J Andrew Mendelsohn & Annemarie Kinzelbach. ISIS: Journal of the History of Science in Society. Volume 108, Issue 2. June 2017.
Over the past twenty-five years, history of science has expanded into history of knowledge. Plurality has been the main message. Commonality, by contrast, is the main finding of the present study. It examines the knowledge practices of the full range of participants in cases of public inquiry—trials, tests, inspections—involving human bodies in contexts of criminal law, police, public health, marriage and family, claims to community aid, and regulation of trades. The cases come from the archives of three agencies of inquiry and evaluation—a government, a university faculty, and a guild—in a variety of polities in the Holy Roman Empire between about 1500 and 1650. Participants of widely differing education, occupation, and experience—learned, artisanal, and domestic, as well as specialized versions of these—are found to have shared practices of observation, description, explanation, and argument. This finding opens the prospect of a history of shared empirical rationality, in contrast to the hegemony of difference, dialogue or transfer, and “expertise,” in how we understand knowing in modern as well as premodern Europe.
How we know: if there were a single answer to this question, historians and social scientists, even most philosophers, would not be asking it. When we study knowledge, we usually see different knowing practices: scholarly, artisanal, philosophical, experimental, mathematical. This expectation holds across the arts and sciences and beyond, even in the early modern period. The knowing practices of artisans, physicians and medical practitioners of all sorts, jurists, farmers, theologians, merchants, engineers, actuaries, householding women, administrators, and, indeed, “the state” are all now under study for their relevance—and hence necessarily their distinctive relevance—to the history of science, broadly conceived. The fading of the idea of “the” scientific method, itself relatively recent, spurred the search for styles or “ways of knowing” or far-reaching practices of quantifying, visualizing, being objective, establishing facts, and managing information and renewed the study of transfer across domains and learned/lay divides without assuming diffusion from above or from European centers. All this research presupposes plurality. Distinction is especially evident in public settings, where special knowledge typically is claimed by groups or individuals and put to use by states, courts of law, and communities, and where historians study the construction and contestation of expertise as well as the interaction of different “experts”—scientific, medical, legal, or more specialized—with each other and with “lay” people.
Yet the early modern period, we propose, offers an opposite story about the same plurality of knowers and domains, a story that also promises insight into modern times. It is a history of common rather than uncommon knowing, of shared empirical rational practices rather than specialties and interactions, a history that the very focus on “expertise” tends to obscure. We tell one version of this history through a collection of stories. They were cases in their time, and in this essay they stand for other, similar ones. They take place where we would least expect them: in those places of distinction among knowers, public settings.
Hans Mohr, Highest Justice of the Free Imperial City of Frankfurt am Main, wanted to know “whether the cranium and the dura and pia mater had been damaged by the beating.” This seems a question for the surgeon. But it was asked of Katharina Hansenn, housewife. And she answered.
It was Thursday, 21 May 1551. Mohr’s task was to provide evidence (beweisen) as to whether Anna, wife of Martin Rode, had died from maltreatment by her husband or from unrelated illness. So in the Rathaus that day and the following week, he questioned twenty-one “witnesses.” They ranged from university-educated doctors to barber-surgeons to neighbors and relatives. There is nothing remarkable in this—until we notice that Justice Mohr was asking doctors and housewives the same questions. All were expected to answer questions we would call “medical” or “for experts,” and by and large they did. Moreover, as we shall see, these questions concerned both what was seen (as one would ask of an eyewitness) and how and why death occurred (as one would ask of an expert witness). This is the observation from which the argument of this essay unfolds. The central claim is that groups of widely differing status, education, occupation, and experience in fact shared empirical rational practices. These were practices of observation, description, explanation, and argument.
Our argument unfolds across a range of at least five different kinds of case of inquiry for public decision: from the diseased former soldier accused of endangering his community (purity and danger, public health) to the artisan family seeking annulment of a marriage contract (family economy, material production and human reproduction) to surgeons under investigation for malpractice (guild regulation of a trade and practical art) to individuals claiming community resources (charitable care, poor relief) to classic forensic cases like that in which Hausfrau Hansenn testified regarding the body of Anna Rode (conflict and violence). These situations of uncertainty or disagreement occurred in a variety of polities in the Holy Roman Empire between the 1510s and the 1650s. Resolving them in ways acceptable to their communities involved making observations and arguments about the body in health and illness, anatomy, diet, materia medica, relations between bodies and their natural and human environments, law, and the practical arts. The cases come from three kinds of source, each representing an agency of inquiry and evaluation: the archives of a government (Frankfurt am Main, a city-state), a medical faculty (Tübingen, university of a territorial state, the Duchy of Württemberg), and a guild (or, more precisely, the sworn jurymen master barber-surgeons nominated from their guild in a major center of wealth and the arts, Ulm). Studies of public cases involving human bodies usually concern one or two of the classic forensic types (infanticide, insanity) and one or two kinds of participant, such as physicians. Or they focus on the female body. The present study makes a simple move: to study the full range of participants and a variety of situations, involving both male and female bodies, at once. The method is, moreover, to read the sources without assuming who knows and to look for commonality of practice as much as construction of difference. Each case examined here, we find, displays the same broad participation and commonality across difference that is evident in the story of the inquiry into Anna’s death in Frankfurt in 1551.
This commonality is unexpected: generally for the reasons already given and specifically because we know to expect conflict and strategies of distinction among health practitioners in all their early modern variety—doctors, midwives, barber-surgeons, herb women, apothecaries, “empirics” and purveyors of “secret remedies,” clerics, bonesetters, astrologers, and so on—and from others claiming knowledge in public settings. Moreover, the shared language (humoral, Galenic) by which the body—especially the female body—was understood by doctors and patients and in both learned and vernacular medical literature is well known, but it is not the same as shared practices of inspecting, describing, and constructing or countering evidence and explanation. In the ever wider and more various social history of knowledge, as Peter Burke writes in his survey under that name, medicine exemplifies the “plurality of knowledges.” This is a reason to consider broadly the implications of the cases presented in this essay.
