From the mid-fourteenth century a resurgence of Gaelic society in Ireland reduced the area of English government to the Pale, comprising the ‘loyal’ counties of Dublin, Louth, Meath and Kildare.Footnote 1 A document prepared for Henry VIII in 1515 stated: ‘ther byn more then 60 countryes, called Regyons, in Ireland inhabytyd with the Kinges Irishe enymyes’, in other words the Gaelic Irish.Footnote 2 The descendants of the Anglo-Normans outside the Pale, who had ‘degenerated’ by adopting Gaelic ways, were labelled the king's ‘Englyshe greate rebelles’.Footnote 3 In Scotland, Gaelic society and culture also prospered.Footnote 4 Alexander III had incorporated the Highlands and Islands into the Scots kingdom in 1266, but by 1400 there existed distinct Scots- or English-speaking Lowlands (Galldachd) and Gaelic-speaking Highlands (Gáidhealtachd).Footnote 5 K. W. Nicholls wrote that Gaelic society comprised ‘clans or lineages’ descending in the male line ‘forming a definite corporate entity with political and legal functions’.Footnote 6 The clan (sliocht) occupied particular lands and the chief was supported by literate, privileged, hereditary professionals; ‘as they [the chiefs] had Brehons of one Sept or Family, so also they had Historians, Physicians, Chirurgions, Poets and Harpers of other peculiar Septs, to every one of which certain Lands were assign'd’.Footnote 7 This article provides an assessment of medicine as it was practised by the hereditary physicians of Ireland and Scotland from c.1350, when the first extant Gaelic medical manuscript was compiled, to c.1750, when the last members the Morrison hereditary medical family practised in Skye, with a particular focus on the physicians, their medical schools and manuscripts, and their encounters with patients.Footnote 8
I
The literature relating to medicine in pre-modern Ireland runs to hundreds of publications.Footnote 9 While over 100 medieval Gaelic medical manuscripts are extant, very few of them have been studied in detail.Footnote 10 In Ireland the principal medical manuscript collections are held by the Royal Irish Academy (R.I.A.), Trinity College, Dublin (T.C.D.), the National Library of Ireland (N.L.I.) and the King's Inns, while in Britain, the British Library (B.L.), the libraries of Oxford and Edinburgh universities, and the National Library of Scotland (N.L.S.) hold the majority.Footnote 11 Recently, a number of excellent electronic sources with digital images have become available.Footnote 12 Unfortunately, the inability of researchers to engage with Gaelic manuscripts due to ignorance of the language, difficulty in interpreting scribal abbreviations and lack of English translations hampered detailed analyses of the texts until recently. While Sir Norman Moore appreciated that the Gaelic manuscripts were translations of Latin medieval medical treatises,Footnote 13 many early scholars concentrated on the identification and history of the medical kindreds rather than deconstructions of the texts.Footnote 14 In 1929, Winifred Wulff published her ground-breaking textual analysis, with an English translation, of an Irish rendition of the medieval Latin text Rosa Anglica, written by the English physician, John of Gaddesden (c.1280–1361), c.1314.Footnote 15 This was, as Aoibheann Nic Dhonnchadha commented, ‘the authoritative introduction … to the vast and fascinating subject of early modern Irish medical texts’.Footnote 16 Wulff translated several other medieval Irish tracts on plague (T.C.D., MS 1435),Footnote 17 love sickness (R.I.A., MS 23 F 19)Footnote 18 and gynaecology (R.I.A., MS 23 F 19).Footnote 19
Many authors have since written about medieval medicine and the Gaelic hereditary physicians.Footnote 20 Nollaig Ó Muraíle identified over fifty hereditary medical kindreds practising in Ireland and Scotland during the late medieval period.Footnote 21 Charlie Dillon referred to the centres where medical study and scribal activity was carried out as ‘medical schools’.Footnote 22 Áine Sheehan studied the medical families in the context of the other Gaelic professional elites, especially the poets and the brehons. She showed that the physicians, whose services were always in demand, fared better than the others following the collapse of the Gaelic world in the seventeenth century.Footnote 23 While analyses of individual texts were provided by Paul Walsh,Footnote 24 Shawn SheehanFootnote 25 and James Carney,Footnote 26 it was the recent work of Aoibheann Nic Dhonnchadha,Footnote 27 Eithne Ní GhallchobhairFootnote 28 and Deborah HaydenFootnote 29 that established the uniqueness of the Irish translations. They were not, as was originally supposed, slavish copies of the originals, but selective compilations based on creative adaptions of the original texts.Footnote 30 Thus, as Nessa Ní Shéaghdha has suggested, copying the texts was not merely an intellectual exercise, but a gleaning of the information contained therein with a view to its practical application.Footnote 31
