Medical writing in Irish, 1400-1700

by Aoibheann Nic Dhonnchadha

The extensive corpus of medical writing that survives in Irish comprises more than a hundred manuscripts written during the period c. 1400 to c. 1700. These documents, most of which are housed in Irish libraries, are the most important written record extant for the institutional organisation and medical practice of physicians in late medieval and early modern Ireland and Scotland.

Medical kindreds

Professional medicine in the Gaelic world of the time was the preserve of a number of learned families who exercised their occupation on a hereditary basis. The hereditary principle was a distinctive organisational feature of the Gaelic learned orders in general, being adhered to also by poets, lawyers, historians and musicians. Among the most eminent medical kindreds of Munster during this period were the families of Ó Callanáin (Callanan), Ó hÍceadha (Hickey), Ó Leighin (Lane), Ó Nialláin (Nealon), and Ó Troighthigh (Troy); of prominence in Leinster were Mac Caisín (Cashin), Ó Bolgaidhe (Bolger), Ó Conchubhair (O’Connor), and Ó Cuileamhain (Culhoun, Cullen); particularly associated with Connaught were the families of Mac an Leagha (Mac Kinley), Mac Beatha (Mac Veigh), Ó Ceandubháin (Canavan), Ó Cearnaigh (Kearney), Ó Fearghusa (Fergus), and Ó (or Mac) Maoil Tuile (Tully, or Flood), and with Ulster the families of Mac (or Ó) Duinnshléibhe (Donleavy), Ó Caiside (Cassidy), and Ó Siadhail (Shields).

These kindreds were involved in medical practice over successive generations, and, collectively, were responsible for the organisation and regulation of medical schools, the formulation and development of a curriculum, the practical training of students, and the translation, composition and transmission of medical texts. Physicians enjoyed a high legal status in Gaelic society, and were supported by the hereditary tenure of lands that were granted to them by the landowning artistocracy in exchange for medical services.

Medical schools

Specific details of the establishment, organisation, and regulation of the schools of medicine that were conducted by the hereditary families in various parts of Ireland are scant. However, scribal colophons and marginal notes found in two manuscripts that were written largely in the medical school run by the Ó Conchubhair family at Aghmacart (modern Co. Laois) in the Mac Giolla Pádraig lordship of Upper Ossory provide some insight into the workings of such an institution. The principal scribes of the manuscripts in question were Risteard Ó Conchubhair (1561-1625), writing in 1590 in Royal Irish Academy (RIA) 439 (3 C 19), and Donnchadh Albanach Ó Conchubhair (1571-1647), a Scottish student at the school, writing in National Library of Scotland (NLS) 73.1.22 in 1596-1600.

It seems that for most of the period 1590-1600 the Aghmacart school was headed by Donnchadh Óg Ó Conchubhair (fl. 1586-1610), who, by 1590 certainly, and probably several years prior to that, had acquired the position of official physician (ollamh leighis ) to the third Lord Baron of Upper Ossory, Fínghean Mac Giolla Pádraig (d. 1613). A position as official physician to an Irish lord was one of the most prestigious medical appointments the country had to offer; such posts were limited in number, keenly contested, and richly rewarded. Evidence of Donnchadh Óg’s suitability for office is found in a comment made by Risteard Ó Conchubhair, a kinsman and student of his, who in a colophon written in RIA ms 439 (3 C 19) in October 1590 described his master as `the best of the doctors of Ireland in his own time’, adding in parentheses: `understand that he never left Ireland to study’. The names of a few Irish doctors who studied abroad during the period under review and who acquired the qualification `bachelor of medicine’ are recorded in the manuscripts, but Risteard’s statement suggests that at the close of the sixteenth century an Irish medical education and a continental one were regarded as equally worthwhile, and that a decision to remain at home was not an impediment to professional advancement.

