Arabism of Montpellier) are evident in his commentary, and that he is one
of the earliest witnesses in Paris for the reception of Avicenna's psychology
and medicine.
Scientific Interests
Gerard's prologue reveals that the Viaticum was important enough to be
worth glossing, but at the same time was felt to be inadequate in some
respects. T h o u g h the work is clear in many places, he says, "if anyone
wishes to scrutinize it carefully, he will find many difficulties in the causes,
signs and cures of the diseases." Gerard remedies this deficiency by add-
ing what he considers necessary f r o m Avicenna, al-Râzï, Alexander, and
others. 20
The prologue is worth a brief analysis because it provides an overall
context for the specific content of Gerard's chapter on amor hereos. It
amounts to a defense of medicine as a science—that is, a discipline whose
subject is capable of being k n Brought
o w n through
to you by its causes. University
| Cambridge It is divided
Libraryinto
Authenticated
Gerard of Berry's Glosses on the Viaticum § 55
three parts: a general exposition of w h y a physician m u s t k n o w elements

and causes; an explanation of the w o r k ' s origin; and an accessus to C o n s t a n -
tine's text. 2 1
T h e a r g u m e n t of the first part runs as follows. Every element and the
h u m a n b o d y as c o m p o s e d of elements share materiality and thus the capac-
ity for m u t u a l changing and being changed. T h e h u m a n b o d y does not
escape these m o t i o n s and changes, n o t only because of its diverse material
composition, but also because it suffers passions (passiones) by reason of
w h i c h the medical " a r t i f e x " considers the h u m a n b o d y as subject. T h e r e f o r e
the artifex m u s t k n o w and consider each element and bodies generated f r o m
elements so that the causes of the subject and its passions may be plainly
evident. 2 2 Indeed, in every art the causes of the subject and of passions are
interlinked; the physician recognizes that they are necessarily generically the
same, since they are principles of k n o w i n g and of being. As Avicenna says,
a thing is truly k n o w n w h e n it is k n o w n of w h a t it consists and f r o m w h a t
it receives perfection in being.
Gerard is concerned, then, to place the m i c r o c o s m of the h u m a n b o d y
within the m a c r o c o s m of elemental change. In so doing he can establish the
claim of medicine to scientific status, since it can proceed t h r o u g h k n o w l -
edge of causes, reduced, in this approach, to their material and efficient
aspects. T h e h u m a n b o d y is subject to illness and is the physician's s u b -
ject insofar as it is material and resolvable into elements, analytically and
actually.
N o t every aspect of elemental causality is relevant to the different f o r m s
of medicine. T h e natural philosopher (phisicus naturalis) considers the " f o u r
radical causes" in themselves w i t h o u t comparison to other things. T h e o -
retical medicine considers the elements in comparison w i t h the h u m a n b o d y
and the balanced t e m p e r a m e n t . Practical medicine considers elements in
comparison with particular conditions, like place, time, c o m p l e x i o n , age,
and sex. Practical medicine in turn may be general or p a r t i c u l a r — w h a t to
do in particular circumstances—and this is the heading under w h i c h Gerard
places the Viaticum.
In light of the prologue, then, the chapter on amor hereos can be seen as
Gerard's effort to establish a truly scientific, that is, natural philosophic,
discourse on m o r b i d love, one that offers a k n o w l e d g e of causes. To c o n -
struct his account, he draws u p o n t w o w o r k s of Avicenna (d. 1087), the
Canon medicine and the Liber de anima. F r o m the f o r m e r he b o r r o w s the
definition and s o m e s y m p t o m s and cures for lovesickness ( c ishk). T h e latter
w o r k gives Gerard the means, t h r o u g h faculty psychology, to relate mental
and emotional conditions to physical states, that is, to specify their material
basis.
T h e essay on amor heros, asBrought
Gerard term
to you bys | it, is bipartite:
Cambridge a definition,
University Library
Authenticated
causal analysis, and discussion of s y m p t o m s and cures are followed by a

series of glosses on specific words of Constantine's text. 2 3 T h o u g h brief,
the glosses are of particular interest, since their emphases on the master text
as well as their content reveal the interpreter's "selective will." 2 4 While
Gerard's essay on love develops within the bounds of Galenic medical mate-
rialism and Avicennan faculty psychology, his glosses on particular phrases
of Constantine's text suggest a broader intellectual and literary understand-
ing of love. They are a particularly revealing "hermeneutic filter" through
which a medical view of love situated itself in a broader cultural context.
Causality
Paraphrasing Avicenna's definition of love in the Canon, Gerard describes it
as a melancholic worry. It is similar to melancholy because the entire mental
attention and thought, aided by desire, is fixed on the beauty of a form.
Gerard then explains w h y this type of love is melancholic and h o w the fixa-
tion occurs, giving both material and dynamic aspects of the process.
Gerard begins by noting the difficulty of causal analysis, but continues
anyway to explain that the disease of love is caused by a misfunctioning of
the estimative faculty. This term derives f r o m faculty psychology, which
localizes mental functions such as perceiving, judging, and remembering in
specific parts of the brain. T h e condition of the brain's substance in turn
affects the function of the mental faculties or "inward w i t s . " T h e classifica-
tion of the mental faculties was by no means uniform; it varied f r o m author
to author and sometimes within the work of a single author.
According to Avicenna, on whose account of mental faculties in Liber
de anima Gerard draws, 2 5 the estimative faculty is the one that makes "in-
stinctive" j u d g m e n t s about what is to be pursued or avoided: when the lamb
flees f r o m the wolf, it does so at the p r o m p t i n g of the virtus estimativa. In
lovesickness the estimative faculty misfunctions because it is misled by an
excessively pleasing sense perception, so strong that it eclipses other sense
impressions that might contradict it. Hence the estimation judges a f o r m to
be better, more noble, and more desirable than all others: it has "overesti-
mated" the object. Because the estimative faculty is working too hard, in-
nate heat and spiritus rush to the middle cerebral ventricle where the faculty
resides, leaving the first ventricle, the site of the imaginative faculty, too
cold and dry—melancholic, in fact (Figure 3.2). This produces a "bad c o m -
plexion" or balance of h u m o r s that in turn affects the imaginative faculty's
operation: the image adheres abnormally strongly on the "screen," so to
speak, of the first ventricle; as Gerard puts it, the imaginative faculty be-
comes fixated on the image.
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Figure 3.2. A d i a g r a m o f t h e three cerebral ventricles a n d t h e m e n t a l faculties l o -
cated w i t h i n t h e m . T h e first ventricle c o n t a i n s c o m m o n sense a n d i m a g i n a t i o n , t h e
s e c o n d t h e i m a g i n a t i v e a n d e s t i m a t i v e faculties, t h e t h i r d the faculties o f m e m o r y
a n d b o d i l y m o t i o n . A l b e r t u s M a g n u s , Philosophia pauperum, sive Philosophia natu-
ralis, 1490. B e t h e s d a , M a r y l a n d , H i s t o r y o f M e d i c i n e D i v i s i o n , N a t i o n a l L i b r a r y
of Medicine.
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W h e n he localizes the imaginative faculty in the first ventricle of the

brain, Gerard departs f r o m Avicenna's account of the mental faculties.
Moreover, Avicenna places little emphasis on the spiritus, a key feature of
Gerard's a t t e m p t " t o fuse psychology, physiology, and physical causa-
t i o n . " 2 6 B o t h imagination and spiritus are, however, central to Salernitan
teachings on the psychophysiology of desire. U r s o of Calabria, a c o n t e m -
porary of Gerard's w h o s e w o r k s were m u c h read in Paris, w r o t e extensively
in his Glosses on Aphorisms a b o u t the interactions of b o d y and soul, and o n
the psychological and physiological processes of desire. Very similar t o
Urso's teaching is one of the Prose Salernitan Questions (before 1200) attrib-
uted to Alain de Lille ("Master Alan"). T h e parallels between Gerard's ac-
count and the Salernitan question are striking, particularly on the roles of
spiritus and imagination in generating lovesickness. In answer to the ques-
tion " W h y d o w e strive for the f o r b i d d e n ? " Master Alan explains:
The soul has three cells destined for its operations, the first of which is the
fantastic, in which occurs imagination, which is called the appetite of the
soul, which is hot and dry. Spiritus are so to speak instruments of the soul
by which it works. Appetite thus is aroused by nature through heat and
dryness, and if the desired thing is denied, heat and dryness do not cease;
rather they increase more and the consumption of humors is greater,
and the humors rarefy further; once rarefied, they are moved more, and,
moved, they excite the appetitive faculty, and thus appetite grows greater
and greater. Whence the appetite must be satisfied or the destruction of the
subject follows. . . . Because of excessive pleasure the spiritus are moved
more, and frequently, and immoderately, and [so is] the imagination,
whence its cell grows hotter and dries out and the spiritus rarefies more.
Once rarefied they are moved more, whence follows greater imagination,
and it replicates the desired thing more. Thus we see lovers sometimes
become mad (maniacos) because of excessive thought and imagination.27
Master Alan outlines a psychophysiology of desire in w h i c h the spiritus m e -

diate the dynamic, destructive interchanges of m i n d and body. Gerard may
well have blended Salernitan theories of imaginative desire such as those of
Alan or U r s o w i t h Avicenna's faculty psychology in order to explain the
causes of amor heros.2S
U n l i k e Master Alan, however, Gerard describes the interplay of mental
faculties responsible for the lover's affliction in hierarchical m e t a p h o r s .
Closely following Avicenna's De anima, he retains the language of male g o v -
ernance that the "prince of physicians" uses to describe the functioning of
the mental faculties. A f t e r receiving a p o w e r f u l l y pleasing sense impression,
the estimative faculty, the noblest of the perceptual faculties, orders the i m a g i -
native faculty to fix its gaze on the mental image of the beloved. T h e i m a g i -
native faculty in t u r n orders the concupiscible faculty to desire that person
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alone. T h e concupiscible obeys the imaginative, w h i c h obeys the estimative,

at w h o s e rule (imperium) the other faculties are inclined toward the desired
person, even t h o u g h she may n o t be desirable in reality. 29 T h e inner w o r l d
of perception and desire is thus structured like the outer system of hierar-
chical rule: those at the top rule and give orders, those b e l o w b o w and obey.
T h e pathological m o m e n t thus subverts the " n o b l e " faculty of estimation
f r o m below.
Finally, the glosses to individual phrases of the Viaticum reinforce the
foregoing etiological analysis. In explaining Constantine's dual causality
(the need to expel excess h u m o r and the sight of beauty), Gerard remarks
that the h u m o r a l cause is not the cause of " t r u e love" (amorem verum), rather,
the sight of beauty that sends a soul mad " t o u c h e s the cause of true l o v e . "
Thus, while he accepts an ultimately Platonic notion of love as generated
by the sight of beauty, he nonetheless materializes it by reducing it analyti-
cally in the foregoing essay to its material and mechanical c o m p o n e n t s .
In addition, six of the glosses focus o n statements in the Viaticum that
suggest the close relation of b o d y and soul.Gerard emphasizes their recip-
rocal effects: the soul is m o v e d to its actions according to the various natural
and accidental complexions of the body, yet the soul's passions in t u r n can
affect the body. For example, Gerard says that C o n s t a n t i n e c o m p a r e s s o u n d
to spirit (sonitum esse quasi spiritum) because the soul intensely delights in
music; that j o y is transferred to the body, because the soul is greatly " b e -
f r i e n d e d " (amicatur) by the body. Hence C o n s t a n t i n e teaches remedies for
b o t h b o d y and soul.
T h e technicalities of faculty psychology and h u m o r a l t h e o r y can easily
obscure the implications of Gerard's analysis of the causes of love for the
notion of subjectivity in the M i d d l e Ages. If it is true that the subject is
constituted by "a distinct inner space w i t h a law of its o w n , " as Bloch says,
then Gerard's chapter on love, together w i t h the Salernitan and Avicennan
texts on which it rests, may be seen as an i m p o r t a n t c o n t r i b u t i o n to medie-
val subjectivity. 3 0 T h e medical writers trace o u t the interior space that d e -
fines m a n b o t h as the subject of medicine and as a desiring subject w h o
suffers the accidentia of that desire. Faculty psychology and the m i x i n g of
elements provide the " l a w s " that regulate the interior space and its exterior
manifestations. Earlier than the thirteenth-century allegorical p o e m s to
which Bloch refers, writers like Gerard, U r s o , and Master Alan offer " f u l l -
b l o w n d y n a m i c model[s] of the m i n d . " 3 1 Evidence that medicine did p r o -
vide such a model, and that its utility was quickly perceived, lies ready to
hand in the adoption of the medical language of love for the i n n e r m o s t
w o r l d of mystical experience by William of Auvergne, William of Auxerre,
H u g h of St. C h e r and others. 3 2
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Love and Nobility

In general Gerard prefers to offer knowledge based on causes rather than
the form of cognition represented by Isidore's etymologies, which conflate
"the qualities of things and their origin," and which assume the natural
unity of linguistic signs and their referents. 33 Nonetheless, the Parisian phy-
sician's explanation of the name amor heros betrays the persistence of the ety-
mologizing habit of mind Isidore bequeathed to the Middle Ages. The
"confusion" of eros, heros (hero), and herns (lord) invoked to explain the
transformation of eros to hereos in fact reveals that etymology was a useful
prop for a medical theory whose causal explanations did not extend to social
factors. 34
The manuscript of the Viaticum upon which Gerard based his glosses
contained the reading: "love that is called heros." The Parisian master
glosses: "Heroes are said to be noble men who, because of their wealth and
the softness of their lives, suffer the more from this disease." Did Gerard
know the Liber de heros morbo, which, as I have argued elsewhere, linked
love and nobility as early as the early twelfth century? 35 In view of the cur-
rently limited manuscript evidence for the Liber, such a claim would be
difficult to maintain. Gerard's explanation may simply reflect the fact that
"noble" was available as a meaning of heros as much in the late twelfth
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Figure 3.3. Melancholia, mania, and phrenesis, but not lovesickness, which was
thought to be a disease of noble men, are listed a m o n g the diseases of the head on
this "disease w o m a n . " Paris, Bibliothèque Nationale,
Brought to MS lat. 11229,
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century as w h e n the Liber was c o m p o s e d . T h e Liber and Gerard's chapter

w o u l d then be parallel manifestations of the same cultural need to attribute
an e x t r e m e f o r m of passionate love to the nobility.
For Gerard that linkage is f i r m l y based in medical considerations. In
keeping w i t h his materialist bent, he argues that the material conditions of
wealth and leisure, typical of the nobility, predispose an individual t o love-
sickness. As Constantine's De coitu indicates, "a leisured heart (cor ociosum)
and daily j o y increase libido." 3 6 Given that Gerard associates lovesickness
and melancholy, De melancholia may offer another relevant gloss on Gerard's
attribution of love to the nobility. It teaches that a great deal of sweetness,
rest, and sleep allow digestive p r o d u c t s to collect, w h i c h can in time t u r n
into black bile and cause melancholy. 3 7 Because the noble way of life ran the
double danger of generating excessive libido and melancholy, it is easy to
see h o w the medical profession could label love an occupational hazard of
the nobility. It became another m a r k of precedence, like wealth and leisure
themselves.
Gerard may likewise have f o u n d s u p p o r t for the nobility's melancholic
love in the pseudo-Aristotelian Problem on melancholy. As translated i n t o
Latin by the Parisian master David of D i n a n t (before 1210), the p r o b l e m
asks w h y all those principally concerned w i t h philosophy, civic affairs, p o -
etry, or other arts appear to have been melancholic and to have suffered
f r o m diseases of black bile. A m o n g the heroes (de heroibus) Hercules was
one such victim of melancholy. M a n y of those w h o suffer f r o m melancholy
are also libidinous, because sexual desire arises f r o m the f u m o s i t y or s m o k i -
ness of black bile. 38 T h e conjunction of black bile and libido in m e n of ac-
complishment, w h o in the M i d d l e Ages w o u l d have ordinarily belonged to
the nobility, w o u l d have lent f u r t h e r scientific weight to Gerard's designa-
tion of lovesickness as "heroic l o v e . "
As a deferral, albeit unwilling, of instinctual satisfactions that wealth
and leisure can c o m m a n d , amor heros distinguished the noble f r o m the base.
It does n o t appear, for example, a m o n g the c o m m o n ailments described in
the Thesaurus pauperum (Treasury of the poor), a h a n d b o o k for those t o o p o o r
to afford the elite care of a university-trained physician. 3 9 N o r is it f o u n d
a m o n g the diseases of the head in the schematic guide to c o m m o n diseases
and their bodily localizations in Figure 3.3. T h e absence of love f r o m this
and similar diagrams suggests the restricted epidemiology of amor heros.
Lovesickness and Noble Love:

Gerard and Andreas Capellanus
In its association w i t h the nobility, amor heros begins to resemble the c o n -
ventionalizing and aestheticizingBrought
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scholars as "noble love," "courtly love," " f i n ' a m o r s , " and so on. Andreas
Capellanus, w h o may have been a contemporary of Gerard's in Paris, de-
fines love as follows: "Love is a certain suffering {passio) born within, p r o -
ceeding f r o m the sight and immoderate cogitation on a f o r m of the opposite
sex, on account of which one desires above all things to enjoy the embraces
of another and by mutual wish to fulfill all the precepts of love in the e m -
brace of the other" (1.1.1). 40 T h o u g h rhetorically m o r e elaborate and lack-
ing reference to melancholy, his definition resembles Gerard's: "This disease
(passio) . . . is very similar to melancholy, because the entire attention and
thought, aided by desire, is fixed on the beauty of some f o r m or figure."
Like the physician, Andreas too recognizes imagination's role in passionate
love. " T h e true lover is engaged without interruption by the continual
imagination of his beloved" (2.8.48). Imaginative preoccupation in fact de-
fines the type of love that Andreas spoofs.
T h e two works also share an interest in the nobility's relation to pas-
sionate love. In keeping with his interest in the effect of class difference on
erotic behavior, which structures the dialogues of the first book, Andreas
insists that love not only makes an ugly w o m a n beautiful, but also makes a
low-born one noble in the sight of the lover (1.6.181), a claim that is remi-
niscent of Gerard's description of the lover's "overestimation" of the beloved
as more noble than she is in reality. Andreas also contends that nobility
derived f r o m moral excellence is the best reason for loving (1.6.13-15).
Granted that Andreas' definition of nobility is ethical and Gerard's socio-
economic, the two nonetheless localize passionate love in an elite, be it
moral or social.
Despite their commonalities, the two works diverge in key respects. In
the first place, "love" in each work has a different ancestry and network of
affiliations. I have elsewhere argued that Salernitan theories of imagination
and desire, rather than the discussions of lovesickness by Constantine and
Avicenna, underlie Andreas' account of passionate love; Gerard's lacks the
theological heavy artillery Andreas brings to bear in Book 3.41 Moreover,
as Karnein has shown, Andreas appropriates medicine in order to unmask
courtly pretensions, to lay bare the libido masquerading as refined love. 42
The thrust of De amore is anti-courtly, and the blunt realities of medicine
are meant to drive the point home. Gerard, in contrast, has no such p o -
lemical agenda, though the concerns of his masculine, scholastic milieu per-
meate his exposition of Constantine's chapter.
Signa Amor is
As love assumed new importance in twelfth-century culture, both vernacu-
lar and Latin, so too did the signs that betray—or
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passion. 4 3 T h e s y m p t o m s of love, signa amoris, reveal particularly well the

confluence of medical, literary, and religious discourses on love in the first
part of the thirteenth century. In Marie de France's lai Guigemar (ca. third
quarter of the twelfth century) the hero, w h o m love had "pierced to the
q u i c k , " "spent a sleepless night, sighing in anguish. In his m i n d he c o n -
stantly recalled her speech, her appearance, her sparkling eyes and beautiful
m o u t h : the pain she caused reached deep into his heart. . . . A little c o m f o r t
w o u l d have gone s o m e way towards assuaging the suffering w h i c h had
drained his face of c o l o u r . " T h e lady, in turn, rose before daybreak " b e -
wailing the fact that she had spent the night awake. Love, w h i c h was t o r -
turing her, was the cause. T h e maiden, w h o was w i t h her, could see f r o m
her appearance that she was in love w i t h the k n i g h t w h o was l o d g i n g in her
chamber for his cure." 4 4 T h e Art d'amours advised readers to fake the s y m p -
t o m s of love in order to be successful w i t h the ladies: "It is w o r t h m u c h to
be pale and discolored, for it seems that it is f r o m the pangs of love, and
then the w o m e n feel pity because of i t . " 4 5 Richard de Fournival (d. 1260)
likewise claimed that a lady could identify a true lover by his appearance:
" W h e n he is before you humble, pensive, full of sighs and has a piteous and
loving look, and it seems w h e n he looks at you as t h o u g h he will cry while
laughing, k n o w that it is one of the m o s t beautiful and true proofs that one
can find in one's friend, w h e t h e r he loves f r o m the heart or n o t . " 4 6
Gerard divides the s y m p t o m s of love into those arising f r o m the soul
and those f r o m the body, and j o i n s to Constantine's list a n u m b e r of signs
f r o m Avicenna's chapter on cishk in the Canon.47 H e also makes a m o d e s t
effort to relate s y m p t o m s to causes, but it is n o t until Arnald of Villanova's
Liber de amore heroico (before mid-1280s) that a comprehensive physiological
mechanism for explaining the s y m p t o m s emerges. 4 8 Several bodily s y m p -
t o m s arise f r o m overheated spiritus. T h e eyes are hollowed because they
" f o l l o w the spirits racing to the place of the estimative faculty." T h e dryness
of the eyes, absence of tears, and general d r y i n g of the b o d y may similarly
be attributed to a c o n s u m p t i o n of moisture by the overheated spiritus. Inter-
estingly, the only one of Constantine's remedies that Gerard chooses to
gloss is wine; w i n e is r e c o m m e n d e d because it humidifies the body, recti-
fying its excessive dryness. This g r o u p of s y m p t o m s literalizes the c o m m o n
literary figure of " b u r n i n g love," which is signalled by the flames on A m o r ' s
clothing in Figure 5.2.
A second g r o u p of s y m p t o m s indicates that passionate lovers lack
emotional control. Avicenna mentions their emotional lability—they eas-
ily swing between crying and laughing (compare Richard de Fournival's
" p l o u r e r en riant"). Gerard b o r r o w s Avicenna's observation that the lover
will cry w h e n he hears love songs, and especially if they are a b o u t rejection
or separation. T h o u g h this s y mBrought
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sickness in Islamic culture, Gerard's decision to incorporate it into his c o m -

mentary on the Viaticum suggests that he considered its inclusion w a r r a n t e d
by the plights of c o n t e m p o r a r y E u r o p e a n s in love. 49 T h e p r o l o g u e to G o t t -
fried von Strassburg's (d. ca. 1210) Tristan similarly alludes to the same deep
emotional identification w i t h a m o r o u s tales:
All are agreed that when a man of leisure is overwhelmed by love's tor-
ment, leisure redoubles that torment and if leisure be added to languor,
languor will mount and mount. And so it is a good thing that one who
harbours love's pain and sorrow in his heart should seek distraction with
all his mind—then his spirit will find solace and release. . . . Now we hear
too much of one opinion, with which I all but agree, that the more a love-
sick soul has to do with love-tales the more it will despond. . . . The noble
lover loves love tales.50
Gerard will specify distraction as one of the cures for love, b u t fails to say
w h e t h e r love tales are an efficacious diversion.
T h e final s y m p t o m that calls for explanation is f o u n d neither in the
Viaticum n o r in the Canon and may represent Gerard's addition to the tra-
dition. Preoccupied w i t h depressed t h o u g h t s and worries, Gerard observes,
the lover scarcely understands w h e n other people speak; b u t if the topic is
love (or the beloved), he is suddenly m o v e d . This recalls Origen's s y m p -
t o m o l o g y of amor languens (the lover can think and speak of n o t h i n g else b u t
the beloved) and Andreas Capellanus' description of an impassioned lover:
If someone broaches a topic with him, he does not listen closely to his
words, and normally fails fully to understand any entreaty unless the other
makes reference to his love, in which case the talk could continue for a
month without the lover's forgetting a scrap of the whole conversation. 5 '
T h e s y m p t o m also recalls an item appearing in various lists of the signs,

rules, or precepts for love, namely that the lover or friend gladly listens to
talk of the beloved. 5 2 W h e t h e r Gerard d r e w f r o m such collections or f r o m
his o w n experience, the s y m p t o m reveals in any event that love abstracts
the lover f r o m language and f r o m the social discourse of masculine society
(recall that Gerard defines erotic lovers as noble men). 5 3 T h e lover's help-
lessness and inarticulateness seem those of an infant, in-fans, the one w h o
cannot speak. T h e fifteenth-century physician Jacques Despars characterizes
the lover's loss of language as infantile-seeming behavior in his c o m m e n t a r y
on Avicenna. T h e spiritus and breathing of the patient are uneven or inter-
rupted, he explains, on account of the violent rapture of the m i n d in the
beloved object, j u s t like that of an infant or boy crying w i t h heaving sobs. 5 4
Gerard's addition of the s y m p t o m , then, obliquely indicates that amor heros
is incompatible w i t h the conventions of masculine adult social behavior.
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T h i s latent contradiction becomes apparent if we step back for a m i n u t e

to review the entire c o m p l e x of s y m p t o m s that signals m o r b i d love. T h e
s y m p t o m s of the disease, as outlined by C o n s t a n t i n e and Avicenna, and as
synthesized by Gerard and other medieval physicians, essentially feminize
the male lover. B e y o n d the passivity inherent in being a patient, w i t h the
helplessness and vulnerability that it implies, the s y m p t o m s c o n n o t e traits
customarily associated w i t h the feminine in medieval culture. E m o t i o n a l
lability, excessive o r inappropriate laughing or crying, fasting, misregula-
tion of speech, that is, inappropriate speech or silence—all these s y m p t o m s
of lovesickness are corporeal signs associated w i t h the feminine. 5 5 Isidore of
Seville, as w e have seen, calls excessive love femineus amor, " w o m a n l y l o v e . "
" T h e r e is n o order or decency in their gestures," says Jacques Despars.
" T h e y ramble in speech, are completely fickle, variable, and u n s t a b l e " (totus
inconstans, varius et mobitis)—classic misogynist descriptions of the feminine.
" E v e r y w o m a n is by nature fickle," says Andreas Capellanus, and Boccac-
cio reiterates: " G i o v a n e d o n n a è sempre m o b i l e . " Such lovers are difficult
to cure, claims Despars, because their m i n d s are little exercised in "virile
virtues." 5 6 T h r o u g h the signa amoris and the disease of love the lover's b o d y
and behavior are thus metaphorically assimilated to the unattained object of
his desire, yet in the male lover this " f e m i n i n e " state signifies pathology. 5 7
T h e mistrust of passionate love implicit in medical semeiology surfaces
elsewhere in Gerard's chapter. According to Constantine, "Just as loyalty is
the ultimate f o r m of affection, so eros is a certain e x t r e m e f o r m o f plea-
s u r e . " Gerard selects loyalty as a key w o r d and glosses it as follows: " W h o -
ever intimately cherishes another reveals all his secrets to that person, and
conceals w h a t has been revealed to h i m . " I p r e s u m e that Gerard wishes to
discriminate between the behavior of loyal friends and erotic lovers. Yet that
contrast becomes m u d d l e d , because in this gloss the rhetorics of vernacular
literature and of clerical didacticism intermingle. In vernacular lyric the
poet/lover and lady have a m u t u a l obligation to hide their love f r o m others
and to reveal their hearts to each other (celar-retener).5S Yet secrecy is also
one of the key elements in friendship according to n u m e r o u s schemes of the
"signs of love" (signa amoris). In the French translation of the Twelve signs of
true love, " T h e first sign of true love is a loyal heart, w h i c h can conceal
n o t h i n g f r o m his f r i e n d . " 5 9
T h e tradition of the "signs of love" still awaits a t h o r o u g h investigation;
Karnein has traced a n u m b e r of its strands in connection w i t h the praecepta
and regulae amoris in Andreas' treatise. 6 0 According to Karnein, Andreas
transposes signs derived f r o m a learned tradition of friendship based on
Cicero's De amicitia into literary rules for love. Andreas assumes that the
audience perceives b o t h the distinction between spiritual and erotic f r i e n d -
Authenticated
66 § Lovesickness iti the Middle Ages
ship and the ironic transfer that he accomplishes. Yet Karnein has also
s h o w n that the distinction was lost w h e n the interpretive p a r a d i g m for De
amore shifted and the rules were henceforth read as s t r a i g h t f o r w a r d precepts
for npble love.
T h o u g h as technical prose Gerard's text is less a m b i g u o u s and therefore
less o p e n to m a j o r interpretive shifts than Andreas', his chapter nevertheless
blurs rather than clarifies discursive boundaries. O n e w o u l d expect the signa
amoris to permit better and finer discrimination a m o n g the types of love,
and yet the reception history of Gerard's gloss shows that the opposite result
occurred.
T h e chapter entitled " D e scissione cordis per a m o r e m " ( " O n the cut-
ting of the heart t h r o u g h love") in H u g h of St. Cher's chapter of De doctrina
cordis (On the Doctrine of the Heart, ca. 1235) b o r r o w s Gerard's s y m p t o m s of
lovesickness, point for point, to describe the signs of ecstatic love, " c o m -
m o n l y called loving par a m o u r s (amare per amores)."6' Ecstatic love may
be taken in bono or in another way, as a mental alienation that the physi-
cians call amor ereos. A l t h o u g h the latter type of love is greatly r e p r e h e n -
sible, H u g h nonetheless declares: "Let us prove one love b y the o t h e r . " As
Lee Patterson has noted, H u g h conflates and confuses the rhetorics of
earthly and spiritual loves by using the same verba to describe dissimilar res;
Gerard's s y m p t o m s of love enable h i m to do so. 6 2 H u g h ' s w o r k was i m -
mensely popular, surviving in over 180 manuscripts, and was translated into
Middle English. His incorporation of Gerard's signa n o t only sanctioned the
authority of the medical view, but helped to create contrary conditions for
its reception. T h e signa could point to m o r b i d love, or to reprehensible love,
or they could signal spiritual love; amor heros could be viewed as a disease,
as lust, or as true love. Like the allegorizations of love-languor in the Song
of Songs, this ambiguity enabled the s y m p t o m s of illness to b e c o m e signs
of love's positive value. As Richard of Fournival explains in the Consaus
d'amours: "Nevertheless, I have often recognized the great value and the
great sweetness of love w h e n I ceased to drink and eat, to sleep and rest
f r o m the distress of loving well. T h e h o p e of m y desire c o m f o r t e d m e such
that it seemed to m e that it cost m e nothing; rather it pleased m e so m u c h
that it seemed to m e there was n o other paradise than to love par amours,"53
Cures
Gerard adds a n u m b e r of passages f r o m Avicenna to Constantine's list of
cures. By far the m o s t significant of these involve therapeutic intercourse.
Avicenna considers it the best cure for lovesickness, t h o u g h it m u s t be e x -
ercised according to "law and f a i t h , " a proviso not in the Viaticum. W h a t
did this stipulation mean? Marriage,
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Authenticated
Figure 3.5. Tavern scene

with wine, w o m e n , and
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tration perhaps suggests what could happen in "therapeutic" marriages. But

there were also plenty of opportunities for sexual activity outside of mar-
riage, at least for men. 64 In particular Gerard recommends (again following
Avicenna) consorting with and embracing girls, multiple intercourse with
them, and switching to new ones (Figure 3.5). Jacques Despars, an exposi-
tor of Avicenna, clarifies the relation of this cure to law and faith. "Insani
amantes" can make love with those w h o m the law permits: prostitutes,
public women, and slaves ("meretricibus aut publicis feminis aut de servis
emptis quas sclauas vocamus") but not virgins, religious women, married
women, or close relatives. In terms that smack of a connoisseur's appraisal,
he specifies that the "bought women" ought to be slim, beautiful, clean,
"full ofjuice" ("succi plenas"), and animated ("corde vivido"). 65
As with Constantine, we are once again confronted with the problem
of the West's receptivity to the system of sexual morality underlying Islamic
medicine. At a time when the Church was attempting with some success to
regulate sexuality outside marriage and to enforce clerical celibacy, Gerard
and the other physicians who write about lovesickness appear to stage a
rearguard attack on "official" sexual morality. In view of this and other
aspects of medieval medical teaching on sexuality, Jacquart and Thomasset
have questioned Foucault's assumption that medicine is a "normalizing dis-
course," a force of regulation and repression. They advance the hypothesis
that medieval medical discourse on amor hereos and sexuality opened a space
of freedom in which a Western ars erotica could develop untrammeled by
theological repression. 66 The physicians
Brought to who
you bydealt with lovesickness,
| Cambridge how-
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Figure 3.6. T h e aristocratic game of chess was a diversion in itself, or doubly so if

the o p p o n e n t were a lovely lady. Ivory mirror back, France, 1320-40. T h e Cleve-
land M u s e u m of Art, Purchase f r o m the J. H . Wade Fund, C M A 40.1200.
ever, may have found it easier to theorize about sex therapy than to imple-
ment it. That, at least, is the implication of Boccaccio's story of the young
physician, who, after diagnosing the noble Giachetto's love for the servant
Giannetta, placed responsibility for the execution of the cure in the hands
of Giachetto's mother (Decameron, II.8). Like Hippocrates w h o dared not
advocate the obvious but incestuous remedy for Perdica's malady, Boccac-
cio's doctor (though not Giachetto's mother!) shrinks f r o m arranging a
therapy condemned by the Church.
T h o u g h Jacques Despars' vivid
Broughtdescription of therapeutic
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University Library
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may well substantiate Jacquart and Thomasset's claim, in Gerard's case

the ars erotica amounts to little more than rewarmed Ovid. 6 7 For the rest,
Gerard's cures follow the lines laid d o w n by his two authorities. Sleep, h u -
mectation (to counter the heat and dryness generated by the disease), good
nourishment and baths are to be prescribed. 68 T h e patients should be occu-
pied in various ways so that they will be distracted f r o m thoughts of the
beloved. Hunting and games (Figure 3.6) are helpful, as are the counsels of
old women. Gerard somewhat abbreviates Avicenna's recommendation that
an old w o m a n disparage the beloved, speaking of her "stinking disposi-
tions." This aversive therapy, whose roots can be traced back to Lucretius
and Ovid, easily became a lightning rod for clerical misogyny, of which
Bernard de Gordon's version of the cure is perhaps the most famous
example. 6 9
The Price of Subjectivity

