Neophilologus (2017) 101:603–620

DOI 10.1007/s11061-017-9527-7

Illness as a Burden in Anglo-Saxon England

Penelope J. Scott1

Published online: 29 May 2017

 Springer Science+Business Media Dordrecht 2017

Abstract As a culturally constructed concept, illness may be conceptualised

through various metaphors across different times and cultures. This paper presents
evidence based on readings from the Dictionary of Old English Corpus in Elec-
tronic Form (Healey et al. 1998) and the Dictionary of Old English (DOE) that in
Old English illness is conceptualised as a heavy burden. The significance of the
ILLNESS IS A BURDEN metaphor in Old English is greater than in Present Day English,
in which, as pointed out by Goddard and Wierzbicka (2014) it would not be usual to
speak of a heavy illness. The paper also investigates whether there is evidence for a
nascent form of the military metaphor for illness and medicine, as identified by
Sontag (1978/1991) and exemplified in Middle English by Dı́az-Vera (2009). The
military metaphor suggests a different approach to illness, in which one ‘fights’ the
affliction. This is not well-evidenced in Old English, and it is argued in this paper
that these two conceptual metaphors are based on distinct cultural schemas (Quinn
1987). While ILLNESS IS A BURDEN is to an extent grounded in embodied experience
(Lakoff and Johnson 1999), the conceptualisation in Old English cannot fully be
understood without also taking into account cultural schemas influenced by the
humoral theory of disease aetiology, and by the religious context.

Keywords Old English
Conceptual metaphor
Health and sickness
Cultural

schema
Semantics
Anglo-Saxon England

& Penelope J. Scott

[email protected]
1
HS433, Department of English, Xi’an Jiaotong-Liverpool University, Suzhou, China

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604 P. J. Scott

Introduction

The later part of the twentieth century saw a turn in medical anthropology towards
the idea that human experiences of illness and pain are culturally specific, and that
even concepts long treated as ‘neutral’ should not be assumed automatically to exist
within different cultures (Kleinman 1978, p. 662). The result is a more nuanced
view that attempts to establish how illness and medicine is viewed in a given
cultural context (Good 1977; Kleinman 1978). Similarly, cross-cultural and cross-
linguistic work in lexical semantics reveals even embodied concepts such as pain to
be culturally specific (e.g., Goddard and Wierzbicka 2014). A cultural linguistic
framework, which aims to account for the influence of cultural factors in the
creation of concepts is enlightening both in cross-cultural and diachronic studies of
illness, avoiding ethno-centrism and presentism.
Sontag (1978) highlighted the metaphorical nature of Anglo-American concep-
tions of illness and medicine, and numerous studies have since argued that
conceptions of health, illness, and the body are metaphorical (e.g., Kirmayer 1992;
Yu 2009; Nerlich et al. 2002). From a historical perspective, we can see metaphors
of health and the body changing throughout the history of English (Dı́az-Vera 2009;
Swan 2009). These diverse metaphorical conceptions allow us to gain insight into
the conceptual landscapes of the cultures concerned. The aim of this article is to
investigate how illness is metaphorically conceptualised in Old English.
While the Anglo-Saxon medical texts provide useful insights into the medical
tradition of the time, they are limited in perspective, saying little about the
experience or cultural significance of illness. This study is therefore based on
readings from the whole corpus of Old English (Healey et al. 1998), and argues that
illness is conceptualised in terms of weight-related conceptual metaphors in Anglo-
Saxon England. Though such embodied metaphors are often argued to have a
universal basis (e.g., Lakoff and Johnson 1980), I argue that this metaphorical
conception of sickness is related to cultural schemas, and that while the perception
of weight is a shared human experience, the way in which it is metaphorised is
culturally specific. Furthermore, the metaphor is shown to decline in the later history
of English, problematising a universalist perspective.
Other health-related metaphors have been proposed in the Middle English period
(Dı́az-Vera 2009), including DISEASE AS A CONQUEROR, which may be an early form of
the military metaphor in Modern English discussed by Sontag (1978/1991).
Evidence exists for some crossover between medical and military language in Old
English, though only in non-religious genres. Whether this constitutes a nascent
form of the military metaphor is considered in ‘‘The Military Metaphor in Old
English?’’ section. The two health-related metaphors discussed in this paper shine
light on the influences of religion and medicine on perceptions of health within a
period that has been under-represented in this area.

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Illness as a Burden in Anglo-Saxon England 605

