Review of Irma Taavitsainen, Turo Hiltunen, Jeremy J. Smith and Carla Suhr eds. 2022. Genre in English Medical Writing, 1500–1820: Sociocultural Contexts of Production and Use

Studies on medical discourse seem to be on the rise. In Genre in English Medical Writing, 1500–1820: Sociocultural Contexts of Production and Use, Irma Taavitsainen, Turo Hiltunen, Jeremy J. Smith and Carla Suhr benefit from their experience and profound knowledge of English historical linguistics and medical texts to gather diverse interdisciplinary contributions, which revolve around forms and functions of medical discourse conveyed through different genres across various centuries, from the Late Middle Ages to the long eighteenth century (1500–1820). Therefore, this insightful book stands for an outstanding contribution to the field of medieval scientific writing style, as it deals with key research questions such as 1) how authors created and utilised medical discourse, 2) the purposes and readers of medical texts and 3) the transmission of medical ideas through space and time.

In addition to the lists of Figures, the Image Gallery, the list of Tables, the Notes on Contributors, the Preface, the Acknowledgements and the Index, the book contains 17 contributions by different scholars dealing with a wide variety of topics, structured around medical discourse in social and cultural contexts of production and use. As the editors posit in Chapter 1, genres play a key role in the understanding of the history of medical discourse. That is why from the very beginning the complexity of this term, which is used in the context of historical genre analysis, is clarified. This is why the edited volume excels in the field of medical genre and medical discourse analysis, as it places texts in social and cultural contexts of production and use. The volume also gives variation in medical discourse forms the importance they deserve, since treatises tend to be readjusted and repurposed to fit new readerships and new sociocultural trends.

The vast majority of medical writing that circulated in Europe until the Middle Ages was in Greek. It was then eventually adopted by ensuing civilisations and translated into different European vernaculars from the extant corpus of Latin, Arabic and Greek. During the Early Modern English period, medical tracts were produced for physicians with different levels of medical training, which undoubtedly expanded the readership of these texts. As a result, existing tracts were modified and/or readjusted for diverse target audiences, which entails a clear reflection of how sociocultural functions and textual forms are closely interwoven. In Chapter 1, the editors also highlight how the different pieces of research in the volume make use of interdisciplinary and cross-disciplinary approaches and contribute to the philological enterprise in a broader way. The end of Chapter 1 describes the way in which the different contributions have been conceived and assembled: Chapters 2–5 concern Late Medieval texts; Chapters 6–10 deal with terminology of medical science; Chapters 11–13 discuss the process of change and how it takes place in specific genres; Chapters 14 and 15 revolve around Early Modern medical recipes and the communicative function of persuasion; Chapter 16 argues that medical topics are not limited to medical discourses; finally, Chapter 17 displays illustrations of textual features connected to the aforementioned themes.

The group of book chapters devoted to Late Medieval texts opens with John Arderne’s writings on surgery and his book of medical recipes, which circulated extensively in England throughout the Late Middle period. Peter Murray Jones makes use of Arderne’s surgical writings to call into question the presumptions made thus far about periodisation and the arrival of the culture of the print in Europe. He recounts how a late fourteenth-century surgical tract remains in use in manuscript form up to the seventeenth century. Latin and Middle English translations of Practica on fistula in ano and Experimenta continued to be hand copied in England after the sixteenth century. Surprisingly, the procedures were not renovated or substituted in the subsequent centuries despite the lack of coherent structure that encouraged the translator of at least one Middle English translation to rearrange the tract, as well as the difficulty that Middle English grammar and lexicon could entail for sixteenth- and seventeenth-century readers. As for sixteenth-century witnesses, Peter Murray Jones highlights and proves that they were ordered and owned by practising surgeons and medics. The author also demonstrates that the unsuccessful attempt to print Arderne’s work does not imply that his knowledge was out of surgical use. Therefore, Peter Murray Jones succeeds in revealing that Arderne’s writings circulated extensively and were highly valued throughout the sixteenth and seventeenth centuries, as copying his treatises was appealing to Early Modern physicians due to their practical usefulness.

