Tuesday, 12 May 2020

NVivo Cantando!

NVivo is a popular software package for qualitative data analysis. Stephanie Jesper takes a topical look at it ahead of our NVivo Digital Wednesdays session next month.

An empty NVivo all ready to be filled

This week would've been the week of the Eurovision Song Contest: one of my favourite weeks of the year. But a certain global pandemic got in the way. So instead I'm spending the week playing with NVivo. It's not the same. Still, I'm keen to make my NVivo play as interesting as possible in every way that I can... maybe I could liven it up with a little Eurovision-related qualitative data analysis?

The 2020 contest may have been cancelled, but what's another year I could play with? My number one Eurovision Song Contest is 1977 (there were some really wild dances that year), but it's probably better to choose a contest with a more famous winner. And I believe pretty-much everybody knows the winner from 1974 so let's go with that...

NVivo is a qualitative data analysis tool. Most data analysis is quantitative: it's about counting numbers. And spreadsheets are really good at that. You can throw in a load of numerical data and get really quite sophisticated analysis at the touch of a button. But a lot of data we get is in the form of text; of words. And that sort of thing is a bit harder to automatically analyse in a meaningful way. NVivo is a tool to facilitate that analysis.


The first thing NVivo needs is some data. You can import all kinds of everything into NVivo: the spreadsheets you've collated, the bibliographic data you've amassed, the voice recordings you made when you were conducting interviews... all kinds of other materials you might want to analyse like emails, tweets, transcripts, video... or in our case song lyrics.

I've sourced the lyrics to all the 1974 Eurovision Song Contest entries (translated into English where necessary) and I've imported them into NVivo. Now what?

Frustratingly, it's not just as simple as saying "Hey, NVivo, my love: shine a light on these texts. I wanna know all the juicy details". NVivo isn't that clever. It's not an artificial intelligence tool. It's more like a glorified highlighter pen that can add up. You're going to have to do a lot of the hard work.

But that's no reason to go running scared from NVivo. Helpfully it's been built to look like a Microsoft Office application, so that makes it a bit easier than it could be to navigate. And down the left-hand side of NVivo's navigation pane are three important subsections: Files, Codes, and Cases. The first of these is relatively straightforward: we've just imported a load of files. But what are these codes and cases?

Cases and classifications

It's important to stress that NVivo's a pretty open environment and you can use these fields how you like, but there are some standard principles. We'll start with cases. Let's say you've done several interviews with different people. Each person might be considered a "case". You might've interviewed them twice so there'd be two files associated with them (or maybe even more), but they're the one case.

Files and cases also have associated "classifications". These are your metadata. File classifications may be things about the file itself: what type of file it is, when it was recorded, etc. Case classifications are the demographics of your case: maybe you interviewed some great operatic diva from the stage, some jazz heroes from the local club, and some rock'n'roll kids from satellite TV: here's where you'd put all the useful background information about them. In my case I'm putting in here the information about the songs: artist, country, score, placing, etc.:

I've linked my files to my cases, and added case classifications

These classifications are useful because they offer an extra layer of potential analysis with which to toy (do the songs sung in English perform better than the songs sung in other languages, for instance?).

Codes and nodes

And then there's the codes. These are where most of the action happens in a tool like NVivo. And it's action that is very much on you. There are ways to automatically code in NVivo but you'll miss a lot if you do that. Or get a lot of stuff you don't need. NVivo isn't some magic fairytale tool. You're going to have to go through all your files and manually code them up. This involves making your mind up about what approach to take. Is there a pre-existing set of themes or categories you could apply, or are you just going to work from the bottom up, tagging things as you see them? Which method works best in your eyes?

Here I've tagged up the winning song from 1974: Abba's "Waterloo":

Tagging up Waterloo: coding strips show where certain nodes are being applied

I'm working very much bottom-up: I've noticed certain themes and I've created a "node" for each one, e.g. "Love", "War", etc. I've even nested some nodes beneath others ("War", I've decided, is a subset of "Society"). Again, how you do this is up to you.

