I like to ask my students this question at the beginning of the term to help them get a mindset of what disease and illness was like in the early modern period and medieval ages. When confronted with the inevitable reality of disease, how did people of the Middle Ages react? Of the different forms of healing available, what factors determined which ones they turned to? Availability was one such factor, but we must also consider other factors such as the cost of services and treatment, the healer’s reputation, their suitability to treating the disease as well as explaining its underlying causation, as well as the past experience of the sick themselves, their family, and friends. More importantly, reliability was an ideal attribute to be found in practitioners.
Patients consulted astrologers, empirics, wise-women, midwives, nuns or priests known for their magical or miraculous healing powers, knowledgeable friends, as well as physicians or surgeons. They sought out healers and choose the one that most pleased them.
Physicians were, of course, expensive—but money was not the only consideration. Medical decision-making was a complex process. Medieval and early Renaissance patients were medically promiscuous. They often and perhaps even always consulted several different types of practitioners at the same time, or one after the other. This was true of both the rich and poor; the rich did not rely exclusively on physicians. To a large extent, patients perceived no firm cultural barrier between different medical practitioners, and behaved accordingly.
Moreover, as Gianna Pomata writes in Contracting a Cure: Patients, Healers, and the Law in Early Modern Bologna (1998), the transaction between healer and patient was regulated by a business-like arrangement, known as the healing contract that dates back to the thirteenth century. Here’s an example of a contract from Bologna outlined in Pomata’s book, undersigned in 1244 by Rogerio de Bruch of Bergamo and Bosco the wool carder in Genoa:
“In the name of the Lord, amen.
I, Rogerio de Bruch of Bergamo, promise and agree with you, Bosco the wool carder, to return you to health and to make you improve from the illness that you have in your person, that is in your hand, foot, and mouth, in good faith, with the help of God, within the next month and a half, in such a way that you will be able to feed yourself with your hand and cut bread and wear shoes and walk and speak much better than you do now. I shall take care of all the expenses that will be necessary for this; and at the time, you shall pay me seven Genoese lire; and you shall not eat any fruit, beef, pasta—whether boiled or dry—or cabbage. If I do not keep my promises to you, you will not have to give me anything. And I, the aforementioned Bosco, promise to you, Rogerio, to pay you seven Genoese lire within three days after my recovery and improvement.”
The promise of a cure is obviously a key feature in the agreement between healer and patient. To the patient, it was valuable because it outlined exactly what was to be expected from the healer and that payment was to be dismissed if cure was not provided—it was a legal binding document that could protect him from fraud as well. To the healer, it served to win the trust of potential clients, to showcase his learned medicine and prognosis. In addition, to those patients seeking out self-help, practitioners would actually build their authority on the difficulty of treatment and the dangers of treating selves without proper medical knowledge.