In the Middle Ages, the term “blind” was capacious, denoting both complete lack of sight and lesser forms of visual impairment. Though absolute blindness was generally considered beyond medical remedy, treatments for innumerable other ocular complaints were ubiquitous in medieval leechbooks and remedy collections. In Beatrix Busse and Annette Kern-Stähler's words, these Middle English medical texts describe visual impairment not as a total, static state, but as liminal: a “gradual process of decay or of moving towards blindness,” what they call “blindness as a process of becoming.”1This article explores how conceptualizing blindness as a dynamic movement, rather than a static state, might illuminate the relationship between late medieval medical and literary cultures. I focus on the devotional poetry of fifteenth-century priest John Audelay, which is preserved in Oxford, Bodleian Library MS Douce 302; a brief overview of this manuscript and its treatment of Audelay's impairment is provided below. The article's first section proposes that approaching the material and medical realities of Audelay's blindness as evidence rather than metaphor allows us to understand his writing as the product of a nuanced system of medieval healthcare that, particularly where ocular health was concerned, was shaped as much by continual care as it was by discrete moments of trauma and treatment. The second section discusses the form of the spiritual “remede” presented in Audelay's “Carol 2,” arguing that his didactic prescription constitutes a regimen of care that asserts the efficacy of durative, long-term treatment. Ultimately, I suggest that John Audelay's poetry offers one example of how we might productively think through late medieval health as a durative and dynamic process, rather than a discrete destination.Aside from the devotional verse contained in Douce 302, we have only one other document with which to reconstruct Audelay's life: a 1417 court record that identifies him as the personal chaplain of the Lestrange family, arrested for his involvement in their assault of a knight at a London public church.2 Sometime after that record was produced, Audelay went on to become the first priest of the newly established Lestrange chantry at Haughmond Abbey in Shropshire, where he composed Douce 302 around 1426. According to his repeated assertions in that manuscript, he had also become blind, deaf, and ill.Reading Audelay's poetry alongside his experience of impairment reveals the shaping power on his writing not only of his blindness, but also of the medical care he received because of it. The extent of Audelay's blindness is unclear, as is the state of his overall physical health during the production of the manuscript. His vision appears to have deteriorated more quickly than his hearing, as the text identifies him as “blynd, def to be” (Counsel of Conscience l. 20, emphasis mine). Audelay's deterioration probably occurred sometime after 1417, as it seems unlikely that the Lestrange family would have allowed a blind man to participate in the assault. The onset of Audelay's impairment was also more likely gradual than sudden; it seems extremely unlike him to neglect the metaphorical potential in being abruptly struck blind, an unmistakably miraculous event depicted in many theological and secular texts.3 That leaves an interval of nearly a decade in which Audelay's eyesight, hearing, and overall health were declining at best and entirely compromised at worst. It is this nine-year period and, in particular, the medical care Audelay received in its duration, with which I am chiefly concerned.In attending to this liminal state—to the process of going blind, rather than being blind—I take up Julia Kristeva's recent appeal for the critical medical humanities to fully account for the entanglement of “hard” biomedical sciences and the “soft” cultural praxis of care. Reification of this divide, she warns, risks reinforcing a system in which health is considered a definitive, atemporal state, while the art of care is considered a process embedded within (and dependent upon) biographical time and subjective interpretation. Relegating care to the field of culture and health to the domain of biomedicine risks eliding the mutually constitutive nature of their relationship.4 “To the definitive idea of ‘healing’ resulting in a ‘state of health,’” Kristeva writes in Hatred and Forgiveness, “it would perhaps be truer to appose, if not oppose, the durative idea of ‘care.’”5 Taking care seriously involves understanding the process of healing as a shaping force in its own right, rather than a phase to be passed through on the way to total health. And accepting Douce 302 as the creation of an aging priest—one whose eyesight, hearing, and overall health were failing—means accepting Audelay himself as a poet embedded in medical and spiritual processes of durative care.Audelay refers to his blindness repeatedly, a strategy which keeps the impairment