Art is the subjective expression and application of our experiences and knowledge, making observation an important aspect to its creation. Subjective perception can fenestrate empathy and open a window to human suffering. This skill is especially important for professionals who treat physical and mental ailments, but no one characterized this observational ability better than Shakespeare.

The 16th and 17th century was a time devastated by the plague and a society that was losing faith had begun making art orbiting their cynicism. Shakespeare’s work had brought light to a dark era, exploring the comedy in tragedy and romance. What made him a great literary force, however, was his powerful skill of observation. He portrayed this skill the most in his use of medical imagery, referred to by E.K. Chambers as “an apothecary and a student of medicine”¹. 

On average he made 12 major medical references per play¹, where it is also critical to note that there were no extensive medical works published in England until 1699². Medicine at the time was still based on the works of Plato, Hippocrates and Galen, fundamentally consisting of the concept that all matter consisted of the four basic elements: fire, earth, water, and air. In the body, this translated to the four humours: black bile, yellow bile, blood, and phlegm³. An imbalance between the four humours would result in a physical or mental ailment, diagnosed through observation, palpation, and evaluation of urine and heartbeat. This is exemplified in Hamlet, where Hamlet emphasizes the importance of the heartbeat and health, telling Gertrude: “My pulse, as yours, doth temperately keep time, / And makes as healthful music”⁴. Yet, the most noteworthy of Shakespeare’s medical mentions was his awareness of neuroanatomy, specifically to his three references of the pia mater. The pia mater is the innermost layer of the meninges, directly adherent to the surface of the brain and spinal cord. It was discovered in the late 14th century, but was not common knowledge until the 17th century, making it a very obscure part of the anatomy at the time³.  

Studying Shakespeare’s medical imagery really showed that he had a distinct interest in therapeutics and the association between physical ailments and human character. He had a very conscious understanding of the influence of the mind on the body and vice versa⁵. The medical knowledge of Shakespeare was so extensive that it required immense observation and the devourment of an astronomical number of books², but can also be attributed to his relationship with John Hall, an English physician and herbalist.  His ability to appreciate defects of the human mind and calamity of the body has amazed many great minds for centuries⁶, including that of Sigmund Freud. His medical imagery was such an important aspect of his writing style, using it more than any other contemporary¹, applying it to express understanding of human temperament and behavior. He adopted the origins of disease both literally and metaphorically⁷, which can be exemplified in Romeo and Juliet. Friar Laurence demonstrates a compelling contradiction where plants can be poisonous, but isolated ingredients from the same plants can be used to make therapeutics. Shakespeare makes a point that plants are like people: they can destroy and they can rectify⁶. 

To this day, Shakespeare’s portrayal of mental illness has not been matched. Since there was no treatment for mental disorders, Elizabethan England bustled with the erratic, the paranoid, and the delusional, making his depiction of such solely based on observation. A lot of the time, both mental and physical illness inhabited the same character simultaneously, for example in Richard III, Richard showed symptoms of kyphosis and psychopathy, shaping him into an absurd killer⁶. He was a true window of human suffering. 

Shakespeare was a student of character, using his observational skills to intuitively associate physical ailments to character temperaments, a trait medical professionals should aspire to attain as a way to develop empathy. After all, it is the art of medicine.

References

1. Chambers, E. K. (1930). William Shakespeare, A Study of Facts and Problems. London: OUP.
2. Bucknill, J. C.  (1860). The Medical Knowledge of Shakespeare. Longman & Co., Paternoster Row. 
3. Davis, F. M. (2000). Shakespeare’s Medical Knowledge: How Did He Acquire It? The Oxford. III.
4. Shakespeare, W. (1603). Hamlet. https://www.playshakespeare.com/hamlet/scenes/act-iii-scene-4
5. Spurgeon, C. F. E. (1935). Shakespeare’s Imagery and What it Tells Us. Cambridge University Press.
6. Cummings, M. (2003). Shakespeare and Medicine. http://www.shakespearestudyguide.com/Medicine.html
7. Maerker, A. (2016). Shakespeare’s Medical World. The Researcher’s View. http://blog.wellcomelibrary.org/2016/04/shakespeares-medical-world/