In Shakespeare’s time, medicine was little more than trial and error mixed with a great deal of superstition. Little was known about proven treatments, and disease and germs were not understood. Sanitation and hygiene, even among the upper classes, was rudimentary at best. Streets were filled with garbage and raw sewage, which spilled over into the rivers and lakes. Rats and vermin abounded, and no one made the connection between these conditions and the sicknesses that killed people. Typhoid, syphilis, influenza, and plague exacted a toll on life expectancy, as did poor nutrition, which led to life-threatening anemia and dysentery. Many upper-class women covered their faces with white make-up, which contained high amounts of lead. The make-up poisoned, and even killed, many of them.
Because these health dangers were not understood, the work of physicians often included astrology. Astrologers and doctors, such as Tommaso de Benvenuto da Pizzano (Shakespeare’s possible model for Helena’s father, Gerard de Narbon), often resorted to bleeding people when they became ill in an effort to cleanse their bodies from bad humors, or bodily fluids.
Physicians in Shakespeare’s day wore unusual outfits, complete with a long black cloak, leather gloves, leather boots, a pointed hood, and a mask with a long, pointed beak, which was filled with bergamot oil. Though the outfit may have been rooted in superstition, it probably did protect doctors, simply because it provided a barrier against the germs and bugs that would have covered their patients. Their odd appearance, however, often inspired dread in townspeople, who came to regard physicians with wariness. Anyway, only the very wealthy— mainly the nobles—would have been able to afford treatment by a doctor. Other segments of the population might be treated by a barber, who, in addition to cutting hair, also pulled teeth and bled patients.
The ailment the King of France suffers from in All’s Well That Ends Well, fistula, which is an abscess that creates an opening between two organs, would not have been well understood at the time, and it is true that a physician may have told those afflicted with the condition that there was nothing that could be done. How Helena cures the king so quickly and completely is inexplicable, certainly in terms of medical knowledge either then or now, and her healing powers remain one of the story’s most implausible folk-tale elements.
After she heals the king and is wed to Bertram, Helena is ordered back to Rossillion. Distraught by Bertram’s letter stating he will never return home as long as she is there, she departs on a pilgrimage to the burial site of Saint Jacques le Grande. Also known as the Way of St. James, the pilgrimage leads travelers to the Cathedral of Santiago in northwest Spain, the burial site of the Apostle James, St. James the Greater, a follower of Jesus Christ and the brother of the Apostle John. The purpose of the pilgrimage was to have the pilgrim’s greatest sins forgiven; the only other two pilgrimages that could do the same thing were to Rome and Jerusalem. There were several popular routes pilgrims could take to the shrine, each passing through other towns and stopping at notable locations along the way. A majority of those who undertook the trip were French, and the Way includes many stops in France before continuing on to Spain. The Cathedral of Santiago is still a popular pilgrimage site in the twenty-first century, and priests hold weekly services to welcome those who have made the trip, often on foot or bicycle.
In Shakespeare’s time, this pilgrimage was still popular but considered somewhat dangerous because of the violence resulting from the Protestant Reformation. Audiences would have been familiar with the journey and accepted Helena’s reasons for undertaking it. However, given that Helena leaves for the trip from Rossillion, which borders Spain, how she ends up in Florence, which is hundreds of miles in the opposite direction from the shrine, is never explained. The fact that she is traveling alone is also puzzling.
(extracted from) Shakespeare for Students:Critical Interpretations of Shakespeare’s Plays & Poetry, Second Edition, Volume 1, authored by Anne Marie Hacht & Cynthia Burnstein, published by Thomson-Gale, 2007