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149 Chapter 6 Abortion Experts and Expertise Modern Westerners readily accept the idea that current medical practice differs greatly from the healing techniques of the later Middle Ages. Knowledge about the human body has accumulated in ways that make earlier learning seem less impressive,if not outright primitive. It was not until the mid-twentieth century that scientific and technological advances allowed for the routine termination of pregnancies. Only since the 1950s have operations been conducted in specialized and specifically accredited hospitals,and a wide consensus has built up among practitioners that the physical risk for aborting patients should be minimal. By contrast, women carrying unwanted babies in the years between 1100 and 1500 did not have to resort to abortion to confront rates of mortality in childbirth and average life expectancies that now rank as staggeringly adverse and menacing. From a present-day perspective, late medieval hygienic conditions were altogether unsafe. In cultural terms, however, today’s health care systems retain many elements that first developed in the age of scholasticism. Along with the formation of academic curricula for theologians and lawyers, the teaching of medicine acquired permanent features in the 1100s, and society learned to greet university graduates respectfully as “masters” and doctores, in open recognition of their ability to offer valued services to affluent clienteles. And while the doctrinal expertise of the era has failed to withstand the test of modernity, the consultation of physicians in possession of a doctoral degree 150 CHAPTER 6 has provided enough reassurance to have demand for their cures increase steadily ever since. Parallel to intellectual habits in the neighboring disciplines of law and theology, twelfth-century scholastic medicine found guidance in textual auctoritates that for the most part trace back to the period of antiquity. In line with Gratian and the early civilian teachers, the pioneers in the field were primarily engaged in a bookish pursuit, distilling from older literature uniform and comprehensive readings for classroom use. Through the elimination of internal contradictions and the careful conceptual analysis of statements attributed to ancient writers like Hippocrates and Galen,they put together a coherent doctrinal edifice and imparted it to students in the typical academic formats of marginal glossae, self-standing summae, and monographic treatises. Attempts to forge a learned synthesis from previous,widely scattered data further benefited from the contributions of Arabic doctors such as Avicenna (d. 1037) and Averroes (d. 1198), whose expert commentaries on the Hippocratic and Galenic source material were grounded in a tradition that preceded the inception of professional training in the West by many centuries. With an approach that called for philological and interpretive scrutiny rather than experimental autopsy, the university knowledge of abortifacient procedures and prescriptions also relied on imported repertories . The principal trove of pharmacological data survived on parchment as part, or in elaboration, of the Materia medica composed between 60 and 78 by the Greek physician Dioscorides. In translation, alphabetized, excerpted, and increasingly rendered in vernacular versions,the Materia medica conveyed standard information about the physiological effects of numerous plants and herbs while complicating the endeavor of modern historians to discern medieval scholarly insight from content that by the later Middle Ages had turned incomprehensible or obsolete.1 As branches of higher education, jurisprudence and medicine grew out of similar circumstances. The specialized skills they conferred permitted practitioners to carve out niches of opportunity in larger and preexisting service sectors. One catered to the peaceful resolution of conflict between adversaries, the other to physical comfort and recovery. Not very different from the lawyers who concentrated on public mediation and justice, the 1. On the rise of scholastic medicine, see Nancy Siraisi, Medieval and Early Renaissance Medicine: An Introduction to Knowledge and Practice (Chicago: Chicago University Press,1990),60–96;concerning the academic discussion of reproductive health issues, Danielle Jacquart and Claude Thomasset, Sexuality and Medicine in the Middle Ages (Princeton: Princeton University Press, 1988), 104–286. ABORTION EXPERTS AND EXPERTISE 151 representatives of academic medical doctrine gradually extended their reach and competence into areas long occupied by people whose preparation for the task did not involve certification, literacy, or years of theoretical and fulltime training. Scholastic gynecology, for instance, did not assume a commanding role right away and appropriated the entire spectrum of health care for women in a slow and intermittent process. Twelfth-century university expertise saw the intervention of male doctores as being narrowly restricted to female breast conditions; illnesses affecting the reproductive organs were typically left to the cures of...

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