franciscan - January 1996
© The Society of Saint Francis, 1995
Saint Francis’ Eye Trouble
by David W Hill
During a Franciscan pilgrimage to Assisi in July, led by the Revd David Faulks, we visited a number of shrines in the region of Rieti associated with the treatment of St Francis’ painful and blinding eye disease. So it was natural that a discussion of this aspect of his life should emerge. Being a retired eye surgeon, my opinion was sought and, as a result I looked into the literature, using the Sisters’ library in Assisi and on my return to London the Wellcome Library of the History of Medicine. From these very brief researches I have tried to put together a short account of the illness which so sorely tried Brother Francis.
In 1220 Francis visited the Crusaders in Acre and included the Holy Land in his itinerary, returning to Italy the same year: in his travels he had also visited Egypt. His eye condition was generally thought to date from these visits. Perhaps the most likely cause of his illness was trachoma, an infectious disease of the outer eye, endemic in the Middle East and hot countries for centuries, in areas where hygiene falls short of modern standards. At first affecting the membranes covering the inside of the lids and surface of the eye, it leads to discomfort, watering of the eye, and sensitivity to light. Later stages lead to scarring of the inner surface of the lids with inturning of the lashes, so that the lashes rub against the surface of the globe, and particularly the cornea, the clear window through which light enters the eye; this complication increases the watering and pain. At the same time the ingrowth of blood vessels and scar tissue into the cornea clouds and distorts vision, leading eventually to virtual blindness.
Understandably, the contemporary accounts of St Francis’ life describe only the later stages of his eye affliction, when it became a significant hindrance to his life style. He was in considerable pain at nights and received the attention of the brothers; he assured them that in this good work they would be repaid by the Lord, and given credit for the good works which they might otherwise have been doing. St Francis was very loath to be concerned for himself, and resisted the advice of the Bishop of Ostia, Cardinal Ugolino, that he should seek treatment for his eye condition. In the spring of 1225, following the receipt of the Stigmata the previous autumn, he was at San Damiano in great pain, and was persuaded by Brother Elias, now Vicar General, to receive treatment; unfortunately this was ineffective. In the summer of the same year, after receiving a letter from Cardinal Ugolino, Francis travelled to Rieti and thence to Fonte Colombo, where he received treatment on the recommendation of the Cardinal. It is recorded that he travelled on a horse, his head covered in a large hood with a woollen and linen bandage over his eyes to protect them from the light. Once again the treatment, of an heroic nature, failed to bring relief. Later in the year, he received treatment at La Foresta (San Fabiano); during the visit his prayers miraculously restored the crops of the poor priest, trampled by his numerous visitors. Again in the following spring, 1226, the year of his death, he was treated in Siena.
One of the strange concepts that held sway in Francis’ time was the idea that excessive weeping could lead to blindness; when advised to restrain his tears, Francis preferred, ‘purifying his spiritual vision with floods of tears, and thought nothing of the fact that it was costing him his sight.’ There seems, in terms of modern medicine, to be no rational explanation for this idea; perhaps the truth lies in a confusion of thought between the cause and the accompanying effects of some forms of eye disease. At that time the source of tear formation was hotly debated; prolonged non-emotive weeping was thought by many to come from a disorder of the phlegm, itself derived from water, one of the four elements of the body, according to Aristotle. This disordered phlegm, proceeding from the brain, might take the form of tears affecting the eyes.
Equally strange to the modern mind was the apparently barbarous treatment suffered by Francis on the advice of his doctor, cautery of the temple from the ear to the eyebrow. At first hesitant to receive treatment, Francis blessed “Brother Fire” and asked him to deal kindly with him, then submitted willingly to the treatment and felt no pain. The rationale for this treatment, based on the principles noted in the previous paragraph, was to stem the fluid which for years had accumulated day and night in the eyes, achieving this end by cauterising the veins in the temple. Presumably this was thought to be the route by which the excessive disordered phlegm reached the eyes, causing the disease. Benevenutus Grassus, a highly-respected oculist of about Francis’ time, in his treatise De Oculis gives a full, but to the modern mind a somewhat confused, description of diseases of the external eye; citing for some forms of disease a similar causative rationale, and recommending the use of the cautery as a late treatment when local applications to the eyes had failed.
Fashions change and, doubtless in another century, modern concepts of eye disease and its treatment will seem hopelessly outdated: however, we cannot fail to regret that modern effective methods of treatment of the trachoma infection and its complications were not available to Francis, sparing him pain and preserving vision. Through all his suffering his fortitude and humility remain for us a shining example. f
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