There are further reasons why we can expect to learn generally about knowledge, society, and expertise by studying cases involving the human body. The first is range. Trials, inquiries, inspections: the cases we consider range from criminal justice to civil contracts, from public health to municipal aid to guild regulation of trades, and generally across Policey, the broad early modern term for the tens of thousands of ordinances and countless individual proceedings that made up social, economic, and environmental regulation. Thus our findings are not particular to this or that kind of legal or administrative process. There were formal differences between domains such as law (Recht), police, guild, and market and between proceedings such as inspection (Schau) and trial in court (Gericht). Yet focusing on bodies and their environments brings together cases from all these domains and brings their similarities into view. This omnipresence of the body entails a second reason why we stand to learn from cases involving it. Healers testified throughout the medieval and early modern periods, while representatives of other occupations that could claim special knowledge and experience and that came to be called expert rarely did so until the eighteenth and nineteenth centuries. Healers had, on the other hand, no monopoly: knowledge of the body and of natural environments and substances in relation to health was widespread, in both oral and written form and in the form of domestic practice. This conjunction of contraries—being the knowers most called upon by the polity and, at the same time, sharing knowledge with many others—will test, in case studies, expertise as the now-standard way of thinking about practical knowledge in action.
Why, then, early modern Germany? Recent research on politics in the Holy Roman Empire between the sixteenth and the eighteenth centuries has revealed a staggering degree of participation and initiative “from below” in the political life of communities, especially cities, and thus essentially in their government. This has been shown for free imperial cities yet also where less expected: in territorial “police” states and in so-called inquisitorial criminal justice systems, which had long been the very image of expert-based government and social control—and in Anglo-American historiography of science and medicine still are. Broad political participation, on one hand, and, on the other, the prevalence of university-trained knowers in government in the part of Europe that gave us cameralism and “sciences of state” (Staatswissenschaften): this conjunction of apparent contraries makes early modern German public cases good for thinking about these matters at large. Moreover, the new history of political participation and interaction does not look at participants as knowers. And it virtually ignores the practices of artisanal and learned groups, which are the subject of separate old literatures on guilds and universities and on law, medicine, theology, and humanism and of separate newer literatures on artisanal knowledge and how-to, learned practices, political counsel, jurists practicing rather than prescribing, academic ritual, and “scholars in action”—altogether difficult to grasp except as different kinds and cultures of expertise. Public cases allow us to look instead at everyone in the same settings, reporting on and judging the same situations.
So inclusive is this story of knowing that it includes one other character not usually in the cast: the accused. Studied by historians mainly as the human objects of inquiry, they were equally its subjects—sometimes more than equally, when they won their cases. This is the focus of the first section of the essay. The second section broadens to show that all kinds of participants dealt with the same questions using the same or comparable sorts of empirical rational practice. This did not make participants interchangeable. Groups differed in education, occupation, and experience and in their function in public proceedings. At times they competed for authority. Instead of starting from groups and examining their interaction, however, we start from what all kinds of participant did throughout a trial, inspection, or inquiry and ask, in Section III, what happened to difference and commonality along the way.
Subjects of Knowledge
Creating information, controlling knowledge: these capacities, our case studies suggest, were not restricted to city councilors, jurymen, judges, their advisors, and medical “experts.” They were also in the hands of the accused, which were less bound than usually imagined, and in the hands of wider informed publics. Contrary to principles of inquisition and contrary to the long tradition of regarding criminal law as an arm of the state for social control, we know from historical research since the 1990s that most policing action and most judicial proceedings in early modern Europe were initiated by individuals rather than by the authorities. Moreover, the majority of trials for capital crimes, even in the age of the so-called Carolina (from Constitutio Criminalis Carolina) and its precursor codifications of inquisitorial criminal justice in the Holy Roman Empire, roughly 1500-1800, ended with much milder punishments or with various forms of peaceful conflict resolution between the parties of victim and accused. All such outcomes were determined through very broad written and oral participation by relatives, friends, communities, and the accused him- or herself. Unexamined in this new history of criminal justice as “consensual practice” and “clearing place” for conflicts are questions of evidence and argument, knowledge and expertise. What we show in this section is, first, the knowledge component of such activity and, second, that patterns of informed action reached far beyond proceedings of criminal law to other situations that turned on evaluating the conditions of and events around a human body and in which observations were made, evidence produced and debated, and judgments delivered.
The trial of Martin Rode, with its medical arguments and many medical witnesses, seems to exemplify the rising role of medical expertise in the sixteenth century. Yet the trial and its associated inquiries were in many ways created through the knowledgeable action of the accused and of a wide public. This was not because of Rode’s social status: he is addressed in documents as a barrel-maker, indicating a modest income; according to witnesses, he was also an innkeeper and the owner of a vineyard, indicating a higher income. Rumors that Rode had hit his wife Anna such that she died traveled at least as far as Heidelberg, almost a hundred kilometers away. The governors of Frankfurt could not ignore such rumors without appearing to neglect central tasks of an imperial city’s council: to protect the rights of burghers, to ensure justice, and to reestablish “order” when it was disturbed. The sheer number of Rode-related entries in the minutes of the council proceedings for 1551 indicates that the challenge was taken up. The part played by doctors and barber-surgeons increased rather than resolved uncertainty: results of examination and partial autopsy of Anna’s corpse tended to absolve Rode. Partly on that basis, the accused and his legal counsel asserted a right to call witnesses. Highest Justice Mohr tried to prevent this and to keep to a purely inquisitorial form of trial in which he alone would decide who testified. But the accused prevailed over the inquisitor. In fact, the questions put to witnesses in the file titled “Hans Mohr Highest Worldly Justice against Martin Rode Barrelmaker” were mainly generated not by Mohr in his fact-finding function, as inquisitor, but by the defense mounted by the barrel-maker and his lawyer. Thus although the case turned on questions we would call medical, it was being shaped far less by medical expertise than as a kind of informed debate that began with public opinion (“rumor”), continued in meetings of an elected governing council, and reached its fullest form in hearings that, through the knowledgeable action of the accused and his lawyer, created and tested alternative accounts of an event in the physical and human world.
