A lot of work went into making medieval manuscripts. Scribes labored to not only to copy out the text, but to make even the basic materials they needed.  Illustrators and rubricators spent time adding the tiny details to each page.  Binders needed specifically cut wood to make the best covers. Clearly producing medical manuscripts was not easy or cheap.

Since this overview of the creation of manuscripts started at the finished product and worked its way back, here is a final list of the steps in order starting at the beginning.

• Slaughter animals
• Wash and soak skins in lime solution
• Remove the hair
• Stretch the skin on a frame and let dry
• Cut sheets of parchment
• Make ink
• Make a pen
• Copy text 
• Rubrication
• Decoration
• Correcting
• Glossing
• Check leaves and quire orders
• Sew together
• Add a cover

Once a manuscript was finally fully finished it could at last be stored away.