[Herbalist] [tmr-l@wmich.edu: TMR 04.09.07 Guardo (ed), Los pronosticos medicos (Dangler)]

Tue Jan 25 20:52:45 PST 2005

A review of a book in Spanish that might be useful to someone, if they 
can read it...

Guardo, Alberto Alfonso, ed. Los pronosticos medicos en la medicina 
medieval: el Tractatus de crisi et de diebus creticis de Bernardo de 
Gordonio. Pp. 514. (pb). ISBN: 84-8448-233-2.

   Reviewed by Jean Dangler
        Tulane University
        jdangler at tulane.edu

Medieval Iberian healing is one of the richest areas of investigation 
in medieval studies, due in part to the numerous medical treatises 
composed on the peninsula, as well as to the far-reaching effects of 
medicine and healing in, for instance, the legal realm, the domestic 
sphere, and economics. Medieval medicine and healing have become 
increasingly popular topics during the last ten to fifteen years, as 
evidenced by the numerous articles and books on subjects as diverse as 
the Black Death, women's cosmetics, and Muslim and Jewish contributions 
to peninsular medical practice, by scholars such as Jon Arrizabalaga, 
Montserrat Cabre i Pairet, Luis Garcia Ballester, and Michael McVaugh. 
In addition, researchers including Maria Teresa Herrera of the 
University of Salamanca and Enrique Montero Cartelle of the University 
of Valladolid have coordinated and composed a vast array of editions of 
medieval medical treatises. Also, numerous editions of treatises in 
Arabic, along with their translation into Castilian have been produced 
under the auspices of the Consejo Superior de Investigaciones 
Cientificas (CSIC). These medical treatises are available to modern 
scholars in three formats: transcriptions on microfiche or CD-ROM, 
Castilian translations, and at times English translations.  Such 
formats make these works increasingly accessible to researchers without 
a specialty in Arabic, Latin, or Iberian studies.

Alberto Alonso Guardo's edition of Bernard of Gordon's late 
thirteenth-century Latin treatise on prognosis, Tractatus de crisi 
et diebus creticis, is a fine addition to this expanding corpus of 
medical works. The edition consists of the Latin treatise, as well as 
Alonso Guardo's translation into Castilian, which he hopes will make it 
more available to a broad audience of historians of medicine, 
historians of science, and other medievalists (9). Alonso Guardo 
divides the edition into six main sections: 1. "El autor y su entorno 
cultural" [The Author and His Cultural Milieu]; 2. "El Tractatus de 
crisi et de diebus creticis: una obra cientifico-didactica" [The 
Tractatus de crisi et de diebus creticis: A Scientific-Didactic 
Work]; 3. "Tradicion textual" [Textual Tradition]; 4. "Edicion critica, 
traduccion y notas" [Critical Edition, Translation, and Notes]; 5. 
"Glosario e indices" [Glossary and Indexes]; and, 6. "Bibliografia" 
[Bibliography].

The critical edition is well organized, with one minor flaw. Since 
Iberomedievalists in general are not apt to be familiar with the De 
crisi (they probably know Gordon's wide-ranging treatise on health 
called the Lilium medicinae [Lilio de medicina]), I wish that 
Alonso Guardo had included early on a brief narrative about what the 
treatise entails. Waiting until page 32 of the second section for a 
general overview made it somewhat difficult to contextualize Alonso 
Guardo's introduction in section one. I would have liked to have known, 
for instance, that the aim of the De crisi was to teach 
physicians how to make correct prognoses of bodily illness. 
Additionally, it would have been useful to know the division of the 
treatise in five parts: 1. prognosis according to different diseases; 
2. prognosis according to the seasons of the year, customs, age, 
region, winds, and complexion; 3. prognosis according to paroxysms (a 
severe attack or an increase in violence of a disease); 4. prognosis 
according to symptoms; and, 5. definition and types of crisis, as well 
as critical days. Alonso Guardo could have briefly presented a 
definition of critical days earlier in the edition, especially since he 
avers that the concept is crucial to understanding prognosis in the 
medieval world, which he ably explains in the second section (51-56). 
He defines critical days as those that generate a crisis of the disease 
with a positive result, such as days 4, 7, 11, and 14 of an illness 
(51).