Another decision I've had to make is whether I mark up the refrain: does a repeated chorus count as a repetition of imagery, or does it just skew my analysis? Also, does a "la la la" count as musical imagery worthy of coding? You'll be faced with a lot of questions like this. You might want to save several copies of your project as you go, in case you change your mind about anything.

...and in case NVivo crashes. Which it did for me as I was coding up. That's why I have a file called "esc74 (Recovered).nvp". "Why me?" I despaired. I didn't realise how much this crash would rock me. I was about to cry at the frustration of having to do all that coding again, only teardrops were thankfully spared when NVivo persuaded my file to rise like a phoenix. I let out a little "hallelujah" such was my euphoria.

Exploring the data

Coding took a while. And I didn't do a particularly good job of it. Still, once it was done I could start on the analysis. There's a whole arcade of tools to play with in NVivo...

A wordcloud from Eurovision 1974: 'love' is the biggest word. 'sing

A simple thing that didn't need any coding up was this wordcloud. The words "sing", "one", and "lala" fly on the wings of "love", with "Waterloo" also quite obvious in the mix.

But now we've coded up we can look at other things too. Here's the nodes for "love" and "war" plotted against the "language" case:

Love versus War: 'love' is the dominant theme in all languages except Serbo-Croatian

You probably have to play with the analysis tools a bit to get something really telling from the data, and think about things you want to explore in more detail. But you can get counts and cross-tabulations on all your codes and cases, and one of those combinations might be the revelation you're looking for. Personally, I'm rather fond of this particular visualisation:

What comes before and after the word 'Waterloo' in the song 'Waterloo'?

I've only scratched at the surface of what's possible with the help of NVivo. If you're interested in finding out more, there's our Research data Skills Guide, but we're also doing an "Intro to NVivo" demo on Zoom as part of our Digital Wednesdays research theme this term. That takes place at 2pm on Wednesday 3rd June, and is open to all members of the University. In lieu of this year's Eurovision Song Contest, it may be the best gig taking place this year! Failing that, you could always shove this text into NVivo and see if you can code up all the winning songs I smuggled into it. There's 30 to find...

Monday, 4 May 2020

Looking after your digital wellbeing in lockdown

Ahead of our latest free online course on Digital Wellbeing which starts on 11th May, one of the course facilitators, Alice Bennett takes a look at the challenge of maintaining our digital wellbeing under lockdown...

Wiping down a computer keyboard

If you are a fan of MOOCs – Massive Open Online Courses – you might know that some of us here in the Library and IT have been involved in creating a few of them, one of which is on digital wellbeing. We update it each time we run it, to make sure it covers current issues but when we were preparing to run it again this year, something big happened: a pandemic.

Does this affect your teaching if your teaching was always going to be online? Well, it certainly does if your course is about digital wellbeing! With life in lockdown, working from home and studying remotely have become the new routine for the majority, social media and video calling are the primary means of staying connected and whether streaming or gaming, the digital dominates entertainment too.

Looking over our previous course materials, there was suddenly a very big, very virus-y hole. We talked about tech in the workplace – workplaces that are now closed. We discussed how not to annoy colleagues with emails but made no mention of videoconferencing. We talked about unhelpful comparisons on social media, but hadn’t mentioned comparing lockdown sourdough loaves. Everything was still current, but also somehow very out of date. This course has a global audience and we try to talk about trends rather than specifics, but this was a global event. We had to acknowledge the elephant that had suddenly waltzed into the room.

But what about overload? The pandemic is dominating our lives, so we can’t ignore it, but we didn’t want it to dominate this course. We couldn’t talk about digital wellbeing without mentioning something which pushed so much more of daily life online and has so heavily impacted wellbeing. On the other hand, continually staring the pandemic and its every digital ramification in the face was not the answer. Studying online is not necessarily escapism, but for most it is not about endlessly probing the worst of life’s problems either.

