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De Zeventiende Eeuw. Jaargang 15 (1999)

De Zeventiende Eeuw. Jaargang 15

(1999)– [tijdschrift] Zeventiende Eeuw, De–rechtenstatus Auteursrechtelijk beschermd

Vorige Volgende

Play and health in medical literature⋆
Alessandro Arcangeli

The purpose of this paper is to reconstruct the theoretical framework and some of the most significant ways in which play and games were assessed by medical writers who discussed their implication on human health in early modern Europe.

During the sixteenth and seventeenth centuries, sports and other leisure activities were considered by European physicians within the framework of humoral theory, the ancient medical tradition going back to the corpus of Greek writings attributed to Hippocrates and Galen, to which new access was granted by the humanists' translations of their work into Latin.

The main genre of scientific literature that saw discussion of the quality and quantity of physical activity performed by human beings was the treatise on the preservation of health (de sanitate - or valetudine - tuenda). It was, therefore, more in the context of prevention than of the cure of particular diseases that play was considered. The literature de sanitate tuenda usually consisted of a set of dietetic rules, organized under the heading ‘six things non-natural’ (sex res non naturales). This expression is somehow confusing: not used in the ancient sources, it emerged in the medieval tradition of Latin translations and commentaries on Arabic medical treatises, largely based on Galen. The six elements of this list were usually given as: 1. air, 2. food and drink, 3. sleep and wake, 4. motion and rest, 5. evacuation and repletion and finally, 6. passions of the mind.1

Exercise was the medical category in which the most significant number of amusements fitted. It naturally belonged to the ‘motion and rest’ chapter, of which it could often make up the most significant topic. Discussion of the medical implications of physical exercise had an established tradition going back to the Greeks, and required the writer to assess the implications of physical exercise on the health of the individuals who practised it. He was expected to consider carefully elements such as the general characteristics of the person involved (his or her age, health, gender, or other social indicators), the physical effort required, the time of day and season when exercise was practised, and the environment in which it took place. It was not rare for physicians to express their personal orientations on what type of sports and pastimes were commendable or not.

According to humoral theory, the human body was a delicate balance of elements that had to be carefully looked after. In this context, the benefits widely acknowledged

to exercise were a rise in bodily heat; the limbering up of one's muscles; the opening of pores and its contribution to adequate transpiration and to the expulsion of noxious substances. Bowels and the fear of constipation were dominating concerns of the body culture of our past.

More precisely, what was to be regarded as exercise, and how was it defined? The definition usually given by the western medical tradition involved a series of distinctions. What differentiated exercise from the rest of body movements were the facts that 1. it is voluntary and lively, and therefore provokes either deeper or quicker breathing; 2. its purpose is health: no kind of physical work can be correctly labelled as exercise - exercise is by definition leisure, despite the fact that very similar gestures and efforts may well be involved in both human activities.

Since, for the Galenic body, prophylaxis was essentially a set of dietetic rules, early modern physicians discussed exercise mainly by assessing its relation with nutrition. Physical effort should not disturb digestion: it had therefore to be made before - or far from - mealtimes. Furthermore, moderation was recommended: both excessive effort and prolonged inactivity would be noxious to the human body. It was regarded more befitting to exercise in the open air, rather then in an enclosed environment; and when the weather was not too hot (both as an indication of the appropriate time of day and of the most convenient season).

The physician's viewpoint also classified different sorts of exercise, on the basis of medically significant categories, such as the speed and intensity of movement involved. With respect to speed, a seventeenth-century treatise published in Germany could mention dance and ball games as examples of quickness (veloces), walking and fishing for slowness (tardi).2 There were some sorts of exercise in which the body was active by its own means, others in which it was either moved or carried by something else. Swinging or travelling by means of transport - as occurs in a cradle, a coach or a boat - was judged as moderate, passive exercise (agitatio), befitting children and the elderly.3 As well as to different age groups, there were some sorts of exercise that were more appropriate to particular classes of people according to their gender, health conditions or humoral temperament; and others commendable for their benefit to a specific part of the body.

