Medicine in Flux: An examination of Lázaro de Soto's exegesis of Places in Man. Brianne Alysse Preston Thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy. School of History, Classics and Archaeology Newcastle University December 2014 Abstract This thesis examines Lázaro de Soto's commentary on the Hippocratic text, Places in Man, which is included in his 1594 volume, Tomus primus commentationum in Hippocratis libros. Castilian medicine in the Renaissance has been the subject of only limited study in Anglophone literature. Moreover, de Soto himself has received even less attention and thus a contextualisation of this author and his commentary provides a unique opportunity to broaden our understanding of how ancient medicine was utilised by Renaissance physicians. A case study approach is employed to examine what can be learned about the author of the commentary himself, in addition to asking how this information can be extrapolated further to gain a greater understanding of early modern medicine. This thesis uses both de Soto's work and his biography to address these questions. Many issues that have informed de Soto's medical understanding are considered, including his education and career, and wider medical movements, such as Vesalianism and humanism. Additionally, specific areas of medicine are given special consideration, including anatomy, physiology, pathology and nosology, precepts and de Soto's reception of the Hippocratic author's ideology. In these explorations of de Soto's comments certain trends begin to emerge. The first, which de Soto states explicitly in his dedication, is a concern for the utilitas publica, as the author tries to provide useful medical information and clarification of the Hippocratic text for practical purposes. Moreover, de Soto uses his commentary as a means to demonstrate his humanist erudition, copiously citing ancient authors, both medical and literary. Finally, throughout de Soto's comments he champions the contested Galenism, rejecting newer theories and connecting Galenism to Places in Man in order to strengthen Galenic authority. In short, de Soto employs this commentary to further both his career and his Galenic understanding of medicine. i Acknowledgements This thesis would have never been completed without the help and support of an abundance of people. First and foremost, I would like to thank my supervisor, PD Dr Thomas Rütten, for his eagerness to help and his willingness to share his extensive wisdom and expertise. In all likelihood I would still be staring at a blank computer screen without his help and encouragement. The faculty and staff in the department of History, Classics and Archaeology at Newcastle University provided a brilliant support network. Particular thanks are owed to Professor Jakob Wisse, Dr Susanna Phillippo and Dr Fiona Noble for their help in all things Latin, as well as to Barbara Cochrane and Sandra Fletcher for their brave guidance through the innerworkings of the University's bureaucracy. Dr Helen Berry, too, is owed a hearty thank-you for all of her enthusiasm and encouragement. Moreover, my experience at Newcastle would not have been nearly as rewarding without the camraderie and inspiration found amongst my colleagues in the PhD room - the blogs, the tea-breaks and the afternoon slumps saved my sanity. I owe a huge thank-you to all of my family and friends in both the US and the UK for listening to me warble on about obscure historical matters for the better part of a decade and cheering me on when things got tough. A special thanks is owed to James McSloy for his enduring patience and positivity. Finally, I would like to dedicate this thesis to my wonderful parents, John and Pam Preston, who have always been my rocks, my fans and fonts of never-ending love and encouragement, no matter which silly whim I am off chasing. ii Table of Contents Abstract i Acknowledgements ii Chapter 1. Introduction 1 1.1 Methodology 2 1.2 Structure 3 1.3 Biography of Lázaro de Soto 4 1.4 Medical Humanism in Sixteenth Century Spain 14 1.5 Medicine and the Court of Philip II 16 1.6 Medical Commentary and the history of Places in Man 19 1.7 Examination of Sources Employed by de Soto 30 1.8 Conclusion 35 Chapter 2. The Paratext of de Soto's Commentary 37 2.1 Dedication 37 2.2 Letter to the Reader 55 2.3 Preface 62 2.4 Conclusion 65 Chapter 3. Textual Case Studies 66 3.1 Case Study 1: Anatomy 66 3.1.1 Contextualisation of Places in Man, 6.1 66 3.1.2 Sutures and the Ancients 70 3.1.3 Early Modern Anatomy 73 3.1.4 Teleological Anatomy 77 3.1.5 Early Modern Comparisons of de Soto's Anatomical Understanding 81 3.1.6 Conclusion 83 3.2 Case Study 2: Physiology 85 3.2.1 Physiology in Antiquity 85 3.2.2 De Soto's Physiology 89 3.2.3 Contemporary