And we don’t know the whole story yet. We can talk about digital trends and habits, we can look at how lockdown has changed our behaviours, we can consider how we are using digital technology to combat the virus – but long term, we still don’t know what impact this will have on our digital world and our relationship with it. It may change habits, or people may revert to pre pandemic behaviours – we won’t know for some time what legacy we have been left.

So with this latest run of the course we have tried to strike a balance. We discuss the big digital issues and the immediate ones. If, like me, you have participated in more video conferences in the past few weeks than in the entirety of your life before 2020, we have tips on video calls and working from home, as well as discussing the risk of being always on when working remotely. With so many of us spending more time online during lockdown – whether through choice or necessity – understanding the way we interact with digital technology is even more important. There are risks and unresolved problems with our relationships with the digital world, but similarly there are amazing possibilities. So join us to consider the pitfalls and potentials of digital technology and the impact on our wellbeing, at a time when negotiating our wellbeing and an increasingly online life are especially important.

A girl opens a magical book

The new run of our Digital Wellbeing course starts on Monday 11th May.

Tuesday, 25 February 2020

A Fifteenth-Century Medical Handbook in York Minster Library (YML, XVI. E. 32). Part 4 - a blog by Dr Rebeca Cubas-Peña

Part IV: Reception

In the same manner that modern students take notes in the margins of their study books or come across other students’ annotations in library books, earlier readers marked and adapted the texts they read as a method of assimilating and internalising new and useful material. Through these notes, readers show an engagement and interaction with the texts which represent a natural process of reading. This engagement is manifested not only in the form of annotations but also in the number of devices that readers have added to their books in order to facilitate their navigation and understanding.

Numerous post-medieval owners of the York medieval manuscript engaged with the volume. It is worth mentioning that if it were not for these additions modern readers would think that the manuscript was barely read, since except for a few dog-ears is in excellent condition. Knowing the disposition of a medical book might have been indeed helpful, if not necessary, to a medical practitioner. Given the practicality of such subject matter, the fact that herbals or treatises on simples were copied in alphabetical order, that the headings of the recipes were copied both in the body of the text and the margins, or that several collections of recipes followed the so-called ‘head-to-toe’ principle would have been convenient to the practitioner in need of specific information to heal a patient, especially if in haste.

An incomplete table of contents concerning a collection of recipes written by a sixteenth-century reader (fols. 81v-82r)

Marginal annotations

The margins of the York medical manuscript reveals the presence of annotators who, by adding tables of contents, headings, recipes or comments, have contributed notably to give the manuscript its present form. The majority of these annotations, which were mostly written in the sixteenth century and aimed at facilitating the location of specific information, were written to find relevant recipes fast. How did they do that? By copying the heading of the remedies next to the recipes they refer to. For instance, folios number 104v and 105r show the following marginal titles (in original Middle English here) next to their corresponding remedy: ‘to do a wey here’ to remove hair; ‘for þe quarteyne’ to treat the quartan fever, i.e. an intermittent fever with attacks every third day; ‘for þe blody flyxʒe’ (called the ‘blody menysoun’ in the text) to help with the menstrual flow; ‘for bleynys in þe face’ to remove pimples or sores on the face; ‘for þe goute’ to relieve the strong pain suffered by arthritis in the bones of the haunch (called the ‘goute sciatik’ in the text); and ‘for þe morymalle’ to treat a bad sore (mormal), in this case in the leg. [1]

Post-medieval recipe titles in the margins (fols. 104v-105r)
Some of these indexing notes are of significant interest because they mention individuals who are related to the readers of the manuscript. Thus, there is a very interesting note which points to a remedy that seemed to be good for the stone or calculus that an old man called Johannes Busshy had.
A marginal note (‘for þe ston þat olde Johannes busshy hath’, fol. 157v)
This same annotator, who was probably a medical practitioner and an early owner of the manuscript, also annotated a recipe for a long-time headache which is easily found due to a marginal manicule and a bottom-page note that reads: ‘a medicine for my wife´s headache proved true’. These annotations would have helped the reader to spot successful remedies without difficulty, whilst underlining their efficiency for future readers and owners.
A marginal note concerning a recipe which is also marked by a manicule (fol. 92r)
Other annotations were added to transcribe, translate or explain Middle English terms. A very prolific sixteenth-century annotator drew two carets at the beginning of a word that alludes to the herbe paralisis, a plant that earned this title due to its effectiveness in healing gout, paralysis and rheumatism. The annotator wrote a marginal explanatory note which indicated that paralisis was the cowslip or primrose.

