Saturday, February 1, 2014

A FOURTEENTH CENTURY DIETETIC: 1. What is a dietetic?

This is one of several posts exploring a dietetic written in the fourteenth century by a certain “Brother Leonard” at the monastery of St. Jacques in Liège (today in Belgium). In 2007, Geneviève Xhayet published a transcription, with notes and commentary, of this Latin work and these posts reference that transcription. 

The other posts are:

2. Brother Leonard on diet and health
3 Belgian (Walloon/Liègois) food in the fourteenth century
Brother Leonard on behavior and attitude


In 2007, the Belgian scholar Geneviève Xhayet published a transcription of a previously unknown fourteenth century dietetic: "the 'Health Regimen' of brother Leonard de Saint-Jacques". Saint-Jacques in this case was an abbey in Liège, founded in the eleventh century, an abbey which had once had "a rich collection of scientific and medical works". This collection, subsequently dispersed, was mainly made up of various Latin medical works of the Middle Ages, but also included a number of original works, including several attributed to frater or nonnus Leonardus, sacerdos et monachus monasterii, Sancti Jacobi Leodiensis. Little is known about this monk, beyond the fact that he was one and died on September 26, 1401. Beyond his writings, no evidence survives of him playing a particularly medical role.

Food and medical historians both have good reason to be delighted by the appearance of a previously unknown dietetic work, since such works typically touch in equal parts on food and medicine. This is all the more the case in that of Brother Leonard's, which not only takes a very individual, even idiosyncratic approach, but in large part references specifically Belgian food (information on fourteenth century Belgian food is, to say the least, not common). Yet since Xhayet published her very useful, and richly annotated, transcription, it seems that it has not inspired further examination or commentary. This and the next few posts will seek, in a modest way, to remedy that, examining this document under different lights.

First, however, some readers will have a simple question: what exactly is a dietetic?


Since such works often address food, a modern reader might reasonably think that a dietetic was a work on diet in the modern sense. But if the term is sometimes used in that way, a classic dietetic – or, more typically "dietetic work" – was more broadly a work on dietetics, an ancient discipline which Jouanna explains as follows:
We must begin by clarifying what Greek doctors understood by the Greek word diaita.... from which derive the English words 'diet' and 'dietetics', since the modern definition, which restricts diet to food, does not correspond exactly to the conceptual understanding of the ancient doctors. In certain Hippocratic treatises... diaita has a restricted meaning of alimentary diet, comprising of food and drink. However, Hippocratic doctors also generally understand diaita to include exercise... This technical sense of diaita is a more specialized form of its usual meaning, which refers more widely to the ways of life or habitual behavior of an individual or people, including their dwellings...
If we wish to be more precise about what Greek doctors understood by diaita over and above the principal triad of food, drink and exercise, we must add some secondary elements, in particular bathing and, sometimes, sexual relationships.
Finally, diaita can refer to the regimen of people who are in good health and to that of people who are sick.
In modern terms, this might be summed up as "good health through good habits and good diet". As Xhayet puts it: "Health regimens have the particularity of discussing preventative medicine and of addressing a public of users, not specialists in medical discipline. They define a life hygiene guaranteeing those who follow it a healthy existence." (The term “hygiene”, which tends today to refer to cleanliness, also originally refers to a more general approach to personal health.)

If the specifics of dietetics have largely been discredited, the underlying principle has returned in force; innumerable tomes on diet, exercise, meditation, etc. now again promote the idea that health depends less on intervention by doctors and more on individual choice.