T h r o u g h o u t this chapter I have been concerned to illustrate h o w Gerard's
chapter on love contributed to and benefited f r o m contemporary discus-
sions in medicine and broader developments in literate culture. T h o u g h
in general the physicians tell us much about the material causes of love-
sickness, they are rather more reticent about the particular social and psy-
chological conditions that lead to morbid love. Gerard's attribution of
lovesickness to the nobility and his description of its causality are therefore
important clues to the place of the disease in medieval culture.
In the late twelfth and early thirteenth centuries the most important
non-medical representation of "noble love" appeared in courtly literature.
T h o u g h there was no rigid system of "courtly love" as such, a n u m b e r of
conventions appear frequently enough in literary texts to be taken as general
symptoms. T w o are relevant here: the idealization of the beloved w o m a n ,
and the lover's service to her. T h e lover becomes as it were subject to the
lady as to a feudal lord (Figure 3.7). As Bloch puts it: "Courtliness is, in
many ways, synonymous with the psychologizing of social reality—the
conversion of a set of reciprocal social relations, sensed as external and o b -
jective, into moral values." 7 0 It is precisely this attribution of moral value
to an erotic relation constituted in the guise of a feudal relationship to which
Andreas Capellanus objects. T h o u g h the extent to which literary conven-
tions of love were played out in twelfth-century aristocratic society is still
obscure, we needn't go far for evidence to suggest that by the early thir-
teenth century erotic behavior in literate circles was influenced by literary
conventions. T h e O l d French translators of Ovid's Art of Love gloss the text
in a naively realistic way. For them love service is real and necessary:
Authenticated
Gerard of Berry's Glosses on the V i a t i c u m § 71
Figure 3.7. T h e p o e t , in a p o s t u r e o f s u b m i s s i o n ,
o f f e r s his w o r k to his lady. F r o m t h e Roman de
poire, a p o e m in O v i d i a n style. Paris, B i b l i o -
t h è q u e N a t i o n a l e , M S fr. 2186, fol. lOv.
T h e a u t h o r says, and it is t r u e , that o n e w h o w a n t s to b e g i n his love affair

well m u s t p r e t e n d that h e is p r e p a r e d to d o e v e r y service, e v e r y w i s h a n d
every private d u t y t h a t he can f o r his lady. Because o f this t h e y o u t h say in
their s o n g s t h a t they w a n t t o s h o w their loves that t h e y are p r e p a r e d in
w o r d and deed. T h e y sing this in their little s o n g : " T o serve m y lady / I
h a v e given m y heart and m y s e l f . " 7 1
Richard de Fournival counsels that t h e lover should address his lady in such
w o r d s of s u b m i s s i o n as these: "Je sui v o t r e sers, et appareillés a faire vos
c o m m a n d e m a n s . . . . si v o u s pri, d a m e , p o u r D i u , q u e v o u s m e retenés
p o u r v o s t r e ami et p o u r vostre serf, ou a u t r e m e n t la grans valours de v o u s
et h a u t e a m o u r s qui s'est en m o i h e r b e r g i e m ' o n t mis a le m o r t ! " 7 2
If courtliness psychologized social relations b y t r a n s f o r m i n g t h e m into
m o r a l ones, courtly values in t u r n influenced social r e l a t i o n s — a t a price. As
Authenticated
the Ovidian passage above makes clear, in s o m e circles lovers had to pretend
to serve their ladies in order to have a chance of success. Richard de F o u r -
nival warns against dissemblers w h o assume the posture of service w i t h o u t
meaning it f r o m the heart. 7 3 A n d even his o w n stance in this regard is n o t
above suspicion, since he claims at the end of the w o r k to have been skep-
tical of love in his youth: "I held love of so little w o r t h that it seemed n o t h -
ing to me; it seemed to m e a very illusion and a foolishness of those lovers
I heard complain that they were dying of love." 7 4
Erotic subjectivity as defined by literary conventions that contravened
the realities of gender roles and power relations b o r e the price, as I shall
argue in the last chapter, either of duplicity or of the mental alienation of
lovesickness (Figure 3.8). 75 In Gerard's analysis of love, w e can see that the
patient's "overestimation" of the beloved w o m a n corresponds to the ideal-
ization of the beloved in literature. T h e patient considers her better, m o r e
noble, and m o r e desirable than other w o m e n , even t h o u g h this may n o t
objectively be the case. 76 T h e overestimation of her desirability immobilizes
the lover's mental faculties in meditation on her mental image. A l t h o u g h the
woman's overestimated nobility and superiority m i r r o r at a psychological
level the lover's o w n social elevation, the metaphorical language of Gerard's
causal analysis reveals that her e n n o b l e m e n t threatens the inner hierarchy of
self-rule. Gerard's chapter thus reveals a kind of fault line w h e r e the clerical
intellectual culture of the universities intersects vernacular literature. Set
against the idealization of the beloved object, w h i c h is a narcissistic m i r r o r -
ing of the noble lover in the ennobled love object, a process familiar in
courtly literature, there is a loss of inner control and governance in the n o b l e
subject, a degradation of the mental faculties expressed in the infantilization
or feminization of the lover's b o d y and behavior.
Gerard's aim is to bring Constantine's chapter o n love u p to date in light
of recently available medical and psychological texts; it is n o t to critique
" c o u r t l y love." Nonetheless, if w e read the m e t a p h o r i c language of his
causal analysis and the signs of love in light of later medical texts, a p r o -
f o u n d ambivalence toward idealized passionate love, " n o b l e l o v e , " emerges.
T h e lover's m i n d is subjected to the imaginary d o m i n i o n of a w o m a n w h o
seems m o r e noble than she is; the psychological and physiological d e g r a -
dation that follow threaten to result in the "destruction of the s u b j e c t , " as
the question of Master Alan puts it. Gerard's chapter refracts these cultural
stresses concerning erotic love. In chapter one I argued that the high m e d i e -
val celebration of Christ's Passion e n d o w e d h u m a n passio w i t h n e w value
and meaning. Within this general revaluation of suffering, assigning love-
sickness to the nobility tended to elevate the disease further, to m a r k love-
suffering as itself noble, refined, a t e s t i m o n y to the sensitivity of " n o b l e
Authenticated
Figure 3.8. The sick man ("Ii malades enfers")

shown bed-ridden after he has been wounded by
the arrow of desirous thought. " H e must uncover
the wound to cure the malady, or otherwise he
cannot be healed" (Bernier de Chartres, La vraie
médecine d'amour). Vienna, Bildarchiv, Osterreich-
ische Nationalbibliothek, Cod. 2609, fol. lv.
hearts." " W h e n we are deeply in love," says Gottfried, " h o w e v e r great the
pain, o u r heart does not flinch. T h e m o r e a lover's passion burns in its f u r -
nace of desire, the m o r e ardently will he love. This s o r r o w is so full of joy,
this ill is so inspiriting that, having once been heartened by it, n o noble
heart will f o r g o it!" 7 7 A n d Chaucer's Troilus claims to prove the nobility of
his love t h r o u g h his ability to suffer f r o m it. 78
O n the other hand, the same fusion of the courtly and the m o r b i d i m -
plies that there was a price to be paid for subjection to eros. It disrupted the
lover's place in the order of things, and threatened h i m w i t h psychological
a n d / o r social abasement. We need to recognize h o w p r o f o u n d l y disturbing
the "feminization" of love in the late twelfth century was to intellectuals and
clerics, university men w h o s e sense of self was rooted in ontological, intel-
lectual, social, and legal superiority to w o m e n . 7 9 Traces o f t h a t disturbance
are inscribed in the scientific discourse o n love in Gerard of Berry's glosses
and in the w o r k s of later physicians.

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§§ 4 §§
WHAT PART OF T H E B O D Y
D O E S LOVE AFFLICT?
Giles' Gloss on the Viaticum
F r o m Gerard's essay and glosses we move to a different f o r m of textual

exegesis with the briefest of the Viaticum commentaries on love, attrib-
uted to Giles (Egidius) and preserved in a single manuscript. Whereas
Gerard, in addition to clarifying the letter of the text, essentially rewrote
Constantine's chapter in light of Avicenna, Giles instead disputes t w o
short questions about lovesickness. Since he covers diseases of the head
contained in the first book of the Viaticum selectively, the two questions
on amor, brief as they are, indicate that the nature and cure of m o r b i d
love were intellectually compelling problems that warranted dialectical
inquiry.
It is not easy to determine the particular historical audience for which
Giles undertook that investigation, since his identity is uncertain. A head-
ing on the first folio of the unique late thirteenth- or early fourteenth-
century manuscript records the author's name; there are n o other explicit
clues to his biography or milieu. 1 Nonetheless, of all the thirteenth-
century men named Egidius with attested interests in medicine or natural
philosophy, it seems likeliest that the author of the Viaticum commentary
was Aegidius Portugalensis, also k n o w n as Giles of Santarem (d. 1265),
a Dominican friar and physician in Paris in the 1220s. T h o u g h it is of
course possible that Egidius is someone w h o has been lost f r o m the his-
torical record, the case for Giles of Santarem is worth making, since it
provides a context for understanding the questions on love.
Giles was born around 1184 in Vaocela, Portugal into a family of lo-
cal nobility. 2 H e was first educated in Coimbra, where he studied phi-
losophy and also medicine, in which he rapidly excelled. Because the
King saw in him a future royal physician, he supported his studies and
granted him a n u m b e r of benefices. In order to advance his studies, Giles
set out for Paris. Legend has it that, fired by ambition for worldly glory
and reputation, he was persuaded en route by the devil to detour to To-
ledo so that he might learn necromantic arts. H e supposedly made a pact
with the devil, signed with his o w n blood, and then spent seven years in
Authenticated
Giles' Gloss on the Viaticum § 75
apprenticeship as a sorcerer. He set forth for Paris once again, where his
magic arts as well as his own skill won him great acclaim as a healer. But
a horrifying vision convinced him to renounce magic, burn his books of
magic, and return home. 3
We are on firmer historical ground with the records of his entry into
the Dominican order around 1220 in Portugal. Once admitted to the order,
he returned to Paris once again, this time to study theology. There he was
a close friend of H u m b e r t of Romans, w h o entered the order in Paris in
1224 and persuaded his own teacher and friend, H u g h of St. Cher, to do so
as well. 4 T h e novices Giles and H u m b e r t served together in the Dominican
infirmary. During this period of his life it also appears that Giles taught
medicine. T h o u g h no formal records of the medical faculty survive f r o m
this period, a fifteenth-century manuscript of Giles' remedies for various
ailments contains a brief biographical notice which claims that the D o m i n i -
can Giles of Portugal, master in arts and medicine, compiled the work:
"Questa opera e trattato fu compilato perlo Venerabile religioso Maestro
Gilio diportugallo dellordine disancto domenico. Il quale . . . fu maestro in
artj et in medicina et compilo lodicto tractato. Et apresso che fu nellordine
fu grande Theologho et uisse nellordine .XL. a n n j . " 5 Giles' designation as
master of medicine implies that he taught the subject. Since the Viaticum, as
Gerard's commentary shows, was a standard text in Paris in the early thir-
teenth century, Giles would very likely have had the opportunity to lecture
on it.
Sometime before 1233 Giles left Paris for Spain; it may have been in the
general exodus of masters and students of 1229 that resulted f r o m violent
conflicts between town and gown. 6 From 1233 to 1245 Giles was prior of
the Dominican province of Spain. He lived in the convent of Santarem
(Scalabitano) until his death in 1265, and was canonized in 1748.
Apart f r o m the Viaticum commentary in question, t w o of Giles' medical
works have survived. O n e is the previously-mentioned collection of reme-
dies, the other a translation f r o m Arabic of al-Râzï's De secretis in medicina
into which was incorporated John Mesue's Book of Medical AphorismsΡ T h e
manuscripts indicate that the translation was accomplished at Santarem,
probably in the last period of Giles' life.
Can the Gloss on the Viaticum be attributed to Giles? His biography, as
we have seen, certainly admits it as a reasonable possibility, and other indi-
cations support it as well. Giles' questions appear to have more in c o m m o n
with earlier thirteenth-century problem literature such as the Prose Salerni-
tan Questions than with medical and natural philosophical works of the later
part of the century. For example, although Giles' questions on lovesickness
resemble those of Peter of Spain's Questions on the Viaticum, Version A, and
Authenticated
76 § Louesickness in the Middle Ages
although Giles' questions on other topics in the Viaticum parallel some of

Peter's, Giles' commentary is nevertheless much shorter than Peter's, having
both fewer questions and shorter argumentation within each question. T h e
similarities may result f r o m Giles' use of Peter's questions (or very similar
ones); however, were this the case, we might expect rather more of Peter's
arguments to appear. 8 His commentary thus seems to precede Peter's,
and to stem f r o m earlier in his career (i.e., Paris) rather than later (i.e.,
Santarem).
Textual citations also help to situate the commentary. T h e most useful
a m o n g them for this purpose are quotations f r o m Aristotle's De animalibus.9
T h e Gloss had, therefore, to be composed after around 1210-17. 1 0 It would
thus fit well into Giles' Parisian period in the 1220s. Because his citations of
De animalibus are a m o n g the earliest, one might be tempted to place h i m
after Peter of Spain, whose medical and natural philosophical works are
generally taken as the first significant engagement with that Aristotelian
text. However, the legend of Giles' "Toledo episode" may hide a kernel of
truth about his career that explains his relatively early use of De animalibus.
During the time when Giles is supposed to have studied magical arts in
Toledo (before ca. 1220), that city was h o m e to Michael Scot, w h o trans-
lated De animalibus into Latin. For half a century or more it had sheltered
the scholars whose scientific translations f r o m Arabic had transformed E u -
ropean learning. As J. Ferreiro Alemparte has recently shown, the city's
reputation as a place where necromancers had their o w n "school" is a p o -
lemical inversion of its scientific preeminence. Many of the authors w h o
report stories of Toledan necromancy and necromancers are religious w h o ,
at b o t t o m , denigrate any purely scientific k n o w l e d g e . "
Behind the story of Giles' necromantic apprenticeship in Toledo, then,
may lie the reality of a scholarly sojourn. His youthful interest in medicine
may have drawn him to the city whence issued so many recent medical
translations f r o m Arabic. As we know, he himself in later life translated one
of al-Räzfs medical treatises into Latin. 12 Youthful study of Arabic scientific
texts in Toledo may thus have earned him a reputation as a necromancer
among religious writers mistrustful of worldly accomplishments. In Toledo
he may have learned of or even k n o w n Michael Scot, w h o at that very time
was translating Aristotle's De animalibus. Such contact would help to explain
Giles' relatively early use of this Aristotelian work. 1 3
Giles' commentary on the Viaticum, though called a gloss in the m a n u -

script heading, takes the f o r m of disputed questions. As a method of con-
veying information, the question had a long history in natural philosophy,
reaching back to such collections f r o m antiquity as the pseudo-Aristotelian
Authenticated
Figure 4.1. In this e m b l e m o f " A r i s t o t e l i a n dialectic a r t , " A r i s t o t l e h i m s e l f is seated

o n t h e left. In t h e scene o n t h e r i g h t , Dialectic h o l d s t w o o p p o s e d w i n g e d s e r p e n t s .
T o h e r r i g h t t w o scholars are e n g a g e d in a d i s p u t a t i o n , w h i l e o n h e r left a m a s t e r
m a k e s a p o i n t a b o u t a text. C a s s i o d o r u s , Institutiones. Paris, B i b l i o t h è q u e N a t i o -
nale, M S lat. 8500, fol. 33r, detail.
Problems. T h e Salernitan questions of the twelfth and thirteenth centuries

taught medical and natural philosophical ideas independently of an a u t h o r i -
tative text. H o w e v e r , beginning in the twelfth century questions were used
to explicate texts in the schools, and in the early thirteenth they were r e g u -
larly used in university lectures on standard texts. Differing opinions o n a
controversial passage obliged the master to resolve the p r o b l e m t h r o u g h
the application of dialectic (Figure 4.1). T h i s type oí quaestio thus involves
f o u r elements: the text, dissonant opinions on the text's subject, dialectic
m e t h o d , and the master in the process of regular teaching. 1 4 Disputed ques-
tions in medicine, then, had a d o u b l e pedigree, the older p r o b l e m literature
and the newer f o r m of textual commentary. 1 5
Peter of Spain's contribution (ca. 1246 and following) to the develop-
m e n t of disputed medical questions has recently been emphasized. 1 6 If Giles'
w o r k truly antedates Peter's, then he m u s t be seen as o n e of the earliest
medical writers w e k n o w of to blend Salernitan-type questions w i t h the
question-commentaries c o m i n g into use in the other faculties. 1 7 T h e intel-
lectual climate of Paris, w h e r e b o t h f o r m s of question were in vogue, fa-
vored the union of the t w o types of questions in a medical c o m m e n t a r y .
T h e surviving manuscript may not, however, d o full justice to Giles'
ideas. In m a n y cases o u r d o c u m e n t a t i o n of scholastics' teaching depends on
a student's transcription of the lectures (reportatio) that may or may n o t have
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been edited and polished by the lecturing master. If they were n o t edited,
w h a t survives is w h a t the student heard and was able to j o t d o w n , not
necessarily w h a t the master said. In addition, b o t h hasty notation and the
shared k n o w l e d g e of an intellectual c o m m u n i t y , w h i c h can be assumed
rather than explicitly articulated, contribute to the abbreviated style char-
acteristic of reportationes and classroom questions. O f t e n an a r g u m e n t is
summarized as " t h e r e f o r e et cetera." T h e compressions and ellipses of ar-
gumentation in the Gloss on the Viaticum suggest that it indeed stems f r o m
the classroom rather than f r o m the author's study, w h e r e he w o u l d p r e s u m -
ably have had m o r e control over its f o r m .
Disputed questions, as B e r n a r d o Bazàn has noted, were the site w h e r e
the m o s t pressing intellectual p r o b l e m s of the age were raised and discussed;
as such they are an i m p o r t a n t guide to the period's intellectual interests. 1 8
T h o u g h the section on amor hereos in Giles' c o m m e n t a r y is quite b r i e f — w a s
it too disturbing a topic for a D o m i n i c a n novice to dwell o n ? — i t can be
profitably read in the context of Parisian learning of the early thirteenth
century.
T h e first question on amor heros19 asks w h y the Viaticum classifies love
as a disease of the head w h e n , as an e m o t i o n , it w o u l d seem rather to be
located in the heart. Giles' question can be seen as a response to the chal-
lenge posed by Aristotelian physiology and psychology. 2 0 T h e location of
e m o t i o n s in the b o d y became controversial after Aristotle's biological and
psychological w o r k s began to circulate in the West in the late t w e l f t h and
early thirteenth centuries. Medical writers traditionally maintained that the
brain was the seat of sensation and e m o t i o n , b u t Aristotle claimed that j o y
and sadness, hope and fear, hate and love, and so on all originated in the
heart. Giles' contemporary, the Aristotelian David of D i n a n t , set f o r t h A r -
istotelian teaching o n the affections in his n o t e b o o o k s (Quaternuli) contain-
ing excerpts, paraphrases, and interpretations of Aristotle's writings. 2 1 His
n o t e b o o k s conveniently s u m m a r i z e s o m e of the Aristotelian biological and
psychological notions that the Galenic-Arabic medicine of the early thir-
teenth century had to grapple with.
In David's account of the Stagyrite's teaching, n o affect in the soul can
take place w i t h o u t a " s u f f e r i n g " or " b e i n g affected" of the heart (cordis pas-
sione). B u t it then remains debatable w h e t h e r the affect in the soul occurs
because of the heart's being affected, or w h e t h e r the heart's being affected
results f r o m the affect in the soul. Because illness or even death can result
f r o m excessive love or other e m o t i o n , David argues that a l t h o u g h the passio
of the heart and the affectus may be simultaneous, the heart's passio is the
cause of the soul's affect. H e defines the heart's passio physiologically, as a
change in the systole and diastole. So, for example, in love the dilation of
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the heart is faster, its constriction slower, and slower is the dilation of the
arterial pulse, w h i c h feels " d e e p " or perhaps " d e p r e s s e d " (profitndus) ,22
Rather than tackling the physiological issues of the first question di-
rectly, Giles instead constructs his a r g u m e n t a r o u n d the semantic a m b i g u i t y
of passio. Whereas, following Constantine's usage, he initially terms love a
morbus afflicting the brain, in subsequent steps of reasoning on locating love
in the heart he calls it a passio. O n the one hand, morbus and passio were
s y n o n y m o u s medical t e r m s for "disease"; o n the other, passio also had a
broader range of m e a n i n g that included various senses of " u n d e r g o i n g " or
"being affected." T h i s broader sense of the w o r d allows h i m to argue that
hate and love are passiones of the heart, and that therefore lovesickness is an
affliction of the heart.
This apparent bit of scholastic logic-chopping in fact rearticulates, in
medieval terms, p r o b l e m s raised in antiquity a b o u t the passions of the soul:
can a "passion" affect the soul in the same way that a "passion" (morbus)
affects the body? W h a t is the dividing line between somatic disease and
illness of the soul? 2 3 A n d w h e r e on that axis is the disease of love located?
Giles' conclusion sides w i t h the physicians' traditional views on love's b o d -
ily location: love is not actually a disease except by virtue of its conse-
quences, and these affect the brain. Like Gerard of Berry, then, only in
indirect fashion, Giles uses the subject of amor heros to p r o b e the p s y c h o -
somatic unity of the h u m a n subject.
If Giles is identical w i t h the D o m i n i c a n novice infirmarían, then p r o f e s -
sional tensions may have motivated, w h e t h e r consciously or not, his e n -
g a g e m e n t w i t h this particular question. As we have seen, lovesickness and
its cures highlighted certain tensions between those w h o cured bodies and
those w h o cared for souls. S o m e bodily cures, like therapeutic intercourse,
endangered the soul's health. We can readily see w h y a question on lovesick-
ness w h o s e terms implicated p r o f o u n d questions on the relations of b o d y
and soul w o u l d attract a m i n d like Giles', scientific by training and religious
by c o m m i t m e n t . Such a question delineates the site of potential conflict
between medical and pastoral care, but in its abstraction and f o r m u l a i c style,
it also distances itself f r o m the overt professional interests of either disci-
pline. By so doing, the disputed question enables the conflict to be m e d i -
ated, if n o t resolved, t h r o u g h intellectual inquiry.
A n interest in the puzzling relation between b o d y and soul subtends the
remainder of Giles' c o m m e n t a r y on amor heros, a question o n the efficacy of
w i n e in curing love (Figure 4.2). O f all Constantine's therapies, w h y is this
one singled out for special attention? Therapeutic intercourse, for example,
was m o r e obviously controversial, especially for a D o m i n i c a n novice in an
age of sexual r e f o r m . Perhaps it was a topic t o o hot to handle. Perhaps,
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Figure 4.2. Is wine a suitable cure for love? From the relatively delicate en-
j o y m e n t on the left to the excess depicted on the right, various stages of
inebriation are shown in this scene f r o m a public house. British Library, M S
Additional 27695, fol. 14.

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since the topic preceding amor heros in the commentary is drunkenness, the
pedagogical desire to give thematic continuity to adjacent chapters dictated
Giles' choice. Finally, practical and theoretical considerations may have i m -
pelled the question.
From a medical point of view, wine is a tricky spirit. N o t only does it
affect both body and mind, but it has opposite effects at different dosages.
It will make a silent man initially loquacious, but in greater quantity he will
become contentious. Beyond that wine will make him mad (amentem), and
finally it will render him senseless and motionless. 2 4
For medieval physicians, the nature of wine's action in producing these
varied effects was enigmatic. If curative effects were supposed to derive
f r o m the nature of medicinal substances, w h y was it, for example, that the
hot and dry nature of wine produced " c o l d " diseases like apoplexy and
paralysis? 25 As Giles argues in the chapter on stupor, every agent acts by
means of its o w n complexion (that is, its substantial composition) and
brings about an effect similar to itself. Because wine is an agent in the h u -
man body by virtue of its heat and dryness it should cause similar effects. 26
As Giles poses the problem for lovesickness, wine's beneficial effects on the
disease are questionable because the lover's malady is accompanied by de-
pressed thoughts and by excessively heated spiritus, as we saw in Gerard of
Berry's explanation. T h o u g h Constantine recommends wine as a cure for
love, other authorities disagree. Isaac (Judaeus) says that it sharpens and
deepens thinking, but this is counterproductive in lovers already given to
depressed thoughts. And in the Remedies for Love O v i d says that wine
should not be given to lovers. 27 Giles concludes that wine deepens the minds
of the " w i s e , " that is, those w h o are of sound mind, and quotes a Goliardie
jingle to make his point: " C u m bene sum potus, circa versibus influo totus;
cum sim ieiunus, sim de peioribus u n u s " (When I'm well soused, in poetry
I'm doused; when I'm athirst, I'm one of the worst). Lovers' minds are not
sluggish, however, but depressed instead (non est profondata in bono sed in
malum). Since wine washes away "bad thoughts" (cogitationes malas), it glad-
dens the soul and thus is a suitable cure for "heriosis" when drunk in m o d -
eration. It is hard to resist the conclusion that beyond the dialectic play of
authorities, the realities of practical treatment influenced Giles' choice of
question and its elaboration.
Giles' questions on the classification and cure of lovesickness emphasize
the challenge the disease posed to medical theory and to medical practice by
probing the subtle links between matter and spirit. In this respect they
evince an interest in the lover's malady similar to Gerard's m o r e c o m p r e h e n -
sive effort to clarify the corporeal dynamics of desire, and one that also

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anticipates Peter of Spain's elaborate sequence of questions on the p s y c h o -

physiology of love. Given his selective coverage of the diseases of the head
contained in the first b o o k of the Viaticum, the t w o questions on amor, brief
as they are, testify to the i m p o r t a n c e of lovesickness as a locus for exploring
various dimensions of man's psychosomatic unity.

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§§ 5 §§
PETER OF SPAIN
Questions on the Viaticum
In quella parte dove sta memora

prende suo stato . . .
L'essere è quando lo voler è tanto

c'oltra misura di natura torna;
poi non s'adorna di riposo mai.
Move, cangiando color, riso in pianto,
e la figura con la paura storna.
Poco soggiorna, Ancor di lui vedrai
che 'n gente di valor, lo più, si trova.
Guido Cavalcanti, "Donna me prega"'
V j ï u i d o Cavalcanti's (d. 1300) philosophical p o e m on love, " D o n n a m e

p r e g a , " owes m u c h to the medical· tradition of lovesickness. T h e Floren-
tine physician D i n o del G a r b o (d. 1327) explicated the p o e m at length;
his c o m m e n t a r y is preserved in a manuscript written by Boccaccio. D i n o
quotes Avicenna and " A l y A b b a s , " and alludes to "medical a u t h o r s " to
elucidate Cavalcanti's stanzas on the lover's appearance, behavior, and the
deadly threat that unsatisfied love poses. 2 O n e such author may well have
been Peter of Spain (d. 1277), a Portuguese logician, philosopher, and
doctor w h o taught medicine in Siena f r o m 1246 to 1250. His series of
questions on amor hereos in the Questions on the Viaticum, c o m p o s e d in
Siena and extant in t w o versions, represents one type of poetic raw m a -
terial that G u i d o Cavalcanti, w h o m Boccaccio calls " m o s t excellent n a t u -
ral p h i l o s o p h e r " (Decameron 6.9) and w h o m D a n t e names as his "first
f r i e n d " (Vita nuova 3), w r o u g h t into his difficult, beautiful p o e m on love. 3
T h e only c o n t e m p o r a r y pope w h o m D a n t e placed in paradise (he was
elected J o h n X X I in 1276), Peter of Spain w r o t e the m o s t philosophically
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ambitious of the surviving Viaticum commentaries. Like Cavalcanti and

Dino del Garbo, Peter read deeply in Aristotle, whose influence is evident
throughout his work. Peter's questions on love range over a wide variety
of topics, from the workings of faculty psychology and the physiology
of appetite to the age of patients, w h y there is pleasure in intercourse,
and the role of gender in lovesickness. While not all of Peter's questions
on lovesickness are original—several appear to derive f r o m Giles of San-
tarem and the loose body of scientific problems known as the Salernitan
Questions—his way of handling them opened new ground that later phy-
sicians worked more thoroughly. 4
Remembered by a chronicler of the lives of the popes as " m o s t accom-

plished in the art of healing," Peter is best known to medical history for the
Thesaurus pauperum, a medical textbook popular for its brevity and practical
nature. 5 His career, however, was that of a medieval polymath: not only
was he one of the most important physicians of the thirteenth century, but
as a logician, psychologist, philosopher and theologian he also has a fair
claim to be one of the principal scholastics of the era. 6 His life is relatively
well attested. Born, according to his most recent biographer, in Lisbon,
Portugal sometime before 1205, Peter attended Lisbon's cathedral school as
a boy. In the 1220s he then moved on to Paris to study logic, physics, meta-
physics and theology. 7 His era in Paris was that of Alexander of Hales,
William of Auxerre, and William of Auvergne rather than that of Albert the
Great and Thomas Aquinas, as earlier biographers supposed. 8 Peter may
conceivably have studied medicine under his fellow countryman Giles of
Santarem (Aegidius Portugalensis), w h o taught medicine in Paris in the
1220s and whose questions on the Viaticum are similar to Peter's.
It is thought that in 1229, when there was a general exodus of masters
and students f r o m the city owing to disputes with city authorities, Peter left
Paris for the north of Spain. There he most likely taught logic and c o m -
posed the Summule logicales in the early 1230s. This widely-used textbook
of logic was instrumental "in developing a dialectical method of interpreting
Aristotelian science." 9
In 1246 Peter reappears as a master of medicine at the newly-organized
medical faculty at Siena, where he remained until around 1250. H e then
returned to Portugal and held a number of ecclesiastical offices, eventually
becoming magisterscholarum at the cathedral school of Lisbon f r o m 1263 un-
til 1272. During this time, he visited the Papal Court in Viterbo and Orvieto
several times.
Peter composed most of his surviving medical and psychological works,
which provide a fruitful context for his ideas on lovesickness, in the period
1246-72. Many of his medical treatises
Brought toare
youversions of lectures
by | Cambridge on Library
University the texts
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Peter of Spain, Questions on the Viaticum § 85
he taught at Siena: Johannitius' Isagoge, Galen's Tegni, Isaac's (Ishäq al-

Isrâ'îlî) De dietis universalibus et particularibus and De urinis, and Constantine's
Viaticum.10 In addition to commentaries on standard medical works, he also
compiled the earliest surviving Western commentaries on Aristotle's De
anima and De animalibus, the latter forming the basis for Albert the Great's
own Quaestiones super de animalibus.11 Peter did not limit himself to c o m -
mentaries, however; he also wrote a textbook of psychology, Scientia libri
de anima, "das umfassendenste Lehrbuch der Psychologie aus der Zeit der
Hochscholastik." 1 2 Its doctrines on the mental faculties illuminate, as we
shall see, several questions on lovesickness.
In 1272 Pope Gregory X s u m m o n e d Peter to Viterbo to become court
physician. At the papal court he probably met other leading scientists, in-
cluding the perspectivists Witelo and John Peckham, w h o were drawn to
the flourishing court school. 13 In 1276 he became Pope, taking the name
Johannes X X I . H e died May 12, 1277, fatally injured by the collapse of the
ceiling in his newly-built study in the papal palace.
The Two Versions of the Questions

A number of Peter's commentaries, including the Questions on the Viaticum,
survive in multiple versions. 14 T h e y most likely record the changes in his
teaching over a span of years. T h e two versions of the Questions on the Viati-
cum allow us to trace changes in Peter's thinking on love over a period of
five or m o r e years (assuming that relative chronology can be established).
In both versions he continues Gerard of Berry's assimilation of Avicenna's
psychology into medical doctrines on lovesickness. Aristotle, however, also
provides loci or starting places for arguments in the questions on amor hereos.
Peter's fusion of Avicenna and Aristotle anticipates, and may even have
helped to shape, the later Montpellier synthesis of classical and Arabic natu-
ral philosophy.
Because many of his arguments focus on the physiological bases of love
psychology, Peter's ideas on morbid love assume a decidedly somatic bias,
one that is more evident in what I call the Β version than in the A. T h e
A version is further distinguished f r o m the Β in that it quotes Gerard of
Berry's commentary on the Viaticum almost verbatim (lines 3 3 - 4 6 ; not in
B), and contains two questions that appear to derive f r o m Giles. If we as-
sume that Peter developed greater intellectual independence as he gained
experience teaching medicine, then perhaps the A version is indeed the
earlier. 15
Since it is sometimes difficult to penetrate the thickets of Peter's proce-
dure, Table 1 gives an overview of the t w o versions. T h e f o r m of Peter's
commentary, like that of Giles, Brought
is that toofyou
disputed questions,
by | Cambridge a method
University Library of
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Table 1
Outlines of Versions A and Β
Version A
O f which psychological faculty is love a disease, the imaginative faculty,

the cogitative faculty, the estimative faculty, or the fantasy? Solution:
Love is a disease of the estimative faculty because it is damaged first and
primarily.
O f which part of the body is love a disease, the heart, the testicles, or the
brain? Solution: O n e must distinguish between love as a passio of the
heart, which is not a disease, and love that is accompanied by the s y m p -
toms of melancholy, which is a disease of the brain.
In which humoral complexion does it occur the most, in the melancholic,
or in hot complexions (choleric and sanguine)? Solution: Since sexual
stimulation is the major cause of amor hereos, it occurs most frequently
in hot complexions.
In which sex does it occur most frequently? Solution: Lovesickness occurs
more frequently in w o m e n because they are less hopeful than men and
are more easily sexually stimulated. However, it is m o r e tenacious and
difficult to cure in men.
In which age does it occur most often, in youths (iuvenibus) or in boys
(pueris)? Solution: In youths, especially at the end of adolescence w h e n
they desire intercourse the most.
Is traveling abroad useful in curing lovesickness? Yes, because one sees
beautiful (hence distracting) sights. N o , because one's suspicion and fear
of losing the beloved increase. Solution: Traveling is beneficial because
one is distracted by the scenery and consequently will forget the beloved.
Are ugly w o m e n to be brought before the patient? Yes, because they are
contrary to the w o m a n he thinks beautiful, and cures are effected by
contraries. N o , according to Avicenna. Solution: N o , because contraries
illuminate each other and thus his beloved will seem m o r e beautiful by
contrast.
Are beautiful w o m e n to be brought before him? N o , because like added to
like causes the disease to g r o w worse. Yes, according to Avicenna.
Solution: Yes, because the patient will be distracted by m o r e beautiful
forms f r o m his previous preoccupation.
Is drunkenness a useful cure? N o , because it is sexually stimulating. Yes,
according to Isaac. Solution: It is useful when it completely hinders the
inner wits, so as to cause oblivion, but not useful when it merely i m -
pairs these mental functions.
Questions on certain texts. 1. al-Râzî says that fasting is beneficial but Avi-
cenna says that temperate food is useful. 2. Avicenna (actor) says that the
beloved should be scorned; on the contrary, this will only make the
lover remember her. Solutions: Fasting reduces the seminal matter
which arouses sexual desire, while good food produces subtle and laud-
able h u m o r s that do not lead to erections and aid in combating weakness
and wasting. Even though scorn causes the lover to bring his beloved to
mind, nonetheless it withdraws his mind f r o m its obsession with her.

