Title: Health Care in Gondor and Rohan
Theme: Potluck (April Theme)
Summary: What would health care have looked like in Gondor and Rohan? Tolkien doesn’t tell us much, but what he does say provides good food for thought.
Word Count: 2,299
Recently, I wrote a story where Finduilas is rushed to Minas Tirith’s Houses of Healing when it is time to give birth to Boromir. This was a relatively small detail, one that I was not terribly attached to and hadn’t put a lot of thought into before writing this particular story, but it was something that most reviews picked up on. It seems that medicine is one of those topics people like speculating on.
That fact isn’t all that surprising. Sickness and injury is a part of life and is bound up in death, and so most fanfic writers will probably have to deal with the subject at some point. But canon is frustratingly (or intriguingly) vague. There are just enough hints so that the canon-conscious fanfic writer has some bounds to work within, but how exactly we are to fill in those bounds is less defined. The problem is made all the more difficult because many of the implications we do know about medicine (particularly Gondorian medicine) come from the incidents following the Siege of Minas Tirith. Can we really draw lessons from such extraordinary situations?
Still, there are hints and implications scattered throughout the canon, for those who want to develop this area of our Middle Earth lore. I cannot offer a definitive answer to the question, “What would health care look like in Middle-earth?” What I can offer – and what I try to develop in what follows – is a starting place, for other fans of Tolkien and fanfic writers to start developing their own views on this subject. Since my original story was set in Gondor (meaning my thoughts and conversations have featured on that story), I will focus on the kingdoms of men that feature most into the Lord of the Rings.
First, Gondor. Of all the cultures that feature into the Third Age, we probably know the most about health care in Gondor. Following the Siege of Minas Tirith, Faramir, Éowyn, and Merry are brought to the Houses of Healing, a special building set aside for the healing arts. Tolkien gives this description:
These were fair houses set apart, for the care of those who were grievously sick, but now they were prepared for the tending of men hurt in battle or dying. They stood not far from the Citadel-gate, in the sixth circle, nigh to its southward wall, and about them was a garden and a greensward with trees, the only such place in the City. There dwelt the few women that had been permitted to remain in Minas Tirith, since they were skilled in healing or in the service of the healers. (“The Pyre of Denethor,” The Lord of the Rings)
This passage clearly lays out the purpose the Houses of Healing served both in peacetime and in the aftermath of the great battle. The Houses of Healing were intended for “the care of those who were grievously ill.” It seems, then, that more routine medical care did not happen here. Tolkien does not directly tell us what would happen to those less serious injuries and illnesses in peace time, but he does suggest that, for many Gondorians, the sick might most naturally be taken to their homes, not to the Houses of Healing. This point is made most clearly through the story of Faramir’s injury:
Even as the Nazgûl had swerved aside from the onset of the White Rider, there came flying a deadly dart, and Faramir, as he held at bay a mounted champion of Harad, had fallen to the earth. Only the charge of Dol Amroth had saved him from the red southland swords that would have hewed him as he lay.
The Prince Imrahil brought Faramir to the White Tower, and he said: ‘Your son has returned, lord, after great deeds,’ and he told all that he had seen. But Denethor rose and looked on the face of his son and was silent. Then he bade them make a bed in the chamber and lay Faramir upon it and depart. (“The Siege of Gondor,” The Lord of the Rings)
It is telling that Imrahil does not take Faramir directly to the Houses of Healing and send for Denethor to be brought there, as we might expect to happen today. Even when Denethor sees how sick Faramir is (remember, he’s sick enough that Denethor, once broken by his last palantír-encounter, thinks that Faramir is already dead or so near that it makes little difference), he does not carry him off to the Houses but instead orders that the servants “make a bed in the chamber and lay Faramir upon it.”
This is most likely partly due to Denethor’s despair, but also indicates that even in battle, even with the Steward’s son, your average Gondorian’s first impulse was to treat the sick in the home rather than in the Houses. This interpretation is supported by the events that happen after Faramir, Éowyn, and Merry are healed of the Black Breath. After Aragorn had rested for a little while, “men came and prayed that he would heal their kinsmen or their friends whose lives were in peril through hurt or wound, or who lay under the Black Shadow. And Aragorn arose and went out, and he sent for the sons of Elrond, and together they labored far into the night.” (“The Siege of Gondor,” The Lord of the Rings) As I said above, we must be careful not to generalize too far from an extreme situation like this. That said, it’s clear that in this instance the ill and dying were scattered throughout the city; not everyone was brought to the Houses.
None of this means that Gondorian medicine was primitive. On the contrary; Gondor has one of the most specialized and advanced medical systems among the mortal races of men. The Houses of Healing has an herb-master who Aragorn holds in low esteem, but who does seem to know a thing or two about the normal ailments. Even Imrahil (or at least the men of his military company) appeared to be familiar with triage, determining that Faramir’s wound from the arrow was not serious. Gondor also clearly had embalmers, and embalming requires a certain knowledge of anatomy if not necessarily of healing.
There are of course limits to Gondorian medicine. Finduilas, the mother of Boromir and Faramir, died when she was quite young. Whatever illness she died from was untreatable, and she probably had access to the best medical care in Gondor. More generally, the appendices speak of fevers and plague that struck Gondor so that large numbers of peoples died. Gondorian medicine could not stop that from happening.
We know even less about Rohan than we do about Gondor. Tolkien never mentions any Houses of Healing, nor do we have details of the kind of healing any character received in Rohan. There are, however, a few references in passing.
