15.10.46, Turner and Butler, eds., Medicine and Law in the Middle Ages

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Will Rogers

The Medieval Review 15.10.46

Turner, Wendy J., and Sara M. Butler, eds. Medicine and Law in the Middle Ages. Medieval Law and Its Practice, 17. Leiden: Brill, 2014. pp. 391. ISBN: 978-90-04-26906-4 (hardback).

Reviewed by:
Will Rogers
University of Louisiana, Monroe
way2@case.edu

This reviewer was, unfortunately, unaware of the work done by the late Shona Kelly Wray, until reading Wendy J. Turner and Sara M. Butler's Medicine and the Law in the Middle Ages. According to the collection's introduction, Wray suffered an aneurysm and cardiac arrest during a research trip to Italy. Even in death, her absence is felt throughout the collection: Turner and Butler pay homage to her continuing project--an inquiry into medicine and law in Bologna--and grieve that her presence, while everywhere in the collection, is gone. This personal narrative of Wray and her work bridging medicine and law brings into focus the rich collection Turner and Butler have produced.

The continuing development of the medical humanities has produced excellent scholarship in many different fields, but its influence upon studies of medieval history, religion, and literature seems particularly powerful. And surely readers will consider Turner and Butler's edited collection a welcome addition to humanistic inquiry into medicine and, as the title suggests, medicine's relationship to law. Treating their subjects not separately but rather as interdisciplinary areas of inquiry, Turner and Butler, along with the rest of the contributors, highlight the connections between medicine and law across genre, language, and time.

In their introduction, Turner and Butler make clear that their approach is, in many ways, novel, even as it follows the example of Wray's aforementioned work. With a concentration on reading and critiquing these medieval sources of medicine and law together, Turner and Butler, along with their contributors uncover how two bodies of knowledge intersect and interact, shedding light on each other equally. Indeed, "a study of medical practice through the eyes of the law...furnishes a unique opportunity to see medicine in action" (7). Simultaneously, Turner and Butler describe the law as invested in medicine and physicians for their expertise in court cases and legal matters.

The first section of the collection, "Medical Matters in Law and Administration of Law," brings together essays by Han Nijdam, Fiona Harris-Stoertz, Hiram Kümper, Carmel Ferragud, Joanna Carraway Vitiello, and Wendy J. Turner. In "Compensating Body and Honor: The Old Frisian Compensation," Han Nijdam discusses the Lex Frisionum and the Old Frisian Compensation Tariffs, and traces how revenge and honor function not only with respect to the injured body, but also to the body healed by physicians. And in so doing, Nijdam fleshes out how "the compensation tariffs compensated more than just the physical body; they compensated all the lasting effects" (56). By examining the fullness of the body--beyond the physical--Nijdam's essay reflects just how medicine might be used for legal purposes, and how the body could be the location where medicine and law interacted.

Next, in "Midwives in the Middle Ages? Birth Attendants, 600-1300," Fiona Harris-Stoertz examines the dearth of evidence for midwives in the early Middle Ages. Following Monica H. Green's assertion that the evidence and argument for midwives assisting childbirth throughout the Middle Ages has been overemphasized, Harris-Stoertz nonetheless asserts the existence of the concept of the midwife in Latinate culture and literature from 600-1300 (60). The resiliency of their appearance in literary sources may have led to the reappearance of midwives after 1300 even as this continuity nevertheless obscures their actual presence in the historical record. While Harris-Stoertz notes that her reading of evidence is necessarily speculative, she also makes a case for a more nuanced position, noting that that "the idea that midwives re-emerged only in the thirteenth century should be re-considered carefully" (59-60). By looking at a variety of sources, including Robert Mannyng's Handlyng Synne and the Infancy Gospel of Matthew, Harris-Stoertz offers a view of varied positions supporting women in childbirth, and this chapter offers added depth to a complicated question.

