ELEANOR OF AQUITAINE. Not up to the intellectual weight of her husband, King Henry, she is still one of the few women of that time who emerge from the monk-written chronicles with a blazing character. She bore ten children, and she backed her elder sons’ rebellion against their father, who imprisoned her for it (though quite nicely). After his death, she ruled England on Richard’s behalf while he was away on crusade, as well as raising the ransom when he was held hostage on his way back. When he was killed, she spent her time trying to get the erratic King John out of trouble. Outliving all her sons except John, she died in her eighties, having had probably more adventures than any queen before or since.
At the end of her life, she took the veil at Fontevrault in Anjou, France (most beautiful of abbeys), where, despite their turbulent marriage, she was put to rest beside Henry Plantagenet.
FATHER ADALBURT’S pronouncements were made by naive real-life clergy round about this time.
DOCTOR. For clarity, I have applied the title to physicians though, in fact, it was conferred only on teachers of logic and philosophy in those days.
CATHARS. That name for the sect, and “perfects” for its priesthood, were not what the Languedoc heretics applied to themselves but were given to them by the Church that wiped them out. I have used them because that is how both are now generally referred to. The full crusade against them, and its burning of thousands of Cathar men, women, and children, didn’t begin until after the time of my story, but already one or two were being sent to the stake and enough cruelty inflicted on them by the Church to justify my account of what Adelia and her friends suffered in the fictional palace of a fictional Bishop of Aveyron, in order to demonstrate an Inquisition that was starting to flex its horrifying muscles.
Her subsequent enforced stay in the Cathar village is based on the classic Montaillou by Emmanuel Le Roy Ladurie (Penguin Books, 1980), which, because it, in turn, is based on the papers of the painstaking inquisition endured by that village’s people, gives us insight into the lives of men and women of that region during the Middle Ages.
BAGPIPES. The cornemuse des Pyrenées, the samponha, was, and is, sufficiently like the Scottish bagpipes to make the Highlander Rankin feel at home.
THE APPENDECTOMY. I believe it is feasible that Adelia could have performed one, and for her patient to have survived. The existence of the appendix was known in very early times. Certainly, the Salerno School, with its practice of anatomy, would have been aware of it, and of its danger when infected.
ANESTHETIC. Man has been aware of the properties of opium since the days of the pharaohs, whilst laudanum, extract of opium—usually with wine—certainly appeared in the Middle Ages if not before, though its use for anesthesia was prohibited by the Inquisition as an evil, the Church not approving of interference with God-appointed pain, nor of the shedding of blood, thus reducing surgeons to the status of barbers.
SURGERY. The practice stretches back to the time of the Sumerians around 4000 B.C.—archaeologists have discovered sharpened bronze scalpels, knives, and trephines among Nineveh’s remains. In the Hammurabi Code from that time, there’s a list of what the physician should be paid if he “make a large incision with an operating knife and cure it,” etc. In India around 600 B.C., an ancient surgical text describes procedures for surgery, even cosmetic.
Above all, we should not underestimate the hardihood of the human body Neolithic skulls have been found showing that they underwent successful trepanning—the growth of bone inward from the operation site suggests that the patients lived for a considerable time afterward.
From what we can gather from early records, the survival rate after amputation was about fifty percent.
Fanny Burney, writer and diarist, lived for many years after having had a breast removed because of cancer in 1811 without benefit of anesthetic.
In September 1942, Wheeler B. Lipes, a twenty-three-year-old corpsman, was acting as pharmacist’s mate on board the American Navy submarine USS Seadragon in enemy waters when, in the absence of a qualified doctor and without access to penicillin, he successfully took out the appendix of a nineteen-year-old shipmate.
In 1961, a Russian doctor, Leonid Rogozov, on an Antarctic expedition, cut out his own appendix under local anesthetic with the help of nonmedical colleagues, and lived to tell the tale.
HEMORRHAGE. In olden times, this was stemmed by cauterization—a risk in itself but not an automatically fatal one.
SUTURES were in use from the first, though some early surgeons employed ants to bite the flesh of the wound together, cutting the insects’ bodies away and leaving the teeth in place.
SEPSIS. A killer, of course, and one that Adelia would not have been aware of, as was no one else until the nineteenth century But though the Middle Ages are depicted as being unsanitary—and mostlywere—cleanliness was prized by some. Jews and Arabs, of course, had it written into their religious rituals, and a Christian to be dubbed a knight had to take a bath before the ceremony Medieval household accounts show considerable outlay spent on laundry and fullers—robes that took months, even years, of needlework to make had to be kept clean if they were not to disintegrate from sweat and dirt.
Also, though the infant mortality rate was horrific, a child that survived beyond the age of five probably developed an immunity that could carry it into old age.
PALERMO CATHEDRAL has been altered and restored so many times—and not, in the opinion of many, to its advantage—that it no longer has the splendor it had in the twelfth century, so I have transferred to it the wonderful and great mosaic Pantocrator of its more untouched rival, Cefalù, a building which John Julius Norwich describes as “not just the loveliest Norman exterior in Sicily, but one of the loveliest cathedrals in the world.”
THE DISINTEGRATION OF SICILY. The glory of enlightenment that was the Kingdom of Sicily lasted only sixty-four years. The marriage of William II and Joanna was apparently happy, but also tragic in that it was childless. William himself was not statesman enough to preserve what his country had been, nor to pass it on to good hands. He died at the age of thirty-six and his kingdom descended into violence and medieval bigotry. For a while Joanna was virtually imprisoned by her husband’s illegitimate successor, Tancred, and had to be rescued by Richard the Lionheart. In 1196 she was married off again, this time to the Count of Toulouse, to whom she bore three children, dying in childbirth with the third, aged thirty-four, outlived by the indomitable Eleanor of Aquitaine, her mother.
EXCALIBUR. Nobody knows what happened to it. In the upheaval that followed William’s death, King Arthur’s sword disappeared—like the great kingdom to which it had been given.
Acknowledgments
MY GRATITUDE, as always, to my editor, Rachel Kahan, for her excellent and painstaking judgment. And to my agent, Helen Heller, who, like Rachel, knows how a plot should be shaped. I rely on them both. And I would like to thank the whole team at Putnam for the work that makes my books look as well as they do. Also, the staff and stacks of the wonderful London Library provide me with everything I need for the immense amount of research that goes into every novel. Thanks, too, to my daughter, Emma, for taking so much secretarial work off my shoulders, and to my husband, Barry, the rock to which I cling.
Ariana Franklin, A Murderous Procession
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