Medical literature also took into account less immediately physical implications, such as the value of exercise for spiritual recreation, which in turn had a positive effect on one's health. Both the Italian physician Bartolomeo Traffichetti in the sixteenth century and the English Everard Maynwaringe (1628-1699?) during the seventeenth, wrote in similar terms that ‘that which is most delightful, will probably prove most beneficial’4.

It would be inappropriate, though, to think of medical discussion on exercise as a

field of unanimously shared beliefs and opinions. Galen himself had defined his own seminal assessment of the matter by means of criticizing alternative theories, and early modern medical science was well aware of those precedents.5 The sixteenth-century Italian polymath Girolamo Cardano (1501-1576) offers, in his books De sanitate tuenda, a fairly uncommon but authoritative example of criticism directed against Galenic orthodoxy. He openly criticized the ancient Greek model, accusing it of proposing intensive athletic exercise, appropriate more to a soldier's than to a civilian's requirements. Consequently, Cardano confirmed that physical exercise favours human health, but he denied that it helps in prolonging life. One has to understand - says Cardano - that vigorous physical condition and long life are two incompatible goals: if you are strong you will be in excellent health, but will exhausts your resources more quickly; if, on the contrary, long life is what you want (and that was a very popular topic in Renaissance culture), you will have to aim for a lower standard of physical vigour.6

Although Cardano and his followers were making a point against Galen, they did nevertheless share with him some fundamental opinions. Criticizing excessive body building and proposing rather a mean model between muscular strength and weakness was not a novelty on the scene of medical literature. Galen himself had constructed the type of harmonically developed body by referring to the body of the athlete or gladiator as a negative example: according to Western medical tradition, a healthy body should not look like Rambo's.7

As for the parts of the body involved in each sort of exercise, as well as commenting on the benefit of particular practices (for instance, that of dancing or running for one's feet),8 medical literature tended to recommend what was useful for the body as a whole. In this respect, in a short treatise Galen had praised ‘exercises with the small ball’ (ludus parvae pilae), a practice in which he found that the whole body was involved in a balanced way.9. When sixteenth- and seventeenth-century physicians mentioned it, they tended to translate Galen's ludus into a current amusement. Thus, in the first printed book entirely dedicated to the medical topic of physical exercise - Christoval Mendez' Libro del exercicio corporal, published in Seville in 1553 - the description of the game of pelota, which the author regarded as the best, took up as many as four chapters.10 Similarly, according to the English Elizabethan physician Thomas Cogan (1545?-

1607), Galen commends ‘the play with the little ball, which we call tenise’.11 A Portoguese professor of medicine active at Pisa towards the turn of the century, Roderigo de Fonseca, recognized the appropriate equivalent to the ancient model in the street game played with paddles (mestole or lacchette), rather than the palla alla corda played indoors, which he judged to be much too violent. And he added the pallamaglio, hunting with the crossbow and the dancing of galliards as further sorts of exercise that involved a similar balance between the different parts of the body.12

Other writers had their own preferences. In a treatise on the preservation of health intended to serve for the use of his own children, Heinrich Ranzow (1526-1598), a sixteenth-century governor of Schleswig-Holstein, displayed his aristocratic taste by stating that he personally opted for hunting: not only does it exercise the whole body symmetrically; it also gives remarkable pleasure to one's mind. To this effect a wide number of elements of this loisir contribute: from exposure to the extreme temperatures of the open air to horse riding; from physical and mental effort to the strategic skills involved in the hunt, which are seen as being comparable to those of a military manoeuvre. Even the barking and howling of the hounds is recorded as an exercise for the huntsman's hearing, while following the wild animal keeps his sight in good form. Ranzow was aware of the lesson of Xenophon, and quotes directly from his treatise on hunting.13