None of this was new in 1550. Before exploring the Rode hearings, let us consider an earlier simpler yet analogous case. In 1517 in Frankfurt, Clauß Guntram was charged with killing a man named Genßhenn. The defendant claimed that he had wounded Genßhenn unwillingly in an act of self-defense and that his alleged victim did not die from this injury but had in fact been cured before he died and that an intervening illness had led to his death. Guntram named a number of witnesses, who testified that Genßhenn’s stab injury had been completely healed after less than three weeks and that he had thereafter been back to work, hauling wood, walking distances, and even celebrating his recovery. Among these witnesses was a barber-surgeon. Yet the structure of such medical arguments and the emphasis on evidence of recovery from injury reflected the state of the art in contemporary vernacular “lay” legal texts, such as the widely circulated Layen-Spiegel, or “Layman’s Guide,” to civil and criminal procedure; it was first published at Augsburg in 1509 and in thirteen more editions in the sixteenth century and would later appear in the Carolina itself, which was, after all, not only a new codification but a lay guide—in German, not Latin—to criminal procedure. Such texts guided lay inquisitors—but also the accused objects of inquiry.
Trials for criminal offenses were not the only kind of proceeding in which the objects of empirical inquiry became its subjects. Beyond autopsy and examination of wounds and corpses lay a wide domain of official inspection (usually Schau, sometimes Besichtigung) of the condition of human bodies, ranging from suspected leprosy to cases for poor relief and, as we shall see, to cases involving marriage and family economy. Central to the development of such procedures was leprosy inspection, which for centuries was very widely practiced and took place in monasteries, in leprosaria outside of cities, in senate rooms of medical faculties or the dean’s own home, and in spaces specially designated by city governments.
Late medieval clergy, nobility, and, eventually, less privileged members of society countered accusations of leprosy by demanding that they be examined by medical doctors. Or they challenged the results of such examinations and appealed their cases. Official town physicians complained of people hiding leprosy, but also of poor people simulating the disease by maltreating their skin. For a leprosy certificate could be a ticket indoors, as could one for a new condition manifested on the surfaces of people’s bodies, the so-called French pox. As opportunities for subsidized medical treatment increased in the sixteenth century, ailing inhabitants of towns maneuvered for access to charitable or municipal institutions. This entailed passing a medical examination—with a positive result. In 1544, for example, Caspar Vögelin of the south German imperial city of Nördlingen reported himself to official town doctor Johann Widman. The certificate issued by Dr. Widman supported Vögelin’s account of his condition and his suggestion that he be funded for treatment at a mineral spa: this had a chance of curing him quickly and thus more cheaply than other methods. Agreement was at once medical and economic. Inspection was not “expertise” imposed on the “public” or laypeople as objects of inquiry and knowledge. The empirical and evaluative practice that made up such “expertise” was Vögelin’s as well as Dr. Widman’s.
Not all such cases went so smoothly. More conflicted ones show still more the variety of components that could make up knowledgeable behavior. In 1594, again in Nördlingen, Maria Adam showed her skin problems to the town barber-surgeon “in office” (im Amt). She did not get the result she expected: a certificate entitling her to months of living and being cared for in the pox-house at communal expense. So she took her case to the junior physician in office, to whom she named signs that she held were those of sickness and that, according to the barber-surgeon, she had not mentioned before. And when she found that this physician agreed with the barber-surgeon, against her interpretations and expectations, she appealed to the senior physician in office. Of course, we can see this as pursuing one’s own interests; more interestingly, we can see it as a knowledge struggle over rival diagnoses. Confident knowing of one’s history and condition, capacity to present and represent oneself with assurance to experts, culturally scripted behaviors of women’s obstinacy, civil defiance, and attempted fraud: each of these possible ways of interpreting events would be one or another contextual or analytical construction of Maria Adam’s informed behavior.
The most interesting such cases are those in which the person in question seems, on the face of it, to be thoroughly at the mercy of power and knowledge. In 1656 seventy-two-year-old former soldier Martin Naff appeared at the Medical Faculty of Tübingen to be examined by members of the faculty and a surgeon. He had been sent by his regional bailiff, whose office was in the town of Horb on the Neckar (about thirty kilometers from Tübingen) and who was the local representative of the policing powers of the Habsburg Empire. Naff’s medical history, as related in a letter from the bailiff to the faculty, revealed years of skin disease—and years of accusations, banishments, and in the end even incarceration. Neighbors had once “accused” Naff of being afflicted with Malazej (leprosy). This accusation was upheld and resulted in his separation from family, income, and community. In 1653 he returned home with a testimonial from the Collegium Medicum in far-away Strasbourg stating that he was free of leprosy. The following year, around Christmas 1654, he used an ointment, and a rash broke out on his head four weeks later. Instead of treating him, the barber-surgeon whom he consulted denounced Naff to the authorities as having the so-called French disease. Naff spent the next four weeks in prison. The bailiff’s letter to the Tübingen faculty listed the allegedly “infected” parts of Naff’s body and demanded certainty (gewissheit) concerning the nature of the disease. Told in this way, the tale of Martin Naff is one of a man pushed around and battered by knowledgeable governing forces around him.
