Arthritis, the ‘ache and euel in fingres’, and medieval scribes

Common rue. Photograph by Carly Still

Common rue. Photograph by Carly Still

     This plant is Ruta graveolens, known as ‘common rue’. It is native to the Balkans, but grows in many other places around the world, including the South of France. It was in France that ‘Macer Floridus’, a pseudonym used by Odo of Meung, lived towards the end of the eleventh century. He drew together a range of classical influences to write De Viribus Herbarum, a Latin text on the virtues of different herbs. This text was later translated into English and was evidently widely circulated, since there are a great number of surviving copies from the Middle Ages, including eight manuscripts now kept in British libraries. In Odo of Meung’s text, here quoted in its English translation, the common rue is praised for its effect on upset stomachs (‘she dooth mekyl goode to the stomak if she be ofte drunke’*). The herb is referred to using the feminine pronoun ‘she’, as was often the case in medieval writing. Rue was recommended as an abortifacient (‘she putteth out the child’) and a way of promoting menstruation, which was refered to as ‘flours/flowers’ (‘[she] purgith women flourgh’).[1] Rue is an unpleasant herb to take orally, as it is bitter to the taste – Shakespeare described it as the ‘sour herb of grace’ (Richard II). It has also been shown to have a range of hostile side-effects, including gastric pain and vomiting (which is interesting, given the medieval use outlined above), kidney and liver damage, and rash when applied to the skin.

Tacuinum Sanitatis

Harvesting rue. Tacuinum Sanitatis. Image credit: Wikimedia Commons.

        Despite this unpleasantness, a medieval scribe might have been interested in the herb’s supposed relief of arthritis, or ‘artetica’ in Middle English:

‘hit destroyeth that passion that fallith in the whirlbon of the thighe, and that disease is clepid artetica’

We are told that rue, when soaked in water and vinegar and drunk by the arthritic person, may destroy pain that afflicts the ‘whirlbone’ of the thigh – otherwise known as arthritis. ‘Whirlbone’ is a magnificent medieval word that means ‘the bone with a rounded end that turns, or ‘whirls’, in a socket’. To imply that there is a ‘passion’ in the bone, in its modern sense relating to strong feelings or emotions, may seem odd, but for medieval people the word implied ‘suffering’ or ‘pain’, as in the ‘passion and death of Jesus and his martyrs’ [2]. Finally, ‘disease’ probably conveyed something more like ‘discomfort’ or ‘pain’, as opposed to its modern day pathological meaning.

      John Trevisa’s English translation of Bartholomaeus Anglicus’ thirteenth-century text De Proprietatibus Rerum gives a vivid and detailed description of the impact of arthritis, focusing on the fingers and toes especially:

‘Arthetica is ache and euel in fingres and tone with swellinge & sore ache; and whanne hit is in the fyngres hit hatte cyragra, and in the toone, hit hatte þe whirlebones and ioyntes..sciatica passio; and cometh of colerik blood & of fleumatik humour, & cometh most ofte of reumatik cause.’

Arthritis is an ache and evil in the fingers and toes, with swelling and sore ache; and when it is in the fingers it is called sciatica and in the toes it is called gout…in the whirlebones and joints [it is called] sciatic disease; and it comes from choleric blood and from phlegmatic humour and comes most often from a rheumatic cause

This text explains both the symptoms and perceived causes of different types of arthritis, including the irritation and compression of the sciatic nerve which results in pain, numbness and a tingling sensation. It refers to the prevalent theory about matter, or the ‘four humours’, stating that arthritis stems from a combination of choleric blood (a prevalence of yellow bile) and phlegm, and that it has a rheumatic cause (ie. related to the bones, muscles, tendons, joints,  or nerves). The text stresses the discomfort involved, describing it as an ‘evil’, conveying ‘extreme discomfort’.

         Exploring this agonising pain, which might be treated using this strange rue concoction, made me think of the distress that a medieval scribe with arthritis would have suffered. The two most common types of arthritis are osteoarthrisis, which affects the smooth cartilage lining of the joint and often develops in people over 50 years of age, and rheumatoid arthritis, which often starts at between 40 and 50 years old and affects joints, leading to pain and swellings. As medieval scribes might expect to reach 70 or 80 years old, it is very likely that some would have been affected. As seen above, many medieval medical texts also mention gout, which is a type of arthritis where crystals of sodium urate form inside and around joints, causing sudden and severe pain in the joints, along with swelling and redness.[3] It can affect the fingers as well as the toes, and it would have made writing extremely difficult for writers. It is common, impacting upon more men than women today.


James Gillray, The Gout, 1799.

     It is perhaps hard to imagine that a professional administrative scribe, such as a notary or a government or royal clerk could have continued to work whilst afflicted with such a painful condition. However, my recent research focuses on scribes who were prolific despite experiencing tremors that intruded severely upon the process of writing. In addition, the tribulations of scribes are well-known. Their own accounts, and manuscript illuminations, depict them writing with cramped hands as they reached the bottom of their sloped desk, developing painful back-ache and eye strain, and growing weary as they stared at the ‘whit paper’.[4]

        So, it is quite likely that medieval scribes – especially elderly men – suffered from the agony of arthritic hands. They may also have been dosing up with vinegar-soaked rue … and giving themselves ulcers in the process.

[*] Though I have retained the Middle English spellings, I have transformed the letters thorn and yogh to their modern English equivalent for ease of interpretation

[1] See Gosta Frisk, A Middle English Translation of Macer Floridus De Viribus Herbarum (Nedeln: Kraus, 1973)

[2] Philippa Maddern spoke of the word ‘passion’ in detail at her 2013 Leeds IMC paper, as well as about other potential misunderstandings that we might make relating to medieval good and ill health. An article on this topic by me, inspired by this work, is forthcoming with The Mediaeval Journal.

[3] These details of symptoms are all taken from the UK’s NHS website pages for the conditions of arthritis and gout respectively.

[4] William Caxton, Recuyell of the Histories of Troye.



  1. As someone with rheumatoid arthritis (RD) .. yes. It would be very painful to write in the set position scribes use. Anything you need to hold for a long time hurts. RD onset though is normally between the ages of 15-40 and juvenile versions do exist. Ankolysing spondilitis (arthritis that causes the spine to fuse) tends to be more common in males though, than RD. Certainly Osteo arthritis coild be a problem even if they were relatively young – anything high impact will lead to damage.

    There is quite the debate in current medical literature though as to whether the non osteo/gout forms existed prior to the discovery of the Americas… mostly because there is no unequivocal archaeological evidence of arthritis damage and an inability to determine causation, e.g. whether it is triggered by infection or genetic.

  2. Hi Anne,
    Very interesting! I got the ages for rheumatoid arthritis from Arthritis Research UK’s website, but I am interested in your comment that it generally develops earlier. I’ll look into it further. In fact, I am sure that I will do detailed research into arthritis in the future, as it is pertinent in relation to the work of scribes – especially given what you say about the pain when writing in a set position.

    Re: your second paragraph – wow, that’s an interesting debate. I would think that it is difficult to distinguish between the types precisely by looking at medieval medical texts alone, since the medieval and modern terminology relating to ill health are often not equivalent.

    Your comment was very useful and inspiring for my future research, thanks!

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