Edmond Holling (1554-1612), an English Catholic physician who taught in Bavaria around 1600, gave his preference to the country walk: the mountain reliefs of southern Germany oblige you to walk up and down, and by doing so you keep a variety of different muscles exercised. As for your back and arms, as long as you periodically bend down to pick a flower, they will also be fit.14

In spite of a series of modern adaptations, the sixteenth- and early seventeenth-century literature I have been quoting was firmly rooted in the Galenic tradition, to the extent that it often borrowed examples that were quite old-fashioned. This is because, among the Renaissance literate, humanism had stimulated a detailed interest in all aspects of life at the time of classical antiquity, including games and gymnastics. One of the protagonists of this revival, although not the only one, was Gerolamo Mercuriale (1530-1606), a professor of medicine at Padua, Bologna and Pisa. Mercuriale's six books De arte gymnastica, first published in 1569, claimed to be based on the writings of over a hundred ancient authors; they quickly became a work of reference on the subject and had a wide European circulation for more than a century. In one of his few references to modern amusements, Mercuriale criticised the effects that contemporary dances had on health, although only because they were performed at inappropriate times (after meals, and at night, when people should rather sleep).15

A cluster of publications all dating to the late 1660s seems to mark a rise of interest in contemporary amusements among the medical profession. In 1668 a treatise de sanitate tuenda was published by Pierre Gontier, King's Physician to Louis XIV. Based as it was on the series of the ‘six things non-natural’, it was still traditional in its structure, with twelve books out of eighteen dealing only with food and drink. Nevertheless, in his discussion of motion and exercise, a significant number of references to modern amusements were added to the usual antiquarian information. Among the dances, he mentioned such specific Gallorum saltationes as pavanes, gaillardes, courantes, bourrées, and voltes; and he included some (generally encouraging) details about their effect on human health. His Latin text also accomodated some French vocabulary when he listed and described a series of modern ball games (balle, ballon, jeu de paume, longe paume, raquette, battoir, prendre à la volée). He also referred to dice and card games, though only to blame them for not exercising the body at all; whereas about trictrac he acknowledged, at least, that it keeps sight and memory well occupied. A quite different playing instrument, the catapult, obliged Gontier to mention the recent French civil revolts (the Frondes); as for the ritual fights during which it was commonly used by the Parisians, he observed that - rather than preserving people's health - it frequently caused serious wounds and occasional deaths.16

A year later, in 1669, Michel Bicaise, professor of medicine at Aix-en-Provence, published a treatise which deserves special interest for at least two good reasons: because in it 1. he paid an exceptional attention to the subject of games and exercise and 2. he chose to write in the vernacular, i.e. for a wider, less specialized public. Its title reads ‘La manière de régler la santé par ce que nous environne, par ce que nous recevons, et par les exercices, ou la gimnastique moderne’, and it adds a special concern for the French people, as well as for the author's fellow citizens of Aix. In the author's vocabulary it is easy to recognize once again the traditional theoretical framework of the ‘six things non-natural’; however, the reference to modern gymnastics suggests that the content has been updated. The subject matter indicated in the title is distributed over three books. The first deals with things that surround us: stars and climate, but also noises, clothes and other human beings. The second with things we consume, i.e. what we eat, drink or smoke. It was the third book, however, that was the most important in the author's opinion. It dealt with a wide range of human activities; and self-consciously stated that, while sixteenth-century scholars had only described ancient types of exercise, it was time to turn to, and examine, their modern equivalents.17

From the very title of the third book - in which jeux as well as exercices are at stake -

we immediately appreciate the importance Bicaise gave to the play element. He starts with a chapter on exercise in general, followed by reflexions on exercise for children; here he scrutinizes the pros and cons of the spinning top, snowballs, the catapult and other throwing games. Next comes a detailed discussion ‘de la paume et du mail’: according to Bicaise, the former requires too sudden and quick running forward, resulting in excessive sweating and fatigue; it is particularly harmful after a meal, when it would agitate your humours like a tempest at sea. The maglio demands a huge effort from one's arm, which causes chest pains and explains why players often cry out during their games.