at the forefront of the text while simultaneously raising questions about its legitimacy. Just how blind was Audelay? How deaf? How ill? How capable of contributing to the compilation's structure and form? Douce 302 is a complex volume, comprised of what Susanna Fein has identified as “four genre-based mini-anthologies”: The Counsel of Conscience, a labeled collection of various devotional texts including the long poem Marcolf and Solomon.Salutations to five religious figures: the Virgin Mary, St. Bridget, St. Winifred, St. Anne, and God himself.Carols, numbering twenty-five, organized by subject.A Meditative Close, which contains a number of prose and verse texts, including a concluding poem at the very end in which Audelay “lays authorial claim . . . to its composition and compilation.”6The manuscript is predominantly in English and comprises thirty-five folios. Its text is written in two hands, one belonging to its primary writer (Scribe A) and the other to a compiler (Scribe B) who inserted incipits, explicits, and other details. Scribe B also finished the manuscript, twice adding new texts to its end: first a commonplace Latin poem entitled Cur mundus militat sub vana gloria and, some time later, an original English poem by Audelay, which Fein calls his “Conclusion.” Presumably neither hand belongs to Audelay, whose self-reported impairment would preclude substantial participation in the manuscript's material production.7 Nonetheless, Audelay is emphatic about his role in the volume's creation: he definitively identifies the poetry as his own “makyng,” and in the “Conclusion” he asserts that the “boke” as a whole contains both his “wyl” and his “wrytyng.”8 Repeated acts of naming and claims of authorship indicate that he understood the book to be his own; the “Salutation to St. Bridgit,” for instance, asks readers to pray for “hom that mad this mater with dewocion, / That is both blynd and def, the synful Audelay” (ll. 201–202), and the Meditative Close informs the reader that Audelay “made this bok by Goddus grace, / Deeff, sick, blynd, as he lay” (ll. 51–52).9 This is the central, vexing paradox of Douce 302, an object that, in Rory Critten's words, “claims to have been produced by a man who is described in its texts as someone presumably incapable of inscription.”10In its insistent, penitential deployment of his impairment, Audelay's work becomes inextricable from the moral signification of his suffering body. This poetic emphasis on the spiritual valences of Audelay's blindness occurs seemingly at the expense of any substantial engagement with its material experience. References to the physicality of his impairment are limited; one rare example occurs in Carol 24, “On Dread of Death,” in which Audelay admits that “blyndnes is a hevé thyng” (l. 7). This omission of his physical experience is, perhaps, unsurprising. As a chaplain and then a chantry priest, at the onset of his blindness Audelay may have been better-versed in the spiritual metaphorization of bodily impairment than in its realities. Especially when it afflicted the clergy, blindness was often understood to be a mark of holiness that endowed its sufferer with a particular form of divine authority. Peter of Limoges's popular Moral Treatise of the Eye, for example, cheerfully reassures readers that holy men rejoice when they lose the use of one or both eyes, because physical blindness leads to spiritual clarity of sight. Audelay describes his blindness—and perhaps his ill health as a whole—as a “gracious visiting” on five separate occasions throughout the Counsel of Conscience, identifying it as an indication of God's chastisement and his own spiritual election.11 His work appears, in many ways, to be a model example of David Mitchell and Sharon Snyder's claim that disability, when represented in literature, often takes the form of an “opportunistic metaphorical device.”12 The resulting shift between registers of meaning renders Audelay's body liminal, nearly invisible except as a sign of something else.Many scholars, following Audelay's example, have understood his verse to be deeply informed by this hard-won spiritual authority, a byproduct of the physical consequence of sinful living. Robert Meyer-Lee, arguing that Audelay's blindness constituted a later trauma which brought the earlier trauma of the 1417 assault to the fore, writes that Audelay's repetitive assertions of his own impairment are “both urgent reaffirmations of his election and ineluctable repetitions of his curse.” Fein calls the events of 1417 “scarring”; Bennett speculates their impact to be “deeply traumatic.”13 Edward Wheatley has observed that for many scholars, the metaphorical impact of Audelay's ailing body seems to “outweigh” its material significance.14In centering Audelay's body, this article provides one means of redressing this critical imbalance, first by discussing the material realities of Audelay's life as his blindness developed, and, second, by thinking