A small illuminated and gilded initial.

Pen to Parchment: National Handwriting Day

By Krista Stracka ~

Red and black lettering with an illuminated D in blue and red, gilded with gold. and decorated with leaf patterns.
Detail of lettering in Liber Medicinalis, 1450

In honor of National Handwriting Day, we recognize the craft of the highly-skilled medieval scribes and artists who meticulously copied and illuminated the fifteenth-century Liber medicinalis (or The Book of Medicine), a Latin translation of selected portions of alQānūn fī al-tibb [The Canon of Medicine] by Ibn Sīnā held at the National Library of Medicine.

A thick leather bound book with clasps.
Liber Medicinalis, 1450
National Library of Medicine #101141493

Ibn Sīnā, also known as Avicenna, was a Persian physician and polymath who first wrote the Canon in 1025, an encyclopedic work that is revered as one of the most influential books on medicine. Used for centuries as the standard textbook for physicians, the Canon was described by William Osler as “a medical bible.” Within the five extensive books are important contributions to fields like neuroscience and drug research.

No matter how often this early manuscript is pulled to display for tours, it never ceases to amaze all who gaze upon it, not only for the significance of its content but for its physical features. After the original clasps are released from the edge of the sixteenth century brown calf binding, the cover is opened to reveal the beautiful gold leaf of the ornamental initial and the tiniest script in Gothic book hand on the vellum page, often mistaken at first for printed text. How could lettering so small and consistent possibly have been handwritten? In short, the answer is a lot of preparation and teamwork.


A detail of the start of a text block beginning with an L decorated with faces in profile on either side.
Flourishes in Liber Medicinalis, 1450

As demand for books increased in the later medieval period, scribal work expanded outside of the monastery to include secular, professional scribes. For any scribe of this period, the first step was the completion of a lengthy apprenticeship to gain mastery of this often grueling and tedious work. Production of just one book could take months or even years. To speed the process, the work was often distributed amongst multiple scribes who worked concurrently on different sections. At least three different “hands” (another term for scribes) wrote the five sections of the Liber medicinalis.  The first scribe (leaves 1–78) was a calligrapher active in Bruges during the 1450s named Willelmus de Predio, who is identified on leaf 78. Based on unique variations in the writing of the individuals, he and a second scribe (leaves 379–388) are likely to have written later sections as well. For instance, the second scribe chose to pen flourish letters in the top lines with heads in profile, decorations that were also added in the fourth section (leaves 389–460).

Preparing the Parchment

The parchment page is textured with small dots from the hair folicals of the animal.
Detail showing follicles in the parchment of Liber Medicinalis, 1450

Before these scribes put a pen to the page, the design and layout was planned and the writing surface was prepared, a process based on the book’s intended purpose. Although the use of paper in bookmaking had increased by the 1450s, this manuscript was written on softened, untanned calfskin known as vellum, or more broadly as parchment—a term that also includes the skin of goat and sheep. To create a thin smooth surface for writing the laborious work of parchment-making included steps to stretch, scrape, clean, and treat the skin before cutting to size and sending to the scribes as sheets.

A line of pricked holes on the edge of the parchment page.
Pricked edge in Liber Medicinalis, 1450
A fully ruled page a quarter filled with writing.
Unfilled ruling in Liber Medicinalis, 1450

With the parchment in hand, the scribe or the apprentice prepared it for writing by first “pricking” and then “ruling” the page to create a template for that precise script. Pricking the parchment involved the use of an instrument like a spiked wheel to add puncture marks (or “prickings”) at designated intervals. These prickings served to guide the drawing of the horizontal and vertical ruling pattern for the columns and rows. The ruling layout of this manuscript is most visible on the final leaf as most of the inked lines were left unfilled. The design called for two columns of sixty lines each, which measures to about twelve handwritten lines per inch!

Script and Scribal Tools

A ruler shows about 12 lines per inch.
Very small writing in Liber Medicinalis, 1450
National Library of Medicine #101141493

To fill these lines, the scribes used one of the most important tools in their kit—knowledge and skill of the script planned in the design. Each scribe used a formal Gothic book-hand to write this book—a script characterized by upright, un-joined letters made with sharp strokes that required frequent lifting of the pen.  To fit the selected portions of the Canon in one book as opposed to multiple bound volumes, it required use of a small font.

So with the parchment prepped and tools at hand, the scribes copied word-for-word from an existing book (the “exemplar”). The Canon was first translated from Arabic into Latin by Gerard of Cremona in the late twelfth century, a copy likely serving as the exemplar for this book. Seated at an angled desk with the exemplar placed in a reading frame and a filled ink pot readily at hand, the scribe held a quill pen in his right hand and a knife in the other to sharpen the pen and scrape mistakes from the page. Though beautifully executed, this manuscript is not entirely error-free. The second scribe mistakenly called the section beginning on leaf 79 the second book, but correctly calls it “liber tertius” in the explicit on leaf 423. A knife was not taken to the page to correct this error.

Process of Illumination

A space left in the writing for later addition of illustrations.
Space for an illustration in Liber Medicinalis, 1450

Finally, during the process of writing, the scribes left spaces for the highly skilled illuminators to illustrate, paint, and apply gold leaf to create the decorated initials found throughout the book. At the beginning of Book 3, space for a 25-line initial was left blank, unintentionally offering the opportunity for us to view this step in the process. The largest initials can be found at the beginnings of Books I and IV with smaller 2-line and 3-line initials at beginning of paragraphs throughout, all beautifully illuminated in gold, blue, pink, and white.


A small illuminated and gilded initial.
An illuminated letter in Liber Medicinalis, 1450

Each manuscript book is unique and reveals clues about the story of its composition. Based on the high quality of the vellum, its decorated letters, the clean margins, and the selection of a font size that is not exactly reader-friendly, it is likely the Liber medicinalis was intended as a gift, once belonging to the Benedictines of Saint-Amand near Valenciennes. Due to its condition, we are currently unable to digitize the book but invite you to appreciate the penmanship of these scribes in person throughout the year, not only on National Handwriting Day.

You can arrange a tour of the NLM and its incunabula collection by contacting the NLM Visitor Center. For information on access to the collections explore our website.

Portrait of Krista StrackaKrista Stracka is a Rare Book Cataloger for the Rare Books and Early Manuscripts Section in the History of Medicine Division at the National Library of Medicine.



  1. Liber medicinales is dog Latin — I point this out because it is repeated several times, so probably not a simple typo.Was Liber medicinalis intended? Or Libri medicinales?

  2. How embarrassing. Thank you for these corrections.
    We’re so happy to know that other experts are reading and willing to reach out to help us improve our accuracy.
    Please know that the post and the catalog record have been corrected, based on the document itself.
    ink on parchment

  3. Merci pour ces informations que je trouve très intéressantes.
    Meilleures salutations

    Dr Safiatou SEKOU DORO

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