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Version Β
Lecture: Definitions, causes, s y m p t o m s , cures

Incidental Questions: O f what part of the body is love a disease, the tes-
ticles or the brain? Solution: the brain.
Why does a cold complexion increase appetite in the stomach and diminish
it in the testicles, while heat does the contrary?
Why does appetite in the stomach cause the utili to become rigid through
cold while appetite for coitus causes the member to become rigid
through heat?
Why is appetite in the stomach aroused through cold, but appetite in the
w o m b aroused t h r o u g h heat, since both stomach and w o m b desire to be
filled?
O f which psychological faculty is love a disease, the imagination or the
estimative faculty? Solution: the estimative faculty.
W h o m does this disease befall the most, those of melancholic complexion
or youths (who are not of melancholic disposition like the aged)?
Solution: Love is called a melancholic worry not on account of its h u -
moral material, but because of s y m p t o m s similar to melancholy. [There-
fore the young are m o r e subject to it.]
In which sex does the desire for coitus occur m o r e and in which sex is the
pleasure greater? Solution: Love is more intense in men but w o m e n en-
j o y intercourse more.
Why is there so much pleasure in intercourse? 1. T h e sensible and nervous
disposition of the genitals. 2. Each faculty delights in its o w n operation.
3. T h e motion of moisture through the genitals induces a certain itching
and pleasurable movement. 4. T h e rubbing of members against each
other. 5. Some assign a final cause, the fetus, lest generation cease.
Which sex enjoys coitus more? Solution: M e n enjoy it more, but w o m e n
have a twofold pleasure, in emission and in reception.
D o the eyes suffer more in love? Yes, since they are close to the brain and
are of a watery and fluid substance. N o : Constantine says that all parts
of the b o d y except the eyes are attenuated. Solution: T h e eyes appear
larger when the rest of the face grows thin f r o m insomnia-and waiting.
Is intoxication a useful cure in this disease? Yes, say O v i d and al-Râzî. N o ,
because it disturbs the mind's operations. Solution: T w o things are use-
ful in the cure—restoring proper j u d g m e n t , for which intoxication is
not useful, and relieving preoccupation and anxiety, which O v i d
recommends.
Are baths useful? N o , because like good food they stimulate desire. Yes,
say al-Râzî and Serapion. Solution: Baths and good food are useful be-
cause they relieve melancholic worry.
Is it useful for patients to see ugly shapes? Yes: cures are achieved by con-
traries. N o , says Constantine. Solution: N o , because the sight of an ugly
w o m a n will cause the patient to become even m o r e ardent about the
w o m a n w h o seems more beautiful to him.

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teaching based on an authoritative text in which the master voiced, evalu-

ated, and resolved o p p o s i n g views on various passages. 1 6 T h e full structure
of disputed questions (arguments, c o u n t e r a r g u m e n t s , solution, response to
arguments) is, however, m o r e fully apparent in Peter's c o m m e n t a r y , w h o s e
questions are b o t h longer and m o r e n u m e r o u s than Giles'.
C o m m o n to b o t h versions of Peter's w o r k are questions a b o u t the psy-
chological and bodily "place" of the disease, categories of patients, the role
of gender in susceptibility to lovesickness, and w h e t h e r wine and u g l y
w o m e n are useful cures for m o r b i d love. Five questions are u n i q u e to the Β
version, t h o u g h s o m e of t h e m are paralleled elsewhere in Peter's medical
works. T h e y explore the physiological and psychological bases of sexual
desire as it affects the genesis and severity of amor hereos.
Version B: The Introductory Lecture

O n e manuscript of the Β version (Vatican pal. lat. 1166) contains the only
copy of the Portuguese master's s u m m a r y exposition of amor hereos, titled
Lectura super Viaticum. O p i n i o n s on lovesickness f r o m the authorities (Avi-
cenna, al-Râzî, Pantegni) are arranged in the usual order of definition,
causes, s y m p t o m s and cures. A l t h o u g h the lectura offers no developments
in medical thinking about amor hereos, it does anticipate s o m e of the topics
addressed in the debated questions. It provides a convenient e p i t o m e of
w h a t m i g h t , in the absence of similar surviving w o r k s , be called " s t a n d a r d "
scholastic doctrine o n lovesickness ca. 1250.
Peter opens his lecture by s u m m a r i z i n g various definitions of lovesick-
ness. To Avicenna's definition of ilisci as a "melancholic w o r r y , " he j o i n s
that of the Pantegni and a versified definition of love s o m e t i m e s f o u n d in the
margins of Viaticum manuscripts. 1 7 T h e p o e m , w h i c h defines love as the
sickness (mentis insania) of a m i n d m o v i n g a m o n g p h a n t o m s , b r i n g i n g m o r e
s o r r o w than joy, is f o u n d in O l d French and Middle English as well as Latin
sources. According to a recent study, the p o e m , extant in several f o r m s ,
developed f r o m t w e l f t h - c e n t u r y religious and philosophical literature. 1 8 As
we saw above w i t h Gerard of Berry's c o m m e n t a r y , clerical mistrust of love
filtered into medical teaching on lovesickness; in Peter's c o m m e n t a r y it did
so t h r o u g h this p o e m . Bernard de G o r d o n , the m o s t misogynistic of writers
o n lovesickness, incorporated the versified definition, n o w c o m m o n p l a c e in
the generations after Peter of Spain, into his o w n exposition of amor hereos
in the Practica dicta Lilium medicinae.19
Peter's e t y m o l o g y of amor hereos is curious and m o r e difficult to explain
than many. H e derives hereos f r o m heremis and explains: "that is, f r o m n o -
bility w h o are m o s t accustomed to contracting this disease." T h e explana-
Authenticated
Peter of Spain, Q u e s t i o n s on the Viaticum § 89
tion recalls that of Gerard of Berry, but the t e r m itself is a mystery, since
heremis ordinarily means " h e r m i t s . " It may be a ghost w o r d resulting f r o m
a copyist's error (especially since elsewhere in the Questions m o r b i d love is
called amor hereos), or it may bear a significance dimly reflected in D o m e n i c o
da Ragusa's (fl. 1394-1427) distinction between hermete (?), a type of m e l -
ancholy caused by the sight of beautiful f o r m s , and amor w h i c h is called
herios.20 Whatever the w o r d means, Peter reaffirms the connection between
lovesickness and the nobility, and reinforces it by explaining that the m a t e -
rial cause of the disease is an excess of seed produced in those w h o live in
leisure, quiet, and bodily pleasure.
W h e n Gerard of Berry lectured on the Viaticum in Paris a generation
before Peter assumed his position at Siena, he noted that the causality of
lovesickness was a difficult topic. By the middle of the thirteenth century,
however, increased study of the Aristotelian corpus led to an interest in and
ease w i t h m o r e c o m p l e x causal analysis. As a result, the sections o n causes
in medical treatises expanded significantly. A little m o r e than a generation
after Peter of Spain's treatises were written, William of C o r v i compiled a
catalogue of causes of amor hereos that begins w i t h the causa primitiva, m o v e s
t h r o u g h cause extrinsece, causa antecedens, causa antecedens humoralis, and ends
w i t h the causa contunda.21 Peter's list of causes here is far m o r e m o d e s t , l i m -
ited to the material cause of excess seed, and to three psychological roots o f
the disease: the desired object, the desire itself, and f r e q u e n t t h o u g h t s a b o u t
the object. H e then lists f o u r factors necessary for intercourse: a h o t c o m -
plexion, imagination, " a n elevating w i n d i n e s s , " and an abundance of seed.
T h e presence of conditions for intercourse in the section on causes e x e m p l i -
fies the underlying premise, we m i g h t call it, of the Β version: that amor
hereos can be u n d e r s t o o d as the result of the physiological processes of
appetite.
T h o u g h Peter passes over the s y m p t o m s of lovesickness quickly, w i t h -
out any notable addition, he does mention the pulse test f r o m Avicenna's
chapter on ilisci. H e follows Gerard of Berry once m o r e (and anticipates
Arnald of Villanova) in declaring that the prognosis is p o o r for lovesick
patients w h o fail to satisfy their desires. T h e b o d y will generate black bile
(cholera nigra), the brain will g r o w too cold, and as a result, the patients will
suffer f r o m melancholy. Peter thus reaffirms Constantine's view that unless
treated, amor hereos will lapse into melancholy or mania; in the last sentence
of the lecture he stresses that "this disease generates the m a t t e r and d i s p o -
sition for melancholy unless it is c u r e d . "
Peter turns to Avicenna and al-Râzï for his discussion of cures. "Avi-
cenna says that the better cure is to lie w i t h the b e l o v e d " (B 4 6 - 4 7 ) .
Al-Râzï r e c o m m e n d s wise counsel and stories, freshwater baths, travel, lis-
Authenticated
tening to songs, and drinking wine. H e also says that melancholic h u m o r

should be p u r g e d w i t h the appropriate medicine. At this point in his presen-
tation there follow the disputed questions on love that are contained in the
other manuscripts of the Β version. M y discussion is organized by the se-
quence of topics c o m m o n to b o t h versions. Because Peter's questions o n
gender and lovesickness deserve m o r e detailed c o m m e n t a r y than is possible
in this s u m m a r y , they have been reserved for separate treatment in the next
chapter.
The Psychology of Love
VERSION A
T h e Viaticum posits a dual causality for the disease of love. Against the
psychological cause of love—sight of a beautiful f o r m — i t balances a so-
matic one, the body's need to expel excess h u m o r a l matter. As w e have
seen, Gerard of Berry's causal explanation outlines h o w the inner senses or
mental faculties are derailed by the perception of an excessively pleasing
f o r m . Peter tackles the p r o b l e m of causality by inquiring a b o u t the precise
mental and physical sites of m o r b i d love, devoting a question in each v e r -
sion to the mental faculty and part of the b o d y affected by lovesickness.
T h o u g h he acknowledges in the second question of the A version that the
psychological cause of amor hereos is m o r e i m p o r t a n t than the physical
cause, nonetheless, by investigating causality t h r o u g h love's place in the
body, Peter lessens the Platonism evident in Constantine's and Gerard's
chapters on love. Correspondingly, he a u g m e n t s the sense of material de-
t e r m i n i s m associated w i t h the disease. 22
T h e first question of version A seeks to determine w h i c h of the internal
senses or inner wits is primarily d a m a g e d by amor hereos, for w h i c h there
are f o u r possibilities. To Gerard's analysis of the roles of the estimative and
imaginative faculties, Peter adds consideration of the virtus cogitativa and the
fantasia (Figure 5.1). Since one faculty (virtus) could exercise several differ-
ent functions, each of w h i c h had its o w n name, the t e r m i n o l o g y of the inner
senses and their functions can be confusing. 2 3 Fortunately for o u r u n d e r -
standing of the debated question, Peter himself c o m p o s e d w h a t is in effect
a h a n d b o o k of psychology (Scientia libri de anima), in w h i c h he catalogues
the mental faculties and explains their functions.
Peter's first a r g u m e n t simply claims that since lovesickness damages the
imaginative faculty, it is therefore a disease of that faculty. T h e imaginative
faculty, located in the first cell of the brain, receives the f o r m s of sensible
objects (through sense perceptions) and transfers t h e m to " h i g h e r " mental
24
faculties for f u r t h e r processing. Brought to you by | Cambridge University Library
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Ά pbantaiïa C /Cogi'tatíua cíWmatíua

îmagfnacm
Êmcmoîan'ua Caput
aftnfuecôif pbancaftt
cum
3Cu«»ß»tS
co;¡>?cjcpícJtf
Figure 5.1. " C a p u t p h a n t a s t i c u m " s h o w i n g t h e internal senses a n d their l o c a t i o n s .

T h i s d i a g r a m separates phatnasia (B) f r o m t h e i m a g i n a t i v e f a c u l t y (D), a n d s h o w s
t h e c o g i t a t i v e a n d t h e e s t i m a t i v e faculties in (C). M a t t h i a s Q u a l l e , Parvuli . . . phi-
losophie naturalis cum comentariis ( H a g e n a u , 1513). B e t h e s d a , M a r y l a n d , H i s t o r y o f
Medicine Division, National Library of Medicine.
O n e of the higher faculties to w h i c h the imagination transmits images

is the estimative faculty, w h o s e definition Peter, like Gerard of Berry, d e -
rives f r o m Avicenna: it is that power by w h i c h w e j u d g e non-sensible
" i n t e n t i o n s " of sensible f o r m s — w h e t h e r s o m e t h i n g is to be p u r s u e d or
avoided (the sheep's estimative faculty j u d g e s it is time for flight w h e n it
perceives the " i n t e n t i o n s " of a w o l f ) . Since the lovesick patient errs in his
j u d g m e n t about the desirability of pursuing the beloved, so runs the next
a r g u m e n t , his estimative faculty m u s t be d a m a g e d by the disease.
Peter next argues that w h e n Constantine speaks of the lover's "assidu-
ous t h o u g h t s , " he refers to the w o r k i n g s of the cogitative p o w e r as it reflects
on the image of the beloved w o m a n . In the Scientia libri de anima Peter e x -
plains that the cogitative faculty is the fantasia or "fantastic f a c u l t y " (virtus
fantastica) w h e n acting under theBrought direction ofbythe
to you intellect in
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reflecting upon sensible forms.25 The virtus fantastica is situated in the middle
cell of the brain and works on images after they have been received by the
common senses and imagination.
Last of all, Peter proposes the fantasia as that faculty which is primarily
damaged by lovesickness. Its task, according to the Scientia, is to "judge,
distinguish, compose and divide" sensible forms in the absence of the ob-
jects themselves. B y so doing, it produces a judgment concerning the ob-
ject. It can be led astray either by not heeding the evidence of the senses, or
by refusing the rule of the intellect. Peter focuses on the comparative func-
tion of the fantasia in the question on lovesickness. Amor hereos, he declares,
is a suffering (passio) of that faculty whose task is to compare one object
with another. Since the lover judges one woman to be more beautiful than
all others, or one object to be better than others, the fantasia must be the
affected faculty.
The plethora of inner wits as possible victims of "sensible damage"
from lovesickness may seem a particularly fine bit of scholastic hair-
splitting. Because the solution to the question is borrowed almost wholesale
from Gerard's discussion of misestimation and because in the replies to the
arguments the roles of the fantasia and cogitative faculty are never really
discussed, Peter may have advanced the four faculties more from a desire
for thoroughness than from a concern to pinpoint the exact psychological
process by which love overwhelms the mind and body. But to dismiss the
arguments without further consideration would be to miss an important
aspect of Peter's approach to amor hereos. Even where he adopts the opinions
of previous authorities, whether moderni or antiqui, he does so critically,
enriching the field of intellectual play with additional possibilities in order
better to test the truth of their statements. In this instance, as psychology
had become more complex through the assimilation o f Aristotelian and
Avicennan psychologies, Peter lays out a fuller continuum of those mental
functions involved in perceiving and responding to a desirable form. Gerard
may have been correct in his assessment of the psychological damage in-
volved in amor hereos, but Peter tests that view against a fuller understanding
of psychological functioning.
VERSION Β
In the Β version of the Questions, lovesickness potentially affects only two

mental faculties, the imaginative and the estimative. As a result of this re-
duction in scope, the underlying causal issue stands out more sharply: is the
image itself or the overappreciation of the image more important in the
etiology of lovesickness?
Peter first proposes the imaginative faculty
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disorder.
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Amor hereos impairs both its function (operatio) and its organic substance.
O n the other hand, the estimative faculty, which apprehends "non-sensible
f o r m s " that entail pleasure or pain, may be the damaged faculty. Because
love is generated by j u d g m e n t s about intangibles like good and evil, rather
than about sensible qualities like heat or odor, the disease of love, so Peter
argues, must damage the faculty responsible for such j u d g m e n t s , which is
the estimative. Moreover, love is a disease of the faculty that "operates as it
apprehends," that is, that composes and divides images as part of its f u n c -
tion. Since lovesickness involves the comparison of one w o m a n to others,
as we have seen f r o m Gerard of Berry's analysis, and since comparison and
evaluation belong to the estimation, love must be a disease of that faculty.
Peter concludes, as in the A version, that the virtus estimativa is the place
of disturbance in lovesickness; the lover's malady is rooted in faulty j u d g -
ment rather than faulty perception. Whereas the A version reconciles the
arguments for the imagination and the estimative faculty by distinguishing
between immediate and mediated damage caused by lovesickness, the Β
version offers a somewhat different distinction. Peter draws a temporal di-
vision in the operation of the internal senses affected by amor hereos. Love is
a passio of the imagination in its initial motions, but in its completed f o r m
(complementum) is a disease of the estimative faculty.
Peter's focus on perception and the initiating role of the imagination
anticipates the later thirteenth-century interest in the stages of visual per-
ception in lovesickness that was stimulated by contemporary interest in o p -
tics. 26 Furthermore, his distinction between initial and completed stages of
the disease proved fruitful for later analyses of amor hereos. Gerard of Solo,
one of the leading masters at Montpellier in the middle third of the f o u r -
teenth century, took as the theme of his disputation on lovesickness (Deter-
minatio de amore hereos) Peter's question on which part of the body love is a
passio. T h e most interesting intellectual problem of the Determinatio—when
does love leave the realm of health {latitude sanitatis) and become m o r -
bid?—develops f r o m Peter's temporal distinction between initial and c o m -
pleted phases of lovesickness. 27 Both Peter and Gerard thus investigate time
and, as we shall see in Peter's case, matter as ways of discriminating amor
that is called hereos f r o m other types of amor.
The Locus of Love: Heart, Brain, or Testicles?
VERSION A
T h e opening words of Constantine's chapter on love define it as a disease of

the brain, yet he gives the body's need to unburden itself of excess h u m o r s
a causal status equivalent to the Brought
sight oftoayou
beautiful form. Where then, Peter
by | Cambridge University Library
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asks in the second question, is lovesickness actually located in the b o d y ? His

dialectic efforts to localize love somatically paradoxically reveal a b r o a d e r
view of love psychology.
At the same time that it exemplifies the intimate connections between
physiology and psychology, the second question also serves as a m o d e l of
dialectic m e t h o d . As the editor of Peter's philosophical w o r k s has pointed
out, Peter exemplifies the doctrines of his t e x t b o o k on logic, the Summule
logicales, in his philosophical teachings. 2 8 T h e same can be said of his medical
pedagogy. If w e read the chapter on lovesickness in light of the Summule
logicales, we find illustrations of equivocatici, a r g u m e n t s f r o m contraries
(11. 5 5 - 5 8 ) , f r o m genus (59-62), f r o m similarity (74-77), and f r o m defini-
tion (77-82). 2 9 F u r t h e r m o r e , recognition of the semantic a m b i g u i t y of amor
(equivocado) unlocks the sometimes cryptic a r g u m e n t s of this question.
T h e first a r g u m e n t that Peter advances, that opposites are predicated of
the same subject, derives f r o m Aristotle's Categories. To take Aristotle's e x -
amples: disease and health require as their subject the b o d y of an animal;
white and black require as their subject a b o d y w i t h o u t f u r t h e r qualification;
and justice and injustice have as their subject the h u m a n soul. In an a r g u -
m e n t that corresponds closely to Giles of Santarem's first question, Peter
contends that since the heart is the seat of e m o t i o n , and since hate lodges in
the heart, so too will love. T h e crux of the a r g u m e n t , of course, is the silent
substitution of " l o v e " for "lovesickness." 3 0
T h e next a r g u m e n t for placing love in the heart defines it as one of the
"accidents of the soul" or emotions, themselves one class of the " n o n -
naturals" (res non naturales)—air, rest and m o v e m e n t , f o o d and drink, sleep
and vigils, excretion and repletion—that affect health and disease. 31 In the
psychology Peter sets forth in the Scientia libri de anima, the brain and the
heart interact closely in the development of emotions, or "passions (acci-
dents) of the s o u l . " T h e p o w e r that governs the diversification of the e m o -
tions according to the type of stimulus is the virtus affectiva (affective
faculty), w h o s e seat is the heart. Since, however, the genesis of e m o t i o n
depends on perception and the w o r k i n g s of the imaginative and estimative
faculties, and since e m o t i o n in t u r n disturbs perception and j u d g m e n t , the
virtus affectiva in its w o r k i n g s is closer to the brain (proximius est cerebrum).32
T h e e m o t i o n s then " r e t u r n " to their source, the heart, w h i c h is also the
origin of m o t i o n , f r o m w h i c h point the appetitive faculty (virtus appetitiva)
can direct pursuit or avoidance. A l t h o u g h brain and heart interact d y n a m i -
cally, Peter focuses for the sake of this a r g u m e n t on the role of the heart in
the generation of emotions.
T h e c o u n t e r a r g u m e n t , in w h i c h the testicles are proposed as the site of
lovesickness, is a study in equivocation. Capitalizing once again on the a m -
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Peter of Spain, Q u e s t i o n s on the V i a t i c u m § 95
Figure 5.2. A m o r r e m o v e s the h e a r t f r o m a d r e a m i n g

K i n g R e n é a n d h a n d s it t o Desire. K i n g R e n é d ' A n j o u ,
Le cueur d'amours espris (1457). V i e n n a , B i l d a r c h i v ,
O s t e r r e i c h i s c h e N a t i o n a l b i b l i o t h e k , C o d . 2597, fol. 2r.
biguity of amor and also playing on the m e a n i n g of actus, Peter defines it as

t h e sexual act and calls it a passio o f the testicles. B u t w h a t exactly does
passio m e a n in this context? N o t "disease" (morbus), certainly, b u t rather t h e
philosophical sense of " b e i n g affected, suffering, u n d e r g o i n g . " Yet in the
conclusion to the question passio shifts to m e a n morbus—because t h e act of
love involves t h e testicles it is a morbus that afflicts t h e m .
T h e next a r g u m e n t , w h i c h links diseases and their h u m o r a l substances,
"materializes" t h e origin of lovesickness. Since the o f f e n d i n g substance in
lovesickness is excess seed, amor hereos m u s t be a disease o f the testicles.
M o r e o v e r , since t h e cure, as he rather crudely puts it, involves the applica-
tion of "plasters o r w o m e n to the testicles," the disease m u s t be located in
this o r g a n . T h e i n s t r u m e n t a l use of w o m e n m a k e s it clear that the patients
are assumed to be male, and that testiculi, w h i c h can refer to the o r g a n s o f
either sex (gonads), are here a s s u m e d to be the male sex o r g a n s . W h e r e a s
w o m e n may receive special consideration as possible sufferers of lovesick-
ness, as w e shall see in the next chapter, m o s t of the q u e s t i o n s p r e s u m e that
m e n are the patients.
Finally, the last t w o a r g u m e n t s locate amor hereos in t h e brain, " t h e p r i n -
ciple m e m b e r , n o b l e . . . the f o u n d a t i o n of the w h o l e b o d y and t h e seat o f
the s o u l , " as Peter calls it in his treatise o n preserving health. 3 3 Because t h e
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classic medical authorities on love, Avicenna and Constantine, place the dis-
ease in the brain, and because amor hereos is defined as a melancholic worry
accompanied by depressive thoughts, and a disease similar to melancholy,
lovesickness must be located in the brain, where these originate.
Peter distinguishes between two types of love in his resolution of the
debate: O n e is located in the heart, but is not morbid; the other is located
in the brain, and is a true morbus. Aristotle is right, but so is Avicenna: it all
depends on what you mean by amor. "Cardiac love" may be a passionate
emotion, but "cerebral love" can become a disease (Figure 5.2). To the ar-
guments about testicular localization he responds that coitus is not a morbus,
but rather the failure of the estimative faculty is, and that the application of
women or plasters to the testicles cures the s y m p t o m s but not the disease
per se.
VERSION Β
T h o u g h the corresponding question in the Β version duplicates some of the

arguments of A, it also contains new material. T h e possible locations of
love are reduced f r o m three (brain, heart, testicles) to t w o (testicles and
brain). This reduction not only sharpens the dichotomy between mind and
body, but also strengthens the bond between corporeality and sexuality.
Without the mediation of the heart, man's upper and lower halves seem to
polarize. If we step back to consider this intricate debate f r o m some dis-
tance, it begins to resemble one of the dialogues in Andreas Capellanus' De
amore, in which a man and a w o m a n f r o m the higher nobility converse
together. T h e lady sets her suitor a problem: Which is a lover to prefer, the
solaces of the upper half of the body, or of the lower? Their ensuing debate
introduces analogies between appetites for food and sex, alludes to the inter-
play of mind and body in sexual desire, and considers whether sexuality is
the efficient and final cause of love. 34 T h e central issue of the controversy
(as of De amore as a whole) is clear: what is the relationship between sexual
desire and love? This, too, is the problem in Peter of Spain's questions on
the Viaticum, articulated in the language of scholastic medicine rather than
in that of courtly badinage.
To return, then, to Peter's debate: T h e first argument, which posits that
love is a disease of the testicles, echoes the A version's contention that a
disease belongs to that part of the body which it affects. Since love per se
involves the testicles, lovesickness is located there. As in the A version, here
too the reasoning depends on the unacknowledged ambiguity of amor,
which means both "love" (sexual act) and lovesickness.
T h e second reason for locating amor hereos in the testicles leads Peter to
Authenticated
consider the nature of appetite. Appetite, he claims, is dual: it is b o t h g e n -

eral o r "universal," originating in the brain, and particular, located in a
specific part of the body. Since love entails an " a p p e t i t e " or desire for an
object, this desire m u s t be located in a particular part of the body, and the
testicles are the o b v i o u s spot.
T h e third reason, w h i c h echoes an a r g u m e n t of the A version, advances
this line of reasoning a step further. Since action and potential belong to the
same subject, in this case the testicles, inability (impotentia or lack of inter-
course) w i t h respect to this action m u s t be attributed to the testicles as well.
T h e disease resulting f r o m this lack is n o t h i n g other than amor hereos caused
by superfluities located in the testicles.
T h e first c o u n t e r a r g u m e n t for the cerebral localization of love is t w o -
pronged: since love involves t h o u g h t s and cares, and these stem f r o m the
brain, love is a disease of the brain; and since it is a melancholic w o r r y , it is
of the brain.
T h e second a r g u m e n t is u n i q u e to the Β version. If love were really
located in the testicles, then eunuchs and those n o t able to have intercourse
w o u l d not suffer f r o m it. But since " w e see" (videmus) that they are in fact
liable to lovesickness, it cannot be a disease of the testicles, b u t rather m u s t
originate in the brain.
Like that of the A version, the solution distinguishes between t w o as-
pects of love. Love as a disordering and depression of the t h o u g h t is a dis-
ease of the brain. Sexual desire, however, also plays a role in amor hereos and
itself has t w o aspects. O n e is mental (animalis, f r o m anima), based on the
image of the desired object in the mind, and thus is located in the brain.
T h e other aspect of sexual desire, arising f r o m the body's natural f u n c t i o n -
ing, is in turn t w o f o l d . O n e type is " f l u c t u a t i n g , " so called f r o m its d e p e n -
dence on the varying a m o u n t s of heat resulting f r o m digestion, in w h i c h
the liver plays an i m p o r t a n t role. T h e other type is " f i x e d , " linked to the
innate heat that is " r o o t e d in seminal m o i s t u r e " in all parts of the body, as
Peter explains in his questions on De animalibus.x H e apparently means that
since the testicles conserve m o r e seminal moisture than other parts o f the
body, they generate m o r e naturalis stimulatio coitus than other m e m b e r s .
T h u s lovesickness is a disease of b o t h the brain, and, t h r o u g h these elaborate
bifurcations, of the testicles as well. Like his auctoritas Constantine, then,
Peter emphasizes the part man's psychosomatic unity plays in the d e v e l o p -
m e n t of lovesickness, but unlike Constantine, he pursues the precise routes
by w h i c h m i n d and b o d y collaborate in the lover's decline.
Such dialectic acrobatics may have tested the extent to w h i c h the play
of logic usefully enhanced medical discussion. While the final conclusion o f
the first question reaffirms Constantine's statement that love is a disease o f
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the brain, in general the terms o f such discussions may have opened medical
discourse to philosophical development, as is apparent in Gerard o f Solo's
Determinado de amore hereos.x
In the Β version three subquestions on the relation o f heat and cold to
appetite in the stomach and the sexual organs amplify the main question.
Their appearance in a chapter on amor hereos sets the erotic malady in a
larger context o f appetite and its physiological manifestations. Although
Aristotle (De anima 414b) could have provided the general inspiration for
the collocation o f these topics, the more specific rationale for these particu-
lar questions appear in a commentary by the Salernitan master Maurus. In
his commentary on the Isagoge o fJohannitius, a general introduction to Ga-
lenic medicine, he locates desire (desiderium) in the stomach, the penis, and
the womb. 3 7 T h e Prose Salernitan Questions, which incorporated Maurus'
statement and which Peter knew well, offered a ready source for comparing
and contrasting these appetites.
These questions appear again later in Peter's Questions on the Viaticum in
the chapters on sexual disorders, as well as in the section on mammalian
procreation in Peter's commentary on Aristotle, the Questiones super de ani-
malibus.38 The recurrence o f the same set o f questions in three different con-
texts marks Peter's interest in how heat and cold determine the mechanics
o f appetite. His focus on the mechanics o f appetite (heat and cold) lend his
exposition a more emphatic materialism than those o f other authors in this
volume.
The Patients
In both versions the attempt to classify likely groups o f sufferers according
to humoral complexion, age, and sex unifies the next set o f questions.
These questions, a favorite means o f inquiry in Peter's commentary on the
Viaticum, greatly broaden Gerard's restricted epidemiology. In contrast to
Gerard's socioeconomic explanation o f lovesickness as a disease affecting the
nobility, Peter's analysis in Version A concentrates on bodily composition
arising from the balance o f humors, that is, on material causality.
In the first o f the questions on the sufferers o f lovesickness, Peter argues
that imagining the delights o f intercourse provokes adolescent males, o f an
age most suited for love, to suffer amor hereos (Figure 5.3). In general, how-
ever, the most important underlying cause o f the disease is what we would
call a high metabolism—in medieval terms, a hot complexion—that gen-
erates what Peter calls sexually stimulating heat. Since o f the four humoral
complexions two were considered hot, namely the choleric and the san-
guine, and two cold, namely the melancholic and phlegmatic (Figure 5.4),
Authenticated
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Figure 5.3. A chart with five "ages of man": infancy (to 7), childhood (to 14), ado-
lescence (to 21), " y o u t h " (adulthood, to 45), and old age. Adolescence is the age
for love and for reproducing (ad gignendum sit adulta). Munich, Bayerische Staats-
bibliothek, M S lat. 19414, fol. 180r.