through the ways in which those conditions would have shaped his poetry. In doing so, it resists what Bridget Whearty has identified as a critical pattern that favors a diagnostic approach to the diseases endured by medieval characters, transforming them into “human-shaped [collections] of debated signs” while neglecting to consider what those diseases might mean for the character as an embodied, suffering individual.15 The entanglement of biological life with cultural life is a central tenet of the critical medical humanities, which insists that patients be understood not as solely “diseases and bodies” but as “whole persons in contexts and in relations.”16 Privileging that entanglement becomes particularly important in considerations of the Middle Ages, when the divide between science and faith was nebulous at best. Indeed, in his discussion of medieval blindness, Wheatley has argued that the omnipotent figure of Christus medicus, always superior to his mortal counterparts, necessarily subsumed any medical model of disability within a more influential religious model. “Above all,” Wheatley claims, “the medical model seems inapplicable to this study because medical options for the visually impaired were very limited: cataract removal was a possibility at certain times and places in medieval Europe, but no other treatments resulted in similarly consistent success.”17Wheatley's formulation of blindness as a fixed state rather than a process necessarily omits extensive medieval traditions of preventative and durative medical care, which I examine in detail below. And while the reduction of patients to the signification of their bodies is something to be avoided, attention to the experience of those bodies is absolutely crucial. Put differently: while reducing the suffering body to biomedical data is harmful, to ignore that body entirely is equally damaging. In the words of Anne Whitehead and Angela Woods, understanding the entangled nature of health involves accounting for “the body as it suffers, bears and is transfigured by illness; the irreducibly subjective experience of embodiment.”18 Attention to this medical context offers new ways of understanding Audelay's work. It also suggests the usefulness of literary authors to the history of medicine and to the medical humanities more broadly. Accepting the medical culture in which Audelay was embedded as its own source of evidence, rather than solely a vehicle for metaphor, reveals a nuanced system of medieval healthcare, one in which large-scale traumas and treatments were accompanied by continual, daily acts of care.Sometime after the events of 1417, Audelay relocated from Knockin, the ancestral home of the Lestrange family, to Haughmond Abbey, where he became “The furst prest to the Lord Strange . . . / Of thys chauntré, here in this place” (“Audelay's Conclusion,” ll. 49–50). His transition from personal chaplain to chantry priest may indicate that his vision had already begun to fail; Haughmond Abbey was located just fifteen miles from Knockin, and its infirmary, which made use of lay practitioners as well as clerical ones, would have would have provided myriad opportunities for contact with both secular and monastic medical practice. Another opportunity for treatment emerged from Haughmond's close ties to the Hospital of St. John the Evangelist in Oswestry. Located five miles north of Knockin and twenty miles northwest of Haughmond Abbey, St. John's had been annexed to the abbey since 1217. Haughmond was obliged to supply the hospital with a chantry priest and, in return, would have drawn on the hospital's medical expertise and resources to supplement its own infirmary.19While any attempt to detail life at Haughmond during Audelay's lifetime is hampered by the loss of the abbey's fifteenth-century cartulary records, archaeological excavations and studies of other contemporary religious houses can provide some information.20 The abbey's infirmary has been the subject of some debate. The earliest archaeological reports of its ruins, published in 1909, identify one of the largest chambers as the infirmary hall; if true, the room would have been nearly 3,000 square feet in size and well lit by a number of large windows, one of which took up almost the entirety of the room's western wall. This hall was divided into four separate bays and abutted by a chamber that might have housed the abbey's infirmarer. More recent reports assert that though the abbey's infirmary certainly existed—and is attested to in multiple surviving documents—it cannot be reliably identified among the ruins that remain.21 Regardless of its location, like most infirmaries, Haughmond's would have not only served the temporarily indisposed but likely also provided long-term care for members of the monastic community who were no longer able to carry out their duties; in all likelihood, only half of its total space would have served the transient sick, while the rest would have been