Barber-Surgeons and Pastoral Care

The analogies of confessor to physician, penitent to patient and sin to sickness are familiar ones – both to confessional handbooks and literary representations of confession as well as to recent scholarship on medieval religious practices.² Canon 21 of the Fourth Lateran Council explicitly invokes the analogy in setting out the priest’s role in confession: ‘the priest must be prudent and cautious, so that in the manner of an expert physician he may pour wine and oil on the wounds of the injured person’.³ Middle English pastoralia takes up and extends these analogies, in ways that clearly show that the reach of pastoral care includes real bodily sickness as well as the soul. The Book of Vices and Virtues, for example, records that sin ‘is ariзt gret seknesse, and þe schrift is þe medicine’, but also that both ‘wikked humores’ in the body and ‘wikked tecches [vices]’ in the heart need to be driven out to restore a person to spiritual health.⁴ Medieval healthcare, however, was administered by a spectrum of practitioners ranging from physicians and surgeons to barbers, midwives and apothecaries.⁵ In London, barbers and surgeons were organised under separate guilds; elsewhere, according to Carole Rawcliffe, ‘there was no overt demarcation between the two groups at least for organisational or administrative purposes’.⁶ Such separation, where it occurred, however, did not preclude barbers from undertaking surgical procedures. Under the London Barbers’ guild structure were two crafts: ‘barbery proper’, practised by ‘Barbitonsures’ and defined as that concerned with phlebotomy and tooth-drawing; and barber-surgery (though this is not a medieval term), practised by ‘Masters of the Barbers exercising the faculty of Surgery’. Surgeons (distinct again from barbers ‘exercising the faculty of surgery’) remained a relatively elite and small group – with numbers sometimes fewer than twelve and no more than twenty in the guild.⁷ Barbers proper and barbers practising surgery, which I mainly refer to under the catch-all term ‘barber-surgeon’, had particular responsibility for shaving, bloodletting and dental procedures such as tooth-drawing.⁸ Outside Cambridge and Oxford, the numbers of barber-surgeons in the fourteenth century in fact far outweighed numbers of physicians: the 1381 Lay Poll Tax returns for York, for example, record eighteen barbers, but just one physician.⁹ On this evidence, the ordinary medieval man or woman would more rarely encounter a physician but was likely to have been rather better acquainted with his or her local barber-surgeon. Identifying ‘the surgeon’s rapid emergence as a figure of literary significance in the fourteenth century’, Jeremy Citrome documents, in a number of Middle English examples, the transformation of the surgeon ‘into both religious metaphor and psychological agent’.¹⁰ Citrome’s study sheds particular light on the transference of the surgeon’s treatment of wounds to the confessor’s cure of the soul, both of which might require a corrective or punitive form of wounding as much as a process of healing.¹¹ However, on the cultural impact of the barber-surgeon’s more mundane crafts of shaving, tooth-pulling and teeth-cleaning, Citrome is wholly silent. Yet, the hygienic and surgical care of the mouth (in which physicians, surgeons and barbers might all variously be implicated) provides a powerful analogy for the work of pastoral care, and especially for confession in the late medieval period. More than just analogy, however, the barber-surgeon’s work of shaving hair, paring skin and flesh, and filing teeth plays a crucial role in keeping the body’s form and physiology in check and, thus, in turn, in facilitating virtuous living and spiritual fitness. More particularly, in its concern with the superfluities of the body, the barber-surgeon’s craft works to correct the vitiations of regimen and diet and of unregulated eating and drinking. In his concern with the pathologies of the mouth, the barber-surgeon works to maintain the mouth’s two primary offices: its capacity to eat and also to speak.

The barber-surgeon’s attentiveness to the skin’s surface and the body’s superfluities arises in part from the medieval adherence to the theory of humours and the importance of humoural balance. As On the Properties of Things discloses (following Galen), ‘þe body renneþ, lykeþ [leaks], and droppiþ, as in swetynge, spettinge, and oþir suche’ (i, 148). Thus food and drink are needed to restore what is lost in the body.¹² Hair, nails and teeth are the by-products of the last part of the digestion process, which works to restore the body. Formed from humours that transgress the edges of the body, hair, nails and teeth are necessarily subject to trimming, cutting and paring. So, Bartholomaeus records that teeth are humours pushed to the boundaries of the body;¹³ nails, like hair through the pores of the skin, pass the end of the fingers and ‘þere þe fumositees [fumes] entreth and ben idryed outward by þe aier, and chaungiþ into substaunce of nayles’ (i, 226–7). If humoural imbalance occurs in the body through excess consumption or abstention, however, food is imperfectly digested and so ‘apostemes’ (any morbid swelling or inflammation) develop.¹⁴ Similarly, if any of the four humours are out of balance – moisture, dryness, heat or coldness, which precipitate rottenness, cracking, swelling or hardness respectively – protuberances form at the margins and boundaries of the body, as On the Properties of Things relates:

When there is not enough heat in the body to digest food perfectly, undigested ‘moisture’ is drawn to the body’s extremities, causing ‘diuers eueles’. Since the physiological processes of assimilation and purgation are imperfect, the quest to maintain human form requires intervention in the body. The three crafts (or ‘operations’) of surgery, as Guy de Chauliac recounts, are: ‘to loose þat is contynue’ through bloodletting and ‘garsynge’ (scarification); ‘to ioyne þat is departed’ through healing wounds and fractures; and ‘to kut of þat is to moche’, such as ‘postomes [apostemes]’ or ‘kernellis [a swollen gland or pathological lump or growth]’.¹⁵ This third aspect – cutting off that which ‘is to moche’ – is part of a general medical project, akin to shaving hair, bloodletting and drawing teeth, which is concerned with superfluous bodily material and which works to remedy the body’s propensity to overspill its own bounds.

If the body’s ability to digest and assimilate food is naturally subject to a gradual decline, so too, as earlier chapters explore, is it compromised by eating habits: excessive eating of rich food fosters the physiological circumstances for sin, but such sin might also manifest itself in excrescences and protuberances on the surface of the body and on the inside of the mouth. Eaterly attitudes underlie human disposition to vice or virtue, but also to swellings, lumps, growths and blemishes. The barber-surgeon, concerned with the external surface of the body, with the skin and its convexities, acts to remove superfluities and aberrations in bodily form. In the same way, the goal of the confessor is to pare away the superfluous matter created by sin – both on the invisible material of the soul and in sin’s psychosomatic manifestation in the body. To some extent these are therefore complementary activities: the barber-surgeon (as well as the physician) is in league with the confessor. Both are vital agents in maintaining spiritual and bodily health in the Middle Ages. Confessor and surgeon sometimes might even have been the very same figure, despite prohibitions against the religious shedding blood.¹⁶ John Ottryngton, Chaplain of St John’s Ouse Bridge in York, for example, appears in the records ‘accused before the Dean and Chapter court in 1424 of practising surgery, including incision of women’s breasts’.¹⁷

The fifteenth-century Middle English translation of the thirteenth-century De doctrina cordis – a ‘devotional bestseller’ – provides a striking example of the convergence of pastoral care and the craft of barber-surgery.¹⁸ Chapter 5 of The Doctrine of the Hert treats ‘How and in what wise a mynche [nun] shuld yif [give] here hert to God be þe yifte of counseyle’, and explains what it means for a nun to submit herself in perfect obedience to her superior. To do so, it takes up the terms of the craft of barber-surgery:

The ‘cloystrer’, then, should submit to her superior as a man does to a barber-surgeon – or to his razor – when his beard and head are shaved.²⁰ The analogy is drawn out in vivid, experiential detail: the physical manipulation of the head tilted first one and then the other way, the opened mouth, the lifted chin. As such, both processes – being shaved and submitting to religious governaunce – are understood as forms of correction that are not entirely comfortable for its subjects, and not entirely without risk: the razor is sharp.²¹ The ‘cloystrer’ and the barber’s patient should therefore submit without resistance. In this Middle English translation, however, the analogy is unstable: ‘As longe as þou art under þe governaunce of þi sovereyn in religioun, so longe þou art under þe hondes of a barboure for to schave away þi synnes.’²² It is, of course, the superior’s task metaphorically to shave away sins, but the syntax makes possible that it might also literally be the barber’s.