The medical texts also represent a major resource for the study of late medieval Irish. Whitley Stokes, Lilian Duncan and Winfred Wulff all noted the lexicographical importance of the texts and Wulff was impressed with the ability of the scribes to translate technical terms from Latin into Irish.Footnote 32 Liam MacMathúna found that native Irish terms with a provenance back to the Old Irish period (600–900) were used frequently by the scribes to represent novel medical concepts in the texts; a new vocabulary was not required to express the medical terms of the Latin exemplars.Footnote 33 Nessa Ní Shéaghdha and Charlie Dillon noted that the medical texts, unlike other contemporary writings, were written in a distinctive style of early-modern Irish reflecting the spoken language; many of the texts were transcribed from dictation.Footnote 34 Thus, ‘Gaelic joined Greek, Arabic and Latin as one of only four languages in which this body of medical knowledge was formally and systematically studied and taught’.Footnote 35 While a knowledge of Latin was essential for translation, Jason Harris observed that the later medical scribes ‘were not concerned to employ standard Latin orthography, most likely because they did not know it’ and that by the end of the fifteenth century the majority of Irish physicians were out of step with contemporary spoken and written Latin.Footnote 36 This lack of familiarity with Latin may account for the absence of any Gaelic translations of later medical innovators such as Andreas Vesalius (1514–64) or William Harvey (1578–1657); it may also explain the observation that ‘Gaelic medicine remained at the conservative wing of the European medical spectrum’.Footnote 37
Samuel Johnson dismissed ‘the whole [Gaelic Scots] nation’ as ‘illiterate’, observing that there ‘is not … an Erse manuscript a hundred years old’.Footnote 38 He would have been amazed to learn of ‘a great mass of Gaelic scientific writing lying unknown’ to the English-speaking world.Footnote 39 Scottish scholars generally refer to the language of the medieval texts as ‘Gaelic’, but this is the same language as ‘Irish’ which was spoken in Ireland at the time.Footnote 40 Thus, physicians travelling between Ireland and Scotland would have effortlessly understood each other. In this article the terms ‘Gaelic’ and ‘Irish’ are used interchangeably. In the early twentieth century George MacKay, Donald MacKinnon, John Comrie and Hugh Cameron Gillies all wrote of the Gaelic medical kindreds and their manuscripts in Scotland.Footnote 41 Derick S. Thompson in discussing the Scottish learned professions argued that, as the Gaelic chiefs lost their temporal power, the hereditary physicians became ‘almost the ultimate custodians of the old learning and the old libraries’.Footnote 42 While a chief's requirement for an archivist or judge disappeared with his rule, he still had need of a physician. Thompson identified three major medical dynasties in Scotland (MacBeath, MacLachlan and MacConacher) and several minor ones that survived into the eighteenth century. The Clann Meic-bethad (MacBheathadh, MacBeath, Beaton, Bethune) was the dominant Scottish medical kindred for over 400 years and the subject of an extensive study by John Bannerman.Footnote 43
II
In the late-medieval Gaelic world, physicians received benefits appropriate to their status as members of the professional class.Footnote 44 They held hereditary tenure of lands (lucht tighe) of approximately 250 acres in return for providing medical care to their aristocratic patrons.Footnote 45 In Argyll in the sixteenth century the McLea physicians had five merklands, approximately 175 acres, from the Lamonts of Inveryn.Footnote 46 The O'Sheil physicians in Offaly held lands in Ballyshiel, a townland of 228 acres, while the Ó Nialláins and the O'Cassidys had 240 and 315 acres in Clare and Fermanagh, respectively.Footnote 47 In 1600 the MacCarthy Mór in Cork provided the Dunleavy physicians with three ploughlands, approximately 380 acres.Footnote 48 Patrick McDonogh Oge O'Connor, hereditary physician, was listed as a native plantation grantee in Laois in 1626–32 with 1,246 acres,Footnote 49 while in 1386 the Scottish king Robert II granted the 100,000 acre island of Jura to Ferchar Lighiche.Footnote 50
The inheritance of these lands was by tanistry rather than primogeniture. Although the Ó Conchubhair succession at Aghmacart in Laois was from father to son for three generations from 1500, it was not necessarily to the eldest son. Similarly, the lands of the MacBeath physicians in Mull were inherited through a kin-based system throughout the seventeenth century.Footnote 51 Tanistry was traditional in the Gaelic world, as expressed by Risteard Ó Conchubhair in 1590 in relation to a medical manuscript he had transcribed (R.I.A., MS 3 C 19): ‘Also I bequeath possession of this volume in conformity with the custom … it shall not be given to the descendant who is oldest in years or richest unless he be also the most learned’.Footnote 52 Tanistry would obviously make it easier for the kindred to ensure that at least one member of the extended family would be a trained physician, thereby justifying the family's continued possession of the hereditary lands. In the early seventeenth century, the Flemish scientist, Johann Baptista van Helmont (1579–1644), observed that:
the noblemen of Ireland grant a field to a member of their household who takes care of their health … This person will have a book left to him by his ancestors, stuffed full of remedies. So whoever inherits the book inherits the field … this tome outlines the symptoms of disease along with home-grown remedies …Footnote 53
Nollaig Ó Muraíle identified over fifty Gaelic medical kindreds.Footnote 54 The etymology of some of the names points to a long tradition of practice; medicine had emerged as a distinct profession in Ireland by the eighth century at the latest.Footnote 55 ‘Mac an Leagha’ (McLea) means ‘the son of the physician’ (líaig, ‘leech’), ‘Ó hÍceadha’ (Hickey) translates to ‘descendant of a healer’ (íccaid, ‘healer’) while ‘MacBheathadh’ means the ‘son of life’ (betha, ‘life’).Footnote 56 Evidence that new medical lineages could be established is provided by the O'Meara and Ó Nialláin families; members of these traditionally ecclesiastical kindreds became physicians to the Butlers of Ormond and O'Briens of Thomond in the early seventeenth century.Footnote 57 The Beaton family was pre-eminent in Scottish medicine for 400 years, becoming physicians to both the lords of the Isles and the kings of Scots.Footnote 58 They descended from a MacBeath follower of the daughter of an Ó Catháin from Ulster when she married Angus Óg of the Isles, c.1300.Footnote 59 A Beaton physician accompanied James VI of Scotland to London on the latter's accession to the English throne in 1603 and Fergus Beaton from Ballenabe in Islay (d. c.1628) held a royal appointment from Charles I.Footnote 60 A female Scottish physician, Christine Leche, successfully treated a servant of the king in 1443, indicating that women practised medicine in the Gaelic world.Footnote 61 Scottish Gaelic doctors were much appreciated. In 1536 the Lowlands historian, Hector Boece, wrote: ‘Beside mony craftis and science, quhilkis thay have translatit in their awin tongue, thay profess maist the science of medcinary, and ar richt excellent in it’.Footnote 62
