Reforming Medicine in Sixteenth Century Nuremberg by Hannah Saunders Murphy Doctor of Philosophy in History University of California, Berkeley Thomas A
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Reforming Medicine in Sixteenth Century Nuremberg By Hannah Saunders Murphy A dissertation submitted in partial satisfaction of the requirements for the degree of Doctor of Philosophy in History in the Graduate Division of the University of California, Berkeley Committee in charge: Professor Thomas A Brady, Jr, Co-chair Professor Jonathan Sheehan, Co-chair Professor Thomas Laqueur Professor Ethan Shagan Professor Elaine Tennant Fall 2012 Reforming Medicine in Sixteenth Century Nuremberg © 2012 by Hannah Saunders Murphy All rights reserved. 1 Abstract Reforming Medicine in Sixteenth Century Nuremberg by Hannah Saunders Murphy Doctor of Philosophy in History University of California, Berkeley Thomas A. Brady Jr. & Jonathan Sheehan, Co-Chairs In 1571 the Nuremberg physician, Joachim Camerarius (1534-1598), submitted for the appraisal of his city's Senate, a substantial manuscript titled "Short and Ordered Considerations for the Formation of a Well-Ordered Regime.” As one of these 'considerations', he petitioned the Council to establish a Collegium medicum: an institutional body that would operate under the council's mandate to regulate and reform the practice of medicine in the Imperial City of Nuremberg. Although never published, this text became the manifesto of an ongoing movement for the reform and reorganization of medicine throughout the sixteenth century. This 'medical reformation' was a professional claim to social status and political authority on the part of academically educated municipal physicians. More elusively and more importantly, the medical reformation was also the consequence of a series of epistemological shifts within medical knowledge, as practiced and conceived by German municipal physicians in the sixteenth century. In a series of chapters on publications, personal libraries, and correspondence networks respectively, this dissertation examines the way in which the Nuremberg physicians re-created their practice of medicine, privileging their medical 'methodologies,' tactile processes, observation, consensus between physicians and new pharmaceutical distillations, over the simple reception of Galenic branches of knowledge. The municipal physicians and their medical reformation offer a perspective on distinctly artisanal practices: experience, demonstration, an engagement with the vernacular, and professional consensus. However, they do so from a non-artisanal social background. As all were graduates of German, French and Italian universities, no one more embodies the world of scholastic learning than they. Their claim to professional primacy was based not just on an appreciation of the value of new mechanical and technical processes, such as pharmacy, diagnostics and treatment but, also, on an appropriation of their social role. When the Collegium medicum was established in 1592, it elevated university educated physicians above other practitioners in the medical marketplace. It restricted pharmaceutical innovation to physicians, rather than apothecaries, awarded to the physicians jurisdiction over the allocation of medical duties among the medical marketplace, and put in place a set of relationships between physician, patient and polity that endures to this day. i Table of Contents List of abbreviations and glossary of terms...............................................................p. ii Acknowledgements....................................................................................................p. iv Introduction ............................................................................................................p.1 Part One The Emergence of Municipal Medicine Chapter 1 Nuremberg's medical marketplace.....................................................p. 23 Chapter 2 Theory and practice in Galenic medicine..........................................p. 57 Part Two Medicine and Practice Chapter 3 Anatomy, botany and the pursuit of practice.....................................p. 88 Chapter 4 Libraries and medical knowledge......................................................p. 122 Chapter 5 Correspondence and consensus..........................................................p. 156 Part Three Medical Reformation Chapter 6 Camerarius and the manifesto for medical reform..............................p. 184 Chapter 7 The negotiation of reform in Nuremberg............................................p. 218 Conclusion Ordinary physicians and general practice...........................................p. 253 Bibliography .............................................................................................................p. 261 Appendix I List of