The Medieval Review 11.04.07

Faith Wallis. Faith Wallis. Medieval Medicine, A Reader. Readings in Medieval Civilizations and Cultures. Toronto: University of Toronto Press, 2010. Pp. 563. $85 (cloth) ISBN 9781442601697. $42.95 (paper) ISBN 9781442601031.

Reviewed by:

Maud Kozodoy
Brown University

The most recent volume in the valuable Readings in Medieval Civilizations and Cultures series (series editor Paul Edward Dutton) is a rich collection of primary sources depicting the development between 500 C.E. and 1500 C.E of western European medicine. It covers medical theory and practice as well as the profession of medicine and its practitioners, inside and out of the central institutions of medieval intellectual culture: the monastery, the court, and the university. Edited by Faith Wallis, the work is a significant accomplishment, providing not only a coherent history of its subject but a fascinating series of windows onto medieval society. The remarkable variety of sources on display here is a testament to Wallis's expansive understanding of the role played in that society by medicine and medical theory, from their inception in scattered translations of ancient texts and practical handbooks competing (sometimes unsuccessfully) with the healing powers of saints, through their development into a full theoretical system of rationalized care studied, taught, and elaborated within dedicated faculties in European universities. In brief, this is a work that will be indispensable to anyone teaching a course on the history of medicine in western Europe.

Three broadly conceived sections divide the material both chronologically and with respect to the types of sources presented. The first treats the period from the early sixth to the late eleventh century. Beginning with the remnants of ancient medicine that filtered into early medieval Europe in the form of reworked summaries and Latin commentaries on Greek texts, supplemented by non-systematic practical handbooks and manuals and a few pseudepigraphical works from late antiquity, Wallis proceeds to the Christianization of northern Europe. Her sources here reflect a growing faith in the healing power of religious individuals and rituals, alongside the presence of (occasionally effective) doctors. We find stories of clerics performing healing rituals with the aid of Church-associated substances like oil, wine, and water and descriptions of healing techniques that combine normative religious language with quasi- magical adjurations of demons or of medicinal herbs themselves. The growth of European courts shaped some forms of medical practice, as did the very different surroundings of the monasteries, with their herb gardens and dedicated areas for the care of the sick. This section is especially valuable given the relative paucity of scholarly writing on medicine during the period.

The second section covers the period from 1100 to 1500, in the course of which European medicine reinvented itself as a science based on theoretical principles. Through translations by Constantine the African and others, medical scholars gained access to the highly systematic and theoretical works of the great Arabic physicians as well as to an expanded library of Galenic texts. The formation of the core medical curriculum, the Articella, also helped put medicine on a more systematized footing. Teaching texts from the medical school of Salerno, where much of the new interest in theory was sustained, highlight attempts to rationalize such formerly empirically based fields as surgery and pharmacy. From its roots in Salerno, scholastic medicine blossomed in the later universities. Here Wallis draws her texts (and some of her images) mainly from the three centers of medical learning in western Europe: Paris, Montpellier, and Bologna. They run the gamut from the institutional (required reading lists and curricula for the newly formed medical faculties) to the conceptual (essays on the status of medicine itself), from the dialectical (academic discussions of Aristotle versus Galen) to the artistic (anatomical and surgical illustrations). A series of writings on diagnosis, the causes of disease (in this case epilepsy), therapeutics, the newly scientific field of surgery, and, finally, the contested roles of astrology and alchemy complete the picture. What emerges by the end is a "coherent culture of health and healing in late medieval Europe" (xxiv).

The third section is perhaps the most evocative, but also the most uneven. Titled "Medicine and Society," it treats the same chronological period as the second but from a wider perspective. While still sometimes relying on texts written by physicians or for physicians, it opens the door to the bedside encounter, to the correspondence between doctor and patient, to considerations of medical ethics and professional conduct, fees and licensing, hospital care, and the newly invigorated genre of the regimen sanitatis (called here "lifestyle advice"). Regrettably, though, the subject of medical ethics per se is somewhat scanted, whereas the (admittedly fascinating) institution of the hospital seems overrepresented. Jewish participation in medieval medicine, a large subject in itself, is here reflected but dimly in three court cases from Manosque in the south of France. A final chapter offers three satirical views of physicians from the literature of the period; many more could be adduced.