Looking more closely, however, we find the opposite. Naff’s behavior exemplifies what historians of the patient have revealed to be common patterns of self-directed selection of remedies and choosing of practitioners. Naff himself procured and used the guethleuth salben, an ointment either specifically used by lepers or produced by the inmates of a leprosarium, even as he denied being leprous. Naff himself procured from a barber-surgeon a bandage to avoid contamination. All in all he consulted four barber-surgeons, among these a traveling Swiss and a “foreigner.” Moreover, he evaluated medical treatments by refusing to pay selected bills. Not paying was not simply pecuniary or deviant behavior, but a version of the negotiated patient–practitioner relationship that was governed in other places, as Gianna Pomata has shown for Bologna, by written contracts for cure and tribunals to address disagreements. And, finally, it was Martin Naff himself who took the initiative of seeking inspection and certification by another authority, the Strasbourg Collegium, and who undertook the long journey for this purpose.
And there is more, lest this seem mainly a history of power without much knowledge and information in it. Let us rejoin Naff under inspection by the Tübingen medical faculty. Contrary to accusations of infection, Naff argued that the condition of his health and skin derived from hardship during his earlier life as a soldier, from the bad dietary habits he acquired through lack of female company, and from the noxious vapors emanating from the walls of the various prisons in which he had been confined, which had damaged his rohr (bone or penis). The faculty decided the same. It responded to the bailiff that Naff’s “scabies and varices” were not contagious but resulted from his old age and from alterations in his blood due to dietetic mistakes, frost, and the appalling conditions under which he had been living and asserted that the resulting signs had been misinterpreted as those of leprosy or the French disease. Inspection from above and patient narrative from below were one. The professors were not merely informed by the man who was the object of inquiry: the faculty’s evaluation (Gutachten) was virtually Naff’s own account. Moreover, the faculty’s report was written under and signed by its dean, Samuel Hafenreffer, author of the first major book on skin diseases in Germany, which went through seven editions in the mid-seventeenth century. The professor and leading authority shared interpretive and explanatory practice with the old soldier.
Public of Experts
Ways of evaluating the condition of human bodies between health, disease, and danger were shared not only by inspectors and inspected but also by wider publics. Fellow inhabitants of Naff’s hamlet, Eutingen, participated in knowing and decision making in situations of uncertainty.
For some time clamor rings out and rumor is spread that he [Naff] is tainted with the epidemic French Disease. This induces abhorrence in many inhabitants of the hamlet, and everyone is saying that during the last summer he had rashes on his whole body. He also applied the leper-ointment, and with this he drove the rashes back into his body. Recently he also was examined by a noble barber-surgeon, who explicitly acquainted me with the fact that the above-mentioned Martin, a subject [under the powers] of my office, was infected with the mentioned pestilence inside his body, particularly in his mouth and other body parts.
So the bailiff wrote to the medical faculty. Villagers’ claims were taken seriously enough to set in motion, repeatedly, a whole apparatus of observation, evaluation, communication, and intervention spread across several centers of knowledge and governance as far as a hundred kilometers apart. The villagers of Eutingen were not to be overruled by the Collegium Medicum of Strasbourg; their opinion was supported by that of a “noble” barber-surgeon in the regional administrative center; and the Habsburg representative did not hesitate to refer the case to a medical faculty and Europe’s leading dermatological authority. Identifying (plausible) leprosy or the French pox may seem not much to expect of villagers—until we recall that the whole system of official inspection, of Schau, which operated for several centuries throughout the Holy Roman Empire and beyond, was built up around the difficulty of making exactly these empirically based judgments. In this system, local communities in effect practiced Schau before the experts did. Like a practitioner watching his patient, the people of Naff’s hamlet even monitored therapeutic outcomes—the effect of an ointment—and explained them. Their explanation was not “popular.” In explaining the perceived treatment outcome as an act of driving noxious matter back into the body, these villagers represented the disease in the same way that physicians and surgeons did.
Questions of community boundaries and security, of purity and danger, were not the only kind to be addressed through common ways of observing and judging bodies and their environments and evaluating their histories. Questions of the ability to reproduce and to produce—of marriage, work, and family economy—were another. These have been studied mainly as part of the history of the body and power. Yet they can also be understood as belonging to the history of empiricism, broadly conceived.
In 1605 in the city of Ulm, a recently betrothed dyer named Andreas Heffelin had to appear before a jury of seven. It was a jury of barbers: the officially sworn master barbers and barber-surgeons of Ulm. This jury not only questioned and listened; it inspected. The object of inspection was Heffelin himself—his whole body and especially his left arm. Heffelin was being examined to settle the question of whether the marriage contract could be annulled. His bodily condition would be decisive for this question. Yet it had already been evaluated by “lay” people—namely, his bride and father-in-law—though too late for them to have avoided contracting marriage in the first place. They presented evidence to the Ulm marriage tribunal that Heffelin might not be able to work at his trade, and thus support his wife and family-to-be, and, indeed, that he might not be fit to make a family at all—in short, to produce and reproduce. On close inspection in the familial milieu, he appeared to have a problem with his left arm, and its condition suggested to the family that he could be afflicted with the French pox, a diagnostic judgment that, as we have seen, was by no means obvious, even to physicians and surgeons.
The family’s judgment that Heffelin might have the French pox was cogent and sufficiently well founded that it took the jury of seven artisanal masters considerable empirical work—observational and history-taking—and knowledge of similar cases to construct an alternative explanation: that the damage in his left arm resulted from maltreatment of a malignant ulcer (Geschwer) that had affected the bone. Likewise, the family’s prognosis for Heffelin’s working life could only be countered persuasively by a carefully worked out and circumspect alternative one: that more bone fragments might break from that damage but that in the end a permanent cure was likely.