Stadtärzte.................................................................................p. 283 Appendix II Georg Palma's Library.........................................................................p. 287 ii List of abbreviations AHR: The American Historical Review ARG: Archiv für Reformationsgeschichte, (Archive for Reformation History) BJHS: British Journal for the History of Science GNM: Germanisches Nationalmuseum, Nuremberg MVGN: Mitteilungen des Vereins für Geschichte der Stadt Nürnberg SCJ: Sixteenth Century Journal StA N: Staatsarchiv Nürnberg StadtA N: Stadtarchiv Nürnberg StB N: Stadtbibliothek Nürnberg UB Erlangen: Universitatsbibliothek Erlangen Glossary of terms Ambtsbücher: Nuremberg kept list of all those who held formal positions in the city, recorded in Ambtsbücher. Most people who held this kind of office swore oaths to the city. Apotheke: Apothecary. Apothecaries swore oaths and were recorded in Nuremberg's Ambtsbücher. Arzneybücher: vernacular medical books of remedies, often with simple instructions. Bürgermeister: Burgher master, also burgo-master. These were citizens of Nuremberg, eligible for membership to the city's Greater Council. They were not patrician, and were often mercantile and artisanal figures. Chirurgeon: a learned surgeon, often with a minimum of one year's university study Collegium medicum: College of medicine - an organized, corporate body with a hierarchical structure. The composition of Collegia medica could vary from city to city. In medieval Italy they were structured similarly to guilds and often included apothecaries and surgeons. German Collegia medica were exclusively the preserve of learned physicians, and were more similar to the later scientific academies than the earlier guilds. Composita: complex remedies included multiple ingredients, which were distilled (the medical purpose of sucfh remedies was granted by the artificial process of preparation, as opposed to simple remedies, in which the medical purpose was tied to the primary ingredients). Geschworne Frawe (Fraue): Patrician women appointed as official supervisors to midwives. They engaged in no gynecological activities, but often accompanied midwives and witnessed childbirth. Geschworne Handwerke : Artisans and craft-workers in Nuremberg. They were recognized by the city Senate and they swore oaths, but, because Nuremberg had no guilds, they were neither formally organized nor represented. Hebammen: Midwives. In most German cities, Nuremberg included, midwives were t rained as apprentices and had to undergo testing before they were licensed. In Nuremberg, they swore oaths to the city and appeared in the Amtsbücher. Leibarzt: Literally a 'body-physician'. The term refers to the Galenic division between exterior medicine that was the preserve of surgeons and internal medicine, which iii was the domain of learned physicians. A Leibarzt was a learned physician who practiced medicine and the term often, though not exclusively, referred to a position held as the physician of a specific patient. For example, before entering the employ of Nuremberg, Volcher Coiter was the Leibarzt, the official court physician, of Margrave Ludwig VI in Amberg. Senate: The term Senate refers to both divisions of the Nuremberg Rat, that is the entire political body that comprised Nuremberg's government, encompassing both the Inner and the Greater Council. The former was the executive arm of the city's government and was comprised of patrician family members. The latter was a large assembly of the city's burgher citizens. Simplicia: Simple remedies were herbal remedies. They could be lone herbs, or they could combine a number of medical ingredients. Importantly, in simple remedies the medical efficacy was tied to the individual, primary ingredient. Sondersiechenschau: Nuremberg's annual 'inspection of lepers'. This was a charitable ritual established by a medieval bequest. Petitioners who had or were suspected of having leprosy could come to the city and receive a medical diagnosis. This was provided in conjunction with religious service, alms and food and drink. Wundarzney: The vernacular term for a surgeon. As opposed to a chirurgeon, a person referred to as a Wundarzney had no university training. He was qualified by apprenticeship and, sometimes, by exam. In Nuremberg, Wundarzney swore oaths to the city, but they were not included in its Ambtsbücher. iv Acknowledgements The early modern physicians believed that good health relied on the balance between nutrition, environment, emotion and the spirit, and they would be the first to tell me how lucky I have been. Over the past six years, I've been given every kind of conceivable support. I owe far too much to adequately summarize, however I would like to at least acknowledge, if not properly convey, the depth of some of my debts. This project received generous funding. I am particularly grateful to the IIE