"It All Depends on the Dose": Poison and Medicines in European History ed. by Ole Peter Grell, Andrew Cunningham, and Jon Arrizabalaga (review)

"It All Depends on the Dose" presents a dozen workshop papers to illustrate the complex relationship between medicine and poison in the Western medical tradition from classical Rome through the twentieth century.

The first chapter, from Toine Pieters, canvases a handful of strong and dangerous drugs including arsenic, opium, morphine, warfarin, and even chemotherapy, to "pinpoint a remarkable continuity in the blurred boundaries between medicine and poison" (p. 22). This sweeping overview, with its abundant anecdotal evidence, perfectly sets the stage for the collection and its stated purpose.

In the lone pre-thirteenth-century chapter Helen King provides a clear and concise summary—perhaps the best anywhere—of Galen's various comments about poison and antidotes across his corpus. She pays particular attention to the number and diversity of sources of Galen's knowledge about poisons and remedies and how they worked their way into so many of Galen's texts.

Montserrat Cabré and Fernando Salmón present a surprisingly unique tale from a thirteenth-century collection of miracles from Castile, the Cantigas de Santa María. One of these (cantiga 188) suggests that a young woman's death was caused by an internal poison and describes an unusually early postmortem dissection of her heart (to which she continually pointed as her health waned). The chapter demonstrates the intriguing potential for examining religious and medical discussions about poisoning in conjunction with each other.

Moving on to the mid-fourteenth century, Jon Arrizabalaga details numerous examples manufactured poisons reputedly used to spread pestilential disease. By considering accusations of poisoning water, food, and air alongside accusations of deliberately spreading plague, the chapter nicely shows how prominent medical theories about the nature of poison convincingly explained the possible mechanisms of poison and plague spreading, both accidental and intentional.

Georgiana D. Hedesan provides a spectacularly clear and systematic overview of Paracelsus's many comments throughout his works on the relationship between poison, medicine, and disease. Her chapter will be essential reading for a long time, not least because it shows how Paracelsus's contribution to toxicology was far more sophisticated than a slogan about the importance of dose. Particularly useful is Hedesan's attention to Paracelsus's dual approach to poison both as a spiritual essence and as a discrete physical substance.

Ole Peter Grell outlines how Martin Luther's views on sexual abstinence and prostitution—both to be avoided—may have been anchored in both classical and contemporary medical theory. Celibacy could encourage a kind of self-poisoning according to Galenic ideas about the poisonous nature of retained semen or menses; prostitution could help spread the poison that acted as cause of pox (later known as syphilis). The chapter also raises important questions about how religious reformers and doctrine could be informed by medical authority, even without direct attribution.

No book on the history of poison could be complete without attention to political assassination in Italian Renaissance courts, and Alexander Pastore's chapter provides a fine specimen. While readers will hardly be surprised by its conclusion that we can "verify the strong presence . . . of poison in Renaissance Italy" (p. 128), its dense collection of anecdotes from a wide array of sources provides an intriguing starting point.

Taking up a different social lens in the early modern world, Alisha Rankin surveys the relationship between gender, poison, and antidotes in terms of authorial attribution. She shows how, on one hand, exotic or complex poison remedies intended for courtly use were usually ascribed to highly elite men rather than women; yet on the other hand, such strong gender differences seem to dissolve in the context of medicinal recipes for antidotes generally, to which women were clearly important contributors.

José Ramón Bertomeu-Sánchez argues that the pioneering toxicological work of Mateu Orfila in the...