In Fistula in Ano, John of Arderne sets out not only his operative procedures but also his code of conduct for the ideal medical practitioner. The remarkable parallels between the ideal description offered by Arderne, himself a practicing surgeon in England at the end of the fourteenth century, and the portrait of a physician given by Chaucer in the "Prologue" to The Canterbury Tales have virtually escaped critical attention. Only D. W. Robertson has noted, in passing, that Arderne's reference to "proverbial expressions" (206) applies to Chaucer's physician. One possible reason the connection of Arderne's Fistula in Ano to Chaucer's physician has been obscured is that Arderne himself has been identified (probably erroneously) as the model for Chaucer's "doctour of phisik,"(1) an identity suggested by Muriel Bowden (208-09) and recorded in the apparatus of Robinson's edition as "not impossible" (661). Nevertheless, available evidence confirms only that Arderne was Chaucer's contemporary and that the translation of Arderne's Fistula in Ano was concurrent with the production of the surviving manuscripts of The Canterbury Tales. These historical coincidences - together with the similarity of Arderne to his predecessors Henri de Mondeville and Lanfrank - suggest that Arderne and Chaucer's pilgrimms and early audiences had similar expectations about successful medical practice.(2)

Details from Chaucer's "Prologue" correlate well with aspects of Arderne's code. The physician's fitness, as indicated by the lack of "superfluitee" (I[A].436) in his diet, accords with Arderne's emphasis on "mesure" (4.25) as a substitute for gluttony and drunkenness. The physician's ease in accepting Harry Bailly's hospitality accords with Arderne's recommendation that medical practitioners not criticize the foods offered to them in the course of their practice (4.29-31). Furthermore, the apparel of Chaucer's physician conforms to Arderne's advice that physicians should dress in ways that command respect: the practitioner's clothing should be "honeste, no??t likkenyng hymself in apparalyng or berying to mynistrallez, but in clothing and beryng shew he the maner of clerkes" (6.28-30). Arderne also mentions clothing as part of the compensation for surgical treatment of fistula in ano (6.5), leaving open the possibility that Chaucer's physician wore gifts from a patient. In his clothing (however acquired) and demeanor, Chaucer's physician fulfills expectations for the late-medieval practice of medicine.

Also, Chaucer's physician conducts his practice within the bounds outlined by Arderne. The collusion with apothecaries, so that "ech of hem made oother for to wynne" (I[A].427), for example, was the norm. Though Arderne prides himself on his own ability to compound pharmaceuticals, he sometimes uses as a base a "common" (28.9) preparation made by apothecaries. Like Chaucer's physician, Arderne does not eschew gold but appends both gold and silver to a lengthy list of postoperative remedies for fistula (27.38). In light of other points made by Arderne, the frugality of Chaucer's physician (I[A].441-42) should be regarded as prudent management of resources rather than as stinginess; for example, Arderne encourages practitioners to secure prepayment for their services (5.39-40).(3) With the exception of those retained by wealthy households, medieval physicians and surgeons had little promise of predictable, regular income. According to Carole Rawcliffe's research, medieval medical practitioners only occasionally received large fees in the form of annuities and properties. Arderne acknowledges that fees are negotiable; and, though he attempts to set a base price for his procedure in curing fistula in ano ("ffor neuer in all my lyf toke I lesse than an hundred shillyng for cure of that sekenes" [6.8-10]), he admits that a practitioner may need to take less "as hym think better and more spedefulle" (6.10-11). In addition to the risks of irregular work and difficulty in collecting fees, practicing medicine is dependent on the practitioner maintaining good health. Thus, the ostensible motive of Chaucer's pilgrims - expressing gratitude to the saint who has helped them during their own sicknesses (I[A].18) - takes on added significance for the physician.

Initial comparison with Arderne's code points to Chaucer's physician being adequate, and even excellent, in the practice of medicine. However, the impression that Chaucer's physician is both perfect (I[A].422) and unsurpassed (I[A].412) results from uncritical acceptance of the pilgrim-narrator's summary judgments. Although Chaucer's physician does excel in the shop talk of medical practice, his conversation should not be confused with action (Curry 3). Furthermore, Arderne attacks shop talk itself in his caveat that the medical practitioner "be no??t y-founden temerarie or bosteful in his seyingis or in his dedes; and abstene he hym fro moche speche" (4.8-10). By Arderne's standards, Chaucer's physician is injudicious in acquiescing to the innkeeper's wager because the medical practitioner should "als moche as he may withoute harme fle he the felawshippe of knafes and of vnu [n]este persones" (4.19-21). Finally, the pilgrims' wager for merry tales is incompatible with Arderne's prohibition against mirth: "be a leche no??t mich laughyng ne mich playing" (4.18-19). Judged solely on the basis of the "Prologue," the physician largely conforms to Arderne's code. Ironically, however, the "Physician's Tale" and its reception reveal the teller's professional incompetence in a skill no longer expected from physicians - that of healing or consoling through storytelling.

To enhance his healing talents, Arderne recommends to the practitioner the tasks of reading, study, writing, and praying as activities appropriate to his continuing education (4.21-23) and expects the medical professional to know biblical phrases and stories of comfort (7.4-29). Yet Chaucer's physician is well known for his inattention to biblical studies (I[A].438). Arderne's code contains high expectations for tales told by physicians: "[I]t spedeth that a leche kunne talke of gore talez and of honest that may make the pacientes to laugh, as wele of the biblee as of other tragediez" (8.10-12), in order to "make or induce a li??t hert to the pacient or the sike man" (8.13-14). Fulfillment of these expectations should be possible because of the physician's training, as Arderne indicates when he encourages the young practitioner to learn "gode prouerbez pertenyng to his crafte in counfortyng of pacientez" (7.4-5). For Arderne, the context of faith is paramount in that he encourages the medical practitioner to "sette god afore euermore in all his werkis, and euermore calle mekely with hert and mouth his help" (4.4-6).