Metaphor and Illness

It was Susan Sontag’s Illness as Metaphor (1978/1991) that first elaborated on the
use of medical metaphors, particularly with respect to TB and cancer. Her treatment
examined common usage as well as literary depictions of illness, and was critical of
the social and psychological implications of certain medical metaphors. One of the
metaphors she identifies is the military metaphor, observing that as a result of this
conceptualisation, ‘‘cancer cells do not simply multiply; they are ‘invasive.’ […]
Cancer cells ‘colonize’ from the original tumor to fat sites in the body […]’’ (Sontag
1978/1991, p. 66). She argues that when discourse surrounding a particular disease
comes to be metaphorical, people’s perceptions and actions are affected. Referring
to the normalisation of a treatment for cancer often regarded to be ‘‘worse than the
disease’’ she observes that ‘‘[t]here can be no question of pampering the patient.
With the patient’s body considered to be under attack (‘invasion’), the only
treatment is counter-attack’’ (Sontag 1978/1991, p. 65, brackets original). Lakoff
and Johnson (1980) claim that conceptual metaphors ‘‘are a matter of thought and
action’’ (p. 153) and become a feature of literal language. This is nowhere more
evident than in the interaction between cancer and the military metaphor. As Sontag
(1978/1991) states, ‘‘[t]alk of siege and war to describe disease now has, with
cancer, a striking literalness and authority’’ (p. 67), noting that many early cancer
treatments from the twentieth century actually have their origins in chemical
warfare (Sontag 1978/1991, p. 66 fn).
Conceptual Metaphor Theory (CMT) places strong emphasis on embodiment,
and argues that a great number of basic metaphors are universal. While Lakoff and
Johnson (1980) do allow for the existence of culturally specific structural
metaphors, which take into account not only embodied experience but cultural
frames, early versions of CMT have been criticised for a relatively universalist
approach. Recent scholarship in metaphor analysis aims to elaborate on these
‘cultural frames’ (e.g., Kövecses 2000; Yu 2009; Sharifian 2011; Geeraerts 2015,
pp. 20–24), providing greater insight into the world view of a cultural group. This
debate becomes especially pertinent in the case of metaphors of health and sickness,
since we are dealing with conceptualisations even more closely tied to bodily
experience. However, although the body is an integral factor in our conceptual-
isations, our worldviews are ‘‘culturally coloured’’ (Yu 2009, p. 260) and the
resulting metaphorical conceptualisations rest on a number of cultural frames.

Illness as a Burden

The concepts encoded in the adjective ‘heavy’ are flexible, subjective, and
experiential, and usage is contextually determined. In its most basic literal
interpretation, the perception of weight merely serves to allow one to make a
judgement about the object: lead is heavy. But often the speaker conveys something
more than this; the experience of that perception, which tends to be associated with
a negative value judgement. While not all sensations of weight necessarily are

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interpreted as negatively-emoted burdens, all metaphorical extensions of the term in

Old English do carry with them some negative value. For example, in the domain of
emotions, Swan (2009, p. 470) shows that in the History of English a heavy heart is
associated with unhappiness, while a light heart is a metaphor for happiness. The
following extract of two of the senses listed in the Dictionary of Old English sense
definitions for hefig reaffirms the negative figurative meaning associated with
weight:
5. weighed down, oppressed (by sorrow), sorrowful
5.a. of moaning, groaning, lamentation: expressing or indicative of grief;
sorrowful, doleful

8. hard to bear, onerous, grievous, difficult, oppressive

8.a. of servitude, poverty, loss, hardship, torment, illness, affliction, etc.: hard to
bear, grievous, oppressive, severe, grave
(DOE, s.v. hefig)

The DOE entry for hefig lists fourteen major senses, many of which carry
negative emotive value. Sense 1 represents the ‘primary’ sense, arguably the oldest
and most literal sense:
1. heavy, of great weight
1.a. of earth, mud, etc.: heavy in relation to bulk, dense, thick

Despite the primacy of Sense 1, the high frequency of figurative usages of hefig
testifies to the cultural significance of the the DIFFICULTIES ARE BURDENS (Lakoff and
Johnson 1999, p. 189) metaphor in Old English, and the sub-metaphor ILLNESS IS A
BURDEN, which is to be the focus of this article. Literal uses of hefig represent a
minority of forms in OE, and can be divided into two categories: descriptions of
objects and descriptions of physical sensations. In the case of the former, a quality is
ascribed to an object, often differentially, and that quality is determined through
perception. In the case of the second, it is that experience itself that is the focus.
Unsurprisingly, heaviness as ascribed to concrete objects tends to be more neutral in
emotive value:
(1) Hefigere ic eom micle þonne se hara stan oþþe unlytel leades clympre,
leohtre ic eom
micle þonne þes lytla wyrm þe her on flode gæð fotum dryge (Rid 40: 74).
[Much heavier I am than the grey stone or great clump of lead, much lighter I
am than the little insect that walks here on the water with dry feet].1
For descriptions of sensations on the other hand, the usage is more likely to be
viewed negatively, and it is here where literal uses of ‘heavy’ form part of the
concept of illness. The few instances of bodily symptoms being described in terms

1
Translations from the Old English are the author’s own except where otherwise specified.

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Illness as a Burden in Anglo-Saxon England 607

of a sensation of weight come invariably from medical texts, the following being in
Bald’s Leechbook and the Lacnunga:
(2) […]& hwosta & nearones breosta & mare hefignes þonne sar (Lch II (2):
21.1.14).
[…and cough and oppression of the breast and more heaviness than sore]
(Translation Cockayne 1864–1866, p. 205).
(3) Þonne sio wæte wamb ne þrowað seo þurst & sio swiðe wætre gecyndo
biþ, ne þrowað seo þurst ne hefignesse metta & gefihð wætum mettum (Lch II
(2): 27.1.4).
[When the wet stomach does not suffer thirst, and it is very wet in nature, it
does not suffer thirst nor heaviness of foods, and responds well to moist
foods].
(4) Wið innoðes hefignesse, syle etan rædic mid sealte, & eced supan, sona bið
þæt mod leohtre (Med 3 (Grattan-Singer): 132.1).
[Against heaviness of the innards, give (the patient) radish with salt to eat, and
vinegar to sip, soon the disposition will be lighter].
(5) Se drænc is god wið heafodecce & […] wið breosta hefignesse […] (Med 3
(Grattan-Singer:
178.3).
[The drink is good against headache and […] against chest heaviness…].
Each of these examples refers to a specific negatively viewed sensation of
heaviness. Within the medical treatise they appear in the place of a disease or
ailment, being the object of a wið… phrase ‘‘against …’’, and justifying a remedy.
While this may serve as a metonymical basis for the usage of hefigness as ‘illness’,
it does not on its own account for the construction of the burden metaphor for
illness, as we will see in ‘‘Therapy and Aetiology’’ and ‘‘Illness and Religion’’
sections. The following examples follow from the conceptual metaphor: ILLNESS IS A
BURDEN:

