received: 2008-02-10	UDC 614.2:398.1"15/17"
original scientific article
PHYSICIANS AND THE REFORM OF POPULAR CULTURE IN EARLY MODERN EUROPE
William EAMON
New Mexico State University, Department of History, US-NM 88003 Las Cruces, Box 30001 MSC 3H
e-mail: weamon@nmsu.edu
ABSTRACT
The ancient rivalry between the learned physician and the unofficial, popular healer seems to have broken out with particular vindictiveness during the early modern period. Emboldened by a rapidly changing and increasingly competitive medical marketplace, charlatans and popular healers challenged traditional medicine in printed tracts and in public performances in the piazzas and market-places. The university-trained physicians responded to the challenge with a barrage of attacks on "popular errors". The "errors of the people" in medicine became emblematic of the credulity and backwardness of popular culture in general. This paper focuses "upon physicians" writings on "popular errors" written between the mid-1$h century and the early 18th century and analyzes the cultural codes and stereotypes about popular culture that emerged from these writings.
Key words: physicians, reform, charlatans, popular culture, medical marketplace
I MEDICI E LA RIFORMA DELLA CULTURA POPOLARE AGLI ALBORI DELL'EUROPA MODERNA
SINTESI
Nel periodo iniziale dell'etá moderna, l'antica rivalitá tra i medici dotti e i guaritori popolari, non ufficiali, sembra essere scoppiata con malevolenza particolare. Incoraggiati da un mercato medico che cambiava rapidamente e diventava sempre piu competitivo, i ciarlatani e i guaritori popolari sfidarono la medicina tra-dizionale servendosi di opuscoli stampati ed esibizioni pubbliche nelle piazze citta-dine e nei mercati. I medici con istruzione universitaria risposero alla sfida con una serie di attacchi volti a stigmatizzare i cosiddetti "erroripopolari". Gli "errori della gente" in medicina divennero emblematici della credulitá ed arretratezza della cultura popolare in genere. Il presente contributo mette a fuoco gli scritti dedicati dai
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medici agli "erroripopolari", ra la metà del Cinquecento e gli inizi del Settecento, analizzando i codici culturali e gli stereotipi relativi alla cultura popolare che emerge da tali documenti.
Parole chiave: medici, riforma, ciarlatani, cultura popolare, mercato medico
In 1580, the French physician André du Breil, a professor at the University of Paris, warned the king, Henri III, that "empirics" were "ruin[ing] your republic" (Lingo, 1986, 583). In France, as elsewhere in Europe, physicians were sounding the clarion call to rid the medical world of irregular healers. Seven years before du Breil uttered his warning, the university physicians at Montpellier began a legal campaign to "exterminate all empirics from this city" (Lingo, 1986, 583). French physicians were still ringing the alarm thirty years later, when Thomas Corval de Sonnet, a physician and poet from Rouen, pleaded with "all those who go by the honorable title docteur [...] [to] pick up the arms of your pen and to combat and vanquish that pernicious and diabolical sect" of irregular healers (Lingo, 1986, 583).
And so they did. As these nervous warnings suggest, the ancient rivalry between learned physicians and popular healers broke out with particular vehemence during the early modern period. Emboldened by an increasingly competitive medical marketplace, popular healers challenged traditional medicine in printed tracts and in public performances in the piazzas and market-places. The university-trained physicians responded to the challenge with a barrage of attacks on "popular errors" in medicine. The "errors of the people" in medicine became emblematic of the credulity and backwardness of popular culture in general.
The barrage of writings by early modern physicians addressing the errors of popular culture - amounting to an entire genre, in fact - confronts us with body of work with unique opportunities to understand interpreters of culture in early modern Europe. As I shall suggest in what follows, the authors of the books of medical errors did not confine themselves solely to the errors that people committed in matters of health, but mounted a wholesale attack upon popular culture in general, and upon the mental capacities and moral character of the people.
The Renaissance books on popular medical errors had no medieval precedent. To be sure, medieval physicians like Guy de Chuliac chastised people who cured by charms and condemned women healers, and this essentially anti-feminist attitude continued (Brockliss, Jones, 1997, 266); but there does not seem to be a medieval precedent for books that catalogued popular errors in medicine. The manuscript tradition was, on the other hand, amply supplied with popular regimens for health and books of medical secrets that were passed into print under titles like Treasury for the Poor or The Secrets ofWomen attributed to Albertus Magnus. New vernacular works
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collecting medical recipes did not restrict themselves to the secrets of the established authorities. Indeed, the period's most popular book of secrets, The Secrets of Alessio Piemontese alleged that its remedies had been collected not only from learned men but also from "poor women, artisans, and peasants" (Eamon, 1994).