An annotator explains that ‘paralisis is þe cowslope or primerose’ (fol. 87r)
There is a more consistent and modern annotator who marked the margins of the manuscript with notes and drawings written in pencil. At first, I suspected that these annotations may have been written by Elizabeth Brunskill, a former York Minster librarian who did a comprehensive study of the volume that includes a full transcript of the manuscript, a list of contents, and relevant bibliographical material, among other things. [2]
Elizabeth Brunskill´s transcription of a table of contents in the York medical manuscript (Add. MSS 198, fol. 79a)
She also developed an analysis of the Liber de Diversis Medicinis, the source text of the third Booklet of the York medical manuscript. Brunskill compared the booklet to Margaret Ogden’s celebrated edition of the treatise and wrote some notes on the margins of her transcript. [3] Due to this exhaustive analysis of the volume and the modernity of the script, I assumed that she was responsible for the pencil annotations in the manuscript. However, it is highly unlikely that anyone took notes on the book once it entered the library.

What seems more obvious is that whoever wrote these pencil annotations intended to gloss and transcribe words whose spelling or meaning were not easily understood. The annotator transcribed the Middle English word ‘loue ache’ as ‘lovage’, a plant in the parsley family ― normally Levisticum officinale ― used in medicine and cooking. This person also transcribed and translated the word ‘cropen’, which as glossed means ‘crept’ and appears in the heading of a recipe for a worm that is bred or crept into a man´s body.

An annotator glossing the word ‘lovage’ in pencil (fol. 54r)
Cropen glossed as ‘+cropen i.e. crept’ in the margins (fol. 80r)
Marginal drawings and bookmarks

Alongside these marginal notes, the York medical manuscript contains several finding aids in the form of manicules, drawings of circles and crosses, illustrations and bookmarks. The annotations already discussed include a manicule and a black cross, but there are other extraordinary examples worth mentioning. For instance, there is a drawing of a tongue next to a recipe for the man who has lost his speech, or a drawing of a heart that was drawn in the middle of the word ‘palsy’ and points at oil for palsy, cold gout and other cold causes.

A marginal drawing of a tongue (fol. 22r)
A drawing of a heart next to a recipe for ‘Oyle mad for palesye for cold goutys & for oþir colde causys’ (fol. 156r)
My personal favourite, however, (which I need to include for obvious reasons!) is the dead bovine which someone drew next to a charm against the plague, or death, among cattle. This excellent illustration, which depicts the animal expiring, shows the bovine on its back breathing its last breath (look how it comes out of its mouth!) with an overhanging cloud. 

A drawing of a dead bovine next to a charm against the plague (fol. 166r)
Marginal notes and illustrations are not the only finding devices in the York medical manuscript: the edges of some leaves contain bookmarkers. Unlike modern bookmarks, which consist of external elements placed amongst the pages of a book, medieval bookmarkers were made by modifying the original appearance of the folios of the manuscript. Finger-tabs, for example, were made by cutting the fore-edge of the leaf and passing the tab through the slit.
A finger-tab (fol. 65)
There is also a thread to the fore-edge in the sixth booklet of the manuscript which might have had originally a piece of fabric or other material hanging out the page and is probably marking the opening of the Prophecies of Esdras: a text that predicted the future based on the day of the week in which Christmas day fell.
A string to mark the folio (fol. 119r)
Together with the medieval and post-medieval annotations and finding aids that have been preserved in the margins of the York medical manuscript, these bookmarks bear testimony to how the manuscript was vastly read and annotated after its production; demonstrating that the volume has been both valued and useful through the centuries.