(6) Ærest þu cwæde þæt ic hæfde forgiten þæt gecyndelice god þæt ic oninnan
me selfum hæfde,for ðæs lichoman hefignesse (Bo: 35.95.26) (cf. BOETH.
Cons.Phil.pr. 3.12.1 primum quod memoriam corporea contagione, dehinc
cum maeroris mole pressus amisi).
[First you said that I had forgotten that natural good that I had within myself,
because of the heaviness of the body].
(7) Þam gelamp, þæt he for ðæs lichaman hefignysse & mettrumnesse wæs
forðfæred on sæternes dæg (GD 1 (C): 10.83.29) (cf. GREG.MAG. Dial.
1.10.17 eueniente molestia corporis).
[It happened to him, that on Saturday he died (was journeyed forth), on
account of the heaviness and weakness of the body].

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608 P. J. Scott

(8) Ða he ða eft ham hwearf, þa wearð he semninga on middum þæm siðfæte

mid hefigre aðle gehrinen & gestonden (Bede 4: 32.378.19) (cf. BEDA.
Hist.eccl. 4.31, 446 repentina medio itinere molestia tactus est).2
[When he returned home again, he was immediately seized and held by a
heavy illness in the middle of the expedition].
These examples go beyond the metonymic sense that a heavy sensation indicates
illness, and conceptualise the abstract notion of illness as a heavy entity in itself. In
examples (9–11) illness is conceptualised as an oppressor. This notion of illness as a
physical oppressor reflects another conceptual metaphor, which is a sub-metaphor of
ILLNESS IS A BURDEN: ILLNESS IS AN IMPEDIMENT TO MOTION. Examples pertaining to this
metaphor are particularly common in Bede’s Ecclesiastical History and Gregory’s
Dialogues.
(9) …se wæs mid þa grimmestan untrymnisse hefigad & ðrycced (Bede 5:
5.396.15).
[…he was with the most savage illness oppressed and crushed].
(10) […] he wæs bewered from þære biscopþegnunge mid hefigre untrym-
nesse (Bede 4: 6.280.15) (cf. BEDA. Hist.eccl. 4.5, 352 grauissima infirmitate
ab administrando episcopatu prohibito).
[He was prevented from the episcopal ministration by a heavy illness].
(11) se wæs ofseted & geswænced mid hefigre mettrumnesse his lichaman
(GD 4 (C): 27.298.3)
(cf. GREG.MAG. Dial. 4.27.4 cum graui molestia corporis fuisset depressus).
[he was oppressed and wearied with heavy ill health of his body].
The above examples reflect another well-described conceptual metaphor:
DIFFICULTIES ARE IMPEDIMENTS TO MOTION (Lakoff and Johnson 1999, p. 189), which
in the usage above is interacting with the LIFE IS A JOURNEY metaphor. LIFE IS A
JOURNEY has been discussed at length in terms of Present-Day English by Lakoff and
Johnson (1999), and is exemplified in Old English by death-related euphemisms
such as forðfaran, literally ‘to journey forth’, and forðfēran ‘to be journeyed forth’.
In the context of this metaphor, a difficulty in life is viewed in terms of a physical
impediment. But unlike Present-Day English, in which difficulties are viewed as
obstacles to be overcome (Goddard and Wierzbicka 2014, p. 77), impediments such
as illness are commonly viewed in terms of a weighty burden in Old English. The
conceptualisation of illness so far is characterised by sub-metaphors of the EVENT
STRUCTURE metaphor (Lakoff 1990), which sees changes in state in terms of physical
force. Three of Lakoff’s sub-metaphors are in evidence here:

2
The burden metaphor also exists in Latin, and endures into English (albeit opaquely for most speakers)
in words such as grief. I have included the corresponding Latin in the above examples to show that while
Latin influence cannot be ruled out, the burden metaphor in Old English does not result entirely from
translation. Examples (7) and (8) show molestia ‘annoyance’ where OE has hefigness and hefigre aðle.

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Illness as a Burden in Anglo-Saxon England 609

STATES ARE LOCATIONS

ACTION IS SELF-PROPELLED MOTION
DIFFICULTIES ARE IMPEDIMENTS TO MOTION

Thus, in the example ‘‘he wæs bewered from þære biscopþegnunge mid hefigre
untrymnesse’’ (Bede 4) we see that illness is a heavy restrainer, and that this
restraint can prevent one from entering a state, conceptualised as a location. Illness
in the Old English Bede is conceptualised in terms of an ontological metaphor as an
entity separated from but imposing upon the person. As it ‘grows’ in size, its
oppression becomes greater:
(12) Se leofa biscop Eadbryht wæs mid grimre adle ðread & gestanden; & seo
dæghwamlice weox & hefigode (Bede 4: 31.376.31).
[The beloved bishop Eadbryht was vexed and grounded with a grim disease;
and every day it waxed and grew in heaviness].
The DIFFICULTIES ARE IMPEDIMENTS TO MOTION metaphor links here to a ‘basic’
metaphor proposed in Lakoff and Johnson (1999, p. 189): DIFFICULTIES ARE BURDENS.
So far, I have presented a partial analysis of the metaphorical conceptualisation
of illness in Old English, and this has been largely in terms of the EVENT STRUCTURE
metaphor and includes a number of well-documented, cross-linguistically attested
metaphors. The picture is far from complete, however, and account needs to be
taken of the cultural context. In the next section I will discuss the influence that
Anglo-Saxon ideas about disease aetiology and therapy have upon the conceptu-
alisation of illness.