First, from “The King of the Golden Hall”:
‘Dear lord!’ cried Wormtongue. ‘It is as I feared. This wizard has bewitched you. Are none to be left to defend the Golden Hall of your fathers, and all your treasure? None to guard the Lord of the Mark?’
‘If this is bewitchment,’ said Théoden, ‘it seems to me more wholesome than your whisperings. Your leechcraft ere long would have had me walking on all fours like a beast.’
I do not know that Wormtongue literally was using leeches to treat Théoden; Théoden may simply have meant that Wormtongue was draining him of his energy and good health. Nevertheless, it is a metaphor that Théoden was familiar with, at the very least. Later, after the Battle of Helm’s Deep, Théoden observes that his old age “is an ill that no leech can wholly cure, not even Gandalf.” This suggests that Wormtongue might have actually been using leeches to treat him, or that there was at least a possibility of this.
(Théoden was born in Gondor, so there is the possibility that he heard about the practice of leechcraft there rather than in Rohan. Personally, I find this less likely than him hearing of the practice in Rohan. First, Théoden was born in 2948 T.A. and his family left Gondor in 2953, meaning Théoden was at most five years old. Also, his reference isn’t lost on the other Rohirrim presence who weren’t born in Rohan. It seems most likely to me that Rohirrim were at least aware of the practice. But that’s my opinion, not fact, and other readers might interpret the situation differently.)
Also in the aftermath of Helm’s Deep, Tolkien describes Gimli as wearing “no helm, and about his head was a linen band stained with blood; but his voice was loud and strong.” (“The Road to Isengard,” The Lord of the Rings) While we are not explicitly told how Gimli got this bandage, I think it is reasonable to assume that he was wounded in battle and the Rohirrim dressed his wounds. (At the time, Gimli was in the Glittering Caves, separated from all but the Rohirrim. Either he was carrying the bandage on himself, or the Rohirrim had first aid supplies at hand.) Linen is the kind of fabric that easily shows stains, and the only stain mentioned is blood. This suggests to me that the Rohirrim had some basic knowledge of first aid, and that they cared for the wounded.
The last mention of Rohirric medicine in Lord of the Rings comes after Éowyn is injured at Pelennor Field, and it is veiled. Discussing Éowyn’s psychological state, Éomer says that “Care and dread she had, and shared with me, in the days of Wormtongue and the king’s bewitchment; and she tended the king in growing fear.” Gandalf further adds that “she was doomed to wait upon an old man, whom she loved as a father, and watch him falling into a mean dishonoured dotage; and her part seemed to her more ignoble than that of the staff he leaned on.” (both quotes from “The Houses of Healing,” The Lord of the Rings) Clearly Éowyn waited on Théoden, and this comparison to his staff suggests that she may have supported him physically. It seems likely to me that Éowyn became a kind of nursemaid to Théoden.
What exactly was Théoden suffering from? For that, we must turn to Unfinished Tales. There Tolkien writes that in 3014 T.A. the king became sickly, adding that “his malady may thus have been due to natural causes, though the Rohirrim commonly lived till near or beyond their eightieth year. But it may well have been induced or increased by subtle poisons, administered by Gríma.” (“The Fords of Isen,” Unfinished Tales) So sickness was not unheard of in Rohan, and the Rohirrim had some means of fighting it. They may have even been more successful at disease-prevention than were the Gondorians, since there are several mentions of plagues in Gondor but none in Rohan’s history – though in all fairness, this was probably due to the greater presence of large cities in Gondor than Rohan.
The above quote also mentions “subtle poisons, administered by Gríma.” This is of course only a possibility, not a canonical fact, but assuming it is true, where did Gríma get it? It is possible that Gríma received them in Isengard and was taught by Saruman how to administer them. But it seems more likely to me that he manufactured them in Rohan; he kept Théoden ill for several years, and I do not think Gríma would have gone to Isengard himself if it could be avoided. This doesn’t prove that the Rohirrim were expert poison-makers, of course, but it does suggest a more advanced medicine than the reference to “leechcraft” suggests to a modern reader. The Rohirrim probably had some knowledge of chemistry and knew how to prepare draughts and other concoctions. Even if Gríma did not prepare these poisons himself, he had to know how to administer them, which is not nearly as easy as injuring someone with a sword or arrow.
Based on this, I believe it is likely that both the Gondorians and the Rohirrim had people skilled in healing. In Gondor, this was probably more specialized and set-apart than in Rohan; I can more easily imagine in Rohan that there were some people learned in healing arts but who most of the time carried out other functions, and only worked with the ill or injured at need. Gondor seems to have developed a professional medical group, complete with distinctions (note that in the passage describing the Houses of Healing Tolkien describes both lady-healers and those that serve the healers; and that also Aragorn calls for the herb-master, implying there are perhaps other herbalists).
None of this touches on one of the more interesting questions related to this topic: access. All of the injured and sick characters we see receive treatment are from the upper rungs of nobility. They would likely have the best access to health care of anyone in their respective societies. It seems altogether likely that tradesmen and peasants would have had less access to quality health care. Tolkien, however, does not definitively answer this question either way. He never mentions nobility or class when describing who is brought to the Houses of Healing, but it does seem noteworthy that the upper-class all end up there, whereas not everyone did. That said, this is an area where fanfic writers have a lot of latitude in how they describe medical care. You could make a case that health care was universally available, or that the rich received significantly better care than the poor.
I hope this essay helps you develop your own view of Gondorian and Rohirric medicine. As promised, I have no pat answers – but I do hope the food for thought proves useful!