Dietetic works can be categorized in different ways. Xhayet, for instance, speaks of two models:
One is the monthly or seasonal regimen which, deriving in the last analysis from the Hippocratic regimen, attempts to put Man in harmony with his environment and its modifications through the year. From late Antiquity on, the tradition of hygienic advice according to the period of the year is spread in the Latin West in the form of dietetic calendars.....
The second model rests on the action of "non-natural things", that is factors exterior to Man which influence his humoral balance. Such regimens examine in succession the effects of air, of sleep and waking, of movement and rest, of food and drink, of becoming full and evacuating, finally the various emotions or "accidents of the soul" on the balance of humors in the organism.
Another way to distinguish between such works is by their formats, which can include:
  • Full length works on medicine and/or health
  • Succinct guidelines
  • Church calendars
  • Regimina sanitatis (health regimens)
Foundational works of Western medicine, notably those of Hippocrates (c. 460 – c. 370 BCE) and Galen (129 – c. 200/c. 216), are often dietetic in nature; to a large degree, they established the very precepts of the concept. Both these writers left works specifically on food, and so closer to the modern idea of a dietetic work, but overall the idea that good habits and diet are essential to good health is fundamental to their work.
Diet is the topic found most frequently in the works that make up the Hippocratic corpus. De prisca medicina treats the medical art as a step on the progressive discovery of a regimen of life, which came on the heels of the discovery of the rules of cooking. Another treatise, De diaeta [Regimen], constitutes the culmination of dietetic learning in the classical period. Dating from the end of the fifth century B.C., it declares that health is dependent on the balance between what one eats and what one's body consumes....
With Galen, hygiene acquired its titles of nobility; this was chiefly by virtue of the synthesis that he carried out among the Hippocratic ideas, Aristotelianism, and the discoveries of Hellenistic science....
Galen's conception of health postulates the existence of an ideal equilibrium, a perfect harmony.
(Sotres)
Of Galen's works, De cibis boni et mali succi, in particular, addresses foods and their qualities as its main subject; for example: “Peas indeed lack windiness, however they do not cleanse as much as broad beans. As for lentils, that they produce bad and melancholy juices, almost no one does not know.”

A number of later writers, influenced by one or both of these major figures, also wrote full-length works largely guided by dietetic principles.

A rare example of a dietetic reduced to succinct guidelines is De Observatione Ciborum, the letter the Greek physician Anthimus (early sixth c.) wrote to the Frankish king Theuderic on food. Anthimus begins with an overview of the value of good diet to health: “if the food has been well prepared, it is well digested and gives pleasure and nourishes good humors. Health clearly consists first of all in this. Thus he who chooses to follow these ways will need no other medicine.” He then methodically passes in review the foods he believes available to Theuderic and the best ways to prepare them, as well as, often, their inherent qualities in regard to health: “Sometimes one may wish <to take> the flesh of cranes, though they have black meat and engender melancholic humors.”; “Wild pigeons are not suitable. But the squabs of domestic pigeons are fit and good and for both the healthy and the sick, either boiled or above all roasted.” As brief as it is, De Observatione Ciborum is an exhaustive and even valuable dietetic work – one which in this case strictly addresses diet in the modern sense.

Note too that Anthimus addressed his advice to a powerful figure; the same was true of a number of later dietetic works as well.

Church calendars had a much broader agenda than health. In general. life in the Middle Ages followed a rhythm defined by the various feasts and celebrations of the Church; this was all the more true for monks. It is generally believed that the Venerable Bede (c. 672/673 - 735) was the first to include dietary guidelines in the calendar that ruled his monks' daily lives. Here for instance is part of the entry for January:
In January do not be bled. Take a potion against congestion [“suffocation”], take pills; take a cup full of the best wine at breakfast to infuse the blood. Take ginger and rhubarb.
(Note that this also shows that the practice of being regularly bled for one's health already existed by the eighth century.)

But similar stipulations can be found in a number of later calenders – so many, in fact, that Borst has collated a number of these into a kind of master Church calendar. The entry for each month begins with a variety of sections with statements on the month and its associations, the key holidays for the month, synonyms for the month, etymologies, and then a (typically brief) section on “Remedies”. The remedies for January are substantially the same as Bede's, but in footnotes Borst provides variations from other documents, such as this one: "In January you must drink ginger and rhubarb with white wine, or others say costus and clove." Other variants for that month offer different degrees of bleeding (or not), different potions to take, and different amounts of wine.