The lack of a university within Ireland in the late medieval period forced Gaelic medical students to travel abroad to gain degrees.Footnote 63 Johannes de Kylloylac O Kannin from Meath, was a bachelor of medicine in Montpellier in 1330.Footnote 64 It is likely that a small number of Gaelic physicians encountered the classical Latin texts for the first time in universities such as Montpellier and Paris and translated them into Irish. Two prominent translators, Cormac Mac Duinnshléibhe (fl. 1459) and Tadhg Ó Cuinn (fl. 1400–15), were described as basillér a fisígecht (bachelor in physic), but from which universities is unknown.Footnote 65 The Annals of the Four Masters recorded the death of Donnchadh Duinnshléibhe, a ‘doctor of medicine’, in 1527.Footnote 66 James Neylon, a member of the Ó Nialláin medical kindred from Clare, graduated in medicine at the University of Oxford in 1549, while Owen O'Sheil returned to Ireland with his doctor's degree in 1620 having studied in Louvain, Padua, Rome and Paris.Footnote 67
The Gaelic word ollamh, originally used to denote the highest grade of file or poet, was later applied to any expert in art or science, a professor.Footnote 68 While few had university degrees, many Gaelic doctors were referred to as ollamh leighis. Maeleachlainn Mac an Leagha (fl. 1500), described as ollam in da Mac Donnchaid, was the official physician to two MacDonogh chiefs in Sligo.Footnote 69 Donnchadh Óg Ó Conchubhair (fl. 1581–1611) was priomh ollamh or chief physician to Finghin Mac Giolla Phádraig (d. 1613), third Baron Upper Ossory.Footnote 70 In Scotland the title ardollamhnachd referred to the chief physician of the MacLeans of Duart. From the middle of the sixteenth century the title ollamh was almost exclusively associated with medicine; in 1541 it was understood without further elaboration that Fergus ollamh of Ileach (Islay) was a physician.Footnote 71
As pointed out by Áine Sheehan, some Gaelic doctors were readily accepted by the English of Ireland.Footnote 72 In 1341 William Ouhynnouvan (Ó Ceannabháin), ‘the King's Surgeon’, was awarded ‘the weirs of Lymerick in Ireland’ for his good service to the king overseas; he was also afforded the protection of English common law, ‘notwithstanding that he is by birth of the Irish nation’.Footnote 73 Similarly, Denis Collier, ‘phisician and surgien’, was admitted a citizen of Dublin in 1575 for attending to the mayor and others during an outbreak of plague.Footnote 74 In 1580 ‘Nicholas Hykie, doctor of physic’, was employed by the city at an annual salary of ‘ten pounds, lawfull mony of Irland’.Footnote 75 William Kelly, a surgeon, ‘in consideration of his long service in Ireland, France and Scotland in her Majesty's wars’ and ‘for his perfection of science’ was awarded a pension of 2s. per day in 1587.Footnote 76 The Butlers of Ormond employed Dermot O'Meara and later his son Edmond as their personal physicians throughout most of the seventeenth century.Footnote 77 In 1606 Sir John Davies observed that Catholic priests in Clonmel escaped arrest under penal laws by residing ‘in the houses of gentlemen and noblemen under the name of surgeons and physicians’.Footnote 78 The protection the physicians enjoyed among Old and New English patrons may account for the survival of so many medical manuscripts from the 1300–1650 period.Footnote 79
One of the chief activities of Gaelic medical professionals was the translation and transcription of Latin medical texts.Footnote 80 These works encapsulated the tenets of classical Greek and Roman medicine which had been preserved in Arabic texts. By the eleventh century this ancient knowledge was being translated back into Latin in southern Europe.Footnote 81 Gaelic medical practice was based on compilations of Irish translations of these texts rather than personal observation and experience with patients. According to John Bannerman ‘little originality was displayed and few advances made’,Footnote 82 while Nessa Ní Shéaghdha concluded that ‘reading was thought the chief source of medical knowledge’.Footnote 83 However, considerable knowledge of locally grown herbs existed which predated the arrival of Latin learning. Bretha crólige, a medical law text from the eighth century, stated that the purpose of a garden was the production of herbs for the sick and referred to honey, garlic and celery as medicinal herbs.Footnote 84 Moreover, as noted previously, an Irish vocabulary already existed to represent the medical concepts of the texts being translated.Footnote 85