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AQJVA·.
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Figure 5.4. This diagram correlates qualities (in the center) with h u m o r s ,
ages o f life, seasons, and elements. Reading clockwise f r o m the top: Fire,
s u m m e r , youth, and choler are hot and dry; earth, a u t u m n , maturity, and
melancholy are dry and cold; water, winter, old age, and phlegm are cold
and moist; air, spring, childhood, and blood are moist and hot. Paris,
Bibliothèque Nationale, M S lat. 11130, fol. 48r.
Peter concludes that those of sanguine or choleric complexion are more

likely to contract lovesickness.
In the Β version Peter treats the roles of age and complexion in amor
hereos in a single question on melancholy. Throughout the Middle Ages
amor hereos stood in an ambiguous relation to melancholy. According to the
Viaticum, amor leads to a passio melancholica if the thoughts are not relieved,
and this causal role of love in melancholy appears again in the Prose Saler-
nitan Questions, a body of literature that Peter of Spain drew upon and re-
worked throughout his medical career. As Salernitan lore had it, a certain
girl w h o awaited her lover in vain contracted mania, caused by the melan-
cholic humor that her worried thought had generated. 39
Avicenna calls love a "melancholic worry," intimating a close connec-
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tion between the t w o b u t failing to specify its nature. 4 0 To confuse the pic-
ture further, Constantine's De melancholia discusses b o t h h u m o r a l and
psychological causes for melancholia and mentions lovers as subject to the
disease.
Peter concludes that amor hereos is a "melancholic" disease only insofar
as the s y m p t o m s are similar to melancholy; he does not argue for a c o m m o n
h u m o r a l origin. Consequently, his analysis stops short of positing a " t y p e "
of melancholy lover, w h o s e bodily constitution and t e m p e r a m e n t predis-
poses h i m to lovesickness. In this, he and Arnald of Villanova, w h o c o n -
siders melancholy a possible complication of lovesickness, agree. 4 1
Fourteenth-century medical writers, o n the other hand, tend to assert a
closer connection between amor hereos and melancholy, classifying the f o r -
mer as a subspecies of the latter. Gerard of Solo (in his c o m m e n t a r y on the
ninth b o o k of al-Räzi's Ad almansorem), J o h n of Gaddesden, J o h n of T o r n a -
mira, and the fifteenth-century a u t h o r Jacques Despars all designate amor
hereos as a melancholic disease. 42 By the seventeenth century B u r t o n was
able to identify the t w o in his t o m e on "Love M e l a n c h o l y . " This shift, if it
indeed occurred and is not merely a reflection of the limitations of surviving
evidence, may have resulted f r o m m o r e intensive study of Avicenna, w h o
associates love and melancholy, and f r o m the g r o w i n g popularity of t e m -
peramental " t y p e s " used to explain behavior (Chaucer's Reeve, for e x -
ample, is a "sclendre colerik man").
Symptoms
Whereas the A version lacks any discussion of signs and s y m p t o m s , one
question of the Β version concerns the effect of amor hereos on the eyes.
A l t h o u g h C o n s t a n t i n e had said that all of the b o d y except the eyes wastes
away, Peter argues that because of the eyes' aqueous substance, w h i c h is, as
he puts it, "passible and fluxible," they m u s t suffer f r o m the effects of love-
sickness as well. In his b o o k on preserving health, he notes that crying,
fasting, and excessive wakefulness all take their toll on the eyes. 43 Since these
s y m p t o m s a c c o m p a n y lovesickness, it stands to reason that the eyes should
be affected. In addition, the eyes, of all the bodily m e m b e r s , have the closest
connection w i t h the brain, and m u s t therefore suffer w h e n the brain does,
as happens in lovesickness. T h e solution focuses on Constantine's statement
that the eyes of a lovesick patient appear larger: this may, Peter says, either
be due to the fact that the face has thinned so m u c h that the eyes seem
proportionately larger, or because insomnia causes vapors to distend the
eyes, m a k i n g t h e m in fact larger.
T h e singling out of this particular s y m p t o m for special t r e a t m e n t in-
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vites commentary. T h e question may have offered a chance to integrate

Aristotelian physiology with the traditional s y m p t o m s of amor hereos de-
rived f r o m Arabic medical treatises. When compared to Arnald of Villa-
nova's more completely integrated physiological conception of s y m p t o m s
in the Tractatus de amore heroico, however, Peter's isolated question seems a
hesitant step toward harmonizing s y m p t o m s with causes.
But perhaps we owe its presence in his lecture to less technical motives.
If, as I have suggested, s y m p t o m s of illness correspond to cultural values,
other considerations may motivate Peter's interest in ocular symptoms. 4 4
T h e eyes, which Peter describes as " w i n d o w s of the soul" admitting light
in the manner of stained glass, allow the image of the beloved w o m a n to
enter the imagination, where, according to the Β version, lovesickness be-
gins. 45 O n this point medical theory and literary practice agree. O n e of the
staple conventions of vernacular love literature in Peter's time is the entry of
love through the eyes. T h e Lover in the Romance of the Rose is pierced
through the eye with the arrow of Beauty, which lodges in his heart (Figure
5.5). T h e affliction of the eyes, whose radiant and fluxible substance inter-
posed between the outer world containing the beloved and the inner world
filled with appetitive desire, is possibly the most fitting symbol of the dis-
ease and its causes. T h e eyes, moreover, betray the patient in a manner
unlike the other symptoms. T h e changes in the pulse require the expert
divination of the physician; the obsession with the beloved's image can only
be revealed by the patient himself. The hollow eyes, in contrast, enable the
knowledgeable to "read" f r o m afar the sign of the patient's secret disease.
Cures: Travel, Women, and Wine

" T h e best, readiest, surest way, and which all approve," says Robert B u r t o n
of the cures for love melancholy, "is loci mutatio, to send them several ways,
that they may neither hear of, see, nor have an opportunity to send to one
another again. " 4 6 However, travel is not a m o n g the cures Constantine sug-
gests, nor does it appear in Avicenna's chapter on ilisci. Al-Râzî does never-
theless recommend it, and in the later thirteenth century it was standard
therapy (cf. Bona Fortunas prescription in the next chapter). T h e principle
underlying the treatment is the familiar (and Ovidian) "out of sight, out of
m i n d . " In the A version Peter formulates the principle a little differently,
stressing the positive value of the distraction provided by scenery, whose
novelty attracts the patient's attention and causes him to forget his erotic
obsession.
T h e cure had its dangers: William of Saliceto, writing in 1250, describes
another type of amor hereos besides that for a w o m a n — l o v e for a distant
Authenticated
Peter of Spain, Q u e s t i o n s o n t h e V i a t i c u m § 103
3 4
r
è
V? 4P
Figure 5.5. T h e G o d o f L o v e strikes t h e Lover's eye

w i t h t h e a r r o w o f beauty. Scene f r o m t h e Roman de
la Rose. Philadelphia M u s e u m o f A r t , Philip S.
C o l l e n s C o l l e c t i o n ('45-65-3), fol. 14r, detail. P h o t o -
g r a p h e d b y J o a n B r o d e r i c k , 1985.
h o m e l a n d . Patients languish f o r their countries and the only cure is t o

return. 4 7
T h e next c o n t r o v e r t e d topic, w h e t h e r ugly or b e a u t i f u l w o m e n s h o u l d
be led b e f o r e t h e patient, is c o m m o n to b o t h versions and p r o b e s a p p a r e n t
contradictions in Avicenna's therapy. O n the o n e h a n d , the A r a b i c physician
advises that horrible old w o m e n should disparage the beloved in the p a -
tient's presence, b u t on the o t h e r that he should distract h i m s e l f (as C o n -
stantine r e c o m m e n d s ) w i t h o t h e r y o u n g w o m e n . T h e pedagogical s t r a t e g y
o f Peter's questions, h a r k i n g back to that o f the second question, seems
designed to p r o v o k e reflection o n t h e n a t u r e of contraries and similars. H e
quotes Galen's principle that cures are effected by contraries: omnis cura per
contrarium. T h i s was generally u n d e r s t o o d to refer to elements and qualities:
h o t is cured by cold, m o i s t by dry, and so on. By p r o p o s i n g t o apply t h e r a -
peutic principles generally associated w i t h altering the b o d y to p s y c h o -
logical cures, Peter forces his students to think m o r e deeply a b o u t the
differences b e t w e e n somatic and psychological cures. M o r e o v e r , t h e q u e s -
tion c o n f r o n t s t h e m w i t h the real therapeutic issue: h o w can t h e physician

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t r a n s f o r m the patient's desire to a less d a m a g i n g f o r m ? D o e s he merely s u b -

stitute another object, or does he t r a n s f o r m desire into loathing? In keeping
w i t h the O v i d i a n d i c t u m that "a n e w love drives o u t the o l d , " Peter c o n -
cludes in b o t h versions that another beautiful w o m a n should be substituted
for the unattainable object of the patient's desire. Diversion, in his view, is
m o r e successful than conversion.
T h e last t w o questions of the series address somatic cures for love: w i n e
and food. While C o n s t a n t i n e tempers his praise of w i n e w i t h a caution
against inebriation, another authority on lovesickness, al-RäzT, r e c o m m e n d s
a t h o r o u g h sousing (ebrietas plurima assidue).48 Characteristically, o u r a u t h o r
chooses to inquire into the contrasting effects of inebriation o n the b o d y
and the mind. Alcohol generates excesses in the b o d y that tend to stimulate
sexual desire, thus thwarting a basic therapeutic principle of amor hereos (see
lines 117-30), namely reducing sexual stimulation. Nonetheless, the loss of
m e m o r y that follows diligent drinking lessens the lover's preoccupation.
Peter harmonizes the conflicting authorities by arguing that there t w o
types of drunkenness, j u s t as there are t w o types of love, and t w o m e a n i n g s
of maior. O n e type completely befuddles the internal senses, and thus aids
the cure of lovesickness since the patient forgets the beloved object. T h e
other type merely perturbs the inner wits, exacerbating the disturbance that
causes lovesickness in the first place: this kind of drunkenness, says Peter, is
useless as a cure.
In the Β version, Peter again counters the authorities' prescription of
potation w i t h an a r g u m e n t that drinking will only m a k e lovesickness
worse. Whereas in the A version drunkenness is objectionable because it is
b o t h sexually stimulating and mentally befuddling, the Β version raises
only the latter objection. Peter concludes that inebriation is of n o help in
restoring the m i n d to an ordered love, w h i c h is one way to cure lovesick-
ness; however, the disease can also be cured by t h o r o u g h intoxication,
w h i c h frees the m i n d f r o m cares and w o r r y .
T h e authorities (al-Räzi and Avicenna) disagree n o t o n l y a b o u t d r u n k -
enness, but also about w h e t h e r fasting or a m o d e r a t e diet is to be r e c o m -
m e n d e d for the lovesick. According to the A version, t w o aspects of
nutrition need to be considered. Fasting may help to eliminate superfluities
that w o u l d otherwise a u g m e n t sexual desire, but the leanness and wasting
induced by amor hereos have to be countered by " t e m p e r a t e " food, that is,
b y f o o d that generates beneficial h u m o r s rather than potentially h a r m f u l
superfluities.
T h e last question of the A version inquires why, given that oblivion is
an i m p o r t a n t part of the cure, the beloved should be scorned w h e n this will
only cause the lover to think about her m o r e . Peter admits that she will
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indeed be brought to mind during this process, but declares that the vilifica-
tion will in fact detach the patient's mind f r o m its preoccupation with her.
To this array of therapies the Β version adds only one new question,
on the usefulness of baths. As though he were all too familiar with the
bathhouses-cum-brothels that dotted the medieval urban landscape, Peter
suggests that baths are counterproductive as a cure because they only in-
crease the desire for intercourse. O n the other hand, eminent medical au-
thorities hold that baths are indeed effective. Peter sides with the authorities
and explains that baths, which are a m o n g the genus deliciarum (type of plea-
sures), and nourishing food distract the mind f r o m melancholy. 49
Influence
Peter's contemporary fame and long years of teaching insured that his ideas
on amor hereos found their way into the works of later medical writers. T h e
surviving manuscripts indicate that within a generation or two of his stint
in Siena, readers were demanding copies of his commentary on the Viaticum.
Several of the manuscripts were written at Montpellier in the early four-
teenth century, a sign that Peter's ideas interested medical students or teach-
ers there. N o r was his work ignored in the later part of the century. T h e
German physician Amplonius Ratinck acquired copies of both the A and
the Β versions of the Questions on the Viaticum. Moreover, Peter's w o r k en-
joyed more than local interest; it circulated outside the medical centers of
the Continent, reaching England in the fourteenth century. 50
Nonetheless, it is at Montpellier that we can trace the deepest engage-
ment with Peter's teaching on lovesickness. T h e work of one Montpellier
physician clearly shows familiarity with the exposition of lovesickness in
the Questions on the Viaticum. Gerard of Solo is best k n o w n to students of
amor hereos for his commentary on the ninth book of al-Râzî's Liber ad al-
mansorem, in which he discusses lovesickness as a third type of melancholy,
called amorereos in the Renaissance edition of his Opera.51 His Determinado
de amore hereos, however, though it duplicates some of the material con-
tained in the commentary on al-Râzî's ninth book, offers more t h o r o u g h
treatment and different emphases than the commentary. 5 2 Most importantly
in this context, the Determinatio at points resembles Peter of Spain's series of
questions on love closely enough that direct influence seems likely.
Like Peter of Spain, Gerard analyzes love as a phenomenon of appetite,
and examines its distribution in various classes of people, its relative inten-
sity in men and w o m e n , and the sources of sexual pleasure. Like his prede-
cessor, he is, moreover, thoroughly Aristotelian, drawing u p o n De anima
and the Nichomachean Ethics for the psychology of friendship and love, and
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the distinctions a m o n g action, habit, and passion. Gerard's m a n n e r of using

philosophical and natural philosophical a r g u m e n t s s h o w s that amor hereos
had b e c o m e a topic t h r o u g h w h i c h medicine could parade its claims to b e -
ing a " p h i l o s o p h y of the b o d y . " T h e intellectual ancestry of this philosophi-
cal somaticism is rooted, as far as the evidence allows us to j u d g e , in Peter
of Spain's inquiry into the lover's malady.
It is harder to pinpoint Peter's contribution to the ideas of other M o n t -
pellier masters w h o w r o t e a b o u t amor hereos in the later thirteenth and early
fourteenth centuries, since their treatises are not in the f o r m of disputed
questions, as is Gerard's Determinatio. Bernard of Gordon's chapter on love
in the Practica dicta lilium medicinae (1305) shows f e w signs of e n g a g e m e n t
w i t h Peter's ideas except in the "Clarificatio." 5 3 T h e r e he discusses c o n t r o -
versial i s s u e s — h o w m u c h wine? does amor hereos afflict the brain o r tes-
ticles? does it strike m e n or w o m e n m o r e o f t e n ? — t h a t Peter also raises.
Bernard concludes w i t h several lines of verse in w h i c h he defines love as
insania mentis. T h e same versified definition of love appears in the lectura
that opens the Β version of Peter's commentary. 5 4 W h e t h e r his influence on
Bernard was direct or mediated is difficult to tell; in any event, Bernard's
chapter suggests that the issues Peter articulated passed into scholastic m e d i -
cal writing on lovesickness b y a r o u n d 1300.
M o r e problematic is the relation of Peter's discussion of amor hereos to
Arnald of Villanova 's Tractatus de amore heroico c o m p o s e d before the m i d -
12805, and possibly a dozen years earlier. Arnald studied medicine at M o n t -
pellier in the 1260s, w h e n the Viaticum appears not to have been part of the
curriculum. 5 5 His treatise on heroic love diverges considerably f r o m later
treatments of the subject b y the Montpellier masters B e r n a r d of G o r d o n
and Gerard of Solo, s o m e of w h o s e concerns, as we have seen, are similar
to Peter's. Nonetheless, the t w o Iberians' discussions of lovesickness share a
n u m b e r of topics.
At the m o s t general level, Arnald, like Peter, integrates medicine and
natural philosophy, a feature m o r e evident in the Β version of Peter's c o m -
m e n t a r y than in the A. B o t h address the issue of w h e t h e r love really is
a morbus: Peter distinguishes between t w o types of love, one of w h i c h is a
morbus, while Arnald declares that, properly speaking, love is n o t a morbus
b u t an accidens,56 H e also notes that the mind's fixation on the pleasing object
is due to the pleasure of intercourse, as does Peter in the Β version (11. 1 9 5 -
247). B o t h consider w h e t h e r h o p e or lack of it has a role in the disease's
origins. 5 7 T h o u g h they arrive at opposite conclusions, it may be significant
that they raise the same question. As far as therapy goes, Arnald's statement
that the proper cure ( f o r m a rectae curationis) for this disease is by contraries,

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and thus the pleasure associated with the beloved should be turned into
revulsion by showing or narrating her odious traits, may be a response to
Peter's conclusion that beautiful rather than ugly women should be brought
before the patient to distract him.
All this does not add up to proof of Arnald's knowledge of Peter's work,
although if Peter were an alumnus of Montpellier, such contact might have
been possible. N o r should the differences between the t w o be underempha-
sized. Arnald gives a coherent mechanistic explanation of the disease that
integrates etiology with semeiology, whereas Peter's treatment is frag-
mented by the question form and, apart f r o m the lectura in the Β version
(11. 1 - 5 3 ) , does not offer a systematic presentation. Comparison does, h o w -
ever, reveal that ca. 1245-85 a c o m m o n set of questions and approaches to
amor hereos emerged in scholastic medicine, and that Peter of Spain's Ques-
tions on the Viaticum shaped the problematic at an early stage.
Peter of Spain continued the process, begun by Gerard of Berry,

of synthesizing Constantine's chapter on lovesickness with more recently
translated medical and philosophical texts. To Gerard's incorporation of
Avicennan psychology into the Viaticum's chapter on love Peter added a
variety of physiological considerations: on the nature of appetite in itself;
on the contrasts between appetites for food and sex; on the effects of heat
and cold on these appetites; and on the relation of sexual appetite to love-
sickness. These were important themes in his general medical teaching; they
indicate that he approached lovesickness f r o m a broad perspective, viewing
it as a specific case of general processes of desire and appetite.
To his teaching on lovesickness he brought his characteristic habits as a
thinker: logical rigor, psychological acuity, psychosomatic interests, and
philosophical vision. The A and Β versions of his exposition of Constantine
allow us to see developments in the theory of lovesickness being forged, as
it were, in the classroom. Like that of Aquinas, to w h o m he is often c o m -
pared, Peter's procedure is both analytic and synthetic. T h r o u g h his various
distinctions and semantic clarifications he resolves the questions into their
separate aspects. Lovesickness becomes a specific process in specific organs
and faculties. At the same time, the premises drawn f r o m Aristotle's bio-
logical works place lovesickness in a wider framework of mammalian ac-
tivity. At the level of both specific detail and general procedure, we can
see in his teaching a gravitation toward a problem expressed otherwise in
thirteenth-century philosophy as the interrelation of particulars and univer-
sale. Given that amor is general and ambiguous, what can be said of the
specific variety discussed by the medical authorities Constantine and Avi-

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cenna? If it does not yield a scholastic Summa amoris, the Portuguese physi-
cian's dialectical play nonetheless preserves some of the excitement that
must have filled the lecture halls where the young master of medicine and
his even younger students matched Arabic medicine against Aristotelian
philosophy, pitted authority against authority, and boldly tried to measure
the quantity and quality of pleasure.

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§§ 6 §§
THE M E A S U R E OF P L E A S U R E
Peter of Spain on Men, Women,
and Lovesickness
Men do not know how to feign their feelings of love, but women do it
well. Just as the fire which is covered by cinders is the most ardent and
the most dangerous and lasts longer than the one which is uncovered,
so the love of women is stronger than that of men. Jupiter and Juno
argued about who was the warmer, man or woman . . . To get an an-
swer to their questions, they went to a wise man named Tiresias. He
said that women were more ardent than men.
Art d'amours'
I n one o f the last stories told in the Decameron ( X . 7 ) , Lisa, an apothecary's

daughter, fell in love with K i n g Peter o f A r a g o n . B u t her l o w l y condition
prevented her f r o m fulfilling her passion, and as her love increased, so did
her melancholy until " b e i n g unable to endure it any longer, the beautiful
Lisa fell ill and began to waste visibly away f r o m one day to the next, like
s n o w in the rays o f the s u n . " 2 Despite this and similar instances o f women's
love melancholy in medieval literature, modern historians o f medicine
w o r k i n g f r o m printed medical sources o f the M i d d l e A g e s have termed
lovesickness an "echte M ä n n e r k r a n k h e i t . " 3 T h e i r assessment rests on the
opinions o f such medical writers as Gerard o f B e r r y and B e r n a r d o f G o r -
don, both o f w h o m claim that amor hereos afflicts noble men. 4
Peter o f Spain's Questions on the Viaticum invite us to reconsider h o w
medieval medical writers understood the relation o f gender to lovesickness.
In elucidating the Viaticum's chapter on love, Peter inquires w h i c h sex s u f -
fers m o r e f r o m lovesickness. His answer, in keeping with his somaticism,
links susceptibility to lovesickness with the p s y c h o p h y s i o l o g y o f sexual
pleasure. A s s u m i n g that the degree o f pleasure affects one's likelihood o f
falling ill with love, Peter applies terms o f qualitative and quantitative m e a -
surement to sexual experience, adumbrating w h a t J o h n M u r d o c h has called
" a veritable f u r o r to m e a s u r e " in the later M i d d l e A g e s . 5 This analysis
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spurred other medical writers and natural philosophers to develop further

the contrasts of intensive and extensive sexual pleasures and to rethink in
turn the relationship between gender and lovesickness.
Lovesickness and Gender

In literary accounts of love, the torments of lovesickness spare neither sex.
Many of the famous patients whose minds were alienated by love are
m e n — o n e thinks of the young Dante, Boccaccio's Giachetto, Arcite, and
Troilus—yet their female counterparts clearly exist as well: Boccaccio's Lisa
and Lisabetta, for example, and Christine de Pisan's faithful w o m e n in The
Book of the City of Ladies.6 Vernacular poems more nearly contemporary
with Peter of Spain also offer powerful examples of w o m e n stricken by the
aegritudo amoris.
Ovidian lore f r o m the Ars amatoria and Remedia amoris, which incor-
porate ancient medical ideas on love as illness, contributed to the stock of
cultural themes about w o m e n in love (Figure 6.1). L'art d'amours notes that
love is a "pure art" that " w o m e n and young men of ease" k n o w by nature. 7
In the anonymous twelfth-century adaptation of the Aeneid, the Roman
d'Eneas, heroines like Dido or Lavinia, w h o were afflicted with the madness
of love and all its symptoms, express their torments in the language of love
as illness derived f r o m the Ars and the Remedial T h e psychology of
thwarted and abandoned w o m e n evident in the Heroides also influenced lit-
erary representations of w o m e n in love. Chrétien de Troyes in turn en-
dowed his heroines with the signs of the amatory malady derived f r o m
Ovid. Fénice in Cligés, for example, complains that she is dolcement malade
(1. 3044) and her nurse Thessala explains that she is suffering the max d'amors
(1. 3073). 9
T h e Ovidian language of lovesickness found in secular texts partly
overlaps that of divine languor in the Song of Songs, which enjoyed a re-
surgence of commentary in the twelfth century and contributed a richly a m -
biguous vocabulary of love to medieval spirituality. 10 T h e female speaker's
refrain, quia amore tangueo (2.5, 5.8), characterizes spiritual love as a type of
earthly lovesickness (Figure 1.3). T h e equivocal meaning of the phrase al-
lowed many vernacular lyrics to b o r r o w the vocabulary of spiritual languor
in order to describe a very secular "love-longing"; in a number of these
lyrics the speakers are women. 1 1 O t h e r texts that do not claim to be imagi-
native literature also show that w o m e n used the language of the Song to
express both the exaltation and the painfulness of their experiences of love.
A m o n g the Epistolae duorum amantium, one of the woman's letters to her
lover confesses: tui presencia dum careo . . . permota amore tuo langueo ("while
Authenticated
Peter of Spain on Men, Women, and Lovesickness § 111
tmîômc
Figure 6.Í. The lover says: "Nightengale, my lady is dying." From the
Roman de poire. Paris, Bibliothèque Nationale, MS fr. 2186, fol. 79r.
I lack your presence . . . I languish, frenzied by your love"). 1 2 In the thir-

teenth century, the biographer of the mystic Julian of M o u n t C o r n i l l o n re-
lated that she suffered a divine love-languor that her c o m p a n i o n s m i s t o o k
as an earthly illness. 13 W h e t h e r directed toward a sacred or a secular object,
women's passionate love, figured as illness, was thus a familiar part of
thirteenth-century culture.
Natural philosophy, in contrast to love literature, investigated w o m e n ' s
sexuality rather than their erotic maladies. T w e l f t h - and early t h i r t e e n t h -
century natural philosophers, w i t h the notable exception of Hildegard of
Bingen, considered w o m e n to be m o r e libidinous than men, and to take
greater delight in sexual activity. 14 As the encyclopedist B a r t h o l o m a e u s
Anglicus, Peter's contemporary, puts it, w o m e n are "hasty in likinge of
Venus." Moreover, " t h e femel desireth m o r e than the male and is m o r e
y m o e u e d to loue in alle k y n d e of bestes, as Ysidorus seith libro xi°." 1 5 C o n -
stantine the African asserts in the Pantegni that w o m e n enjoy intercourse
m o r e than men d o because m e n receive pleasure only f r o m the expulsion of
seed, whereas w o m e n enjoy themselves d o u b l y (dupliciter delectantur), in e x -
pelling their o w n seed and in receiving that of the male, an idea still current
as late as the eighteenth century. 1 6 Constantine's physiological view a b o u t
women's double pleasure achieved wide currency in the Salernitan ques-
tions. 1 7 An inquiry of this type, incorporated into the Art d'amours, adds a
psychological twist to women's sexual desire. In answer to the question
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about why animals love only during the rutting period but women love all
the time, the author says that women have reason and memory "and they
remember the pleasure they have had of love and the delight; therefore, they
desire it always." 18
There are, however, some few indications that physicians before Peter
of Spain had considered the problem o f women's lovesickness. One o f the
prose Salernitan questions mentions a girl who fell into mania because the
lover whom she awaited never showed up. Though it is not explicitly desig-
nated as such, the incident might be construed as a case o f lovesickness. 19
Bernardus Provincialis, a late twelfth-century physician, states more clearly
that amor hereos is no respecter o f sex in his Commentarium super tabulas Sa-
lerni. He says that if any youth or girl is afflicted with love for someone
unobtainable, he or she, with hands held or tied behind the back, should
bend over to drink water into which glowing iron has been plunged. This,
he claims, is a "physical and empirical and rational remedy" because it settles
the humors aroused by amore illicito vel hercos [for hereos?].20
Bernard's commentary aside, other medical texts before Peter o f Spain's
Questions that describe amor hereos both imply and explicitly claim that men
are the primary class of patients. Avicenna's suggestion (repeated by Gerard
o f Berry and others) that the patient purchase and enjoy girls as part o f the
cure is clearly meant to benefit male patients. Gerard's claim that amor heros
is a disease o f noble men who suffer from it more often because o f their
wealth and the softness o f their lives proved long-lived. The author o f the
Art d'amours, a cleric no doubt, somewhat scornfully described their ama-
tory disposition in terms that recall Gerard's: "When rich young men are at
leisure, they want to practice the art of love. They want to amuse them-
selves, to ride horses, and to be prized and praised for having love and riches
with which they are fat and puffed up." 2 1 In the late thirteenth century
Bernard o f Gordon repeated Gerard's view that noblemen are most subject
to the disease, as did Jacques Despars in the fifteenth.
Gerard's masculinization o f the morbus amoris is difficult to explain. He
implicates social and economic factors—leisure and wealth—in lovesick-
ness, but why he should attribute the disease to men is unclear. The De
amore of Andreas Capellanus, which, as we have seen, parallels Gerard's
gloss in a number o f ways, also corroborates the physician's views on this
point. Though Andreas concedes the imperium o f love over both sexes, he
addresses the treatise to Walter and the how-to advice exemplified in the
dialogues and the chapters on the love o f nuns and prostitutes is tailored for
men who must possess nobilitas and probitas morum in order to attain their
aspiration o f loving curialiter. Moroever, Andreas generally reserves the
rhetoric o f love-as-illness for aristocratic male speakers.22 Gerard's claim that
Authenticated
noblemen are predisposed to suffer amor hereos coincides with literary repre-
sentations of aristocratic young men as the primary victims of lovesickness
or as the ones likely to experience love as illness, as in, for example, the
Roman de la Rose.21
This view may have been a commonplace in Parisian academic circles
in the 1220s, when Gerard's gloss had circulated for one or t w o decades and
when Peter of Spain pursued his studies at the University. As noted in chap-
ter one, William of Auvergne, bishop of Paris (1228-49) and teacher of
theology, offers a bit of evidence for the incidence of m o r b i d love a m o n g
the young Parisian clerks. He tells his students: "You ought to remember
some things which you experience continually. You see that love is a certain
raptus, just like that which is called morbus eros, which is a most violent
and intense illness, in which someone w h o loves is in such rapture that it
barely permits him to think of anything besides the w o m a n he loves in this
way." 2 4 T h e apparent off handedness of the remark suggests that love as a
medically-defined illness was both c o m m o n knowledge and c o m m o n ex-
perience, as does its pedagogical strategy of moving f r o m the m o r e familiar
(morbus eros) to the less (raptus). William attributes morbus eros to men ex-
plicitly in the phrase "the w o m a n he loves" and implicitly in the reference
to the experiences of the male audience. His contemporary and colleague,
William of Auxerre, agreed that amor morbus for some w o m a n drives many
mad, w h o must then be cured through diet and medication. 2 5
Important university thinkers during Peter of Spain's intellectually for-
mative period thus assumed that men were the usual patients of morbus
amoris, an idea embodied in some contemporary imaginative literature. Yet
other vernacular poems provided numerous examples of w o m e n w h o suf-
fered max d'amors, and some physicians in turn recognized that lovesickness
affects all. Within this complex context, then, Peter of Spain framed his
controversial questions on lovesickness and gender.
Peter of Spain's Questions

