Medicine at the Courts of Europe

1500-1837

Vivian Nutton

• Publisher: Taylor & Francis
• Year: 2018
• Print ISBN: 9781138388185
• eBook ISBN: 9780429758881
• Edition: 1
• Topic: History
• Subtopic: World History
• Index: History

Originally published in 1990, Medicine at the Courts of Europe 1500-1837 is a collection of essays examining the whole range of medical activities in a variety of European courts, from Rome of the Borgias to the Russia of Catherine the Great. It documents the diverse influences of custom, wealth, religion and royal intervention, along with foreign innovation, popular literary satire and matters of litigation which so changed the face of court medicine over three centuries. By looking at court medical practitioners in such a wide chronological, geographic and thematic context, these essays provide many new insights for all those interested in the history of medicine, society and politics from the sixteenth century to the early nineteenth century.

1

De Morbis Aulicis: On Diseases Found at Court

Werner Friedrich Kümmel

The treatise On the Health of Princes, which Bernardino Ramazzini, Professor of Medicine at Padua, published in 1710 has nowadays fallen into almost complete oblivion.¹ It was not always so. Although he had to bear the costs of publication himself because the publisher was not convinced that the book was likely to sell well, despite the author’s reputation and standing, Ramazzini’s book in fact aroused great interest amongst royal body-physicians and court physicians generally,² and was reprinted twice within two years. In 1724 there followed a French, and in 1753 even a Portuguese, translation, and its inclusion, from 1714 onwards, in the frequent reprintings of Ramazzini’s Complete Works brought it to a still wider readership.

The first contributions to the corpus of writings about illness attributed to life at court had appeared in the sixteenth century, and more had followed towards the end of the seventeenth. However, Ramazzini was the first to embark on a broad discussion entailing an exploration of the related theme of the health of princes. Thus, the rapidly subdividing science of health and disease acquired a new speciality, which the present chapter will analyse and explain in relation to its context. There exist no earlier studies of this corpus, nor, indeed, has the whole process of differentiation to which I have referred yet been investigated.

Ramazzini’s De principum valetudine tuenda was based on the same fundamental idea as, ten years previously, had inspired the book on the diseases of workers and craftsmen that had made his name and given him a place in history as the founder of occupational medicine;³ namely, that ‘not only diseases arising from the constitution of the body, but also disorders brought on by one’s life-style or the practice of an art or job should be taken into consideration and the appropriate treatment set in hand’.⁴ Underlying this challenge to the medical profession may already be discerned the thesis he was to formulate in 1710, of the connection between diseases and the conditions of the patient’s life. ‘Just as particular diseases are typical of different ages, temperaments, seasons, and places, so, equally, the conditions under which an individual lives, whether through chance or through choice, bring special diseases in their wake’.⁵ Ramazzini did not claim to have made an entirely new discovery. Hippocratic medicine had already arrived at the basic conclusion that health and sickness were greatly influenced by individual living conditions – which were by no means confined to such externals as seasons, locality, and climate. The author of On Regimen, writing around 400 BC, put forward as his own discovery the idea that health depends not simply on nourishment, but on the quantitative balance between the intake of nourishment and physical activity; and that it was further affected by such factors as the age and constitution of the individual, the seasons, changes in wind direction, place of residence, the weadier in a particular year, and the rising and setting of the planets.⁶ Since most people have to earn their living, and, in the process, usually eat and drink whatever comes to hand, put themselves to great exertion, expose themselves to harmful extremes of heat and cold, and in general are forced to live an unplanned life, the author sketches out guidelines for healthy living mainly for this group, and only secondarily for the minority whose wealth allows them to arrange their lives entirely with a view to maintaining health, without concern for the means of sustaining life.⁷

This emphasis, which still reflects without qualification the high esteem in which riches were held in early Greek culture,⁸ might have led to the emergence of an embryo ‘occupational medicine’, but this was not to be. Indeed, the doctors of Antiquity were remarkably uninterested in the connection between work and disease. This lack of interest, which has often been noted, but without any explanation being advanced, can perhaps be attributed to the fact that this conception of wealth as the best prerequisite for health was overshadowed by the opposite thesis, that, in reality, wealth was more likely than poverty to produce ill-health. In the Hippocratic treatise Airs, Waters and Places, we hear that, among the Scythians, the noblest and most powerful suffer from rheumatic complaints, because they are constantly using their legs to hang on to their horses, which also causes sores and ulcers on their thighs; the ‘poor’, i.e. the working population, are not thus afflicted because they do not ride.⁹

Philosophers and poets went further, and linked wealth and leisure in general with sickness, and, conversely, the simple life with good health.¹⁰ Some authors even described the individual threats to health of certain professions.¹¹ In Galen’s view, too, the rich suffer more from disease than the working masses, and specifically from those arising from a superfluity of blood, because they eat and drink too much, take too little exercise, and thus allow an excess of blood and harmful fluids to accumulate in their bodies.¹²

