Medieval Cataracts and Couching

A cataract is a medical condition where the lens of the eye becomes increasingly cloudy, leading to blindness. You would think that the Middle Ages had no way to treat this condition, but you'd be wrong. There was a method used that was actually developed thousands of years ago and described in medical texts. It was called "couching."

Couching is described in Greek and Sanskrit documents. It involves pushing the cloudy lens away from the pupil and into the interior of the eyeball, allowing more light to enter. This was done by inserting a thin sharp needle into the eye through the pupil and, well, simply pushing the lens until it is no longer blocking the light. This was done, of course, without access to anesthetics.

The result was more light, but the light was no longer being focused. The client's world was blurry—assuming the client was not rendered completely blind by damage to the eyes or killed by infection.

Roman artifacts found in the British Isles suggest that the technique was introduced there during the Roman occupation, and perhaps survived throughout the early Middle Ages, although we know of no cases prior to the 1560s.

Physicians and surgeons elsewhere knew of it. John II of Aragon went blind from cataracts by the time he was 70. A physician in his employ, a Jew named Abiathar Crescas, performed couching in September 1468 and restored his sight—or what there was available considering the lack of a functioning lens. John lived until the age of 80.

John's son, Ferdinand, would later, along with his wife, Isabella of Castile, expel all Jews from Spain. This was a major change in policy, since Jews had been prominent in the Court of Aragon. Tomorrow we'll look at the relationship between Aragon and Jews.

The End of John II of Aragon

John II of Aragon lived to the age of 80. He had been married twice, had a few children (one whom he treated poorly, a few who had better careers), including a few illegitimate ones who did all right for themselves (one became a Duke of Villahermosa, one became the Archbishop of Zaragoza).

He caused the Navarrese Civil War (1451-1455) because he refused to allow his son Charles, Prince of Viana, to inherit Navarre. That war could be said to have stretched out with periods of civil unrest until 1461, when Charles died, possibly poisoned by John's second wife.

Because of John's mistreatment of Charles and the Navarre succession, he also had to deal with a Catalan Civil War, also called quite specifically the "War Against John II." Some in the Principality of Catalonia wished to support Charles' rightful claim to Navarre, some were willing to back John's actions. 

After a lot of back-and-forth (the French weighed in on John's side as well), including Catalans bringing in pretenders to the throne to try to push John out, and lawyers enumerating the violations of the constitution of which John was guilty, it all ended when Charles died in 1461. Navarre went to John's daughter Eleanor  for about two weeks in 1479 and then passed to Francis Phoebus, another Prince of Viana.

At the end of John's life he suffered from cataracts and was blind by the age of 70. Fortunately for him, he had a surgeon who restored his eyesight through surgery. That surgeon was a Jew named Abiathar Crescas, who was also a leader among Jews of Aragon. When John died, Abiathar preached a memorial sermon at the funeral service.

Tomorrow we'll look into the medieval surgical technique for cataract removal.

John II of Aragon

The father of Ferdinand II of Aragon was John II of Aragon (1398 - 1479, pictured here). He had other titles as well, including King of Sicily and King of Navarre, which he gained from marrying Blanche I of Navarre, daughter of King Charles II of Navarre.

Their eldest son was Charles, who was made Prince of Viana by his maternal grandfather. He was also named the successor to Navarre after his grandfather and mother, a decision by them which angered John.

When Blanche died in 1441, John refused to allow Charles to rule, retaining control of Navarre, even though Charles was referred to as king by the people of Navarre.

John decided that, instead of naming Charles as the successor to his own possessions of Sicily and Aragon (as well as Navarre), John would seek another heir. He therefore married Juana Enriquez in 1447. She bore him two children, Ferdinand and Joanna. Charles saw this (correctly) as an attempt to disinherit him from Aragon. John named Ferdinand his successor when Ferdinand was nine years old.

In 1451, Charles rebelled against his father's possession of Navarre and the Navarrese Civil War began, a period of unrest and fighting until Charles was captured in 1452, the same year Ferdinand was born. Charles was released if he promised not to seek the throne of Navarre until after John's death.

All this actually took place while John was still a prince; the current king in Aragon while John was growing up was Alfonso V. Alfonso died in 1458, and Prince John became King John II of Aragon, offering Charles Naples and Sicily. Charles declined, and returned to Navarre in 1459, with a plan to marry Isabella of Castile. That fell through (she later married Ferdinand, of course). Charles died in Barcelona in 1461; the suspicion was poison, administered by his stepmother Juana.

John had several more years in him, however, and we'll wrap him up in a few paragraphs next time.