[1] The dictionaries used to translate the medical and herbal terms have been the Middle English Dictionary https://quod.lib.umich.edu/m/middle-english-dictionary/dictionary and J. Norri, Dictionary of Medical Vocabulary in English , 1375-1550: Body Parts, Sicknesses, Instruments, and Medicinal Preparations (Oxon, New York: Routledge, 2016).
[2] Her notes are in loose paper in York, York Minster Library, Add. MSS 198.
[3] M. S. Ogden, ed., The ‘Liber De Diversis Medicinis’ in the Thornton Manuscript. MS. Lincoln Cathedral A.5.2 (London, New York and Toronto: Oxford University Press, 1969).

A Fifteenth-Century Medical Handbook in York Minster Library (YML, XVI. E. 32). Part 3 - a blog by Dr Rebeca Cubas-Peña

Part III: Provenance

Reverend Edward Churton: a Yorkshire donor

According to the Liber Donorum ― a book that keeps the records of the manuscripts and printed copies given to the York Minster library until 1924 ― the manuscript was given to the Minster by a man called Reverend Edward Churton in 1843. The entry for that year reads: ‘Medicine by William de Killingholme Ms -Six sermons preached in 1582 Ms and Wiclifi Dialogis 4to (Quarto). All given by Reverend Edward Churton. Rector of Craykes’. [1]

Liber Donorum (fols. 38r, 39r)
Reverend Edward Churton (1800-1874) was born at Middleton Cheney (Northamptonshire) and lived in the North Riding of Yorkshire from 1835 ―the year when Bishop Van Mildert appointed him rector of Crayke― until his death. During that time, he was Canon of York and rural Dean and Rector of Crayke in 1845, Archeadon of Cleveland from 1846 to 1874, and Prebendary of Knaresborough from 1841 to 1874. He was a theologian and Spanish scholar who was also interested in Anglo-Saxon literature, although the donations his wife made to the library on his behalf after his death indicate that his interests revolved mainly around religious matters.
Reverend Edward Churton bequeathed the manuscript to York Minster [3]

The library record shows that his collection was divided into ‘Manuscripts’ and ‘Printed Books’, both under the heading: ‘1874. The following works were presented to the Library by Mrs Churton, in memory of her husband Edward Churton m.a., Archdeacon of Cleveland’ (fol. 56r); the rest of the books were under ‘The Churton Gift’. Churton’s wife gave nine manuscripts to the library (including a fifteenth-century copy of the Vita Bernardi), the remainder are printed copies. According to the Liber Donorum, he donated nearly three hundred printed copies published between 1550 and 1840. They contain primarily theological and scholarly discussions in the form of tracts, dialogues, defences, testimonies and sermons.
Liber donorum (fol. 56r)
He also edited a few religious and literary books, such as the minor theological works of Bishop John Pearson, or his thorough study of Góngora in Góngora: An Historical and Critical Essay on the Times of Philip III and IV of Spain, with Translations.

Another good instance of Churton’s literary and theological standards can be found in a letter (YML, MS Add 651) he wrote when he was in Crayke on January 23rd, 1854. Addressed to Reverend G. C. Hodgkinson, Principal of the diocesan Training College of York, who faced a doctrinal enquiry before the Archbishop of York and Bishop of Ripon, the letter supports Reverend Hodgkinson by warning him of a man called W. Baxter, who intended to discredit him. The tone of this epistle, which finishes with a Latin sentence and allusions to the Spanish work El Curioso Impertinente and Bishop Barnet’s History of the Reformation, reveals not only his scholarly education but also his interest in Spanish literature.

