The Medieval Hospital and Medical Practice (review)

Since the late 1980s, interest in the history of medieval hospitals has increased. No longer are they viewed as centers of caring rather than curing that showed "little careful thought for the comfort, cleanliness, or, ironically, health of the patients."¹ Indeed, recent research acknowledges that these institutions provided patients with a regimen of care that combined sacramental medicine with medicine for the body (if, indeed, the two can be separated in this essentially anachronistic way). In short, medical historians now argue that the sick were offered both physical and spiritual therapeutics and that a good diet, clean bedding, and a constant round of prayer and masses were just as "medicinal" as drugs are now considered to be today.

Enter Barbara S. Bowers's The Medieval Hospital and Medical Practice, a compilation of revised and updated papers delivered in 2001 at the Thirty-Sixth International Congress on Medieval Studies, Kalamazoo. It brings together research undertaken by academics around the globe on the medieval hospital and medical practice in the Middle Ages. The collection itself, which is divided into four sections (On Doing Medieval Medical Research, Physical Evidence: Archeology and Architecture Technology, New Approaches to Written Sources, and The Monastic Connection), comprises fifteen contributions. These include those by medical historians (e.g., Peregrine Horden), art historians (Renzo Baldasso), archaeologists (William White), and historians of botany (John Riddle) and leprosy (Rafael Hyacinthe). Such an interdisciplinary study, which examines documentary evidence, archaeology, architecture, and iconography, to name but a few fields, is to be applauded. More important, the authors' findings are, on the whole, presented in such a way as to be accessible to those without any specialist knowledge.

A common thread running throughout the book is a discussion of therapeutics, and a number of authors point to those foundations that placed great emphasis on the Regimen sanitatis (regimen of health), prayer, and the sacraments. In her discussion of the hospital of Notre-Dame des Fontenilles at Tonnerre, Lynn Courtenay offers an important insight into how the religious and liturgical life of this foundation shaped the nature of the care given to the poor and infirm: "liturgical music was thought to play a significant role in the patients' wellbeing, just as prayers, relics of saints, and the divine office were deemed efficacious in cure" (p. 89). Music was an important part of the Regimen and was thought to influence a patient through its capacity to calm a troubled mind or quickened pulse. The extent to which the right emotions were essential to the preservation or restoration of health is examined in depth by Horden, who argues that "spiritual medicine is genuinely medicinal" (p. 142). He also stresses that religion was in fact the true source of healing offered in all medieval hospitals and that in their wards, medicine without doctors achieved its fullest expression. It is research into this area of hospital life that will demonstrate still further how seriously many of these institutions took their role as centers of "medical" expertise.

That said, it is perhaps less evident that every author offers "the latest cuttingedge scholarship" (p. xiii). For instance, some readers may find those chapters concerning leprosy a shade simplistic: "medieval regulations . . . denied a person with leprosy a place in society, forcing him to withdraw outside the town walls in leprosaria" (p. 211). Instead, they may wish to consult Carole Rawcliffe's pioneering study, Leprosy in Medieval England, (reviewed below). On balance, however, this book is thoroughly recommended and serves as a model for future collaboration.