Chapter 3 deals with the changes in medical practice by showing the sixteenth-century revisions of an originally late fourteenth-century medical tract by John Mirfield, namely the Gouernayl of Helþe. This text was then updated to approach the primary issues of the new times. Lori Jones focuses on Wellcome MS 647, a miscellaneous medical manuscript, to reveal the modernisation of medieval medical treatises to suit new perspectives towards healthiness as well as new ways of life in a period in which the Gouernayl of Helþe circulated both in manuscript and in print form. Jones studies and analyses in depth 1) its reconfiguration of content (with the exception of the last two chapters that remained unrecorded), 2) the modernisation of phraseology and 3) the shift in its target audience. Finally, the author approaches the influence of the religious unrest in England during the period in which the manuscript was written, which accounts for the difference of attitude in the treatise under study. This religious touch also gives meaning to the significant reduction in the references to ancient medical authorities who had no rival during the Middle Ages and reveals a writer who directly speaks to the reader of the manuscript.

Chapter 4, by Benati, deals with the Low German translations of the first two surgical handbooks printed in High German, which enjoyed enormous popularity and circulated extensively during the Early Modern era. In 1518, Hieronymus Brunschwig’s Buch der Cirurgia –the Boek der Wundenartzstedye– was translated and printed in Low German, and around two decades later part of Hans von Gersdorff’s Feldtbuch der Wundarzney was also translated, but copied in a medical miscellaneous manuscript (Copenhagen, Kongelige Bibliotek, GKS 1663 4^to, ff. 1r – 86v) under the title Dat velt bock. Benati reveals how both handbooks were not only translated but also underwent a great transformation to be adapted to a different audience and medium (print vs. manuscript). The collation carried out by the author of both Low German treatises with their corresponding High German sources discloses that the role that translation has played in the two handbooks has been remarkably different. This is due to the medium of transmission (print vs. manuscript) and to the expected readership. Printed books were conceived to be sold and to circulate among wider audiences (practitioners and readers interested in medicine), which explains why all treatises from Brunschwig’s handbook have been integrally translated. By contrast, the prescriptions from Gersdorff’s handbook became part of a medical commonplace book conceived by an anonymous compiler of various medical sources. As for the translation, the printed edition of Brunschwig’s handbook opted to replace High German specialised terminology by the Low German consolidated term. When a consolidated alternative did not exist, the original High German term was borrowed and subsequently adapted to the target language. Once the translation was printed, it became a stable fixed text. Regarding the translation carried out in Kongelige Bibliotek (Copenhagen), the author continually reworked the manuscript, adding glosses and marginalia or directly omitting passages from the original source.

Chapter 5, which is the last chapter in the volume devoted to Late Medieval manuscripts, focuses on the Early Modern afterlives of John of Burgundy’s medieval treatise on plague to prove how it continued to have an impact on Early Modern society and medicine. Honkapohja studies the context of these Early Modern manuscript witnesses and deals with the changes in medical discourse and their relationship with the causes and transmission of the sickness under consideration. He provides an index of post–1500 witnesses, drawing special attention to the attribution of the tract found in the different incipits and to the genetic filiation of these copies. Some owners are unveiled as well as the reason why they possessed a copy of John of Burgundy’s treatise, and evidence is provided for some of these post-medieval witnesses of later hands, which clearly demonstrates the use of John of Burgundy’s treatise after 1500. These later hands and marginal additions therefore suggest that the text continued in use throughout the sixteenth century. Although the treatise only survived in manuscripts and was never printed, it did not remain as a mere historical antiquarian concern. Finally, Honkapohja also succeeds in the analysis of lexical evolution as for medical terminology in his sixteenth-century corpus.

Continuing with plagues, Chapter 6 by Tanturri examines different perspectives towards the medical debate, revolving around the plague which outbroke in Noja (1815–1816), to subsequently analyse the treatments and therapies employed by doctors to fight against a devasted infected town. He studies the works on the plague and its treatment by several authors, namely 1) Francesco Romani and Luigi Smith, who followed John Brown’s taxonomy, 2) Pasquale Panvini, who considered the use of oxygen to cure the plague, 3) Giuseppe Zocchi, whose focus was on testable therapeutic opportunities and 4) Giuseppe Giannini, who provided therapeutic advice. Subsequently, the focus changes to the different therapies tested in Noja. After this detailed journey through the medical debate and the therapies examined, Tanturri highlights the disorientation of the medical profession at that time.

