The Medieval Review 16.09.21

Jacquart, Danielle. Recherches médiévales sur la nature humaine: Essais sur la réflexion médicale (XIIe-XVe s.). Micrologus' Library, 63. Firenze: Sismel, 2014. pp. xii, 477. €85.00 (hardback). ISBN: 978-88-8450-578-1 (paperback).

Reviewed by:

Donna Trembinski
St. Francis Xavier University

For those who study medicine, the name of Danielle Jacquart will already be very well known. In her many books and articles, Jacquart's work has sought to demonstrate the threads of Arabic thought in Western academic medicine and how interconnected the study of medicine was to other medieval disciplines such as natural philosophy and theology. The present volume, Recherches médiévales sur la nature humaine: Essais sur la réflexion médicale (XIIe-XVe s.), continues in this vein, drawing together sixteen previously published articles, along with two new essays. The previously published essays are ordered chronologically--with a couple of exceptions--ranging from the earliest "La morphologie du corps feminine selon les médecins de la fin du Moyen Age" published in Micrologus I in 1993 and ending with an essay that discusses how William of Conches used commonly held medical theories, always in service to understanding that man was created by God, in his philosophical works ("Les emprunts de Guillaume de Conches aux théories médicales," 319-353). This last piece was previously published in 2014, the same year as the current volume. The two new essays are placed at the end of the volume.

In spite of the chronological organization of this collection of essays, there are methodologies, themes, and topics that can help to combine the disparate essays into a more clear, if not perfectly coherent, whole. The works of three late medieval authors Peter of Abano (d. 1316), Jacques Despars (d. 1458), and Michel Savonarole (d. 1468), are perhaps the most explored in these essays, though Jacquart's knowledge of many other medieval physicians' work--both Latin and Arabic--is also brought to bear on her subjects. Jacquart's work is also largely situated in the realm of medieval academic theoretical medicine, though she is also sensitive to the ways in which academic medicine interacts with practical hands-on diagnosis and treatment.

One of the themes that Jacquart's collection of essays explores is the practice of medicine itself--four of the chapters explore the differences between empirical observation and hands-on medicine and theoretical medicine. In "L'observation dans les sciences del la nature au Moyen Age" (45-67), Jacquart notes that medieval scholars of astronomy and medicine "recognized the difficulty of obtaining a trustworthy observation" with the naked eye (46). Judgments can be flawed and certain properties of a given substance may be hidden. As a result, some medieval scientists began to use new technologies that aided observations. Jacquart points to the work of Thierry of Freiberg's observation of rainbows with a beryl stone and Peter of Maricourt's exploration of magnetic polarization with the help of a compass as evidence of scientists incorporating new tools and techniques to aid in their observations.

Another chapter "De la faillibilité de l'art medical aux erreurs de practicien au début du XIVe siècle" (277-296) also deals with potential fallibility--this time of medical diagnosis. Of course, misdiagnosis was conceived as possible in the Middle Ages--misleading signs could and did lead practitioners astray and they rightly feared gaining a reputation for misdiagnosis. Various strategies were developed for reducing the chances of misdiagnosis though--reviewing past literature, consulting the stars, consulting with a colleague--though some were reluctant to do this for a variety of reasons.

In "En feuilletent la Practica maior de Michel Savonarole: Quelques échos d'une practique" (251-275), Jacquart explores the ways the work suggests that the Italian physician actually put his medical knowledge into practice. Indeed, Jacquart argues that Savonarole's knowledge was not only "livresque" (259) and that on occasion his suggested methods of dealing with medical issues were entirely practical. Certainly, she writes, he as "less reticent than other doctors" to resort to surgery (260). He also demonstrates a willingness to use narcotics, especially opium in his practice. Surprisingly in the religious context of the High Middle Ages, Savonarole's work shows clearly that he preferred to alleviate the pain of his patients even though it was commonplace to suggest that suffering was a way to atone for one's sins. As Jacquart's comments at the end of the essay suggest, Savonarole's Practica maior allows its readers a glimpse into how late medieval physicians may have actually operated at the end of the Middle Ages.

A final essay related to this theme explores the genre of "secrets" in medieval medicine. The genre began, Jacquart suggests, as a way to signify a work that derived from practical application without reference to authorities. Physicians were advised to keep such works hidden lest they fall into the hands of the ignorant. Yet, by the end of the Middle Ages, Jacquart argues, though the genre of secret writing in medical literature was still popular, it no longer contained references to the idea that the text need be hidden. This perhaps reflects a growing trust in experimentation and even fallible observation.

Another theme that emerges from only a couple of Jacquart's essays is the development and use of medical treatises at various courts. In the first essay of the book, Jacquart explores the Liber phisionomie of Michael Scot ("La physiognomonie à l'époque de Frédéric II", 3-21), which was dedicated to the Emperor Frederick II. The book's most original parts deal with reproduction and would have been of particular interest to Frederick who was about to marry Isabella of England and wished to ensure strong and suitable offspring. Also dealing with pregnancy and moving on to the care of infants after they were born, "Naissance d'une pédiatrie en milieu de cour" (195-219), explores how a group of physicians operating in the courts of France and Burgundy in the fifteenth and sixteenth centuries began to develop a series of texts aimed at the care of children--perhaps contributing to the birth of pediatrics, as the title of the essay suggests.