Thus Schau, the general empirical evaluative practice on which such a case turned, was an activity of perpetuating a community’s welfare as much in terms of its familial and economic reproduction (Heffelin and dyer families) as in terms of its boundaries and security (Naff and his hamlet). What was being observed and evaluated was at once a medically defined physical condition (ulcer, maltreatment, pox, cure) and a socially defined physical condition (productive and reproductive capacity in a given type of community and economy, ability to exercise a particular trade). A turn of phrase clinches this identity of the medical and surgical and the familial and economic: the appeal to the marriage tribunal was articulated as a request to allow the return of unsatisfactory goods: “ist die Braut, wie auch iren Vattern, ein Reukauff ankomen.” The term “Reukauff “—literally, “regretted purchase”—denoted the right to withdraw from a sales contract. A jury consisting of guild masters was hardly out of place in carrying out a procedure representable as quality control of goods, a typical function of guilds in their capacity of evaluation, which was the role in which we find these barber-surgeons acting here: as observer-judges rather than as healers.
Judgment or testimony by medically trained men is thus not necessarily best understood as “medical expertise.” The same can be seen in cases of criminal law, such as the trial of Martin Rode. Official town physician (Stadtarzt) Dr. Stock testified that he saw Anna when she had “lost her senses” before she died but that she did not die from the beating. The injury to her head was no Causa necessaria. Her own bile and rage (Bilis vnd der Zoren) caused her illness. Had Anna died from the injury, he added, she would have shown “epilepsia.” It looks as though Dr. Stock is applying the knowledge of the learned physician. Yet before he testified, the court had already heard the same reasoning—from the defense lawyer: notably, the either/or structure of “died because of the illness and not because of the beating” and the argument that Anna’s symptoms when she “lost her senses” were not those of injury to the head. These ways of accounting for death in cases featuring variables like lapse of time between injury and death made up a legal literature going back to the thirteenth century, including case reports in the form of jurists’ consilia.
The formulas of reasoning and argument used in such cases were not empty. They were a form of what is all too crudely called knowledge and can more precisely be called generalizations from analogous situations, but in the form of rational practices rather than theories and created through the cumulative effect of many cases rather than acts of innovation. Thus the formulas were not dead either. They lived through configurations of society and polity and the observed physical world. Causa non necessaria was neither medical nor legal knowledge. It expressed a configuration of exigency (the court needed a yes or no) and responsibility (Stock was the official town doctor, charged with forensic duties) and uncertainty (over a week passed between injury and death, and observational evidence was varied). The learned physician, in short, was equally a nonmedical participant.
And, vice versa, the housewives were as much medical as lay participants. “Whether the cranium and the dura and pia mater had been damaged by the beating”? This, as we saw at the outset of this essay, was one of the dozens of questions put by the judge to barber-surgeons, to physicians, and—probably minus the Latin—to housewives. When Katharina Hansenn, housewife, answered to the effect that she observed no head injury “and indeed [the] only [marks] Anna had [were] small blue spots at both knees,” she was not reporting what she happened to glimpse in the chaotic aftermath of some violent incident. She answered as an observer on a par with the medical men and as a witness to the official postmortem. Focusing on late medieval Spain, Debra Blumenthal plausibly explains the continuing role and authority of women without office testifying in juridical trials on a par with medical men in office by noting that householding women were de facto “experts” through their domestic medical experience. Our case studies support this explanation, but it goes only so far. Housewife attendance at Anna’s postmortem shows a continuum of domestic and public life.
As to explaining death and thus resolving the matter that busied Frankfurt almost weekly for much of 1551, the most cogent and evidence-based account did not come from the physicians or the surgeons but from the housewives and, reportedly, from the deceased herself.
“Whether the witness,” Highest Justice Mohr asked Hausfrau Hansenn as he had asked Stadtarzt Stock, “holds that the fatal illness phrenesie first began on the seventh day after the beating and [that the deceased] had suffered long before from an internal illness such that she died because of the illness and not because of the beating”? Hansenn answered essentially yes. She believed Anna “would not have died from the beating had illness not already been present beforehand.” And what was this preexisting condition? Ever since she had had a stillbirth, Anna had not ceased to “have bodily complaints.” Unlike the testimony by the barber-surgeons and the physicians, this explanation accounted for major signs observed at the official autopsy. Hansenn ascribed the large black area on Anna’s back (which she saw only after the death) to the great heat of the illness. On the testimony of the surgeons and the physicians, these appearances seemed significant yet of uncertain meaning.
Evidence of this internal condition was attributed to Anna herself. Anna’s relative the apothecary’s wife, last of the twenty-one witnesses, spoke for her (in answering the fourth question to the 40th Article, to be precise): “Yes, he did beat me, but such beating harms me not at all, if only the lump were not in my body, which I worry will carry me off and kill me. Then, my Martin and I are content in our relationship and one.” We will never know for sure whether Anna really felt and said what others said she did, but we do know that Martin was acquitted and that—together with the testimony of her speakers—Anna’s was the most evidence-encompassing account of her own death. Judge and jurymen could acquit with more confidence on the medical account given by Housewife Hansenn and Apothecary’s Housewife Wörner Winneck than that given by Stadtarzt Stock—not to mention the barber-surgeons, who all said they couldn’t say. It is a fitting conclusion at this point in the story of shared empirical rational practices that the most robust causal explanation constructed in the trial—most robust because it accounted for more observations and testimony, medical or otherwise, than any other—was told as patient narrative.
Difference and Commonality
It may seem at this point that we have romanticized a past of knowledge shared by all and evaluations accepted by everyone. Yet, as emphasized from the outset, in this history of common knowing there were differences among groups participating in inspections, inquiries, and trials. In pursuing these differences, however, we will not follow the literature on the rise of medical forensic expertise. Nor will we focus on clash or cooperation between different medical experts and between “expert” and “lay” witnesses, nor on their relative authority and how this changed historically. Instead, in any given case, we show momenta of differentiation and “dedifferentiation,” a term preferable to “leveling,” which denotes mainly the status of claims to knowledge or expertise.