retained for long-term residents.22 This would have included Audelay, whose blindness and ill health would have eventually forced him to retire from his position as chantry priest. Scriptural prohibitions barred blind clergy from administering the sacraments. The book of Leviticus, for instance, was understood to forbid a man who was “blear eyed” or had “a pearl in his eye” from “offer[ing] bread to his God” or administering the Eucharist to others.23 A number of practical concerns existed as well. Spilling the Eucharistic wine or dropping the Host set into motion an exhaustive procedure of cleansing and purifying that would have been time-consuming and inconvenient if it happened consistently, and dropping either at the moment of transubstantiation was punishable by excommunication.24 The likelihood that Audelay's retirement from his position as chantry priest would have been followed by a relocation to Haughmond's infirmary is, therefore, quite high. Audelay himself suggests that his move to the infirmary enabled his poetry; in the epilogue to the Counsel of Conscience he observes that God, who has rendered him “blynd, def to be,” has also given him the “wil, wit, tyme, and space” to write (ll. 19–20).How long Audelay remained in the infirmary before his death, and the duration of time that elapsed before his vision was lost entirely, is difficult—perhaps impossible—to ascertain. Macular degeneration, glaucoma, and cataracts were all common ailments in the late Middle Ages, and depending on severity could develop over the course of multiple years before total blindness occurred. Both cataracts and macular degeneration generally progress slowly, affecting the central vision and causing blind spots in straight-ahead sight. Glaucoma, however, affects the peripheral or side vision first, before moving inwards to impact direct lines of sight. Untreated, the patient experiences anywhere between three to fifteen years of progressively tunneling vision before eyesight is lost completely. Whatever Audelay's ailment, by the time of Douce 302’s production in 1426, it had advanced far enough that he recognized himself as blind and had reason to foreground the impairment in his writing. As Julie Orlemanski has recently argued, medieval subjects who interpret and represent their own embodiment “inhabit a contentious hermeneutic circle that churns between competing systems of explanation.”25 Audelay's poetry suggests that while these various understandings might jostle against one another, they are also, in many ways, integral to each other. As his body's state of health changed, so too did its spiritual signification: God (who had, Audelay explains, “me chastist for my levyng”) provided a kind of embodied intervention in the form of a corrective treatment that brought Audelay to a greater understanding of his faith (Our Lord's Epistle on Sunday, l. 201).As recognition of his impairment grew, Audelay and his caretakers at Haughmond would have turned to medical texts, supplemented by their own experiential knowledge of potential cures. One fifteenth-century leechbook, for example, instructs readers in the production of a poultice “ffor to makyn þyn yȝen clere.”26 These recipes and the books that contained them would likely have been present throughout Audelay's care, whether in the possession of Haughmond's library or owned by the secular physicians, surgeons, and apothecaries who worked closely with its infirmarer. The abbey's collection, though now largely lost, was apparently substantial; one extant document notes that the library (bybliotheca) required repair in 1518. What few texts can be traced back to the abbey include a graduale and works by Isidore of Seville, Petrus Comestor, and Hugh of Fouilloy—and, for a short time at least, Douce 302, which contains a note stating that it was compiled ad exemplum aliorum in monasterio de Haghmon (for the example of others in Haughmond monastery).27 That Haughmond's library would have also included medical books is almost certain. Monastic libraries were supplemented by external contributions, many of which were medical in nature; St. Augustine's Abbey in Canterbury, for example, owned no fewer than twelve copies of the Salernitan Ars medicinae from eight different named donors. Medical texts were also produced within the monasteries themselves. In addition to the reproduction of Latin and English texts, monastic scribes also concerned themselves with the process of translation; likely to be literate in both languages, many had firsthand experience with healing and viewed the dissemination of practical medical texts as a charitable undertaking. As Audelay himself writes, only the sinful neglected to educate their “unkonyng” neighbors (“Over-Hippers and Skippers,” l. 56).28By the end of his life, Audelay likely experienced a regimen of monastic healthcare intended to treat or mitigate his illness and impairment. That care would have been carried out under the auspices of Haughmond's