The roving eye of the filmmaker and the probing mind of the historian, which so often seem incompatible, are combined with remarkable effect in this lustrous book. Presenting the full elaboration of a noteworthy article that whetted the appetite of a wide range of scholars ("Symbolic cartography in a medieval parish: from spatialized body to painted church at Saint-Aignan-sur-Cher," Speculum 75 (2000): 615-667), The Art of Healing will not disappoint. The author begins with a wide shot of Saint-Aignan and the surrounding countryside, proceeds to a tighter frame of the romanesque church that was once the heart of a healing center, and ultimately zooms in on its painted walls. Her scrutiny is systematic but sympathetic, and meticulous but imaginative. As result, a topography that may look ordinary to the casual observer, a church whose original architecture disappeared under disfiguring alterations, and modest paintings which art history has "abandoned for the great works," yield vivid testimony of "the richness and variety of medieval solutions to mortality" (157). Reconstructions of society by Emmanuel LeRoy Ladurie as well as 'deconstructions' of the body by Mary Carruthers and Caroline Walker Bynum help shape a frame for piecing together the puzzle of a dynamic community and unraveling complex cultural strands. While examining a dizzying spectrum of vital interactions-- between geography and politics, power and imagery, metaphor and ontology, ritual and health, body and terroir--Kupfer manages to maintain a sharp focus on the precise subject, identified in her subtitle, "Painting for the sick and sinner in a medieval town."
The paintings, rather than historic individuals, are the characters in this drama. The town of Saint-Aignan is not merely the stage but the centerpiece of this story "about place" (12). The landscape was visibly dominated by the collegiate church, which, benefiting from regional healing cults, spawned dependent chapels and hospitals from the twelfth century on. These dependencies fell under the "controlled and controlling sponsorship" (45) of the collegiate chapter, though not without growing competition from municipal authorities. Around 1200 a series of frescoes was created in the crypt, celebrating "Christus medicus" and depicting saints surrounded by noble donors, humble supplicants, and healed givers of thanks. The series, together with the architectural framework of the church, conveyed a unified and basic message. In addition, it reflected the contemporaneous expansion of ecclesiastical power which was manifested most methodically at the Fourth Lateran Council in 1215-- and particularly, with regard to this book, in Canons 21-23. The shared purpose of the paintings was "to reveal the intercessary power uniquely vested in the saints while advocating their exemplary status; to privilege the health of the soul over physical well-being without diminishing the potential for the miraculous restoration of the body" (87). In more specific terms, complementary visual clues, most unmistakable in the portrayals of a repentant Mary Magdalen and a redeemed Charlemagne, underscored the links between penance, forgiveness, and health. The most concrete and timely suggestions pointed to the sacrament of confession, thereby placing priestly intercession both above medical intervention and private contrition. A further implication was the reaffirmation of "ecclesiastical constraints on the role of women as healers" (131).
The messages were conveyed with great impact, Kupfer argues, because their visualization was in direct harmony with the experiences and preoccupations of the viewers, as it drew on local circumstances. Positing a regional correspondence between health concerns and cults of saints, inspired by many of the pictorial representations and, most immediately, inferring from the reported admission to charitable institutions of patients who were "burning" ( ardentes), she proposes the "tantalizing hypothesis" (59) that endemic ergotism may have been the principal issue at Saint-Aignan. She concentrates on the regional cult of St Silvanus, and believes that "the Fire of St Silvanus" referred --as did the more famous "St Anthony's Fire"-- to the disease caused by a fungus on rye, which was a grain widely grown in thee area. Plausible as that hypothesis may be, and even though the author professes due caution (59), the dangers of a retrospective diagnosis become apparent. Confidence in such a diagnosis is undermined by even the slightest imprecision, for example, by stating inaccurately that "lupus" was presented as "synonymous with cancer" by the surgeon Henri de Mondeville (57). More importantly, quite a spectrum of syndromes fell under the characterization of "fire." These deserve further study, which should include a thorough examination of medical discussions, well beyond a passing allusion (without citation) to "medieval medical definitions of gangrenous ergotism" (55). It is difficult to argue, at the same time, that ergotism benefited from nosological specificity and that it overlapped with leprosy and other diseases (56-57). In fact, one may discern a subtle incongruity between the rather forceful and unequivocal proposition in the text, and the subtle ambiguities and reasons for doubt buried in the footnotes, including the admission that the associations of saints with particular diseases were changeable (170, n53).