The surviving manuscripts of Peter's Questions on the Viaticum contain three
facets of his thinking on lovesickness and gender. T h e first reflects the influ-
ence of Gerard: Peter claims that noblemen suffer more than others f r o m
love. The second and third aspects compare men's and women's suscepti-
bility to lovesickness; the third is distinguished by its use of the language of
measurement to compare sexual pleasure. 26
Peter strikes out into new territory (as far as the sources permit us to
judge) by raising the problem of w o m e n and lovesickness. T h o u g h in both
versions he debates whether men or w o m e n are more subject to amor hereos,
Authenticated
the distinction in the Β version between intensity of pleasure in m e n and

quantity of pleasure in w o m e n proved m o r e attractive to later writers
searching for a vocabulary to c o m p a r e sexual experience. A discussion of
the A version will highlight b y contrast the novelty and difficulty o f B's
a r g u m e n t a t i o n o n the measure of pleasure.
VERSION A
Several questions of the series of ten on amor hereos in the A version consider
in w h i c h complexion, sex, and age this disease occurs m o s t often. T h e
f o u r t h question concerns the relative susceptibility of the sexes. Peter argues
that because w o m e n are, according to Aristotle in De animalibus, " w e a k e r
in h o p e " than m e n , they are therefore m o r e subject to amor hereos.27 T h e
lean syllogism tells us n o m o r e about women's hopelessness, but Aristotle's
r e m a r k is part of a passage dealing w i t h similarities and contrasts of dispo-
sition and habit in male and female animals:
Woman is more compassionate than man, more easily moved to tears, at

the same time is more jealous, more querulous, more apt to scold and to
strike. She is, furthermore, more prone to despondency and less hopeful
than the man, more void of shame, more false of speech, more deceptive,
and of more retentive memory. 28
Peter investigates women's despondency in his unpublished Questiones super

de animalibus, the earliest surviving Western c o m m e n t a r y on Aristotle's text. 2 9
In that w o r k Peter asks w h y w o m e n despair m o r e than men, have less
confidence, and are m o r e jealous. T h e answers rest o n medical-biological
c o m m o n p l a c e s and u n w i t t i n g l y reveal s o m e t h i n g of the psychological
stresses that w o m e n in medieval society labored u n d e r . Starting f r o m the
medical c o m m o n p l a c e that w o m e n are moister than m e n , Peter argues that
because m o i s t u r e retains an impression less easily than dryness, w o m e n lack
confidence concerning things p r o m i s e d to them. 3 0 T h e y are jealous because
they realize that they are b y nature less perfect than m e n , and so e n v y the
superior sex, o r because they are occupied w i t h children or a business
(Figure 6.2). Fearing that others are o u t to cheat t h e m , w o m e n b e c o m e
envious. 3 1
T h i s biological-social explanation for women's despondency helps to
explain the a r g u m e n t for men's susceptibility to amor hereos in the Viaticum.
Since m e n have drier brains than w o m e n , the image of the desired object is
imprinted m o r e deeply in the imagination, and since lovesickness is partly
caused by a s t r o n g impression u p o n the imagination, men, w i t h their drier
brains, are m o r e likely to contract it. 32 T h e solution to these o p p o s i n g ar-
g u m e n t s denies neither sex the chance to suffer f r o m love. A l t h o u g h amor
hereos "is m o r e quickly and frequently
Brought togenerated in w o mUniversity
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Figure 6.2. Woman engaged in cheesemaking and child-

care, from the Tacuinum sanitatis. Vienna, Bildarchiv,
Osterreichische Nationalbibliothek, Cod. ser. nov. 2644,
fol. 61 r.
lack of hope in them and because they are more frequently sexually stimu-
lated," in men the disease is m o r e difficult to cure because "the impression
of any desirable f o r m in the brain of a man is deeper and m o r e difficult to
eradicate than the impression of a f o r m in the brain of a w o m a n . " 3 3
As far as epidemiology is concerned, then, female patients seem to pre-
dominate numerically (frequentius), but men are more profoundly stricken
by the disease. Peter thus links predisposition to amor hereos to biological
dispositions humans have in c o m m o n with other animals, and—apart f r o m
an unelaborated phrase about women's sexual excitability—to different
physiologies of the brain in men and women, determined by the basic p o -
larity of dryness and moisture.
VERSION Β
In contrast to the A version, the Β version of the commentary focuses on

the intensity of sexual pleasure as the key to understanding susceptibility to
amor hereos. T h e arguments are Brought
at first to
sight confusing,
you by because
| Cambridge Peter
University seems
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to claim that each sex suffers more f r o m love than the other. T h e ambiguity
stems f r o m his attempt to reconcile Constantine's pronouncements on
women's greater sexual pleasure with other medical and philosophical tra-
ditions that grant preeminence in this regard to the male sex. Replying to
the question "In which sex is the desire for intercourse greater and in which
is pleasure greater?" he argues first that men have a greater desire for inter-
course because the four factors stimulating sexual desire—imagination of
the desired object, an imbalanced complexion, an "elevating windiness"
{ventositas elevarli, the spiritus necessary for erection), and an abundance
of seed—occur more in men than in women. 3 4 Women, however, have a
greater pleasure in intercourse, and where there is a greater pleasure, he
argues, there is a greater desire. "Therefore the desire for intercourse is
greater, and love is greater and more intense in w o m e n than in m e n . " In
addition, w o m e n fall in love more easily than men and thus desire both sex
and love more than men do. 3 5 T h e solution to these arguments sounds para-
doxical, if not downright contradictory: love is more intense (intensior) on
the part of men than on the part of w o m e n , but pleasure is greater on the
part of women. 3 6 What, then, is the intended distinction between intensior
amor and maior delectatio?
T h e meaning of the contrast is clearer if we compare a second question
on pleasure raised in the same section: Which sex delights m o r e in inter-
course? T h e argumentation reveals that Peter perceives a qualitative differ-
ence between the experiences of men and w o m e n . For his claim that men's
sensations are more intense than women's he gives three pieces of evidence:
they have an inherently m o r e intense sense perception, they emit m o r e d u r -
ing intercourse, and are " m o r e consumed" by it. Women, on the other
hand, have a double pleasure, but it is not of the same quality as that of
men. 3 7 Despite his failure to specify this qualitative difference, Peter clearly
uses contrasting terms, intensity and quantity, to compare pleasure in men
and women. T h e comparison leads to an assessment of sexual pleasure as
"separate but unequal": intensity of pleasure in men is "greater" than quan-
tity of pleasure in women. And since in the terms of his analysis, sexual
pleasure partially determines lovesickness, he can conclude that men have
intensior amor but w o m e n have maior delectatio. T h e philosophical and physi-
cal bases for this duality are apparent if we turn again to his commentary on
Aristotle, the Questions on D e animalibus.
Evidence from the Commentary on Aristotle's

De animalibus
In this work Peter raises the same questions on appetite and pleasure as he
does in the Viaticum commentary, this
Brought time,
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mammalian procreation rather than in that of lovesickness, and poses the

problems of sexual appetite and sexual pleasure separately. In determining
which sex takes greater pleasure in intercourse, he adduces a principle f r o m
Aristotle's Physics that grounds the distinction between intensive pleasure in
men and quantitative pleasure in w o m e n . H e cites the famous dictum that
(in his words) "matter desires forms just as the ugly the good or the beau-
tiful and the female the male" (Physics 192a 22-23). 3 8 By appealing to the
traditional association of w o m e n with matter and men with f o r m , he not
only rationalizes the superiority of men's pleasure, but reveals the ontologi-
cal basis for that superiority. Since f o r m is a greater perfection than matter,
and since an early theory of intensity held it to be a perfection of a thing's
form, men, by nature more perfect and " f o r m a l " than w o m e n , must expe-
rience a greater intensity of pleasure. 39 T h e association of w o m e n with m a t -
ter suggests a lesser pleasure to the extent that matter is inferior to f o r m ,
and this is supported by another statement in the commentary. To the ques-
tion of w h y there is shame in the act of generation, Peter replies that in this
work w o m e n hold the place of matter and men the place of f o r m , "in which
a man glories; a w o m a n reviles herself in this." 4 0 Little wonder that, o p -
pressed by the consciousness of serving the place of matter instead of f o r m ,
the intensity of her pleasure might be less than his.
Further debate on sexual pleasure follows f r o m the Aristotelian p r e m -
ise. T h e familiar quotation f r o m Constantine on women's double pleasure
makes its appearance once again. However, the conclusive argument for
greater masculine pleasure hinges, as it does in the Viaticum commentary,
on a qualitative difference between the sexes. Men are hotter than w o m e n
(another medical commonplace), and since heat stimulates intercourse,
Peter concedes that men take greater pleasure in it. A second qualitative
difference distinguishes men and women, yielding greater delight to the
masculine sex: male seed is more digested, i.e., refined and perfected, than
female seed, hence its emission gives men greater pleasure. In summary,
Peter says that "although w o m e n take pleasure in a n u m b e r of ways, a
greater pleasure increases more in men than in w o m e n . " 4 1 As in the Viati-
cum commentary, he contrasts a numerical superiority of pleasures in
women with a qualitative superiority in men. Women's association with
matter links their pleasures with quantity rather than quality, suggesting a
mensuration of number and extent, the attributes of matter, rather than of
intensity, which is reserved for qualitatively superior men.
Quantification of Qualities
Perhaps prompted by Constantine's remark that "eros is a word designating
the greatest pleasure" and by Avicenna's inclusion
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coadjuvant cause in his definition oflovesickness, Peter systematically c o m -

pares the experiences of m e n and w o m e n in order to obtain a relative m e a -
sure of w h i c h sex experiences greater pleasure d u r i n g sexual activity. H e
refines the understanding of the causal mechanisms of lovesickness b e y o n d
Constantine's "necessity of expelling superfluous h u m o r " and the "sight of
a beautiful f o r m " w i t h the psychological acumen of a three-time c o m m e n -
tator o n Aristotle's De anima and w i t h the physiological concerns of an
Aristotelian biologist. 4 2 Attributable to b o t h his Aristotelianism and his p s y -
chological interests is the implicit recognition of delectatio as a final cause of
amor hereos (Figure 6.3). Later writers, a m o n g t h e m Arnald of Villanova
and Gerard of Solo, explicitly acknowledge the final causality of pleasure
a m o n g all the other immediate, mediate, and coadjuvant causes of the dis-
ease. 43 J o h n of Tornamira expresses the extent to w h i c h physicians assimi-
lated the correlation of sexual pleasure w i t h lovesickness w h e n he defines
hereos as multum delectabile, because the lover desires ultimate carnal delight
from a woman.44
T h e contrast between intensity and quantity that Peter applies to sexual
pleasure is a rather early and not w h o l l y clear attempt to f o r m u l a t e a relative
measure of the quality, of pleasure. T h e quantification of other qualities,
such as charity or heat, for example, had been discussed in early t h i r t e e n t h -
century philosophy, but a rigorous analysis of the p r o b l e m of qualitative
change or measurement became possible only in the late thirteenth century
or early fourteenth century, w h e n the conceptual tools for these p r o b l e m s
were fully developed. 4 5 Michael M c V a u g h has s h o w n , for example, that
although Peter of Spain was aware of the p r o b l e m s involved in q u a n t i f y i n g
the quality of heat, his analysis was limited by the lack of an adequate ter-
minology. 4 6 Still, a writer at m i d - c e n t u r y w h o wished to discuss alterations
in heat or charity had at least a traditional context and some points of ref-
erence for his analysis; one w h o attempted to assess the relative sensations
of pleasure w i t h the language of intension and remission was u n d e r t a k i n g
something quite new. Peter's analysis does not represent a conceptual b r e a k -
t h r o u g h or a development of the language of intension or of m e t h o d s of
quantification; rather, it extends current t e r m i n o l o g y to a n e w subject.
In this Peter not only anticipates the "mania to m e a s u r e " that invades
fourteenth-century science and philosophy, b u t also evidences the close c o n -
nection between medicine and philosophy in the later M i d d l e Ages.
Peter of Spain's cogitations on the measure of pleasure were i m m e d i -
ately imitated and extended by b o t h natural philosophers and physicians,
w h o clarified the t e r m i n o l o g y of the discussion while maintaining the basic
distinction between intensity and quantity or extensivity. T h e first and
clearest reaction to Peter's w o r k on this topic is contained in Albert the
Authenticated
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3Ικ jA mh»4\
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4 lÇ"<îtrKttnÎ<r tbturfôf ttugtvnft
Figure 6.3. Cleric and w o m a n e m b r a c i n g in t h e " D "

o f Deus, t h e first w o r d o f t h e Viaticum's b o o k (6) o n
sexual d i s o r d e r s . T h e passage explains that G o d created
sexual pleasure so as t o e n s u r e p r o c r e a t i o n . C a m -
b r i d g e , St. John's C o l l e g e , M S D . 2 4 (99), fol. 146. B y
p e r m i s s i o n o f t h e M a s t e r s a n d F e l l o w s o f St. John's
College.
Great's questions o n t h e De animalibus (1258), w h i c h are "closely m o d e l l e d "

o n Peter of Spain's questions on Aristotle, indicating their i m p o r t a n c e in t h e
eyes o f the greatest t h i r t e e n t h - c e n t u r y natural philosopher. 4 7 T h e changes
Albert m a k e s in his discussion of sexuality and pleasure, h o w e v e r , b o t h
reaffirm and clarify the philosophical basis of Peter's ideas o n m e a s u r i n g t h e
relative intensity of sexual experience. Albert, like Peter, cites t h e a n a l o g y
b e t w e e n m e n and w o m e n , f o r m and m a t t e r , f r o m the first b o o k of A r i s -
totle's Physics, b u t unlike Peter, goes o n t o a r g u e explicitly that men's p a r -
ticipation in the act is formalius ( m o r e formal) than that of w o m e n , a n d
hence gives greater pleasure. 4 8 T h e l a n g u a g e used to describe w o m e n ' s d e -
light is r o o t e d in the analogy w i t h m a t t e r . In addition to t h e familiar delec-
tatio duplicata, they are said to e n j o y themselves in pluribus modis, w h i c h he
t e r m s " e x t e n s i v e " pleasure. H e phrases it in a n o t h e r way: " Q u a n t i t a t i v e l y ,
pleasure is greater in w o m e n , b u t intensively it is greater in m e n . " 4 9
Since Albert's and Peter's discussions o f pleasure are so similar, it is
difficult to sort o u t indebtedness a m o n g later writers w h o a d o p t t h e distinc-
tion b e t w e e n extensivity and intensity. In fact, t h e contrast b e c o m e s a c o m -
m o n p l a c e in late t h i r t e e n t h - and f o u r t e e n t h - c e n t u r y medical and natural
philosophical texts on sexuality, appearing in such diverse places as Pierre
de St.-Flour's Concordancie, a f o u r t e e n t h - c e n t u r y medical dictionary, and a
Authenticated
m i d - f o u r t e e n t h - c e n t u r y c o m m e n t a r y on the De secretis mulierum.50 T h e s e

later writers sometimes develop the analysis beyond that f o u n d in either
Peter's or Albert's works. For example, Pietro d ' A b a n o , while repeating the
substance of Peter's a r g u m e n t a t i o n a b o u t pleasure in his Conciliator (1305),
adds yet another dimension to the measure of female pleasure, that of time.
Their pleasure is extensively greater than men's because, a m o n g other
things, it lasts longer. Yet like Peter of Spain and Albert the Great, he grants
men a greater intensity of pleasure w i t h i n its shorter duration. 5 1
Influence on the Medical Tradition of Lovesickness

Peter's analysis influenced, it may reasonably be assumed, the m o r e special-
ized medical tradition of amor hereos. T h e idea that intensity of masculine
pleasure is greater, and hence that men are m o r e subject to amor hereos,
appears in the chapter devoted to lovesickness in Bernard of Gordon's Prac-
tica. Bernard notes at the end of the chapter that the disease occurs m o r e
often in men, because they are hotter than w o m e n and hence receive m o r e
intense pleasure f r o m intercourse. W o m e n , however, enjoy themselves
m o r e extensively because they delight in b o t h their o w n and male seed. 52
Gerard of Solo, active at Montpellier a r o u n d 1 3 3 0 - 5 0 , analyzes amor
hereos in t w o w o r k s , one a c o m m e n t a r y on the ninth b o o k of al-Râzî's Liber
ad regem almansorem, the other an unpublished Determinatio de amore hereos,
b o t h indebted to Peter of Spain's c o m m e n t a r y on the Viaticum.53 T h e s e
w o r k s reveal that t h o u g h the level of detail had increased, the difficulties of
quantifying pleasure had not been solved completely half a century later. In
the Determinatio Gerard raises the same question that Peter had: W h o is m o s t
likely to suffer f r o m lovesickness? His premises are similar as well: those
w h o enjoy intercourse the most, and desire it the m o s t , are m o s t susceptible
to amor hereos. H e organizes his inquiry a r o u n d the f o u r complexions, s u g -
gesting each one in turn as that m o s t likely to contract the disease, and
concludes that choleric youths are m o s t likely to suffer f r o m amor hereos. In
the distinctions he makes concerning the m o d e s of appetite, however, he
discusses the differences between men and w o m e n . H e says that sexual ap-
petite is t w o f o l d , extensive and intensive. T h e f o r m e r is greater in w o m e n
because they delight in m o r e ways than men, for they take pleasure in f o u r
things in intercourse: reception of male seed, expulsion of their o w n seed,
m o t i o n of the w o m b , and friction of the male m e m b e r w h i c h induces pruri-
tum et titillationem,54 Gerard then considers w h y there is so m u c h pleasure in
intercourse w i t h o u t returning to explain intensive pleasure in m e n . Peter's
and Albert's definition of quantity or extensivity as " m a n y m o d e s " appar-
ently invited subsequent writers f u r t h e r to define or specify w h a t these

Authenticated
modes were, leading to the tetrad just listed here and to Pietro d'Abano's
triad above.
Gerard's commentary on al-Râzî contains a fuller explanation of the
contrast between the masculine intensity and the female extensivity of plea-
sure. The context, like that of the Determinatio, is an examination of the
types of people susceptible to lovesickness. Unlike the Determinatio, h o w -
ever, the section opens with the remark that this disease can befall anyone. 5 5
As Gerard proceeds, he distinguishes appetite for intercourse f r o m appetite
for food on the basis of heat and cold, just as Peter of Spain had done in his
questions on both the Viaticum and the De animalibus. Because appetite for
intercourse depends on heat, it will be greater in men, since they are hotter
than w o m e n — t h e same argument that Peter had used in his commentary
on Aristotle's De animalibus and that Albertus repeated in his Questiones.
Thus, Gerard says, "it is apparent that a man takes pleasure more intensely
than a woman, because he is hotter, but a w o m a n takes pleasure m o r e ex-
tensively because she takes pleasure in m o r e ways than a m a n . " 5 6 In fact,
one of her pleasures is so great, Gerard remarks with an unusual rhetorical
inversion, that poor w o m e n as well as rich ones become whores in order to
satisfy the desire it generates. 57
T h e impulse to measure sexual desire and pleasure did not wane with
the Middle Ages. In our own time, the sophisticated equipment of Masters
and Johnson was in part designed to answer some of the same questions that
the Portuguese physician had debated so many centuries earlier. 58 But the
twentieth century is not the only post-medieval era to apply available tech-
nology to the subject of sexual desire and pleasure. In visual and verbal
fantasies of the eighteenth century, "lecherometers" or "Female T h e r m o m -
eters" gauged the level of women's desires, replacing the medieval metric of
intensity/extensivity with a mechanics of pressure. 59 Women's relatively
hidden physiological responses to sexual stimuli elicited mensurations of
their desires and pleasures according to conceptual schémas of the age.
Women and Lovesickness

Peter of Spain's influence on the application of the language of measurement
to sexual pleasure proves easier to trace than his contribution to changing
ideas about the relation of gender to lovesickness. That he never finally
synthesized his arguments on gender and lovesickness into any clear epide-
miological statement may in part explain the difficulty of charting the i m -
pact of his ideas. We find, for example, that the opinion of Gerard of Berry
on the social origins of amor hereos and men's susceptibility to it was still
voiced in the fifteenth century. Jacques Despars wrote in his commentary
Authenticated
on Avicenna s Canon that the disease is called hereos or hereosus "because it

befalls noble men and heroic men more [often] than it does simple men of
the c o m m o n people." 6 0 Nonetheless, a century later w o m e n appear in case
histories of lovesickness and in the seventeenth century the physician
Jacques Ferrand claimed that w o m e n were the primary sufferers of "la m a -
ladie d ' a m o u r . " 6 1 Since Peter of Spain is the first physician in surviving
sources to investigate women's lovesickness in comparison to men's, we may
reasonably explore the connection between his ideas and similar ones ex-
pressed in later medical texts.
To recapitulate briefly the three aspects of his thinking on lovesickness
and gender: In the first, he m o r e or less duplicates Gerard of Berry s opinion
that aristocratic men are disposed toward the disease. In the second, e m b o d -
ied in the A version, he claims that w o m e n suffer f r o m love m o r e frequently
than men do, but that men are harder to cure. T h e third aspect, evident in
the Β version, is generated f r o m the equivocal senses of amor and maior in
the statement that men have intensior amor but w o m e n maior delectatio. T h e
wide semantic range of amor allows him to interpret it as "sexual desire"
and thus to narrow the focus of his argument about the incidence of love-
sickness to sexuality, while the ambiguity of maior enables him to distin-
guish the intensity of men's pleasure f r o m the quantity of women's. T h e
coexistence of the first and third aspects within a single manuscript of the Β
version (Vatican, pal. lat. 1166) suggests that Peter responded in an ad hoc
fashion to the opportunities presented by Constantine's text, without a fo-
cused concern to refashion medical thinking on lovesickness and gender.
Even so, his interest in w o m e n invites explanation, especially given
Gerard's delegation of amor hereos to men a generation earlier. Most specu-
lative, but also most tantalizing, is the possibility that Peter introduced
w o m e n into medical discourse on lovesickness in order to reflect clinical
realities. That is, he may have sought to adjust academic theory to account
for female patients seen in practice. We k n o w f r o m medical Consilia, written
advice given by physicians in response to individuals' requests, that univer-
sity-trained doctors did treat w o m e n of the well-to-do classes. 62 Literary
representations of lovesick w o m e n may also have influenced Peter's delib-
erations on the topic, especially since he knew his O v i d well. It should not
be forgotten, however, that dialectical discourse itself can generate its o w n
subjects. Once the question of which sex is more subject to amor hereos is
raised, w o m e n perforce enter the discussion. 63 T h e method of his inquiry,
then, rather than any particular interest in women, may have spawned the
debate. Finally, a certain a m o u n t of professional ambition may have led the
new teacher of medicine to raise the question in the first place in order to
outdo Gerard's magisterial claim.
Authenticated
If the causes of Peter's interest in the topic of w o m e n and lovesickness

cannot be pinned d o w n exactly, his questions nonetheless express a willing-
ness to consider w o m e n as patients of amor hereos that is found elsewhere
a m o n g his contemporaries. Sometime after 1230-35, H u g h of St. Cher
(pseudo-Gerard of Liège) composed his immensely popular (180 mss., n u -
merous vernacular translations) De doctrina cordis for an audience of w o m e n
religious. T h e last part of the treatise, De scissione cordis per amorem, describes
amor extaticus in terms of amor ereos, "since we test and recognize one love
by the other." 6 4 Although H u g h too repeats the attribution of amor ereos to
viri nobiles, it apparently posed no impediment to the female audience's
understanding of themselves as potential subjects of lovesickness. Hugh's
fusion of medical and mystical loves for w o m e n of the mid-thirteenth cen-
tury shows that in the mind of at least one of Peter of Spain's contempo-
raries, medically-defined amor hereos supplied a useful way of describing
women's experience of love.
T h e association of w o m e n and lovesickness evident here and in Peter of
Spain's Questions came to be more clearly defined by later physicians. His-
torians of medicine have noted a tendency a m o n g medical writers of the
Renaissance not merely to consider w o m e n subject to m o r b i d love, but to
deem them, as did Jacques Ferrand, the primary victims of the malady, or at
least particularly susceptible to it. 65 An admittedly metaphoric description
of the change might run as follows: In the Middle Ages, a number of aca-
demic physicians viewed amor hereos as a disease primarily located in the
brain rather than in the testicles, and primarily as an affliction of noblemen.
T h u s amor hereos resided at the top of physical, social and sexual hierarchies.
As a result, however, of Peter of Spain's attention to the role of sexual physi-
ology in generating lovesickness, the disease gradually shifted " d o w n w a r d "
to become, in the estimation of some later writers, an illness of the sexual
organs and of women, thus preserving the homology between the corporal
and social "place" of the disease (Figure 6.4). 66 In the generation after Peter
of Spain, Arnald of Villanova names a complexio venerea or humiditas titillans
in organis generationis as antecedent causes of amor hereos; the shift in localiza-
tion f r o m brain to testes is thus apparent even before the end of the Middle
Ages in some writers. 6 7 Such a gradual "decline" in the localization of amor
hereos may help to account for its transformation f r o m a "heroic" malady to
a "hysteric affliction."
That transformation was never fully completed; noble men continued
to be numbered a m o n g love's victims in literature and medical writing. T h e
mutual validation of medicine and literature may help explain w h y the
"melancholy lover" persisted even as the "lovesick maiden" entered path-
ography. 6 8 Amor hereos reverses the hierarchy of perception and reason, sub-
Authenticated
Figure 6.4. Women's Iovesickncss was a stock theme in Dutch genre painting. This
burlesque example emphasizes the woman's middle-class status and the sexual i m -
plications of the malady. Jan Steen (Dutch, 1626-79), " T h e Doctor's Visit" (1663-
65). Philadelphia M u s e u m of Art, John G. Johnson Collection of Philadelphia
(J510).

Authenticated
ordinating j u d g m e n t to sense perception. As Arnald of Villanova remarks,

such an inversion of the proper relation of psychological powers parallels
the reversal of the social hierarchy evident in the conventions of fin'amors,
which subordinates the male lover to his natural and social inferior, the
beloved woman. 6 9 Such a h o m o l o g y betweeen the social and the psycho-
logical, between fin'amors and amor hereos, literature and medicine, would
offer a powerful system of analogies difficult for medical ideas alone to dis-
place. In any event, Peter of Spain, the summus medicorum monarcha, provides
an early and fascinating comparison of the fundamentally similar and yet
distinctive sexual pleasures of men and w o m e n .

Authenticated
§§ 7 §§
IS LOVE C U R A B L E BY HERBS?
Bona Fortuna s Treatise on the Viaticum
Non est medicabilis amor herbis.

Love is not curable by herbs.
Ovid, Remedies for Love
La sua bellezza ha più vertu che petra,

e Ί colpo suo n o n può sanar per erba;
ch'io son fuggito per piani e per colli,
per potere scampar da cotal donna.
Dante, Rime, 101
I n the decades after Peter of Spain debated his questions on the Viaticum,
some of Europe's leading physicians scrutinized the disease of love, a m o n g
them William of Saliceto (fl. 1258-75), Arnald of Villanova (ca. 1 2 4 0 -
1311), Bernard of Gordon (ca. 1258-1320), William of Corvi (or Brescia,
ca. 1250-1326), Dino del Garbo (d. 1327) and Gerard of Solo (fl. 1330-50).
Some, like Arnald and Gerard, returned to the topic more than once. M o r e -
over, translations of al-Râzï's Liber continens (1281) and Ibn Jazlah's Tacuini
aegritudinum et morborum (1280) enriched the store of medical doctrine on
love available to Western physicians and other readers.
Bona Fortuna wrote his treatise on the Viaticum ( Tractatus super Viati-
cum) in this context of active intellectual speculation on the nature and treat-
ment of morbid love. Although in the absence of a firm date for his activity
it is difficult to j u d g e the particulars of his indebtedness to his contemporar-
ies, or theirs to him, we can discern in his chapter on amor hereos the intel-
lectual currents of the late thirteenth and early fourteenth centuries. But this
is not to rob him of his individual contribution to the medical tradition of
love; Bona Fortuna has his o w n distinctive interests and approaches. His
therapy for love, for example, with its empirical pharmacy and appeals

Authenticated
Bona Fortuna 's Treatise on the Viaticum § 127
to experience, seems to e m b o d y the a t t e m p t s of a practitioner to find

remedies that w o r k (Figure 7.1). It suggests that medical energies devoted
to the p r o b l e m of love may have been as m u c h practical as speculative
a r o u n d 1300.
Evidence is currently lacking for Bona F o r t u n a s identity, career, and

place of teaching. C o d i c o l o g y and textual evidence suggest that he may
have been a Montpellier master w h o taught a course on the Viaticum s o m e -
time between 1300 and 1320. T h e t w o f o u r t e e n t h - c e n t u r y manuscripts that
contain the Tractatus (or Summa) on the Viaticum list a name, magister Bona
Fortuna, and codicological evidence dates his activity before the m i d -
fourteenth century. A l t h o u g h only these t w o manuscripts survive, their
textual difficulties suggest that others n o w lost once circulated a m o n g
readers and copyists. B o t h manuscripts have been carefully read and a n n o -
tated b y a variety of medieval readers; one of t h e m was available in the later
fourteenth century at the Sorbonne. 1
Like the commentaries of Gerard of Berry and Peter of Spain, this trea-
tise reflects the circumstances of medical teaching in a university, but unlike
t h e m , it reveals s o m e t h i n g of Bona F o r t u n a s presence as a teacher. We are
r e m i n d e d that the Tractatus is a series of lectures by such phrases as "I'll say
n o w w h a t I said the other d a y " or "as I said the other d a y . " 2 Bona Fortuna
addresses his students frequently and directly, telling t h e m straightfor-
wardly w h a t they o u g h t and o u g h t not to d o as they prepare medicines and
treat patients. 3 T h e s e crystallized m o m e n t s of Bona F o r t u n a s teaching s u g -
gest that the text as we have it may be based on a reportatio by o n e of his
students. 4 This w o u l d account for b o t h the sense of i m m e d i a c y the text
conveys, and also for some of the gaps and omissions c o m m o n to b o t h
manuscripts. D u e to the obvious p r o b l e m s of taking lecture notes, even
reportationes edited by the master are not always fully reliable witnesses for
w h a t in fact was said. H o w e v e r , since b o t h manuscripts are by and large
intelligible, they may be taken as adequate guides to the master's teaching.
T h e university milieu offers Bona Fortuna s o m e of his m o s t striking
analogies. Parchment and b o o k s present themselves as ready objects of
comparison. Bona Fortuna instructs his students to note that the skin has
three layers, as can be seen in p a r c h m e n t . 5 Elsewhere he explains that dolor
pungitivus (piercing pain) can be imagined by means of a simile: " F o r w e see
that w h e n p a r c h m e n t nears fire, it does not contract equally in all parts, but
rather m o r e in one part than in another. Whence also sometimes it is pierced
t h r o u g h in one part and not in another. A n d this type of pain often occurs
in pleurisy." 6 T h e craft of b o o k m a k i n g also provided material for the prac-