Here, then, was part of the error: too many people presumed to act as their own physicians. Printed books of medical secrets supplied the credulous public with a host of supposedly "miraculous" cures for everything from scab and itch to syphilis. People everywhere endangered their health by following the medical proverbs that circulated in the countryside. At any rate, that is how it seemed to the doctors, who were also convinced that the most dangerous proverb of all was: "every man his own physician."
The "popular medical errors" literature was originated by Laurent Joubert, the Chancellor of the Faculty of Medicine at Montpellier (Davis, 1975, 258). In 1578, Joubert published the first volume of a projected series of works on popular errors, titled The Errors ofthe People in Medicine (Joubert, 1989). An urgency bordering on missionary zeal pervades the work. In Joubert's judgment, popular culture was shot through with error, ignorance, and superstition. Even when the people did get something right from a medical point of view - in one of their proverbs, for instance - it was always for the wrong reasons. They used bad logic and failed to understand rational causes. They dosed themselves with whatever remedies some midwife, empiric, or cunning woman recommended, so that in the end, "their poor bodies are altered and mixed up by a chaos of remedies, and their minds tossed about by hope and despair" (Joubert, 1989, 123).
The main problem, Joubert concluded, was that "everybody makes medicine his business." There were just too many "meddlers" who tried to "cut in on a portion of the profession" with their quack remedies and panaceas (Joubert, 1989, 69). Joubert reserved special contempt for midwives, who made extravagant but foolish claims for "secrets" that they alone supposedly knew: "What disgusts me is how these women share among themselves a few small remedies, which, after all, are not even of their own invention but were taken at some time or other from physicians and later passed around among themselves. For women have never invented a single remedy; they all come from our domain or from that of our predecessors. They are very ignorant to think we do not know about these remedies and to think they know more about them than we do" (Joubert, 1989, 173).
As Joubert's diatribe suggests, women healers and midwives were symbolic of the ignorant intruder into the domain of official medicine. The hierarchy of medicine demanded that midwives, surgeons, and barbers be instructed and overseen by physicians. "It is most fitting that [the physician] be present everywhere," wrote Joubert, "in case some complication arises. For all illnesses are within his knowledge and under his jurisdiction." This sweeping, imperialistic expansion of the domain of the physician was unprecedented and a sign of things to come. By the mid-eighteenth
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century, for example, doctors had expanded their medical practices into the domain of assisting normal births, a task previously the exclusive sphere of women midwives (Petrelli, 1971). The rise of the "man midwife" was a logical extension of the critique of women's errors in medicine (Wilson, 1995).
Joubert's work had considerable impact within the learned community. It went through numerous French editions, was translated into Latin and Italian, and was widely imitated. The term "vulgar errors" came into widespread use among intellectuals. At the beginning of his treatise, Joubert invited physicians throughout Europe to send to him instances of false proverbs and popular errors that they may have encountered, so that he might add them to his catalogue. His aim was to build an authoritative, international lexicon of popular misconceptions in medicine: thus would physicians declare total war on "superstitions" (Joubert, 1989, 25).
Fig. 1: Charlatan's Chapbook "Imaravigliosi et occultisecretinaturali" (Courtesy of the Department of Special Collections, University of Wisconsin Library). Sl. 1: Šarlatanov zvezek "I maravigliosi et occulti secreti naturali" (Oddelek za posebne zbirke, Knjižnica Univerze v Wisconsinu).
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Fig. 2: Charlatan s Chapbook "Fontana dove n 'esce fuori acque di Secreti" (Courtesy of the Department of Special Collections, University of Wisconsin Library). Sl. 2: Šarlatanov zvezek "Fontana dove n 'esce fuori acque di Secreti" (Oddelek za posebne zbirke, Knjižnica Univerze v Wisconsinu).
One physician who avidly took up Joubert's challenge was the Roman doctor Scipione Mercurio, who opened up the Italian front in the war against popular errors with his influential De gli errori popolari d'ltalia (1603). If Joubert thought that the French were susceptible to errors, Mercurio went to great lengths to convince readers that the Italians were more ignorant by far. Their errors, he wrote, "both in number and quality, [are] far greater than those of the French." If it was going to be a contest to determine who was the most ignorant, Mercurio was out to prove that the Italians were victorious (Mercurio, 1645, 3).
