Letter 10029: Your distinguished nobility and your great record of loyal service persuaded me to entrust you with governing in...

CassiodorusWisibad|c. 522 AD|Cassiodorus
barbarian invasionfriendshipgrief deathillnesstravel mobility
From: King Theodahad of Italy
To: Count Wisibad [Gothic military commander]
Date: ~536 AD
Context: A remarkable letter granting medical leave to a Gothic count suffering from gout — containing one of the most vivid and detailed medical descriptions in all of late antique literature.

Your distinguished nobility and your great record of loyal service persuaded me to entrust you with governing in peacetime the city of Ticinum [Pavia], which you had defended in war. But now, struck by a sudden flood of gout in the joints, you have asked permission to seek the waters at Bormio [in the Alps] — specifically therapeutic for this condition, known for their drying properties. I grant your wish with a healing order, so that through this royal benefit I may secure the good health I rightly desire for you.

Far be it that the tyranny of this most grievous affliction should disarm a man of such martial prowess. In a strange way, it forces vigorous limbs to wither through an infusion of punishing moisture. It fills mobile joints with a swelling that turns to marble, and what nature had left loose for graceful movement, it locks into ugly rigidity through an alien solidification. It knows how to drain everything else, yet seeks the hollow spaces of the joints, where it stagnates like a swamp — turning liquid into stone, making what was designed for flexible bending into shameful stiffness.

This condition — incurable yet allowing a kind of "health" that still suffers — binds the free, contracts the living, and diminishes bodies that have lost no limb to amputation. With all members intact, a man's full stature vanishes: he appears smaller, yet nothing has been taken away. The services of his limbs are stolen from the living man. His body lives but does not move. Reduced to the level of insensible things, he is carried not by his own will but by another's effort. This living death is called "well" compared to all other torments, and one is said to be "doing better" even though there is no proof the cause of so great a danger has actually departed.

The pain may subside, yes — but it leaves behind consequences worse than itself. In a novel form of misery, the illness appears to depart while the patient never stops being ill. Even debtor chains are sometimes released from those they torment, but these bonds, once they have captured a man, never release him for the rest of his life. The disease leaves its wretched marks as it retreats and, like barbarian invaders, defends the occupied territory of the body with its own signs — so that hostile health might never dare to enter where this fierce intruder has once established itself.

Though harmful to everyone, this disease is especially cruel to those who have flourished in the exercise of arms — lest those hardened limbs be softened by the disease's slow corrosion, and the man who could never be conquered by an external enemy is instead defeated by an internal adversary.

Go then, with God's guidance, on your own feet to the place I have described. Far be it that our warrior should travel on other men's shoulders. Let him be carried on horseback, not borne by human porters — for it is a hard thing for a strong man to live in such a way that he cannot even manage the tasks of an unarmed civilian.

I have described all this at such length so that you may be seized with the most passionate desire for your cure. Use those waters — first by drinking them as purging agents, then through the drying exhalations of the hot baths. There, rightly, the indomitable neck of this disease is bent: internally, the body is cleansed through copious flushing; externally, its drawing power restores freedom. As if two allied remedies were mustered together, the disease is defeated when caught in the middle. Let us love the gifts God has granted there. Against this scourge of the human race, the timely defenses of these baths have been provided. What no decade of endurance can overcome, what no thousand potions can soften, is driven out there by pleasurable remedies. May God grant the desired blessing — so that I may confirm the place's excellent reputation through your own restored health. For I long to see you escape anything that robs a man of bodily wellbeing.

Modern English rendering for readability. See the 19th-century translation or original Latin/Greek for scholarly use.

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