Arden 19 Playing A Role 1317, 9th month, 23 th day. Today, a delegation of the Physicians, Midwives, Pharmacists, Herbalists and Civil Ingegneres appeared before the council, for the third and final day. The room was filled with scribes, scholars, guild representatives and knights. All of our pages were present, seated in positions behind the presenters and council members. They would move documents from one place to another. Iason had increased the page core from 6 to 10 just a few weeks ago, when we took charge to their training. He also moved them into our new and larger apartments. I made sure the Ardenʼs Boys were seated in the gallery along with some important military people and senior “civil servants”. Uncle Iason asked me to present a summary of the medial philosophy as expressed over the past two days. “I have asked our Princes to play the role of recanters on this subject, as much of the material is new to them, they should not have formed fixed ideas as most of us have.” Medicine seams to be a changing mixture of the scientific and the spiritual, Including divination. In the past, following the fall of the Roman Empire in the west and the stagnation in the east; medical knowledge outside of Parga was based chiefly upon surviving Greek and Roman texts, preserved in monasteries and elsewhere. Ideas about the origin and cure of disease are not, however, purely secular, but are also based on a spiritual world view, in which factors such as destiny, sin, and astral influences play as great a part as any physical cause. This sits in opposition to our Aristotelian approach and background. We are also fortunate to have the best collection of these ancient writings. We have always tempered spiritual beliefs with observation and experience. Since before the fall of Rome, the distraction of libraries by barbarians and religious factions, there was no single, organized, standard of medicine. Except for us, and our studies have been small but persistent. Outside Parga someone struck down by injury or disease can turn to folk medicine, prayer, astrology, spells, mysticism, or to an established physician, if such is available to him. Here everyone has the same options but a physician is and has always been available. Classical texts, such as those by Galen, are widely used here as elsewhere but on a different basis. Where others use them as authority rather than experimental confirmation; we use them a guide or starting point for observation and experimentation. Outside of Parga as Christianity grew in influence, a tension developed between the church and folk-medicine, since much in folk medicine was magical, or mystical, and had its basis in sources that were not compatible with Christian faith. Spells and incantations are often used in conjunction with herbs and other remedies. Such spells had to be separated from the physical remedies, or replaced with Christian prayers or devotions. Similarly, the dependence upon the power of herbs or gems needed to be explained through Christianity. We have known for a very long time that faith is often an important factor in illness treatment outcomes. We have shown that effective treatments are also independent of belief; but if an effective treatment is believed useful the results are more often than not, positive. For some maladies that are not life threatening, belief in a charm or potent is often enough to cause improvement, even if the charm or potent is nothing more than water or a small pebble. The religious ones teach that the God or gods often sent illness as a punishment, and that repenting would cure all ills. This leads to the practice of sacrifice, penance and pilgrimage as a
means of curing illness. Here we teach that no explanation is required if a nostrum or potent produces results. Spells, incantations, sacrifices, prayers, devotions or penance is up to the beliefs of each. The remedies, advice, methods and potent that prove reliable are used independently. A unified theory of medicine is beginning to develop, based largely on the writings of the Greek physicians such as Hippocrates and Galen, and others. Hippocrates wrote about diseases, surgery, and bone fractures as well as human anatomy. Galen wrote more than 500 treatises on physiology, hygiene, dietetics, pathology, and pharmacology. We continue to study and refine what has gone before. Dioscoridesʼ Herbal and compendiums like Bald's Leechbook include citations from a variety of classical works alongside local folk remedies from the Anglo Saxons and others. In the Byzantine Empire the organized practice of medicine never ceased and we have access to it. The Salernitan masters gradually established a canon of writings, known as the ars medicinae (art of medicine) or articella (little art), which became the basis of other European medical education. We use this and have combined them with our own and other historical works as our basis. From the founding of the Universities of Paris (1110)), Bologna (1158), Oxford, (1167), Montpelier, (1181) and Padua (1222), the initial work of Salerno was extended giving medical leadership to these newer institutions. Our new university can qualify a Doctor of Medicine in 5 years, not ten, as our arts training is completely covered in the intermediate schooling, all of us receive. The numbers of