In Chapter 7, Smith focuses on ‘excitability’, a term which broadened its meaning in the late eighteenth century, acquiring a physiological sense thanks to the writings of John Brown (a Scottish physician). At this point, the author excellently establishes a link with Tanturri’s chapter and analyses the evolution of the term from the Middle Ages up to the late eighteenth century, according to the Oxford English Dictionary (OED),¹ to reveal when excitability acquired its physiological meaning and how it was subsequently employed by Romantic writers with that scientific meaning.

Chapter 8 provides a detailed study of three different eighteenth-century medical dictionaries and their author’s comments and perspectives towards dictionaries and encyclopaedias, namely, 1) Cyclopaedia, by Ephraim Chambers (1728), 2) Robert James’s medical dictionary (1742-5) and 3) two dictionaries by James Keir, a translation of the Dictionnaire de chymie by Pierre-Joseph Macquer and his own incomplete dictionary partly published in 1789. McConchie’s research evidences the systematisation of knowledge associated with enlightened thinking.

In Chapter 9, Smith successfully studies the term ‘invention’ in Romantic literature, conceived as artistic creativity, specifically in the works of Samuel Taylor Coleridge, Mary Shelley and John Keats. He analyses the use of different terms, namely ‘painting’, ‘passion’, ‘burning’ and ‘touch’ in their writings and their medical denotation, demonstrating that this explicit medical meaning is due to their engagement with scientific –and specifically medical– thinking through the ideas and writings of Doctor William Cullen. This research has been possible thanks to the availability of The Consultation Letters of Dr Cullen corpus,² as he collates the use of these terms in the corpus with their presence in the works of the three Romantic writers.

In Chapter 10, De la Cruz-Cabanillas reports on a corpus of medical recipes extracted from manuscripts at University of Glasgow Library, dating from the sixteenth to the eighteenth centuries. Her study identifies the origin of new ingredients coming from America, Europe and Asia, and illustrates their use and application to cure certain diseases through a wide variety of recipes in the corpus. In addition, she provides the dates of the introduction of these substances into English, with the help of lexicographic references, mainly the OED.

The following three chapters address the process of change and how it occurs in specific genres. Chapter 11, by Taavitsainen, focuses on Walter Bailey’s medical works and provides evidence of how his transitional discourse juxtaposes old and new vernacular medical writing. She illustrates how Bailey, on the basis of several genres, including an herbal, incorporates 1) sensory observations, 2) linguistic formulae characteristic of recipes (imperative mode take + ingredients and measurements), 3) depiction of earlier author’s versions regarding ingredients and measurements combined with his own comments and 4) a summary followed by his personal opinion. Therefore, Taavitsainen succeeds in illustrating how a highly educated medical doctor combines long-standing genres (herbals, commentaries or recipes, among others) with discourse forms characteristic of the developing empiricist repertoire, an ongoing process of change in learned vernacular medical writing.

In Chapter 12, Ratia provides a thorough analysis of the discourse, layout and typographical features of London bills of mortality covering plague epidemics during the seventeenth century. Recurrent plague outbreaks throughout the seventeenth century undoubtedly promoted the development of this genre, juxtaposing several discourses (medical discourses on prophylactics and advice-giving or religious advice and prayers) with mainly death-related imagery and statistics. Thus, the corpus and methodology used in Ratia’s analysis shed light on the changes and main characteristics that the genre bills of mortality experienced during the seventeenth century.

Chapter 13, by Suhr, focuses on a hybrid genre which originated during the second half of the seventeenth century, namely pamphlet advertisements of proprietary medicines. Applying move analysis to her corpus, Suhr identifies the structural elements (seven moves) of this hybrid genre: 1) endorsement, 2) symptoms, 3) virtues, 4) directions for use, 5) testimonials, 6) addressing critics and competitors and 7) sales information. Her research demonstrates that, with the aim of promoting medical products and reaching the general public, the genre of pamphlet advertisements of proprietary medicines merged well-established conventions and old traditions of medical tracts with coetaneous innovations and linguistic features.