After a survey of a series of means of transport, a specific chapter is on the subject du jeu. From its very beginning, the author stresses parallels and interactions between medical and moral discourse. Play brings with it pleasure, which is perceived as harmless but open to abuse. Morals, acting as a spiritual medicine, have therefore introduced laws and instructions to regulate players' behaviour; medicine proper has followed the same path, and fixed its own rules. These are enumerated in a list of nine articles, consisting of situations to be avoided, and of miscellaneous observations on the relationship between play and health. One should avoid: 1. playing games that are too serious or 2. games only determined by luck (the sudden changes of mood they bring with them tend to upset the humoral balance), as well as 3. contention (it triggers one's bile), 4. subsequent disappointment, and 5. war simulations. Subsequent remarks include the indication that 6. ‘from play you can tell the inclination and temperament of the players’ (and that everyone should choose the most appropriate to his or her constitution); that 7. ‘the force of imagination is the cause of the excesses we find in play’; 8. that ‘one feels stunned and heavy after playing’; and last, according to astrology, 9. ‘Venus, Mars and Saturn are the masters of play’. On the whole, the reader gets the impression that the moral concern, expressed by Bicaise at the beginning of these pages, had firmly oriented his scrutiny and led him to discover rather les maux than les biens of play and games.

In the following chapters he discusses a broad series of specific amusements and physical activities: dance, military exercises, hunting, comedy, music, laughter, walks, and horse riding. After the concern expressed about play and games, an enthusiastic assessment of dance brings a sudden change of mood. It loosens the whole body, being the best preparation for gymnastics; makes you moderately thin; and helps transpiration, which is particulatly useful for the health of women. Above all, while other sorts of exercise only employ one limb, the whole body participates in dance, whose harmonious movements favour a salutary equilibrium. With his last remark Bicaise has joined the game of choosing which exercise is best for you. While his preference for dance originated outside medical literature, it even antedated Galen's ‘small ball’: it had in fact been advanced by an ageing Socrates in a well-known passage from Xenophon's Banquet.18

Among the other activities, military exercises and hunting are judged to be utterly

unsuitable for individuals of particular temperaments; comedy is examined for its remarkable effect on spectators; singing and playing musical instruments (which Bicaise acknowledges as curative, as well as preservative) are considered from the points of view of both performer and audience. Laughter can be helpful in moderation, dangerous and even deadly in excess. Walks are classified according to a remarkable number of characteristics, including their spacial pattern (circular movement being the best); as for where to go, the ideal place should be well equipped with singing birds, flowing streams, trees and flowers. Although this book may look somehow idiosyncratic in the opinions it expresses, it offers a selection of topics that is highly representative of the cultural and social orientations predominant at the time.

A third publication, after those by Gontier and Bicaise, was issued in 1670 by Vopiscus Fortunatus Plemp of Amsterdam (1601-1671), a professor of medicine at Leuven. It belonged to the tradition of treatises on the health of a particular category of people, the literate, a genre inaugurated at the end of the fifteenth century by Marsilio Ficino.19 While obviously everyone recommended exercise as an antidote to the drawbacks of sedentary life, Plemp pays more attention than average to listing and describing the different types of exercise. They include some professionally orientated activities, such as practicing speech (pronunciatio); but also walking, ball games (with reference to the Italian game of pallamaglio), dancing, being transported in various ways, throwing sports, and end with the game of bowling a hoop (Lat. circilasia; ‘nobis Belgis notissima, vocaturque reepen, Hollandis hoepen’). Of the last, Plemp comments: ‘You may observe that it is not decent for intellectuals to play this game. That is correct, if they bowl those hoops along in town squares, as our children do. It would not deserve blame, on the other hand, if they do it in their own houses or in the country’. A remark that resembles Baldesar Castiglione's prescription that a courtier should only perform calm dances when in public, whereas he is freer to frolic in the lively ones when either in private or masked.20