John Mirk’s Festial similarly demonstrates the implication of the craft of barber-surgery in pastoral care. Mirk’s explanation (provided to spare priests from shame when ‘lewed men, þe wyche beth of many wordus and prowde in here wytte, wollon askon prestus diuerse questions of þinggus þat towchon þe seruice of Holy Chirche’) of the traditions surrounding Schere Þursday (that is, Maundy Thursday) in the Festial demonstrates that the craft of barber-surgery mirrors, but also facilitates, spiritual processes.²³ Drawing on the authority of John Beleth (‘as Ion Belette telluth and techuth’), Mirk explains:

Shaving off the superfluous filth on the exterior body mirrors – operates in parallel with – the shaving of the superfluities of sin from the interior. Both actions are necessary to prepare the Christian to receive the body of Christ in the form of the host as part of the Easter liturgy. Exemplifying the confluence between medicine and religion emerging in vernacular theology in this period, Mirk retains Beleth’s explanation of physiology in glossing spiritual practices, not dismissing as irrelevant the detail that it is specifically the superfluity of the stomach which produces facial hair and that of the heart which produces nails. The stress in Beleth’s twelfth-century Summa de ecclesiasticis officiis, however, is on the way in which shaving hair and trimming nails act as a reminder – it ‘signifies that’ (‘significat quod’) we ought to ‘trim back the faults and sins which are superfluities in us’.²⁵ Mirk’s Englishing instead implies they are complementary, indeed, parallel actions. The physical act of paring away bodily superfluities itself is necessary, in conjunction with confession, to rid the body of sin and make it fit for devotion: ‘schauon’ (to shave) and ‘scheron’ (to shear) are actions – including scraping, chafing, paring, polishing, shaving, cutting into and cutting off – that are to be performed both on the body and on the soul.²⁶

I have gone to such lengths to set up some of the ways in which barber-surgery is implicated in spiritual work – as preparation for participation in liturgical performance and for consuming the host; as a means of figuring the process of cleansing and regulating the soul – because it underscores the way in which the physical care of the body and its material shaping are imaginatively, as well as literally, implicated in shaping Christian identity and cultivating virtuous habits. As medieval surgical treatises and encyclopaedias also show, shaving and shearing take on more specific connotations in the mouth itself, and in ways that have very specific implications for properly formed speech and for understanding how utterances have material and spiritual consequences. As allegories and analogies for thinking about the processes of speaking and confessing, common oral remedies and the daily practices of washing and cleansing the mouth – whether performed by medical practitioners or delineated in the textual tradition – destabilise the allegorical level on which they at first operate, since they also have a real effect on these cognitive processes and spiritual practices.

Oral Surgery

Further to shaving and paring the body’s surface, the barber-surgeon is the specialist practitioner of oral surgery.²⁷ Oral hygiene, tooth-drawing and treatments for diseases of the mouth are the common stuff of remedy books and also, by the fourteenth century, of vernacular medical and surgical manuals. Thus, fourteenth-century Middle English receipt books record remedies for: ‘vermibus in dentibus’ (tooth-worm), ‘зelow [yellow] and stynkyng teþe’, ‘touþ-ache’, ‘cancre in þe teth’, stinking breath, speech impediments, blisters and ‘waggyng of teth’.²⁸ Surgical treatises such as Guy de Chauliac’s, as well as encyclopaedias such as Vincent of Beauvais’s, provide detailed descriptions of treatments for the mouth’s pathologies. The textual basis for oral surgical knowledge in this period is in large part indebted to the late tenth-century encyclopaedic medical treatise (the al-Tasrif) of Albucasis (Abu al Qasim al Zahrāwī), a surgeon from Cordoba. Book 30 of the al-Tasrif, which circulated independently from the rest of the treatise, deals specifically with surgery and was known through Gerard of Cremona’s twelfth-century Latin translation, the Liber Alsaharavi de cirurgia.²⁹ Widely influential, Cremona’s Liber was also translated into medieval vernaculars and drawn on in particular by Italian and French surgeons.³⁰ Guy, for example, substantially derives his knowledge of dentistry, as well as his illustrations of surgical instruments, from Albucasis.³¹

The textual tradition of oral surgery betrays a particular concern with deformities or diseases that might diminish the powers of the soul that operate through the mouth and its parts. Remedies thus include cutting the strings under the tongue if they are hindering speech because they are too tight: ‘þe cure of þe þrede or of þe ligament drawynge þe tonge is kyttynge by þe brede [crosswise] til þat þe tonge be lousede fro his wiþhaldynge, as Albucasis saith’.³² While cutting a ligament is recommended in this instance, the majority of the remedies prescribed in surgical treatises take the closely related forms of scraping, shaving, shearing, filing and rubbing. Thus, in the instance of a tooth full of filth, worms and holes, Guy recommends that, if washing the mouth has had no effect, a process akin to shaving be tried:

To ‘rowme’ is to scrape or bore out the decayed matter from the tooth with a razor-like shaving knife. In the event this does not cure the problem, then the tooth should be cauterised (‘brenne it’) and, if necessary, extracted (‘drawe it out’).³⁴ Similarly, in the case of discolouration, if washing and ‘frotynge’ (rubbing) have failed to clean them, the teeth should be scraped or shaved: ‘for þat þere were hardenede filþes, schaue hem with schauynge knyfes and wiþ spatures [cutting instruments]’.³⁵ These procedures are likewise derived from Albucasis, whose recommendation to scrape the rough, blackened scales that collect on the inner and outer surface of the teeth and on the gums becomes a medieval medical commonplace.³⁶ Archaeological remains from York provide evidence that these kinds of treatment were carried out: three skulls excavated from the cemetery of the Gilbertine Priory of St Andrew in Fishergate showed ‘a polished appearance on the teeth and abrasion of the enamel on their external surface, probably indicating regular cleaning of the teeth during life’.³⁷ Encyclopaedias and surgical treatises attest that the tongue as well as the teeth might be subject to a form of scraping, as a fifteenth-century surgical treatise (after ‘saint William of Touke’, an unidentified authority) extant in London British Library MS Sloane 563, records: ‘ffor filthe abowte þe teth þat cometh ofte tyme of þe stomake And clevith on þe tongue and so þe teth ben foule shave [scrape] þe tongue wiþ trene [wooden] knife made of hasell’.³⁸