Chapters 14 and 15 deal with Early Modern medical recipes and the communicative function of persuasion. In Chapter 14, Kuna identifies the conceptual categories and major patterns of persuasion in a transcribed corpus of sixteenth- and seventeenth-century Hungarian medical recipes. After tracing the history and main characteristics of Hungarian medical discourse, the author presents the different mechanisms established in recipes for persuasion. Her analysis (reliability testing of semantic categories) further reveals the frequency, co-occurrences and positional distribution of persuasive phrases and strategies in the texts analysed, as well as their conceptual categories. Therefore, Kuna shows that persuasion is a key strategy in Hungarian medical recipes from the sixteenth and seventeenth centuries.

Continuing with medical recipes and persuasion, Mäkinen’s study in Chapter 15 deals with persuasion in Early Modern English medical recipes through the lens of metadiscourse. He examines how persuasion is intertwined with the informative and instructive concepts of recipes in Corpus of Early Modern English Medical Texts (EMEMT; Taavitsainen et al. 2010).³ The analysis is conducted through the combination of three Aristotelian rhetorical concepts (‘ethos’, ‘pathos’ and ‘logos’) with a survey of metadiscourse practices. First, the author analyses the record of metadiscourse items and their importance in persuasion and then offers quantitative observations on metadiscourse items in the recipes under study. The data prove the validity of the methodology used in the analysis and the solidity of the results obtained.

Chapter 16, by Rajala and Uotinen, combines various disciplines, specifically literary analysis, disability studies and health studies. The authors use Horkheimer and Adorno’s (2002) research to analyse the role of myth, interpretation and speculation in the depictions of Richard III’s physical and social disability in Shakespeare’s Richard III and in scientific reports published from 2012 onwards, once Richard III’s bones were discovered. The authors demonstrate that medical matters are not limited to medical discourse. In fact, the results show that they do play an important role in the history of representation, the politics of narrative and the subjectivity of speculation and interpretation.

Finally, in Chapter 17, Jones investigates the images in manuscripts and/or printed books of the Early Modern era which were chosen and referenced by the different authors in the volume. The chapter may be the prelude to the Image Gallery that follows, which illustrates the above themes with visual examples.

All in all, this volume is a welcome contribution to the field of medical writing from the Late Middle Ages to 1820. It brings to light treatises and genres whose analysis has been utterly neglected in the literature (e.g., bills of mortality or pamphlet advertisements on proprietary medicines). It provides new insights into the periodisation and arrival of print culture in Europe. Special attention is given to medieval medical treatises and their afterlives to investigate how they were updated in time as well as to the study of the transitional medical discourse which combines old and new vernacular medical writing. What is more, it can safely be claimed that the volume also contributes to the study of other vernacular medical texts (cf. Chapter 4 by Benati)

The volume also enhances studies on medieval and Early Modern medical recipes regarding persuasion. A first corpus on Hungarian medical recipes is under construction, and Kuna (Chapter 14) shows what is just a taste of her research on persuasion in Hungarian medical recipes, as more data will be analysed in the near future. Likewise, the use of a well-grounded methodology by Mäkinen (Chapter 15) in the study of how persuasion and informative and instructive concepts of recipes are connected is above all innovative and may be tested in future research on the topic.

In the volume, medical recipes are also concerned with the lexicon. De la Cruz Cabanillas (Chapter 10), for instance, describes the use of new vocabulary related to medical ingredients in a corpus of manuscripts largely edited for the first time. Moreover, the contributions by Smith (Chapters 7 and 9) reveal the psychological, medical and/or scientific meanings of some terms.

Special attention is given to the systematisation of knowledge in dictionaries and encyclopaedias and to the different ways to approach and treat a well-known disease in the period under study. Last but not least, the volume addresses multidisciplinary studies connected to current issues such as Richard III’s bones.

Undoubtedly, Genre in English Medical Writing, 1500–1820: Sociocultural Contexts of Production and Use is to become a reference for all specialists in historical linguistics, philology and history of medicine alike. It is indeed a must for the shelves of every university library. We can only be glad that the editors decided to gather such an enlightening and well-documented collection of research papers which shed light on the underexplored forest of medical writing.