By Madeleine P. Cosman
Bulletin of the New York Academy of Medicine, Vol.49:1 (1973)
Introduction: Sometimes jocularly, sometimes seriously, modem critics maintain that all medieval medical practice was malpractice. While amusing, such judgment ignores not only the sophistication of much medieval medical and surgical practice but also the attempts and the achievements of medieval medical legislators to establish professional standards and to enforce these in practice. Therefore it is especially fascinating to examine documents of medicolegal case histories adjudged in their own time as malpractice litigations; and then to compare this evidence from the legal dockets with the contemporary legal dicta whose purposes were to legislate against such malpractice.
Such investigation of actual case histories and of official legislative documents has at least three salutory effects. First it permits the modern critic to apprehend what the medieval medical mind considered malpractice. Among the numerous types of malpractice pleas are suits brought because of lack of success of promised cure, excessive payment demanded for services, aggravation of an original complaint because of medical folly, death due to medical negligence and, even, “iatrogenic sequelae,” in which the effects of cure and curer caused new injury to the patient.
Beyond allowing an understanding of malpractice, the cases and the dicta demonstrate better than almost any other type of source material the actual state of medieval medical and surgical practice. For unlike any other documents, malpractice case histories permit disease and modalities of cure to be examined from three separate vantage points: those of the patient, the practitioner, and the professional peers who sit in judgment. Thus the positive-good practice-is appreciated through its negative-malpractice. What is more, these malpractice cases provide-better than any theoretical treatise, no matter how comprehensive or how brilliant-apprehension of the medical world as it was, not as it might have been or ought to have been. Thus for such subjects as medical fees, medical women practitioners or, of particular significance, astrology and zodiacal computations in medical and surgical practice, the case histories of the legal dockets and the accompanying legal dicta demonstrate the manner in which all of these functioned in actual practice, not merely in learned theory.