As in the Gaelic law schools, the scribal medical work took place in secular medical schools under the patronage of a ruling family. Sometimes the writing was done as the physician travelled, visiting and treating well-to-do patrons. Risteard Ó Conchubhair from Aghmacart in Laois journeyed through Kildare, Kilkenny, Wexford, Carlow and Offaly between May and November 1590 while transcribing Bernard of Gordon's Lilium medicinae (R.I.A., MS 3C 19).Footnote 86 His hosts were the Gaelic Mac Giolla Phádraigs and Ó Moores, and the Old English Lyes, Birminghams, Fitzgeralds, Graces and Butlers.Footnote 87 That a doctor could move seamlessly among these two antagonistic ethnic groups emphasises the high regard in which they were held. Similarly, between December 1611 and January 1613 Angus Beaton from Husabost in the Isle of Skye transcribed a 476-page manuscript (N.L.S., Adv. MS 72.2.10) for his teacher Duncan Ó Conchubhair (1571–1647) as they travelled around Lorn from Lismore to Ardnacriosh, Muckairn, Dunollie, Island Stalker and Ardchonnel.Footnote 88 Angus pleaded with the reader not to blame him for his poor handwriting as it was the first book he had ever written.Footnote 89 Another example of peripatetic writing is provided by a colophon in B.L., MS Arundel 333 written c.1514 where Donnchadh (O'Ahiarn) states that he wrote the manuscript in the house of John the Scot in either Cork or Clare.Footnote 90
Good information survives for the Ó Conchubhair medical school at Aghmacart, which flourished from 1500 to 1611 under the patronage of the Mac Giolla Phádraigs of Upper Ossory.Footnote 91 Six members of the family across four generations practised medicine, the most important of whom was Donnchadh Óg Ó Conchubhair (fl. 1581–1611), priomh ollamh leighis, ‘the best of doctors in his own time – and that without leaving Ireland to study’.Footnote 92 The inference is that students often went abroad to study medicine, but, equally, that a good medical education was attainable in Ireland at this period. The other doctors associated with the school were Donnchadh Óg's grandfather (Giolla Pádraig) who wrote a medical text c.1500 (N.L.I., MS G 12), Donnchadh Óg's father (Donnchadh Liath, d. 1562), brother (Conchubhair, fl. 1566) and son (also Giolla Pádraig), as well as Risteard Ó Conchubhair (1561–1625) who was a relative and a pupil at the school. Risteard Ó Conchubhair's surviving manuscripts are the sources for information about the school. Two Connacht students attended: Iollann Máig Bheatha and Feargach Ó Fearghusa, while Niall Mac Iomhair and the aforementioned Donnchadh (Duncan) Albanach Ó Conchubhair came from Scotland. Also present in 1596 were Cathal Ó Duinnshléibhe, the scribe of R.I.A., MS 23 N 16, Tadhg Mac Giolla Mártan and someone called Domhnall. Members of the Leinster medical families of Mac Caisín and Ó Cuileamhain were also connected with the school.Footnote 93 We can surmise, therefore, that the school attracted not only students of the local hereditary medical families in Leinster, but also from as far away as Ulster and Scotland.
The most comprehensive record of scribal activity from a Gaelic medical school is from Aghmacart, but it is likely that similar work was done elsewhere of which only fragments remain. Extracts from many texts were compiled into handbooks for ease of use.Footnote 94 Table 1 demonstrates the extent of the work undertaken at Aghmacart. Most of the texts were transcriptions of previously translated Latin texts by unknown translators. However, the priomh ollamh Donnchadh Óg Ó Conchubhair translated a text on a skin disease called ‘sahaphati’ (R.I.A., MS 3 C 19) and another ‘on stretching and yawning’ (R.I.A., MS 23 N 16).Footnote 95 As noted above, sometimes the work which was being transcribed was dictated to the scribe by another person. For example, Cathal Ó Duinnshléibhe wrote in January 1592 that his father (dháid) William had dictated the text to him.Footnote 96
List of works transcribed or translated at the Ó Conchubhair medical school, Aghmacart, 1590–1600.
* Only two works were translated, both by Donnchadh Óg Ó Conchubair, ollamh leighis, the head of the school.
† Donnchadha Óg added a section not in the original text about ‘diversion’.
Sources: Nic Dhonnchadha, ‘The medical school of Aghmacart’, pp 11–43; Irish Script on Screen (I.S.O.S.) (https://www.isos.dias.ie/english/index.html) (27 June 2020); Donald MacKinnon, A descriptive catalogue of Gaelic manuscripts, p. 273; O'Grady, Catalogue of Irish manuscripts, i, 280–5.
Learning by rote was a common practice. The English Jesuit priest, Edmund Campion (1540–81), who stayed in Ireland from August 1570 to June 1571, left an uncomplimentary eye-witness account of the medical and law schools of ‘the mere Irish’:
they speak Latin like a vulgar language, learned in their common Schools of Leach-craft and Law … conning by rote the Aphorisms of Hypocrates, and Civil Instructions … I have seen them where they kept schools, ten in some one chamber, groveling upon couches of straw, their books at their noses, themselves lying flat prostrate, and so to chant out their lessons by piecemeal, being the most part lusty fellows of twenty five years and upwards.Footnote 97
However, as Jason Harris has pointed out, Campion was residing with the Old English Stanihurst family in Dublin at the time and his comments probably reflect their prejudices against the Gaelic Irish.Footnote 98 Richard Stanihurst (1547–1618) later added his own diatribe against Gaelic doctors in his book De rebus in Hibernia gestis: ‘empiriks … plainly untaught and completely uneducated in all matters of surgery … they become doctors by heredity, not by learning. Having learned to recite from memory Hippocrates’ aphorism “Life is short, art is long”, they consider themselves sufficiently brilliantly educated.’ He also referred to their ‘ancient murky manuscripts, which are written in Irish and punctuated with many emendations’. Any cures or healing they might achieve ‘ought to be attributed to the efficiency of nature rather than the use of these empiricks who lack all theoretical skill’.Footnote 99 Similarly, Martin Martin from Skye referred to a fellow islander as ‘the illiterate empiric, Neil Beaton’ who became a physician ‘without the advantage of education’.Footnote 100 Thus, not everyone was impressed by the scholarship of the Gaelic physicians.
