Lecture: Early medical printing and the Fasciculus medicinae of Johannes de Ketham

On Monday the 19th May 2014 I attended a lecture in the Royal College of Physicians in London. It was in honour of their library’s recent acquisition of  a 1500 edition of the Fasciculus medicinae. Along with discussing the  Fasciculus medicinae itself, Peter Murray Jones, Fellow and the Librarian of King’s College, Cambridge, discussed early medical printing in Europe with lots of pictures and examples.

The Fasciculus medicinae is made of a number “little bundles” of short medical texts from different time periods and subjects. It was a practical work with instructions for medical practitioners in how to treat patients. It was printed by the De Gregori brothers in Venice (I am sorry but I may not have the correct spelling for this name). They had experience of printing other medical texts such as the Articella and the a work by Antonio Gatzio, very unusual as he was still alive when the work was published. It is thought that this work was created for the German market as the text came from that region, and the work did not focus on Italian medical knowledge.

The Fasciculus medicinae was published during the golden age of printing in Venice, a time where the art of woodcutting had reached a high level of skill and sophistication. As a result the Fasciculus medicinae is a really beautiful piece of art, despite being a practical medical textbook. The contents of the book changed depending on the year of printing. The 1500 version discussed here contained the fasciculus section (small bundle), Tossignano’s section on avoiding pestilence (surprisingly common in those days), Luzzi’s section on dissection (a very popular popular public spectacle at the time) and Al-Razi’s section of the sickness of children. It seems to have been a very popular book as the brothers kept producing new updates and versions. All together according to Murray Jones there are thirty three different versions and the last edition was produced in 1668. Any author/publisher would be delighted with that type of longevity.

A curious element of the Fasciculus medicinae is that it is referred to as a product of Johannes de Ketham. Murray Jones helpfully explained that de Ketham was not in fact the author, but probably was the owner of an early copy. This was plausible as stated above the information including in the work was already circulating around Germany. There are a number of different reasons why de Ketham was awarded this honour. My favourite was the idea that although the book was produced in Venice, it was planned to market the book in Germany and de Ketham was then selected for the purpose of marketing. I really like this idea as it shows the De Gregori brothers as having the type of marketing savvy that we would expect from marketers today.

Another really fun part of the presentation was inclusion of the Atlas of Early Printing.Produced by the University of Iowa, it animates the history of early printing in terms of the spread of printing, universities, paper mills and much more. You can watch history unfold as the coloured dots spread out from Germany to the rest of Europe, or you can look at a particular year or time period. There is also information about the 15th Century book and the Printing Press model. My inner book geek really enjoyed this and I am sure that yours will too. Have a go, it is great fun!

The Atlas of Early Printing

The Atlas of Early Printing

A fascinating part of the lecture was the discussion about blood-letting calendars. I had no idea that they existed but when you think about it, of course they must have! These little inventions were beautifully illustrated but quite grim. They were used to track when medical practitioners should, and should not, conduct blood-letting on their (poor, unfortunate) patients. The physicians wore them as they went about their consultations.It really is extraordinary that any of these little items still exist. They were used for one year only and then discarded. I am very happy that some are still with us today as they are quite a charming, if morbid, piece of medical history.

In turns out that for medical practitioners at the time, urine was a central concern. They used it to diagnose illnesses and to prescribe treatment. Reflecting this, the Fasciculus medicinae had a picture of a wheel of urine glasses. Each section related a particular colour of urine to a stage of digestion. Wonderfully, however, it colour of the urine was blank so the reader could full in their own colour. This ability reminded us that we were looking at a textbook and the reader could improve their knowledge through this fun little exercise.

Urine wheel (Royal College of Physicians)

There were also a set of woodcuts depicting the full human body and the various aliments that can inflict humans. The first was the Bloodletting Man, an image which showed the reader the different veins and which ones should be cut for each ailment. The picture was similar to that on the calendars, however it was very naturalistic. As Murray Jones pointed out, it had proper physical details such as muscles, and hair, something that I was not expecting.

After this image, my favourite image of the night was featured; the Zodiac Man. It is what is sounds like, a figure of a man covered by images of the Zodiac. It turns out, as Murray Jones explained, that medical practitioners used the horoscope and the phases of the moon when deciding on treatments of their patients. Each sign was positioned on the part of the body that it governed and it made for a really striking image. As a bonus treat we were shown an image from the Guild Book of Barber Surgeons of York. This book featured a turnable wheel which the medical practitioner could use to calculate the phase of the moon and then check to see could blood be letted from a particular part of the body.

Zodiac Man (Royal College of Physicians)

Next we got to see the image of the Diseased Woman. As a woman I was curious to know what these medical practitioners would have made of me in 1500. Unsurprisingly many of the diseases featured were centred around the womb and pregnancy. There were also some more cringe-worthy “illnesses” such as forgetfulness, which women were considered to be afflicted due to the delicacy of their sex. However the 1500 version had come a long way from the 1491 one in terms of the illustration; the 1491 image looked like the woman was a squat frog!

My second favourite image of the night was the Wound Man. This image was quite remarkable, a full bodied man was covered in wounds from arrows, knives, cudgels etc. many of which were still stuck in his body. It was a bit gory and bizarre; I could not take my eyes off it. Murray Jones described how this image is also used in Wellcome 290. I loved this image, mainly for the picture of the heart. It is shaped like a the hearts we use when not being anatomically correct. I was under the mistaken assumption that this was a new phenomena but obviously not!

Wellcome 290 - Wound Man

Wellcome 290 – Wound Man


The last full body image was that of the Diseased Man. This image showed us the four faculties of human beings. Again the body itself was portrayed in a classical style, with defined muscles, hair, bellybutton etc. I would love to compare the diseases they attributed to woman and those they assign to men. I wonder do men have forgetfulness or do women share any “manly” traits.

One of my favourite things about old books are markings left behind by past owners and readers. Sometimes they can give real insight into how the text was used. This edition had part of its texts and images marked up with red by a reader. There were also notes from medical practitioners underlying sections  and adding their own remedies. It shows us how this text was not just an exercise in imagination but a real, practical textbook that was used to inform the actions of medical practitioners.

The last three images, scenes of medical practitioners carrying out their work gave us lots of insight into the worlds of medicine and publishing. The first, depicting a man and boy offering medical practitioners cups of urine, shows us how samples were given. Not only that but according to Murray Jones, also showed us how mistakes can happen in the printing process. The cups are being held in the figure’s left hands which points at a reversed woodcut. The next image of a sick man in a bed being attended to shows us how sponges and lamps were used to try and fend off the bad air. In terms of printing a white cat was shown in the scene in the 1491 version but not in the 1500 one. The cat may have been phased out or removed deliberately. I would love to know why the cat, a symbol of hope, was excluded from the later versions. Finally we get a dissection scene. Here we get an image of how these examinations may have taken place. This image also showed us how scenes change over time, woodcuts were totally changed depending on the edition.

Bedside scene without the white cat (Royal College of Physicians)

I am really glad Murray Jones showed us the other editions. I felt that the audience got a really good insight into the history of the Fasciculus medicinae.  This lecture was really interesting and I feel like I learned a lot, not only about the Fasciculus medicinae, but about early European medical printing. If you get a change do visit the RCP website and have a look at the images. You can also order the book to have a look at in the reading room.

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