Logic, Signs and Nature in the Renaissance: The Case of Learned Medicine (review)

Over the past twenty years, the study of medicine in the Renaissance has moved substantially away from a history of great discoveries or of confrontations between obstinate bigots, eyes firmly focused on the pages of their books, and iconoclastic experimenters. Very few of the familiar figures of the Renaissance fit these stereotypes; even Vesalius edited Galen, and Paracelsianism owed much to ideas from the Hippocratic Corpus. The more that is known about medical writing, or about medical and surgical teaching, the more Renaissance medicine is seen as a reengagement with challenging texts from the past as part of an ongoing concern with the diseases and ailments of the present.

Ian Maclean's substantial and frequently innovative study is concerned with medical thinking: the logic and interpretive methods used by learned physicians of the sixteenth and early seventeenth centuries when faced with their sick, or potentially sick, patients. He concentrates on semiotics, as well as on the ways in which discoveries were made and formulated in writing. Although an interest in quantification is often present, the mathematization of evidence is not. Equally, while some concentrated on building systems, others, particularly at the end of the sixteenth century, were exploring anomalies or the full implications of an individual case. More might be said about the role, and definition, of observation within academic medicine, or about the intellectual difficulties of deciding that an epidemic was one of plague, and not pestilential fever, but this would merely add further examples to substantiate Maclean's larger theses.

Two theses, in particular, can be singled out. Again and again Maclean emphasizes the logical underpinnings of Renaissance medicine, drawing attention to the role of logic in the education of the learned and to the continuity between the learned medicine of the fourteenth century and that of the sixteenth. The texts that formed the basis of medical education may have changed somewhat in that period, but the ways of interpretation continued; one might note, for instance, the role of Aristotelian logic in William Harvey's exposition of the circulation of the blood. That this is in part the result of the institutionalization of medicine in universities, guilds, and colleges is briefly suggested in a wide-ranging chapter that looks at some of the constraints under which medicine operated. All readers will benefit also from Maclean's expert survey of the transmission of books and knowledge in the sixteenth century.

More controversial is Maclean's contention that Renaissance Galenism was alive and flourishing at the end of the sixteenth century. Certainly there is a good deal to be said for this argument, particularly if one looks at university medicine and the thought processes it represents. Besides, in many universities medical instruction was based firmly on the interpretation of classical sources, and continued to be so well into the nineteenth century. Virchow studied the Hippocratic Epidemics, and Hippocrates' On Head Wounds formed the basis for university instruction in surgery in some Italian universities until Napoleon. But some changes take place under an identical rubric: the Galenic anatomy before and that after Vesalius are rather different things; and the syntheses of Fernel, Da Monte, or Horst, although all would claim adherence to some form of Galenism, are all different.

But there are divergences that can be traced: the image of the learned physician changes over the sixteenth century, as astrology and uroscopy become the province of the quack. A belief in Galenic physiology disappears after Harvey, replaced by a different understanding of humors. Maclean is right to assert the continuities, and to view many of the disputes of the 1580s and 1590s as a sign of vigor rather than decline. What is still to be explained, however, is the process (or processes) whereby the ancient medical texts...