On 10 September 1624, the provost of the Imperial Abbey of Wettenhausen wrote to the Lutheran mayor and councilors of Ulm requesting an evaluation (guttachten) by the sworn surgeons or the physicians in office regarding the death of one of his subjects, Margarete N. The jurymen master barber-surgeons received two letters and the “instruction to find what is right.” After considering the written accounts of Margarete N.’s fate, they decided that it would be necessary to interrogate the late woman’s husband and the practitioners involved.
It had all begun when Margarete visited a barber who agreed to let her blood, a situation of typical patient–practitioner commonality. All later accounts agree that she began to feel pain after this practitioner, “the resident village-barber” Hans Spitz, stopped the bleeding by applying a pressure dressing. That same Saturday afternoon, according to her husband’s testimony, Margarete demanded help from Spitz, but he made her wait till Sunday evening. In the account sent to the Ulm masters of surgery, Barber Spitz knew no remedy (remedium) for this pain and sought a nearby colleague’s evaluation and recommendation (gutachtung). This second barber suggested warm wine dressings. Spitz had them applied to Margarete’s arm several times that evening. When the pain only grew worse, Margarete consulted a third barber and for three days used a remedy he recommended—in vain. Thereafter, her husband consulted Spitz again, which was no help. On day eight—earlier, in Spitz’s version—Margarete removed the bandage and walked about three kilometers to see a fourth barber. The following day, she traveled some eleven kilometers, still unbandaged, to see a fifth barber, named Jelin. He “inspected” her wound and declared that gangrene (“der kalte Brand”) had taken hold in her hand. In the presence of “two judges” (“in bey sein zweier Richter”), this diagnosis was confirmed on day twelve, when fingernails and skin could be removed without causing pain. Jelin predicted that she would die and offered amputation as final resort. On day eighteen, Jelin—in cooperation with his father, Surgery Master Matheis Jelin, who traveled more than twenty kilometers for the purpose—amputated Margarete’s lower arm. This, too, was in vain. She died thirteen days later. Right through the final stage, when Jelin diagnosed fatal gangrene and offered to amputate, Margarete typifies the self-directed if desperate patient, seeking help as and where she saw fit, from qualified barber-surgeons whose capacity to know what was wrong and what to do was not fundamentally different from hers, yet who at the same time inspected and evaluated. In short: this is a story of momenta of both commonality of knowing and differentiation of knowing into procedures.
These contrary momenta continued during the inquiry. The provost wanted to know which of the barbers who accused each other was to blame for the death of Margarete, which barber would have to answer to the husband’s monetary damage claims, and which practitioner would have to be paid by whom. The master jurymen of surgery had to judge not only whether Spitz, the first barber, or one of his colleagues was the “causer of such an irreversible event”—but also whether one of them should be banned from the surgical art. In their report, they approved the various barbers’ remedies as conforming to the art and remarked that Jelin, the amputator, had not been accused. They concluded by explaining the course of the illness and effectively blaming the patient: removing the bandages prevented recovery. This was, in effect, to close ranks in a situation that threatened to undermine the legitimacy of an entire region’s official surgical practice. Humoral theory supported this account: removing the bandages had allowed moisture into the limb; thus deprived of its natural warmth, the limb died of gangrene. Not theory, but documented experience, supported the patient’s account: she removed bandages and, in the most active possible way, sought further help because she knew by experience that the dressings were not lessening the pain and that she needed other remedies. The jury of masters knew by theory that removing the bandages led to fatal gangrene. The jurymen masters’ position was fraught enough that they sought legitimating approval for it from the Ulm town physician, which they received. Margarete’s position, represented by her husband’s testimony, was also supported—by the provost. He suspected that one or more barbers, not the patient, were to blame, at very least because they accused each other. Thus what differentiated in the end was not some obvious—or blurred—divide between lay and expert or professional knowledge and practice. What differentiated knowledge of what happened to Margarete’s arm, and why, into two accounts was referral of the case to an outside adjudicator. And yet the judgment of the outside experts dedifferentiated: the sworn masters explained the effects of bandage removal by reference not to their special surgical knowledge but to widely shared humoral theory.
Differentiation and dedifferentiation were no less subtle yet significant in juridical cases, which, according to standard stories of the rise of expert medical testimony in the sixteenth century and earlier, ought to have been considerably more straightforwardly differentiated and expert-led. We can see this by returning to the case of Clauß Guntram in 1517, whose well-informed defense against charges of having killed another man was presented in Section I, above. Guntram named a barber-surgeon, Master Hans Albrecht, as witness. Albrecht testified that he “examined” the wound inflicted by Guntram the following day. By measuring with his instrument, he “found” that the stab ended at the rib. This was a standard procedure, detailed in contemporary books of surgery, for therapeutic and forensic prognosis. A wound ending at the bone without injuring it was considered minor. In addition to basing his testimony on this manual procedure and know-how, the master alluded to his special knowledge with the remark that he applied a bandage as appropriate for such wounds (“wie sich Zu solichenn wunden geburt”). Moreover, he presented himself as a master of his art by stating that he “healed” the man in less than three weeks. Finally, Albrecht presented prognosis as part of his special knowing by recounting how he cautioned the convalescent victim, Genßhenn, against hard work for a quarter of a year to allow full recovery. These are the ways in which differentiation of knowing occurred in this case.