Donnchadh Óg’s immediate forebears were physicians. The death of his father, Donnchadh Liath Ó Conchubhair, who was evidently a physician, and one of note, occurred on 15 August 1562 (RIA ms 996 (23 N 17), p. 121i ; Trinity College Dublin (TCD) ms 1372, p. 98), and a medical manuscript written in part by his grandfather, Giolla Pádraig mac Giolla na Naomh Ó Conchubhair, survives, National Library of Ireland (NLI) G 12. A brother of Donnchadh Óg’s, Conchubhar Ó Conchubhair, was described as a `surgeon’ in an English administrative document of 1566 (Fiants of Elizabeth, No. 897). Giolla Pádraig, a son of Donnchadh Óg’s, participated in the writing of both RIA ms 439 (3 C 19) and NLS ms 73.1.22, and it can be confidently assumed, therefore, that he too followed in his father’s footsteps.

It appears, however, that Donnchadh Óg’s appointment to the post of official physician to Mac Giolla Pádraig did not go unchallenged. Niall Mac Íomhair, a Scottish student who attended the Aghmacart school in 1596, noted in NLS ms 73.1.22 that the Mac Caisín family, another medical kindred of Ossory, were in contention with Donnchadh Óg regarding the post, unjustifiably so in Niall’s opinion since the Mac Caisíns were insufficiently skilled to be appointed to such a position.

The translation of texts from Latin and the provision of manuscripts for educational and reference purposes were two of the central functions of Irish medical schools. Translations made by Donnchadh Óg of short passages from the works of the Portugese physician, Valescus de Tharanta (fl. 1382-1418), and the Italian physician Niccolo Bertruccio (d. 1347) survive. It is clear from comments made by Risteard Ó Conchubhair and by Donnchadh Albanach that Donnchadh Óg actively supervised the writing of both RIA 439 (3 C 19) and NLS 73.1.22, and in two particular instances in the former volume Risteard states that the texts he has completed writing were copied from exemplars that had been written by Donnchadh Óg himself. Of interest too is the following note in which Risteard specifically mentions the existence of a schoolhouse at Aghmacart: `It is I Risteard son of Muirchertach [Ó Conchubhair] who has written [this] in the company of my master and kinsman in the schoolhouse (a ttech na sgoili ) in Aghmacart on the 6th day of March. And upon my word I am thirsty and hungry. 1590′ (RIA ms 439 (3 C 19), f. 254vbw-z).

Medical texts

Irish medical texts comprise in the main translations or adaptations of Latin treatises. A commentary on the Aphorisms of Hippocrates that was translated into Irish in 1403 by two medical scholars of Munster origin, Aonghus Ó Callanáin and Niocól Ó hÍceadha, is one of the earliest dateable translations, and one of the most widely disseminated in the manuscripts. The Aphorisms, a collection of just over four hundred concise statements on a wide variety of medical topics that had been arranged since the time of Galen (d. c. A.D. 200) into seven books, was the best-known work of the Hippocratic corpus, and one of the central texts of the Articella, the collection of short treatises that formed the basis of advanced teaching in medicine throughout Europe from the twelfth century to the sixteenth. Many of the Hippocratic aphorisms are difficult to understand, or capable of a variety of interpretations, and commentaries served the purpose of making the text more accessible to students by explaining difficult points in the light of standard medical doctrine. More than a dozen copies of the commentary translated by Ó Callanáin and Ó hÍceadha survive, none of them complete. The earliest dated copy, containing the final sections of the work, was written on an island in Loch Gara, Co. Sligo, in 1413 by a scribe who signs himself simply Gilla Padraig Albanach , `Giolla Pádraig the Scot’ (TCD ms 1318, cols 487.1-499a.24). Giolla Pádraig is otherwise unidentified, and his cognomen is ambiguous, being equally descriptive of a Scottish scribe working in Ireland or of an Irish scribe who had close associations with Scotland.