III
Van Helmot believed that the Gaelic medical manuscripts contained local cures, but for the most part they were Gaelic translations of medieval Latin texts. While the scribes often added interesting colophons to the text, they did not describe clinical cases in any detail nor treatments given to specific patients. Winifred Wulff commented that ‘one is struck by the wide knowledge of the medieval physicians, as well as by their lack of any great powers of observation’.Footnote 101 Similarly, Standish O'Grady wrote that the Gaelic physicians were ‘staunch Arabians’, adding that ‘the Irish-writing leech was a scholastic … no observer and recorder, no rash intruder into the domain of research; but a book-builder, a compiler, an arranger’.Footnote 102 Francis Shaw observed that, while the fourteenth century Gaelic doctors wrote in Irish, their learning was all borrowed.Footnote 103 Although modern scholars have challenged these views, nevertheless, the Gaelic medical texts contain few remedies that can be identified as being specifically local. A possible exception is a prosimetrum transcribed in 1509 by Conla Mac an Leagha (R.I.A., MSS 24 B 3, 23 N 29), which, while based in part on Latin sources, also makes reference to Dian Céacht, physician to the mythical Tuatha Dé Danann, and his children, Míach and Oirbea, as well as to the land of Ireland and its physicians.Footnote 104 However, in this text, as Deborah Hayden has shown, the Irish translator or scribe occasionally substituted Dian Céacht's name for that of Galen which appeared in the exemplar as the authoritative source.Footnote 105 Thus, the Gaelic scribes were quite selective in what they copied, compiling manuscripts of different texts for their own use. Beatrix Färber commented on Tadhg Ó Cuinn’s An Irish materia medica (1415): ‘the text appears to be no slavish rendering of the voice of ancient authority, but a sensible selection of information believed to be of practical use’;Footnote 106 the text contains a number of items for which no Latin source has been found indicating a local source for the knowledge. Similarly Angus Beaton's big book (N.L.S., Adv. MS 72 2 10) was a compilation of several sources as, in the words of Donald MacKinnon, ‘Dr O'Conacher had evidently the idea of compressing a small medical library into one volume’.Footnote 107
Some compilations were commissioned for use by doctors as convenient handbooks, re-emphasising the practical rather than theoretical nature of the texts; the staining of the manuscripts suggests that they were actually used as handbooks. In 1563 two Irish scribes, Dáibhi Ó Cearnaigh and ‘Cairbre’, assembled a compendium of texts (B.L., Add. MS 15,582) for the Scottish physician John McBeath. Described by Gillies as a vade mecum, it contains sections on health maintenance, humours, cupping, bloodletting, cautery, cutting for stone, abscesses, materia medica and recipes against various diseases.Footnote 108 Part of another compilation with particular emphasis on urinalysis (University of Edinburgh, MS La. III, 21, ff 10-85) was also prepared for John McBeath by Caipre Ó Cendamhain; in this text several pages were left blank to be filled in later ‘as further experience and knowledge might render desirable’.Footnote 109 Two Irish medical manuals are the Book of the O'Sheils (R.I.A., MS 23 K 42) and the Book of the O'Lees (R.I.A., MS 23 P 10 (ii)). The seventeenth-century Book of the O'Sheils contains the Aphorisms and Prognostica of Hippocrates (c.460–c.370 B.C.), Aegidius’s (1140–1224) De urinis, Bernard of Gordon's Lilium particula prima on fevers, with extracts from Valescus de Taranta (fl. 1382), Galen (c.130–c.210) and Avicenna (c.980–1037).Footnote 110 Dealing with a range of diseases, the fifteenth-century Book of the O'Lees is a highly organised, sophisticated treatise with forty-four tables divided into compartments containing the details of each disease under twelve headings including treatment and management.Footnote 111 This book would have been an invaluable, easy-to-use resource for practising physicians who, at a glance, could see all the relevant features of a specific disease and its treatment. The scribe of the sole surviving Irish copy, which may have been composed c.1434, has been identified as Conall Ballach Mac Parthaláin (fl. 1484).Footnote 112
Pre-eminent among the Gaelic translators was Cormac Mac Duinnshléibhe (fl. 1459) from Tír Chonaill who translated at least nine medical texts from Latin to Irish, including Bernard of Gordon's hugely influential Lilium medicinae.Footnote 113 Domhnall Albanach Ó Troighthigh used this text for his transcription written in Clare in 1482 (B.L., Eg. MS 89); the ‘Albanach’ again points to a Scottish connection.Footnote 114 Three of Tadhg Ó Cuinn's translations are extant and date from the early fifteenth century.Footnote 115 A translation of Gaddesden's Rosa Anglica from 1400 is attributed to the Clare physician Nicholas O'Hickey (fl. 1403), but Winifred Wulff stated that ‘there is nothing in the MS to indicate who the scribe may have been’.Footnote 116 Eoin Ó Callanáin (fl. 1414), Donnchadh Óg Ó Conchubhair (fl. 1586–1610) and Diarmaid Ó Sirideáin also translated works.Footnote 117
The Irish physicians did not always translate verbatim from the Latin originals. Donnchadh Óg Ó Conchubhair added a section on ‘diversion’ not in the original to his copy of a section of the Collectorium by Niccoló Betruccio (d. 1347).Footnote 118 He also added a chapter from Valescus de Taranta's Philonium to the copy of Bernard of Gordon's Lilium medicinae that was being transcribed by one of his students.Footnote 119 In Cormac Duinnshléibhe's manuscript, Anathomia Gydo, a translation of Guy de Chauliac's De anathomia, some sections of the Latin text were not translated into Irish.Footnote 120 One fascinating omission was a detailed description of the order of dissection of a cadaver – abdomen, thorax, head, limbs – originally described by Mondino de’ Liuzzi (d. 1326) in Bologna.Footnote 121 This scheme allowed for four separate dissections starting with the parts that would putrefy earliest.Footnote 122 Thus, it seems likely that anatomical dissection was not an important component of Gaelic medical education. Extracts from other works not in the exemplar were also inserted into the text, two of which were from the Chirurgia of Lanfranc (c.1250–1306).Footnote 123 When translating Gaddesden's Rosa Anglica, based in part on the Lilium medicinae, the translator liberally added extracts from the Lilium that Gaddesden had not used. Pádraig Ó Siaghail, in writing a section of the Book of the O'Sheils (R.I.A., MS 23 K 42) in 1657-8, added a reference to beer and whiskey as a cause of drunkenness among the Irish in his copy of the Lilium where the original only mentioned wine.Footnote 124 Risteard Ó Conchubhair, in R.I.A., MS 3 C 19, complained that neither Bernard of Gordon nor Cormac Mac Duinnshléibhe, whose exemplar of Lilium medicinae he was copying, had condemned charms (pisseoga) against sterility which would only be cured by repentance and leading a good Christian life.Footnote 125