The dedifferentiation of knowing in Guntram’s trial occurred in twofold fashion. First, the barber-surgeon testified in response to questions that were put to all nine witnesses, exactly as we saw in the Rode case. If medical qualification and experience singled him out from the others, the procedure and context of testimony grouped him right back with them. Second, the barber-surgeon’s statements were no more exact in description or relevant in explanation than those of the other witnesses. Two neighbors recounted visits to the victim Genßhenn while he was bedridden for the second time—that is, after his alleged recovery. They inquired into the nature of his sickness and reported patient narrative just as a doctor might have done: Genßhenn described the feeling of a “lump on his heart.” They also presented evidence against the lethality of the stabbing: the victim had let them “see” that his scar was closed and himself did not attribute his second period of illness to the stabbing. Even Pastor Conradt vonn Steinhem, who visited the bedridden Genßhenn to hear confession and administer the sacraments, testified that “outside of confession” he had asked “how the wound was doing” and received Genßhenn’s answer: “it is healed.” And the barber-surgeon? He attested recovery by recounting from everyday life: some weeks after the stabbing he and Genßhenn had gone to market together to buy pigs, walked back, and shared a meal. The evidence he gave to account for Genßhenn’s fatal illness following recovery was as much everyday as medical: the convalescent had failed to follow the surgeon’s orders and had overtaxed his body too soon through hard work. Albrecht was able to cite the late patient’s account: Genßhenn had reported that he had felt a “cracking” in his body when lifting timber. If it was obvious that one called the barber-surgeon and not the pastor or the neighbor to treat a stab wound, they were virtually all of a piece in giving—creating—evidence.
It might be objected that we have been able to illustrate these processes of differentiation and dedifferentiation happening within a single case because we have chosen one from early in the sixteenth century, before the rise of expert witnessing was formalized in new criminal law. Yet the same dynamics of differentiation and commonality of knowing can be found in trials such as the Rode case of 1551—after a half century of legal reform that included the Carolina, supposed watershed in the rise of expert medical witnessing, and with testimony by two official town doctors and six sworn barber-surgeons.
These dynamics began at the sickbed, in observational practice before Anna died. Anna’s foster mother, Anna Buchens, came when she heard about the beating and was asked to attend at the bedside. Herself a midwife, she cared for Anna to the end. Despite her expertise, however, she called for the official town doctor, Johann Stock, to examine the sick woman, using the official term “besichtigen.” This was to differentiate official observation not only from everyday observation of the body but also from experienced—expert—observation of the body, a differentiation we will explore in the conclusion of this essay. This differentiating momentum in the case began at about the same time as its opposite, when Rode’s mother and Anna’s sister also came to examine her: “Annen zubesichtigen.” They and other “lay” female witnesses would later be able to provide more detailed explanations and observations than Dr. Stock. Anna drank too much—beer, wine, and huge quantities of mineral water; she had had constant health complaints since a stillbirth; they had observed no signs of serious injury or severe illness after the violent encounter with her husband, nor vomiting or bleeding. Moreover, they would report signs of other sickness, such as fever, confirm that Anna had fallen down the cellar stairs, and testify that she had been able to work and talk sensibly after the beating. These, then, were the momenta of differentiation and dedifferentiation of knowers—official medical expert and “lay” female witness—before Anna died.
The dynamic continued after her death. Six barber-surgeons participated in examining the body and dissecting its visible wounds. They found a bruise over the left eye and black-and-blue areas on the back. Dissection and probing of these revealed coagulated blood and no bone breakage behind the bruise. Following examination, the six barber-surgeons deliberated and reported their conclusions collectively at the town hall. They concluded that they could not decide whether Anna died from being beaten, falling, or another sickness. No one else was invited into this procedure—though, as we know, others attended.
Yet as soon as the case file began to take shape, this differentiation of expert official observation from other observation began to dissolve. The barber-surgeons’ postmortem report to the council was not copied into the file. It sat in an official book in the town hall, never even quoted (though referred to) in the more than 150 manuscript pages of the Rode proceedings preserved today. Thus there was nothing written to prevent the institution of oral testimony from having the same leveling effect we saw in the Guntram trial thirty-five years before. In this way, the central practice of inquisition—questioning—had the opposite effect from the one usually attributed to it with regard to the rise of expertise. Inquisition broke up the collective unanimous expert opinion of the sworn master surgeons in their official deposition to the city council. Surgeons and physicians were individually questioned, and their individual responses were recorded alongside and undistinguished from those of all other individual witnesses, notably the housewives. And the answers given by all were generally comparable with one another in terms of descriptive and explanatory content.
The hearings did more. “Did you assist in anatomizing Anna after her death?” Highest Justice Mohr wanted to know—again, asking the housewives as well as each of the six sworn surgeons and the official town physicians. Clearly, he assumed that the housewives could perfectly well have assisted in the official autopsy, but that is not specifically the point here. “No, I did not help,” Anna Housewife of Johann von Buchens answered, “but once the barber-surgeons had cut her open I saw that there had been black and blue coagulated blood (geliebertt blut) in the bruises and spots (mälern), but whence this bleeding came is unknown to me.” To be sure, the mayor did not ask the housewives to join the surgeons in carrying out the postmortem inspection. But Anna Buchens observed the body as carefully as the barber-surgeons did and testified with approximately the same level of descriptive detail. Yet this, too, is not specifically the point here. The point is, rather, one of mechanisms of dedifferentiation: the witness hearings retroactively transformed specialist official inspection, the “Besichtigung” ordered by the mayor, into knowing in common. This is especially remarkable because that event had been officially closed, signed, and sealed in one of the city’s books.
Conclusion
Commonality in diversity is the main finding of this study. To see this, rather than difference and dialogue, required setting aside categories like expert and lay to examine the practices of all concerned. Historians have come to examine a range of witnesses and other participants in early modern criminal and witch trials, but this may be the first study, regarding any historical time and place, of the knowledge roles of the full range of participants in a much wider variety of public cases. Hidden in the diversity of situations in these cases, whose protagonists usually belong to separate histories, is a set of common practices: observing, inspecting, and reporting; weighing of diverse evidence and certifying or judging on that basis; reasoning to causal accounts of complex events in the physical and human world. The cases were diverse in at least four ways: participation; situation and applicable rules; evaluating institutions; and polity, which ranged from village to city to empire, from self-government of sovereign city-states to local government in the Habsburg Empire (with consultation of an institution in a neighboring territorial-administrative state) to government of a small principality by the provost of an abbey (with consultation of an institution in a confessionally opposite state). These four kinds of diversity show the depth and extent of the commonality of knowing practices.
