Most historians of medicine have come to realize that social context is as important to the practice of medicine and to its teaching as it is to law, political science or any of the other modern scholarly disciplines. The examples of the problems posed by HIV and TB to our society clearly underscore this finding, as does the transformation of many modern anatomy courses to procedures reminiscent of video games.
When Professor Katharine Park proposes to place fifteenth and sixteenth-century academic dissection within the larger list of late medieval opportunities to cut and inspect a dead body, including embalming of royal corpses, autopsies to establish cause of death, and fetal excision, one can only applaud her goal. Having explored various accounts of the autopsy route, I have been waiting for a systematic examination of post-mortem procedures conducted for the purposes of embalming. While understanding the relevance of exploring the examination of the corpses of holy women, on which this book focuses, I nevertheless find the space Professor Park gives to the search for physical relics of Christ in the corporeal hearts of female blessed rather bizarre.
Perhaps the most telling theme in the procedures she examines is the deference, verging on worship, of "authority." Thus the pious "investigators" discovered in their dissections of these holy women what they expected to find, just as other inquirers, schooled in post Galenic anatomy and physiology, disclosed structures that "had to be there". Mysterious "pores in the cardiac septum" were essential to the Galenic physiological doctrine. Thus, generations of early anatomy teachers and students dutifully found and demonstrated these non- existent intraventricular foramina, just as the pious nuns who dissected the heart of Chiara found the cross which she predicted mystically distinguished her heart.
More congenial to this reviewer are the valuable discussions on how the attitudes of important surgeons and physicians such as William of Saliceto, Guaineri and Savanarola gradually changed concerning the treatment of pregnant women. While Saliceto, who apparently was deprived even of direct observation of miscarriages, had to rely on animal dissections, personal reports by women and traditional authoritative works for information, Guaineri created a collaborative relationship with midwives which enabled him to practice alongside them in order to learn, help, and define their "scope of practice."
Giovanni Michele Savonarola, the paternal grandfather of the vituperative Florentine reformer, Girolamo, is less sympathetically portrayed. Academically trained, and having achieved an eminent reputation as a successful practitioner, Michele Savonarola served as court physician to the d'Este court in Ferrara. During that service, he composed in the Ferrarese dialect a small treatise on gynecology, obstetrics and child care which he addressed to the women of Ferrara. Eminent medical historians have contended that this is an unusual and early example of an academician communicating his findings in the vernacular for use by pregnant women and midwives. Professor Park is less convinced, depicting Savonarola as a haughty aristocratic physician who attempted to limit midwives scope of practice and to define pregnancy and childbirth, perhaps for the first time, as "natural" but at the same time an "acute illness."
Discussion of the 1494 Italian Fasciculo illustration of female anatomy covers much social and intellectual ground, unfolding its appeal to a humanist vernacular public, and its attempt to make women's secrets available in principle to all readers--a group that excluded most women. "The Evidence of the Senses," in chapter four contains an analysis of Berengario da Carpi's early efforts at printed representation of female anatomy and properly finds in them an iconography symbolizing the rejection of the authorities in favor of Berengario's very considerable practical experience. The figures depicted with downcast eyes, pointing fingers and books left underfoot seem almost to make the corpse a willing assistant in this effort. The treatment of Berengario and Zerbi is framed by intriguing but somewhat tenuous connections between Berengario and the cult of a noble Bolognese mystic, and married virgin, Elena Duglioli. As a preface, we learn that he was a skeptical member of two of the committees that examined her corpse for miraculous resistance to decay. As an epilogue of a sort, we view a painting of St. Cecilia by Raphael, donated by Elena, that hung in the church where her dissection took place. St. Cecilia, identified with many female mystics, ignores earthly musical instruments and gazes upward at heavenly choirs, rejecting external senses in favor of spiritual experience, as Berengario's female figures reject literary authority in favor of physical experience.
Professor Park deserves credit for attempting, as others have before her, to dismiss the contention that superstition enforced by the Church doctrines created the main obstacle to academic dissection. This notion propounded by nineteenth-century anti-clericalists has been attacked and disproved by historians since the time of Duhem. Similar anti-Catholic attitudes have distorted historical accounts of sixteenth-century practitioners, such as the claim that Amboise Pare was a Huguenot, based mainly on the findings that he dressed as a bourgeois and was sometimes referred to as "religious." Apparently his reputation for honesty, compassion and decency clinched the case. We may hope that such specious reasoning disappears in twenty-first- century texts.
Overall, Professor Park helps us see anatomy in the context of medical practice, and as it relates to non-medical social forces including family structures, legal parameters, devotional practices and religious institutions. She focuses on the double meaning of "Women's Secrets," first as tools to lure, manipulate and undermine decency and male prerogative, and then to indicate the mysterious origin of life and of human society both hidden away in the female body. The discussion of Vesalius' use of both of these attitudes toward women to exalt his own skill and research and signal the ribald and irreverent side of his own personality is original and provocative. The focus on social context is refreshing, if disorienting for traditional medical historians seeking to follow the discussion which flies across the disciplines, and perhaps it is just what is needed to attract younger scholars, especially women, to look again at our sometimes too-arcane discipline.