The juxtaposition in the title of this book refers to the interaction, rather than the commonly emphasized dichotomy, between faith and science in medieval Christianity. The volume, the third in the York Studies in Medieval Theology, contains a quodlibet lecture and five papers which were presented at a York conference in 1999, and five invited essays. The editors have avoided the usual pitfalls such as unevenness and lack of cohesion, thanks in part to their noted scholarly standards, proven familiarity with the field, and evident talent for drawing diverse topics and approaches into integrated discourse. Their own relevant studies include Peter Biller^ñs pathbreaking study, The Measure of Multitude: Population in Medieval Thought (Oxford, 2001) and Joseph Ziegler^ñs well received monograph, Medicine and Religion c. 1300: The Case of Arnau de Vilanova (Oxford, 1998). No doubt the editors task was facilitated by the quality of the authors, more than half of whom are leaders in their field. The coherence of the collection is enhanced by references of the authors to each other, dovetailing themes, and shared sources (with a list of abbreviations, pp. ix-xvi). The articles cover a wide range of subjects, from doctrines to practitioners and from the classroom to the infirmary, while they leave aside some obvious aspects such as monasticism, hagiography, and magic. Bridging the vantage points of religion and medicine, they form and elegant thematic arch, from the first, on Christianity^ñs adoption of the most influential physician, to the concluding essay, on medicine^ñs infiltration into Christian theology. A reviewer^ñs summaries cannot do justice to the richness of the narratives, the tightly woven arguments, or the lucid syntheses in Ziegler^ñs introduction (pp. 3-14). I hope, rather, to serve the reader by highlighting the themes and sharing a few of the thoughts that they triggered.
Eleven different perspectives converge on one central thesis, increasingly current among careful historians but still in need of broader circulation, namely that science and faith were neither inherently hostile nor far apart but symbiotically linked in matters of health. At the very foundation of medical thought, the teachings of Galen were initially mistrusted but eventually and thoroughly depaganized by Christianity. The phases and reasons of this adoption are explained in the first article by Vivian Nutton (pp. 17-32), with an erudition that matches the depth and width of this interaction. It would be a great boon if Nutton, who is more qualified than anyone, favored us with a full-length study on the treatment of Galen by the three monotheisms, a monograph that would be a logical complement to the dual legacy of the venerable Owsei Temkin in Galenism: Rise and Decline of a Medical Philosophy (Ithaca, 1973) and Hippocrates in a World of Pagans and Christians (Baltimore, 1991). The other bridgehead of Religion and Medicine is built by Ziegler (pp. 201-242) on a methodical comparison of theological commentaries, written between the mid-thirteenth and early-sixteenth century, on the proposition that Adam was immortal before the Fall. The collation illuminates the permeation of medical doctrine into religious thought, which included not only the application of complexional theories but also the introduction of natural explanations. As a subtle nuance, it seems that Franciscan commentators were more comfortable with the trend than the Dominicans. In any event, the sophistication of Ziegler^ñs arguments is underscored by his emphatic warning, worth reiterating, that this surge of natural reasoning cannot and should not be simplistically interpreted as the triumph of reason over superstition (p. 236).
The complexity of the relationship between religion and medicine is further demonstrated by Danielle Jacquart^ñs in-depth look at one mid-fifteenth-century commentary on Avicenna^ñs Canon of Medicine, which was written by Jacques Despars between 1432 and 1453 (pp. 35-45). Jacquart shows succinctly but persuasively that theological doctrines, including those hardened by the Paris condemnations of 1277, induced medical writers to sidestep sensitive aspects of astrology, natural philosophy, and sexology, while also supplying them with arguments for medically unorthodox positions, especially the claim that the physician was able to delay natural death. With an equally sharp focus, Michael McVaugh (pp. 47-67) probes the life of Arnau de Vilanova, whom no one in the world has studied more comprehensively. In the early 1290s Arnau began to assume the dual character of university physician and spiritual reformer, and to compose a dozen tracts of which half represented one career and half the other. His medical outlook was shaped at the university of Montpellier in the 1260s, and his religious concerns sprang from Hebrew studies in Barcelona in the early 1280s, with a teacher, the Dominican friar Ramon Marti, who denounced Galen as a liar, falsiloquus (p. 57). McVaugh finds that Arnau^ñs two orientations existed side by side until at least 1291-92 and that, therefore, it is incorrect to project back their fusion displayed so dramatically in Arnau^ñs clash with Paris theologians in 1300. In Paris at that time, ironically, medical doctors went on to become theologians in greater numbers than anywhere else, although the trend was echoed in Oxford. William Courtenay documents this trend with prosopography, and he seeks to explain it (in the volume^ñs briefest essay, pp. 69-75). He believes that the major cause should be sought in the internal structure (p. 73) of both universities, rather than in the appeal of ecclesiastical benefits or in failed medical careers. Courtenay gives no indication whether clerical orders, ordination to the priesthood, or pastoral ministry may have been factors for moving from medical to theological studies.