Authenticated
Figure 7.1. Practical m e d i c i n e . O n t h e left a p h y s i c i a n inspects a

patient's u r i n e . O n t h e r i g h t is a scene in an a p o t h e c a r y ' s s h o p , w h e r e
m e d i c i n e s w e r e p r e p a r e d a n d sold. Paris, B i b l i o t h è q u e N a t i o n a l e ,
M S fr. 218, fol. l l l r .
tical exercise of medicine. Bona Fortuna advises his students to construct

casts for broken bones using cloth prepared as in bookmaking. 7 The Trac-
tatus thus assumes an audience thoroughly at home with the materials of
books and their making, and places itself squarely in a university milieu.
The text contains no clear evidence of its exact place of composition.
The likeliest places, however, given its date and the fact that both manu-
scripts are of French origin, are Paris and Montpellier, between which there
was an active commerce of masters and manuscripts. 8
The evidence for Bona Fortunas presence at either place is evenly bal-
anced. One manuscript belonged to the Sorbonne, and the text contains
references to Paris and to French words. 9 No comparable southern refer-
ences have come to light. The flimsy weight of statistical probability, how-
ever, inclines the scale toward Montpellier. Of medical authors whose
Authenticated
Bona Fortuna's Treatise on the Viaticum § 129
university affiliations are known, 10.3% were associated with Montpellier,

while only 3 % were affiliated with Paris. 10 In fact, many of the physicians
writing on amor hereos around 1300 were associated with Montpellier. Bona
Fortunas reworking of Constantine's teaching reflects, if not a collégial re-
lationship with the Montpellier masters Arnald of Villanova or Bernard of
Gordon, at least a similar approach to the topic of lovesickness. T h e Paris
manuscript of Bona Fortunas Tractatus (Paris, B N lat. 15373) also contains
texts by Arnald and Bernard. Since the handwriting in part of the m a n u -
script appears to be southern French, it may have originated at M o n t -
pellier—not a guarantee of Bona Fortunas activity there, of course, but a
mark of interest in his work at that medical center.
An ingenious solution to the problem of Bona F o r t u n a s identity has
been offered by Luke Demaitre. Bona Fortuna may be identical with Ber-
nard de Bona Hora, since both names may be translations of the French
name " B o n h e u r . " 1 1 Bernard was a master of medicine at Montpellier w h o s e
presence there is documented in 1313 and 1320. Indeed, the chartulary's
portrait of the vigorous married cleric w h o in 1320, along with Jordanus de
Turre, did not care to obey either the Chancellor or his deputy and would
not do as much for them as for a goose, and w h o then cursed and beat up
another master in medicine, tallies with the forthright personality Bona
Fortuna presents in the Tractatus.12 While the experimenta bearing Bernard
de Bona H o r a s name in Montpellier recipe collections do not seem to be
duplicated in corresponding sections of Bona Fortunas commentary on the
Viaticum, not all Bona Fortunas experimenta would necessarily be preserved
in the Tractatus.13 Whether or not Bona Fortuna is Bernard de Bona Hora,
either Paris or Montpellier would be a fitting place for his medical teaching.
The Treatise
The Tractatus super Viaticum follows the structure of Constantine's text f r o m
first book to last. Bona Fortuna generally divides the exposition of each
chapter into definition, causes, signs, and cures, each of which he may in
turn subdivide either simply or elaborately. T h o u g h the f o r m of his treat-
ment is not syllogistic like that of Peter of Spain, Bona Fortunas careful
divisio textus is no less scholastic. 14 U n d e r each heading he quotes and inter-
prets Constantine's words, adding ample material of his o w n . He cites
medical authorities relatively sparingly; none are directly named in the
chapter on lovesickness, although it appears that he was familiar with the
discussions of Avicenna, al-Râzî, and Gerard of Berry. Cited authorities are
almost exclusively classical and Arabic physicians; references to c o n t e m -
porary writers appear to be lacking. He cites Hippocrates, Galen, and
Authenticated
Avicenna m o s t frequently. O f t e n Bona Fortuna quotes medical authors in

order to disagree w i t h them. 1 5 E v e n C o n s t a n t i n e is not i m m u n e f r o m criti-
cism. W h e n Bona Fortuna feels it necessary, he will point o u t Constantine's
errors and advance his o w n rectifications, sometimes based o n his practical
experience. 1 6
A l t h o u g h the following discussion emphasizes the practical aspects of
Bona F o r t u n a s chapter on lovesickness, since it stands apart f r o m other
w o r k s in this respect, this does n o t imply that he is " m e r e l y " empirical. In
fact, he is quite concerned that his students follow the via rationis in their
practice of medicine: " o n e m u s t always proceed rationally." 1 7 This in t u r n
requires the ability to adjust theory or general r e c o m m e n d a t i o n s to the i n -
dividual requirements of the case. T h e physician's o w n efforts, his industria,
bridge the distance between the rules of the art and the individual patient. 1 8
Bona F o r t u n a s concern for the h a r m o n i o u s integration of general rules and
the varying requirements of the individual patient's circumstances is p o i n t -
edly expressed in the chapter on amor hereos, w h e r e he counsels the physi-
cian to use his industry to distinguish a m o n g universal and particular cures,
and to find those m o s t appropriate for his patient. In his concern to adjust
theory and practice, and to bridge the gap between universals and particu-
lars, B o n a Fortuna agrees w i t h such leading medical thinkers of his time as
Bernard of G o r d o n and Arnald of Villanova. 1 9
T h e Tractatus a m p l y d o c u m e n t s b o t h the particulars of medical practice
and the hazards of late medieval life that physicians were called u p o n to
remedy. T h e f o r m of such i n f o r m a t i o n ranges f r o m lists of experimenta—
fruits of practice n o t predictable b y t h e o r y — t o details about patients he has
seen recently, to advice about c o m p o u n d i n g and storing medications. H e
notes, for example, that one m i x t u r e should be boiled for as long as o n e
w o u l d cook an egg, or that another paste o u g h t to be shaped into pieces the
size of the eucharistic host, or that certain p o w d e r s will remain p o t e n t for
u p to a year.
H e reports several m e m o r a b l e cases. A n entire household w e n t bald as
a result of mice that had fallen into their stores of oil and had putrefied. In
another case, a m a n was so bitten by lice that he bled in a h u n d r e d places.
D u r i n g the treatment of another patient, a scutella full of lice was recovered
f r o m his body. 2 0 Anecdotes like these reveal that teacher-practitioners such
as Bona Fortuna exercised their callings in b o t h the academic w o r l d of scho-
lastic disputation and the " r e a l " w o r l d of mice, lice, and other dangers. 2 1
A m o n g the other medical dangers posed by late medieval life, lovesickness
claimed the attention of this practicing physician.
O n e area of medicine that provides an i m p o r t a n t context for B o n a F o r -
t u n a t chapter on amor hereos is that of sexual disorders. His teachings o n the
subject, scattered t h r o u g h o u t the Tractatus,
Brought distinguish
to you by | Cambridgemedical opinion
University Library on
Authenticated
sexuality f r o m theological; in this he is j o i n e d by other thirteenth-century

medical writers. In his discussion of involuntary emission of semen, he
notes that one of its causes is the strong virtus that accompanies y o u t h or
adolescence. O n e cure, therefore, m i g h t be to lessen its strength. B o n a
Fortuna, however, objects to this m e t h o d , and parts c o m p a n y f r o m the
theologians:
Then note concerning the cure of this disease. If therefore it is because of

excessive seed, and the patient is adolescent or youthful, and other circum-
stances are suitable, and there is a strong virtus, then as far as medical opin-
ion is concerned, whatever theological opinion might be, it is not safe to
break such virtus. Wherefore note that the generation of seed is one of the
good things . . . Whence I, as far as medical opinion goes, would not resist
but would do something else.22
O u r author's f r e e d o m f r o m the restraints of theological discourse is p e r -

haps n o w h e r e m o r e evident than in his chapter on the suffocation of the
w o m b . O n e of the causes of the disease was t h o u g h t to be retained seed that
became corrupted and poisonous, and, consequently, needed to be p u r g e d
f r o m the body. O n e means, acceptable in classical medicine and f o u n d in
the w o r k s of Galen and Avicenna, was to arouse the w o m a n to o r g a s m so
that she ejaculated the retained seed. T h e arousal was often achieved by a
w o m a n w h o manipulated the patient manually. Some scholars have s u g -
gested that such practices were problematic in the medieval Christian West.
It has been argued that although physicians were familiar w i t h Galen's rec-
o m m e n d a t i o n , the conventions of d e c o r u m obtaining in medical w r i t i n g
prevented t h e m f r o m endorsing it explicitly, assuming that they f o u n d it
acceptable practice. 2 3 Bona Fortuna, however, speaks w i t h o u t the least hesi-
tation or circumlocution, r e c o m m e n d i n g masturbation by an obstetrix and
providing technical directions for it. 24 T h e manuscripts contain n o m a r g i -
nalia expressing surprise or outrage at this therapy, w h i c h suggests that the
latitude of accepted medical practices was wider than we tend to assume. To
j u d g e f r o m the attitudes Bona Fortuna expresses elsewhere in the treatise,
his discussion of love unfolds within the liberal b o u n d s of late medieval
medical discourse on sexuality.
Outline of the Chapter on Lovesickness

I. T h e disease
A. definition
B. causes
1. principal: extrinsic apprehension
2. adiuvant: beauty; need to expel
Brought to youexcess seed
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II. Symptoms
A. those w h i c h signal the disease
1. physical
2. behavioral
3. involuntary (pulse, breathing)
B. those which signify the person p r o v o k i n g the disease
(the pulse test)
III. Cures
A. physical
1. restore the body's composition
2. restore the balance of h u m o r s
B. psychological
1. for patients w i t h o u t discretion
2. for patients w i t h discretion
C . universal cures
1. travel
2. business
3. litigation
4. intercourse
IV. Additional helps
Definition
Unlike Peter of Spain and other writers concerned to localize m o r b i d love
in the brain or in other organs, Bona Fortuna skips the controversy by de-
ferring to Constantine's placement of amor eros a m o n g other diseases of the
brain. H e does, however, offer his o w n definition of the illness. T h o u g h it
is based on Constantine and Avicenna, it m o r e strongly emphasizes the role
of the visual i m a g e in the generation of the disease. As he notes, the defini-
tion includes an understanding of the disease's causality centered in the " e x -
trinsic apprehension" of a f o r m .
T h e essential role of sight in the birth of love, debated f r o m Plato and
Aristotle to Andreas Capellanus, had entered the Western medical tradition
of lovesickness in Constantine's Viaticum. With the revival of interest in
optics in the second half of the thirteenth century, physicians discussed the
role visual images played in the disease's causality. Arnald of Villanova,
D i n o del Garbo, and Gerard de Solo all c o m m e n t e d on the species or appre-
hensum that the imagination or phantasia m u s t store in order for the m i n d to
reflect u p o n it. 25 Bona Fortuna makes the species vel passio—a likeness of an
object that mediates between the material w o r l d and the m i n d — t h e princi-
pal cause of lovesickness. 2 6
Authenticated
Plato, however, w r o t e a b o u t desire for absolute beauty, n o t for an in-

dividuated f o r m , and even C o n s t a n t i n e uses the abstract n o u n formositas for
the sight that sends the soul into madness. In contrast, B o n a Fortuna
stresses the individual, singular f o r m w h o s e species provokes excessive
t h o u g h t . O t h e r writers catalogue the qualities in w h i c h the beloved is
t h o u g h t to excel all other w o m e n : so, for example, Gerard of Berry and
Peter of Spain say she is t h o u g h t to be m o r e noble, m o r e beautiful, and
better than the rest, and Bernard of G o r d o n adds that she is superior in the
e n d o w m e n t s of nature and culture. Nonetheless, neither they n o r others use
the t e r m "individual" to denote the preeminence of the beloved in the o p i n -
ion of the lover. O n l y Arnald of Villanova, in his Tractatus de amore heroico,
uses singularem to denote the object of love. T h e lover's e r r o n e o u s j u d g -
ment, arising f r o m the error of his estimative power, drives h i m to desire
the object as t h o u g h it were uniquely superior: cogitur hanc rem ut singularem
vehementer optare.27 Perhaps Bona Fortuna was influenced by Arnald's f o r -
mulation. In any case, these t w o authors stand apart f r o m their c o n t e m p o -
raries in their decision to express the lover's valuation of the beloved in
terms of unique individuality rather than as the s u m of superior qualities.
T h e y may reflect s o m e t h i n g of the late thirteenth-century disputes on the
cognition of singulars, which, as Lain Entralgo has s h o w n , were gradually
absorbed into medical thinking in the conception of an individuated p a -
tient. 2 8 Since, however, it is the beloved, not the patient, w h o s e i n d i v i d u -
ality is at stake here, literary sources may have exerted m o r e influence o n
the semantic usage of Arnald and Bona Fortuna than philosophical debates.
Causality
For Bona Fortuna, to define is to explain a thing's causes; in his definition
of love, the concept of the species links the definition to the reasoned cause
(propter quid) of the disease. H e bases his account of causality on the p s y -
chology of Aristotle's De anima rather than on that of Avicenna, w h i c h
Gerard of Berry and Peter of Spain had used. T h e m o s t i m p o r t a n t difference
between the t w o systems for the analysis of amor hereos is the absence of the
estimative power f r o m Aristotle's classification of mental powers. C o n s e -
quently, the terms used to denote the process by which the lover values the
beloved excessively, his " m i s - e s t i m a t i o n " of her w o r t h , will require s o m e
explanation.
Bona Fortuna subordinates Constantine's "necessity to expelí superflu-
ous h u m o r " and "sight of b e a u t y " as coadjuvant causes to w h a t he t e r m s
the principal cause: an external apprehension that is considered " f i t t i n g and
congenial." T h e cause lies not in the beauty itself, but in the apprehension

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of it. B u t mere apprehension does n o t suffice to initiate the m o r b i d c o n d i -

tion. T h e image has to be considered conveniens et amicum. With these terms,
Bona Fortuna continues the Platonic strain of the medical tradition of love-
sickness embodied in Constantine's phrase in sibi consimili forma conspiciat ("it
[the soul] sees a similar f o r m within itself"). " T h e similar is fitting and
congenial," w r o t e c o n t e m p o r a r y physicians, and D i n o del G a r b o n o t e d in
his gloss o n Cavalcanti's love canzone " D o n n a m e p r e g a " (ca. 1311) that the
image of the beloved, w h o s e apprehension causes love, is perceived sub ra-
tione similis et convenientis ("in the guise of the similar and the fitting"). 2 9 As
such, B o n a Fortuna remarks, it pleases the patient above all things.
B y defining the species as fitting and desirable at the m o m e n t of percep-
tion, Bona Fortuna avoids to s o m e extent the p r o b l e m of d e t e r m i n i n g
w h e r e in the perceptual process and h o w exactly the m i s j u d g m e n t charac-
teristic of the disease occurs, a p r o b l e m Peter of Spain had solved by d e -
claring that the disease begins in the imagination b u t is completed in the
estimation. B o n a Fortuna, in contrast, states that the principal cause, the
extrinsic apprehension, moves the phantasia vel intellectum, w h i c h then in
turn disturbs the reason. This description is d r a w n f r o m the third b o o k of
Aristotle's De anima (433a-34a), w h e r e the psychological causes of local
m o t i o n are analyzed. Peter of Spain's c o m m e n t s on Aristotle's text (in his
Expositio libri de anima) clarify w h y Bona Fortuna m i g h t have felt he could
dispense w i t h the traditional appeal to a damaged estimative p o w e r in favor
of his slightly m o r e c u m b e r s o m e Aristotelian exposition. Peter notes that
"intellect," w h i c h denotes the practical (rather than speculative) intellect,
apprehends an object per suam speciem insofar as that object is g o o d or bad,
and hence is m o v e d to pursue or avoid it. 30 T h e practical intellect is thus
analogous to Avicenna's estimative power. Peter's exposition f u r t h e r clari-
fies w h y Bona Fortuna equates phantasia vel intellectus, powers generally
considered distinct in m o s t medieval classifications of the internal senses.
Aristotle says there are t w o movers, the practical intellect and appetite.
Peter agrees, if by "intellect" b o t h "intellect" and " p h a n t a s y " or " i m a g i n a -
tion" are u n d e r s t o o d . If the n a m e "intellect" is not used to designate b o t h
intellect and phantasy, then one has to posit three movers, intellect, appe-
tite, and phantasy or imagination. 3 1 Bona Fortuna thus proposes a causal
explanation based on an understanding of Aristotle's De anima very close to
Peter of Spain's, in w h i c h the species plays the crucial role of m o v i n g the
fantasy or practical intellect and consequently the reason to desiring and
pursuing the desired object.
T h e concept of species situates Bona F o r t u n a s explanation f i r m l y in
c o n t e m p o r a r y thinking about amor hereos. We have already seen certain af-
finities w i t h D i n o del G a r b o s explanation of h o w the species is perceived,
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and parallels are also evident in the Practica of William of C o r v i (or Brescia)
and in Gerard of Solo's Determinatio de amore hereos (ca. 1335). 32 T h e s e a u -
thors' attention to species situates their w o r k within a larger c o n t e m p o r a r y
problematic, that of species in medio, a concept at the heart of interlocking
controversies in optics, psychology, epistemology and philosophy. 3 3 T h e
emergence of visual species in causal analyses of amor hereos in the late thir-
teenth and fourteenth centuries also placed lovesickness in a fertile nexus of
debates on imagination and magic in natural philosophy and theology. T h e
language of species, as I have s h o w n elsewhere, allowed a cross-fertilization
a m o n g disciplines that resulted in the entry of magic, previously excluded,
into academic medical w r i t i n g on love. 3 4
Signs and Symptoms

It has been remarked concerning medieval p a t h o g r a p h y that, in the w a k e of
later medieval philosophical developments, the real and concrete person b e -
came the protagonist of his story of illness. 35 T h e narrative and dramatic
elements this development implies suggest w h y medicine and the arts
forged such a productive alliance over the lover's malady in the later M i d d l e
Ages and the Renaissance. O f all the categories under which physicians c o n -
sidered lovesickness, s y m p t o m a t o l o g y provided the richest field for artistic
elaboration; as w e have seen in chapter three, the signa amoris were c o m m o n
g r o u n d for literary, religious, and medical discourses on love.
Bona F o r t u n a s division of s y m p t o m s or signs into three classes allows
the narrative and dramatic potential of the diagnosis of love to stand o u t
m o r e sharply than in the w o r k s of Gerard of Berry or Peter of Spain. O u r
master of medicine divides the signs of the disease of love into the following
groups: 1. those taken f r o m the external appearance of the b o d y ; 2. those
taken f r o m behavior (ab operationibus moralibus)\ 3. those taken f r o m the
parasympathetic nervous system (pulse, breathing). H e has n o t h i n g n e w to
add to the first g r o u p , d r a w n f r o m C o n s t a n t i n e and Avicenna. To the sec-
ond, he adds the desire for solitude, f o u n d also in William of C o r v i , w h o
says that the lover stat libenter solitarius ("gladly remains alone"). 3 6 H e d e -
votes m o s t attention to the third class of signs, which he subdivides to in-
clude a section o n signs revealing the beloved {signa super re amata). T h e s e
are involuntary changes in pulse and breathing that occur w h e n the beloved
is mentioned. T h o u g h C o n s t a n t i n e notes that the pulse is disordered in pa-
tients suffering f r o m erotic love, he does n o t specifically allude to the pulse
test as a diagnostic tool; Gerard, Egidius, and Peter of Spain o m i t it as well.
T h e r e seems to have been little interest in it a m o n g writers on lovesickness
until the later thirteenth century, w h e n it appears not only in the Tractatus,
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but also in the works of William of Saliceto, Arnald of Villanova, William

of Corvi, and Bernard of Gordon, w h o quotes Galen's story of a successful
diagnosis of love. 37
T h e popularity of the pulse test at this time is probably due to the in-
tegration of Avicenna's Canon into medical curricula, and was doubtless
reinforced by the recovery of the pulse story in Galen's De praecognitione in
the early fourteenth century. 38 Renewed interest in classical stories, such as
Valerius M a x i m u s ' account of Antiochus and Stratonice, that narrated
savvy diagnoses using the pulse test (cf. Figure 1.2) may have also contrib-
uted to its currency in medical circles. 39
In keeping with his pedagogical and practical concerns, Bona Fortuna's
description of the diagnosis of love f r o m the pulse is the most elaborately
detailed of similar accounts. From his step-by-step instructions it is but a
short distance to a case history such as that by Pieter van Foreest. 40 But the
distance between Bona F o r t u n a s instructions and Foreest's experience is the
distance between late medieval and Renaissance pathography. 4 1 O u r physi-
cian's cures come closest to bridging that gap, but even they remain firmly
rooted in the intellectual world of the late Middle Ages.
Bona Fortuna introduces the section on s y m p t o m s by explaining:
"Sometimes [the patients] conceal and in no way wish to reveal the person
w h o m they love." The physician must therefore recognize the signs that
involuntarily betray the identity of the beloved, since joining her with the
patient is the best cure. T h e ideal doctor must therefore exercise his inge-
nuity to ferret out the patient's secret. Since the pulse, " b y elucidating the
passions of the soul, manifests the mind's secrets," the doctor can use
changes in the pulse to determine the object of the patient's desire (Figure
7.2). 42 As Bona Fortuna says, it is impossible that the pulse not change w h e n
the right w o m a n is named, thus involuntarily revealing the patient's secret.
Since the patients of academic physicians such as Bona Fortuna were
generally well-to-do, and therefore likely to be acquainted with literary cul-
ture either as readers or listeners; and since some of the patients Bona For-
tuna envisions farther on in the chapter are scholars and hence literate, the
"code of secrecy" in the literature of fin' amors offered both a model for and
an endorsement of Bona Fortunas patients' reticence about naming w h o m
they desired.
But that reticence was potentially double-edged. O n the one hand it
may have been part of the game of love (however seriously played), one of
the "rules" by whose enactment the lover declared himself to be a m o n g the
"noble hearts." O n the other hand—and possibly simultaneously—social
pressure of various kinds and the patient's own internalized values could
render the game of love a dubious one fraught with conflict. Secrecy be-
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Bona Fortuna's Treatise o n t h e V i a t i c u m § 137
Figure 7.2. T a k i n g t h e pulse. L o n d o n , British Library, M S A r u n d e l 295, fol. 266.
tokened not only that one loved fashionably and well, but also served as a
defense against fear of disapproval, censure, familial rejection or worse. As
noted in the first chapter, the specter of incest forced the lovers in antiquity
to hide their passion. Bona Fortuna himself suggests in a series of "thera-
peutic" objections to love w h y a late medieval lover might refuse to admit
his desires. " H o w will you eat? What will you drink? What will you spend?
H o w will you live? All your goods will perish and thus you will be
wretched." To these reproaches Bona Fortuna adds that this mad love will
earn the lover the rejection and hate of his friends. Faced with such social
censure, the patient may well have decided to "conceal and in n o way reveal
the beloved."
Diagnosis, then, involves two conflicts of will: between the patient and
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Figure 7.3. Jan Steen, " T h e Doctor's Visit," ca. 1663. T h e painting of Venus and
her lover on the wall suggests the malady for which the doctor tests the patient's
pulse. Cincinnati, T h e Taft M u s e u m , Gift of M r . and Mrs. Charles Phelps Taft
(1931.396).
the family who presumably object to the desired person, and yet who are
anxious to remedy the patient's languishing; and between the patient, deter-
mined not to reveal his secret, and the doctor, just as determined to find a
cure. In Bona Fortuna's chapter at least, the physician intervenes in the
patient's love life—recommendations of therapeutic intercourse notwith-
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s t a n d i n g — o n the side of convention, order, and responsibility. As in the

anecdote of the y o u n g m a n cured by a t r u m p e d - u p charge of h o m i c i d e (be-
low), the attitudes and values of the family win out over individual desire.
T h e other authors treated in this v o l u m e s h o w that medical discourse on
love is n o t always as strongly normalizing as it is in the hands of Bona
Fortuna or Bernard of G o r d o n . 4 3 Yet as Bona F o r t u n a s therapy for s u f f o -
cation of the w o m b shows, he is neither prudish nor theologically conser-
vative a b o u t sexual topics in general. Significantly, then, the type of
passionate love represented by amor hereos—a kind of emotional and social
excess—appears to a physician like Bona Fortuna to require m o r e constraint
t h r o u g h medical intervention and social pressure than d o sexual diseases,
like involuntary ejaculation or suffocation of the w o m b , that are caused by
physiological excesses. T h e c o m p l e x social rituals of love evidently threaten
the order of things m o r e than does mere libido.
Bona Fortuna's discussion of the pulse test and of the remedies for love
signal indirectly his o w n discomfiture w i t h erotic love and its conflicts w i t h
n o r m a l social order. Similarly, the stories of Antiochus, Perdica, and the
lovers in Decameron 2.8 and 10.7 illustrate the potential d r a m a that the pulse
test offered for exploring characters and values in conflict. In the seven-
teenth century that d r a m a was represented visually in a genre of painting
k n o w n as the " D o c t o r ' s Visit" that flourished in the Netherlands. 4 4 Masters
like Gerrit D o u , Jan Steen (see Figure 6.4), and Gabriel van Mieris typically
portray a well-to-do y o u n g w o m a n feebly reclining in a chair o r even toss-
ing in bed, while a physician takes her pulse. His dress and bearing convey
his power to reveal her secret and his authority to ordain a remedy. T h a t
love is her secret malady is sometimes indicated by the titles of the paint-
ings ("Liebeskrankheit," " M a l d ' a m o u r " ) and sometimes by iconographical
clues like b a c k g r o u n d paintings (Figure 7.3).
Cures
Bona F o r t u n a s section on cures refers to experimentation (in the medieval
sense of the word) m o r e often than those of other c o n t e m p o r a r y writers
on amor hereos.45 H o w e v e r , Bona Fortuna offers the fruits of his experience
to validate and specify general therapeutic suggestions m a d e by previous
medical authorities. For example, w h e r e al-Râzî, Avicenna, o r Gerard of
Berry r e c o m m e n d p u r g i n g excessive h u m o r (Figure 7.4) as one part of
therapy, Bona Fortuna offers specific c o m p o u n d s and recipes for d o i n g so.
Despite O v i d ' s d i c t u m that "Love is not curable by h e r b s " (Remedies for
Love) Bona Fortuna instructs the physician h o w to c o m p o u n d a decoction
of wild endive, honeysuckle root, dandelion, and basil, to w h i c h a little
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Figure 7.4. P u r g a t i o n " u p w a r d . " F r o m t h e Tacuinum

sanitatis. V i e n n a , B i l d a r c h i v , O s t e r r e i c h i s c h e N a t i o n a l -
b i b l i o t h e k , C o d . ser. n o v . 2644, fol. 99v.
d o d d e r is a d d e d after it has c o m e to the boil. It should then boil f o r as l o n g

as o n e cooks an egg. A c c o r d i n g to b o t h medieval and m o d e r n herbáis, B o n a
F o r t u n a s empirical p h a r m a c y , unusual in medical discussions of amor hereos,
was p r o b a b l y effective for its stated p u r p o s e s . T h e simples he lists generally
have laxative, diuretic, or cathartic properties, and hence p r o b a b l y effected
the p u r g a t i o n f o r w h i c h they w e r e i n t e n d e d . C o m p o u n d ieras, w h i c h he
also r e c o m m e n d s for lovesickness, w e r e c o m m o n l y used p u r g a t i v e s based
on aloes.
T h e p a r a g r a p h s o n basil (Figure 7.5) at the end of t h e chapter o n love
suggest that t h e physician could n o t always predict t h e effects o f his simples
or c o m p o u n d s . T h e recipes given in this section are the "certain h e l p s "
p r o m i s e d at the outset of t h e chapter and thus are an integral part of B o n a
F o r t u n a s d o c t r i n e on lovesickness. T h e remedies for persistent diarrhea that
he describes allay severe reactions to t h e p u r g a t i v e c o m p o u n d s he r e c o m -
m e n d s earlier in the chapter. T h e basil-stuffed chicken and a l m o n d - b a s i l
crepes (tortellos) that he suggestsBrought
are delightful
to you by |culinary touches.
Cambridge University Library
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jfiuamt arçmun
f t a Ï Ï ^ ^ ,UYU,nn
â", -m" " ' " ί ¿ « M Ó t u m «fetairfef
¡ K
1 J , , U , , U;! " S T I Ï Ï Î "<mfM.Ouïr» gm,rj«i
S · ·»""»r.frte iciitln qnaup muoiur.trgioilv « i c n t i l i f c ·
Figure 7.5. Basil, according to the Tacuinum sanitatus, "dissolves superfluities of t h e

b r a i n . " Vienna, Bildarchiv, Osterreichische N a t i o n a l b i b l i o t h e k , C o d . ser. n o v .
2644, fol. 39v.

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As with these purgative and anti-purgative recipes, Bona Fortuna cites

his o w n experience to confirm the recommendations of earlier authorities
in his discussion of universal and particular cures. Documenta universalia, he
explains, will work for all patients, but documenta particularia cure only
some. N o doubt prompted by Avicenna, he critiques Constantine's recom-
mendation of songs and instrumental music by pointing out that they cheer
up some patients, but plunge others into deeper sadness. Hence they are
particular rather than universal cures. T h e doctor must, therefore, de sua
industria (by his o w n efforts) find out and administer what in fact will work
in a given case.
In Bona Fortuna's opinion, there are four universal cures for lovesick-
ness: travel, litigation (Figure 7.6), business, and intercourse with other
women, whose efficacy he attests by appeals to his o w n experience in prac-
tice. To illustrate the point that change of scenery (mutatio regionis) is a uni-
versal cure for lovesickness, he relates the case of a young man w h o m he
caused, with the consent of the young man's relatives, to be charged with
homicide. T h e man was forced to flee the country, and so was cured of
lovesickness by separation f r o m the object of his desire (Figure 7.7). 46 Bona
Fortunas particular experience with this young man thus confirms the effi-
cacy of the traditional universal cure. Moreover, without being a case his-
tory, it nonetheless provides interesting information on the social context
of treatment for lovesickness. Bona Fortuna was apparently called in by the
young man's relatives, and physician and family together plotted a rather
extreme, though effective, cure.
Bona Fortunas psychotherapy is as remarkably specific as his somatic
therapy. Like Bernard of Gordon, w h o classifies patients suffering f r o m
love as rational or irrational, Bona Fortuna divides them into the corrigible
and the incorrigible. If a patient cannot respond to rational arguments, then
one is to treat him with caution and gentleness. O n e must proceed with
such a patient, he says, "just as we do with boys w h o m we teach A B C
without blows, but with all gentleness, w h o m we promise nuts, apples, and
other things." If, for example, the patient is a scholar, he should be p r o m -
ised honors and benefices.
Bona Fortuna's sensitive handling of his patients stands in sharp con-
trast to the violence of Bernard de Gordon, w h o recommends whipping
unreasonable patients until they begin to stink, or of Gerard of Solo, w h o
advocates blows with a good belt. Bernard's opinion in fact became prover-
b i a l — " Q u e le Medecin qui va sans Gordon, va sans bastón," says Jacques
Ferrand in his encyclopedia on erotic melancholy (1623), only then to dis-
tance himself f r o m the Montpellier master's therapy. 47 In their r e c o m m e n -
dation of beating, Bernard and Gerard seem to be a m o n g the minority of
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Figure 1.6. T h e clamor and bustle in this c o u r t r o o m scene show w h y

lawsuits would distract the lover f r o m his preoccupation. Part of a leaf
f r o m the Noveliae of Johannes Andreae. Cambridge, Fitzwilliam M u -
seum, MS 331, detail.
writers on lovesickness. If, however, the patient is "corrigible," then Bona

Fortuna follows Avicenna, Gerard of Berry, and others in advocating vili-
fication of the beloved, a cure in which the misogyny of the "clerks" (to
use the Wife of Bath's phrase for educated male intellectuals) is readily
apparent.
Given Bona Fortunas claims of practical experience in curing amor her-
eos and the striking specificity of his remedies, it is tempting to argue that
lovesickness was a disease of some frequency, and that physicians in the late
Authenticated
Figure 7.7. A rider is handed a glass of wine at a tavern or

inn. From the Tacuinum sanitatis. Vienna, Bildarchiv,
Osterreichische Nationalbibliothek, Cod. ser. nov. 2644,
fol. 87r.
thirteenth and early fourteenth centuries were not only ready to diagnose
amor hereos, but did it regularly enough to elaborate semeiology and to com-
pare the efficacy of various therapies. New signa, the foundation of diag-
nosis and prognosis, would appear to reflect the fruits of practice. For
example, Bona Fortunas claim that symptoms of a dry mouth and tongue,
and bitterness in the throat, as though the patient had eaten unripe plums,
signal amor hereos caused by adust ("burnt") humor, suggests experience
with lovesick patients on the basis of which these signs have been proven
accurate and reliable.
Inviting as it is to see in Bona Fortunas chapter the traces of actual cases
of amor hereos, we must also remember that what seems to derive from
experience could be, in fact, a recasting of traditional accounts without re-
course to observation. The dry and bitter tongue and throat, for instance,
could be accounted for in two other ways, neither of which implies any
interaction with patients. It could derive from symptoms in al-Râzï's expo-
sition in the Liber continens o f coturub vel ereos (a c o n f l a t i o n o f l y c a n t h r o p y
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and lovesickness), in w h i c h dryness of the t o n g u e and throat are repeatedly

mentioned. Alternatively, the s y m p t o m s could be " p r e d i c t e d " f r o m the
causality of amor hereos. As the Viaticum says, excessive h u m o r can cause
lovesickness. T h e heat of the patient's complexion, generated b y insomnia,
could then b u r n such matter, rendering it " a d u s t " and even m o r e malig-
nant. T h i s f o r m of h u m o r , o f t e n melancholic, is associated w i t h dryness,
bitterness, o r sourness. 4 8 T h e excessive heat t h o u g h t to be generated w i t h i n
the b o d y in amor hereos could also contribute to dryness in the throat. To
such s y m p t o m s " p r e d i c t e d " by causal theories of amor hereos, then, Bona
Fortuna need only have added the descriptive simile quasi pruna novella im-
matura to arrive at his seemingly new, empirically derived s y m p t o m .
T h e s e considerations cast d o u b t on o u r ability to recover the realities of
medieval medical practice f r o m texts w h o s e f u n d a m e n t a l orientation is to
theory and to authority. 4 9 Despite the difficulties these w o r k s present, h o w -
ever, careful interdisciplinary study of b o t h texts and contexts can enlighten
us a b o u t physicians' experience w i t h lovesick patients. Medieval medicine
was a social and pragmatic art, c o m p o s e d of practica as well as theorica, and
practiced between and a m o n g historical individuals. T h e medical tradition
of amor hereos was intellectually v i g o r o u s and long-lived because there was
a continuing social need to w h i c h it responded. T h a t need is the subject of
the next chapter.

