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Charms, cures, surgical skills and the supremacy of the Arderne manuscript

RCSI Heritage Collections houses a medieval medical manuscript of unique research interest.

Ten years ago, our then special collections librarian wrote a blog post on the ‘Lentaigne Manuscript’ (RCSI/MS/97), telling of the history of the 1851 donation to RCSI Library and its Lentaigne namesake, and referencing previous research published in 1943, by the late RCSI Professor J.D.H. Widdess (PRACTICA MAGISTRI JOHANNIS ARDERNE. (An Account of an early 15th Century Manuscript in the Library of the Royal College of Surgeons in Ireland.)

Recently, a new piece of research on RCSI/MS/97 has been published by Peter Murray Jones, Fellow, King's College, Cambridge, giving us more to know and love about RCSI’s own ‘Arderne Manuscript’.

RCSI/MS/97 - marginalia and illustrations appear throughout the manuscript

Master surgeon John Arderne (1307–c.1380) had served King Edward III as an army surgeon at the battle of Crécy in 1346. In 1376, Arderne wrote PRACTICA MAGISTRI JOHANNIS ARDERNE, which Jones (2022) explains was more of a step-by-step guide than an academic manuscript, as Arderne’s university-trained competitors were writing. It utilised practical illustrations and visualisations of surgery, most famously of his specialism: fistula in ano.  

The Practica on fistula in ano and its widespread circulation is at the centre of the research by Jones (2022). Aderne's writings were still being copied in the following fifteenth century and there are more surviving manuscript copies of Arderne’s texts than of any other surgical writing from England. Later copies, from the 16th century, were commissioned and owned by practicing surgeons. The particular Arderne early 15th century manuscript held by RCSI Heritage Collections is noted by Jones for its provenance and proven usage. It is interleaved and bound with the writings of a previous owner, Walter Hamond, Chirurgeon, who possessed it in 1645.  

Aderne's writings and fistula in ano illustrations on vellum, with Hamond's writings and illustrations on paper, interleaved and bound by Hamond

What we know of Hamond, we glean from both Widdess and Jones. After being freed of the Barber-Surgeons Guild in London, he was a sea surgeon in service with the East India Company. After some time in a failed colony in Madagascar, Hamond returned to England in 1645 and that same year, interleaved and bound the RCSI/MS/97 manuscript. The label on the spine of this binding reads 1349, but we know Arderne actually wrote it in 1376.  On the title page he wrote:

The Workes of Master John Arderne, Chirurgian, of Newark in Nottingham Shire written by his own hand in the yeeare of our Lord 1349 – with Some Observations
collected in blank paper By Walter Hamond Chirurgian, 1645


On the first page of his ‘Observations’, opposite the first vellum leaf of Arderne’s Experimenta, Hamond recorded a running title ‘The Practice of M[aste]r John Arderne’, and he began by translating Arderne’s charm for staunching blood at the beginning of the text:

Write in a paper the following letters and hang them about the arme 

or neck of the Hemorois [Humerus] and itt will stay itt [...] and if 

you will nott believe itt you may chuse otherwise Take a Hasell wand 

of one year’s growth and slitt itt in the midell and so forth [...]. 

"So Hamond does not distinguish between the Experimenta and the Practica, all being subsumed as ‘The Practice of M[aste]r John Arderne’, and nor does he balk at what might be regarded as ‘superstitious’ or ‘magical’ experiments". (Jones, 2022, p. 21)

Opposite the folio with stages of the fistula in ano operation, Hamond wrote:

My good and loving frend Mr Geofrey Guilbert died about the 1

September the news was brought me this day Sep 5 1645 of whome

I had this booke

It is concluded that his friend Mr Geoffrey Guilbert gave Hamond this Arderne manuscript, but no more is known of Guilbert.

Walter Hamond's added title page from 1645

Hamond goes on to comment upon and further develop, or modify, the cures and procedures laid out by Arderne. His use of the manuscript is shown by Jones (2022) to demonstrate that copying the work in manuscript was “attractive to early modern medical practitioners, (and) there is no question of the supposed distinction between manuscript and print eras acting as an obstacle to (Arderne’s) continuing popularity. Nor did his ‘barbarous’ Latin or Middle English translations (Jones 2015) put off those who were used to reading and writing in early modern English” (Jones, 2022, p. 28).

Jones further argues that this fourteenth-century English surgical text remaining in active use as a guide to surgical practice until late into the seventeenth century, particularly in its manuscript form,  “overturns assumptions made about periodisation and the coming of print culture to Europe”. In relation to book history, he points out, this undermines the general distinction “in which the incunabular era (pre-1501) is distinguished from later printing, and which treats manuscript books as co-existent with incunables, but as having more or less lost the battle for media supremacy by 1500” (Jones, 2022, p. 13).

Jones outlines how Hamond, like Arderne, discusses the fees structure for such a skilled procedure as fistula in ano, naming prestiguous patients by way of example and considering fee adjustments for the less wealthy. Hamond reflects on Arderne's fees as compared to his own, adjusting for inflation:

the rates and rewards given to the author three hundred years since, were as he saith of a noble person for this cure was 40 lb a liverie gowne and 5 lb a yeare during life of others 40 lb or 40 marks with his cloak and he protesteth that never in his life did he take lesse of the poorest patient for his Cure than 100 shillings or 5 lb wherby itt is evident that Mr Arderne was better paid in those dayes Considering that then the rate of silver , the price of victualls, and the rent of Houses was nott the twentieth part so much as itt is in these times. Yett I must with thankfullnes confesse that I rec[d?] from Mr Wild in anno 1630 the somme of 100 lb for effecting the same cure.

It is the practical nature of Arderne's work, it can be concluded, that appealed to Hamond. As shown by Jones and by WIddess, the practical is often intertwined with the superstitious. As previously outlined by Widdess (1943), practical tips in the administering of cures are offered by Arderne, such as how to measure time using prayers in the preparation of a recipe:

taken from the fire, and allowed to stand without motion for the space of one Paternoster and one Ave, in order that the litharge of lead which is in it may descend to the bottom of the pan

Apart from notes on weights and measurements, Arderne explains the effect of the heavenly bodies and Zodiac signs on medical outcomes. "Virgo is said to be bad for bleeding, and bad for pharmaceutical operations. The same sign has the qualities " cold and dry ", and governs the belly and intestines. The moon as it passes from one sign to another complicates prognosis, for, as Arderne says

A surgeon ought not for to cut or burn in any member of a man's body, nor do phlebotomy whiles the moon is in a si~o~n governing or tokening that member.

"A circular figure for use in deciding on prognosis, and two charms against fevers complete this mediaeval surgeon's vade mecum" (Widdess, 1943, p. 80).

Circular figure used as a guide to prognosis, " Circulus 16 angnlorum ", the circle of sixteen angles (Widdess, 1943) 


Widdess, J.D.H. Practica magistri johannis arderne. Ir J Med Sci 18, 77–81 (1943). doi: 10.1007/BF02952253

Jones, Peter Murray. “John Arderne’s Afterlife in Manuscript and Print.” Chapter. In Genre in English Medical Writing, 1500–1820: Sociocultural Contexts of Production and Use, edited by Irma Taavitsainen, Turo Hiltunen, Jeremy J. Smith, and Carla Suhr, 13–31. Studies in English Language. Cambridge: Cambridge University Press, 2022. doi:10.1017/9781009105347.003.