such fully qualified physicians remains comparatively small outside Parga. Here we graduate as many as are needed and while small in total number, represents a good sized group in relation to our total population. Our scholars have shown that the principles of the four humors are not wrong but not necessarily accurate in all instances. The idea that sickness is caused by an unbalance between the four is viewed as a result, not a cause. If the balance can be resorted the sickness will leave, it is the cause or agent of imbalance that is often not known or fully understood. In Parga, as many women are involved in the practice of medicine as men. Mostly as midwives, and nurses. However, the professionalization of medicine (guilds) and the development of university faculties of medicine, still exclude women from the profession. Abbess Hildegard of Bingen wrote the Liber Simplicis Medicinae (Simple Book of Medicine) around 1160. Another famous woman physician was the Italian Trotula, whose works on women's ailments spread across Europe. Here women continue to function as midwives, nurses and we princes urge you to include them as doctors in your guilds and our university. Our physicians and surgeons use the ancient Greek method of tying off blood vessels. We also use spirit soaked thread or horse hair to tie off blood vessels and close wounds. After amputation, the common procedure in other places, is to cauterize the open end of the amputated appendage to stop the hemorrhaging. This is done by heating oil, water, or metal and touching it to the wound to seal off the blood vessels. We also believed in dressing wounds with clean bandages and ointments, including such thing as eggs, oil of roses, and turpentine. Our ingegneres have designed artificial hands and limbs for amputation patients. We must all work together to improve the general health of our citizens. All our citizens including women and children. It is our belief that Pargaʼs children are this stateʼs greatest treasure. All agreed this was a fair summary. Iason was asked to review diseases or pestilence and make recommendations for what should be done to enhance the general health of our state. Dysentery (the “bloody flux”)
A malady thought to spread through contamination of food and water, perhaps by fecal matter. Symptoms: After 1-6 days incubation, watery stools, fever, cramps, dehydration. In advanced stages, bloody stools, meningitis, conjunctivitis, and arthritis. Acute form: watery, bloody stools, cramps, fever, weakness. Chronic form: intermittent diarrhea, mild abdominal discomfort. Result: Generally weakened condition. (Note: Endemic in armies and common in cities. Infantile diarrhea is a leading cause of death for infants. ) Ergotism (“St. Anthony's fire,” “holy fire,” “evil fire,” “devil's fire,” “saints' fire”) Poisoning from spoiled grain, especially rye. Symptoms: (Convulsive) Degeneration of the nervous system causes anxiety, vertigo, aural/visual hallucinations, and the sensation of being bitten or burned; stupor, convulsions, and psychosis. (Gangrenous) Constriction of the blood vessels causes reddening and blistering of skin, then blackening, with itching and burning, and finally necrosis. Result: 40% mortality. Lingering symptoms, including thinking impairment, among survivors. (Note: Ergotism is known as a rural disease, particularly of marshy areas, and one that followed crop damage or famine; especially after a severe winter and a rainy spring. Children are more susceptible probably because of their smaller size. Not common here as we grow no rye and are a much dryer climate. Moldy grain should not be eaten or given to livestock.) Gonorrhoia A genital tract problem, apparently transmitted through sexual contact. Symptoms: (Male) After 2-8 days of contact, urgency and burning sensation on urination, profuse discharge of pus. Inflammation of prostate and seminal vesicles may lead to fever and urinary retention. (Female) After 2-8 days of contact, mild urethritis; or may be entirely asymptotic. Sometimes it appears in the upper tract, acute fever and abdominal pain. It may invade, probably the bloodstream and produce reactions in other parts of the body, most commonly arthritis; the sufferer develops fever and hot, swollen, painful joints. Women with gonorrhoia are through to pass it to their babies on delivery, it seams to cause blindness. Results: In males, symptoms subside in several weeks; in females, a month or two. May result in infertility for both males and females. Treatment: We have not cure for this however drinking the waters from Apolloʼs Temple when combined with the juice of lemons and other herbs seams to be helpful if taken at the first signs. Influenza. An acute, extremely contagious condition of the upper chest, is thought to spread by breath. Symptoms: After 1-2 days, a sudden onset of chills and fever, headache, backache, muscular aches, and general malaise; weakness, prostration, nausea, eye pain, mental confusion. After 1-5 days the respiratory symptoms become more prominent: dry or sore throat, cough, runny nose. Serious complications include bronchitis and bacterial pneumonia. Leprosy (“lepry”) Transmitted by breath or contact, leading to disfigurement. Symptoms: After a time, facial features begin to coarsen and the voice becomes hoarse.