Mercurio reserved special venom for the "errors committed in the piazza" by the ciarlatani, who, he said, endangered the public with their ridiculous and sometimes poisonous drugs. Mercurio was referring to the itinerant remedy vendors who moved about from city to city and set up portable stages, where they performed comedy routines in order to attract the crowds to whom they sold their remedies (Eamon, 1994;
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Katritsky, 2001). The ciarlatani showed up in every Italian city of any size, and the crowds they drew made it seem that they were clear threats to the medical establishment (Gentilcore, 2006). How could people be so foolish, Mercurio wondered, as to credit such remedies as those "made of useless junk and sold in the piazza to the imprudent public, authorized by the presence of a vagabond dressed in velvet and wearing a gold tricorne, approved by a clown, registered by the doctrine of Dr. Graziano, proved by an unbridled whore, sealed by Burattino's jokes, confirmed by a thousand false testimonies, and accompanied by as many lies?" Besides being vagabonds, wrote Mercurio, the ciarlatani have no understanding whatsoever of the causes of diseases. They seemed to imagine that practically all ailments are caused by worms, which they claim their potions will quickly eradicate. In reality, Mercurio insisted, diseases have complex causes relating to subtle humoral imbalances, which only the physician can comprehend. "Since a medication cannot take into account all these things unless it is composed by a very learned physician," he pronounced, "the ciarlatani, who are very ignorant, cannot compose them safely" (Mercurio, 1645, 265-268).
That there was an economic issue at stake in the moral crusade against popular errors is easy to see. The nostrums vended in the open marketplace competed directly with conventional remedies and cut into the physicians' monopoly over the medical marketplace. Yet these narrow economic interests merely echo a broader and more important concern about the city as a moral and economic environment. The real issue, it seems, was fraud: whether you could trust those with whom you dealt on the piazza every day. Mercurio was obsessed with the problem, and catalogued dozens of charlatans' deceits. He reported, for example, that the ciarlatani made a powder for intestinal worms out of ground coral, which they bought for a lira and sold for more than twenty (Mercurio, 1645, 267). It was not just the credulous common people who fell for such tricks. The English physician James Primrose reported in his book, Popular Errors (1651), that he knew a gentleman who paid twenty pounds for a supposed "secret" that he could have bought from an apothecary for a fraction of that amount (Primrose, 1651, 18). The physicians' concerns about the trustworthiness of charlatans and itinerant healers reflected more general anxieties about a market in which trading in unfamiliar goods from distant places became a daily occurrence (Park, 2001; Eamon, 2007).
In other words, from the physicians' point of view, charlatans were outsiders, and as such were grouped with a host of threatening 'others': vagabonds, exiles, atheists, actors, gamblers, prostitutes, Gypsies, and beggars. In the critique of irregular healers, the net was cast wide: the range of those who were tarred with the label of charlatan included not only irregular healers who peddled their wares on the streets, but midwives, Paracelsians, and even surgeons and apothecaries if they got out of line or failed to submit to the local health authorities. For André du Breil, the professor of medicine at Paris whom I introduced at the beginning of this article, the Paracelsians
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were fellow travelers of the empirics. In fact, he insisted, neither were true empirics; rather, they were like those who call themselves Christians but who in reality carry out the work of the devil (Lingo, 1986, 591).
It is not always easy to draw the line between "legitimate" and "superstitious", or between official and unofficial healers and remedies in the context of the early modern period. The most notable thing about the medical world of early modern Europe was its pluralism (Park, 1985). People had recourse, when ill, to a wide variety of healers, many of whom were considered official or at least semi-official. In most Italian cities, even charlatans were licensed (Gentilcore, 1995). That there was an
Fig. 3: Giuseppe Maria Mitelli: "Ciarlatano" (source: Carracci, A.: Di Bologna, l'artiper via. Ristampa anastatica. Sala Bolognese, Arnaldo Forni Editore, 1983). Sl. 3: Giuseppe Maria Mitelli: "Ciarlatano" (vir: Carracci, A.: Di Bologna, l'arti per via. Ponatis. Sala Bolognese, Arnaldo Forni Editore, 1983).
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openness to exchange between physicians and popular healers cannot be ignored. The seventeenth-century French physician Pierre-Martin de la Martiniere held that the popular remedies of the peasantry should be viewed as a pharmaceutical storehouse similar to the natural resources exploited by the Iroquois in the New World; and the Italian physician Leonardo Fioravanti prided himself on "going to the people" for empirical remedies (Eamon, 1993, 2003).
