Les "Consilia" Medicaux (review)

Most personal consultations are too occasional, oral, and private to make history, but some have left a revealing imprint. These include the pronouncements of physicians that became formalized as consilia in the early age of the university. Although this distinct branch of medical literature has fascinated historians for some time, it was not examined comprehensively until this important study by Agrimi and Crisciani. Their compact but thorough book, as one of more than sixty volumes in a series on the spectrum or “types” of medieval sources, presents a profile of the genre rather than an analysis of separate texts; at the same time, it points out many directions for further research.

The typical medical consilium reports an individual case, identifies the ailment and its causes at the hand of authoritative doctrine, and prescribes corresponding treatment by diet and medication; written down at the request of the patient or of colleagues, it was subsequently touched up, copied, and readily assembled in collections. This precise definition excludes not only the medico-legal consilium of expert testimony but also more closely related documents such as the anecdotal exemplum, the tractatus on one observed disease, the tabula of signs and causes, the merely prescriptive regimen, and the experimentum or proven remedy. While the medical consilia drew on such preexisting practical literature and on traditional learning, the genre as such had no precedent in Greek, Arabic, or even Salernitan Latin writings. It was created in northern Italy, more specifically in Bologna, where the study and profession of law provided both stimulus and model. Collections of consilia appeared from 1250 on, most prominently in association with Taddeo Alderotti and his pupils. Within a century a set format evolved, shaped above all by Gentile da Foligno. The genre was an integral part of medicine, both in the teaching of practica and in daily practice, for Michele Savonarola and other famous fifteenth-century university physicians.

At the junction of academe and profession, the consilia taught students how to proceed in accordance with doctrine, and they demonstrated to patients that learning benefited treatment. The genre had certain weaknesses, including a restriction to well-heeled patients, a preoccupation with food, and a fascination with vocabulary and rhetoric. The latter may have led Petrarch, at the time when the format was becoming fashionable, to scoff at physicians who “glory not in the effect of their treatment but in the inane elegance of their remarks.” ¹ The positive significance of the consilia lies in their patent combination of theoretical and practical concerns, their aim to bring order and rationality to the confusion of a concrete case, and their individualization of medical scientia. By their lucid portrayal of these features, Agrimi and Crisciani expand their already remarkable contribution to a better understanding of scholastic medicine.