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§§ 8 §§
RECREATING A C O N T E X T FOR
THE LOVER'S MALADY
The love of melancholies is hateful, twisted, and death-carrying, like

that of voracious wolves . . . They have intercourse with women but
they hate them.
Hildegard of Bingen 1
O η St. Valentine's Day in 1402, Gadifer de la Salle, k n i g h t errant and

veteran military adventurer, was elected to the C o u r t of Love of Charles
VI. Its m e m b e r s met to c o m p o s e and p e r f o r m love poetry, b u t they also
held j o u s t s in h o n o r of the ladies. Gadifer's election to the c o m p a n y
meant that he was recognized "as a tried knight and as an established
courtier, w i t h an understanding of fashionable style and recognized lit-
erary interests." 2
Gadifer was participating in w h a t had b e c o m e a standard set of ritual
practices, regardless of w h e t h e r they were organized a r o u n d a C o u r t
of Love or not. Between the twelfth and the f o u r t e e n t h centuries, the
cultural fantasy of "noble love" evolved into a f o r m of social behavior
a m o n g the aristocracy. T h e thirteenth-century Art d'amours notes that
" o n e w h o wants to begin his love affair well m u s t pretend that he is
prepared to d o every service, every wish and every private d u t y that he
can for his lady." A r o u n d 1400 Christine de Pisan w a r n e d naive y o u n g
w o m e n against believing courtiers' v o w s of love and service. She was
echoed by the w i f e of the K n i g h t of the Tour Landry, w h o cautioned her
daughters against loving " p e r a m o u r s . " 3 " L o r d e s and felawes " she claims,
saye that alle the honour and worshyppe whiche they gete and have, is
comynge to them by theyre peramurs . . . but these wordes coste to
them but lytell to say, for to gete the better and sooner the grace and
good wylle of theyr peramours. For of such wordes, and other much
merveyllous many one vseth full ofte; but how be it that they saye that
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Recreating a Context for the Lover's Malady § 147
'for them and for their loue they done hit,' In good feyth they done it
only for to enhaunce them self, and for to drawe vnto them the grace
and vayne glory of the world.
H e n r y of Lancaster (d. 1361), one of the m o s t p o w e r f u l nobles in E n -

gland, gives the masculine side of the story w h e n he confesses that he
persuaded go-betweens to help his plans for seduction b y claiming love-
sickness ( " I ' m a dead man unless you help me"). 4 To j u d g e f r o m these
warnings, courtly lovers talked a g o o d line, and had to d o so as part of
their s e l f - f a s h i o n i n g — " t o enhaunce t h e m self, and for to d r a w v n t o t h e m
the grace and vayne glory of the w o r l d . " A n d w o m e n had to beware of
the social consequences of falling for their lines.
Late medieval art corroborates that the ideals of noble love penetrated
the rituals of everyday life a m o n g the nobility. T h e m a n kneeling before his
mistress in Figure 8.1 is carved atop a gravoire, an i n s t r u m e n t that b o t h sexes
used to part the hair. Similar scenes are f o u n d on f o u r t e e n t h - c e n t u r y m i r r o r
backs, small caskets, and covers for writing tablets. T h e images and p o s -
tures of courtly love, w i t h its inversion of men's usual " m a i s t r i e " (mastery),
appeared on objects associated w i t h m o m e n t s of literal self-fashioning:
g r o o m i n g , a d o r n m e n t , and writing. These images on objects of daily use
support the claim that " B y 1400 courtly love had b e c o m e for m a n y n o t j u s t
a way of talking but a way of feeling and a c t i n g . " 5
Just as courtly love in the later M i d d l e Ages was m o r e than a simple
literary posture, m o r e than a set of rhetorical clichés, so t o o was lovesick-
ness m o r e than a traditional category of medical writing: it m u s t also be
u n d e r s t o o d as a f o r m of social behavior. Recovering the circumstances of
that behavior, however, is a difficult task. T h o u g h each a u t h o r in this vol-
u m e approaches lovesickness w i t h different questions and concerns, as a
g r o u p the c o m m e n t a t o r s share a c o m m o n perspective, that of literate, u r -
ban, university-trained physician-teachers—in short, that of the masculine
intellectual elite. T h e y view their subject f r o m the vantage point of distance
and authority, and their view is f r a m e d by scholastic rationalism. While that
f r a m e encloses a vision of love in the h u m a n subject conceived as a b o d y
c o m p o s e d of elements in a state of continuous interaction and change, it for
the most part excludes direct evidence for the social setting and context of
lovesickness.
H o w , then, may we understand the lover's malady as a socially-influ-
enced f o r m of medieval culture? This chapter draws together converging
lines of evidence f r o m medicine, mysticism, art, literature and magic to
argue that in the later Middle Ages the lover's malady was a social and p s y -
chological response to historical contradictions in aristocratic culture. It
offered a way of controlling a historically- and socially-conditioned experi-
Authenticated
Figure 8.Í. A gravoire, a toilet accessory for parting the

hair. The lover kneels before the lady, caressing her hip,
while she chucks his chin in affection. New York, The
Metropolitan Museum of Art, Anonymous Gift in Mem-
ory o f j . Pierpont Morgan, 1918 (18.71).
enee of eros that was felt to threaten the n o r m a t i v e hierarchy of gender and
power.
A theoretical p r o b l e m m u s t be addressed at the outset: h o w " r e a l " was
this disease? As a historian of medicine has put it: " T h e conservative ten-
dency of medical literature was j u s t t o o s t r o n g to rule o u t the possibility
that writers talked about diseases they had never seen or (perhaps) on a
f u n d a m e n t a l level never really expected to s e e . " 6 S o m e literary critics have
also been reluctant to grant the historical reality of amor hereos, w h i c h is
seen as a f o r m of "courtly love." Since " c o u r t l y love" in this view never
existed as a social practice or social ideology, or existed only as a set of
ironic literary conventions, lovesickness is simply a literary posture, a g a m e
of poetic conventions. 7
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As t h e first chapter has s h o w n , the medical tradition of lovesickness h a d

a l o n g history b e f o r e the t r o u b a d o u r s sang of refined love in the t w e l f t h
century. Amor hereos c a n n o t in a n y simple fashion, therefore, be r e d u c e d t o
an o u t g r o w t h o f medieval literary style. W h i l e there is n o d e n y i n g t h e c o n -
servative tendency of medieval medicine, t h e preservation of o n e culture's
texts a n d ideas by a n o t h e r is an active a p p r o p r i a t i o n , a l l o w i n g f o r selection,
m o d i f i c a t i o n , and amplification of w h a t seems i m p o r t a n t a n d u s e f u l . 8 T h a t
the medical analysis of love s u r v i v e d t w o cultural transfers, f r o m G r e e k a n d
Latin medicine o f late antiquity to medieval Islam, and f r o m Islam t o E u -
r o p e a n Latin C h r i s t i a n i t y argues f o r its relevance to the experiences o f t h e
b o r r o w i n g cultures, since m e d i c i n e was, after all, a practical art. As t h e
differences a m o n g t h e Viaticum c o m m e n t a r i e s reveal, C o n s t a n t i n e ' s t e a c h -
ing o n lovesickness was n o t disseminated u n t h i n k i n g l y , b u t r a t h e r was
elaborated and developed t h r o u g h t h e creative efforts of g e n e r a t i o n s o f
teacher-practitioners. T h e m o r e than t h i r t y s u r v i v i n g discussions o f love-
sickness, in the f o r m of translations, c o m m e n t a r i e s , a n d chapters in n e w
practical h a n d b o o k s of medicine attest that lovesickness was as " r e a l " f o r
medieval physicians as melancholy, headache, baldness, a n d scalp lice—as
real as the o t h e r diseases of the head a m o n g w h i c h amor hereos was classified.
M y analysis t h e r e f o r e assumes that t h e d o c t o r s ' i n v e s t m e n t of intellec-
tual e n e r g y in t h e subject of m o r b i d love r e s p o n d e d t o practical needs as
m u c h as to theoretical advances w i t h i n the universities. In B o n a F o r t u n a 's
anecdote o f the lovesick y o u n g m a n charged w i t h h o m i c i d e , f o r e x a m p l e ,
w e can see that patients o r their families on occasion s o u g h t medical help
f o r the lover's malady, and that physicians did their i n g e n i o u s best t o
cure t h e m .
Medicine and Society

Since h u m a n subjects are o p e n s y s t e m s in constant interaction w i t h t h e
w o r l d , their desires, hopes, and fears bear the s t a m p of their place in society
and history. While there m a y be a biochemical c o m p o n e n t t o lovesickness,
it is also shaped, like o t h e r mental illnesses, b y social and cultural settings. 9
Because the manifestations o f culturally shaped illness e n c o d e social rela-
tions, social relations can conversely be " d e c o d e d " f r o m their inscription in
the medical accounts o f lovesickness.
W h a t clues a b o u t the social c o n t e x t of the lover's m a l a d y can be gleaned
f r o m the medical accounts? Since medieval society had clearly d e m a r c a t e d
g e n d e r roles (both theoretically and functionally), the relation o f lovesick-
ness and g e n d e r is significant. T h o u g h , as chapter six has s h o w n , t h e r e w a s
s o m e d e b a t e a b o u t h o w susceptible w o m e n are to the disease, m o s t m e d i e -
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val physicians claimed that m e n suffered f r o m lovesickness m o r e often.

Despars summarizes general opinion on this point. T h e disease of love af-
fects m e n m o r e than w o m e n , he explains, because m e n are generally hotter,
their seed m o r e " i t c h i n g , " and their desire for intercourse m o r e v e h e m e n t .
Moreover, they pay less attention to the counsels of m o d e s t y than w o m e n
do, they are less shamefast, and they d o not fear the cleverness and tricks of
w o m e n as w o m e n do of men. 1 0
These physiological inclinations, moreover, were particularly apt to
affect m e n of the nobility. Arabic medical texts that were the sources of
Western teaching d o n o t m e n t i o n a particular social class as m o r e or less
susceptible to the disease; the attribution of lovesickness to the nobility is
peculiar to the E u r o p e a n adaptations of these w o r k s . Already b y 1100 or
so, the retranslation of the Viaticum's chapter on love in the Liber de héros
morbo spoke of " l o r d l y " or " h e r o i c " love. A n d as w e have seen, Gerard of
Berry glossed the phrase "love that is called h e r o s " as "heroes, that is,
noble m e n . "
N o r was this assignment of the disease of love to the nobility restricted
to commentaries on the Viaticum, w h i c h had to m a k e sense of the text's
eros/heros/hereos. In the early fourteenth century Gerard of Solo, c o m m e n t -
ing on al-Râzî's chapter o n lovesickness, says that it is called amor ereos, " t h a t
is, noble love, so called f r o m nobility because it is a very s t r o n g love, for
knights (milites) are m o r e apt than others to have this passion." 1 1 C o m m e n -
tators on Avicenna, w h o s e w o r d for the disease (al-'ishq) was transliterated
into Latin as ilisci or ylisci, equated it w i t h amor hereos and declared it a
hazard of noble life. Jacques Despars, w h o s e c o m m e n t a r y on Avicenna's
Canon dates f r o m the middle part of the fifteenth century, explains that this
insane love is called " h e r e o s " or " h e r e o s u s " because it befalls noble m e n and
heroic m e n m o r e often than simple m e n of the c o m m o n people. T h e nobles
are m o r e given to leisure and delicately nourished w i t h meat and wine; they
frequent dances and often converse w i t h attractive ladies and demoiselles
" w h o are like darts w o u n d i n g the m i n d . " 1 2 Physicians like Arnald of Vil-
lanova and William of Brescia, w h o w r o t e of lovesickness outside the
f r a m e w o r k of textual c o m m e n t a r y , also perceived it as a disease afflicting
noble men. 1 3
Given the anthropological observation that " t h e relation of head to feet,
of brain and sexual organs, are c o m m o n l y treated so that they express the
relevant patterns of hierarchy," 1 4 it comes as no surprise that this disease of
aristocratic men was t h o u g h t to be located in the brain. T h o u g h physicians
debated w h e t h e r love was a disease of the head, the heart, or the generative
organs, they all decided that it was principally an affliction of the brain.
In the physicians' view, then, the lover's malady resided at the t o p of
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three hierarchies: body, gender, and society. A social interpretation of the

disease may therefore reasonably be sought within the structures of mascu-
line aristocratic culture. Further aspects of the medical works support this
localization.
In describing the dysfunction of the mental faculties caused by love, the
physicians note the lovers' tendency to idealize the beloved. As Gerard of
Berry says, the patient considers her better, more noble, and more desirable
than other women, even though this may not really be so. T h e misjudgment
of her desirability fixes the lover in meditation on her mental image. In
medieval lyric the image of the woman, thus internalized, stood as an ideal
for the self. 15 T h e physician William of Brescia (d. 1326) doubtless perceived
the similarity between the idealization in lyric and lovesickness when he
said that the patient fears to lose his love object because he believes he will
be perfected by her or it. 16 Her overestimated nobility mirrors at a psycho-
logical level the lover's o w n social elevation, but at the same time points up
a gap or distance in their relative psychological positions: in her existence as
an idealized mental image, she is "above" the lover, w h o is sunk in de-
pressed thoughts (profundatio cogitationum).
T h e distance between lover and idealized object becomes m o r e apparent
if we examine the social metaphors embedded in causal analyses of the dis-
ease. As shown in the third chapter, Gerard explains the disease's cause us-
ing the language of hierarchy and governance: the faculties at the top rule
and give orders, those below b o w and obey. This telling metaphorical lan-
guage reveals that the ennoblement of the w o m a n upsets the inner hierarchy
of self-rule, threatening the lover with psychological, if not actual social,
abasement. As D i n o del Garbo puts it, the lover's mind loses its liberty, as
it were, and becomes servile: "fit servilis in cogitationibus." 1 7 O r , as
Arnald of Villanova says in his treatise on heroic love, the disease is called
heroic—"lordly, as it w e r e " — n o t only because it befalls lords, but also
because the acts of such lovers toward the desired object are the acts of
servants toward their lords, w h o m they strive to serve with faithful subjec-
tion (cf. Figure 3.7). 18
Finally, the s y m p t o m s of the disease " u n m a n " the lover. As a patient he
is passive, helpless and vulnerable. T h e signs of lovesickness, as shown in
chapter three, connote feminine and infantile behavior. T h e universally-
recognized s y m p t o m of lovesickness in the Middle Ages, wasting f r o m fail-
ure to eat, is associated, as Caroline B y n u m has shown, with the feminine
and the maternal. 1 9 Physicians also observed that the lovesick are unable
to participate in normal social discourse; they are like the in-fans, the
non-speaker. Some of the s y m p t o m s — t h e wasting, silence, interrupted
breathing—embody prelinguistic, infantile modes of signifying. 2 0 And the
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infantile is very close to the feminine as it was construed by medieval soci-

ety—uncontrolled emotion, language, and behavior. T h r o u g h the signa
amoris and the disease of love the lover's body and behavior are thus " u n -
m a n l y " because feminine- or infantile-seeming. Yet at the same time, they
express an identification with the unattained object of desire insofar as they
are "feminine" and a return to childlike object relations insofar as they are
"infantile."
T h e medical treatises give us, then, the following set of relations. An
aristocratic man falls helplessly in love with a w o m a n w h o m he idealizes.
This results in a narcissistic mirroring of the noble lover in the ennobled
love object; at the same time, the elevation of the object entails a loss of
inner control and governance in the noble subject, a degradation of the m e n -
tal faculties. This lowering is paralleled by the feminization and infantiliza-
tion of the lover's body and behavior. T h e lover's state of disease, in other
words, transgresses the usual structures of gender and power. As a "heroic
lover" and noble man he is at the top of the hierarchy, yet is also somewhere
" b e l o w " as a patient unmanned by love.
This tension between idealization and abjection inscribed in the medical
accounts of lovesickness bears elaboration through other sources. Evidence
f r o m medieval mystical writings suggests that idealization is both linked to
the maternal and tinged with ambivalence. A number of literary works and
texts on magic indicate that self-abasement is a way of expressing, in dis-
placed form, hostility toward another that cannot be expressed directly. M y
goal in the following analysis is to suggest that the lover's malady was a way
of both expressing and coping with simultaneous feelings of desire and
hostility.
Mystical Rapture
From the twelfth century onwards, mystical writers described spiritual ex-
perience by its carnal analogues. Some of them tried to put the experience
of ecstatic spiritual love into words by using the language of lovesickness,
at first drawn f r o m the Song of Songs ("quia amore langueo"), and then
later f r o m the medical treatises themselves. As early as Richard of St. Vic-
tor's (d. 1173) treatise on the Four Degrees of Violent Charity, we find that
passionate spiritual and carnal love are semiotically indistinguishable. In this
treatise, Richard first describes the four stages of violent charity: w o u n d i n g
love, binding love, love that makes the lover languish and that is satisfiable
by only one object, and finally love that leads to physical and psychological
disintegration ("caritas vulnerai, ligat, languidum facit, defectum addu-
cit"). This last degree, an incurable illness, morbus irremediabilis, is unsatis-
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fiable; it " o f t e n turns to m a d n e s s " and " o f t e n becomes hate w h e n n o t h i n g

can satisfy m u t u a l desire." " T h u s loving they hate, and hating they love,
and miraculously, or rather miserably, f r o m desire g r o w s hate and f r o m
hate desire." O n l y after describing the psychological progression of the f o u r
steps does Richard declare that they are different in divine and h u m a n affec-
tions. In spiritual desire, the higher the grade, the better; in carnal desire,
the higher the grade, the worse. 2 1 T h e behavior and the s y m p t o m s associ-
ated w i t h the grades, however, are the same.
As noted in the first chapter, other writers also used the analogy w i t h
the psychology and s y m p t o m s of lovesickness in order to clarify the nature
of the mental alienation of ecstatic love. T h e y thus appear to have perceived
a single psychological d y n a m i c u n d e r l y i n g mystical love and lovesickness,
however they differentiated g o o d and bad loves a posteriori b y their objects.
In b o t h m o d e s of love unsatisfied desire for an ideal object alienates the lover
f r o m himself. G o d or an idealized w o m a n is the desired other w h o s e inac-
cessibility turns desire into madness ("alienatio mentis"). W h a t does it
mean, however, to say that G o d and an idealized w o m a n occupy the same
psychological space? 22
Julian of N o r w i c h ' s (d. after 1416) devotion to " m o t h e r Jesus" is p e r -
haps the m o s t f a m o u s case of the medieval perception of God's f e m i n i n e
and maternal qualities, but a significant n u m b e r of t w e l f t h - c e n t u r y m e n
used maternal imagery to describe relations to a G o d usually conceived of
as male. 2 3 N o r was this an arcane clerical tradition. As the beautiful M i d d l e
English p o e m of a b o u t 1400, "In the valley of restless m i n d , " s h o w s ,
the tradition of feminine imagery for G o d reached a vernacular audience.
Christ, w h o t h r o u g h o u t the rest of the p o e m is a masculine lover of the
h u m a n soul in the tradition of the Song of Songs, speaks of himself as a
n u r t u r i n g m o t h e r suckling her babe in one of the last stanzas:
M y loue is in hir chaumber: holde 30ure pees,

M a k e 3e no noise, but let hir siepe:
M y babe y w o l d e not were in disese,
I may not heere m y dere child wepe.
With m y pap y schal hir kepe.
N e mervaille 3e not |)ou3 y tende hir to;
f i s hole in m y side had neuere be so depe,
But quia a m o r e langueo. 2 4
T h e p o e m draws such themes f r o m affective mysticism to shape its invita-

tion to loving union w i t h G o d figured as m o t h e r .
We have already seen that s o m e of the s y m p t o m s of lovesickness signify
Authenticated
a childlike relation to the desired object. T h e story of Antiochus recounted

in the first chapter, an Oedipal comedy in which the lovesick prince is cured
by marriage to his father's wife (see Figure 1.3), also suggests that intense
experiences of love rapture and lovesickness embody powerful desires for
union with the maternal. 2 5 And desire for his mother causes Perdica to
sicken and die (Figure 1.1). Whether carnal or spiritual, these instances of
love madness and its somatic manifestations seem to express t h r o u g h the
idealized and "feminine" objects of love a deep desire for an all-powerful,
sovereign, nourishing " o t h e r " w h o corresponds to the image of the mother
f r o m the earliest stages of psychological development. 2 6
Medieval literature is replete with traces of this desire. In Christine de
Pisan's Epistre au dieu d'amours (1399) Cupid proclaims: " C a r tout h o m m e
doit avoir le euer tendre / Envers f e m m e qui a tout h o m m e est mere, / Et
ne lui est ne diverse n'amere" (For each man ought to have a tender heart
toward woman, w h o is mother to each man, and is neither different nor
bitter toward him). 2 7 It has been argued, in fact, that courtly love "repre-
sents an institutionalized manifestation of an intense fixation on the
mother . . . it is a systematic organization of interpersonal relations, the
conception of which is derived f r o m and b o u n d together by a shared uncon-
scious phantasy." 2 8
In a number of instances that fantasy was hardly unconscious; the desire
for union with the mother was scarcely, or not at all, repressed or displaced.
A remarkable number of medieval stories recount examples of incest be-
tween mother and son. H a r t m a n n von Aue's Gregorius (late twelfth cen-
tury), for example, narrates a version of a widely circulating medieval
Oedipus story, found in the Gesta Romanorum and elsewhere. Instead of the
double tragedy of death and blinding after the discovering of incest, h o w -
ever, mother and son repent and pursue monastic callings. 29 Cantiga 17 of
Alfonso X " T h e Wise" (d. 1284) tells the story, also recounted by Vincent
of Beauvais, Jacques de Vitry, and O d o of Cheriton, of a w o m a n whose son
lay with her and got her with child (Figure 8.2). 30 Even a down-to-earth
bourgeois like the Menagier of Paris saw in a man's desire for his wife a
replaying of the child's desire for the w o m a n w h o nourished and took care
of him. If a w o m a n makes sure her husband is well provided for, in a snug
house, and couches him well between her breasts like a child, then she
will surely bewitch him. " C h e r e seur, j e vous pry que le mary que vous
arez vous le veuilliez ainsi ensorceler et rensorceller" (Dear sister, I hope
that you will bewitch the husband you will have again and again in this
fashion). 31
That men in some fashion desire their mothers and that they recreate
that desire in their adult sexual relations was thus no secret to medieval
Authenticated
Figure 8.2. Incestuous desires could be represented in

art as well as literature. "How a youth lay with his
mother" from the Cantigas de Santa María of Alfonso X ,
the Wise. Escorial, Bibl. MS T.I.I, Cant. XVII. Pho-
tograph granted and authorized by the Patrimonio
Nacional, Madrid.
writers, preachers, artists, and their audiences. T h e opening o f a Middle

English poem, " A song o f great sweetness from Christ to his daintiest
d a m , " neatly expresses the deep affective connection between maternal nur-
turing and adult (masculine) sexuality; articulating a long tradition in the
visual arts and exegesis, it honors mother as bride (Figure 8.3):
Surge mea sponsa, swete in si3t,

And se [)i sone f)ou 3afe souke so scheene;
i>ou shalt abide with Jai babe so bri3t,
And in my glorie be callide a queene.
T h i mammillis, moder, ful weel y meene,
Y had to m y meete J)at y m y 3 t not mys. 3 2
Whether overt or repressed, however, a man's desire to revert to a childlike

state o f dependent, identifying love conflicted with the dominant social and
cultural codes o f masculine superiority that shaped his sense o f self. T h e
Menagier's use o f " b e w i t c h " (ensorceler) for a wife's method o f gaining hold
over her husband, though meant positively, nonetheless intimates that the
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Figure 8.3. M a r y , e n t h r o n e d as Q u e e n o f H e a v e n , a n d t h e i n f a n t j e s u s s h o w their
love for each o t h e r in gestures o f n u r t u r i n g , p r o t e c t i o n , and d e p e n d e n c e . M o t h e r
a n d C h i l d w e r e depicted w i t h increasing f r e q u e n c y f r o m t h e 13th c e n t u r y o n . O x -
f o r d , C o d r i n g t o n Library, M S All Souls 6, fol. 4r. B y p e r m i s s i o n o f T h e W a r d e n
and Fellows o f All Souls C o l l e g e , O Brought
x f o r d . to you by | Cambridge University Library
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desire for union with an object (God, a woman) w h o evokes the maternal
is not simple or without conflict. As Richard of St. Victor so strikingly
announces in his analysis of the fourth step of violent love, aggression and
hate are inseparable f r o m the extreme reaches of both carnal and spiritual
love. N o r is Richard an isolated case; historians of spirituality have docu-
mented this affective ambivalence in other medieval authors writing on love
of God. 3 3
Just as love for the divine can be ambivalent, so too can love for an
earthly woman. In his study of courtly love, Roger Boase has assembled
texts f r o m Arabic and European writers documenting the affinity between
love and hate. 34 Because it treats the nexus of love and hate in terms that
recall the physicians' analysis of amor hereos, Dante's " A m o r , da che con-
vien" is worth quoting at length:
Io non posso fuggir ch'ella non vegna

ne l'imagine mia,
se non come il pensier che la vi mena.
L'anima folle, che al suo mal s'ingegna,
com'ella è bella e ria,
così dipinge, e forma la sua pena:
poi la riguarda, e quando ella è ben piena
del gran disio che de li occhi le tira,
incontro a sé s'adira,
c'ha fatto il foco ond'ella trista incende.
Quale argomento di ragion raffrena,
ove tanta tempesta in me si gira?
L'angoscia, che non cape dentro, spira
fuor de la bocca sì ch'ella s'intende,
e anche a li occhi lor merito rende.
La nimica figura, che rimane

vittoriosa e fera
e signoreggia la vertù che vole,
vaga di se medesma andar mi fane
colà dov'ella è vera,
come simile a simil correr sòie.
Ben conosco che va la neve al sole,
ma più non posso : fo come colui
che, nel podere altrui,
va co' suoi piedi al loco ov'egli è morto.
Q u a n d o son presso, parmi udir parole
dicer: 'Vie via vedrai
Broughtmorir costui!'
to you by | Cambridge University Library
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Allor m i volgo per veder a cui

m i raccomandi; e ' n t a n t o s o n o scorto
da li occhi che m ' a n c i d o n o a gran torto.
[I cannot avoid her coming into my imagination any more than the
thought that brings her there. My rash soul, actively working to its own
harm, depicts her there with all the beauty and malice that is hers, thus
giving shape to its own torment: then it gazes at her so imaged, and when
it is wholly filled with the great desire that it draws from her eyes, it falls
into a rage against itself for having lit the fire in which it miserably burns.
What rational argument has the power to curb when such a tempest whirls
within me? My anguish, which cannot be confined, pours out audibly in
breath from the mouth and also gives my eyes what they deserve.
The hostile image, that remains victorious and pitiless and dominates
the faculty of willing, attracted to herself, makes me go where she is in
reality, as like runs toward like. Well I know that it is snow going toward
the sun, but I can do nothing else: I'm as a man in another's power who
goes on his own two feet to the place where he is killed. When I draw near
her I seem to hear words that say: 'In a moment you will see him die!' Then
I turn to see to whom I can have recourse, but in the same moment the
eyes light on me which so unjustly slay me.]35
Like writers on amor hereos, D a n t e anatomizes the psychological b r e a k d o w n

caused by intense erotic passion. T h e lover's imagination is invaded b y the
image of the beloved; obsessive contemplation of that image generates
"great desire" (Constantine's magna concupiscentia). Sighs and tears, standard
s y m p t o m s of the lover's malady, express his anguish.
T h e beloved, idealized w o m a n is at the same time a d o m i n a t r i x w h o
rules (signoreggia) the lover's faculty of willing, an image that recalls Gerard
of Berry's analysis. Moreover, the stanzas contain a c o m p l e x sequence of
direct and screened hostility. T h e w o m a n is "beautiful and malicious"; she
is a "hostile image, that remains victorious and pitiless"; and she inflicts
psychological death on the lover. T h e lover, meanwhile, b o t h desires her
and rages against himself in an infernal f u r y of passion (fire and w h i r l w i n d ) .
T h e hostility attributed to the w o m a n and the anger t o w a r d self screen h o s -
tility toward her for not yielding to the lover's desires. T h e last p o e m in
Dante's Pietra sequence symbolizes in one of its violent final images the
anger b o r n of thwarted desire. " C o s ì nel m i o parlar," filled w i t h images of
death and vengeance, culminates in a fantasy of rape in w h i c h the lover
promises: " n o n sarei pietoso né cortese, / anzei farei c o m ' o r s o q u a n d o
scherza" (I w o u l d not be pitying or courteous, instead I'd d o like a bear
w h e n it plays).
T h e literary t h e m e of the affinity of love and hate is a c o m m o n p l a c e
because it expresses the c o m m o n experience of ambivalence in erotic life.
Authenticated
Dante's poems depict an ambivalence born of frustrated desire. Psycholo-

gists have argued that ambivalence can also be rooted in early childhood
experiences and re-emerge in severe form in adult life at times of stress or
crisis. It grows out of the infant's relation to its "primary attachment fig-
ure," the mother or other caretaker w h o nourishes and protects it. In an
early developmental stage, the infant begins to perceive the world as differ-
ent f r o m itself and to differentiate itself f r o m the mother. O n c e the mother
becomes an " o t h e r " w h o is different f r o m the baby's self, she becomes part
of the n o w separate and hostile world and is no longer, f r o m the baby's
point of view, under his "control." As source of food, protection, and sat-
isfaction of needs, and yet as part of a threatening environment, the mother
attracts ambivalent feelings of love and hate. 36 In the baby's internalized
representations, which seem to persist through life, the mother is both
" g o o d " and " b a d . "
Ambivalence toward the mother is not a product of the post-Freudian
twentieth century, but can be found in medieval sources (to say nothing of
the literature of antiquity). T h e invectives against w o m e n in Book 3 of
Andreas Capellanus' De amore, for example, read like an encyclopedic list-
ing of the "bad m o t h e r " 's traits. She hoards and controls resources—food,
wine, and money. She acts independently of masculine control; she is fickle,
disobedient, rebellious, and indulges in sexual excess. Worst of all, she does
not love: " N o w o m a n ever loved her husband, nor can she ever bind herself
to a lover with a reciprocal bond of love. . . . she loves no man f r o m the
heart." 3 7 T h e accusations amount to a baby boy's ambivalent view of a
mother whose autonomy is experienced as threatening.
Modern clinical and experimental research has shown that, in addition
to the process of psychological maturation just described, the loss or threat-
ened loss of a loved object also evokes feelings of ambivalence in later life,
an interpretation supported by medieval evidence. 38 Guibert de Nogent's
(d. after 1125) complex feelings for his mother illustrate this kind of a m -
bivalent love. She gave him "a mother's special affection for her last-born"
in childhood, but when she decided to retire into a convent when Guibert
was about twelve, he claims she did it knowing "that I should be utterly an
orphan with no one at all on w h o m to depend," and knowing certainly that
"she was a cruel and unnatural mother." 3 9 Klapisch-Zuber has documented
similar ambivalent feelings a m o n g Florentines abandoned by their mothers
upon remarriage. 40
Behind the desire for an idealized object lies a desire for the maternal,
but that desire is ambivalent. In order, however, for psychopathologi-
cal states like lovesickness to develop, more than ordinary ambivalence
seems to be involved. In the view of a leading theorist of attachment,
Authenticated
John Bowlby, "anger and hostility directed toward an attachment figure,

whether by a child or an adult, can be understood best . . . as being in
response to frustration." For children the greatest source of anxiety and
frustration, and thus of hostility, is "experiences of repeated separation or
threats of separation." The disruption of affectional bonds in early life is
thus pathogenetic; it plays a role in contemporary clinical disorders includ-
ing depression and chronic mourning (Freud's "melancholia"). 41 "Early
loss, it seems, can sensitize an individual and make him more vulnerable to
setbacks experienced later, especially to loss or threat of loss," Bowlby
contends. 42
Young children in the Middle Ages faced profound threats to their e m o -
tional security. Numerous catastrophes could sever them f r o m the figures
they depended on for love as well as for the necessities of life. A child's
development could be hindered at the start if its mother died in childbirth.
Though statistics are hard to come by, the death rate f r o m the complications
of childbirth was doubtless high. 43 If the child survived infancy, the practice
of wetnursing, a childrearing practice that began among the nobility and
then spread to the middle classes, could seriously rupture its affections at a
crucial developmental stage. 44 After having become attached to the wetnurse
to w h o m it had been given shortly after birth, a year or two later the child
would have had to leave her to return home to its natural parents. If Bowl-
by's analysis is correct, this trauma may in some cases have resulted in long-
term disturbances of affective life. Whether or not a child was wetnursed, it
ran a significant risk of being orphaned at an early age. 45 The early life of
Peter Damian exemplifies both these perils. Rejected by his mother shortly
after birth, he was rescued f r o m the verge of death and cared for by a priest's
concubine. Though his mother restored him in her affections and took him
back, Peter was orphaned by the deaths of both parents while he was still a
young child. In Italy children might lose their mother as a result of the
dowry system: young widows left their husband's families with the dowry
but without their children, w h o remained behind with their father's f a m -
ily.46 Finally, noble boys often left home around the age of seven to be
taught the aristocratic arts of war and courteous service in another house-
hold. Duby has suggested that this separation entailed a desire to regain
maternal love. In his view the fabulous female creatures of romance "are
probably best understood as substitutes for the knight's lost mother. . . .
When they imagined themselves winning, by violent and dangerous means,
these enticing, elusive, dominating fays, they must have felt they were con-
quering their anxieties and returning to the warm bosom of their earliest
infancy." 4 7 Guibert de Nogent describes the trauma of separation for a boy
as old as twelve.
Authenticated
Figure 8.4. T h e siege of the Castle of Love on this ivory mirror back depicts the
relation between eros and aggression in stylized and playful f o r m . N u m e r o u s ex-
amples of the motif survive f r o m the fourteenth century. Paris, ca. 1320-50. Seattle
Art M u s e u m , Donald E. Frederick Memorial Collection (49. 37). Photo: Paul
Macapia.
All these circumstances indicate that the medieval aristocracy, the class
most subject to lovesickness, was exposed to significant disruptions of the
affectional bonds between children and their attachment figures, whether
mothers or wetnurses. As a consequence, anxiety, anger, and hostility t o -
ward maternal figures may well have complicated their feelings of love. T h e
conventional scene in Figure 8.4, k n o w n variously as the "assault o n " or
"siege of the castle of love," illustrates in light, playful fashion the current
of aggression that runs throughout medieval visions of erotic relations.
(One thinks, for example, of the cruel punishments in Andreas' Garden of
Authenticated
Love.) In pathological cases like lovesickness, exaggerated infantile and

adult feelings of " l o v e h a t e " may have fused to p r o d u c e the idealization and
depression characteristic of the disease. 48
Since expressing anger t o w a r d a p o w e r f u l figure of attachment is diffi-
cult, such feelings are often displaced or projected. Freud argues that in
melancholia the sufferer punishes and t o r m e n t s a loved one by means of the
illness, w h i c h is resorted to so as to avoid expressing hostility openly, a
theory s u p p o r t e d by recent clinical studies. 4 9 In the first chapter w e saw h o w
a variety of medical and literary texts f r o m antiquity and the early M i d d l e
Ages connected melancholy and anger, or lovesickness and anger. T h e c o n -
nection was also evident in the later M i d d l e Ages. " A n g e r engenders m e l -
ancholy," claimed the O l d French Art d'amours, and D a n t e w r o t e :
U n dì si venne a m e Malinconia
e disse: " I o voglio un p o c o stare teco";
e parve a m e ch'ella menasse seco
D o l o r e e Ira per sua compagnia. 5 0
[One day Melancholy came to me and said: "I would like to stay with you
a little while." And it seemed to me that she led with her Sorrow and
Wrath for company. ]
With remarkable psychological acuity, Hildegard o f Bingen (d. 1179)

foreshadows Freud's understanding of the connection between anger and
melancholy. T h e love of melancholies, she says, is "hateful, twisted, and
death-carrying, like the love of voracious wolves. . . . T h e y have inter-
course w i t h w o m e n b u t they hate t h e m . " 5 1 Viewed in this f r a m e w o r k , the
depression and self-abasement characteristic of m e l a n c h o l y — o r lovesick-
ness—is n o t h i n g other than hostility toward the object redirected to the self.
Sexual Magic and Revenge

