Medicine from the Black Death to the French Disease (review)

Roger French, Jon Arrizabalaga, Andrew Cunningham, and Luis García- Ballester, eds. Medicine from the Black Death to the French Disease. The History of Medicine in Context. Aldershot, U.K.: Ashgate, 1998. vi + 330 pp. Ill. $84.95 (1-85928-382-9).

The fifteenth century in Europe witnessed extraordinary changes in intellectual, social, political, and cultural life, and yet it remains relatively understudied by historians of science and medicine. The articles collected in this volume, while not intended as a comprehensive overview, provide valuable insights into a range of topics concerning the medical world of the fifteenth century. I can only briefly suggest here the variety and depth of the contributions, which can be consulted with profit.

In a brief introductory essay, Roger French argues that although new diseases threatened the explanatory and therapeutic basis of "rational" medicine, university-trained physicians maintained their monopoly over the "medical marketplace" that included "empirics," women, Jews, and other practitioners. French underscores the need of future research to put "the various kinds of practitioner into their contexts and [to see] how they interacted with society at large, both in normal times and at moments of crisis" (p. 3). To differing degrees, the articles in this volume contribute to this larger project.

Three articles deal with epidemic disease. In his "preliminary study" of Hebrew plague treatises from 1350 to 1500, Ron Barkai finds that "'rational-scientific' medicine continued to have a central place in Jewish culture" (p. 20) during this period although, he feels, "[p]aradoxically" (p. 16), most writers ultimately attributed the plague to God. Carefully examining the civic death registers of Milan, Ann Carmichael shows that methods of diagnosis increasingly relied on a simplified examination of bodily signs of contagion, as academic physicians became linked to the state system of surveilling and controlling diseases and populations. Roger French and Jon Arrizabalaga find that in the face of the new, infectious disease called morbus gallicus (the French Disease, often identified with "syphilis"), a "civil war" raged among physicians who chose differing intellectual strategies to try to preserve the status of university medicine against competition from unlicensed healers.

The remaining articles vary widely in scope, purpose, and methodology. In a fascinating study, Fernando Salmón and Montserrat Cabré examine how in late-fifteenth-century Spain the evil eye was transformed from a "vulgar" belief into a proper scholastic morbus explained by Galenism and natural philosophy. They argue that medical discussions of fascinatio implicitly supported the broader cultural trend that viewed women (especially older ones) as dangerous to the spiritual and physical health of their neighbors. Peter Murray Jones illuminates the practice and patients of Thomas Fayreford, an ordinary physician of southwestern England, through a sensitive reading of his commonplace book and other writings. Vivian Nutton performs a great service by providing an overview of medicine at the German universities, drawing on material either unavailable or unread by medical historians who have traditionally focused on English, French, and Italian schools. Two articles treat surgery: Michael McVaugh uses the case of hernia surgery to show that "progress" in a medical practice (not just a medical theory) can be understood as socially constructed; Katherine Park identifies an established, well-defined group of "empirical" surgical specialists active in northern Italy, who were distinct from both general surgeons and barber-surgeons on the one hand, and itinerant sellers of charms and nostrums on the other. By comparing the writings of Gentile da Foligno and Gabriele de Zerbi, Roger French argues that the growth of detailed anatomical knowledge was aimed at neither improving medicine nor simply describing accurately the human body, but rather at constructing an ideal image of the learned physician as one who understands the whole of nature and therefore "can charge high fees" (p. 309). Michela Pereira discusses the medieval meanings of the alchemical "elixir," especially in the pseudo-Lullian Testamentum, in order to clarify the later interest in...