Apart from the York medical manuscript, no medical volume is registered amongst the books he bequeathed to the library. In fact, it seems that he did not have any connections with the medical profession, as he does not seem to have undertaken any medical courses or practice medicine, and he was no collector. Given the scholarly disposition of Churton’s father, it is possible that the manuscript was handed down to him after his father’s death. There is also a chance that he acquired the manuscript in an antiquarian bookshop ― as part of a lot of old books ― or that someone gave it to him as a gift. [4]

Other owners: Frauncis Acton

An intriguing line of enquiry regarding the provenance of the York medical manuscript has to do with the fact that a volume copied in a variety of Midlands dialects ended up in Yorkshire. The most obvious and quickest hypothesis is that Churton himself brought it up north. However, the manuscript contains other two post-medieval marks of ownership worth analysing. One alludes to a Johannes breythe/brogston, who wrote his name on the top margin of the first folio of the volume in the sixteenth century and is now rather stained by reagent. Unfortunately, nothing is known about this individual.
Mark of ownership written by Johannes breythe/brogston (fol. 2r)
The other one alludes to a Frauncis Acton of the church of Stretton, who scribbled down her name upside down nearly at the end of the manuscript.

Mark of ownership written by Frauncis Acton (fol. 171v)
The history of the Acton family dates back at least to the fourteenth century. Several members of the family, many of them named Francis or Frances, were settled in Acton Scott, a village near Church Stretton (Shropshire). Based on the date of the script, the most plausible candidate seems to be Francis Acton (1749-1762). She was the daughter of Richard Acton, 5th Baronet of Acton, and Lady Anne Grey, and had a sister named Elizabeth. [5] She was only thirteen years old when she died, which might explain the childish appearance of her script. Considering that her sister married a Yorkshire Esquire named Philip Langdale, a possible explanation might be that the couple took the manuscript with them up north after their marriage, where presumably Churton acquired it somehow. This might clarify how a manuscript that was probably still in the Midlands, more particularly in Shropshire, by the eighteenth century ended up in York Minster Library in 1843.

[1] J. Raine, A Catalogue of the Printed Books in the Library of the Dean and Chapter of York (York: John Sampson, 1896). The book also records later entries in loose pieces of paper. Electronic access to a digitized version of the Liber Donorum is available via the University of York library catalogue (item permalink https://yorsearch.york.ac.uk/permalink/f/1d5jm03/44YORK_ALMA_DS21268468450001381).
[2] The information concerning Churton’s life has been taken from the Oxford Dictionary of National Biography.
[3] Photo taken from The Project Canterbury <http://anglicanhistory.org/england/echurton/>
[4] The idea of the antiquarian bookshop was kindly suggested by Caitlin Henderson in private correspondence: C. Henderson, ‘For the ston that olde John Busshy hathe’: An Analysis of the Codicology and Marginalia of William Leech of Killingholme’s Medical Manual, York Minster Library XVI E. 32 (unpublished master’s thesis, University of York, Centre for Medieval Studies, 2014).

A Fifteenth-Century Medical Handbook in York Minster Library (YML, XVI. E. 32). Part 2 - a blog by Dr Rebeca Cubas-Peña

Part II: Contents

Collections of herbal recipes and charms

The York medical manuscript is composed of a series of therapeutic texts intended to restore to health by treating diseases or conditions. The majority of these texts are collections of herbal recipes or receptaria which, in the form of plasters, ointments, syrups, powders or waters (amongst others), present a number of treatments to cure various ailments such as headaches, gout or epilepsy. Herbs, gems and metals tend to be the main ingredients of these remedies that, for the most part, date back to classical times and follow a head to heel sequence, traditionally known as a capite ad calcem order.
Collection of recipes (fols. 89v-90r)
Generally, recipes are rather formulaic: 