infirmary, shaped by—and now visible through—the textual resources at its disposal. The healing process with which Audelay would have been most personally familiar was one in which gradual corrections and adjustments were the norm, rather than invasive, large-scale operations. Within this healthcare framework, and particularly within remedies for degenerating eyesight, it was frequency and consistency of treatment, not intensity, which were directly related to efficacy.Weakening eyes were often treated first with an adjusted dietetic regimen in an attempt to balance the body's humors. In the Chirurgia parva, for example, Lanfranc of Milan assures his readers that mild eye issues are “sone sesed” with a temperate diet and the application of an egg white to the eye.29 Popular vernacular dietaries like the Salernitan Regimen sanitatis and the Dietary of Queen Isabella include a more specific enumeration of nonnaturals from which to abstain in the name of ocular health: lentils, pepper, mustard, beans, garlic, onions, milk, and wine are to be avoided, as are intemperate behaviors like too much bathing, too much (or too little) rest, long labor amid dust and smoke, excessive lacrimation and bloodletting, and, of particular importance to monastic and secular scribes alike, “to behold moche on newe bokys.”30 The dietetic adjustment described above might have been accompanied by more overtly medicinal additions in the form of daily drinks and powders intended to strengthen the eyesight. One fifteenth-century manuscript, for example, recommends that its readers “dryncke euery daye ruwe and use hit yn thyn mete and hit shall make the haue clere sight and feire.”31 During his time in Haughmond's infirmary, Audelay would likely have been subject to many of these dietary changes. While monks in good health were expected to consume a relatively uniform diet, admission to the infirmary was accompanied by what Barbara Harvey calls a “sensitivity to individual need,” and meals were often tailored to the particular ailments and humoral complexions of patients.32These daily acts of assessment and adjustment would probably also have involved remedies, particularly as Audelay's vision worsened. Because monks were especially susceptible to eye strain and other sight-related complaints, Haughmond's herb garden would have included a number of medicinal plants used in eye remedies, and its infirmarer would have been well-versed in the preparation of ointments, salves, and poultices that promised to repair, or at least slow, ocular degeneration.33 Like dietaries and regimens of health, these remedies also emphasized the connection between regular, attentive care and efficacy against ocular ailments. While some recipes found in leechbooks are intended to treat particular complaints, such as the pearl, hawe, or web (all issues with the transparent membranes that cover the eye), others are for nonspecific ocular degeneration, such as dimming or blearing of the sight. These more generalized remedies are especially likely to emphasize the importance of consistent, recurring treatment. One instructs a patient who “may nat wel y see” to “smere þyn yȝen a lytyl þerwith whenne þou gost to bedde wyt a feþyr & do so ofte & for soþyn yt wele þe helyn.”34 Many include some variation on the promise that nightly application “whanne þou gost to slepe” will render the eyes “hole.”35 The same emphasis on frequency of application is repeated in a similar recipe “ffor þe sigȝt,” which assures its readers that if they apply the tincture “oft . . . without dowte þou shalt haue hele.” In the same volume, a recipe for eye drops advises its reader to apply the liquid “euery day.”36 And eight ocular remedies in another text specify that they should be administered twice daily, in the evening and the morning.37In addition to encouraging repetition in their application, these recipes are also characterized by repetition within their manuscripts. They are frequently doubly redundant: it is not uncommon for the same recipe to appear in multiple places in a single manuscript, and, even more regularly, for a manuscript to include multiple recipes for the same ailment. The first redundancy generally seems like scribal error, but the second suggests a number of significant uses. The inclusion of multiple remedies for the same complaint facilitates personalized treatment based on individual complexion; it also affords adjustment over time, from mild or temperate medications to more aggressive ones, or simply from one ineffective remedy to a more promising alternative. While these alternate remedies are sometimes scattered throughout the manuscript, they also often form a collected grouping, or string, of remedies addressing a particular complaint. The visual impact of these sequences is especially marked when they are accompanied by the common pattern of rubrication in recipe collections, in which the ailment to be treated (or a capitulum marking it) is penned in