Gabriele Zerbi's De cautelis medicorum and the Tradition of Medical Prudence

Medieval and Renaissance allegories of Prudence depict her with three faces. Having the faculties of memory (memoria), understanding (intellegentia), and foresight (praevidentia), ¹ she “surveys the threefold times of life”: ² past, present, and future. In the ancient tradition, such a knowledge was reserved to Muses and seers ³ —and to physicians. “Declare the past, diagnose the present, foretell the future” was the threefold obligation of the Hippocratic physician. ⁴ The art of medicine, so defined, is a matter of prudence, because it is the combination of careful history taking, diligent examination and diagnosis, and skillful treatment and prognosis. Yet the tradition of medical prudence has a second strand: the Hippocratic Corpus contains codes of conduct for physicians, which concern the social components of the relationship between the physician, the patient, and the patient’s family. Prudential behavior in this context involves modesty and sobriety, the avoidance of a bad reputation, and the rejection of unreasonable demands. The tradition of treatises on medical prudence was advanced in the Middle Ages by authors who wrote De cautelis medicorum (On rules of caution for physicians), and was continued into the Renaissance by the Paduan professor Gabriele Zerbi. It is the purpose of this article to investigate the structure, content, and sources of Zerbi’s treatise, to analyze his use of ancient authorities and his indebtedness to the De cautelis medicorum tradition, and to place his insights within the context of Renaissance humanism.

Zerbi’s Rules of Caution for Physicians

Gabriele Zerbi (ca. 1435–1505) was a seminal writer on a number of medical subjects. ⁵ He is perhaps best known for the first textbook on geriatric disorders, the Gerontocomia scilicet de senum cura atque victu (Rome: Eucharius Silber, 1489), ⁶ and for his major contribution to anatomy, the Liber anathomie corporis humani et singulorum membrorum illius (Venice: Boneto Locatello for the heirs of Ottaviano Scoto, 1502). Of primary concern in the present context, however, is his treatise De cautelis medicorum. ⁷ This compendium contains rules to promote the observance of the canones of practical and theoretical medicine and to ensure the integrity of the physician and his profession. ⁸ Such cautelae medicorum Zerbi thinks to be necessary not only because of human weakness—ignorance, negligence, poor judgment, and inattention—but also because of human evil: fraud, infamy, and delusion (fol. a1). ⁹ The cautelae are general rules of conduct that are applied to each of the various tasks of the physician—namely, the preservation of health, the prevention of disease, rehabilitation, and cure (actus conservativus, preservativus, renovativus, and curativus: fol. a2). Zerbi’s rules vary in character and origin; many are drawn from the ancient medical authorities and combine pragmatic elements, primarily aimed at preserving the reputation of a physician or a group of physicians, with traditional medical morality. ¹⁰ This combination of pragmatism and deontology reflects the dual purpose of the cautelae medicorum: to define the ideal of the physician, and to make it work in a world full of wickedness and ignorance.

Zerbi divides his recommendations into six groups:

1. 1. Rules for the course of studies and the perfection of the physician, “according to the congenital dispositions of the soul and the body” (secundum dispositiones tam animae quam corporis a generatione contractas: fol. a2).

2. 2. The obligations of the physician toward God.

3. 3. Recommendations for acquired dispositions and general conduct, “concerning the dispositions of the body and the soul acquired in the course of time” (quo ad dispositiones animi et corporis ex tempore acquisitas: fol. a2).

4. 4. The proper attitude toward the patient.

5. 5. Rules for the attitude toward the patient’s family and other people involved in the cure.

6. 6. Regulation of the physician’s relationship with the general public.

This division reflects the general pattern of traditional codes of medical practice, which had been set by the Hippocratic Oath and the ancient treatises on medical etiquette. It is Zerbi’s explicit aim to convey the views of the ancient medical authorities, “imitating . . . whatever has been written by the ancients and particularly by...