Herbals sought to provide the physician with information on the curative properties and medical application of plants. The most celebrated example of the genre in Irish is the herbal whose opening words are Arón barba, iarus, pés vituli, adhón tri hanmanna in geadair (`Aron barba, iarus, pes vituli, i. e. the three names of the cuckoo-pint’) and whose translation from Latin was completed by Tadhg Ó Cuinn, `bachelor of medicine’, on the Feast of St Luke, 18 October, 1415. The earliest dated extant copy of Ó Cuinn’s herbal, written mainly by Donnchadh Ó Bolgaidhe (fl. 1466-75), a Leinster physician, was completed in 1466, NLI ms G 11, pp. 1a1-67a41. In this copy the treatise comprises 291 articles of varying length arranged alphabetically according to the Latin names of the substances described. The text is mainly concerned with plants of course, but as is often the case in herbals, miscellaneous articles dealing with drugs derived from the animal and mineral worlds, with compound medicines, or related topics, are also included. Most plant sections are arranged in a similar fashion: the name of the plant is given in Latin and in Irish; its quality and degree follow, and an account of its medicinal properties, preparation and medical application. In Ó Bolgaidhe’s copy the usefulness of the text is augmented by marginal captions that cite parts of the body or conditions that the plants were considered to heal, or effects they were believed to produce; these inscriptions allow the reader to speedily locate the remedy he requires.

The French physician Bernard of Gordon (d. c. 1320) completed his lengthiest and most celebrated work, Practica seu Lilium medicine, on 5 February 1305. The work comprises seven particles or books, and deals with diseases of the body in traditional head to toe arrangment. The first and longest book is devoted to fevers, the second to diseases of the head, the third to those of the eyes, ears, nose and mouth, the fourth to those of the respiratory system, the fifth to those of the nutritive organs, the sixth to those of the liver, spleen, kidneys and bladder, and the seventh to those of the reproductive organs. The work’s widespread circulation among European physicians is accounted for by the comprehensiveness of its subject matter, its orderly arrangement and lucid style, and, above all, by its practical usefulness to its readers. Attracted no doubt by these same qualities, Cormac Mac Duinnshléibhe (fl. c. 1459), `bachelor of medicine’, undertook, probably about 1470, the formidable task of translating the Lilium into Irish, a task that had been completed by 1482, the year of writing of the earliest dated extant copy of the text, British Library ms Egerton 89, ff. 13ra1-192vb13. Irish renderings of two earlier works of Gordon’s, his Liber pronosticorum (1295), and De decem ingeniis curandorum morborum (1299), were also produced by Cormac. Incidentally, it may be noted in passing that some Latin medical texts were translated more than once into Irish. A case in point is Gordon’s De decem ingeniis : in addition to Cormac’s version the manuscripts (e. g. Corpus Christi College Oxford ms 129, ff. 42r1-47v32) contain a translation made by Diarmaid Ó Sirideáin, a medical scholar about whom little is known.

A number of medical texts of ultimately Arabic origin were translated into Irish, among them the Isagoge in artem parvam Galeni , an eleventh-century Latin adaptation of an introduction to medicine written in Arabic by Hunayn ibn Ishaq (Johannitius, d. c. 873). The basic concepts of Galenic medical doctrine are set out in clear and concise terms in the Isagoge, and the text provided students with an elementary introduction to the theoretical foundation necessary for medical practice. An anonymous Irish translation of the work survives in a unique copy, written in 1592, RIA ms 449 (23 N 16), ff. 56r12-61r25. As one of the core texts of the Articella the Isagoge was often commented on by medical professors during the Middle Ages, and the exposition on the work composed by Taddeo Alderotti (d. 1295), a professor at the university of Bologna, and a successful and wealthy physician, was translated into Irish during the fifteenth century.