Comparison of de Soto's Physiology 99 3.2.4 Syphilis 101 3.2.5 Conclusion 103 3.3 Case Study 3: Pathology and Nosology 105 3.3.1 Nosology and Symptomology in de Soto's Commentary 106 3.3.2 Dry Pleurisy 108 iii 3.3.3 Prognostics 112 3.3.4 Utilitas Publica 113 3.3.5 Conceptions of Pleuritic Disease in Antiquity 115 3.3.6 Conceptions of Pleuritic Disease in the Renaissance 120 3.3.7 Conclusion 124 3.4 Case Study 4: Precepts 126 3.4.1 Defining Melancholy: Humour, Illness and Temperament 127 3.4.2 Ancient Melancholy 129 3.4.3 Literary and Religious References in Comment 125 138 3.4.5 Early Modern Melancholy 140 3.4.6 Mandrake, Hellebore and other cures 144 3.4.7 Conclusion 150 3.5 Case Study 5: Ideology 153 3.5.1 Relevant Epistemology and Paths to Knowledge 153 3.5.2 Techné and Tuché 158 3.5.3 De Soto's Defence of Medicine and Humouralism 161 3.5.4 De Soto's Reaction to Quackery 165 3.5.5 Conclusion 166 Conclusion 168 Bibliography 174 Primary Sources 174 Ancient 174 Medieval/Early Modern 177 Secondary Sources 181 iv Chapter 1. Introduction Girolamo Cardano, sixteenth-century Italian physician, mathematician and philosopher, noted in his commentary on the Aphorisms, first published in 1564, that in reading a commentary, more information is learned about the commentator than the author of the work being elucidated. Employing this principle, the intent of this thesis is to gain a greater understanding of the Spanish physician, Lázaro de Soto, through an exploration of his 1594 commentary on the Hippocratic text Places in Man.1 Pushing Cardano's claim further, a commentary not only reflects the author, but also the time in which it was written. De Soto's commentary helps to illustrate the role of the genre of commentary in Castilian medicine in the Renaissance, as well as contemporary medical theory and practice. This thesis will contextualise de Soto's commentary on Places in Man in order to gain a greater understanding of medicine in early modern Spain. Very little scholarship has been carried out on de Soto and his work, and none on the scale of this examination; moreover, vallisoletano physicians have largely been ignored by Anglophone scholarship. Thus, by contextualising de Soto's commentary, this thesis will also help to further illuminate characteristics of the careers of humanist court physicians in the Spanish siglo de oro. Examining the life and work of de Soto provides an opportunity to better understand the medical training and career of an academic physician in early modern Castile. A staunch Galenist, de Soto follows a conventional understanding of flux and humoural theory, likely due to the more conservative teaching he received at the University of Valladolid. He discusses issues, but rarely disagrees outright with either the Hippocratic author or Galen. De Soto's focus in commenting on Places in Man is to elucidate the words of the author, making his medical theories and recommendations more accessible, thus advancing the medical art. Moreover, de Soto aims to connect this Hippocratic text to his understanding of humouralism, arguably in an attempt to defend the contested Galenism. Some attention is lent to philological concerns, an element seen in his inclusion and discussions of Greek terms; however, as was often the case in humanist medical works printed toward the end of the 1 See Girolamo Cardano, Opera Omnia, vol. 8, ed. by Charles Spon (Lyon: Jean-Antoine Huguetan and Marc-Antoine Ravaud, 1663), 251; Ian Maclean, "Foucault's Renaissance Episteme Reassessed: An Aristotelian counterblast," Journal of the History of Ideas 59 (1998): 163; Ian Maclean, Logic, Signs and Nature in the Renaissance: The case of learned medicine (Cambridge: Cambridge University Press, 2002), 224; Nancy Siraisi, The Clock and the Mirror: Girolamo Cardano and Renaissance medicine (Princeton: Princeton University Press, 1997), 147. 1 sixteenth century2, de Soto is more concerned with what the Hippocratic text says rather than the individual words themselves. Familiar humanist themes are seen throughout de Soto's commentary with the inclusion of ancient sources and references, both medical and literary. Many of these references will be discussed throughout the case studies to follow, aiding in the contextualisation of de Soto's comments. 1.1 Methodology One of the methodological difficulties in examining de Soto's commentary stems from the limitations of space in this study. Due to this limitation, the framework of this thesis takes a case study approach in order to provide the most complete representation of the commentary possible. In her critical edition of Places in Man, Elizabeth Craik organises the chapters of the Hippocratic text upon which de Soto commented into seven thematic blocks: the introduction (ch.