medical theory, medical practice, print culture, Practica
Luke Demaitre has provided us with a book on later medieval medicine unlike any other, systematically illuminating the intersection of medical theory and practice as reflected by about two dozen of the most prominent and highly circulated Latin medical manuals spanning the eleventh through fifteenth centuries. Demaitre does not advance a particular argument about these guides, but provides a wonderfully descriptive and comparative tour of them. Even while constrained to one genre of medical text, Medieval Medicine is essential reading for anyone looking for a synthetic overview of academic medicine in the later medieval period.
The first chapter establishes the intellectual background of the texts, particularly the Galenic and Avicennan foundations of late medieval medicine, [End Page 667] and the coalescence of the medical textual tradition that would underlie medical training (and practice) for the academic physicians who composed Latin medical encyclopedias. The second chapter explores three paradigms of disease, provocatively suggesting the frameworks of fever, pestilence, and poison as a way of getting inside the minds (and texts) of medieval physicians. Next comes a chapter covering the maladies that manifest themselves on the body’s surface, including various apostemes, cancer, and leprosy. The remaining five chapters mimic the head-to-toe organization so often employed by medical compendia themselves, beginning with the head, face, and senses, and moving downward through the various parts (and potential ailments) of the body. All of the chapters sample widely from a variety of exemplary Practica, including those by Constantine the African, Gariopontus and other Salernitan authors, as well as later writers such as Gilbertus Anglicus, Bernard of Gordon, William of Varignana, Niccolo` Bertruccio, Antonio Guaineri, and Giovanni Savonarola, to name just a few of the more well known.
Demaitre masterfully immerses us in the texts. His vibrant descriptions and attention to detail—characteristic features of the medical manuals themselves—will reward even readers already well acquainted with them. Along with relaying the contents of the Practica, Demaitre continually provides clear and accessible explanations of the medical thinking and textual tradition behind them. Clearly sensitive to the differences among texts, Demaitre also takes care to point out elisions, omissions, and other ways authors deviated or maintained the positions of earlier medical authorities. Demaitre shows not only how medical advice was steeped in the learned medical textual tradition, but also how physicians used and questioned folk remedies and medical authorities alike, both providing sometimes seemingly bizarre advice. This juxtaposition helps illustrate the compilers’ effort to draw from a wide range of sources as well as to reconcile folk wisdom, experiential learning, and textual authority.
While these large and well-ordered encyclopedic texts may at times appear disconnected from the real world of medical practice, Demaitre uses both small and large excerpts from the compendia to show how they are not always so. We see authors’ medical thinking as elite academic doctors, of course, but we also see the authors as practicing physicians dealing with both the aches and pains of everyday life as well as with more unusual diseases and patients. Demaitre carefully guides his reader through the wide latitude of physicians’ theoretical knowledge and into their diagnostic descriptions and processes. We see first-hand how medieval physicians understood symptoms, situated them within larger disease frameworks, noted effects of diseases on various parts of the body, undertook particular [End Page 668] treatments, and documented the results. The texts thus not only paint a vibrant picture of sophisticated medical practice, but also bring to life the varied personalities, idiosyncrasies, and individual styles of the authors.
Demaitre’s steadily maintained focus on the texts may pose some challenges for those not already familiar with larger cultural and intellectual backdrops to their production. One might wish to know, for instance, more about the contexts under which the texts were created and how such conditions may have given rise to variations between them. Although a detailed study is clearly beyond the scope of the book, it might have engaged...