As recommended in the Latin and vernacular translations of the al-Tasrif, when there are too many teeth or when teeth are overgrown they too should be shaved and filed down or extracted.³⁹ Albucasis further urges the surgeon to carry out the filing of the tooth gradually over a number of days so that the tooth is not loosened.⁴⁰ Repeating this lore, Guy records: ‘If þe toþe were encresede ouer kynde, even it, and playn it sliely [cautiously] with a file, and move it nouзt.’⁴¹ Albucasis further instructs that if a tooth is broken and causes pain when speaking it should be filed down until the ‘tooth is smooth and neither injures the tongue nor hinders speech’.⁴² Mediating Albucasis’s instructions on overgrown teeth, Vincent advises variously in the Speculum doctrinale that the tooth should be extracted with a pair of forceps (‘cum forcipibus extrahatur’), or, if another tooth would be affected, levelled with a file (‘si quid superfuerit lima explanetur’).⁴³ Vincent further records, ‘if any of the teeth is larger than is proper, which will be clearly ugly, it is necessary to correct it with a file, and remove what is superfluous, whereby it should be made equal to the other ones, corresponding in proportion’.⁴⁴ Such filing, then, might also be carried out on aesthetic grounds.

In the case of dead flesh in the mouth, ‘fretynge’ (MED, s.v. ‘freten’ (v.), ‘to file or scrape’, ‘rub to pieces’) and ‘frotynge’ (MED, s.v. ‘froten’ (v.), ‘to rub’, ‘to polish’) are commonly prescribed – actions that imbricate with those of scraping or filing.⁴⁵ The remedy for ‘fetore oris’ (stench of mouth) outlined in On the Properties of Things, for example, dictates that when rotten teeth are the cause they should be extracted, but when rotten gums are they should be ‘ifrotid and iclansid’ with medicines, and the roots likewise ‘frotid and iclensid’ with powders and honey (i, 370). In the case of discoloured teeth, Lanfrank advises the teeth and gums should be ‘froted’ with a medicinal powder.⁴⁶ In a section on remedies for toothache, Guy records a recipe (‘Take of mercurye, of peritorye [a medicinal plant] menely [moderately] brent’, etc.) which he instructs should be applied by ‘frotyng’: ‘frote þe rootes of þe tieth and of þe gomes, of moyste gomes and nouзt of drye gomes’.⁴⁷ ‘Frotyng’ is not, however, simply an abrasive method of cleansing a part of the mouth; it is also, for example, a means of drawing superfluous humours from the body. Thus Guy advocates ‘wasshynges of þe mouthe or frotynges of þe tonge’ as part of the tripartite therapy for ‘wlaffyng’ (that is, stammering or stuttering), which is caused by excessive moisture.⁴⁸ Elsewhere in the Cyrurgie, ‘frotyng’ is the means by which the humours causing a swollen tongue can be led out of the body (through spitting); ‘ranula’ – an abscess under the tongue ‘lettynge [hindering] his [its] werke’ – similarly should first be treated with ‘rubbynge and frotynge’ medicines.⁴⁹ The Middle English translation of Gilbertus Anglicus’s medical writings prescribes ‘frotyng’ as a means of diagnosis as well as remedy: in order to diagnose whether the gums are the cause of stinking breath, ‘frote and rubbe þy gummes with þi fyngir and þy mouþe wil stynke’. In which case, ‘if þer be eny roted flesshe, let freten it awei and þen hele it vp’.⁵⁰ Like Absolon, the parish-clerk-cum-barber-surgeon in ‘The Miller’s Tale’, who ‘rubbeth now, who froteth now his lippes / With dust, with sond, with straw, with clooth, with chippes’, medieval care of the mouth commonly requires abrasive treatment.⁵¹ Instructions to barber-surgeons to employ ‘fretynge’ and ‘frotynge’ variously indicate: rubbing or scraping the gums, lips, tongue or palate of the mouth in order to remove dead or diseased flesh and growths (such as epulis and ulcers); an abrasive method of cleaning and polishing the teeth or gums; and a technique for applying medicines via the mouth, especially to draw out excess or corrupt humours.

The removal of teeth, however, is always prescribed as a last course of action, because of the dangers inherent in the process, but also because of its implications for speech and for reason. The presence of teeth is associated with an ability to discern good from evil, with participation in rational society and with appetite. Their loss thus has wide-ranging implications for human status. As the Cyrurgie outlines, every attempt should be made to save a tooth loosened – either by a blow, by ‘lubrifieng’ (which makes the sinew ‘sliddry’) or by ‘fretynge’ (which loosens the flesh of the gums) – through withdrawing nourishment to reduce excess moisture, or by bloodletting and binding. The patient in turn is instructed to avoid eating hard foods and to ‘lesse [reduce]’ his speech.⁵² MS Sloane 563 observes, in cases of toothache, that only after first making a ‘ruptory’ behind the head to let blood from an artery in the temple, and thereafter trying cautery, should extraction be resorted to: ‘þe laste remedy of alle is to drawe owte þe tothe’.⁵³ What might in part lie behind this anxiety about pulling teeth is their physiological connection with the substance of the brain. The Prose Salernitan Questions record the example of the philosopher at Delphi who died after having a tooth drawn: since teeth are formed from the overflow of the substance of the brain and the marrow of the eyes or cheekbones, drawing a tooth might cause the substance of the brain to be drawn out with it.⁵⁴ Thus, in Guy’s instructions for ‘pullynge vp of tieþ by þe rootes’, he urges that, after having ‘þe pacient putte bytwene þe legges in a clere place’, the barber-surgeon should ‘vnhelle [uncover] þe roote of þe tothe al aboute, and move it slyly and fully þat no schrewed [corrupt] siknesse come to the tieth of þe eyзe or of þe bone of þe iawe’.⁵⁵ This movement must be done with care because of the risk, recalling the fate of the philosopher at Delphi, of disrupting humoural matter ‘of þe eyзe or of þe bone of þe iawe’ into the teeth, thus bringing further sickness. At most, tooth extraction can lead to death; at the least it can diminish the ability of the human to think and to create and craft speech.

The dictates of surgical texts and encyclopaedias for the care of the mouth and its parts thus have as their goal, alongside mitigating unsightly teeth and the social embarrassment of bad breath, the promotion of the work of eating and the preservation, even improvement, of the capacity to speak. In cataloguing the varied treatments for the passions of the mouth, these medical texts remind us not only that disease and deformity in the mouth have implications for the action of eating and speaking, but also that the painful experience of toothache, or an ulcerated tongue or gums, might punctuate meal times or interrupt the repetitions of prayer in daily devotions. As such they are part of the spectrum of experience of the everyday body. In his Confessions, Augustine recounts a time when he experienced ‘the agony of toothache’, in which ‘the pain became so great that I could not speak’. When he asks (through a written note) his friends to pray on his behalf the pain vanishes, leading Augustine to recognise both ‘the sting’ of God’s ‘lash’, as well as the swiftness of his mercy.⁵⁶ Medicalised descriptions likewise point to the painful, embodied conditions of which they are the symptoms – conditions that might, as they do for Augustine, be embedded in the processes of coming to self-knowledge and knowledge of God.