Therapy and Aetiology

Recent scholarship on the state of health and medicine in Anglo-Saxon England

draws primarily on the collection of medical texts upon which the Anglo-Saxon
leech might rely (e.g., Cameron 2006/1993). From these texts we can gain insight
into the kinds of ailments that troubled people at the time, the types of medical
remedies available, and the extent to which Anglo-Saxons had faith in these
remedies. Some of these texts were direct translations of Latin originals, for
example, the Herbarium and Peri Didaxeon. Others, including the Lacnunga, Bald’s
Leechbook and Leechbook III were compiled in Old English, drawing upon both
native medical knowledge and continental learning. There is little to tell us about
doctors and patients: as Cameron notes, only a few are mentioned by name,
including Oxa and Dun in Bald’s Leechbook, to whom certain medical recipes are
attributed. Another is Cynefrith, who is named in Bede’s account as the physician
who attempted to treat St. Æthelthryth’s neck swelling. This account can be found in
Bede’s Ecclesiastical History, and Ælfric, who used Bede for his source also
includes it in his hagiography. Cameron (2006/1993, p. 22) assumes the swelling to
be caused by bubonic plague and sees Cynefrith’s treatment as being unlikely to
have had any aim beyond palliative care. Bede’s Latin version is unlike Ælfric’s Old

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610 P. J. Scott

English in that it includes the physician’s own retelling, which notes that many
believed she would be healed from this purging of noxious matter:
(13) ‘‘Iusseruntque me’’, inquit, ‘‘incidere tumorem illum, ut efflueret noxius
umor qui inerat. Quod dum facerem, uidebatur illa per biduum aliquanto
leuius habere; ita ut multi putarent, quia sanari posset a langore […]’’ (BEDA.
Hist.eccl., p. 394).
[‘‘I was ordered,’’ he said, ‘‘to cut this tumour so as to drain out the poisonous
matter within it. After I had done this she seemed to be easier for about two
days and many thought that she would recover from her sickness…’’]
(Translation Colgrave and Mynors 1969, p. 395).
The treatment was unsuccessful, but while such an account can provide valuable
insight into Anglo-Saxon perceptions of health, the religious underpinnings also
have to be taken into consideration when viewing this as a testimony to the state of
physicians in Anglo-Saxon England. All accounts of these events suggest
Æthelthryth to have considered her illness to be a manifestation of earlier sin.
That she dies, and then is healed in her grave through corporal purification, is an
integral part of her hagiography. This is not to question the historical veracity of the
events, but it is worth noting that the telling of these events cannot be separated
from the religious context. For our purposes, it is the conceptualisation of health and
sickness, as rooted in the cultural context that is of interest, and as such it is
necessary to take into account non-medical texts, since they often provide greater
insight into how illness is perceived and experienced.
In the religious and historical texts discussed in the preceding section, there is the
possibility of Latin influence through the Latin language of the originals in the cases
of Bede’s Ecclesiastical History and Gregory’s Dialogues, as well as the influence
from Christianity. Similarly, medical texts give us a picture of Anglo-Saxon views
on health, illness, and disease with influence from Latin language, and Roman and
Greek medicine. Of the medical texts compiled in Old English, Cameron identifies
Leechbook III as providing the most valuable insight into the Northern European
native medical tradition; with only approximately one third of recipes having a
Mediterranean source (2006/1993, pp. 74–75).3 The sources available to the Anglo-
Saxon medic would be Latin, but since post-Hippocratic medical texts had already
been translated into Latin by this time, we can assume that Greek medical learning
would be known to the Anglo-Saxons (Cameron 2006/1993). One such influence is
the humoral theory of disease aetiology, which pervades the Anglo-Saxon medical
texts, with inflammation, retention of dangerous fluids, and subsequent ‘welling up’
often being cited as causes of disease. The following recipe for dysentery (utwaerc)
in Bald’s Leechbook explains how neglect of initial symptoms can lead to more
serious disease due to injury and inflammation caused by humoral impact of the
diet:

3
The aim of the present study is not specifically to investigate conceptions of illness in the Northern
European tradition, but to present an account of the multi-faceted Anglo-Saxon conceptualisations. Latin
influence is therefore taken into account but is not considered to be problematic in terms of its effect on
the evidence here.

