Western Medical Thought from Antiquity to the Middle Ages (review)

Mirko D. Grmek, ed. Western Medical Thought from Antiquity to the Middle Ages. Coordinated by Bernardino Fantini. Translated by Antony Shugaar. Cambridge: Harvard University Press, 1998. 478 pp. $49.95.

After years in which anglophone historians of medicine have had to rely for their basic orientation on textbooks that were either decades old or filled with error, the 1990s have seen a veritable flood of surveys written by excellent scholars and incorporating the latest theories and discoveries. This overview was originally published in Italian in 1993, and has since appeared also in French. The English translation is generally fluent, although there are still signs, especially in proper names, of the original Italian--for example, the curious Thessalus of Thralles (for Tralles), pp. 112, 403, 478--but the opportunity has not been taken to update or to correct the bibliography.

This first volume of a three-volume set covers Western medicine from the Greeks to the Renaissance of the late fifteenth century. Its emphasis is on ideas far more than on practices or structures, and it combines both chronological and thematic chapters. There are inevitably gaps and a few small errors. We learn a great deal about ancient pharmacology but less about medieval, and the reverse is true for surgery. The fifteenth century also is given less than its due. But instead we are given provocative and wide-ranging analyses of charity and medicine, disease patterns, and ideas about health and disease, which help to integrate the whole volume. The historiographic reflections in the preface, however, although useful in reminding scholars of the great names of the past, could have been extended more trenchantly to analyses of major works of the present day, instead of ceasing in the 1960s.

Overall, the standard of exposition is commendably high. Even the weakest chapters are full of interesting detail and solid learning, and the best are masterpieces of succinct presentation and even novelty, as in Professor Strohmaier's survey of Byzantine and Arabic medicine. At times an anglophone audience may have difficulty in becoming attuned to European ways of thinking, or in appreciating the significance of some of the nineteenth-century medical names whom Danielle Gourevitch links with their Roman predecessors--but that is, perhaps, a necessary challenge in an increasingly monoglot and monocultural world.

The book's weaknesses are the result of its strengths. It is a book written by those who love, study, and write books, and who are themselves highly effective professional expounders of words. It is a meditation on texts by textual experts: solid, accurate, and carefully composed, with a very valuable listing of major editions and translations (not all of whose authors are mentioned in the body of the book: e.g., Antoine Ricart). But the world beyond the library rarely appears; sight, sound, and smell do not feature. There are no illustrations, no chronological tables, no maps to orient oneself, no flights of fragrant fancy in the manner of Alain Corbin. This is the world of learned, literate practitioners, a world from which women and children are almost entirely excluded. Handbooks of diet and regimen are discussed as intellectual artifacts rather than related to the world of exploitation and consumption. Surgeons describe their craft, yet there is no substantial mention of the archaeological discoveries that are transforming our understanding of the effectiveness of their work. Those who seek Foucauldian analyses of the body or the medieval mind will not find them here, despite hints in the introduction--and not everyone will regret that omission.

Within its own limits, then, this is an excellent overview of the main outlines of classical and medieval thought, summarizing succinctly and clearly much of what has been achieved by scholars over the last fifty years. It offers a solid textual base on which others can build with confidence, and disproves the notion that because a subject has been known and studied for centuries, there...