The one endemic affliction, which exemplified most insistently- -and with firm biblical precedent-- both the dependence of health on intercession and the overlap between physical and spiritual cleansing, was leprosy. At Saint-Aignan, St Lazarus personified the disease in the frescoes and the foundation of a leprosarium bore witness to its reality. The extent of leprosy and the social treatment of its patients in central France are assessed, in a summary which is arguably the most sophisticated available in English, and which is based on the magisterial studies by Francois-Olivier Touati. Nevertheless, the summary retains vestiges of diehard simplifications about "lepers" as a category. It does not help that, as several citations suggest (181 nn. 75, 81, 99), Touati's dependable authority seems on a par with the far less reliable generalizations of Francoise Briac. As a result, even though Kupfer indicates some misgiving about Robert Ian Moore's book, The Formation of a Persecuting Society (1987), she largely subscribes to his thesis that patients fell under "a comprehensive apparatus of persecution" by the early thirteenth century (137). Also, it seems difficult to reconcile her admission that "images of the leper" were "ambiguous and contradictory" (137), with her later evocation of an increasingly well-defined "group identity" (146).
In view of the importance of penance and sacramentality, and of the extended discussion (95-102) devoted to "The Miraculous Mass of Saint Giles," as it was portrayed at Saint-Aignan and in several other places, it is somewhat surprising to see no mention of the homonymous diptych (probably once a triptych) now at the National Gallery of London. While this elaborate altarpiece is of a considerably later date (around 1500), any student who remembers Suger of Saint Denis would immediately recognize one of the panels. The general reader may be even more surprised by the absence of another "classic," by Matthias Groenewald --and of recent discussions, among which the most germane may be Andre Hayum, The Isenheim Altarpiece; God's Mediciine and the Painter's Vision (Princeton, 1990). Notwithstanding its comparatively late date (around 1512-16), this polyptych, now at the Unterlinden Museum in Colmar, is directly relevant to The Art of Healing in two significant ways. First, by virtue of being commissioned for the Antonite hospital in Isenheim and of emphatically addressing the viewers, the altarpiece eminently typifies the connections which lie at the core of the book, namely between image, disease, society, and salvation. Second, Groenewald's commission was rooted in the regional incidence of St Anthony's Fire or ergotism, which is a central theme in the book.
No caveat or quibble of a fussy reviewer can slight the value of Kupfer's contribution, tarnish the splendor of her achievement, or diminish the enjoyment of reading her book. The Art of Healing enriches two currently thriving areas of scholarship, even if these are neither expressly addressed in the text nor fully represented in the bibliography, namely the discourse on vision and "visual culture," and the history of relations between religion and medicine. In its own right, it stands as a model of inquiry and exposition. Would it be more than mild hyperbole to claim that Montaillou has found a counterpart in Saint-Aignan? A lively and multi-dimensional world unfolds from a limited body of evidence, thanks to ingenious and painstaking interpretation, which the author humbly terms an "experiment" (6). The narrative is engaging, and the language eloquent, with an occasional flourish of jargon (Gallic curlicue?), such as "amorphous spatiotemporal frame" (92), or "Ritual offering is isomorphic with redemption" (115). Indeed, some terminology and a few citations hint at conceptual and methodological influences of certain ecoles. The bibliography concentrates on Francophone historiography, with the inherent albeit tolerable drawbacks that it tends to ignore the perspective of contemporaneous Europe and parallel non-French sources and studies (especially in German), and to include some writings of limited relevance or reliability (for example, once valuable but now largely superseded works of Marcel Candille, Louis Halphen, Jean Imbert, and so on). These Gallic echoes, however, do not attest to provincialism but to total immersion. In sum, the author is to be admired (envied, one might sigh) for her intimate familiarity with the setting, which allowed her to treat the art with so much breadth and depth--and insight.