The scope and variety of Irish medical literature can be further illustrated from a cursory glance at some other works translated during this period. A pharmaceutical tract by Gaulterus Agilon (fl. c. 1250) entitled De dosibus medicinarum provides a concise introduction to the basic principles and operations of medieval pharmacy, and had been translated into Irish by 1459 (edited by Shawn Sheahan, An Irish version of Gaulterus De dosibus, Washington, D. C. 1938). The first book of the Chirurgia magna (1363) of the French physician Guy de Chauliac (d. 1368) is devoted to anatomy, and was translated into Irish by Cormac Mac Duinnshléibhe. Substantial portions of the lengthy Chirurgia of the Italian surgeon Petrus de Argellata (d. 1423), a work composed sometime between 1391 and 1423, had been translated into Irish by 1469. The genre of texts known as commentaries arose from the practice of teaching students by means of systematic analysis and comment on an authoritative texts, and many such treatises contain detailed, informative and comprehensive discussions of medical doctrine. Several medical commentaries were translated into Irish, among them anonymous expositions on the Tegni of Galen, the Colliget of Ibn Rushd (Averroes, d. 1198), and the Viaticum of Ibn al-Jazzar (d. c. 1004). Medieval physicians understood that diet, environment and lifestyle played an important part in the maintenance of health and in its restoration following illness, and devoted much attention in their writings to consideration of the `non-naturals’, six external factors that were believed to have a decisive affect on human health, namely: food and drink, air, evacuation and repletion, sleep and waking, motion and rest, and the emotions. Guidance on the regulation of the non-naturals was provided in texts on health regimen, and varying courses of treatment described according to patient’s constitutional temperament, age, sex and social circumstances. The Regimen sanitatis of the Italian physician Magninus of Milan had been composed by 1334, and was translated into Irish sometime during the fifteenth century (edited by Séamus Ó Ceithearnaigh, Regimen sanitatis Magnini Mediolanensis I-III (Dublin 1942-4) ).

In addition to translations made directly from Latin the manuscripts contain native compilations, works that derive from Irish versions of Latin tracts rather than directly from the Latin sources themselves. The brief compilation on uroscopy that occurs in a unique copy written by Donnchadh Ó Bolgaidhe, NLI ms G 11, pp. 371a1-379b41, comprises sixteen short sections dealing with various aspects of that diagnostic procedure, urine’s colour, consistency, quantity, and contents, for instance, and the guidelines that should be observed in its inspection. The text can be shown to be almost entirely derived from the previously mentioned commentary on the Aphorisms of Hippocrates, translated by Ó Callanáin and Ó hÍceadha in 1403.

Similarly, at least four different Irish translations were drawn upon by the compiler of the the lengthy tract on pathology that is found, uniquely, in King’s Inns Library ms 15, ff. 77-127, a manuscript whose principal scribe, writing in 1512, was Maeleachlainn Mac an Leagha, official physician to the two Mac Donnchaidh lords of Sligo, Mac Donnchaidh of Tirerrill, and Mac Donnchaidh of Corann. Derivative treatises such as these testify to the complete assimiliation by Irish learned physicians of contemporary European medical doctrine.

Medical manuscripts

Most Irish medical manuscripts are written on vellum, the sturdy and durable writing material made from calf skins that was used in Irish manuscripts down to the late fifteenth and early sixteenth centuries when the use of paper began gradually to replace that of vellum. Vellum was a scarce and costly commodity, and already by the eighth century Irish scribes were employing manuscript abbreviations both to economize on its use and to expedite the work of writing. During the late medieval period medical scribes devised a set of unique abbreviations for routine words or technical terms in the texts they copied. The four humours of Galenic physiology are, for instance, frequently represented in the manuscripts by the contractions `.f.d.’ (fuil dearg , `sanguine humour’), `.l.f.’ (lionn fionn , `phlegm’), `.l.r.’ (lionn ruadh , `choler’) and `.l.d.’ (lionn dubh , `melancholy’), respectively. Vellum was evidently the preferred writing material of scribes. In 1578, in the course of producing RIA ms 443 (24 P 14), a very finely written copy of the Irish Lilium, and the only complete one extant, the physician Corc Óg Ó Cadhla (fl. 1577-83) expressed his dejection at the poor quality of his paper and the imperfection of his writing, but explained that he was unable to procure vellum.

