Turquet de Mayerne as Baroque Physician: The Art of Medical Portraiture.

Brian Nance. Turquet de Mayerne as Baroque Physician: The Art of Medical Portraiture.

Amsterdam and New York: Rodopi, 2001. xiv + 238 pp. index. append. illus. tbls. bibl. $23. ISBN: 90-420-1131-9.

Woefully little is known about the clinical encounter between early modern medical practitioners and their patients. Sources are rare and among the few surviving documents medical casebooks are by far the most revealing. Exploited in the fascinating work of historians such as Michael Macdonald, Ronald Sawyer, or Barbara Duden we now know something about early modern attitudes to particular conditions such as madness for example, the social background of healers and patients, and how female patients understood their own bodies. No one, however, has yet tried to explain what actually happened during the medical consultation itself. This is what Brian Nance attempts in his new study based the casebooks of the seventeenth-century English court physician Sir Theodore Turquet de Mayerne (1573-1655).

Nance's source, the over twenty volumes of the Ephemerides morborum (Diaries of Disease) written between 1603-53, is indeed remarkable. And so is their author. After having briefly served Henry IV of France, the Swiss born Calvinist Sir Theodore Turquet de Mayerne became the most famous royal court physician to the early Stuart kings. For fifty years this crafty courtier filled page after page with observations and reflections on patient cases.

There were many reasons for Mayerne to keep case records. First and foremost they were a means to reflect on particular interesting cases and to investigate deeply into questions of therapy. They also permitted him to go back to past decisions in case the same patient returned later. Finally his notes were designed to serve as a defense in cases of alleged malpractice. How real this threat was becomes evident in the conflict that followed Prince Henry's illness and unexpected death in November 1612. Mayerne, responsible for the prince's treatment, was only able to suppress rumors about malpractice and poisoning by writing a public account of Henry's illness and treatment based on his case notes.

Mayerne's sophisticated survival strategies at court are not Nance's main interest. What he wishes to know is how this learned doctor put medicinal theory into action. Thus his focus is on Mayerne's medical gaze, the lens through which he evaluated and judged what was happening inside the patient's body and was guided to his therapeutical decision making.

To achieve his aim Nance works back and forth between Mayerne's casebooks and several key theoretical works of his time, including Mayerne's own publications on medical practice and those of other influential medical practitioners. Nance indeed answers many questions I have often asked myself concerning the daily practice of Galenic humoral pathology. It is well-known that academic physicians viewed most diseases as caused by humoral imbalances unique to each person. But how did they determine a patient's natural temperament without the knowledge of which neither the kind of the disease hidden within the patient's body nor the therapy could be determined? And how did they define and locate within the qualitative space of the body?

Nance explains these complicated matters with admirable clarity. Moreover, he sticks strictly to Mayerne's own vocabulary unlike other medical historians who often compromise between modern disease classification and the vocabulary of the past. Thus he forces his reader to question and finally abandon our modern disease categories and images and become fully immersed in a medical world in which the body is reigned by fluids, qualities, humors, and complexions. He offers us a cosmology in which talking and writing about disease and the human body obeyed very different rules to our modern disease narratives. However strange Mayerne's medical reflections and therapeutical advice may sound to us today, he was outstandingly successful in his own time. At his death in 1655 he left his daughter such a fortune that she was considered the "greatest marriage in England" (10).

Following Foucault, Nance does not restrict his exploration of Mayerne's clinical perception solely to intellectual capacities. Instead he aims at reconstructing Mayerne's medical gaze within the specific social, political, and cultural setting of baroque court culture. This approach requires skillful merging of intellectual history into social history of medicine, two fields which in the history of medicine have seldom been linked. The result in this particular case is not completely convincing, however. How court life stimulated, influenced, and shaped Mayerne's thinking and medical practice remains unclear. Only the chapter on Prince Henry's death offers us a glimpse on what it must have been like to be a court physician and how patronage and professional rivalry shaped Mayerne's intellectual and professional identity.

One also wonders whether the court is actually the most relevant cultural space in which to locate Mayern's medical gaze. We learn that Mayerne in fact deeply disliked court life and escaped it as much as he could in order to investigate nature in the company of those whose knowledge he valued, such as chemists, apothecaries, surgeons, painters, and various artisans and craftsmen. If this is the case--and unfortunately Nance does not discuss it in detail--then it seems more than likely that it was their skills and practices, particularly their keen interest in the methods of experimentation, that had considerable impact on his understanding and perception of bodily processes. How important the collaboration between artisans and natural philosophers and physicians was, not only for their own intellectual development, but also, for the rise of the sciences and medicine in the seventeenth and eighteenth century has been recently pointed to in several studies in the history of science.

Turquet de Mayerne as Baroque Physician is an engaging read. Hopefully, it will encourage other medical historians to explore the still-uninhabited space between intellectual and social history. Only by interweaving the two--however difficult it may be--we will be able to understand why early modern learned physicians such as Mayerne perceived the body and wrote about it in the way they did. More generally, it will help to explain why medicine and the sciences underwent such an enormous transformation during Mayerne's own lifetime.

CLAUDIA STEIN

Warwick University, England