Eruptions of the skin and eyes begin as pale spots that turn into red, raised, firm nodules. Skin spots are insensitive to cold, touch, and pain; hands and feet lose feeling and eventually muscle weakness and paralysis set in, usually in the face and hands. Lesions or unnoticed wounds become gangrenous. Blindness often occurs. The nose decays. The hands and feet become clawed. Results: Eventual, ugly, lingering, friendless death, sometimes taking over 20 years. Fortunately a very rare thing in Parga. The most sulfurous waters from Apolloʼs Temple are used to forestall disfigurement. This is combined with exposure to the sun for long periods. Good results have been reported from this combination. Malaria (“the ague”) A disease thought to spread by mosquitoes. Not common here but not unknown. Symptoms: Shaking chills, then high fever, severe headache. After several hours the sufferer begins sweating profusely; then the headache and fever disappear. Attacks recur every other day (a “tertian” fever) or three days (a “quartan” fever). Weakness. Results: Survivable. (Notes: Chronic in southern and low-lying areas of Europe, including southern and eastern England. The name “malaria” comes from the Italian for “bad air,” which is believed to cause the disease. We believe the agency of mosquitoes as they are the one common feature between all places, including Parga, that have this malady.) Measles A mild, highly contagious disease transmitted by breath. Symptoms: After 7-14 days, cold like symptoms develop (runny nose, dry cough, high fever, aching, plus inflamed and sensitive eyes). Around the third day, bright red spots appear inside the mouth. Day four: characteristic red rash; slightly raised and mildly itchy; starts on face and spreads over the rest of the body. Fever and rash begin to depart after a few more days. Results: Survivable; complications can include blindness and heart or brain damage. Occurs mostly in late winter and early spring. Puerperal fever (“childbed fever”) Symptoms: Chills, high fever, abdominal pain, nausea; possible spread to rest of body. Results: Chances of mortality variable. Possible infertility in survivors. Smallpox (the “red plague”) A severe, highly contagious disease transmitted by breath. Symptoms: After 12 days, high fever, chills, severe headache and backache, and general malaise. Hemorrhages may occur in lungs or other organs. After 4 more days a distinctive itchy rash of red lesions appears on face, arms, legs, and sometimes the trunk. The bumps become pus-filled blisters; they break and begin to dry up in about 9 days but can be persistent. Results: Mortality 25-30% for the severe form; 1% for the mild form. Survivors have distinctive pitted scars and apparent complete immunity to further occurrences.
(Notes: Varies in severity from a mild form with few skin lesions to a highly fatal hemorrhagic form. The majority of deaths occur in the second week of the disease.) We believe people with these breath related diseases should be isolated from others until it passes. Typhoid fever Thought to be a result of human waste contamination of food and water. Symptoms: Diarrhea, abdominal pain, high fever, blinding headache, cough, exhaustion. Patches of red on the abdomen. Symptoms can last for weeks. Complications include pneumonia, intestinal hemorrhage, and coma. Results: 10-20% mortality. "We do not know the causes of these things, some feel it is smells or bad air, others some agent not identified. Perhaps the Atomists are right and it is small particles of something. It does not matter. All we can do is take steps to prevent or limit. Things that smell bad usually are, eliminating them is a good idea anyway. We know from history that good waste disposal, quick and proper burial or cremation of the dead and other measures, benefit us. 1. We should enhance and enlarge state and municipal clean water systems. Improve human and animal waste disposal systems and methods. 2. Encourage cleanness in all ways and forms. 3. Isolate those that seam to spread their sickness to others, through sharing of cups or utensils, cloth or air. 4. Keep our food supply plentiful and of high quality. 5. Prevent the introduction of diseases by visitors that appear sick on arrival. 6. Keep the population density of our state and itsʼ municipal centers from increasing. 7. Enhance and enlarge our system of hospitals. 8. Prevent the introduction of rodents and vermin to our land. 9. Prince Arden and I recommend the medical guilds and our university admit qualified women and grant them degrees. If this means establishing a special university for women and them forming their own guilds, so be it." Now that information was exchanged and suggestions made, plans could be constructed. Later in the evening while Iason and I lay in our bed we could not help but muse on these matters. It was clear in other lands many were suffering greatly. As expressed in Salvo's letter, the church had failed and their leadership had failed. The church and the local nobles had been raising taxes greatly in response to the inflation, caused by rapid population growth for many years now. Reports of growing peasant unrest have been increasing to our Fathers since they were our age. Not that the church or lords had control of the weather, they did have control of things like grain storage, and population growth in general and in cities specifically. Times of shortage were not unknown to them. France has seen such in 1304, 1305 and 1310 at least in some parts. For peasants and city poor, suffering is a potential source of political unrest. Changing weather patterns, the ineffectiveness of governments and religious leadership, which is often the same, in dealing with crises and a population level at a historical high, makes this a time when there is little margin for error. They are also unable to restore order and restrict lawlessness. We will be tested in the future as our fathers were tested, as the leaders in France and other places, but we were just not sure how or when. We were sure, as a society, we would and could meet most any challenges presented. And if we failed it would not be from lack of planning, preparation and leadership.
