Medicine before Science: The Rational and Learned Doctor from the Middle Ages to the Enlightenment (review)

Roger French's last book—posthumously published thanks to the invaluable assistance of Cornelius O'Boyle, who prepared it for publication—will remain a lasting token of the author's prolific writings and interests.

This book will appear in the bibliographies I will supply for my students who study the history of premodern science and medicine. The merit of this work of synthesis lies in breaking the rigid chronological boundaries that so often hamper our grasp of continuities and change. French did not erase the periodical specificities, but stressed long-term resemblances and recurrent patterns that defy chronological compartmentalization. Among the continuities revealed by this approach is the persistent relationship of medicine to natural philosophy. Whether in the Middle Ages or in the early modern period, doctors thought that philosophy would improve their medicine and their performance; they also found that it was attractive to pupils and enhanced their reputation as teachers. Similarly, throughout the seven centuries covered by this book, medicine stressed the role of reason and experience. Learned physicians were ever conscious that they were in a tradition reaching back to Hippocrates and Galen. Despite powerful theoretical challenges throughout the sixteenth and seventeenth centuries, the survival—even the local flourishing—of Galenic medicine (in the London College of Physicians, well into the mid-seventeenth century) is remarkable. Throughout that period a north-south difference in European medicine persisted, but it changed its character in the sixteenth century when the Catholic south became more traditional and the Protestant north was more innovative and vibrant. Finally striking is the interweaving of medicine and religion, of medical thought and theological considerations, throughout the whole period, even as late as the seventeenth century (and sometimes more intensively then, than in the medieval "age of faith").

Roger French's product is a broad and lucid story of how medicine and learned medical men acquired and fortified their position of power, authority, status, and prestige, and how they coped with different crises (mainly theoretical) and gradually abandoned ancient traditions. French touches upon all the major intellectual developments in the Latin West well into the eighteenth century, and their impact on medicine and the learned physicians. This includes Renaissance Neoplatonism, Baconian experimental philosophy, Cartesian mechanism, Newtonianism, and the scientific revolution.

The book starts with two chapters on the classical sources of the Latin medical tradition. Learned physicians of the Middle Ages and the Renaissance were building up their own tradition of medicine by choosing their heroes (mainly Hippocrates and Galen), doctrines, and practices (e.g., bloodletting) from the Greek pool. From ancient sources they borrowed ethical considerations, a fondness for Hippocratic-style aphorisms, Aristotelian-style argumentation, and anatomical curiosity.

The next three chapters deal with the emergence of scholastic medicine, from the earlier schools of the eleventh and twelfth centuries through the universities of the thirteenth and fourteenth centuries, until the challenge imposed on learned medicine by the plague. French sees in this the first in a chain of major sources of discontinuity, leading in the fifteenth and sixteenth centuries to a weakening of the authority of the learned doctor. Hellenism, Italian civic humanism and court culture, the extrauniversity activity of prominent physicians such as Cardano and Paracelsus, the growing popularity of mathematical astrology, the Great Pox, the increased willingness induced by the Reformation to question tradition in every field—all eventually undermined the authority of the learned physician and induced him to change the philosophical foundations of medicine. The semiautonomous discipline of anatomy was to survive the crisis in theory that transformed medicine.

The last three chapters concern the collapse of Galenic complexional medicine (closely linked to the collapse of traditional natural philosophy at the beginning of the seventeenth century), the...