MICHELE L. CLOUSE. Medicine, Government, and Public Health in Philip II's Spain: Shared Interests, Competing Authorities.by W. Bynum

The American Historical Review


Archaeology / History / Museology


on individuals like Martı´n for its daily operations. In an epilogue, Liang also indicates how different branches of the Ferna´ndez de Co´rdoba clan fared: some kept up the tradition of royal service into the seventeenth century, while others married into some of the most prestigious noble families of Spain.

Liang’s basic methodological approach of using family history to explore how empires worked is extremely promising. The book’s main weakness is that it essentially relies on only two individuals to make its case.

This is especially frustrating given that Liang could have highlighted another member of the Ferna´ndez de

Co´rdoba family, the “Great Captain” Gonzalo Ferna´ndez de Co´rdoba, who was central to the Spanish conquest of Naples in 1503 (but whom Liang barely mentions). It is to be hoped that in Liang’s next book, he broadens his view and produces a more satisfying work.


University of Akron

MICHELE L. CLOUSE. Medicine, Government, and Public

Health in Philip II’s Spain: Shared Interests, Competing

Authorities. (The History of Medicine in Context.) Burlington, Vt.: Ashgate Publishing Company. 2011. Pp. xiv, 204. $104.95.

Spain’s rich medical tradition has been well exploited by a number of distinguished Spanish medical historians, but it remains too little appreciated by anglophone scholars. This is just one reason why Michele L.

Clouse’s systematic study of the relationship between doctors and the state in Philip II’s Spain is to be welcomed. The sixteenth century was a significant period, when Spain’s increasing influence in Europe and the

New World began to loom large.

Much of this came during the reign of Philip II (1556– 1598), as he sought to consolidate power to his Castilian throne. The “public health” of Clouse’s title recounts little of what later generations would understand by the phrase, when public health mostly concerned issues such as drains, overcrowding, and disease notification.

Rather, her monograph deals principally with the regulation of medical personnel, their education, training, and licensing. Philip believed that properly trained physicians, surgeons, and apothecaries would produce a healthy community. Cynical modern medical historians might question the premise, arguing that medicine actually had little to offer to patients in the remote past.

That was not the perception of Philip or his subjects.

Having good doctors and proper apothecaries to compound drugs were seen as necessary in the fight against disease and death.

How Spain sought to achieve these aims takes center stage in Clouse’s monograph. The monarch was very important in this process, far more so than in other European countries in the early modern period. Philip took a more active role in medical matters than many of his counterparts elsewhere. Medicine and health were seen as affairs of state, although of course they competed for attention with many other matters of statecraft. Nevertheless, legislation, official reports, and many consultations testify to the value that Philip placed on presiding over a well-educated and well-regulated medical profession.

Much of the practical realization (often only partial) of his aims was mediated through his protome´dicos.

These chief physicians have been analyzed before, both in the Spanish New World lands and in the mother country itself. Clouse paints a picture of these officials as energetic and highly motivated. Luis Mercado (1532–1611) was a physician of vast erudition and international standing. He wrote textbooks that became the standard in the revised medical curriculum of Spanish medical schools and was actively involved with Philip’s attempts to reform hospitals and the structures of poor relief. In most cases, the attempted reforms were only partially successful.

Clouse has cogent things to say about the gaps between ambition and achievement. The Spanish crown was always short of money, so if the program was expensive it was almost inevitably doomed. The political context did not help Philip’s plans either. Even in Madrid and the surrounding Castilian countryside, he had difficulty realizing his goals; the Spanish domains that he wanted to consolidate had their own loyalties and traditions. Local resistance to ideas originating at the royal court jostled with resistance from local officials and medical practitioners, and from pre-existing patterns of health provision. Attempts at hospital reform and consolidation inevitably involved the church, and often even the pope, since most Spanish hospitals were religious institutions. Sometimes, however, the central system worked. Clouse provides a wonderfully revealing account of the thorough examination of Gonzalo

Xerxe’s apothecary shop in Bayona. Xerxe had to produce his books, answer searching questions about his trade, provide samples of his medicines for analysis, and offer his price lists to demonstrate that his charges were reasonable. The investigation lasted two days and cost the apothecary the considerable sum of 1,000 maravedis per day (town physicians generally received a base salary of between 5,000 and 10,000 maravedis per year). At least Xerxe passed his examinations and was able to carry on his business.

This is only one of a number of examples of daily medical life in early modern Spain that Clouse has uncovered. Her volume is rich in detail, judicious in its judgments, and sensible in its conclusions. Above all, she paints a picture of a society filled with people coping as best as they could. Some were admirable, some less so, but she has a wonderful sympathy for them all.


University College London

JOSE´ A´LVAREZ-JUNCO. Spanish Identity in the Age of Nations. New York: Manchester University Press. 2011.

Pp. 408. $125.00. 592 Reviews of Books

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