Medicine and Society in Early Modem Europe - Review

Journal of Social History, Fall, 2001 by Alison Klairmont Lingo

Medicine and Society in Early Modem Europe. By Mary Lindemann (Cambridge: Cambridge University Press. 1999. 249 pp. $18.95/paper).

Lindemann provides the student and scholar with a "revisionist" overview of the history of early modern medicine. She bases her study on the "new history of medicine," but is as critical of some of its conclusions as she is of the traditional history of medicine which preceded it. By describing the medical landscape through the changing lens of historiographical fashion she provides the reader with a critical understanding of the state of the field. Traditional medical history focuses on the "progress" of science and medicine; its impact on health and society; and the great physicians and scientists whose novel ideas and discoveries brought about the "triumph" of medical science. The new history of medicine problematizes the progress and chronology of science and medicine and the importance and far sightedness of individual scientists and physicians. In place of this triumphal history, revisionist scholars attempt to uncover the shared medical beliefs and practices of healers and sufferers from an anthropolog ical and sociological perspective. In addition, such scholars examine the changing roles and functions of various sorts of medical institutions, the nature of and changes in formal medical training as well as the evolution of the patient-healer relationship. This perspective allows for the discussion of advances made in medical knowledge and medical interventions but does not see such advances as having proceeded in a linear or absolute fashion.

In her first chapter "Sickness and Health," Lindemann describes the inter-penetration of naturalistic and supernatural approaches to disease in the early modern era. According to the reigning Hippocratic-Galenic discourse, the environment as well as an individual's "humors" helped to create a state of healthy equilibrium or unhealthy disequilibrium. In addition, certain notions related to ideas of pollution or immorality were seen as possible causes of disease, as in the case of leprosy. While traditional historians of medicine claimed that only laypeople held such "superstitious" notions, in fact, healers and sufferers shared a similar, if not identical, set of assumptions about the body, health, and healing. Moreover, such beliefs cut across social, economic, and cultural differences. Most people attempted to cure their illnesses with or without the help of healers and dealt with mental problems in ways which reveal a coherent set of beliefs and practices. In regard to mental health, in particular, Lindeman n faults Foucault and his followers for imposing a strict and inaccurate chronology on the history of mental institutions and for implying that early modem people saw mental illness as less disturbing or problematic than we do.

The second chapter "Epidemics and Infectious Diseases" focuses on the nature and impact of epidemic diseases, such as plague and smallpox and infectious diseases, such as syphilis, tuberculosis, and influenza. Noting that it is quite difficult to determine the exact nature of plague, Lindemann argues that it is equally problematic to disentangle "the effects of plague from other factors that made the 1300s so disastrous." She reminds us that the "century was a period of endemic warfare, famine, and declining populations even before the plague hit." (43) Moreover, influenza and tuberculosis had as serious demographic consequences as plague and smallpox. All of these diseases provide ample proof of a constant battle against disease, from more ordinary skin ailments, eye infections, and circulatory impairments to the more dramatic problems such as plague, smallpox, and influenza. While historians have tended to focus on the latter because they have left a large body of evidence, most people struggled daily with the former, more ordinary problems.

In the third chapter on "Learned Medicine," Lindemann discusses the pioneers of modern medicine and science, such as William Harvey, Paracelsus, and Sir Isaac Newton. She views them as no more prescient regarding the "rise of scientific ways of thinking" than anyone else of their era. They disagreed with each other and diverged from our notions of "doing science." When William Harvey spoke of pulmonary circulation, "he argued that: 'When ... Nature wished the blood to be filtered through lungs, she was forced to make the extra provision of a right ventricle.' Harvey saw the body much as Galenists did, as a vessel filled with vital forces." (74) While Paracelsus' ideas challenged the Galenic system by teaching that diseases were specific entities rather than an imbalance of humors specific to each individual, his overall conceptualization of disease was no more modem than any Galenist's. He believed occult forces permeated the world; employed the notions of microcosm/macrocosm to explain physical phenomena; an d believed that the stars influenced human behavior. Thus, Lindemann indirectly challenges Butterfield's notion that there was a scientific revolution that "reduces the Renaissance and Reformation to the rank of mere episodes.... changed the character of men's habitual mental operations ... while transforming the whole diagram of the physical universe." [1] She accepts Steven Shapin's more neutral assessment of the period as being characterized by " 'a diverse array of cultural practices aimed at understanding, explaining and controlling the natural world, each with different characteristics and each experiencing different modes of change'." (77-79)