On fracture of the skull or cranium

MARIE-CHRISTINE POUCHELLE, The body and surgery in the Middle Ages, transl. Rosemary Morris, Cambridge and Oxford, Polity Press, 1990, 8vo, pp. vii, 276, illus., £35.00. The original edition of this book appeared first in 1983. This English translation follows that of Jacquart's book on sexuality in the Middle Ages: clearly Polity Press have found a niche in the English-reading market. Ultimately, I think, Pouchelle's book can best be described as political. It aims to show, by doing it, that this kind of history is valid. It is partly defensive, the enemies being Anglo-Saxons (particularly in their adoption of "behaviourist" attitudes) and the rational positivism of modern doctors (which tries to dictate what was "scientific" in the Middle Ages). In opposition to this somewhat bloodless and external approach, the validity of the French treatment that Pouchelle is fighting to promote relies on getting inside Henri de Mondeville and re-creating his motives for action. Pouchelle uses a number of devices to do this. The first is the Unconscious "gleanings from the psychologist's couch"-that is, a largely psychoanalytic approach that points to enduring patterns in the mind, together with the "day-to-day workings of my own unconscious as detected in the phantoms and dreams aroused by Mondeville's text itself". The second is a Bachelardian study of the "anthropological structure of the imagination". Third is a systematic study of the power and significance of the analogies, similes, metaphors, and allegories used by Henri. The selection of material to receive emphasis in these approaches is generally made from a feminist viewpoint. It is also a feature of the work that these approaches have been illuminated by reference more to contemporary literary, religious, juridical, and iconographic materials, which "give us access to the medieval imagination" than to other medico-surgical works. So it is certainly not behaviourist or positivist. It is another enterprise. So to criticize it as misdirected would be grossly chauvinistic and Anglo-Saxon. But it may not be inappropriate to point out some consequences of these different techniques. Whatever the justice in seeing a long duree in history, in practice it allows the historian to jump about chronologically with alarming agility. Lanfranc and Henri himself occasionally appear in the wrong century. With the whole of the Middle Ages to choose from any thesis can be sustained by selective quotation from the sources. Another problem is that a search for structures of thought from the kind of sources mentioned above occasionally obscures a simpler story. The distinction between the similar and organic parts, the sympathy between the parts of the body, the vein between the uterus and breasts, the inversion of the female genitalia, the nobility of organs and-central to this enquiry-many of the analogies made by Henri in describing the body were such well-known parts of standard Galenism that any learned medical man would use them as set-pieces. They are revealed only as platitudes of his education (but unremarked as such by Pouchelle). Would it not be possible to see the Gallic and Anglo-Saxon styles as complementary rather than opposed? In medieval Europe a man kneels in supplication before his superior, and weeps. It is a symbolic act, and when he rises it is into a new relationship. Pouchelle wants to see the action as a regression to the foetal state, followed by a rebirth. But it is surely also a ritual in which the supplicant exposes the most vulnerable part of his body, the neck, to a man who has power and carries a sword. The arrangement into which the man then rises is that the sword is not used as long as he knows and keeps his place. When very similar things happen between animals, behaviourists operate on the only level open to them and explains that it is a ritual that establishes a hierarchy without the need to kill an individual of the same species. All may be valid accounts of the same action. Perhaps we need a Eurocrat to lay down rules for harmonization.