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Illness as a Burden in Anglo-Saxon England 611

(16) Sio utsihtadl cymð manegum ærest of to miclum utgange & þonne lange
hwile ne gymð mon þæs oþ þæt se innoþ wyrð ge onburnen ge þurh þæt
gewundod. Hwilum onginneð of þam midhrife, se is betweox þære wambe &
þære lifre, & þa seaw þa ðe beoð gemengedu of mettum wiþ blod & wiþ oman
geondgeotaþ þone innoþ wyrceað yfelne utgang & for þære grimnesse þara
omena ne mæg beon gehæfd þy se mete ac beoþ somod þa innoþas bedrifen
þonne wyrð þæt to utwærce (Lch II (2): 56.4.1).
[The disease dysentery comes to many first from an over-abundance of
defecation, and then for a long while one neglects this until the innards
become either inflamed, or through that wounded. Sometimes it begins from
the diaphragm, which is between the stomach and the liver, and the juices
from foods which are mingled with blood and bad humours, pour themselves
through the innards and cause a bad faecal discharge, and for the severity of
the inflammations the food cannot be contained, but the innards, along with it,
are driven down, then it turns into dysentery] (Translation adapted from
Cockayne 1864–1866, p. 279).
The humoral system, being based on a somewhat symbolic set of binary
oppositions, including hot/cold, dry/wet, etc., entails the use of metaphorical
language, as we see here with onburnen ‘set on fire’. The remedy does not aim to
kill or destroy the problematic humour, but to restrain or balance it with opposites.
The medical context in Anglo-Saxon England contributes to the prevalence of the
burden metaphor, since inflammation and the welling up of a ‘bad’ humour
represent a physical substance that causes illness. Thus, in the Old English
translation of the Peri Didaxeon, ‘‘þeo blodlæse þane mann alihte’’ (PeriD:
63.43.33) [the letting of blood relieves the man], literally ‘alleviates’, or ‘lightens’.
Though the burden metaphor is composed from relatively basic metaphors, it is
not universal. An alternative way of seeing illness is as an enemy in a war, as
discussed briefly above. In the next section I consider whether this alternative
conceptual metaphor is in evidence in the early medieval period.

The Military Metaphor in Old English?

Sontag’s observation that the ‘‘military metaphor in medicine first came into wide
use in the 1880s, with the identification of bacteria as disease’’ (1991, p. 67)
suggests that it emerges when a separate living organism is the cause of disease,
conceptualised as an enemy.4 Furthermore, it is compounded when health is a public
rather than a private affair, due to the need for cooperation in eradicating the spread
of a pathogen. Dı́az-Vera (2009) has shown, however, that the MEDICINES ARE
WEAPONS and SICKNESS IS A CONQUEROR metaphors go back to Middle English, though
in the case of the former, it is more compatible with the notion of defence than
counter-attack:

4
As Sontag (1978/1991) demonstrates, the metaphor comes to be used for a range of diseases without
this kind of cause.

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612 P. J. Scott

(17) and aboue þe woundes? a defensiff of bol armonyac tofore seyd, tyl þat þe
quyter be engendryd (Lanfranc, Chirurgia Magna 1, f. 27v, cited in Dı́az-Vera
2009, p. 87).
[and on the wounds a defence (a medical ointment), of Bole Armoniac (as)
previously spoken of, until the pus is produced].5
(18) But y kytte no3t þe skyn in manere of a cros, but in þe manere of a
Schelde oþere of a thynge þat ys tryangle in þis manere (Lanfranc, Chirurgia
Magna 2, f. 78b, cited in Dı́az-Vera 2009, p. 87).
[But cut not the skin in the manner of a cross, but in the manner of a shield, or
of a thing that is triangular in this manner].
Dı́az-Vera (2009) shows that though precursors to modern metaphors existed in
Middle English, the conceptions of the body and of medicine differ from that of
today, arguing that ‘‘medieval doctors treated their patients by trying to strengthen
their physical defence (i.e. their body) or to expel the enemy (i.e. the sickness) once
the attack had started’’ (p. 88). An examination of Bald’s Leechbook and Leechbook
III shows a subtly different picture in the Old English period. The military metaphor
is not well attested, though there are some instances in which language that is
congruent with battle and defence is used. In the first example, we see a similar
defensive stance to that in Middle English:
(19) Wiþ lusum sele him etan gesodenne cawel on neaht nestig gelome. He biþ
lusum bewered (Lch II (3): 44.1.2).
[Against lice; give the man to eat sodden colewort at night fasting, frequently:
he will be guarded against lice] (Translation Cockayne 1864–6, p. 337).
Notably, the ‘enemy’ here is animate. The following examples show defence
through ‘driving away’. The word adrifan is given the following definition for Sense
1 in the DOE, usually referring to people or animals:
to drive away, expel (someone/something), force (someone/something) to
move, banish (someone); ut adrifan ‘to drive out’; aweg/onweg/fram adrifan
‘to drive away’; also with prepositions of/fram/to; also figurative (DOE, s.v.
adrifan).
While this is not specifically the language of battle, it suggests the same kind of
defence through expulsion, as discussed by Dı́az-Vera (2009). The DOE also notes
the use of the term with medical ailments in early medical texts. In example (20)
parasitic creatures are again referred to:
(20) Wiþ wyrmum eft, gate tord heard & swiðe drige gemeng & gegnid wiþ
hunig, sele drincan. Þæt adrifþ hie aweg (Lch II (1): 48.2.1).
[Against worms again, mingle and kneed a goat’s turd, hard and very dry, with
honey, and give (the patient) to drink. That drives them away (the worms)].
(21) … lige on þa sidan þe he þonne getenge sie. Gif he on þam innoþe bið
þonne adrifð hine þes drinc ut (Lch II (1): 47.2.7).

