Barbara S Bowers (ed.), The medieval hospital and medical practice, AVISTA Studies in the History of Medieval Technology, Science and Art, vol. 3, Aldershot, Ashgate, 2007, pp. xiv, 258, £55.00, $99.95 (hardback 978-0-7546-5110-9).

Abstract

Medieval medical history has emerged over the last three decades as a flourishing discipline, notable for its broad approach and the wide range of sources used by those who study it. After years of neglect, and not a little academic condescension, the long period between Galen and Vesalius has been subject to sustained scrutiny and radical reassessment, as the fifteen essays presented in this volume testify. They were first given as papers at the thirty-sixth International Congress on Medieval Studies at Kalamazoo, Michigan, in 2001, and are here grouped into four sections devoted to research methods, physical evidence, the reinterpretation of documentary sources and monastic connections. Inevitably, in a collection of this size and provenance, the quality of individual contributions varies considerably, although most reflect the lively, original and often revisionist nature of recent scholarship. Lynn Courtenay's splendid account of the hospital of Notre Dame des Fontenilles at Tonnerre uses topographical, architectural and archival sources to explore the symbiotic relationship between healing and religion. The creation of a pious and affluent female patron in search of salvation, this remarkable hospital offers a striking example of the practice of “medicine without doctors” examined by Peregrine Horden. As he explains, in a stimulating reassessment of the nature of medieval therapeutics, an anachronistic preoccupation with twentieth-century concepts of “medicalization” has led historians both to misunderstand and to denigrate the type of treatment on offer in such places. Paramount among the pragmatic concerns of founders was a desire to eliminate the noxious effects of miasmatic air, although, as Renzo Baldasso shows, few, if any, achieved the sophisticated marriage between architectural design and medical theory apparent at the fifteenth-century Ospedale Maggiore, Milan. Turning to the spiritual environment, James Brodman examines the disciplinary measures increasingly employed in thirteenth-century French hospitals. He provides a workmanlike account of the documentary evidence, but does not explore the wider context of the regimen sanitatis and its preoccupation with moral as well as physical contagion. Monastic customaries on bloodletting and the care of the sick receive similar treatment from M K K Yearl, who draws some interesting conclusions about differences in practice, but ignores the close connection between venesection and the need for celibacy in the cloister. Once regarded as a sterile amalgam of “ignorance” and “superstition”, Anglo-Saxon medicine emerges from these pages as inventive, pragmatic and effective. Both Anne Van Arsdall and John Riddle argue persuasively for a reassessment of the botanical knowledge of early medieval herbalists, while Maria D'Aronco provides further support for the argument that the celebrated St Gall map, with its impressive infirmary complex, may well have been designed for English use. The surviving manuals compiled by Byzantine hospital physicians present historians with another valuable source for this process of re-evaluation, which Alain Touwaide describes in a meticulously researched paper. Approaches to the study of leprosy in medieval Europe have already been transformed, in part through the adoption of a new interdisciplinary research agenda, comprehensively described by Bruno Tabuteau, whose only serious omission from an otherwise exemplary survey is the important work on medical texts by Luke Demaitre. Archival studies have certainly played their part in advancing our knowledge of the disease, as Rafael Hyacinthe reveals in a perceptive chapter on the Order of St Lazarus. With a number of excellent essays to recommend it, and two useful contributions on sources from the archaeologists, William White and Geoff Egan, this collection constitutes a welcome addition to the growing body of publications on medieval medical history. Such a chronologically and thematically wide selection of papers could, however, have made a greater impact as a showcase for new research and methodologies had it been accompanied by an introduction outlining major developments in the field and providing a general overview of the volume's structure and purpose. There is also a general lack of consistency and cross referencing between papers which tighter editing would have addressed. Even so, Barbara Bowers deserves our thanks for bringing these papers together.