Medieval doctors believed that the movements of heavenly bodies influenced the inner workings of the human body. They used charts and images to check the positions of the stars to calculate prognostically important ‘critical days’, and determine when and from which vein blood should be taken.Footnote 126 A volvelle or rotula was a moveable circular astronomical device on a page for working out the position of the sun and moon in the zodiac. A number of Irish volvelles display the names of the signs of the zodiac, the planets, the months and numeral figures.Footnote 127 Medieval physicians also used two other resources, the ‘zodiac man’, a chart depicting the parts of the body controlled by the various signs of the zodiac (melothesia), and the ‘vein or phlebotomy man’, which illustrated the precise vein that should be let (i.e., bled) for a particular problem.Footnote 128 Thus bloodletting, which could be general or specific, was recommended only at particular times and from certain veins.Footnote 129 While there is one extant copy of a Gaelic vein man (B.L., Add. MS 15,582),Footnote 130 no Gaelic zodiac man survives, although it is likely that they existed as they were integral to medieval astrological medicine.
Physicians also used charts depicting the colour of urine to help with diagnosis; the colour reflected the humoral balance in the body.Footnote 131 Typically, a chart comprised images of twenty urine flasks, each of a different colour indicating a specific disorder. Only one Gaelic urine chart exists in University of Edinburgh, MS La. III. 21.Footnote 132 Unlike more sophisticated charts, as in B.L., Harley MS 5311 (c.1406), where the actual colour is painted onto the image of the flask, in the Gaelic version a caption describing the colour and its significance is placed beside the image.Footnote 133 Another illustration from an Irish medical text is a representation of the seven tunics and three humours of the eye surrounding a central lens (crystillina) in T.C.D., MS 1435.Footnote 134 Images of a nasal speculum and a strange diagram of triangular, round and square shapes called ‘pledgets’, possibly wound pads, are also found.Footnote 135
Given the long and laborious process of preparing vellum or parchment and the equally difficult task of making inks, it is not surprising that manuscripts were valuable items.Footnote 136 Twenty-two quaternions (176 folios or 352 pages) were used in creating a copy of Lilium medicinae (B.L., Eg. MS 89) in Clare in the fifteenth century. A note, dated 1500, requests a prayer for Gerald Fitzgerald, earl of Kildare (1456–1513) who bought the manuscript for a score of cows (air fichit bo).Footnote 137 ‘Sixty milk cows’ was the price for transcribing a copy of the Lilium medicinae (N.L.S., MS 2076) belonging to Fearchar Beaton of Husabost in the early sixteenth century.Footnote 138 Fearchar valued his book so much ‘that when he trusted himself to a boat, in passing an arm of the sea … he sent his servant by land, for greater security with the Lilium medicanum’.Footnote 139 B.L., Arundel MS 333, a medical manuscript of 128 folios compiled by various scribes in Clare and Cork between 1514 and 1519 was valued at five pounds in 1590.Footnote 140
IV
Classical medicine provided the theoretical basis for Gaelic medical practice. According to Luke Demaitre, medieval ‘doctors defined the natural human condition of health as an internal equilibrium and harmony with the environment’.Footnote 141 A healthy internal equilibrium was maintained by the balance of the four humours and their associated elements and qualities: blood/air – warm/moist; phlegm/water – cold/moist; black-bile/earth – cold/dry; yellow-bile/fire – warm/dry.Footnote 142 Blood was produced by the liver, phlegm by the brain, black bile by the spleen and yellow bile by the gallbladder. Illness resulted when the humours were disturbed and only when they were rebalanced could health be regained.Footnote 143 Diagnosis and prognosis were determined by taking the patient's history, performing a physical examination, and assessing the pulse and urine (uroscopy); the latter reflected the internal humoral status of the individual.Footnote 144 Good health was maintained by a triad of approaches: regimen manipulated the six ‘non-naturals’ (air, food and drink, evacuation and repletion, sleep and waking, motion and rest, and emotions), drugs countered the effects of the disease, purged the gut and induced sweating, while bloodletting removed the excess humour.Footnote 145
A huge array of foods, plants, animals, minerals and their compounds were used in the treatment of disease. Probably the most comprehensive Irish materia medica is that compiled by Tadhg Ó Cuinn in 1415 comprising 292 entries of medicinal items more or less in alphabetical order (T.C.D., MS 1343).Footnote 146 Another manuscript (R.I.A., MS 23 O 6) from the early fifteenth century contains an alphabetical list, mostly in Irish, but some in Latin, of medicinally useful plants.Footnote 147 Rosa Anglica recommended ‘to him who is constipated, give a clyster (enema) in which are boiled violets, mallows, mercurial, great mallows, bran, cassia fistula, and a little salt’.Footnote 148 While these compounds were supposed to balance the humours, some may actually have had beneficial effects by modulating biological activities; for example, cassia fistula has antioxidant and antimicrobial effects.Footnote 149 A recipe for treating dropsy (oedema) contained a daunting list of fourteen different ingredients.Footnote 150 It is not known whether the ingredients mentioned were actually used by the Gaelic physicians or if other agents were substituted for hard-to-get items.
