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The Modulated Scream

Pain in Late Medieval Culture

In the late medieval era, pain could be a symbol of holiness, disease, sin, or truth. It could be encouragement to lead a moral life, a punishment for wrong doing, or a method of healing. Exploring the varied depictions and descriptions of pain—from martyrdom narratives to practices of torture and surgery—The Modulated Scream attempts to decode this culture of suffering in the Middle Ages.

Esther Cohen brings to life the cacophony of howls emerging from the written record of physicians, torturers, theologians, and mystics. In considering how people understood suffering, explained it, and meted it out, Cohen discovers that pain was imbued with multiple meanings. While interpreting pain was the province only of the rarified elite, harnessing pain for religious, moral, legal, and social purposes was a practice that pervaded all classes of Medieval life. In the overlap of these contradicting attitudes about what pain was for—how it was to be understood and who should use it—Cohen reveals the distinct and often conflicting cultural traditions and practices of late medieval Europeans. Ambitious and wide-ranging, The Modulated Scream is intellectual history at its most acute.

384 pages | 5 halftones | 6 x 9 | © 2010

History: European History

History of Science


Medieval Studies

Religion: Religion and Society


The Modulated Scream, based on a stunning array of primary sources, takes a close look at the many meanings of pain in the later Middle Ages. Compassing churchmen, jurists, physicians, mystics, and the humble women and men who sought cures at the shrines of saints, it is a profound study of a fundamental human experience.”

Barbara Rosenwein, Loyola University Chicago

“A remarkable achievement, an essay in intellectual and social history of the highest quality. The Modulated Scream will become a standard point of reference for scholars wishing to find their way through the dense thicket of medieval pain perception.”

Robert Mills, King’s College, University of London

“Pain brings out the best and the worst in us all. Alongside despair over life-long suffering there is the sympathy that another’s pain inspires. Pain can take the form of torture but it is also a vehicle towards self-understanding. The possibilities of studying pain historically are vast. In The Modulated Scream, Esther Cohen explores with sensitivity and erudition the combinations of feeling and action which medieval Europeans developed in their treatment of pain. From the theories of jurists about torture, the recommendations of doctors on pain relief, the ecstasies of the religious produced in emaciated bodies, to the efforts of every housewife to keep her family pain free, a picture emerges markedly different from our own world, and yet set within a broader frame of universal human sympathy. This is a book which historians will savour, and which many others beyond will greatly enjoy.”

Miri Rubin, Queen Mary, University of London

Table of Contents

List of Figures


List of Abbreviations


Setting the Stage

Part I. Manipulating Pain

1. The Uses of Suffering

2. “Twisting the Mind”: Torture and Truth-Finding

3. Alleviating Pain

4. The Script of Pain Behavior

Part II. Knowledge from Pain

5. The Vocabulary and Typology of Pain

6. The Christian History of Humanity

7. Human and Divine Passion

8. Impassibility





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