If oral treatments have literal consequences for forming speech and for rational thinking, the surgical lexis of scraping, shaving, shearing, as well as ‘fretynge’ and ‘frotynge’, is also taken up to think about the effects of speaking, whether of ‘speaking well’ (through grammatical speech or in confession) or of ‘speaking badly’ (lying, backbiting or other sins of the tongue). Treatises on grammar display an understanding of the surgical power of speech to shape human form and Christian identity. The surgical lexis, in turn, blends with an ethical and spiritual vocabulary for thinking about the effects of sin and the process of confession and reformation, as we see in pastoralia and devotional poems that articulate the deleterious effects of speech (destroying the self and maiming others), as well as its corrective power through confession in surgical terms.

Learning to Speak Well: Grammar and Surgery

Among the various traditions – scientific, philosophical, biblical and pastoral – in which the organs of speech become surgical instruments and speaking becomes a surgical act, the trivial arts provide the most sustained and developed allegory in which the corrective, reforming potential of speaking well (i.e. grammar) is figured in explicitly surgical terms. Grammar and dentistry are in fact logical counterparts, for just as grammar facilitates speaking well, aspects of dental surgery (in theory) work to correct physical impediments to speech. A twelfth-century poem, Ad adelam comitissam, composed by Baudri de Bourgueil for William the Conqueror’s daughter, points to this close association of grammar and medicine, speech and surgery, in medieval thinking.⁵⁷ In his poem to Adèle, Baudri describes her chamber in which, surrounded by richly tapestried walls, the statue of Grammar stands along with other representations of the trivial arts:

In Ad adelam, Grammar files the teeth of children and trims their lips. Her eight-toothed file (‘limam’) and her shears (‘forpicibus’) represent the rules that govern language; so too are they instruments pertaining to the craft of barber-surgery.⁵⁹ Grammar’s instruments are labile images. On the one hand, her shears are a tool used by the teacher-cum-surgeon, who acts on the material of the body, suggesting an intervention in the mouth by an external agent. On the other hand, they are the speaker’s own lips which clip and cut words. Likewise, the file wielded by Grammar becomes a part of the very anatomy of the body it acts upon – an internal, natural organ that works on the materials of speech, on air, sound and voice. In other words, the tongue both should be filed and is itself a file.

Baudri’s conception of grammar is derived from Martianus Capella’s fifth-century work De nuptiis philologiæ et Mercurii. Capella’s description of Grammar as a ‘physician’ with a file ‘divided into eight golden parts’ with which ‘by gentle rubbing she gradually cleaned dirty teeth and ailments of the tongue’ gains widespread currency in the medieval period.⁶⁰ John of Salisbury’s (1159) Metalogicon repeats Martianus’s description of Grammar ‘with a knife, a rod, and the ointment case carried by physicians. She uses the knife to prune away grammatical errors, and to cleanse the tongues of infants as she instructs them.’⁶¹ Holding a rod, John’s Grammar physically disciplines as well as surgically corrects children. In the Anticlaudianus (c.1182), Alan of Lille similarly depicts Grammar – one of seven maidens enlisted to correct the defects of man – holding a file in one hand, with which she ‘cleans the tartar from the teeth’. If ‘one tooth strays from the rest of the row, she cuts the outgrowth back to normal’. She ‘teaches infants to speak, looses tied tongues and shapes words in the proper mould’.⁶² The varying oral surgical treatments these personifications perform – polishing rough teeth with a file; rubbing dirty teeth clean; cutting the strings that restrict the tongue; filing back overgrown teeth – all find their counterparts in received surgical tradition and, arguably, in practice. Learning to speak Latin is imagined as an oral surgical procedure. Soo too do these texts implicate learning to speak well through grammar with the remedial medical work of forming and shaping the child’s mouth, teeth and tongue.

Grammar’s concern with training and moulding the child’s mouth recalls the instructions in regimen for infants to rub the teeth, tongue and gums to encourage both the growth of teeth and the onset of speech, as well as the ability to eat ‘mete’ instead of drinking milk.⁶³ So too does it accord with the correlation of the appearance of permanent teeth with the onset of an ability to discern good and evil and with the entry into pedagogical structures – that is, in other words, to begin to learn Latin and to cultivate a virtuous habitus. As Katharine Breen summarises: ‘as the first subject of formal study, and a learned language with clearly articulated rules, it [grammar] was thought to shape the mind linguistically and morally from the very first repetitions of do, das, dat’.⁶⁴ If grammar is the paradigmatic habitus, it is markedly medicalised and embodied. It therefore bears out not only the bodily basis of medieval theories of virtue acquisition, but also the fundamental role of regimen and medicine – that is, of the care of the self – to them. Rita Copeland observes that grammar

Classroom teaching in general and learning Latinate habits in particular are peculiarly embodied practices in medieval contexts.

This association of oral surgery, physical discipline and education reappears in university initiation rituals, where, in addition to the teeth being filed, the initiate is also made to confess his sins, as he is in The Manuale Scholarium (a late fifteenth-century German handbook comprising Latin dialogues).⁶⁶ Both Marie-Christine Pouchelle and Jacques Le Goff suggest that these rituals originate much earlier in the medieval period and were practised more widely in Europe.⁶⁷ While there is not comparable evidence from England, Ruth Mazo Karras notes that ‘shaving also appears in the records of New College, Oxford, from 1400; it was apparently a “vile and horrible” ritual inflicted upon new masters of arts the night before their inception’.⁶⁸ In the Manuale, the initiate (or bejaunus) is described as rude, unlearned, stinking like a beast, bearing horns and having ‘teeth, sticking out in both directions from his jaw’. Furthermore, the initiate cannot speak properly, but rather mumbles and stammers. Thus, the problem of badly formed, overgrown teeth raised in the medical tradition is displayed with exaggerated and animal effect. A ‘physician’ is summoned and he applies a salve to the initiate’s mouth and nose and then saws off his horns. Next, the physician takes up some forceps and extracts the initiate’s teeth; a sharp razor is used to shave his beard and then he is made to confess to outrageous crimes.⁶⁹ This ritual rids the initiate of his bestiality and effects a process of smoothing, filing and shaving away his superfluities – namely, the excrescences and protuberances of the everyday and unlearned body.

As a parody of confession, this ritual must also reveal something about the perceptions of confession itself; confession works towards producing a body (and soul) unmarred by the deformities and superfluities of sin. In both parodic and serious contexts, speaking enacts a procedure that is articulated in terms of the craft of dentistry and barber-surgery. These examples of the regulating effects of the speech of those acted on not only by surgery but also by formal pedagogical structures raise the question, however, of whether such surgical benefits extend to lay, vernacular teeth and tongues as well.