Aside from this small structural lack, Alonso Guardo's initial studies 
and analyses are excellent. The first section on Bernard of Gordon 
provides a good introduction to his work in medicine at the medical 
faculty of the University of Montpellier from the end of the thirteenth 
century to the beginning of the fourteenth. It also clarifies the 
author's origins as likely from a French town, and not an English 
village (20). Alonso Guardo emphasizes the practical quality of 
Gordon's early treatises, which include the De crisi (21-23), 
but illuminates the notable differences between Gordon's early and 
later works, such as the tendency of the latter to be long, 
speculative, and poorly organized (27-28).

The second section examines the treatise itself, which was completed on 
January 25, 1295. Alonso Guardo details why the treatise would have 
been important to medieval medical students and physicians, citing 
Gordon's four reasons from the prologue of the De crisi. Aside 
from protecting a patient from future risks, a correct prognosis 
secured the patient's confidence in the physician, caused the doctor to 
build his reputation, and allowed him to apply the necessary 
treatments. Alonso Guardo further points out that the medical professor 
who taught ably the way to arrive at correct prognoses increased his 
own fame and attracted new students (33). Alonso Guardo rightly gives 
the reader a brief description of the medieval concept of disease 
(34-36), and lists the various ways that physicians made prognoses 
(36-37). His description and explanation of the contents of the 
treatise are admirable, and indeed serve to illuminate certain aspects 
that might otherwise appear odd to the modern reader, such as the fact 
that Gordon devotes the majority of the first part of his treatise to 
prognosis and fevers. Alonso Guardo explains the fixation on fevers 
with the importance of heat in medieval medical theories of the body; 
innate heat was charged with maintaining corporeal functions (41). 
Indeed, this point cannot be overstated, since scholars such as 
Katharine Park have suggested that in the Middle Ages heat constituted 
the main element that differentiated human bodies from one another; 
hence the physician's interest in fevers and corporeal imbalance.

Alonso Guardo explains that the De crisi derived from works on 
the same topic by Hippocrates and Galen, which were part of the 
curriculum at Montpellier (56-59). The last part of this second section 
is devoted to an analysis of Gordon's didactic style, and of linguistic 
concerns (59-72).

The third section on the textual tradition discusses manuscripts and 
editions. Alonso Guardo provides a useful list of the manuscripts he 
used in composing his critical edition, those he consulted, and those 
he did not use at all, totaling fifty-nine in all. He also describes 
the ten printed Latin editions of the fifteenth, sixteenth, and 
seventeenth centuries, and declares that the De crisi was 
translated into various languages, including Castilian (75-94). 
Medical scholars and philologists alike will find Alonso Guardo's 
discussion provocative of the division between two "families" of 
manuscripts and their variants. A noteworthy observation involves the 
concentration of variants in the second part of the manuscript (on 
prognoses according to seasons of the year, habits or customs, age, 
regions, winds, and complexion), which Alonso Guardo attributes to the 
non-technical character of natural philosophy. He believes that the 
second section of the De crisi was more susceptible to change 
because scribes who were untrained in medicine nevertheless were 
empowered to correct and amend material related to natural philosophy 
(95-96). While the explanation is intriguing, I wonder how it holds up 
in the face of the occasional overlap in the Middle Ages of medicine 
and natural philosophy. Alonso Guardo ends the third section with notes 
on the criteria used in creating the critical edition.

The fourth part of the book contains the treatise and its parallel 
translation. Alonso Guardo provides many Latin variants at the bottom 
of each page, and useful notes regarding sources and other concerns 
related to the Castilian translation. The book's fifth section consists 
of the helpful glossary on medication and medicinal substances, such as 
resins, plants, and breads, and of the word index for access to 
specific lexicon in the treatise. The bibliography constitutes the 
book's sixth and final part.

This critical edition is a fine contribution to the burgeoning field of 
medieval Iberian medicine and healing. Alsonso Guardo demonstrates 
that Bernard of Gordon's De crisi is fundamental to 
understanding medieval medical practice, and that it demands future 
scholarly attention. Gordon's work illustrates the complex ways in 
which disease, prognosis, and the body were formulated in the medieval 
period. His attention to the various factors associated with prognosis, 
that is, fevers, the non-naturals (forces that affected the body and 
caused corporeal imbalance, such as customs, habits, and geographical 
placement), paroxysms, symptoms, and critical days shows the breadth of 
medieval medicine's scope, and the range of knowledge that a late 
medieval physician was expected to possess.

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