Renaissance medicine: a short history of European medicine in the sixteenth century

In his very distinguished career as a medical historian and chronicler of Galen, Vivian Nutton has often been involved in successful collaborative projects to map the course of European medicine, and has written with authority on its history from ancient times to the seventeenth century. The bibliography of this volume refers to no less than forty-nine of his books and articles, many of which address the Renaissance directly, and are based on archival research, comprehensive reading of printed texts of the period, and an impressive range of secondary literature on the subject. Nutton generously acknowledges all his sources, and singles out the work of two predecessors who set out to give broad surveys in his chosen field for students of medical history: Andrew Wear, who produced 154 pages on the period 1500–1700 in The Western Medical Tradition 800 B.C. to A.D. 1800 (1995); and Mary Lindemann, whose Medicine and Society in Early Modern Europe (2nd ed., 2010). Nutton clearly aspires to deal with all the ground covered by them; his aim is ‘to give a broad view of the variegated medical life of the entire sixteenth century for those who may be familiar with some of the great names in literature or art but know almost nothing about the medicine’ (p. 7). In his conclusion, he looks forward to ‘more studies based on local archives, better statistics, and more investigations into the impact of medicine on literature, low as well as high’ (p. 332): all areas that he himself investigates in this book. He provides a good rationale for the termini of the period that he studies (1490 and 1600), and for his geographical spread, and recognizes the over-emphasis of past historians on Italy and France. He redresses this imbalance here with much more material on Germany, England, the Netherlands and Iberia. He also sets out to revise the familiar account of the decline of Galenism by showing its continued vigour as a tradition, in much the same way as Charles Schmitt did for Aristotelianism in the 1970s. He also eschews what the Germans know as ‘Gipfelwanderung’ by restoring the visibility of figures such as Thomas Jordanus, Pieter van Foreest, Lorenz Gryll, Georg Purkircher, Janus Cornarius, and Johannes Lange, many of whom were very well known in their day.

Nutton divides the contents of his book between contexts, people, and beliefs, and begins his account with the discoveries and innovations of the late fifteenth and early sixteenth centuries: the development of the printing press and of postal services throughout Europe, the recovery of ancient medicine, the emergence of new diseases and drugs, and the consequential institutional measures taken to protect the health of cities, which also had to address the recurrent problem of plague. The impact of the massive editions of Galen and Hippocrates as well as other ancient Greek doctors is judiciously charted; one might have expected at this point a paragraph or two more on the survival of mediaeval practical medicine, to accompany the persuasive account of the persistence of Galenic therapeutics. The central section of the book is devoted to the denizens of the medical world. Nutton chooses the metaphor of a ‘kaleidoscope of healing’ to express the variations from place to place and between different classes of healers. He passes in review learned physicians, surgeons, apothecaries, and those of yet lower learning and social status: charlatans, and the women engaged in domestic medicine. Doctors who graduated from the medical faculties of Europe were largely the sons of affluent families, and underwent a very similar training; many had experience of more than one university through the generosity of patrons or city councils, and aspired to lucrative posts as professors and as the personal physicians of magnates or those in high ecclesiastical office. Surgeons outnumbered physicians, and were often specialists in specific procedures; their status in some Italian universities and Montpellier was enhanced by the inclusion of surgical teaching in university courses. They were often regulated by guilds or health boards, as were apothecaries. Below them there was a penumbra of healers of various kinds, some of whom were particularly adept at self-publicity. The greatest number of those engaged in healing was not part of the ‘corporatism of the profession’; many were women practitioners, open to the accusation of sorcery, with specialist knowledge of gynaecology and obstetrics, herbs and cookery. The last category of people involved with medicine that Nutton surveys are patients: he approaches this subject through a moving account of the illnesses of the humanist Erasmus. The last two categories he studies have one thing in common: ‘largely voiceless, frequently invisible and often dismissed as ignorant, both groups still remain among the great unknowns of medical history’ (p. 206).

The last section of the book concerns beliefs under the rubrics of learned medicine, anatomy, Paracelsus and Paracelsianism, and religion and medicine. Nutton writes authoritatively on the impact of the New Galen, on uroscopy and nosology (including that of Fracastoro and Fernel), on plague and putrefaction, and on anatomy, correcting the nineteenth-century’s triumphalist version of Vesalius, and restoring a European-wide perspective on its history. He stresses Paracelsus’s German-ness, and his religious and philanthropic views are given proper emphasis. He chooses however not to delve into the logic of diagnosis and espouses a limited definition of semiotic; these are areas which reveal the forma mentis of learned physicians, and draw detailed commentary from them in their treatises. Together with their views on historia, observation, experience and experiment, this aspect of Renaissance medical learning lends the strongest support to its claim to be an important precursor of the New Science of the seventeenth century. There are rich accounts of the work of Girolamo Mercuriale and van Foreest. The very last chapter of this section addresses the vast topic of the interaction of religion and medicine in the confessional age. As elsewhere in the book, Nutton uses illuminating case histories (those of Simone Simoni and Giovanni Donzellini) to investigate the consequences of the Reformation for the world of medicine, the suspicions of scepticism or worse directed at doctors, and the place of medicine in magical beliefs and Christian thinking. It would have been useful here to have had more on the involvement of doctors in the assessment of preternatural and supernatural events (Antonio Benivieni is discussed; the later case of Jakob Horst comes to mind here).

Nutton’s conclusion addresses the broad issue of change and continuity in a modulated way. This is an enormously rich and well-judged narrative which is given force and interest though the vividly recounted anecdotes and biographical sketches. Given its comprehensiveness, it would be churlish to point to yet other areas (medical ethics, for example, or the interaction of medicine and law) that are not given separate treatment, No-one else could have written a history such as this, which stands as a tribute to its author’s extraordinary linguistic competence, voracious appetite for archives and books, and desire to communicate to his readers the excitement and commitment that he himself has found in a lifetime of productive study in medical history.