Similar practices were also referred to a couple of years earlier by the German physician Valentin Heinrich Vogler (1622-1677), professor of medicine at Frankfurt an der Oder, although in a context where antiquarian references where still predominant. Vogler was sometimes more explicit in indicating the negative effects produced by playing, as in the case of games consisting in hitting a ball towards a target (‘lusus metatorius noster’), in which the parts of the human body are unevenly engaged, and people tend to tire both their arms and their backs to excess.21 Both Gontier and Vogler attacked as unhealthy the volta, the quick Renaissance dance that raised both the bodies of women and the eyebrows of moralists.22

It is common knowledge that a definition of play and games is problematic, and it is significant that they overlap with the fields of sport and physical exercise on one hand and that of the performing arts on the other.23 If, to summarize, we look back over the whole series of our examples, we find that there are a number of activities which early modern physicians frequently classified among the forms of exercise and which today we would not. If, as it seems, they considered a wider spectrum of human behaviour than we would expect, the study of this rich genre of sources becomes all the more relevant to research in the cultural history of play and games. In general, as we have seen, during the sixteenth and seventeenth centuries European medical literature 1. tended to consider a significant range of leisure activities, notwithstanding the variable standards of physical participation they required, and 2. used to classify them within the Galenic scheme of motion, as one of the ‘six things non-natural’.

When we look more closely at the chronology of the material we have analyzed, we observe that a landmark for early modern medical interest in the world of amusements is the translation into Latin of Galen's 'Υγιεινά [Hygieinà]. After the pioneering work of fourteenth-century translators, a new authoritative version was proposed by the English humanist Thomas Linacre (c. 1460-1524) - King's Physician to Henry VII and Henry VIII, and the founder of the Royal College of Physicians - and published in Paris in 1517. By the second half of the sixteenth century the ancient model had been followed by a significant number of physicians, who wrote popularizations and adaptations; in these works an antiquarian interest is predominant, though reference to contemporary practice is not absent. Towards the mid-seventeenth century a series of new treatises on the preservation of health was published, in which attention was directed almost completely towards present amusements. At the same time a European reader would also have been familiar with titles such as Les plaisirs des dames; that is to say, works that covered the same range of human activities, though examined from a moral viewpoint.24

What was the attitude predominant among the medical writers? From their variable opinions on how balanced or unbalanced an effect a given amusement had on human health, we infer that there never was a precise standard, a universally shared set of likes and dislikes. However, if we try to rise above individual preferences or regional traditions, a general approval of a moderate use of the most common loisirs seems to have prevailed. Physicians neither supported sports and games simply and enthusiastically, nor accepted Galen's authority uncritically, as the case of Cardano has shown. Where concern was expressed - as by Gontier and Bicaise in the case of play or by many authors over the more lively dances - this seems to depend on moral values rather than on purely scientific grounds.

Relevant to our discourse is an earlier, exact synchronicity, that between Linacre's translation and Martin Luther's 95 theses. It reminds us that the development of the ear-

ly modern scientific attention to the field of preservation of health occurred at the same time as the confessionalization of European peoples by the post-Reformation churches. Indeed it is certain that a relationship between the moral and the medical discourse existed, as we have pointed out in a number of specific cases; though this is a subject that deserves further historical investigation. As aspects of the Renaissance humanists' reform of education, games and sports undoubtedly constituted a key element in such interplay between morals and medicine.25

Abstract - During the sixteenth and seventeenth centuries, sports and games were considered by European physicians within the framework of Galenic medicine. The genre of scientific literature called de sanitate tuenda (on the preservation of health) consisted of a set of dietitic rules, organized under six headings: 1. air, 2. food and drink, 3. sleep and wake, 4. motion and rest, 5. evacuation and repletion, and 6. passions of the mind. Medical discussion of physical exercise included an assessment of the effects of a number of amusements on human health. While during the sixteenth century reference to classical antiquity was predominant in the discourse about games and sports, in the following century attention was directed towards contemporary practice. Although approval of a moderate use of the most common loisirs prevailed, some authors expressed their moral concern.

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