5
The glosses for (17) and (18) are the author’s own.

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Illness as a Burden in Anglo-Saxon England 613

[…lie on the side on which it (the pain) is pressing. If it is in the innards, then
this drink drives it out].
In example (20), the recipe is intended to adrifþ aweg the worms. This is an
example of the kind of literal basis that may exist for the military metaphor for
medicine, since here we have a literal invader, as with bacteria. In example (21) this
is not the case, since it is ‘pain’ that it to be driven out of the innards. The following
remedy also deals with a literal invader, the flesh worm:
(22) Wiþ flæscwyrmum genim monnes suran, þa leaf gewel togædre, gebræd
on gærse, gecnua, þonne lege on swa þu hatost mæge aræfnan (Lch II (1):
51.1.5).
[Against flesh worms; take man’s sorrel, boil the leaves together, spread them
out on the grass, pound them, then lay them on, as thou hottest may endure
them] (Translation Cockayne 1864–1866, p. 124).
This example shows the perceived necessity for the patient to prioritise the killing of
the disease even with the potential risk of burning the skin. Again, this cannot be
said to be medical metaphor, but rather a literal predecessor based on the need to
remove a physical parasite. Moving away from literal parasites, the following
example personifies a disease as an enemy, describing the cold as a ‘fiend’ of the
disease:
(24) Læt him blod þus, sete glæs on oððe horn & teo þæt blod ut & smere mid
ele & bewreoh hine wearme forþon þe cile biþ þære adle feond (Lch II (2)
32.1.6).
[Let him blood thus; set him on a cupping glass or horn, and draw the blood
out, and smear with oil, and wrap him up warm, in as much as cold is an
enemy in the disease] (Translation Cockayne 1864–1866, p 233).
It does not, however, suggest any attack of this ‘fiend’, and rooted as it is in the
humoral context it is more a caution against allowing imbalance. Not all recipes
personifying a disease as an enemy necessarily draw from the warfare domain,
however: the following remedy, rather than suggesting physical offence or defence,
employs a ritualistic treatment that is more suggestive of illness as an enemy in a
spiritual battle:
(25) Scearpa þone sweoran ofer sunnan setlgange, geot swigende þæt blod on
yrnende wæter, spiw þriwa æfter, cweþ þonne, hafa þu þas unhæle & gewit
aweg mid gange, eft on clænne weg to huse & gehwæþerne gang swigende
(Lch II (1): 32.2.9).
[Scarify the neck after the setting of the sun, pour in silence the blood into
running water, after that spit three times, then say, ‘‘Have thou this unheal, and
depart away with it;’’ go again on a clean way to the house, and go either way
in silence] (Translation Cockayne 1864–1866, p. 77).
The personification of illness, or at least the portrayal of it as a ferocious animal is
evident in examples (9) and (12) above, which used the terms grimmestan

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untrymnisse ‘most savage illness’ and grimre adle ‘grim disease’. The term grimm
is defined in the DOE as:
1. grim, fierce, cruel, terrible
1.a. of people, the devil and other animate beings: fierce, cruel (in disposition
or action); also of personifications
1.a.i. of an animal: ferocious, savage (DOE, s.v. grimm).6
This may therefore represent either personification of the illness as cruel, or the
depiction of the illness as a savage beast. While this does not draw on the warfare
domain, it may point to one of the other enemy-related metaphors proposed by
Dı́az-Vera (2009) in his study of Middle English: SICKNESS IS A DEVOURER, where
‘‘some sicknesses are conceived of as wild animals that devour the human body or
parts of it’’ (P. 85).
In addition to the BURDEN metaphor for illness, we do see personifications of
illness, and depictions of illness as various kinds of enemies. Where Old English
medical texts use verbs of motion that might suggest defence through driving away,
such as adrifan, insects or worms are usually thought to be the cause of illness. This
may be an early predecessor of the military metaphor identified by Sontag (1978/
1991, p. 67), which arises due to another, this time bacterial, invader against which a
battle can be fought. The metaphor becomes extended as a structural metaphor
(DISEASE IS AN ENEMY IN A WAR) when the disease becomes a public health issue, and
is further removed from its grounding in the instance of diseases with no outside
invader at all. Overall, the evidence for DISEASE IS AN ENEMY IN A WAR is very limited
in Old English, and the two examples portraying diseases as enemies do not serve as
convincing evidence for the military metaphor.

Illness and Religion

The interaction between the domains of religion and health is encapsulated in

Ælfric’s statement that ‘‘Se ðe wenð þæt he hal sy. se is unhal; Þæt is. se ðe truwað
on his agenre rihtwisnysse. ne hogað he be ðam heofenlican læcedome’’ (ÆCHom
II, 274.52) [He who thinks that he is whole, he is unwhole, that is, he who relies on
his own righteousness does not consider the heavenly healing]. This statement
reflects a widely attested conceptual metaphor in Old English: RELIGION IS MEDICINE.
In this structural metaphor in which sin corresponds to illness, spiritual healing is
thought of in terms of physical healing, and God is thought of as a healer.
GOD IS A HEALER
(26) Ac se gooda læce, þæt is God, lacnað hiora mod mid ðæm welan (Bo:
39.134.16).
[But the good leech, that is God, heals their mind with the prosperity].
SALVATION IS ETERNAL HEALTH

6
I am grateful to an anonymous reviewer for pointing this out.

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Illness as a Burden in Anglo-Saxon England 615

