Reviewed by Lauryn S. Mayer (firstname.lastname@example.org)
While both the figure of the court fool and that of the medieval madman have been the subject of numerous publications, research on medieval perceptions of intellectual disability has been relatively neglected. As Metzler notes in her introduction, “the overarching interest of historians has been in the more glamourous acquired madness rather than folly or idiocy” (2). Interest in the topic has also been hampered by the all-too-prevalent construction of the Middle Ages as simple, primitive, or childish, a place where intellectual disability would be inherently less visible among the populace, or by excessive caution in applying modern diagnostic criteria to a pre-modern phenomenon. Moreover, there are serious obstacles in doing hard analysis of instances of intellectual disability in the Middle Ages: since intellectual disability was seen as incurable, and the figure of the idiot was rarely deemed a danger to herself or others, there is a severe lack of medical evidence or institutional documentation of cases of intellectual disability. Given all these challenges, it is impressive indeed that Metzler has managed to craft such a careful, comprehensive, and nuanced study of intellectual disability in the Middle Ages.
Metzler’s introductory chapter (“Pre-Conceptions: Problems of Definition and Historiography”) sets itself the task of defining what intellectual disability would have meant in the Middle Ages, and uses modern medical definitions as an entry point to examining their medieval counterparts, while acknowledging the care needed to avoid imposition of categories where they are not appropriate or justified. Her task is to try to distinguish types of intellectual disability that can be seen as primarily biological in origin, and thus less prone to charges of cultural relativism (the recent conflict surrounding the diagnosis in children of ADD or ADHD, sometimes simply from their inability to sit still for extended periods of time, is a timely reminder of the way a society may pathologize behavior that may, in another culture or period, be seen simply as natural or age-related). She therefore selects for her field of inquiry neurodevelopmental disorders as the kind of disorders that will provide the greatest stability for analysis; as she argues, “they are all developmental, in other words either congenital or connected to specific developmental stages of infancy, childhood, or adolescence – they all manifest before adulthood and then remain with the person for life” (4). Their application to the Middle Ages comes from the kinds of circumstances that produce these disorders: “genetic syndromes, congenital metabolic disorders, brain malformations, maternal disease, and environmental influences such as alcohol, toxins, and teratogens” (5), circumstances which, as she argues, “would have been likely risks during the medieval and any other period” (5).
While she founds her study on these more stable disorders, it is important to note that she is not, thereby, refusing to examine the way discourses about these disorders were created and disseminated in the medieval period, and thus deftly charts a middle course between over-simplistic arguments for biological determinism or complete social construction of intellectual disability, using the medieval idea of multivalent truths as a guide: in quoting Ian Hacking’s portrayal of critical anxiety that “something can be both socially constructed and yet ‘real’”, Metzler comments that medieval intellectuals “had an easier job, by splitting a single monolithic ‘truth’ into a number of ‘truths’ according to divine or human, natural or otherworldly modes of understanding”(7). In sum, her project is to examine how neurodevelopmental disorders are discussed across an array of medieval texts, and to try to glean from often scattered and opaque references a picture of medieval attitudes toward intellectual disability.
Chapter Two explores pre-modern terms used to describe intellectual disability in a wealth of languages: Semitic, Ancient Greek, Latin, Old English, Middle English, Anglo-Norman French, and Middle High German demonstrating, in the process, the rich and subtle array of terms that argue for a high pre-modern sensitivity to the kinds and degress of intellectual disability an individual might manifest. For example, Metzler looks at the contexts of the terms stultus and fatuus, arguing that the former referred to “philosophical stupidity, that is, doing something stupid despite having the capacity not to do so” (39) as opposed to the fatuus, “who is foolish because he can’t help himself” (39).
Chapters three through six build on this semantic foundation, and look at the discourses of intellectual disability as they appear in the realms of natural science, philosophy and law. While these chapters, with their rigorous and exhaustive winnowing of texts for mentions of intellectual disability, are invaluable as a resource for future scholars, of particular interest for the medievalist are the ways in which they help to create a more complex view of medieval medicine, philosophy, and law to counter tropes about the “primitive” Middle Ages: how premodern explorations of intellectual disability reveal an early interest in materialist explanations for the phenomenon, a precursor of current interest in genetics and molecular biology, how medieval legal terminology was fluid not because of imprecision because of a wide array of terms for both idiocy and insanity, allowing a particular official to choose the term that best fit the situation, and how rather than there being a cultural conflation between the natural (inherent) fool and the artificial (professional) fool, medieval society had a long tradition of distinguishing between the two.
The final chapter (“Reconsiderations: Rationality, Intelligence, and Human Status”) traces the influence of the rise of clerical culture in the thirteenth century and its interest in categorization, classification, and labelling on discourses of intellectual disability. The thirteenth century, Metzler notes, “saw the outpouring of ordered, standardized, measured, and … rational scientific texts” (222). This phenomenon led inevitably to the greater pathologizing of people with intellectual disabilities: “[u]nder the older, more random, fluid descriptions, each case of ‘idiocy’ was individually described and, if in a legal context, judged on its own merits against a fairly diverse and mobile set of criteria. That is frustrating for historians, because it does not give us a neat, consisten definition to get our teeth into, but it was probably good for people with IDs. In the absence of definite criteria and diagnostic standards, fewer people were pathologized and more people were just ‘getting on with it’ in whatever daily life they may have had” (223).
Metzler concludes her volume by comparing the necessarily rich, fluid, and contingent labelling practices of the “primitive” pre-modern period as practiced on the category of intellectual disability, with the oversimplistic descriptive and evaluative practices too often applied to the Middle Ages by our more “complex” culture, concluding an impressive work of rigorous research with a timely warning against our own potential folly.
Lauryn S. Mayer
Washington & Jefferson College