Some medical manuscripts are handsomely ornamented, carefully executed and expensive productions while others are of a more ordinary nature, the quality of writing materials used, the efficiency of layout and design, the training and skill of the scribe, and the time and care devoted to writing all combining to impart to each artefact its distinctive character. The texts are almost always legible since medical scribes wrote neatly and clearly, and since the physical condition of the manuscripts that have survived is generally good. The manuscripts contain only a handful of medical illustrations; three that accompany various texts in the fifteenth-century vellum, TCD ms 1435, may be mentioned: a diagram of triangular, round and quadrangular surgical pads (p. 51, lower margin); an illustration of a nasal speculum (p. 112); and a diagrammatic representation of the seven tunics and three humours of the eye (p. 260).

A wealth of information regarding the translation and transmission of texts, and their own professional attachments and cirumstances, is communicated by scribes in the numerous notes with which they embellished their manuscripts. Scribal colophons often give the title of the work transcribed, its author, translator, scribe, and date and place of writing; the scribe sometimes identifies the person for whom he is writing the manuscript, or the owner of the exemplar from which he has worked; in marginal notes and line-fillers scattered throughout the text he thanks colleagues who have written passages of text for him, comments on his writing materials, or on the weather, and notes that he is in a hurry, cold, hungry, tired or thirsty; he records personal tribulations, or comments on recent events of public interest; he begs God’s forgiveness for his sins, or for writing on the Sabbath. An item in the text he is copying occasionally prompts a prayer, as when Risteard Ó Conchubhair, having written out a definition of noli me tangere, a corrosive ulceration usually attacking the face, was moved to pen the following words: `May mighty God protect me from the aforesaid disease, or from that accursed ulcer’ (Dia cumhachtac dom dhíon fén ar an eslainti rémhráiti no arin gcrecht mallaighthi sin, RIA ms 439 (3 C 19), f. 23vbz).

Individual patients

Irish medical manuscripts comprise in the main textbooks and manuals written by and for members of the medical profession for academic instruction and study. While they do not systematically record, then, the case histories of a given doctor’s clients, or the treatments dispensed by him, they do contain incidental allusions to individual patients.

In 1496, having completed copying a lapidary, the Connaught physician Conla Mac an Leagha (fl. 1496-1512), noted that he had finished writing the text after he had come to attend Cathal Bearrtha Mac Diarmada Gall, who had been dangerously wounded by an arrow. Conla’s patient was a member of the ruling kindred of the lordship of Moylurg, in present-day Co. Roscommon. Some thirteen years later, on Monday, 19 March 1509, Conla noted in the course of writing another text that he was in Killaraght, Co. Sligo, in the company of Tomaltach Ó Gadhra who had had his foot dangerously cut by one Cormac Ó hAirt. The Uí Ghadhra were lords of Coolavin in Co. Sligo.

On 22 March 1578, Corc Óg Ó Cadhla finished copying the third book of Gordon’s Lilium at Graiguenamangh, Co. Kilkenny, in the house of Brian Caomhánach (d. 1578), where, according to his colophon, he was treating Brian’s two daughters (their forenames are not given) for a menstrual disorder. Brian was head of the powerful Kavanagh family, whose lordship was situated in the present-day counties of Carlow and Wexford.

Conclusion

These and similar references to patients serve to remind one that the successful treatment of the sick was the ultimate goal of the medical learning taught and studied in the Irish schools. However, the precise extent to which the practical content of the texts they transcribed was put into use by physicians is difficult to determine. The occurrence of receipts that recommend exotic or unpalatable ingredients has suggested to some that the prescriptions found in the medical works were not actually followed in practice. This argument ignores the fact that in a majority of cases the ingredients recommended are derived from plants, many of which would have been available locally, and that the texts themselves readily acknowledge that native plants can be substituted for ones of foreign origin. Moreover, if unavailable through importation, non-native substances might be replaced by local ingredients, lists of recognised drug substitutes, known as quid pro quos, functioning as guides for the replacement of one medicament by another. The texts advocated resourcefulness: if the materials for one remedy were unavailable recourse should be had to another.

While the precise nature and effectiveness of the treatment they gave their patients is unclear, the quality of the intellectual training Irish doctors received in their professional medical schools was high. They were well equipped to offer their aristocratic employers a medical service that was informed by the best of contemporary scientific learning.