Vernacular Habits

The Latinate figure of Grammar borrows from the (rude) craft of barber-surgery to figure the close nexus of (grammatical) speech and ethics. In so doing, the analogy of Grammar to the barber-surgeon simultaneously discloses a closer, literal connection between properly shaped, clean teeth and a freely moving tongue, on the one hand, and the capacity to speak well, on the other. The ethical project in which grammar is implicated is, of course, first and foremost a Latinate one, and the body it acts upon a male one. However, medieval understandings of the material basis and effects of speaking, which underpin Grammar’s surgical effects, are themselves the ‘kynde’ attributes described in vernacular natural philosophy and theology: the lips are thin and subtle, On the Properties of Things observes, in order to move easily, but also ‘to forkutte þe aier’ (i, 199); the tongue is ‘ischape as a swerd’ (i, 208); teeth ‘ben able to kerue al þing, and alle þing þat þey fongiþ [receive] þei brusiþ and bitiþ atwynne’ (i, 202). Such descriptions resonate with the figural explanations of how corrective speech might act, as it does in Hebrews 4:12, as a sword piercing the heart or cutting through sin.⁷⁰ Sinful speech – like the barber’s razor – also wounds and harms. Speculum vitae describes the ‘felounes’ (evildoers) ‘Whase tunges er mare sharpe bytande / Þan any rasour in barbours hande’.⁷¹ Chaucer’s ‘Manciple’s Tale’ likewise exemplifies the deadly effects of an unrestrained tongue. Moralising the fate of the crow who tells Phebus of his wife’s adultery, the Manciple ventriloquises his mother’s teaching – teaching that draws on the natural example of the mouth’s physiology, as well as on Solomon, the Psalmist David and Seneca – to warn that a ‘rakel’ (that is, rash or rebellious) tongue works to destroy friendship just as ‘a swerd forkutteth and forkerveth / An arm a-two’.⁷² The work of grammar (which is performed both externally, through pedagogy, but also internally once acquired), then, is to mould and shape mouths and to rein in the tongue under reason. But so too, since the tongue without regulation becomes a deadly weapon, is the training of ‘rude’ and ‘boistous’ mouths the objective of pastoral care. As Middle English pastoralia makes clear: lay, vernacular tongues, like Latinate ones, when governed by reason can also file words and govern and shape the ethical self.

In a section on the gift of ‘cunnyng’ (knowledge) and its corresponding virtue, that of ‘equyte’ (measure, temperance), The Book of Vices and Virtues outlines for its lay (as for its clergial) readers a model of the co-ordination of the rational part of the soul with its lower appetites and with the body. It is this co-ordination that enables the ‘equyte’ that, in turn, leads to good self-governance, virtuous dispositions and filed speech – in other words, a virtuous habitus. Such ‘equyte’ should result from the childhood teaching of the Manciple’s dame, and would have spared Phebus’s crow. The heart, it explains, has two sides: understanding and will are in one side; reason and affection in the other. When these two sides accord, they ‘maken a swete melodie and wel faire seruice’. The particular offices of reason are outlined as fourfold: ‘to enquere’, ‘to juge’, ‘to þenke wel on’ and ‘to schewe þat sche vnderstont bi word’.⁷³ The logical result of inquiry, judgement and careful consideration is the expression of reason in speech. This process ‘makeþ þe resoun speke bi mesure and gladliche be stylle and not speke gladliche, so þat þe word mowe sunnere come to þe vile þan to þe tonge’. In ways not unlike those modelled by Grammar, the material word is here subject to a process of filing by the tongue. The perception of the tongue as a file (or of the substitution of the tongue with a file), in this case drawing on Gregory the Great, is a commonplace one in Middle English contexts. On the Properties of Things thus reveals a similar catenation (likewise citing Gregory):

Armed with the faculty of judgement – in the mouth, between its teeth – the tongue is transformed into a file, which subjects speech to painful but beneficial smoothing and cleansing, just as the barber-surgeon files the tongue and teeth and just as Grammar does. The Book of Vices and Virtues, however, continues that words should come ‘to þe vile’, so

Here, mixing the authority of Gregory with Solomon (Ecclesiastes 5:2), the image of the tongue as a file evokes, not surgery, but filing metal coins: in either analogy, however, words must be filed and tested.⁷⁵ This reminds us that figures and metaphors rarely (if ever) signify singly or uniformly, but multiply: measured, reasoned speech is like surgical filing, like filing metal, like testing money.

This vernacular pastoral model for virtue acquisition shares with the grammatical habit the understanding of the tongue as a file. In a confessional context, these perceptions about speech and the instruments of speech become part of a characteristically medieval ethical project to which the everyday body is subject, and suggest a nexus between epistemological practices, speech-acts and bodily form. The vocabulary of scraping, shaving, filing and ‘fretynge’ – found in surgical treatises and allegories of grammar alike – becomes a fitting mode of understanding the effect of confession (as well as what happens when a subject does not confess), which not only cleanses and reshapes the soul but also erases the material as well as the invisible evidence of sin. As Ancrene Riwle observes, ‘schrift hit schrapeþ’.⁷⁶ In the same vein, Mirk teaches in the sermon for the second Sunday of Lent in the Festial that ‘Lenton is ordeynod only for to schow[r]on’ – that is, to scour, to polish – ‘and to clenson зoure conscience of alle maner ruste and fylthe of synne þat he is defouled inne’.⁷⁷ Book to a Mother instructs the penitent to ‘scrape it [sin] out wiþ sorew of herte and schrift of mouþe and satisfaccioun’.⁷⁸ Literal, material scouring and scraping therefore facilitates spiritual scraping and paring, both accompanying and figuring it. Here too the figure is labile. Confession makes recourse to multiple analogies: confessing is like scraping parchment, like scouring metal, but also, as I discuss below, like having your tongue filed, your teeth scraped, like sweeping your mouth out with a broom, like breaking pots or like self-harming.

The disciplina of the repeated act of penitence is, of course, the primary means of cultivating virtue and self-reformation in the laity. As Nicole Rice emphasises, in the penitential practices that develop after the Lateran Council of 1215, ‘the penitent having expressed contrition for sin, was required to accuse herself and then ... reform her own dispositions to produce a reformed self’.⁷⁹ The vernacularisation of pastoral literature, first intended to aid unlearned parish priests, makes clerical forms of spiritual discipline increasingly accessible to the laity; confessional practice seeks to redress and mitigate the problem of repeated habitual sin in the Christian community at large. According to Breen, an important difference between vernacular imaginings of habitus and their Latinate counterparts is that Middle English authors such as Mirk and Langland are engaged in thinking through how to make virtue accessible to a community already engrained in the habits of sin.⁸⁰ In this context, if the threefold sacrament of penance – working contrition in the heart, confession in the mouth and satisfaction in deed – is its fundamental vehicle, its efficacy is also often questioned.

Two Middle English examples – those of Dame Penance in the Pilgrimage and of Envy in Piers Plowman – demonstrate the ways in which late medieval penitential and confessional allegories offer vernacular versions of the clergial models of habitus, sharing with them an understanding of the surgical effects of both learning to speak and the process of speaking, as well as a literal and figurative understanding of the tongue as an instrument of ethical action and correction. In the Pilgrimage the allegorical tradition of Grammar is written into the attributes of Dame Penance. Here, the corrective process of speaking a confession, as well as the deleterious effects of sinful speech, is imagined as oral surgical treatments. Reading Middle English confessional discourses through the lenses of the craft of barber-surgery, on the one hand, and the authoritative figure of Grammar, on the other hand, discloses both the inherently surgical nature of speech-acts and the ethical project by which ‘speaking the self’ and modifying the mouth transforms the body but also (re)constructs human identity.