In light of Arderne's recommendations for exemplary stories, the "Physician's Tale" reveals previously undisclosed aspects of the character and competence of its teller, aspects that contradict conclusions based solely on the "Prologue." As a storyteller, Chaucer's physician undermines his own credibility by continuously frustrating the expectations of his audience. As digression follows digression, Chaucer calls attention to the physician's responsibility for the narrative, noting that the physician "maketh this descripcioun" of Envy's pleasure in the ill health of others (VI[C].116-17). The abrupt changes in the "Physician's Tale" echo the mutability of things in Nature's "cure" (VI[C].22): The description of the character of Virginia as painted by Nature is followed by advice to guardians; narration of the conspiracy between the judge and churl is followed by the father's, then the daughter's, then the people's responses. When the sequence of responses makes a cure for Virginia impossible, Virginia becomes her own physician. After requesting a "remedye" (VI[C].236), she herself uses the approach prescribed by Arderne - reference to biblical materials. Attempting to face her own death, Virginia consoles herself with the story of Jeptha's daughter (VI[C].240-44). Nevertheless, Chaucer's physician's original and subsequent audiences have seldom been consoled by his tale of Virginia.

Modern scholars have not succeeded in accounting for the apparent inadequacies of the "Physician's Tale." Of special concern has been the confusion of expectations that results from the blurring of genre boundaries within the tale. As Helen Cooper has shown, the "Physician's Tale" can be arguably an exemplum, a history, or a piteous tale (248-50). Though Anne Middleton has succeeded in making a case for the adequacy of the tale, the majority of critics find it distasteful.(4) In addition, the diffusion of causality that Emerson Brown has detected in the "Physician's Tale" is an instance of what John of Arderne calls dupliciter sermo, or "double talk," translated into Middle English as "double worde in his mouthe" (7.2). According to Arderne, the practitioner should never exhibit this trait "ffor ??if he be founden trew in his wordes ffewe or noon shal doute in his dedez" (7.24). In The Canterbury Tales, however, the physician's deeds appear acceptable, but his story is suspect.(5)

The responses of the pilgrims to the physician's tale affirm its inadequacy in meeting audience expectations. Although Harry Bailly begins by calling the tale "pitous" (VI[C].302) and the teller "a propre man, / And lyk a prelat" (VI[C].309-10), he concludes that he has been made almost sick by the tale but that he will treat himself (VI[C].312-14). In causing sickness, Chaucer's physician violates the oath of one of his own authorities, Hypocrates (I[A].431): First, do no harm. In advocating self help, the host appeals to the primary health care system of the Middle Ages, medical care provided within the household. Even though self-help was the medieval medical norm, the host's allegation that self-help is preferable to retaining a doctor of physic runs counter to the perceptions of status and value sought by physicians and surgeons of this period (Alford, Siraisi, Talbot). The host's claim that he could also be revived by "a myrie tale" (1. 316) echoes Arderne's requirements that a practitioner induce a light heart and make a patient laugh. The physician's inability to produce these effects indicates that his character is flawed in precisely the skill most valued by the terms of Harry Bailly's wager - the skill of storytelling.

A similarly adverse reaction from Chaucer's pilgrims follows the "Monk's Tale."(6) When the Knight complains of the tale's "hevynesse" (VII[B2]2669) and its production of "a greet disese" (VII[B2] 2771), he too speaks from traditional expectations for healing through storytelling. In pronouncing the failure of the "Monk's Tale," Harry Bailly also resorts to a medical conclusion that the tale is "no remedie" (VII[B2]2785). To the extent that Chaucer's tales and their reception mirror their fictional tellers, both the monk and the physician fail to heal through storytelling and thus subvert audience expectations that were established by the "Prologue." Each tale convicts its teller as a professional man of less worth than the narrator of the "Prologue" had supposed. Seen in the light of John of Arderne's code of conduct, Chaucer's physician commits malpractice.

NOTES

1. Quotations of Chaucer are from the Riverside edition, cited by section and line numbers (I[A].411); quotations of Arderne are from the EETS edition with thorn transcribed as th. Ussery discusses and dismisses Arderne as the prototype for Chaucer's physician (62-69).

2. See Power's introduction to Arderne (xix-xxvi). Of the fifteen authorities cited by Chaucer's physician (I[A].429-34), Arderne cites seven. For descriptions of the physician's authorities, see the Riverside edition (817), Robbins, and Skerpan. Mann calls this passage "medical expertise or 'mumbo-jumbo'" (92).

3. For the theoretical justification of physician's fees, see Alford (390-96).

4. Justification of the physician and his tale can be argued by relationships with other characters and tales, as in Brown (143) and Kempton (34). Harley attributes critics' allegations "of artistic ineptness" to choices made by Chaucer's editors. Nevertheless, Hanson asserts that the teller "does not understand his materials" (132). For a list of critics who consider the "Physician's Tale" to be deliberately inferior, see the Riverside Chaucer (902). For the literature linking teller and tale, see Corsa's variorum edition (13-20).

5. One could, however, argue that the tale was supposed to be nauseating. For the possibility of using narratives as medicinal purges, see Olson (38-39).

6. In an unpublished paper, Susan Hagen of Birmingham Southern College argues that Chaucer's Monk's failure as a storyteller results from his lack of prudence.

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ELAINE E. WHITAKER University of Alabama at Birmingham

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