Holistic Living: Medieval Manuscripts and the Art of Balancing Life

By Caroline Crosdaile

Much like the stars and the super-wealthy today who obsess over kale the perfect health and fitness regimes, people in the medieval era too had a health obsession. However, before germ theory was established in the late 19th century, their understanding of wellness revolved around a method proposed by Hippocrates in the classical period, later advanced and developed by Galens called “humoral theory”. In brief, humoral theory divided the world into fours - four seasons, four elements (earth, air, fire, water), and four humors (blood, black bile, yellow bile, phlegm). Balancing these humors was a matter of life and death, affected physical and mental health, and was a favorite absorption of people in the medieval era.

“Giving Barley Soup to an Invalid”  Tacuinum Sanitatis , SN2644, folio 44v; 1385–1390.

“Giving Barley Soup to an Invalid” Tacuinum Sanitatis, SN2644, folio 44v; 1385–1390.

The nobility, who had the leisure time and education to contemplate their humoral composition in depth, commissioned beautiful \ and artistically illuminated manuscripts depicting the proper ways in which to cultivate their health. One such popular text is the Tacuinum Sanitatis. Originally titled Taqwīm assiḥḥah, and written in Arabic by Ibn Butland of Baghdad in the 11th century, this health treatise was later translated into Latin and circulated throughout Europe. Lavishly illuminated late fourteenth-century copies from the Italian region of Lombardy remain today, and are now located in collections in Vienna, Paris, Liège, Rouen and Rome. The popularity of the Tacuinum Sanitatis is evidenced by the modern Italian catchall word taccuino, used today to mean any sort of pocket handbook or guide. The illustrated Tacuinum Sanitatis was so widely lauded and unique because it allowed the layperson to be the master of their own health and humors without the aid of a physician. The explanatory introduction to this text reads:

 “The Tacuinum Sanitatis is about the six things that are necessary for every man in the daily preservation of his health, about their correct uses and their effects. The first is the treatment of air, which concerns the heart. The second is the right use of food and drinks. The third is the correct use of movement and rest. The fourth is the prohibition of the body from sleep, or excessive wakefulness. The fifth is the correct use of elimination and retention of humors. The sixth is the regulating of the person by moderating joy, anger, fear, and distress.”


“Representation of Anger”  Tacuinum Sanitatis , SN2644, folio 98v; 1385–1390.

“Representation of Anger” Tacuinum Sanitatis, SN2644, folio 98v; 1385–1390.

These six areas of regulation in health are depicted throughout the manuscript with illustrations of food, drink, activities, and even fabrics that medieval people believed had an influencing effect upon their humors. To our modern eyes these range from sensible to the ridiculous. Beets were written to be dangerous because, “they set the blood on fire”, eggplants had an overwhelming libidinous effect, and olive oil was thought to “put the stomach to sleep”. However, to avoid migraines when eating watercress, it was recommended to consume them in a salad of escarole and vinegar, which actually sounds quite upscale and pleasant. The list of foods and produce goes on and on including; sweet almonds, dill, cherries, spinach, cabbage, pomegranates, apricots, squash, figs, chestnuts, onions, dates, and grapes. The uses and side-effects of all these items are carefully chronicled, listed, and illustrated throughout.

“Eggplants and their Aphrodisiacal Effects”  Tacuinum Sanitatis , SN2644, folio 31v; 1385–1390.

“Eggplants and their Aphrodisiacal Effects” Tacuinum Sanitatis, SN2644, folio 31v; 1385–1390.

The Tacuinum Sanitatis is interesting both in its rendering of everyday life in an era saturated with religious art, and the ways in which it challenges our pre-conceived notions about medieval health. While we may think of nobles as gorging themselves on vast quantities of red meat and wine, the Tacuinum Sanitatis shows us just how many grains, fruits, vegetables, nuts, and herbs were known to them and valued for their beneficial health properties. It is also notable just how seriously the medieval people took mental health, and the Tacuinum Sanitatis demonstrates a holistic approach to the mind-body connection. Much like talk therapy treatment today, “chatting” is even listed in the pages of this manuscript as a health cure, and thought to facilitate better sleep. The dangers: it can cause boredom.

Today we study the Tacuinum Sanitatis perched from the perspective of a time when our own healthcare is rigidly divided between conventional western medicine- and everything else. Despite scientific progress, classic methods of medieval healthcare are still used to cure a wide range of ills today and include herbal teas, aromatherapy, bone broth, and essential oils, as well as supplementing diets with specific foods. Even though the humoral theory behind the Tacuinum Sanitatis may be obsolete, studying the rich art historical record of these illustrations can provide us valuable insight into our own stance on holistic health, and the development of human perceptions on health and sanity throughout time.  


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Mendelsohn, Loren D., "The Tacuinum Sanitatis: A Medieval Health Manual" (2013). CUNY Academic Works.

Witthoft, Brucia. "The Tacuinum Sanitatis: A Lombard Panorama." Gesta 17.1 (1978): 49-60.