The one thing we resolved between, our feels, kisses and mutual comfort was; if our situation ever got so difficult that children were being abandoned and left to starve, we would be the first to see they were cared for. If it would mean giving up our own food and caring for them ourselves, so be it. I am still the most beautiful boy in the kingdom as Iason tells me every day, sometimes several times a day. I think he is not seeing clearly but is blinded by his affection and perhaps lust. As for me he is my equal and I know I am not blinded but deeply in love. Our conversation was so emotionally taxing that even with his continual efforts I was not erect until we stopped talking, that is. He lay is head on my shoulder his lean strong body half on me. His hands in constant contact with my penis. He suckled at my breast and licked my neck, nibbled my ears and kissed my lips. I could feel his stiff penis pressing against my leg and I wanted him. His penis is long and straight. It is not fatter or slimmer but equal along it length with a wide read arrow at the end. His buttocks are round and hard with hollows on either side and he like myself is powerful of shoulders and legs. His penis has blue veins lacing its exterior and is very sensitive to my touch of hand or lips. I pulled him to myself and spread my legs wide so he could easily fit between. Placing my legs on his wide shoulders he entered me and I immediately entered a state of euphoria. After filling my rectum with is seed, we licked my seed from each otherʼs bodies. Tomorrow we will again sleep in the pageʼs bedchamber with our charges. It is an important part of their training, one we both enjoy, as do they. Not that the older pages and our guardians donʼt keep them occupied and filled with ejaculate. It is our desire to build the strongest possible bonds with them. All of them but especially our three younger brothers. 1317, 9th month, 25th day: Today we received another letter from abroad. This one is a more regular occurrence. Dario, has faithfully written to us for most of the past four years. His letters are never coded as they are sent by Lugoʼs family ships. He does not write to us but to our fathers. They have been sharing them with us and including our responses with their own on the return. I asked Iason what he made of this? “I am not completely sure of the implications but it is clear that Dario is seeking a wife and is asking Father to arrange one for him. Lugo is giving his share of the Apolloʼs Temple Inn to him as a wedding present. It looks like our brother Abernath is to have a new business partner.” True but I get the sense that Dario is less than happy about this and that he and Lugo have some misgivings. I take it that Lugoʼs family is pressuring him to take full control of the business and to also seek a wife. It would appear that Lugo is less than happy about his families choice for him. “What about this young cousin of his mother who he wishes to see in our university? Certainly they have good schools, church run ones at that, in Venice.” We must respond quickly expressing our great joy at his imminent marriage and Darioʼs desire to seek a wife here and not in Venice. We must invite Lugo and his new wife for a visit and to attend Darioʼs wedding. “Aye brother and while you put pen to paper I shall seek some explanation from our fathers.” My beloved Iason has the most wonderful fragrance to his body I have ever experienced. Would I live with my had under his kilt, to saver it every moment of the day, would that be possible. I have often wondered how our fathers knew Iason and I would become so completely in love with other. It is clear that one can not be angry or jealous of that other who would and does supply so
complete pleasure. Iason said to me the day we met that we were expected to become lovers and that the pleasure was in the doing. He was correct and it has been, is, and looks to continue.