Hiram Kümper in "Learned Men and Skilful Matrons: Medical Expertise and the Forensics of Rape in the Middle Ages," discusses rape as it developed in the twelfth century. Kümper sees in the "invention of a conception of rape that puts consent at the heart of the crime" (88), the process by which medical expertise becomes valuable in the prosecution of rape. What becomes clear in Kümper's investigation is not only his careful consideration of written sources but that his emphasis on consent is one which modern readers will recognize. At the same time that he argues for a similar conception of rape and consent, he nonetheless argues carefully for a notion of consent that is historically accurate, according to the records he quotes. And this care is evident elsewhere in his essay, when he discusses the limited use of female practitioners in assessing validity of rape accusations.

This emphasis on medical experts and their activities in legal environments ties together the next essay, "Expert Examination of Wounds in the Criminal Court of Justice in Cocentaina (Kingdom of Valencia) during the Late Middle Ages," where Carmel Ferragud tracks the use of expert medical testimony in the "examination and assessment of wounds" (110). In the midst of a "process of the 'medicalization' of society," Ferragud argues for the increasingly important role of medical practitioners (109). His essay works especially well in this collection, as it offers a truly local case for the growing interaction between law and medicine, one which simultaneously seems to describe events beyond the Kingdom of Valencia. Indeed, what becomes clear in the unfolding of Ferragud's work is not only the advanced state of medical testimony in this smaller border town, but also the suggestion that "the existence of medical practitioners played an important part in encouraging colonists" (132).

The process of evidence gathering, and the influence of medicine on the legal system is again discussed in the next chapter, "Forensic Evidence, Lay Witnesses and Medical Expertise in the Criminal Courts of Medieval Italy." There Joanna Caraway Vitiello discusses "the roles of doctors and laypeople in providing forensic evidence, drawing in part from the records of the criminal court at Reggio Emilia during the late fourteenth century" (135). As with the other essays, Caraway Vitiello's work makes important insights without overstating claims or reading past extant evidence. Discussing in detail the use of consilia or learned opinions, authored by physicians or surgeons, Caraway Vitiello writes that often they "give detailed accounts of the wounds suffered by victims, and often they offer an opinion on whether the injured parties were in danger of death" (142). Although Caraway Vitello describes how these consilia were used by courts and authored by medical professionals, she depicts too the use of lay witnesses, using specific anecdotal and textual evidence.

The final essay in this first section, Wendy J. Turner's "Mental Health as a Foundation for Suit or an Excuse for Theft in Medieval English Legal Disputes," uncovers evidence of the Crown's responsibilities toward those landowners who had become incapacitated, along with tracking how the legal system could be used to cheat and defraud these landowners. While wardship in medieval England is a topic that has seen a fair share of attention, Turner's essay will prove especially helpful to readers and scholars working in medieval disability studies as well as historians of law and medicine. By foregrounding how the legal system could help and hinder the lives of those judged mentally incompetent, Turner certainly adds to the growing body of evidence of the treatment of the disabled or impaired. In fact, her examination sheds some light on how those in positions of power were especially suited not only to help but also to harm the interests of those whom these guardians were obliged to protect. As an ending essay in this first section, this essay also serves to expand implicitly the range of consequences of the growing interactions between law and medicine, as medical assessments of mental infirmity could be used by those with knowledge of the law to gain personal profit.

The organization of this collection was obviously well planned, as this seeming indictment of the twisting of the legal system using medical knowledge introduces the next section, "Professionalization and the Regulation of Medicine," which contains chapters by Kira Robison, Iona McCleery, Jean Dangler, and Sara M. Butler. Robison's essay, "Making Right Practice? Regulating Surgery and Medicine in Fourteenth- and Fifteenth-Century Bologna," teases out some important connections in the construction of regulation within and without medical professionals in medieval Bologna. Her description of the medical faculty at Bologna, along with the promotion of academic privilege in the regulation of these professionals is especially clear. This chapter's focus on education and regulation of surgeons and physicians will prove especially useful for those interested in the history of medicine, and this chapter's inclusion of political and legal supports for these hierarchies will appeal equally to legal historians.