The assumption that removing blood would drain the corrupted humours and quickly restore balance was the rationale for bloodletting.Footnote 151 Galen advocated energetic bloodletting especially in the treatment of fever.Footnote 152 From the evidence of the medical handbooks and the phlebotomy charts, bloodletting was a frequent treatment in Gaelic Ireland as elsewhere. The fate of Ó Maelbhrenuinn, the abbot of Boyle, who died following bloodletting in 1225, shows that this could be a dangerous procedure if not done properly.Footnote 153 Some Gaelic lords had ‘chirurgions’ (surgeons) in their entourages to perform surgical tasks.Footnote 154 Mostly they let blood, set fractures and sutured wounds. Some surgical texts (chirurgia) were translated into Irish,Footnote 155 including a very accurate description on how to reduce an inguinal hernia in Rosa Anglica.Footnote 156 Cutting-for-stone was a dangerous operation to remove a stone from the bladder through the perineum. In 1613 Thomas, the young son of Simon Fraser, the sixth Lord Lovat, died having been cut for stone by one Gill-eandris Beatton.Footnote 157 Martin Martin reported that Neil Beaton in Skye had ‘the boldness to cut a piece out of a woman's skull broader than half a crown’ thereby relieving her headaches.Footnote 158 In Ireland Barra Ó Donnabháin identified at least eight medieval skull trepanations with evidence that many of the individuals survived. However, it appears that they were performed by surgeons in the Pale rather than among the Gaelic Irish.Footnote 159 Gaelic surgeons were specifically excluded from the Dublin Guild of Barber Surgeons under their charter granted by Henry VI in 1446.Footnote 160
The Gaelic manuscripts also contain charms and incantations that might be recited to encourage healing or prevent illness.Footnote 161 Irish charms may represent a fusion of sources including the remnants of pre-Christian traditions, imported Christianity and Norse writing.Footnote 162 A number of Viking runes carved on bone, wood and leather have been found in Dublin; at least one of them contains a charm for healing.Footnote 163 Howard Meroney demonstrated that Irish words appeared in Old English charms and according to Charles Plummer ‘Irish was regarded as the language par excellence of magic formulae’.Footnote 164 The charms identified in the Gaelic manuscripts were used to relieve headache, cure diseases of the eyes, staunch bleeding, preserve teeth and prevent baldness.Footnote 165 A cure for impotence involved striking the patient with an elm rod on which his name has been inscribed in Irish ogham script.Footnote 166 Other charms invoked various saints to remove a disease and instructed that various prayers should be said before and after reciting the charm.Footnote 167 The charms often contained nonsense lines such as this charm for staunching blood in R.I.A., MS 24 B 3 which has been traced to the Old Irish period:
Occasionally individual patients are mentioned the manuscripts. In August 1596 Donnchadh Albanach Ó Conchubhair treated Fínghin mac Diarmaid an Bhealaigh for ‘cancir bolgaigh’, probably smallpox (bolgach). His therapy may not have worked, as later he prayed that God would heal his patient.Footnote 169 Corc Óg Ó Cadhla (fl. 1577–83) treated two daughters of Brian Caomhánach at Graiguenamanagh for menstrual irregularities, but the sources do not provide further details.Footnote 170 In 1509 Connla Mac an Leagha attended Tomaltach mac Céin, mic Eógain, who had sustained a dangerous foot wound, while Cathal Bearrtha Mac Diarmada Gall was treated when he sustained a serious arrow injury in 1496.Footnote 171 One of the earliest non-fatal gunshot wounds in Ireland was recorded in 1498 when Edmond Mortel ‘was partially mutilated by shot of gun’; he was obviously treated well as ‘more than a score of children were born to him after that’.Footnote 172 In Scotland in 1650, the Thane of Cawdor had ‘Donal O'conochar phisitiane’ attend his son ‘qhen he was diseasit before his deceas’.Footnote 173 In spite of the poor outcome O'Connor's fee was £66 13s. 8d.; two years later he received £80 for attending the thane himself.Footnote 174
V
Medicine was an integral part of the Gaelic world in the pre-modern era. From c.1350 to c.1750 hereditary physicians from over fifty families were tasked with looking after the health of Irish and Scottish lords and their clans; how much care they provided for the lesser members of the septs is unknown. Physicians, as members of a professional class, had high status and were generously rewarded with hereditary lands. Their medical expertise was mostly based on European medical thought drawn from the classical writings of Hippocrates, Galen, and the medieval Arab world. Gaelic physicians who attended European universities translated the classical Latin texts into Irish. Thereafter, the texts or extracts from them were transcribed, often quite selectively. Medical learning passed in the kindred from one generation to the next, but not necessarily from father to son. Women practised medicine, but few female doctors have been identified. Students learned medicine under the tutelage of an expert doctor (ollamh leighis) in medical schools, which were sometimes peripatetic as the student and teacher travelled about visiting patients. Diagnosis, prognosis and treatment were based on information in the manuscripts, some of which were used as handbooks. History and examination, including that of the pulse and urine, facilitated diagnosis, while treatment was mostly herbal. Advice on health maintenance (regimen sanitatis) was given and surgical procedures, especially bloodletting, were performed by surgeons. Believing in medical astrology, care was taken to ensure that treatment coincided with a propitious arrangement of the zodiac and charts were available to assist with this.