(27) And þeah ðe hit hefityme sy þam ðrowiendum þeahhwæðere wyle se goda
læce to ecere hælðe hine gelacnian (ÆCHom I, 31: 448.273).
[And though it is troublesome for those who are suffering, nevertheless the
good doctor wants to heal them to eternal health].
SIN IS ILLNESS
(28) God is se soða læce þe ðurh mislicum swincgelum his folces synna
gehælð. (ÆCHom I, 31: 448.267).
[God is the true physician who through many sufferings heals his people’s
sins].
The notion of salvation as eternal health is reflected in the polysemy of the word
hælð, which may refer not only to physical health, but also ‘‘spiritual or moral
soundness, salvation (of the soul)’’ (DOE, s.v. hælð).7 Early Christian views on
health and sickness structure their understanding of religion, but the question
remains as to whether health and sickness is structured also in terms of religion.
Although the MEDICINE IS RELIGION metaphor undoubtedly emerges later (see Dı́az-
Vera 2009), it is not in evidence in Old English. While sin is an illness for the
Anglo-Saxons, illness is not sin. God is a leech, but leeches are not conceptualised
in terms of God. Nevertheless, the domains share many systematic conceptual
similarities, which provide the grounding for the RELIGION IS MEDICINE metaphor. One
such shared similarity is the burden metaphor. Since illness is a burden, and sin is an
illness, it is unsurprising to see sin also conceptualised in terms of a burden:
(29) … þæt hi befeallað on swiðe hefige synne wið god ælmihtigne (HomS 49
(Brot 2): 194).
[…that they fall in very heavy sin against God almighty].
(30) Miccle hefigre me is seo rod þinra synna (HomS 32 (Baz-Cr): 115).
[Much heavier to me is the rood (cross) of your sins].
(31) For þæm min unriht me hlypð nu ofer heafod, and, swa swa hefig byrðen,
hy synt gehefegode ofer me (PPs (prose): 37.4).
[Therefore my wrongdoing leaps now onto my head, and, like a heavy burden,
they are weighing on me].
In example (30), sin is described in terms of the physical burden of the cross, and in
(31), the wrongdoings are not only given weight and substance, but also animacy,
‘leaping’ onto the head. Another similarity shared by the two domains is their
structuring in terms of the LIFE IS A JOURNEY metaphor, which interacts with the

7
The words hal, halig, and hælð, broadly corresponding to PDE ’whole’, ’holy’, and ’health’ were
arguably more cognitively related in the Anglo-Saxon period. hal and hælð are both highly polysemous,
referring to spiritual and physical health. According to the OED, the derivation of halig from hal probably
came from the sense ‘‘inviolate, inviolable, that must be preserved whole or intact, that cannot be injured
with impunity’’ (OED, s.v. holy). The Anglo-Saxons may not have been aware of the ’wholeness’ in
halig, since does not display any senses that are outside of the domain of religion. However, the linkage
between the health and spiritual domains does appear to be real for the Anglo-Saxons, which is not only
evidenced on the basis of the polysemy of hælð and hal, but also in the overt metaphorical use of health
for spiritual salubrity, as in examples (26–28).

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616 P. J. Scott

burden metaphor as a sub-part of the EVENT STRUCTURE metaphor, which concep-

tualises changes of state in terms of space and force.
HEALTH IS A DESTINATION
(32) Hrædlice hyt hi afeormeð & to hæle gelædeð (Lch I (Herb): 20.3).
[Quickly it cleanses (the nostrils) and leads them to health].
ILLNESS IS AN IMPEDIMENT TO MOTION
(See examples (9–11) above).
ETERNAL LIFE IS A DESTINATION
(33) Witodlice gif we þæs biddað þe us to ecere hælþe fremað […] (ÆCHom
II, 303.127).
[But if we pray for that which advances us to eternal health…].
We see, therefore, that Anglo-Saxons conceptualise both illness and sin in terms
of burdens, and that the two domains are linked through the RELIGION IS MEDICINE
and LIFE IS A JOURNEY metaphors. While it is true that the burden metaphor may
have its grounding in muscular effort, as Lakoff and Johnson (1999) argue, it is
not universal that illness is understood in this way. As shown above, illness
could also be considered to be an enemy in a war, as is well-documented in
Present-Day English. Goddard and Wierzbicka (2014, p. 76) note that while
Polish provides a wealth of collocations with the adjective cie˛z_ ki ‘heavy’,
including cie˛z_ kie czacy ‘heavy times’, cie˛z_ ka choroba ‘heavy illness’ and cie˛z_ ka
walka ‘heavy struggle’, (Present-Day) English is lacking in such collocations
except for ‘‘a few phrases like a heavy burden and a heavy responsibility’’
(Goddard and Wierzbicka 2014, p. 76, italics original). Instead, they claim,
English speakers would tend to use hard to express these difficulties: a hard life,
as opposed to *a heavy life, suggesting a striking difference in the way in which
life is viewed:
[I]n one case, living is seen as being like carrying a heavy burden, and in the
other, like trying to change the shape of a hard object. In particular, the image
of hardness in English collocations suggests difficulties which possibly can be
overcome (through determination, effort, and resourcefulness), whereas
comparable Polish collocations with the adjective cie˛z_ ki suggest burdens
which simply have to be borne. (Goddard and Wierzbicka 2014, p. 77).
There has been a shift in the way in which English speakers view the troubles of life,
and more specifically, health problems. Old English has many similar collocations
to those that Goddard and Wierzbicka discuss in Polish, including hefigre adle
‘heavy disease’, hefig sar ‘heavy pain’, hefigum gylte ‘heavy crime’, hefigran witum
‘heavy punishments’, hefigre nydþearf ‘heavy need’, and hefig sorg ‘heavy sorrow’.
Making a broader claim with respect to cross-cultural semantics, Goddard and
Wierzbicka make the valuable point that ‘‘[w]hile it is of course of interest to search
for universal tendencies […] it is at least as important to explore the concomitant
cross-linguistic differences, and to try to reveal the cultural underpinnings of
language-specific metaphorical transfers’’ (Goddard and Wierzbicka 2014, p. 78).
The burden metaphor for illness emerges not only out of embodied experience, but