  1. They have a heading that points to the illness or condition the remedy is supposed to heal: e.g. For gout that is in the bones; for an abscess in a woman´s breast.[1]
  2. A list of the plants, minerals and animal or chemical ingredients needed: e.g. Take the grease of sheep tallow, the juice of the celery, the juice of the willow, the root and leaves of belladonna and unused wax.
  3. The measures and weights required: e.g. Take an ounce of parsley, an ounce of olive oil, two ounces of storax, two ounces and a half of calamint, half an ounce of both mastic and frankincense and two ounces and a half of gum Arabic.
  4. The instructions to follow in order to prepare the remedy: e.g. And then boil everything (the ingredients in 2) in a pan and when they are well-boiled put them in a cloth and then in an ointment box. 
  5. Details about its administration (amount, frequency, right time, duration) and storage: e.g. put it in a cloth and in the evening when you go to bed put it in your ear; drink for four days or more if you have need and it shall pass through your anus; eat a spoonful in the morning and another in the evening.
Irrational and superstitious as it may sound, herbal remedies were copied along with charms and prayers. Charms were frequently prescribed to treat episodic illnesses and were an important part of the healing process, as by invoking the help of saints and martyrs, practitioners were appealing to divine intervention.

A charm (fols. 128v-129r)
Hence, a remedy to heal a wound involved the preparation of an ointment and the enchantment of a plate of lead:

‘Medicine true to heal the wound of a man if he is not wounded to death. Make five crosses in a plate of lead: a cross in every corner and a cross in the middle. During the mass say one Our Father and one Hail Mary for each cross to honour the Five Wounds of our Lord Jesus Christ. Then lay the plate above the wound and say thus: as truly as the wounds of our Lord Jesus Christ didn´t rankle, fester or stink, this wound has no power to rankle, fester or stink, but make it heal thoroughly by the will of our Lord Jesus Christ. In the name of the Father, the Son and the Holy Ghost. Amen. Say three Our Fathers three Hail Marys in the name of the Father and Son and the Holy Ghost. Ask the one who is hurt to say three Our Fathers and three Hail Marys to the one who is in control in the name before said, and make sure the plate does not touch the earth once it is charmed. Lay it on the wound for three days without haste and after the third day take the juice of madder and wash the wound and lay the lead on it until it is healed, and if it stinks lay it above. This is a good ointment’ (fols. 128v-129r).

Charms were often accompanied by drawings of crosses which appear normally between the names of the saints. In all probability, practitioners were expected to make the sign of the cross to their patients, either on their bodies or in the air, when they encountered these crosses, as the priest did in church. [2] The repetition of the saints’ names and the touching of the skin when making the sign possibly created a soothing and relaxing, and therefore curative effect on the patient. [3] Unfortunately, many of these crosses were scratched out from medieval manuscripts during the Reformation.
Crosses in charms crossed out by a later reader (fol. 142v)
Sphere of Life and Death

The York medical manuscript also contains other texts to prognosticate and diagnose diseases and their outcomes. As they were not particularly academic, they would have been very helpful to any medical practitioner. [4] One of these prognostic texts is the Sphere of Life and Death, also known as the Sphere of Pythagoras or the Sphere of Apuleius.

Sphere of Life and Death (fols. 6v-7r)
As with other examples of onomancy, [5] the sphere of Pythagoras was used to prognosticate by numbers which correlated with the letters of the individual’s name. Spheres tended to be divided into two hemispheres: one which represented the lucky numbers that would bring fortune to the person involved ― normally the one on the top ― and another hemisphere which predicted disastrous outcomes ― normally situated below. [6] It was frequently used to know whether a patient would live or die ― hence its name ― but it was also employed to anticipate events such as which contender would win a battle or whether a lost object would be found: essentially questions which needed an affirmative or negative answer.


The York medical manuscript holds another evocative diagram used to prognosticate, a chiromancy chart. Chiromancies or palmistries were treatises used to predict the future and interpret an individual’s character and disposition by reading the lines in the palm of his or her hands. These treatises were often accompanied by the drawing of a hand whose fingers were filled with informative captions. The diagram in here is not supported by a treatise but it is followed by a tract which describes bodily characteristics and their importance.
Chiromancy diagram (fols. 122v-123r)
It depicts a left male hand with interpretations of the lines of its fingers written in Middle English, as seen in the index finger which reads: ‘This cross honours and worships, this betokens wound in the head’; or in the space between the index and the middle fingers: ‘if the midward line touches these fingers, that suggests death of a wound’.