Medieval medicine is a field in which there is still groundwork to be done. Many texts remain in manuscript; others await critical editions. Even for those in print, and in English, it is a chore for a teacher to find them. Wallis borrows from existing scholarly translations and adds her own translations both from unpublished manuscripts and from published but heretofore untranslated sources; all are of high quality. For the most part, technical terms have been regularized across the volume, and a glossary is provided of obsolete and archaic medical terms.

As valuable as this volume is for the breadth and variety of its selections, as well as for the care with which they have been chosen, the brief essays introducing each section, together with the paragraphs framing individual selections, are alone worth the price of admission. In her comments Wallis may sometimes provide biographical and anecdotal background to the authors and their texts, sometimes introduce relevant parallel material, and always offer an insightful angle or context from which a student can approach these readings, so alien to the modern medical viewpoint. From her previous work, Wallis is particularly sensitive to the memory-enhancing literary structures that are vital to many medieval texts. These elements, taken together, add up to a remarkable summary work on the development of western European medicine.

At over five hundred pages, Medieval Medicine: A Reader is by no means a meager tome. Still, one is constrained to note the narrowness of the focus on certain parts of western Europe. For example, medicine in the Iberian peninsula (both Muslim and Christian) is strikingly underrepresented. This is odd in light of the burst of recent scholarship on the subject. While none of the main centers of medical learning was located in the Iberian kingdoms, the strands of medical culture that developed there, in particular outside of the slow-developing universities, have as much to tell us about medieval society as do scholastic texts emerging from countries further north. To take just one curious and paradoxical instance from the thirteenth century, Alfonso X, known for his interest in the Arabic sciences, kept physicians in his court at the same time that he himself seems to have held a relatively unenthusiastic view of medicine, judging from his failure to commission any translations of medical texts and from the negative images of doctors in his Cantigas de Santa Maria. Similarly, in light of the volume's stated emphasis on social history, one would like to find more texts written in the vernaculars. Such works, addressed to a somewhat different readership from those composed in Latin, shed their own light on the kinds of medical ideas circulating in the non-professional and non-university worlds. This is true for western Europe as a whole, but especially so for countries like Germany and Christian Iberia, where universities, and faculties of medicine, were late to develop.

To return to the subject of Jewish participation in the medical profession, this is known to have been significant, especially in southern France and Iberia. Aside from their well-known role in translating medical texts from Arabic into Latin and the vernaculars, Jews in the later medieval period comprised up to thirty percent of the medical professionals serving the Christian community throughout the Crown of Aragon; in Castile, Jews were still composing new medical works in Arabic as late as the fourteenth century. Admittedly, exploring in depth the complex interplay of Arabic, Latin, and vernacular medical texts with Jewish and Christian medical practitioners in the Iberian peninsula might well have overburdened an already dense volume; one does, though, miss some attention to the subject.

Finally, a question arising from a reading of this volume: what was it about Arabic medicine that had such a galvanizing influence on the Latin medical world? Without a more substantial selection of Arabic texts than the handful provided here, there is no way for a reader to begin thinking about this. Wallis characterizes the texts as expounding medical theory or as offering "an explicit theoretical framework" (129). She also tells us that, in combination with the increasingly formalized teaching of medicine using scholastic techniques, and with the "impetus to recast medical practice into a more systematic rational form" (129), these texts helped create the new learned medicine. But is the "theoretical" nature of the texts sufficient in itself to explain their attraction? And even if it is, what changed in European thought and culture as a whole to produce this attraction, and the accompanying "impetus" to re-conceptualize medicine on a rational foundation?

In the scheme of things, these are all small quibbles, expressions of a thirst aroused by a book that already offers so much. Moreover, synthetic studies of medieval medicine are still relatively rare, and this is a book of readings intended for undergraduate courses. As such, it is a truly rewarding work, worth acquiring not only by scholars and teachers of medieval medicine in particular but more broadly by anyone teaching in the field of medieval European history and society. It will also make for compelling reading to anyone curious to explore the sheer range and variety of European medicine in a time of ferment, fascinating intercultural discourse, and far- reaching change.