Two other essays are close manuscript studies that reveal new evidence about the work of Jacques Despars and Peter of Abano. "Où il est à nouveau question de Jacques Despars" (221-249) examines the marginalia found in BN Lat. 6915 and argues that Ernest Wickersheimer was incorrect to date the manuscript to before 1432. Wickersheimer dated the manuscript in part based on the fact that a list of commentators on Avicenna's Canon given on folio 43v of the manuscript did not include that of Jacque Despars as one might expect--that Despars influence on the manuscript was nowhere in evidence. However, Jacquart's careful reading of the manuscript's marginalia demonstrates that it has much in common with Despars' commentary on the Canon. Indeed, she speculates that the marginalia could be a copy of Despars' original notes, written in preparation for his commentary.

A second close exploration of a manuscript, this time BN Lat. 16089, results in Jacquart's exploration of the oldest known transcription of Peter of Abano's Compilatio phisionomiae. Based on her study, she argues that Peter's conclusions and beliefs remain remarkably similar between this earlier text and his later work the Conciliator differentiarum, quæ inter philosophos et medicos versantur, though he does move away from the controversial idea that a person's complexion is the substance of the body in the latter work.

Finally, Recherches médiévales sur la nature humaine includes several essays that explore the positions of medieval physicians on particular debates of the time including questions about women's bodies, the senses, skin, sensation and sexual pleasure. "La morphologie du corps féminin selon les médecins de la fin du Moyen Âge" (25-44), argues that while many early and high medieval physicians regarded women's bodies as the inverse of male bodies, late medieval medical text began to move away from this assertion. Unlike men, for instance, women were believed not to have the beauty of symmetry--a reality that was demonstrated by anatomical explorations of differences between men and women's skeletons and skulls. In "Médicine et morale" (69-84), Jacquart argues that Everard of Conty's commentary on Aristotle's Problemata created a dichotomy between the senses--between seeing, listening and smelling by which what is agreeable can be justified according to reason and taste and touch, which are felt more personally. In "Coeur ou Cerveau" (85-108), Jacquart argues that Turisanus proposed a solution to the medico-philosophical debate about which organ was the most vital to human life, the heart or the brain. Taking into account theological and philosophical debates about what animated life, Turisanus concluded that while the heart provided heat which diffused the spiritus and so animated the body, and the brain was the locus of some control over sense and motion, it was the soul itself that regulated the intensity of heat and amount of spiritus in a body. "À la recherche de la peau" (161-179) explores different aspects of how skin was understood in the later Middle Ages, in terms of humors, sense, disease and physiology. Finally, "Au nom de la nature" (297-318), demonstrates that in contrast to Avicenna and many Latin medical theorists, Mondino de' Liuzzi argued that women needed to take pleasure in sexual relations to conceive. Mondino is unusual in other respects too--he suggests that although it is a sin to try to prevent conception it is less of a sin than abortion. As Jacquart's work suggests, even Mondino's position on abortion is ambiguous.

The final two previously unpublished essays also explore how particular authors engage with some of the important philosophical and medical debates of their time. The first is a long discourse on how Peter of Abano understood the concept of complexion ("La complexion selon Pietro d'Abano," 373-416). In this essay Jacquart demonstrates that Peter skirted away from heresy by concluding that complexion was not the substance of the body but was the substance of a person's temperament. Peter appears to situate his understanding of complexion not in philosophy or medicine and not in the human understanding of the natural or spiritual worlds, but between both. The last essay, "Le movement volontaire selon Jacques Despars" (417-456) explores the work of Despars on voluntary motion. Jacquart argues that while he adopts the Aristotelian position that the soul is the form of the body, and thus the locus of voluntary corporeal movement, he also argues that the brain is the first driver of the rational soul for movement--a neat compromise, Jacquart suggests, between what Despars thinks to be true and the demands of religious orthodoxy.

Of course, the intersectionality of medieval medical theory with other sciences, natural philosophy and even alchemy weaves its way throughout nearly all of the essays in this text. It is, however, particularly highlighted in two essays. "Calculs et Pierres" (109-142) explores Angelo of Aquila's knowledge of alchemy influenced his discussion of treating kidney stones. The alchemical allusions throughout his untitled text also allowed extended wordplay which no doubt entertained his readers. It is, however, an open question whether Angelo intended to seriously suggest that kidney stones might be a kind of philosopher's stone. Moving from alchemy to astronomy, "Le soleil, la lune et les états du corps humain" (143-160), explores how various medieval medical texts integrated astronomy into their perception of the qualities and humors of a person. Although most medieval texts invoked astronomy only superficially, Jacquart points to Peter of Abano as trying to "attempt the impossible and create a close agreement between Galenic inspired medicine, Ptolomean astronomy and the rules of Arab astrology" (149). However, he ultimately failed in that task as there was too much incompatibility between medicine and astrology and he was forced to privilege one over the other.

As always, Jacquart's work in these essays is rigorous and thorough. The book is peppered with transcriptions of her many manuscript sources. Jacquart's manuscript work, combined with her knowledge of the intersectional nature of medieval medicine, her handle on the major threads of premodern medical discourse, and her clear understanding of the influence of earlier Greek and medieval Arab on medieval medical texts make her work invaluable to those who study medieval medicine. Having these recently published essays together in one text makes her work even more easily accessible. This volume will prove invaluable to those studying theories of medicine and natural philosophy in the later Middle Ages and will also be useful to those studying the history of science more generally.

Copyright (c) 2016 Donna Trembinski

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