"I have h e a r d , " claimed Jacques de Vitry (d. 1240), " o f a certain old crone
w h o could n o t convince a w o m a n to consent to a y o u n g man's desire." T h e
old w o m a n said to the y o u n g man: " P r e t e n d that you are sick (finge te infir-
mum) and convey to the w o m a n that you are sick on account of loving h e r . "
T h e old w o m a n starved her d o g for three days, and then fed it m u s t a r d . She
took it to the woman's house, w h e r e it began to cry because of the m u s t a r d .
She then told the w o m a n that the d o g had been another w o m a n w h o had
allowed a youth to die of love. T h e gravely ill y o u t h had exacted vengeance
b y magically t r a n s f o r m i n g the unyielding w o m a n into that very d o g . T h e
go-between's fiction w o r k e d , and the resisting w o m a n agreed to take the
y o u n g man as a lover (cf. FigureBrought8.5). 52to you by | Cambridge University Library
Authenticated
Figure 8.5. Love m a g i c w a s practiced t h r o u g h o u t t h e

M i d d l e A g e s . O n t h e left a lover hires a sorceress, a n d
o n t h e r i g h t she cajoles a m a r r i e d w o m a n . Cantigas de
Santa María o f A l f o n s o X , the Wise. Escoria], Bibl. M S
T . I . I , C a n t . LXIV. P h o t o g r a p h g r a n t e d a n d a u t h o r i z e d
by t h e P a t r i m o n i o N a c i o n a l , M a d r i d .
Told in a sermon for the people, the story is a variant of a tale widely
diffused in Europe. Its motif of pretended lovesickness as a cynically effec-
tive seduction ploy means that incurring the lover's malady had a certain
plausibility. More significantly, the illness is associated with a magical act
of revenge against the love object. Desired one moment and transformed
into a beast the next, the woman occupies a dangerous space that attracts
the lover's vengeful hate as well as his desire. The exemplum couples
feigned illness with a fiction of revenge against a woman w h o thwarts the
man's desire. That revenge is both enacted and symbolized by her degrada-
tion into a dog.
Both Hippocrates and Vergil figure in similar stories of sexual revenge
and degradation. In the thirteenth-century Grail romance L'Estoire del Saint
Graal, Hippocrates falls sick with love for a noblewoman f r o m Gaul. When
he arrives at her tower for an assignation she tricks him. After hoisting him
halfway to her in a basket, she leaves him dangling. When daylight comes,
he incurs public ridicule, since criminals were punished in that fashion. In
some versions of the story Hippocrates then takes his revenge. He culls an
aphrodisiac herb, enchants it, and gives it to a hideous crippled dwarf. Any
woman w h o m he touches with it will have no power to resist her passionate
desire for him. The dwarf, w h o slept near the emperor's palace, touches the
woman from Gaul with the herb. Thatto night
Brought you by she finds her
| Cambridge way toLibrary
University his bed.
Authenticated
Hippocrates calls the emperor to see the noblewoman in the arms of the
dwarf, whereupon the emperor declares: "Voilà bien ce qui prouve que la
f e m m e est la plus vile chose du m o n d e " (Behold well what proves that
w o m a n is the vilest thing on earth). T h e emperor then forces her to marry
the dwarf and to become chief laundress in the palace. 53 That she is humili-
ated both sexually and socially suggests h o w closely the t w o are related in
medieval constructions of sexuality.
T h e variant involving Vergil entails a different, though no less humili-
ating, revenge. Like Hippocrates, he falls in love with a w o m a n w h o fails
to return his affections, and w h o leaves him dangling in a basket to be
mocked by the Romans. Figure 8.6 shows that scene on the left side of an
ivory writing tablet f r o m the late fourteenth century. T h e spatial relation
between the t w o — w o m a n in power above, man helpless below—echoes
the symbolically charged postures of courtly love (cf. Figures 8.1, 8.8, and
3.7). After Vergil's release f r o m the basket, he extinguished Rome's lights
for three days. When the desperate Romans came to him for help, his magic
arts enabled them to rekindle their candles f r o m the part of his love's
anatomy Boccaccio calls "the fury of hell." 5 4 The aggressively crude s y m -
bolizing of what the night in the basket deprived him is shown on the right
half of the ivory. N o t e h o w the revenge/fulfillment reverses the relative
position of the woman, so that n o w she is the one below, powerless, and
violated (cf. Figure 8.7).
In these stories men wield magic arts to avenge the humiliation of their
sexual desires. What happens in the inverse situation, when w o m e n are the
agents? T h e discussion of lovesickness in the Malleus Maleficarum (Hammer
of Witches, 1486), a manual for inquisitors and judges, is motivated by a
masculine fear of sexual victimization. It embodies the fear that w o m e n ,
given the power of magic, would turn the tables and avenge their sexual
humiliations by causing men to suffer lovesickness.
The most influential of the witchcraft treatises, the Malleus, though d u -
bious evidence for the practice of witchcraft, does exemplify h o w anxiety
and fear become objectified as magic a n d / o r disease, and culminate in a
persecuting hostility. 55 T h e authors declare that lovesickness (amor hereos) is
one of the commonest forms of bewitchment, and that it affects "optimi,
praelati, alii divites" and "saeculi potentes" (eminent men, prelates, other
wealthy men, and secular rulers). 56 They claim that w o m e n rather than men
become witches because, a m o n g other reasons, through their "disordered
affections and passions" they "search for, brood over, and inflict various
vengeances, either by witchcraft or by some other means. Wherefore it is
no wonder that so great a number of witches exist in this sex." T h e motive
for their vengeance becomes clear when the authors explain h o w witches
are recruited: Brought to you by | Cambridge University Library
Authenticated
Figure 8.6. Detail f r o m an i v o r y leaf o f a w r i t i n g tablet illustrating t h e Lai de

Vergile. French, 14th c e n t u r y . B a l t i m o r e , Walters A r t Gallery (71.267).
For w h e n girls have been c o r r u p t e d , a n d have been s c o r n e d b y their lovers

after they have i m m o d e s t l y c o p u l a t e d w i t h t h e m in t h e h o p e a n d p r o m i s e
o f m a r r i a g e w i t h t h e m , and have f o u n d t h e m s e l v e s d i s a p p o i n t e d in all their
h o p e s a n d e v e r y w h e r e despised, t h e y t u r n t o t h e help and p r o t e c t i o n o f
devils; either for t h e sake o f v e n g e a n c e b y b e w i t c h i n g t h o s e lovers o r t h e
w i v e s they h a v e m a r r i e d , o r for t h e sake o f g i v i n g t h e m s e l v e s u p t o e v e r y
s o r t o f lechery. Alas! e x p e r i e n c e tells us that t h e r e is n o n u m b e r to s u c h
girls, a n d c o n s e q u e n t l y t h e w i t c h e s that s p r i n g f r o m this class are i n n u -
m e r a b l e (part 2, q. 2, c. I). 5 7
T h e hyperbole invites us to consider the emotional subtext of the au-

thors' claim rather than its empirical accuracy. Men w h o have p o w e r and
wealth fear w o m e n w h o don't. Like the vision of the hapless H u k b e r t in
O d o of Cluny's story, the Malleus embodies a nightmarish fantasy of w o m -
en's vengeance for the ills they have suffered; retribution takes the f o r m of
witchcraft and magically caused lovesickness. T h e authors project o n t o
w o m e n a psychology of revengeBrought
that we have
to you by seen at w o r University
| Cambridge k in the stories
Library of
Authenticated
Jacques de Vitry, Hippocrates, and Vergil. They cast men as the helpless
victims, not of their own desires, but of the external, demonic agency of
witches. T h e whole tenor of the Malleus, a blend of hair-splitting scho-
lastic argumentation and disturbing images f r o m collective fantasies about
women, indicates that the rationalized explanation, whatever its degree of
truth, screens a more general and basic fear of and anger toward w o m e n .
T h e Malleus suggests, then, that medieval lovesickness may have involved
displaced, somaticized forms of hostility and fear. 58
In a mid-fifteenth-century Dialogue between a Noble and a Rustic the
lover's malady is presented as a class-specific f o r m of fear of w o m e n . T h e
author explains that what the nobleman views as the "natural disease"
(naturalis infirmitas) of lovesickness, described by Avicenna, the rustic expe-
riences as magical attack; he considers himself "infected" and "molested by
a woman's secret wiles." 5 9 Fear of "women's secret wiles" is displaced and
objectified in the commoner's case as magical attack, in the case of the n o -
bleman as the disease of love. T h e author thus articulates what is hidden
f r o m the surface of the elite medical treatises, though implied by their
metaphors. T h e "natural infirmity" of lovesickness is an upper-class nat-
uralization, and therefore mystification, of a fear of being victimized by
"women's secret wiles."
Lovesickness and "Courtly Love"

This analysis suggests that the social origins of lovesickness may be sought
in circumstances where aristocratic men, already vulnerable to melancholia
and lovesickness f r o m precarious childhood ties, exerted an inordinate level
of power over women, generating fears of reprisal. Circumstances where
w o m e n temporarily or symbolically assumed power, reversing the usual
hierarchical arrangement, would also generate masculine anxieties condu-
cive to lovesickness. Indeed, the two conditions overlapped in late medieval
aristocratic culture. M e n like Gadifer de la Salle, the "powerful m e n " of the
Malleus, and the noble men w h o m the physicians described—these were the
men w h o idealized or played at idealizing w o m e n w h o both were inferiors
in the natural hierarchy and were increasingly losing effective social power
as well. Generalizations about w o m e n in the later Middle Ages and early
modern periods are admittedly difficult. There is, nonetheless, an observ-
able trend toward a tightened hold of patriarchal authority within the family
and the economy. 6 0 It is especially evident in handbooks of conduct for
w o m e n of the upper levels of society. T h e Knight of the Tour Landry in-
structed his daughters to be submissive, humble, and obedient toward men,
and Philippe de Mézières advocated the same for married w o m e n of the
Authenticated
nobility. Even Christine de Pisan, w h o elsewhere shows with eloquent pain

the sufferings inflicted by patriarchal culture on w o m e n , advocates obedi-
ent submission to husbands w h o may be brutally violent in her treatise on
women's conduct. 6 1 T h e sexual hierarchy was transmitted through the
family, and enforced by fathers and husbands, in the worst of cases with
violence as we see in Figure 8.7. A law in fourteenth-century Flanders, for
example, "stipulated that the husband may beat his wife, injure her, slash
her body f r o m head to foot and ' w a r m his feet in her blood.' " 6 2
T h e conventions of courtly literature, no matter h o w seriously enacted,
could not eradicate the strong medieval sense of hierarchy in which man's
place was at the top. " W h o , then, reveals himself such a fool and m a d m a n
as to try to obtain what forces him with oppressive serfdom to subject h i m -
self to another's dominion, and to be wholly tied to another's will in all
things?" asks Andreas Capellanus. 6 3 Even in playing out courtly conven-
tions the customary sexual and social hierarchy asserts itself. A thirteenth-
century French "Minneallegorie," La Puissance d'amour, counsels the lover
that when the w o m a n seems about to grant his desires, he should remain
master of himself ("sires de vous") in order to prevent her f r o m seizing
mastery. T h e fragmentary thirteenth-century text On True Love well illus-
trates the tension between service and hierarchy. O n the one hand, a lady is
advised to love below her station so that she can have the greater obedience
of her lover, and a man is advised to love above his "because a lover is
transformed according to what he loves." O n the other hand, a woman's
use of the polite plural pronoun {vos) to her lover, and the man's use of the
familiar singular (tu) to her is grounded in the fact that " w o m a n is naturally
subjected to man because she was made f r o m him." 6 4
Nonetheless, to paraphrase Chaucer's Franklin, those w h o were to be
"lords in marriage" did play at being "servants in love." T h e lover's abjec-
tion is perhaps most clearly expressed by Guillaume de Machaut, w h o
wrote that his lady should not merely consider him her servant, but hold
him in servility as her serf: "Eins me deves tenir en vo servage / C o m m e vo
serf qu'avez pris et acquis" (Balade C C X X X I ) . 6 5 To the extent that the
courtly conventions of service and idealization were internalized or acted
out, then, they conflicted with powerful structures of masculine dominance.
The strain between the two cultural models for upper-class masculine be-
havior was undoubtedly increased by the deep currents of antifeminism.
Just as love service ran counter to men's usual precedence, so idealization of
women ran counter to a long tradition of denigration. Once again Andreas
provides the commonplaces: " T h e y are prone to every evil"; "Women can-
not be in full possession of outstanding character"; "So it seems that no
man of sense fittingly binds himself to a woman's affection, because she
Authenticated
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ι tropratrmamar
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e τ irmene^ tri trfljattMc
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Figure 8.7. A husband exercises his authority by beating his wife with a
e t eftiium asme mt tome
stick (Paris, ca. 1405). Guillaume de Lorris and Jean de M e u n g , Roman
ο tntr \»ttsmmr ctt male fCDtname

de la Rose, fol. 54, detail. Malibu, C A , T h e J . Paul Getty M u s e u m .
( 8 3 . M R . 177, ms. L u d w i g X V 7).

Authenticated
never continues to reciprocate anyone's love, and she must clearly be con-
demned for all the strong reasons already enumerated." 6 6 To practice love
service to an idealized w o m a n — t h a t is, to take the conventions seriously at
whatever imaginative or active level—was to abase one's o w n sense of self,
of masculine superiority.
Figure 8.8, a fifteenth-century parade shield depicting a knight's sub-
mission before his lady, shows h o w one artist symbolized the courtly lover's
dilemma. A scroll bears the words "You or Death." T h e kneeling lover is
separated f r o m his lady by the center line of the shield. Death, much closer,
occupies the same space as the lover, and even seems to touch him. Death
also mirrors the lady's stance, in effect becoming her double. T h e scene
powerfully signals the psychological threat contained in courtly love by i m -
plying that there is no choice between " Y o u " and " D e a t h . "
Duplicity and lovesickness were two culturally sanctioned ways of deal-
ing with this threat. As the Art d'amours and other works suggest, in some
circles lovers had to pretend to serve their ladies in order " t o enhaunce t h e m
self and for to drawe vnto them the grace and veyne glory of the w o r l d . "
Richard of Fournival warns against dissemblers w h o assume the posture of
service without meaning it f r o m the heart. 67 Chaucer creates a number of
characters w h o illustrate the problem: the glib, false-hearted Diomede, rival
to the lovesick Troilus; the tercelet of the Squire's Tale w h o " m a n y a yeer
his service . . . feyned"; and Jason, w h o in the Legend of Good Women is the
model of deceitful lovers:
T h o w madest thy recleymyng and thy lures

To ladies of thy statly aparaunce,
And of thy wordes farced with pleasaunce,
And of thy feyned trouthe and thy manere,
With thyn obesaunce and humble cheere,
And with thy contrefeted peyne and wo.
There othere falsen oon, thow falsest two!
O , often swore t h o w that thow woldest dye
For love, whan thow ne feitest maladye
Save foul delyt, which that thow callest love! (1371-80)
Jason's strategy of "contrefeted peyne" makes literary and psychological

sense in cultural circles dominated in reality by men but in which love ser-
vice (or talk of love service) is necessary for erotic or social success. D u -
plicity solves the contradiction between power and submission.
T h e other possible way of responding to this dilemma was lovesickness.
T h e success of the lover's malady in the later Middle Ages as a literary pos-
Authenticated
Figure 8.8. T h e scroll above
the lover o n this fifteenth-
c e n t u r y Flemish parade shield
says "You or D e a t h . " R e -
produced by Courtesy of
the Trustees of the British
Museum.

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ture, as a seduction ploy, and as an illness requiring treatment rested on its

ability to modulate an erotic subjectivity that contravened the realities of
gender roles and power relations. Amor hereos mediated between a perceived
social ideal of desire for an idealized woman w h o m one served and the con-
tradictory social and psychological reality of her inferiority. Insofar as ide-
alized love requires a deposition of men's power, a willed vulnerability, so
to speak, it may have been difficult to act out without serious disturbance
of men's sense of self. A dubious desire may have seemed less threatening if
alienated f r o m its origin in the lover and expressed as the morbid t h o u g h
curable delusion of loving a w o m a n " m o r e noble" than she is in reality. T h e
anxiety, hostility, and fear accompanying a socially problematic desire for
an idealized w o m a n could thus be displaced and objectified as the disease
of love.
T h e preux chevalier Gadifer de la Salle's knightly career "gives a flavour
of the violence of the times" and included charges against him of murder
and abduction. He could give himself over to the amorous courtesies of the
C o u r t of Love, we may imagine, because the mal d'amour was a socially-
recognized way of coping with love, hostility, and the inversion of gender-
power relations. By suffering love as a disease, or by imagining himself to
do so in poetry, the lover could alienate himself f r o m responsibility for this
dubious desire and yield himself to its most intense degree. Passion could
thus become a sign of "noble love" and the "feminine" state of illness be
reclaimed into a masculine sphere of value.
That reclamation was aided by a transformed sensibility concerning
masculine values. T h e ethos of courtliness itself represented a "feminiza-
tion" of aristocratic behavior and sentiment in comparison with that of the
earlier Middle Ages. Suffering itself was exalted by Christianity, perhaps
nowhere more so than in the later medieval cult of the wounded, broken
Christ. An early fourteenth-century pietà (Figure 8.9; compare the emacia-
tion of Perdica in Figure 1.1) shows the male b o d y stripped, wounded, and
helpless, held by a powerful female figure. T h e disturbing image, which
deliberately echoes the iconography of Virgin and Child, contrasts with the
dominant values of physical strength, autonomy, and bodily wholeness so
valued by knights. Such qualities, necessary for their military exploits, were
also deeply ingrained in their sense of self and of their desirability. 68
Meditation on the Christian inversion of worldly values represented by
images like the pietà and crucifixion scenes (Figure 1.5) doubtless aided men
in allowing themselves the vulnerability of lovesickness. T h e pierced and
broken body of Christ was both a culturally sanctioned image of masculine
suffering for love and a psychological model for the individual. Moreover,
the homiletic theme of Christ the Lover-Knight w h o languished for his
Authenticated
Figure 8.9. Pietà R o e t t g e n . B o n n , R h e i n i s c h e s L a n d e s m u s e u m (Inv. nr. 24189).

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bride, the human soul, further encouraged imitation of the Savior's love-
sickness. If Christ himself had suffered lovesickness to the death, then his
human imitators may have found it possible and strategic to do so as well. 69
Lovesickness as Cultural Symptom

This chapter has attempted to recreate a context in which amor hereos was
meaningful both as a literary commonplace and as a f o r m of behavior. We
have seen how it could resolve psychological and social tensions in aristo-
cratic male patients. Yet there is another level on which the large b o d y of
medical writing about lovesickness calls for further interpretation. What
functions did it serve for the teachers and students w h o pored over the
manuscripts of Constantine and Avicenna and w h o debated love's causes
and cures?
Taken as a group, the medical discussions of lovesickness enabled the
commentators and their students to master, through scientific discourse,
powerful collective anxieties over erotic love. T h e physicians w h o w r o t e
about love were particularly well placed to articulate this cultural strain,
mediating as they did between the worlds—and worldviews—of clergy and
laity. From the twelfth century onwards, medicine was increasingly secular-
ized; it moved f r o m the monasteries to the urban universities where it was
regulated and professionalized throughout the course of the later Middle
Ages. T h o u g h not secluded f r o m the world as the monasteries ideally were,
the universities were nonetheless dominated by a clerical culture hostile to
w o m e n and the pursuit of passionate love. 70 As Chaucer's Wife of Bath says,
" N o w o m m a n of no clerk is preysed."
Yet on the other hand, the professors w h o wrote and argued about
lovesickness were also practitioners whose clientele was the nobility and the
urban well-to-do. These patients were likely either to be literate or to enjoy
the literacy of clerks; they were the patrons of vernacular literary culture,
and hence those most able to absorb and act out the ideals of courtly behav-
ior. Both patients and physicians were schooled in a c o m m o n literary cul-
ture of love that was stocked with the rhetoric of love as illness and
countless examples of languishing lovers.
And let us not forget the audience of the masters' teaching, the young
male students of the universities, the bachelors. 71 Unmarried, away f r o m
home and kin, of an age, according to the theorists, most suited to love, the
students were on their own against the world, the flesh, and the Devil. T h e y
were grounded in vernacular literature and in the Latin authors w h o spoke
of love, and yet as clerks they were theoretically bound to the ideals of
continence, sobriety, and nonviolence, however lustful, drunken, and vio-
Authenticated
lent their actual behavior was. 72 T h e masters of medicine expounded their

views of the disease of love to an audience of young clerks caught between
the lure of secular pleasures and the ideals of their station.
While courtliness in general is an ethos of self-mastery, ritualizing and
aestheticizing basic libidinal and aggressive drives, the essence of "courtly
love" is its excess, its failure to remain within the bounds of normal social
behavior. As the prince Arcite asks rhetorically in Chaucer's Knight's Tale:
" W h o shal yeve a lovere any lawe?" T h e discourse of lovesickness—
articulated by men and sustained through generations of male teachers and
students—allowed the psychological and somatic " r i o t " of femininity and
vulnerability, which threatened self-control and masculine identity at the
most fundamental bodily levels, to be ordered and controlled within a ratio-
nal (masculine) universe of causes and cures. The corpus of European texts
on lovesickness can therefore be viewed as a counterweight to the energies
unleashed by the powerful idealism of love.
T h e entire body of medical texts, Arabic and European, available in the
West f r o m the late eleventh to the fifteenth centuries both fostered and re-
sponded to medieval views of passionate love. T h e Arabic texts in transla-
tion were appropriated by European intellectuals at the same time that the
troubadours sang their vision of idealized love. T h e authority and pragma-
tism of the medical descriptions of lovesickness were able to assist the evo-
lution of a cultural fantasy into social reality. " I ' m dying of love" became
both a cliché and a medical possibility, remote but dreadful. Once romantic
ideology had become a social practice that the nobility had to reckon with,
the medicalized vision of lovesickness enabled lovesick aristocrats to cope
with their o w n erotic vulnerability.
Women and Lovesickness: From the Middle Ages

to the Renaissance
Women as loving subjects, in contrast to desired objects, have been con-
spicuously absent f r o m m y account. This is in part due to the fact that when
medieval physicians theorized the disease of love, they understood it as a
masculine ailment. As noted in the beginning of chapter six, however, in
literature w o m e n were no strangers to the lover's malady, and historical
w o m e n appropriated to themselves the language of mystical love-languor. 7 3
If, as I have argued above, a single dynamic underlies mystical love and
lovesickness, h o w do we explain the absence of w o m e n f r o m the academic
medical tradition when they seem to appear everywhere else as subjects of
lovesickness? And to complicate the problem further, w h y do they emerge
f r o m their obscurity in medieval medical sources to become prominent vic-
tims of love in Renaissance medical
Broughtaccounts? To resolve
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University questions
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p r o p e r l y requires a n o t h e r b o o k ; I shall close this o n e b y indicating w h e r e

answers m a y f r u i t f u l l y be s o u g h t .
T h e relative silence of the physicians c o n c e r n i n g w o m e n follows f r o m ,
in the first instance, their p r e o c c u p a t i o n w i t h analyzing amor hereos f r o m a
masculine perspective. If I a m right in s u g g e s t i n g that the discourse o f love-
sickness was a way of w o r k i n g t h r o u g h collective anxieties that w e r e p a r -
ticularly intense at the universities, then this self-absorbed analysis held little
r o o m for w o m e n except as desired objects o r the means o f cure.
M o r e o v e r , men's lovesickness needed explanation and cure because it
m a d e t h e m " o t h e r . " Its signs and s y m p t o m s feminized t h e m , separated
t h e m f r o m n o r m a l masculine ways of behaving. B u t t h e s a m e signs and
s y m p t o m s w o u l d only render a w o m a n m o r e feminine. Since they o n l y
reinforced w h a t was perceived as her nature, they required n o diagnosis
or cure.
Given these reasons f o r w o m e n ' s invisibility in academic treatises, their
appearance in Renaissance medical accounts of lovesickness is all t h e m o r e
puzzling. Historians of medicine have n o t e d a tendency a m o n g medical
writers o f the Renaissance n o t merely to consider w o m e n subject to m o r b i d
love, b u t to d e e m t h e m , as did Jacques Ferrand, the p r i m a r y victims of the
malady, o r at least particularly susceptible to it. 74 Cases o f lovesick w o m e n
f r o m Renaissance medical w r i t e r s are o f t e n d r a m a t i c and m e m o r a b l e . For
example, in 1565 Pieter van Foreest (Petrus Forestus) treated a y o u n g
w o m a n w h o s e family had called h i m in w h e n she fell into c o n v u l s i o n s as
the result of unfulfilled love. B y testing her pulse he discovered the object
of her love, and a r r a n g e d w i t h her parents to m a r r y her to the y o u n g m a n
in question, w h i c h cured her illness. 75 In the seventeenth century, D u t c h
genre painting included the r e m a r k a b l y p o p u l a r subject k n o w n as " T h e
D o c t o r ' s Visit" (cf. Figures 6.4, 7.3), in w h i c h a physician e x a m i n e s a y o u n g
w o m a n languishing f r o m the " m a l d ' a m o u r . " 7 6 A l t h o u g h m e n still c o n t i n -
ued to suffer f r o m lovesickness, it became, in s o m e p o s t - m e d i e v a l medical
texts, gradually identified w i t h o r considered a cause of o t h e r " f e m a l e dis-
o r d e r s " such as chlorosis, hysteria, and n y m p h o m a n i a . 7 7
Herein lies a clue to the change. As I have suggested in chapter six,
Peter of Spain's discussion of the role of g e n d e r in lovesickness o p e n e d t h e
way f o r others to p o n d e r the links a m o n g sexual physiology, pleasure, a n d
love. In any case it is clear that a certain branch of medical w r i t e r s o n love-
sickness began to consider it a disease linked t o the sexual o r g a n s and their
h u m o r s . O n c e connected directly to p a t h o l o g y of the sexual o r g a n s , love-
sickness may have then b e c o m e " v i s i b l e " as a disease of w o m e n , since w o m -
en's ailments received special notice insofar as they were related to sexual
physiology. 7 8
To this c h a n g e w i t h i n medical t h ito
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pressures. T h e recovery o f ancient texts brought Galen's story o f the love-

sick wife o f Justus to Europe in the fourteenth century. His authority may
have encouraged physicians to " s e e " what he saw. Similarly, the humanistic
study o f ancient literature (on which Renaissance doctors prided them-
selves) enabled the physicians to ponder the famous lovesick women o f an-
tiquity: Sappho, Medea, Dido, and a host o f others.
All o f these factors would help account for the change in medical writ-
ing. Was there a corresponding change in the social reality o f lovesickness?
Did women suffer from it in actuality as well as on paper? Once again, a
proper answer would entail a detailed interdisciplinary study, and only brief
suggestions can be offered here. Marriageable women outnumbered eligible
men in the early modern period. With marriage closed to them, and with
patriarchal enforcement o f female chastity, they had little hope o f sexual or
romantic fulfillment. Lovesickness may have been a strategy, as in the case
related by Foreest, by which young women could gain the " c u r e " o f mar-
riage. In this case lovesickness would serve as a form o f negotiation for
marriage rather than mediate the masculine dilemma o f dominance and
submission.
Other social conditions affecting women besides a difficult marriage
market deserve investigation as potential determinants o f lovesickness. As
Boccaccio, a master hand at setting the social stage for his stories, wrote in
the Decameron, "melancholy ladies" had time on their hands for erotic rev-
eries, and leisure, as the medieval doctors tell us, is one o f the reasons why
the nobility suffer from love. Working men are too busy to spend their time
in idle obsession with erotic fantasies. Social historians o f women in the
early modern period may be able to clarify whether women's lovesickness
was related to increasing leisure for wealthy middle-class women.
More difficult still, though perhaps more rewarding, would be to in-
vestigate the psychological consequences for women o f the social restric-
tions o f early modernity. In view o f the powerful connections between
melancholy, anger, and lovesickness in men's erotic life, such investigation
might fruitfully consider whether the tightened grip o f patriarchy was re-
sponsible for a somaticization o f women's anger in the form o f lovesickness.
Such research would not only clarify the important question o f possible
gender asymmetry in the psychology o f lovesickness, but also illuminate
the diverse, historically contingent ways in which lovesickness reduces
anxieties and mediates psychological conflicts. A study o f women's love-
sickness will, finally, enlarge our understanding o f how the various dis-
courses on the lover's malady condition individual, historical, and gendered
experiences o f eros.

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PART ONE

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Passionate love . . . [is] a fragile crest where death and regeneration

A s antiquity gave way to the Middle Ages, an unknown poet in fifth-

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T h e m o t h e r ' s a t t e m p t s to c o m f o r t her son w e r e in vain; t o r n b y love

Medical Texts of Antiquity

lematic that w e have seen in Perdica's Malady and that resurfaced in t h e

Lovesickness first b e c o m e s a significant part of medical tradition in t h e

views of lovesickness characterizes the medical tradition as a whole. T h a t

In addition to d e n y i n g that love is a divine illness or an affliction of the

on love under a separate heading, implying its status as a distinct disease,

mania and melancholy, as well as from Oribasius' and Paul of Aegina's

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In Caelius Aurelianus' Platonic f o r m u l a t i o n , an insane person cannot fall in

cholici are luxuriosi because lechery arises f r o m " f u m o s i t y " or smokiness.

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While Isidore c o m p o s e d the m o s t widely-read encyclopedia of the early

Lovesickness in Classical Literature

T h e magister amoris O v i d taught that sickness could be an artful strategy

Lovesickness in Christian Sources

of the sacred text never failed to p r o d u c e a strong impression o n the m i n d .

T h a m a r comes to minister to her sick brother. " A n d w h e n she had p r e -

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Amnon's lovesickness is both real and feigned. It is real enough to cause

pattern of behavior. T h e illustrated Bible moralisée declares that A m n o n r e p -

which s o m e o n e w h o loves is in such rapture that it barely permits h i m to

The Crucified Christ, Model of Love and Suffering

n o w no m a n may despise m e ? " (8.1) T h e r e is m u c h to dwell on in the

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psychologically as a double for C ú Chulainn's wife, then his passionate affair

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T h e generations on either side of 1100 found themselves in a rapidly

element, I am like a leaf the winds play with). 4 T h e materiality of the

We k n o w for certain little m o r e about Constantine than that he was

Figure 2.1. Portrait of a physician, perhaps meant to be Constantine

one apparently f r o m thirteenth-century Salerno, the other f r o m f o u r t e e n t h -

great honor. Constantine then went to Montecassino, where Abbot Desi-

Figure 2.2. D o c t o r treating a patient. F r o m t h e Maqämät o f a l - H a r i r i (1122). V i -

b u t also theology, j u r i s p r u d e n c e , p h i l o s o p h y , and medicine analyzed, d e -

ture, o n the o t h e r it p e r m e a t e d literary depictions of passionate love. " I t is

O h you, m y sickness and m y healer, in b u t a w o r d f r o m y o u lies the cure

T h e Islamic n o t i o n of cishk in all its c o m p l e x i t y , then, m a y have p e n e t r a t e d

Constantine s medical translations and at about the same time (1050-1150)

Eros and Pleasure

medieval Islam a n d C h r i s t i a n E u r o p e (that is, it is salutary to be sick w i t h

thereby infringed; dietetic medicine, study, and p h i l o s o p h y could amelio-

αητκιιη. Ü abiô gtfiçratih ί pira-

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Figure 2.6. According

Johannes Ajflacius and the " Liber de héros morbo"

n e o l o g i s m eriosis, so J o h a n n e s (or w h o e v e r was the a u t h o r of the Liber)

The V i a t i c u m ' s Popularity and Influence

Chartres, 1161 in Hildesheim, and appear in twelfth-century library cata-

T h e Viaticum s division of the causes of passionate love into physical

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I n the century after Constantine had renewed the vigor of European

Gerard's commentary on amor (h)eros, marked by the Aristotelianism

Calling himself "Magister Gerardus Bituricensis, professione phisicus,"

Figure 3.1. A m a s t e r o f m e d i c i n e a p p a r e n t l y teaches t o t h e back o f t h e

a r o u n d 1194, it is difficult to i m a g i n e that G e r a r d w r o t e the c o m m e n t a r y in