Rendering Tolkien's Reality

Paging Dr. Aragorn…

A personal pet peeve of mine is how people will include aspects of medicine in their stories that will end up far removed from any medical culture in Middle Earth. One such story included one character giving an allegorical explanation of a disease that seemed to have more than a bit of influence from modern medicine. It stood out. Terribly. Even the films missed on this one – for instance, Gimli exclaimed to Legolas that the orc on which the dwarf was sitting twitched because of an axe stuck in its “nervous system.”

A lot of what is understood in the cultures of Middle Earth as relates to medicine is a function of the technology of the period. You will not find microscopes in Aragorn’s Houses of Healing. You will not, by extension, hear healers discussing much of anything related to what would be found by microscope – that is, among other things, they do not practice medicine with an eye toward germ or cell theory. Most of the equipment for study of physiology doesn’t exist, so no one is going to express an understanding of physiology that would come from experimentation using such equipment. Biochemistry and genetics proceed the same way – no one in Middle Earth is going to comment on whether Legolas’ hair color is a dominant or recessive trait in elves, and more than likely Sam is not going to lecture on photosynthesis problems when one of his plants isn’t doing well.

For example, look at a disease like the Black Breath. Now, to modern sensibilities, one would get the idea that the Witch King was busy blasting his opponents with some sort of airborne pathogen. That’s nice and all, and probably shows that you paid attention in science or health classes, but if you choose to write about someone suffering from the affliction, you would not have a legitimate basis for imposing germ theory onto the character’s story, because healers at the time did not deal in terms of pathogens and etiology. Medicine in Middle Earth is largely symptom-based; that is, healers recognize disease and choose treatments by a malady’s signs and symptoms, rather than worrying about what etiologic agent or predisposition is involved. An epidemic, for instance, would still proceed through the population according to the behavior of the pathogen involved coupled with the living style of the population, as it would in our world. A healer in the area may decide to quarantine patients and/or their families, as in our world, but he will do so based on an understanding of how and when a disease will likely manifest (and patients become symptomatic), and not on how the pathogen itself works or on what the individual pathogen is, whereas knowing the pathogen would be vital knowledge in our medical culture.

(As an aside, you may desire to use your skills at writing in Tolkien’s universe as a vector for educating readers on a particular medical issue, and while that is admirable, bear in mind that the pursuit might require a bit of reshuffling regarding how much the characters know or could learn about the issue, or it might require writing the story in a universe that comes with a more advanced medical culture. Again, if what you write in Tolkien’s universe isn’t credible to what was the prevailing understanding in that corner of that universe, you may be doing yourself a disservice by using this genre for what you intend to express.)