Even though connections between work and disease in general scarcely concerned doctors in Antiquity, one particular life-style did, certainly from the first century onwards, come into their purview – that of the intellectual worker, which was their own in so far as they were also engaged in study or writing. The health risks to which this group was exposed were discussed by Aretaeus of Cappadocia, Plutarch, Galen, and Rufus of Ephesus. Celsus even put forward the ingenious suggestion that the science of medicine had actually originated in the unhealthy life-style of intellectuals!¹³

These early outlines of a theory of health incorporating the influence of people’s occupations remained virtually unknown in the Middle Ages. The most that happened was that ancient ideas led Arabic physicians to extend the specialization of medicine with particular modes of treatment for individual target-groups – for women in pregnancy or labour, for unweaned infants and wet-nurses, for children and young people, for the old, for convalescents, and for travellers. However, they did not take particular occupations into account, not even that of the scholar. This theme was first taken up from the fourteenth century onwards in Latin-speaking western Europe, when a growing orientation towards outward reality tended to sharpen perceptions of the varying conditions of life.¹⁴ In 1489, there appeared in Book I of Marsilio Ficino’s extraordinarily influential De vita the first comprehensive set of medical recommendations for the scholar, the earliest example of a regimen tailored to a specific occupational group.¹⁵ At the same period, individual doctors also began to take an interest in diseases related to manual labour. In 1473 Ulrich Ellenbog composed for the goldsmiths of Augsburg his short treatise On the Poisonous and Evil Fumes and Vapours of Metal, which, although not published until 1524, was frequently reprinted thereafter.¹⁶ Then, around 1520, Paracelsus is thought to have written the first part of On the Diseases of Miners.¹⁷ A lost work of Burkhard von Horneck (c. 1440–1522), Regimen principum, written for the Emperor Maximilian II, would appear to have applied a similar approach to life at court.¹⁸ That doctors should become more aware of the special life-style at court and its associated diseases, at a period when they were paying increasing attention to the life-styles of people in general, is hardly surprising when one remembers that, outside the realm of medicine, life at court had long been a conventional subject for criticism. The morally based critique of life at court, begun in the twelfth century, had by the sixteenth century hardened into an established commonplace of European moralists. Such critiques ‘developed into a focus for the exposure of every moral evil’.¹⁹ There had even appeared a full-scale anthology of passages critical of court life, published in its second edition by Henricus Petreus Herdesianus (1578) under the title Aulica vita (Life at court). Although such criticism of court life had a moral thrust, and its authors were not doctors, they had begun to touch on certain individual health-related aspects of life at court, such as irregular mealtimes and frequently interrupted sleep, as early as the fifteenth century, well before physicians had made diseases at court into a separate subject for discussion.²⁰ Thus, it can be seen that by 1500 the ground was prepared in various ways for the emergence of this theme.

Towards the concept of ‘court disease’

As an examination of the lexicons confirms, Antiquity and the Middle Ages had no specific terms for diseases regarded as particularly widespread at court, and designated accordingly. Constantinus Africanus merely remarks in one of his reworkings and translations of Arabic texts on gout that it afflicts mainly princes and those who live in luxury without physical exertion, and who eat and drink a lot.²¹

The term ‘court disease’ was coined in Spain, towards the end of the fifteenth century, as one of the numerous names for the apparently new disease, syphilis. The Valencian physician, Gaspar Torrella (1452–1520), doctor at the courts of Pope Alexander VI and Cesare Borgia, noted in 1497 in his book on syphilis that, in southern Spain, the disease was known as ‘morbus curialis’, because it was always to be found in the vicinity of a court.²² This connection, enshrined in the name ‘Mal de Cour’, survived up to the nineteenth century.²³ However, shortly after the first appearance of the concept of ‘court disease’, it was already ceasing to be limited to just one individual illness, and was being used as a collective term. The Spaniard Luis Lobera de Avila, one of Emperor Charles V’s personal physicians, published in 1544 a book dealing with The Four Diseases of Courtiers.²⁴ Later authors, who took up the subject again in monographs only after a long gap, at the end of the seventeenth century, never refer to Lobera de Avila’s work, and hold divergent and only partially overlapping conceptions of what constitute the ‘diseases of the court’. The body of literature which revived the subject, under the name...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Original Title Page
• Original Copyright Page
• Contents
• List of Tables
• Acknowledgements
• Introduction
• 1. De Morbis Aulicis: on diseases found at court
• 2. Medicine at the Papal Court in the Sixteenth Century
• 3. The Court Physician and Paracelsianism
• 4. Prince-practitioning and the Direction of Medical Roles at the German Court: Maurice of Hesse-Kassel and his physicians
• 5. The Literary Image of the Médecins du Roi in the Literature of the Grand Siècle
• 6. Court Physicians and State Regulation in Eighteenth-century Prussia: The emergence of medical science and the demystification of the body
• 7. Medicine at the Court of Catherine the Great of Russia
• 8. The Médecins du Roi at the End of the Ancien Régime and in the French Revolution
• 9. Medicine at the English Court, 1688–1837
• Index