Physicians in Ireland and Scotland spoke the same language and were culturally indistinguishable. They moved seamlessly between the two countries; Scottish students studied medicine in Ireland and Irish scribes produced medical works for Scottish physicians. Observers such as Campion and Stanihurst criticised the Irish doctors for their lack of learning, but their view was through the biased prism of the Old English. In Scotland similar prejudices were expressed by Lowlanders: ‘The peoples of the Highlands are “void of the knawledge and feir of God” and prone to “all kynd of barbarous and bestile cruelties”.’Footnote 175
As the Tudor and Stuart governments began to dominate late sixteenth- and early seventeenth-century Ireland, the Edinburgh government consolidated its control over Gaelic Scotland. These moves split the Gaedhealtacht into Irish and Scottish components, and their different responses to the Reformation enhanced the separation.Footnote 176 After the departure of the Ulster earls in 1607, the power of the Gaelic lords in Ireland declined and their ability to support the learned professional caste, including the physicians, waned. As Áine Sheehan has noted, the collapse of the aristocracy and the development of modern market economics led to a ‘shift from a prestige-based society, where wealth and power was expressed through feasting and raiding, to a profit-based society of rents, taxes, and debt’.Footnote 177 Without patrons the Gaelic medical and law schools declined and the role of the professional poets was undermined.Footnote 178
However, the Gaelic doctors adapted far better to their changing world than the lawyers or the bards. Given their utility in treating illness regardless of the political affiliations of their patients, they continued to practise their craft in an Ireland increasingly dominated by the New English. Thus, doctors such as Denis Collier, Nicholas Hickey and William Kelly were welcomed in Dublin while several Gaelic medical men received land-grants under the plantation of Ulster.Footnote 179 Whereas previously the doctors would have held kindred lands free under the patronage of a lord in return for professional services, they now had to pay rents on the properties they held and, as the Thane of Cawdor noticed, charged fees. As Charlie Dillon has written, traditional medicine was effectively eclipsed by the rise of the New English in Ireland in the early-seventeenth century.Footnote 180
The collapse of the Gaelic medical schools encouraged increasing numbers of ambitious Irish students to seek professional medical training overseas; several of these newly qualified physicians returned to Ireland in the 1610s. In spite of their Catholic religion they were allowed to practise medicine freely and were highly regarded as professionals. Horrified at the unregulated medical marketplace in Dublin in the 1620s, a group, comprising continentally-trained Irish physicians and a number of New English medical doctors, petitioned the government to establish a College of Physicians in Dublin similar to the London college which had been established in 1518.Footnote 181 Although Charles I was happy to comply with the request, the proposed college never materialised and it was not until 1654 that a Fraternity of Physicians was established; the first royal charter creating a College of Physicians in Dublin was granted by Charles II in 1667 and in Edinburgh in 1681.Footnote 182 Thus, Irish doctors were able to continue in their profession long after the destruction of the Gaelic order and medicine was not prohibited to Catholics under the penal laws enacted from 1695 onwards.Footnote 183
In Scotland traditional kin-based medicine continued to be practised until the early-eighteenth century when Gaelic society declined significantly. In the words of the Scottish judge, Lord President Duncan Forbes, in 1746: ‘the Irish language and highland dress gave way to a sort of English, and lowland cloathing; the inhabitants took to the plough in place of weapons … and are as tame as their low country neighbours’.Footnote 184 The last doctor fully trained in the traditional manner was Fergus Beaton, practising in South Uist in the Outer Hebrides in 1700.Footnote 185 Two MacLean hereditary surgeons were in practice in Skye in 1716 and members of the Morrison family were there in 1754, but their training may not have been exclusively traditional.Footnote 186 We can assume, therefore, that by the 1750s traditional Gaelic medical practice had come to an end in Ireland and Scotland.
The decline in Gaelic medicine was not entirely political. Medical knowledge underwent a profound transformation during the sixteenth and early-seventeenth centuries with the publications of Andreas Vesalius's (1514–64) De humani corporis fabrica, Ambrose Paré's (1510–90) La méthode de traicter les playes faictes par hacquebutes et aultres bastons à feu, and William Harvey's (1578–1657) Exercitatio anatomica de motu cordis et sanguinis in animalibus.Footnote 187 These three works overturned the medieval ideas about anatomy, surgery and physiology and laid the foundations for modern medicine. Physicians began to learn from experience and by observing their own patients rather than relying on the teachings of the past and astronomical charts.Footnote 188 In Lowland Scotland medical training in the seventeenth century was by formal apprenticeship or a university degree,Footnote 189 while from Ireland large numbers of aspiring doctors travelled overseas to get a medical education.Footnote 190 Nial O'Glacan (c.1563–1653), an Irish physician who was trained by the Mac Duinnshléibhe physicians in Donegal, became professor of medicine at the University of Bologna in the 1640s. While he adhered strongly to the authority of Hippocrates and Galen he also flirted with the very new idea of pathological anatomy, thus bridging the gap between traditional Gaelic medicine and the new medicine of the seventeenth century.Footnote 191