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as a result of the humoral conception of the body, and also as a result of a Christian
cultural model of forbearance, which we can see attested through the other hefig
collocations. This cultural model includes the following proposition schemas
(Quinn 1987)8:
PHYSICAL LIFE INVOLVES SUFFERING
HEAVEN IS FREE OF SUFFERING
TROUBLES IN LIFE ARE A TEST OF FAITH
PEOPLE SHOULD NOT LAMENT THEIR TROUBLES, BECAUSE TO DO SO IS TO CHIDE GOD
These proposition schemas, among many others, structure the way in which
Anglo-Saxons not only responded to illness, but influenced the metaphorical
conceptualisations that I have discussed throughout the paper. These schemas
represent conceptualisations that, as Sharifian (2011) puts it, ‘‘encompass world-
views and ideologies that have been constructed and developed over centuries’’ (p.
15). As such, they are evidenced in many ways and in varying degrees of subtlety in
the Old English corpus, including in the construction of conceptual metaphors. In
some cases, we find them quite clearly exemplified in didactic texts. For example, in
Ælfric’s Lives of Saints, the sinfulness of sorrow is expressed as follows, reflecting
the fourth schema above:
(34) þæt is þonne se man geunrotsoð ealles to swyðe for his æhta lyre þe he
lufode to swyðe, and cid þonne wið God, and his synna geeacnað (ÆLS
Memory of Saints: 289).
[that is when a man sorrows all too much for the loss of his goods, which he
loved too much, and then chides God, and adds to his sins.]
As Rawcliffe (2009) notes in her study of leprosy in Medieval England, disease
can be a sign of spiritual accomplishment since one has been chosen to suffer on
earth. This notion is implicit in the inspiration found in the story of Job,
particularly following Gregory the Great’s Moralia in Job, which described him as
a ‘‘model of saintly forbearance’’ (Rawcliffe 2009, p. 56). Rawcliffe (2009,
pp. 57–58) argues that the the doctrine of purgatory that took hold following
Augustine in the fifth century had an important impact on the perception of
earthly suffering. The horrors of purgatory were such that to suffer some of this
purgation before death seemed to lighten the sentence somewhat. Additionally, the
sufferers present an opportunity for others to give charity thereby lightening their
load in the afterlife. The idea of forbearance and sharing of the burdens of others
is advocated by St. Paul in Galatians 6:2, who is quoted by Ælfric: ‘‘berað, ic
bidde, eowre byrþena eow betwynan, and ge swa gefyllað soþlice Cristes æ’’
(ÆHom 2: 200) [bear, I command, your burdens between you, and you thus will
truly fulfil Christ’s law].

8
Proposition schemas presented as such can only be taken to be, as Sharifian (2011, p. 15) emphasizes,
‘partial linguistic representations’ of cultural schemas.

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618 P. J. Scott

Conclusion

As a culturally constructed concept, illness may be conceptualised through various

metaphors across different times and cultures. This paper has shown that in Old
English a salient metaphorical conceptualisation views illness in terms of a heavy
burden. The possibility of a nascent form of the military metaphor for illness and
medicine has been investigated through examination of Bald’s Leechbook and
Leechbook III, and the evidence suggests that although the language of physical
force is used with respect to illness, it is predominantly in the cases of literal
parasites. There is no strong evidence that illness was metaphorically conceived in
terms of a war in the Old English period. The extent to which the burden metaphor
is grounded in embodied experience has been considered, as has the role of
culturally-specific schemas, both religious and medical. The unpleasant sensation
that a person feels when carrying heavy objects is likely to lead to negatively
emoted usages of heavy, and since it relates to a physical sensation, it it unsurprising
to see it metaphorised. However, the burden metaphor in Old English does not
merely reflect embodied experience, but a set of ideologies and world-views, and it
is through the examination of these cultural schemas, and the interaction of cultural
metaphors that its prevalence in this period can be explained. As Good (1977, p. 31)
observes, ‘‘[m]edical language, whatever its source, acquires meaning specific to a
particular social and cultural context and in turn integrates illness and cure deeply
into that context’’. In the medical texts, the use of weight to describe diagnostic
symptoms suggests that the construction of pain conceptualisations in Old English
has been influenced by the humoral theory of disease aetiology, with sufferers
feeling their sensations in terms of growing weighty burdens. The burden metaphor
for illness is particularly well attested in the works of Ælfric, as well as in Bede’s
Ecclesiastical History, and reflects a cultural model of forbearance that is rooted in
the religious context.

Acknowledgements I am very grateful to Rob Getz at the Dictionary of Old English for kindly providing
the entries for hefig, hælð, and their related forms prior to their online release.

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