Bloodletting-zodiac man

Medieval practitioners thought that the human body, and by extension the human mind, was a microcosm which, besides being contained in the macrocosm (also known as cosmos or universe), functioned parallel to it. The macrocosm was composed of four elements (water, fire, earth and air) and qualities (dryness, moistness, heat and cold), which corresponded to four bodily humours (phlegm or mucus, yellow bile or choler, black bile and blood). The supremacy of a humour over the rest resulted in a marked definition of the individual’s temperament, who could be ultimately melancholic, phlegmatic, sanguine or choleric. [7] An imbalance of the humours resulted in sickness, and required methods like bloodletting to restore the patient’s corporal equilibrium.

Bloodletting-zodiac man and an astrological diagram (fols. 109v-110r)
Knowing when to bleed the sick was an essential part of the treatment, since otherwise the patients’ lives could be put at risk. For that reason, celestial bodies had to be considered before applying a treatment. That’s where the bloodletting-zodiac man comes in. The bloodletting-zodiac man is an anthropomorphic figure that provides information about bloodletting procedures by depicting in a single diagram what is normally illustrated in two. The bloodletting man shows how the veins had to be cut in order to cure an ailment. Thus, an arrow that points at its right ear comes with this caption: ‘behind the ear for old sicknesses’; or another caption, whose arrow points at the neck, states: ‘for a pustule in the neck’. The zodiac man, on the other hand, indicates the parts of the body that could not be bled when the moon was in relation to their specific zodiac houses. For instance, it was not recommended to bleed a patient´s chest under Leo´s influence.

Uroscopy or urine treatise

Medieval practitioners also believed that they could diagnose and determine the evolution of an illness by looking at the patient’s urine, more particularly at its colour, odour, consistency, viscosity, sediments, or even taste. They identified and diagnosed different ailments with the help of uroscopies or urine treatises, which provided information about the various colours of the urines and how to interpret them.

Urine treatises indicate how a particular symptom betokens a specific ailment. The uroscopy in the York medical manuscript, for example, notes that ‘pale urine in men suggests bowel issues; in women indicates damage to the womb’; or ‘urine red as a rose indicates fever and if he (the patient) pisses continually it indicates the fever continuande’ (a remittent fever said to be caused by the putrefaction of the humours).
A urine wheel (fols. 166v-167r)
This uroscopy is supported by a urine wheel that connects the urine colours with their corresponding interpretations. Thus, two flasks on the top of the wheel, which are yellow and bluish in colour and are described as ‘reddish colour of urine as pure gold’ and ‘reddish colour of a clear gold’ respectively, are connected to a caption in the centre of the wheel that reads: ‘these two urines indicate a perfect digestion’.

[1] All examples translated by the author.

[2] E. Duffy, ‘Charms, Pardons and Promises: Lay Piety and “Superstition” in the Primers’, in The Stripping of the Altars. Traditional Religion in England c. 1400-c. 1580 (New Haven & London: Yale University Press, 1992), pp. 266-298 (p. 266).

[3] I owe this idea to Dr. Irina Metzler, who reminded me of traditional healing practices in Catholic communities.

[4] The texts mentioned in here are a selection and have been chosen by their spectacular diagrams.

[5] A form of divination that involved the letters of a name.

[6] For further details, see Dr Jo Edge’s work. In this podcast she talks about the medical context of the Sphere of Life and Death in late medieval England: https://backdoorbroadcasting.net/2012/05/jo-edge-the-medical-context-of-the-sphere-of-life-and-death-in-late-medieval-england/.

[7] For further details, see C. Rawcliffe, Sources for the History of Medicine in Late Medieval England (Michigan: Western Michigan University, 1998) or https://www.encyclopedia.com/medicine/anatomy-and-physiology/anatomy-and-physiology/humours