By far the most popular format for such works was that of the "health regimen" (Regimen Sanitatis). Of these, the most famous was Regimen sanitatis Salernitanum, a work in verse of uncertain origin (possibly but not certainly the School of Salerno) and date (anywhere from 1050 through the thirteenth century). The opening says that it was written to “the English king” and one tradition has it that it was dedicated to Robert Curthose, oldest son of William the Conqueror. That section includes this simple, and classic, summation of the dietetic approach:
if you lack doctors, make your doctors
these three: a joyful mind, rest, moderate diet.
One of the most famous versions of this work follows extracts of the verse with extended comments and is usually credited (though not without debate) to Arnaud de Villeneuve (c. 1235 – 1311).

But a large number of other Regimina sanitatis are known. One, with the French title of Régime de Santé, was written (probably in 1256) by Aldobrandino of Siena (d. 1287) at the request of Beatrix of Savoy (1198 - 1265/1266). This is often considered the first medical work in French (though that was not the author's native language). Landouzy and Pépin, who published a version of it in 1911, note that “while the commandments of the Regimen Sanitatus [of Salerno] derive directly from Latin translations of Hippocrates and Galen..., Aldobrandino's treatise was... entirely borrowed from Arab doctors, and especially from Avicenna." This is an important shift, since a long tradition of these works now existed in the Arab world and became central to Western works on the subject.

The editors describe the work's sections as follows:
The first discusses general Hygiene and the means intended to maintain physiological balance; in the second are laid out the cares to give the organs in particular: stomach, liver, heart, eyes, hair, etc.; the third part, entirely dedicated to Dietetics, enumerates the different qualities and properties of all foods, animal as vegetable; the fourth, entitled Phisanomy, teaches how to recognize the moral aptitudes of individuals by their physical characteristics.
(Note that these twentieth century authors use “Dietetics” to refer only to food; Aldobrandino himself might have had a broader understanding of the term.)

Aldebrandino methodically reviews foods in different groups, making comments like these: "Cloves are warm at the sixth or third degree"; "Chervil is warm and dry at the second degree"; "Meat of young sheep is less viscuous and less moist, but it is dryer than that of milk fed lamb or sheep, and so, is better to eat."

Arnaud de Villeneuve, who also wrote in the thirteenth century, left a Regimen Sanitatus (in addition to the comments credited to him on the school of Salerno's work). Before looking at food in that work, he reviews a number of other subjects, such as the differences in individuals' make-ups, and in sexes and regions, as well as subjects like coitus and exercise. The general section on food summarizes various qualities of various types of food, but it is followed by separate sections on legumes, fruit, greens, etc. which look in more detail at some of these. A later section looks at what food to use on a sea voyage.

Along the way, here and in a number of other works, Villeneuve offers specific recipes for preparations as different as green sauce and royal paste (essentially preserved ginger). As a result, though he does not examine food and drink in quite as methodical a way as writers like Anthimus and Aldobrandino, he records invaluable culinary details and so is often cited by food historians.

These are only highlights of the Regimine Sanitatis genre. It is wide-ranging and a study in itself.


Leonardo's dietetic has elements of all but the first of these formats. If the work is not as short as Anthimus', it is nonetheless far shorter than the other works cited here and generally laconic in style. Its initial approach is that of a Regimen Sanitatis, first addressing such things as sleep, staying warm, mental attitude, etc. before moving to a general look at certain foods. Then the longest section of the work begins, methodically following the Church calendar. This (now incomplete) section differs from a classic Church calendar mainly in focusing on food and is correspondingly more succinct.

Relative to other dietetic works then, it is something of a hybrid and virtually in a class of its own. Brief as it is, it can repay careful examination and next week that will begin with a look at the work's (in many ways unique) approach to health and medicine.



FOR FURTHER READING:












Hippocrates, Janus Cornarius, Johannes Culmann, Opera quae ad nos extant omnia 1567




(For an English version, see my own translation: 












No comments:

Post a Comment