Dame Penance

At the point that Dame Penance enters the scene in The Pilgrimage of the Life of Man, Grace Dieu has been teaching the Pilgrim about the sacrament of the altar. The Pilgrim has thus witnessed the bread turned into raw flesh, listened to the confusion of Reson at how this could be, and seen the anger of Nature at this transgression of her laws turn to humble repentance. Now the Pilgrim, having observed Moses serve the crowd ‘releef’ (a meal) at his ‘borde’ (the altar), sees two ladies come among the people, one of whom is revealed to be Dame Penance (the other is revealed later to be Charity). Dame Penance holds a hammer in one hand, a broom (‘bysme’) in her mouth and a rod (‘yerde’) in her other hand. Drawing curious gazes from the pilgrims gathered at Moses’ altar, she undertakes to educate them in her allegorical significance. Recalling the maidens of allegories of the seven liberal arts, the capacious allegory of Dame Penance here incorporates and expands upon the attributes of Lady Grammar. Dame Penance uses her rod, we are told, ‘To skouren [scour, polish, beat] chyldern’ (4011). She is thus also ‘off scolys a maystresse, / Chyldren, in ther wantownesse, / Affter ther gyltys to chastyse’ (4475–7). The children she disciplines and trains in school can be any age from twenty to one hundred (4481–2).

The lifelong work of educating these intemperate sinners is that of penance, which is performed through three stages, each of which is represented by one of Dame Penance’s instruments: the hammer is contrition, which is used on the heart; the broom is confession and works in the mouth; and the rod is satisfaction performed externally through the penitent’s deeds. As Lisa H. Cooper remarks, these are standard tools, but ‘[Dame Penance’s] explanation of what she does with them blurs the distinction of the inner and outer self’.⁸¹ Dame Penance with her tools – like Grammar with her file – is an ambiguous and labile figure; she is, at once, external to and inside the Pilgrim, both the figure of the confessor and of the confessant. Her function, Dame Penance claims, is to clean the inner man ‘Off allë fylthe & al ordure [filth]’ (4060), for which purpose she holds the hammer and the broom (4063–5).⁸² In the same way that Mirk explains the Maundy Thursday practices of shaving the hair and beard and clipping nails in the Festial, Dame Penance establishes this kind of introspection as a necessary precursor to participation in the meal that Moses distributes from the altar: she is the ‘porteresse [door-keeper]’ (4577) and ‘trewë chaunceler [chief officer]’ (4580) of this ‘releff’, which is ‘trewë ffoode’ (4589). No man may touch it if he has not first been chastised by her rod and hammer and swept with her broom. Firstly, then, Dame Penance uses the hammer of contrition to beat the sinner’s heart. This painful process softens the hardened filth in the heart, which, when flushed out through the penitent’s tears, Dame Penance washes with a ‘lyë strong’ (4140). Thus, in this domestic allegory, Dame Penance is a ‘lavendere’ (a laundress). Next, she explains that her hammer acts on the sinful man as it would on pots (4159–69). The pot of sin, full of hardened filth, must be broken and each shard scraped clean (4201) by considering all the circumstances of each sin. In this pot, Dame Penance warns, a worm is engendered that gnaws away ‘vp-on hys mayster’ (4282–3) if it is not dealt blows by the hammer. At this point, Dame Penance reveals that she is also a ‘lavendere’ (a laundress) ‘chaumberere’ (a chambermaid) and the Pilgrim’s body is a domestic space (4151–2).⁸³ Once sin has been hammered, the broken shards are swept out with Dame Penance’s broom through a gate that leads out of the building. There are, she clarifies, in fact six gates in the building, just as there were six gates in Nehemiah’s city (Nehemiah 2–3). At this stage, the literal, anatomical meaning of the multivalent allegory is now revealed to be the body of man. Five gates, through which filth can enter the building, are disclosed as anatomical referents – they are the five senses:

If filth enters daily into the body through these five sense organs, Dame Penance asserts that there is only one exit through which the body can be cleansed of this filth, namely and rather euphemistically through a ‘sixth gate’:⁸⁴

This sixth gate – the mouth of man – is as vital to the health of the body through making ‘purgacioun’ as it is to the soul through making confession. Given that the mouth itself, as the organ of taste, is one of the five senses-as-gates through which filth ‘may nat comen oute / Ageyn by hym in no manere’, as Dame Penance has earlier claimed, the reading of the sixth gate as ‘the mouth of man’ rather than as his anus goes somewhat against biology. It is, however, a slippage symptomatic of the interchange and interorientation of mouth and anus. While laden with legal and doctrinal connotations, the medical and physiological meanings of ‘purgacioun’ are emphasised here: thus confession, as Dame Penance continues, is the means by which ‘men putten oute. / Who that wyl with-Innë be Clene off al dishoneste, / To purge hym clene, as he best kan’ (4416–20). Notably, the body imagined here lacks an anus; the mouth is one of five gates wherein filth enters but is, as the sixth gate, the only exit for filth out of the body. Indeed, an anus would not fit Deguileville’s penitential model – which progresses from heart to mouth to deed – and the only exit for sin in this body system is therefore back through the mouth. Speech, issuing as excrement or vomit from this oro-anal orifice, purges the body from the excesses and impurities of sin that have entered it through the five senses.

Next, Dame Penance also reveals that the broom she holds in her mouth between her teeth is, in fact, her tongue: ‘my bysme, that al thys [purging] doth, / Ys myn ownë Tonge, in soth, / Wher-with I swepe & make al wel’ (4439–41).⁸⁵ With this tongue-as-broom, ‘I cerche ech Angle & ech corner; / Euery hoolë, gret & smal, / I remewe, in éspecial, / Clene with-outen & with-Inne, / The fylthe of euery maner synne; / Caste hem out, & sparë nouht’ (4444–9). The scouring performed with the tongue-as-broom is, of course, introspection expressed as confessional speech. Henry of Lancaster’s Le livre de seyntz medicines – contemporary with Deguileville’s second recension of the Pilgrimage – bears out similar perceptions of the mouth. Here, confession is shown to cleanse the soul in the same way that the tongue cleans the mouth:

Just as the tongue helps to heal the mouth and, through ‘frotynge’ and ‘scraping’, clean the teeth, so does the tongue clean the mouth and soul of its sin in the process of speaking a confession. Dame Penance’s ambiguous position (like Grammar’s) makes her tongue that of correction (i.e. the confessor’s), but also the Pilgrim’s own when put to the task of penitential introspection and confession. Having laid bare the literal sense of the allegory – Penance occupies not a room in a house but the Pilgrim’s mouth; her broom is not a broom but the Pilgrim’s own tongue – the anatomical sense continues to show through the domestic allegory like a palimpsest.

From the perspective of this anatomical and medical register, the preceding allegory of contrition in Deguileville’s poem can now be read over again, with the literal meaning of the mouth and its parts showing through its allegorical referents. The hammer breaks the pot of sin and the tears of contrition draw the filthy pieces of pot into the mouth – as Dame Penance asserts, ‘fyrst off allë I begynne / To drawe the felthë hyd with-Inne / Out, to make yt shede a-brood, / Wych with-Inne so long a-bood’ (4175–8).⁸⁷ Notably, the etymology of contrition underlies this process of breaking the pots: contritio (from con and tero), as described by Thomas Tentler, means ‘a breaking up, or a smashing of something breakable into its smallest parts, as if all at once it were completely pulverised’.⁸⁸ Relocating sin from the heart to the mouth, the broken shards of pots become like teeth which must ‘be cerchyd wel / Touchynge hys ordure euerydel, / And yscrapyd clene a-way’ (4199–201). Evoking the technical procedures of barber-surgery – as the Cyrurgie records, to remove ‘hardenede filþes’ from the teeth the barber-surgeon should ‘schaue hem with schauynge knyfes’ – Dame Penance’s scraping and the barber-surgeon’s shaving are homologous activities. In the speech-act of confession, the tongue-as-broom scrapes and files pots-as-teeth in the mouth.