red ink, and instructions and assurances follow in black or brown ink. Unlike modern cookbooks, late medieval recipe collections often move from one recipe to the next with no line break, particularly when their scribes were pressed for space. Instead, recipes commonly unspool across the entirety of the folio with very little white space. The effect is that of a dense square of dark text interspersed with red-labeled ailments. In many manuscripts, these rubrications appear to string themselves out down the page, chainlike and nearly rhythmic in their repetition: For the eyes . . .another for the same . . .another, another, another, another. Wellcome Library MS 404, for example, includes a chain of eye remedies twenty-two recipes long.38My intention in describing these patterns of repetition is not to present the image of a redundant, overstuffed medical canon. Rather, the recurrence in these texts points towards a vibrant medical culture of observation, evaluation, and modification. Though often predicated on repetition and duration of use, treatments were not static. They changed with the progression of the disease, of the seasons, and of the patient's age. They demanded vigilance on the part of both patient and medical practitioner, and participation in the process of bodily adjustment. Incremental care would likely have been present in nearly every facet of Audelay's treatment: in the adjusted dietetic regimen that he would have experienced at each meal; in the drinks and powders that may have supplemented those meals; in the salves, poultices, and drops that may have been applied daily to his eyes; and in the texts that housed those remedies and formally emphasized the connection between physical wellbeing and ongoing engagement with the body. It is therefore not surprising to find that emphasis on durative care present in his poetry as well.Audelay's work makes visible the cultural emphasis on incremental forms of care that structured his life in Haughmond Abbey. As a material object, Douce 302 is the result of a continual process of compilation, correction, and adjustment; Fein argues that it was created in three phases, involving input from at least two scribes and from Audelay himself.39 Upon its completion, responsibility for textual engagement shifted to its audience, allowing the manuscript itself to function as remedy and regimen: to be consumed, gradually and repeatedly, for the betterment of its reader. This emphasis on active reading is underscored by Audelay's innumerable urgings that his reader approach the text mindfully. In “Carol 2,” discussed further below, Audelay pauses in his description of his spiritual regimen to instruct the reader to “forgete hit noght”; in the Counsel of Conscience, he advises the reader to “Remembyr you redely when ye red—ther may ye wyle wyt!” (l. 212). Most strikingly, the manuscript's Meditative Close instructs the reader to “rede thys offt butt rede hit sofft,” in order to “se / What fruyte cometh of thy body” (“Instructions for Reading 4”). The Middle English term “sofft,” while denoting gentleness and agreeableness, also describes a slow, unhurried pace. A “soft medicine” was mild in quality and gradual in operation; a “soft disease” was mild and treatable; a “soft death” was gentle, easy, and painless.40The presence of the term suggests that Audelay understood the act of engaged, devotional reading as a part of maintaining physical health. Indeed, his description of the manuscript affirms its power as an object that, when read mindfully, actually enables both hearing and sight: Here may ye here now hwat ye be.Here may ye cnow hwat ys this worlde.Here may ye boothe here and seOnly in God ys all comforde. (“Audelay's Conclusion,” ll. 1–4)It is the practice of reading Douce 302—in particular, engaging with it both frequently and softly—that yields curative knowledge and thus physical and spiritual wellbeing. The reader's relationship to the manuscript's contents is, then, a form of ruminatio, the process by which the text is not only read but internalized and understood, taken into the body. In Michael Jeanneret's words, “the reader-eater takes possession of the object being read, assimilates this foreign body and makes it part of his own being”; in Mary Carruthers’ terms, ruminatio entails “turning the text onto and into one's self.”41 She maintains that “digestion should be considered another basic functional model for the complementary activities of reading and composition, collection and recollection.”42 In this sense, the gradual but frequent ingestion of Audelay's poetry would have served as the consumption of a remedy, a recipe (receipt) intended to be received into the body and, in turn, to transform it.To be clear, I do not suggest that Audelay's entire poetic sensibility is defined by repetitious, regimental medicine. There are plenty of poems within the text that rely on other medical conceits, like surgery, and some which contain no discernable