THE TACUINUM SANITATIS: A LOMBARD PANORAMA WITH HOLISTIC HEALTH TIPS

An aristocratic couple in richly colored robes flank an apple tree of almost perfect growth. Its green crown bears a rich harvest. While the man in blue shakes the large, red apples from the spreading tree with a long wooden stick, the woman in red observes the scene, but already has a basket ready to collect the fruit lying on the ground.

But what does a romantic apple harvest has to do with a medieval health guide? The following article will tell you.

In the Tacuinum Sanitatis, also known as Theatrum Sanitatis, it is not the medical treatise that dominates the pages, but large, framed miniatures, which in most of the ten manuscripts of the work still preserved today are almost full-page in size. Each miniature depicts a plant, animal, or other health factor that influences human well-being–usually embedded in a scene depicting a related activity typical of the time. Among these are anise, figs, and millet; ducks, intestines, and eggs; the different seasons; activities such as singing and fencing; and even beverages and the four winds. The effects of the individual factors on the body and the recommended way of dealing with them are explained in concise, bullet-point captions. The specific health factor in question is specified in indicative headings.

The large and numerous miniatures in the preserved Tacuina Sanitatis offer a fascinating panorama of life in Italy at the end of the Middle Ages, thereby revealing a unique aesthetic. While the texts provide insights into the medical teachings of the time, the miniatures depict cultural technologies, fashion, food, communication, and much more. The lifestyle propagated, with activities such as wine tasting, fencing, and music-making as well as a wide range of food and luxury items allows conclusions to be drawn about the everyday life of the aristocracy in particular, but also about the rural agriculture and gardening of the time.

The origins of the Tacuinum Sanitatis lie in Baghdad, where the Arab court physician Ibn Butlan created a comprehensive tabular compendium in the 11th century that brings together the effects of 280 health factors on the human body and corresponding consumption recommendations. Two centuries later, this taqwim as-sihha reached Europe via Sicily. There, it was translated into Latin at the court of King Manfred in Palermo and subsequently widely adapted. The original tabular form of the work was preserved in many Latin manuscripts until modern times.

The elaborate and costly illumination and the accompanying abridgement of the text was a special development in Lombardy, which probably originated at the Visconti court in Milan. There, the work was incorporated into the famous Historia Plantarum, the medical encyclopedia for Emperor Wenceslaus, and illustrated for the first time. Giovannino de' Grassi's workshop was possibly responsible for the impressive illumination of the manuscript. These book artists thus laid the foundation for the illuminated Tacuina, whose miniatures are largely based on this manuscript.

From northern Italy, the new genre soon spread to neighboring regions and was adapted in many ways. Sometimes parts of the work were included in anthologies and combined with other writings. For example, Codex C-67 from the Biblioteca Universitaria de Granada contains a compilation from the Tacuinum Sanitatis and Thomas of Cantimpré's (1201–1272) much older Liber de natura rerum, which is less a health guide and more an encyclopedic, moralizing natural history with scattered medical advice. Thus, both texts complement each other in this wonderfully illuminated manuscript.

Ibn Butlan's work and his Latin successors are all about prevention. Illnesses should be prevented through a healthy lifestyle. The focus is less on treating acute complaints and more on maintaining and optimizing health and well-being. The approach was holistic — physical and mental health were seen as closely intertwined, which is why, in addition to foods such as apples, health factors such as sleep and good conversation are also listed.

The basis for this was the ancient theory of the four bodily fluids and the four temperaments, also known as Humorism, which is supplemented by the early medieval Persian doctrine of the sex res non naturales or six non-natural things. While the former deals with the inherent constitution of the human body, the latter concerns physical processes such as digestion or sleep, as well as external influencing factors such as food or climate. Both teachings are united by the idea that health is a state that can be achieved through the harmonization and balance of all factors.