Physicians and theologians were ranged on opposite sides by Bernard de Gordon at Montpellier in 1305, when he contrasted their opinions and dismissed popular lore on incubus in the chapter on nightmare of his much cited Lily of Medicine. Maaike van der Lugt traces the antecedents and continuation of this differentiation (pp. 175-200), and in the process she opens several avenues for further inquiry. One issue for continued discourse is the apparent influence of non-medical authors on the natural explanations of dreams by physicians. Also worth pursuing is the link between these authors, most notably twelfth-century transmitters of classical learning such as William of Conches and Alan of Lille, and thirteenth-century masters at the university of Montpellier. The most significant insight conveyed by van der Lugt is that, though the spotlight is usually on the beliefs in demons and witches promoted by some notorious theologians, a continuous thread of rational explanation was maintained by learned physicians.
Far from the academic milieu, unorthodox piety also interacted with medical theory and practice. Peter Biller compares the two best known heretical movements (pp. 155-174), skillfully mining records of interrogations and depositions before inquisitors, rich documentation that sheds light on items ranging from women healers to bloodletting for the sake of chastity. The Waldensians practiced medicine, without accepting money, as part of their beliefs. The Cathars, in contrast, were not interested in healing per se, but they counted medical practitioners among their educated recruits, and the consolamentum brought them to the bedside of dying patients. Inquisitorial proceedings have, in some sense, a counterpart in synodal legislation. The latter affords Kathryn Taglia a re-assessment of the position of midwives (pp. 77-90), a group that is often portrayed as marginal. Taglia argues that, at least for northern France, the ecclesiastical regulation of midwifery was essentially concerned with emergency baptisms and contained no insinuations of witchcraft. Contrary to sweeping assumptions by some recent historians, the Church did not treat midwives as witches, ignorant empirics, or agents of contraception and abortion.
In an equally welcome revision of modern stereotypes about marginal groups, Jessalynn Bird refutes the claim that the segregation of lepers resulted from the exploitation by theologians of medical notions and, above all, of contagiousness. She documents the more constructive uses of medicine in the theology of Jacques de Vitry, who devoted a chapter of his Historia occidentalis to asylums for the poor and lepers, and who preached several sermons to the Hospitallers (pp. 91-108). Bird^ñs -- and de Vitry^ñs -- focus is on the charitable character of hospitals, but the reader should check the supporting texts (pp. 109-134) for fascinating details on inherently medical concerns with diet (an important paragraph on p. 131), cleanliness, and safety. Regarding the latter, the preacher warns hospital attendants not to place the straw near the fire, nor the women near the men (p. 133, my translation). De Vitry believed that in some places more people die of fetor and the corruption of the air than from the disease of their own body (p. 119, my translation), and his observations and similes evince a keen olfactory perception of the sickbed. Auditory impressions of hospitals may have been less vivid, but they may have included the soothing sounds of music, as we learn from the volume^ñs most revisionist and offbeat (pun intended) article (pp. 135-153). Rejecting the preoccupation of much hospital history with the increasing academic and professional presence, Peregrine Horden explores the potential role of music in the total therapeutic environment ( p. 139). The essay is refreshing in its speculation, which in some instances could stay closer to the evidence (including a significant excerpt on the infirmary, from the Customary of St Augustine^ñs Abbey in Canterbury, p. 148). Also, it is prone to its own dualism by overstating the contrast between the medicalized world of doctors and therapeutic lay activities, and between scholasticism triumphant and anti-scholastic revisionism (pp. 137-138). Nevertheless, by refuting as Cartesian (p. 139) the dichotomy between secular and sacramental medicine, or between care of the body and ministry of the soul, Horden powerfully underscores the leitmotiv of the entire volume.