“Medical Licensing in Late Medieval Portugal," the next essay, is clearly related to Robison's investigation of medical hierarchies in Bologna. Indeed, like Robison's essay, McCleery's evaluation of the licensing systems of late medieval Portugal gives voice to the specific conditions of the pressures exerted on the practice of medicine from legal and political authorities. Most useful, however, for this reviewer will surely be McCleery's discussion of "a biopolitical awareness" (212) and the "means of marshaling healthy bodies in the interests of the state" (213). Licensing, according to McCleery, can be understand, not simply as a manner of regulation, but as a larger part of an ongoing project of centralization. Finally, McCleery's essay offers these insights while presenting several avenues for future study, highlighting one of the strengths of this collection.

Next, Dangler discusses Jaume Roig's Espill, a text that, according to her, is deeply invested in social control, advancing "misogynistic and misogamist" aims (220). Dangler locates Espill within a framework of increasing professionalization of medical figures, and reads various episodes of the text as reflective of larger developments in fifteenth century Valencia. Dangler traces examples of legal terminology within the text, and, in an early part of the chapter ties Roig's treatment of marriage in an early episode of the Espill to Roig's marriage of medical and legal terminologies. And this focus on textual details and their reflection of larger issues concerning medicine and law in Valencia is central to Dangler's examination. In her examination of the episode of Solomon's narration in a dream vision, Dangler argues "the dream-sermon moulds and disciplines men" (235), echoing her early assessment of the text as both pedagogical and responsive to various developments in the professionalization of medicine.

What the preceding three chapters make clear--that professionalization of various figures practicing medicine often pitted surgeons against physicians, and that different forms of training might be viewed with more or less prestige--finds articulation too in the final essay of this section, "Portrait of a Surgeon in Fifteenth-Century England." There, Sara M. Butler describes what she calls the surgeons' "campaign for respectability" (247), a campaign that she admits met with some success. Unlike physicians, surgeons were somewhat cut off from academic prestige, with universities more likely to teach theoretical rather than hands-on knowledge. Nevertheless, Butler finds in the extended description of Nicholas Wodehill, a surgeon, evidence of several options for increasing the status of surgeons in late medieval England.

The final section of the collection moves in a somewhat unexpected direction, a consequence perhaps of the collection's genesis at a conference. With essays by Donna Trembinski and Máire Johnson, the third section, "Medicine and the Law in Hagiography," nevertheless brings together many threads that previous essays in the collection treat. Donna Trembinski's "An Infirm Man: Reading Francis of Assisi's Retirement in the Context of Canon Law," like Turner's article before, makes a compelling argument not only in terms of medicine and its relationship to law but also in terms of disability studies. Noting that "even scholars who work on the history of disability have thus far avoided discussing the implications of Francis's infirmities for his life and mission" (269), Trembinski reassesses Francis's impairments within what is known of his life and activities, including founding his own order. Comparing various depictions of the saint's life, Trembinski locates and explains Francis's impairments as rationale for his retirement from leadership, allowing even that regulatory practices might have forced his brothers to encourage that retirement.

In the other essay in this section, "Medicine and Miracle: Law Enforcement in the Lives of Irish Saints," Máire Johnson interprets hagiographical texts and the saints they describe in terms of their fidelity to Irish law. "One of the many expressions of the interactions between hagiographical saint and historical Irish law can be found at the nexus provided by medicine" (289). Indeed, the activities of the saints, as Johnson demonstrates in this chapter, uphold Irish law and define the contours of sainthood, often doing both in the context of medical miracles.

The collection concludes with a set of remarks by Katherine D. Wilson, and this section and its inclusion offer the reader an opportunity to make connections not only between medicine and law but also among the twelve essays and their different methodologies and subjects. The distinction between theory and practice raised by several essays in the collection, especially those discussing the prestige of medical education or licensure, serves, according to Wilson, as one of the more significant contributions the collection makes. And, indeed, for this reviewer, reading Wilson's concluding remarks makes clear how this collection raises as many questions as it answers, which is particularly appealing. Indeed, although scholars might wish for essays on subjects not covered, it is fitting that such a scholarly endeavor would need to strike a balance between comprehensiveness and coverage. So while this collection contains essays that are focused--almost surgical in their specific interventions--it also makes an effort to include a range of topics, covering almost ten centuries of material and most of Western Europe in twelve well-constructed chapters. Although it is ambitious, the collection responds with clarity and concision to the texts under discussion.

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