Clearly, economics was not the only, or even the main issue driving the diatribes against popular healers. It was, of course, during the early modern period that the physicians asserted themselves as a respected professional group, and this naturally involved distinguishing themselves more sharply from other healers. Yet, as the dubious assortment of villains described in the popular error tracts suggests, charlatans and other irregular healers were despised not so much because they posed a real threat to the physicians' economic livelihood, but because they were seen to represent an affront to the moral and social order. In constructing an image of the popular healer, the writers on popular errors utilized the language codes of the moral order, and set themselves apart from the latter on the basis of the superior knowledge, propriety, and decency of their profession.
According to this construction, official physicians were everything that popular healers were not: whereas the physician's knowledge was based on the authority of science, charlatans claimed to know things only by experience; while the physicians were stable and the model of sobriety and social decorum, charlatans were itinerant and often associated themselves with vagabonds, whores, and gamblers; physicians had a doctorate, charlatans were uneducated; while the physician was grounded in book-learning, the charlatan, with his spiel and sales gimmicks, was part of the oral culture of the piazza and marketplace; physicians managed the whole person, while charlatans peddled a quick fix, and so on (Brockliss, Jones, 1997, 231). These categories all entail issues of identity. When a physician labeled someone a "charlatan" he was saying as much about his view of self and of the prerogatives of the nascent profession to which he belonged as about someone else.
For the writers on popular medical errors, charlatanry was vice personified. "Virtue has not need of jesters, oh poor populace," wrote Mercurio. "Medicine is virtue, therefore to want to sell it with buffoonery is to butcher it." In a nutshell, Mercurio's point comes down to the fact that charlatans lack the authoritative Galenic learning necessary to understand the complexities of diseases in different human bodies. That is university knowledge, and knowledge of such things is "so essential that is impossible for a wandering and boorish man to know them" (Mercurio, 1645, 265). In other words, it is knowledge that is beyond the capacity of the common man.
The most comprehensive attack on popular errors was delivered by the English physician Sir Thomas Browne. In his Pseudodoxia epidemica of 1646, Browne exposed errors not only in medicine and health, but in natural knowledge generally. For
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Browne, popular culture was hopelessly irremediable. In the opening pages of the Pseudodoxia, he discussed in detail the causes of popular errors. Foremost among them was original sin, which made people naturally credulous and easily deceived. Credulity, "a weakness in the understanding [...] whereby men often swallow falsities for truth," was a condition common to all of humanity. But skepticism can also lead to error, because it discourages the intellect from inquiry into the unknown. Another cause of error is laziness, because it is easier to believe what we are told than to investigate for ourselves. But the "greatest enemy of knowledge," Browne thought, was blind adherence to authority. "There is scarce any tradition or popular error but stands also delivered by some good Author," he observed (Keynes, 1964, 52, 40).
Great as the imperfections of the mind were in individuals, thought Browne, they were multiplied a hundredfold in the masses. Feeble-minded, illiterate, and governed by the passions and not by reason, the common people not only fell into error but swarmed with every conceivable vice because of it. They would sooner believe in their foolish proverbs than accept a reasonable argument. They were incapable of thinking abstractly and thus degraded God into physical images. They readily fell for the deceptions of charlatans, fortune-tellers, and jugglers. Hopelessly deluded, they were even mistaken in their judgments as to sense perception, being convinced, for example, that the moon is bigger than the sun. Such foolish and hopeless errors convinced Browne that popular culture teemed with superstition, ignorance, and perversion (Keynes, 1964, 25-30).
I would like to conclude by making some general observations about what the books on popular medical errors can tell us about the increasingly strained relations between elite and popular cultures in an age of secularization. For, without question, the diatribes against popular errors exposed deep-seated cultural conflicts, and bear witness to a widening gulf between learned and popular cultures. It was not just the "errors of the people" that the elite rejected, but their entire culture. Popular errors were seen merely as instances of the people's delusion and of their tendency to be easily led astray into confusion, heresy, and anarchy. Undisciplined and untrained, ruled by their passions instead of being guided by reason, the common people were like wild animals that threatened the social order: when they could not be tamed, they would have to be caged.