Expertise does not need “rethinking.” It needs a rest. Thinking in terms of expertise blinds us to common knowledge. Modern can learn from premodern here. Historical studies of law and science, or law and medicine, usually adopt the language of expertise and the category of expert witness. This disinvites investigation of all participants as knowers. The focus remains on men of science and physicians as experts. Historians of premodern medicine have diversified this picture by studying a variety of experts in trials—legal as well as medical, midwives as well as surgeons and physicians. Yet it remains a picture of difference and interaction. Would setting aside categories like expert and lay and studying all participants as knowers, as we have done, yield similar results for more recent times, showing shared empirical rationality? At the very least, the invention of the concept of lay expertise and controversy over these categories in social studies of recent science, technology, and medicine suggest that it might. Many of the situations of uncertainty, disagreement, or accusation studied in this essay have modern counterparts. This is not to preach continuity over change. The history between then and now may conform neither to lines of continuity nor to lines of change, like the “rise” of special knowledges and occupations, but instead comprise multiple trajectories of emergence and disappearance and re-emergence of knowing in common. Only by revising our outlook will a general history of expertise become possible, a history that does not presume what it ought to explain and that neither expands into the history of every activity in which human beings build up special experience nor contracts into the history of competing claims to such experience.
The problem is not that historical studies have been insufficiently constructionist or, indeed, historical about expertise. Showing how expertise was contested and constructed leaves intact the focus on special knowledge and claims to it—and hence on different groups and their status and rivalry. The very idea of expertise is the problem. It is limiting because it necessarily means special (everyone cannot be the expert), a limitation not lifted by the discovery that there have also been “lay” experts, having their own knowledge and gaining authority or opportunity to pronounce on public matters in certain times and places. Specialty there was, of course, and interaction, but also—and that has been the thesis of this essay—shared practices of knowing. The point is not a wider picture of who knew but, rather, a different picture of what knowing was and, ultimately, how and why it occurred. This essay is not a call for inclusiveness as such. An account of knowledge society—sixteenth century or twentieth—that included everyone according to what made each group special would still miss the point.
This opens a new problem: If knowledge was so common, then why was the testimony of physicians and surgeons needed at all? One way of tackling this concluding question would be to ask what determined why cases were decided in one way or the other. That might show the relative efficacy of diverse participants’ descriptions and explanations. Yet for any given case, this question can seldom be answered, as the historian never fully knows what went on orally behind and around the documents or what documents may be missing. Taken in the aggregate, however, large numbers of cases tend to show that the social status of the accused was less important in trial outcomes than we might expect and that social connectedness—that is, how many people you could mobilize on your behalf (as in the case of Martin Rode) or not (as in the case of Martin Naff)—was crucial. Recent research shows that even trials for crimes punishable by death were usually integrative and oriented toward consensus. For these could destabilize the polity. The perpetuation of polities based largely on negotiated consensus depended on involving as many people as possible in that consensus. The language of this perpetuation was that of peace, as in “Stadtfrieden” or “Landfrieden.” No one could be left out of the peace—or at least that was the ideal approximated as much as possible in practice. Such a system seems to have little or no place for specially experienced knowers.
In fact it did, but not as specialists. To leave no one out of the peace meant to include all who were implicated through social ties, whether of kinship, neighborhood, or household, and all who were responsible, through public office, for the area of social and material life in which the disagreement, uncertainty, or possible injustice occurred. This is where the doctors and surgeons come in. Responsibility more than specialty: that—oddly enough, by our standards and histories of expertise—is how to understand their involvement. Doctors and barber-surgeons in public office testified, inspected, reported, certified, or recommended decisions not as unique or superior knowers but as those on duty in matters of health and disease, injury and death, purity and danger. Their oaths of office made them responsible for bodily aspects of community welfare. That did not exclude the possibility that others had comparable knowledge and experience and that they, too, would contribute, as can be seen in all of the proceedings examined in this essay. These cases suggest that all relevant groups of knowers had to be represented in the process so that consensus and peace could result. Thus physicians and surgeons, who appear to our eyes as expert witnesses and evaluators, in fact belonged to a highly knowledgeable consensus-building society rather than an expert-governed lay one.
Amidst the commonality of knowing, there was one difference between those involved through social ties and those involved through office. This was the difference between being party and not being party to the events and persons in question. Office-holding physicians and surgeons typically swore an oath of impartiality. They were supposed to testify or certify or evaluate knowledgeably without being party—literally, without having had a part in events—from outside the situation of disagreement, uncertainty, or possible wrong-doing and the web of social relations to which it belonged. To act justly, office holders had to be independent, uninvolved. Yet this made them at the same time dependent, on those who were involved. Knowledgeable parties were as vital to proceedings as impartial knowers—not despite but because they were party. They knew events, contexts, bodies far more intimately than the office-holding doctors and surgeons could—or could alone. And we know from all of the cases considered here that this local knowledge meant not only reporting what one saw but also explaining and judging. Impartial expertise did not trump local expertise or personally referred testimony. Otherwise, in the Naff case, for instance, inspection and certification by the far-off Strasbourg Collegium Medicum would have secured the old soldier’s status against villagers’ continuing observations and suspicions. Exactly how implicated knowing and impartial knowing played out in testimony, evaluation, and the resolution or reopening of cases (and how this changed in the period under study) remains a question for further research. But it is beside the point here. Whatever such research might show, it is a fitting conclusion to this study of shared empirical rational practice that the knowledge of the two main kinds of participant in public cases—impartial and party—was not only common but complementary, indeed mutually dependent, in the one way in which they, necessarily, differed.