The reading of the broken shards of pot as teeth is reiterated by the condition that afflicts them:

The fretting of the worm of Conscience mirrors medical descriptions of the pathological condition known as tooth-worm. On the Properties of Things records that ‘wormes brediþ in þe cheke teeþ of rotid humours þat beþ in þe holouзnes þerof, and þis is iknowe by icchinge and tikelinge, and contynual dikkinge [boring, i.e. of worms] and þurlinge [piercing], and by stenche þat comeþ þerof, and in many oþer wise’ (i, 371). The Cyrurgie devotes a whole section to this condition, the rubric of which elaborates: ‘Of filþe, of wormes and of fretynge and of persynge of the tieth’, recalling the very lexis of ‘wormes’, ‘fretynge’ and ‘percynge’ found in the Pilgrimage.⁸⁹ Moreover, the Cyrurgie’s remedy for tooth-worm parallels the remedy of penance prescribed. Firstly, the Cyrurgie makes recourse to medicinal treatments such as mouthwashes and gargles; thus the diseased tooth should ‘be wasshed with water ardaunt [MED, s.v. ‘an alcoholic distillate’] or with wyne’. Similarly, in the first stage of penance, as the Pilgrimage describes, tears of contrition act like a mouthwash and soften the ‘indurat [hardened]’ (4070) sins and make them ‘souple, nesshe [soft], and tendre’ (4073). Next, the Cyrurgie advises that ‘if thise [mouthwashes] avayle not forsoþe, rowme it wiþ a schauynge knyf’ – and ‘rowme’ (as we have seen) is a word, like scrape and shave, meaning ‘to scrape out (a hole), ream out’.⁹⁰ Likewise, in the second stage of penance (in which the conscience must be thoroughly scoured), the Pilgrim’s pots-as-teeth are to be ‘cerchyd wel’ and scraped clean by the tongue. Going to confession – for Lydgate’s toothache-prone reader – might thus evoke the experience of having one’s mouth washed and one’s teeth literally scraped by the barber-surgeon.

Dame Penance is a hybrid allegory: she is a laundress, a chambermaid, a schoolmistress. Like Grammar, so too is she a barber-surgeon. Both external to (in the form of a confessor) and inside the penitent (as the penitent’s own tongue), penitential speech washes the soul as a cloth, or breaks sins as pots or scours them clean like teeth. As a model for thinking about how the process of self-reformation works in those in whom sin is hardened, the heterogeneity of the allegory – washing clothes, cleaning pots, curing toothache – fully occupies the register of the everyday and the experiential as (repetitive) sites for learning to ‘do well’. It also accommodates within it a spectrum of bodily states and conditions, each of which requires forms of the care of the self: the dirty clothes in need of washing; the healthful body in which purgation is necessary; the suffering body that induces tears; the diseased body in which a worm festers. Reading between penitential and medical practice, the literal sense of Dame Penance’s allegory suggests the ways in which the mouth forms the material basis for bodily and spiritual reform. So too does it suggest, with The Doctrine of the Hert and the Festial, that the confessor is in league with the barber-surgeon.

Dame Penance is closely related to Lady Ryghtwysnesse in the poem, who is instead a smith but similarly holds a file, this one ‘callyd “Correccïoun”’, with which she files sins down to the root so that no rust can remain or ‘kankren’ there (15,706–10): ‘She skoureth yt a-way so clene, / That noon ordure may by sene’ (15,711–12). ‘Kankren’ (MED, s.v.) means to corrode, but also ‘to cause (a part of the body) to become cancerous’, or ‘to make an ulcer in a tooth’. Ryghtwysnesse, the Pilgrim learns, files the saw that the deadly sin of Wrath holds in his mouth. Designed to correct him, so engrained is Wrath’s habitual sin that it only sharpens his saw, so that any time he prays or says the Pater noster: ‘Thanne I sawhe my-sylff a-way / ffrom the hooly trynyte’ (15,742–3). Demonstrating the deleterious effects of vicious speech – when the heart does not accord with the mouth in prayer – the Pilgrimage also shows the bivalent potential of the tongue as a file, to either reform the self or destroy it. Langland’s Envy – like Wrath – is an example (in Breen’s words) of the effects of ‘repeated physical and emotional acts’.⁹¹ Langland’s personification of Envy similarly stages confession as a surgical process that takes place in and on the mouth with uncertain effect.

Envy

Passus v of Piers Plowman presents a dream vision in which the dreamer returns to the field full of folk (seen first in the Prologue) and observes Reson preaching to the people, urging them to reform their social and personal behaviour. Repentance then takes up the ‘teme’ (the sermon text and theme) and proceeds to lead an allegorical parade of the seven deadly sins through a series of confessions. The deadly sins are, as scholars have often pointed out, models of habitual sin – engrained, lifelong habits that are likely impossible to break. As Breen summarises: ‘Langland’s sins seem to have produced themselves over their own lifetimes through their repeated physical and emotional acts.’⁹² Envy suffers in ways which encyclopaedic and medical texts identify with both humoural imbalance and indigestion caused through either excess or lack of food; he is ‘pale as a pelet [a stone ball], in the palsy he semed’ (B.v.77), and his body is ‘to-bollen [swollen] for wrathe, that he boot [bit] hise lippes’ (B.v.83). The ‘palsy’ might variously be a form of paralysis or an attack of tremors.⁹³ Similarly, the pastoral tradition commonly gives the aetiology and symptoms of the seven deadly sins real bodily sicknesses. Thus, The Book of Vices and Virtues outlines the threefold effect of envy: ‘þis synne first enuenymeþ [poisons] þe herte & after þe mouþ and after þe dedes’, causing sleeplessness and depressive behaviour.⁹⁴ Wrath likewise causes torment in soul and body, and it even sometimes ‘bynemeþ [deprives]’ a man of ‘mete and drynke’, causing him to fall into a fever or such sorrow that it brings on death.⁹⁵ In Piers Plowman, the causes of Envy’s sickness are his many verbal transgressions which have been his diet, and include ‘chidynge’, ‘chalangynge’ and ‘bakbitynge and bismere [derision]’ (B.v.87–8) through which many a ‘lif and lyme’ have been lost (B.v.98). Envy’s confession therefore attests to the physical potency of vicious speaking. The C-text makes even clearer Langland’s perception of the surgical action inherent in speech: Envy here confesses to having ‘Venged me vele tymes other vrete myself withynne / Lyke a schupestares sharre’.⁹⁶ His envious condition causes him either to take revenge or to ‘fret’ (‘vrete’) – that is, in this instance, to cut – himself within like a pair of shears does. A ‘shupestare’ might be a dressmaker or a female barber, which suggests the tantalising possibility that Langland here is referring to barber’s shears.⁹⁷ In speaking well, the tongue – like Grammar – as a pair of shears prunes and regulates the mouth; in speaking badly the tongue destroys and maims bodies, as the Latin quotation Langland cites immediately following suggests: ‘The sons of men, their teeth are weapons and arrows; and their tongue a sharp sword’ (Psalm 56:5).⁹⁸ As a result of the sins of his tongue (and his immoderate diet), Envy complains:

Because envy and evil will are difficult to ‘defie’ – that is, to digest, assimilate into the body or defecate from it, but also difficult to renounce – Envy is unable to eat.⁹⁹ Sins like undigested food are blocking Envy’s body – preventing eating, purging and confessing. The remedy of confession that Envy attempts to make follows a clinical model not unlike that discernible in the allegory of Dame Penance. Envy’s symptoms are described and diagnosed and then a ‘prescription’ is outlined, firstly for medicinal therapy and finally for surgery to deal with the excess matter or sin built up in his body.¹⁰⁰ The attempted cure first makes recourse to the ‘commune’ instruments of medicine – sugar, sweet things, ‘diapenidion [a sweet drug]’¹⁰¹ – and progresses to the more extreme measures of surgery or ‘mawe-shraping’. Perhaps fallen victim to the confessional dangers of scrupulosity, Envy questions the efficacy of his speech and the power of confession (and, by extension, of medicine) to adequately cleanse his body of sin (or sickness) unless someone ‘shrapes’ his ‘mawe’.¹⁰² This sense is borne out in the A-text, which omits the question ‘whoso shrape my mawe’, but wonders: ‘“May no sugre ne swet þing swage it an vnche, / Ne no dyapendyon dryue it fro myn herte. / Зit shrift shulde, it shope a gret wondir.”’¹⁰³ If medicine will not drive envy out of him, it would be a great wonder if confession did.

The MED glosses ‘shrapen’ as ‘to scrape’ or ‘to scratch’ (and so it belongs to the same vocabulary as ‘filen’, ‘scrapen’, ‘schauen’ and ‘rowmen’) and the noun ‘mawe’ as ‘stomach’. But scraping the stomach fits neither the oral surgical model nor a confessional one.¹⁰⁴ If this is indeed a surgical reference, it is difficult to maintain Envy’s ‘mawe’ is his stomach; surgery is always the last resort in medicinal remedies, and surgical treatises in fact warn against any form of cutting into the viscera because of the potentially fatal consequences. However, as the Cyrurgie makes clear, scraping takes on specific medical connotations when put in the context of the mouth. Oral surgery works to file and scrape the teeth; the act of speech, and in particular that of confession, similarly works to scrape the hardened filth of sin away and to file down signs of man’s bestial excess. ‘Mawe’ might therefore be better read as ‘mouth’ (or at least as a mouth as well as a stomach); indeed, the MED suggests that the noun ‘mawe’ also signifies the ‘jaws’, ‘throat’ and ‘gullet’.

The Shipman’s use of the word ‘mawe’ in the epilogue (found in some manuscripts) to the Man of Law’s tale in The Canterbury Tales also suggests the use of the noun to refer specifically to the mouth. The Host at this point in the Tales has invited the Parson, ‘for Goddes bones’, to speak next. The Parson’s reproof (what ails a man that he swears so sinfully?) smacks, as the Host points out, of Lollardy: the company should thus expect a ‘predicacioun’ – that is, a sermon. The Shipman, however, objects to hearing the suspect Parson preach or teach, instead proposing:

The Shipman reveals himself here to be politically ‘lewed’, deliberately unclergial in his rejection not only of vernacular theology, but also of ‘philosophie’ (a term that encompasses learning in general, as well as natural philosophy and science), ‘phislyas’ (a garbled technical term probably referring to the science of medicine) and ‘termes queinte of lawe’ (legal terms). As Christine F. Cooper observes, this epilogue ‘essentially shuts down the possibility of Latin translation’.¹⁰⁶ There is, the Shipman claims, little Latin in his mouth. In showing the project of vernacularisation to be a contested one (even among the laity), the Shipman also casts doubts about the availability of a Latinate habitus – in part instilled by language, through the rules of grammar, between the teeth and on the tongue – to unshaped, vulgar ‘mawes’.¹⁰⁷

The reading of Envy’s ‘mawe’ as mouth in Piers Plowman is further borne out by the sacrament of penance itself, which, as the Pilgrimage amply demonstrates, entails a logical progression from heart to mouth to deed. The medicinal remedies of sugar and ‘diapenidion’ – like contrition and mouthwashes – should work to drive the sins and sickness lodged in Envy’s heart out from his body. But the second stage of shrift and shame requires that such filth be driven from the heart to the mouth from where it can be purged in confession. A biological logic, on the other hand, would direct this undigested, sinful matter down to the anus. Perhaps conflating, as Dame Penance does, his mouth with his anus, Envy may be seeking the skills of a barber-surgeon to scrape his mouth in order to ensure the efficacy of his confession. Envy, however, is thinking, as Haukyn does, too much about his body. Instead of seeking a cure for his spiritual sin, he wants a remedy for its physical symptoms. He is reading the natural – the relationship between the material and the spiritual, body and soul – too literally, too materially. As a result, he has failed to extrapolate the spiritual truth from the material explanation of the way shrift ‘schrapeþ’ and so remains in ignorance about himself and about God. Envy’s confession therefore raises questions about vernacular understandings of the way in which the material acts upon the spiritual, and of the way in which texts such as The Doctrine of the Hert and Mirk’s Festial understand that physical care of the body has the power to reform the soul.

The barber-surgeon’s crafts – shaving and shaping the body, scraping and cleaning teeth – provide a framework for understanding confessional as well as pedagogical processes, demonstrating an ambiguous distinction between the material and spiritual: speaking acts materially on the body; surgery might act immaterially on the soul. The late medieval insistence on oral confession suggests that the physical, material act of ‘speaking a confession’ has intrinsic physical, moral and spiritual value that we would do well to pay attention to. Reading between medieval textual traditions and practices, the example of oral surgery demonstrates the ways in which medicine provides a form of commentary on, or gloss for, vernacular theology; it also directs us to a discourse of the care of the self in which material bodily practices are understood to have ethical and spiritual effects. As the examples in this chapter make clear, as do those explored throughout this book, this discourse fully occupies the register of the everyday: it takes in the mundane habits of washing, eating and drinking. Medical interventions in the body in the Middle Ages, in Foucault’s terms, ‘define ... a way of living, a reflective mode of relation to oneself’. An understanding of biology and medicine is bound up with concerns, not only of everyday care, but of spiritual good and eternal life. Injunctions to rub the gums, scrape the teeth, shave the tongue or trim the hair are thus instruments of habitus, ‘capable of instilling a whole cosmology, an ethic, a metaphysic’.

The slippage between the material and the spiritual which this book traces is the basis both of the power of the natural and of the recuperation of everyday experience in late medieval thinking. As the example of Dame Penance shows, material practice and literal readings of the mouth are peculiarly powerful in the reconstructive work of medieval penance. But while vernacular theology points to the centrality of ‘kynde’ knowledge about the mouth to understanding sin and salvation, so too does it point to the dangers inherent in it. Just as we might misread the created world or misdirect the mouth’s telos, so too might we misunderstand the relationship of body and soul, seeking a physical cure for a spiritual ill: like Envy, we might take the material too literally. These cautions notwithstanding, we have perhaps been too ready to discredit the material bases of late medieval spirituality. Taking these material bases seriously discloses the importance of the human mouth and its physiology in medieval answers to questions about what it means to be human, just as it discloses the mouth’s centrality to medieval discourses of physical, ethical and spiritual good.