The books of popular errors also brought to the forefront the age-old question of the reliability of empirical knowledge. The validity of empirical knowledge depends to a large extent upon the reliability of the testimony adduced for it. The question is: who qualifies as a reliable observer? In the sixteenth century, numerous claims were made that "naïve" observers who were unbiased by philosophical opinions were the best witnesses. Montaigne, for example, made this point in his essay "On Cannibals". Montaigne's informant regarding the strange customs of the New World Indians was "a simple, crude fellow" who had lived for some time in Brazil: untrammeled by
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theories, he was "a character fit to bear true witness." In order to get reliable reports about things we haven't seen for ourselves, Montaigne argued, "we need someone either very honest, or so simple that he has not the stuff to build up false inventions and give them plausibility" (Montaigne, 1958, 152). Such views contrasted sharply with the emerging New Philosophy, whose validity rested on the claim that "naive" empirical knowledge was inherently unreliable. Thus Galileo contrasted the "eyes of an idiot" with those of "a careful and practiced anatomist or philosopher." (Galileo, 1957, 196)
Thus the message of the New Philosophy was that the sublime mysteries of the universe were beyond the capacities of the common people. Similarly, the books of popular errors raised doubts about the trustworthiness of popular testimony with regard to empirical knowledge. Indeed, not only did the writers on popular errors question the credibility of popular testimony, they doubted whether the common people were capable of reliable seeing. Thus Sir Thomas Browne wrote that because their senses were so dulled, the people "are farther indisposed ever to attain unto truth; as commonly proceeding in those ways, which have reference unto sense, and wherein there lie the most notable and popular delusions" (Keynes, 1964, 26). By invalidating their testimony, the New Philosophy disqualified the people from the arenas where experimental knowledge would be generated.
ZDRAVNIKI IN REFORMA LJUDSKE KULTURE V ZGODNJENOVOVEŠKI EVROPI
William EAMON
Državna univerza Nove Mehike, Oddelek za zgodovino, US-NM 88003 Las Cruces, Box 30001 MSC 3H
e-mail: weamon@nmsu.edu
POVZETEK
Večno rivalstvo med učenimi zdravniki in neuradnimi, ljudskimi zdravilci je v zgodnjenovoveški dobi izbruhnila s še posebno maščevalnostjo. Šarlatani in ljudski zdravilci, opogumljeni s hitro spreminjajočim se in vse bolj tekmovalnim trgom medicine, so tradicionalno medicino izzvali s tiskanimi spisi in javnimi nastopi na mestnih trgih in tržnicah. Univerzitetno izobraženi zdravniki so na izziv odgovorili s serijo napadov na "ljudske zmote in napake." Avtorji knjig o medicinskih zmotah pa se niso omejili zgolj na napake, ki so jih ljudje delali v zvezi z zdravjem, ampak so pavšalno napadli kar ljudsko kulturo na splošno ter umske sposobnosti in moralni značaj ljudi.
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Začetnik literature o "ljudskih zmotah v medicini" je bil Laurent Joubert, rektor Medicinske fakultete v Montpellieru. Leta 1578 je objavil prvi zvezek predvidene zbirke del o ljudskih zmotah. Z vnemo, ki je mejila že na misijonarsko gorečnost, je Joubert obsodil ljudsko kulturo in zatrjeval, da je prežeta z zmotami, nevednostjo in vraževerjem. Joubertovemu zgledu so sledili še drugi. Rimski zdravnik Scipione Mercurio je otvoril italijansko fronto v vojni proti ljudskim zmotam z vplivnim delom De gli errori popolari dItalia (1603). Mercurio je s še posebno sovražnostjo obdelal "na trgu storjene napake" šarlatanov, ki so, po njegovem pisanju, javnost ogrožali s svojimi zdravili. Najcelovitejši napad na ljudske zmote pa je izvedel angleški zdravnik Sir Thomas Browne. V delu Pseudodoxia epidemica (1646) ni razkril le zmot in napak v medicini in zdravju, temveč tudi v naravoslovju na splošno. Menil je, da je nevednost v ljudski kulturi nepopravljiva. "Zmote ljudi" v medicini so postale em-blematične za lahkovernost in zaostalost ljudske kulture na splošno. Avtor članka se osredotoča na spise zdravnikov o "ljudskih zmotah ", napisane v obdobju, ki sega od sredine 16. stoletja do začetkov 18. stoletja, ter analizira kulturne kode in stereotipe o ljudski kulturi, razvidne iz teh spisov.
Ključne besede: zdravniki, reforma, šarlatani, ljudska kultura, trg medicine
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