Nevertheless, Mattioli and Partini bore in mind and explicitly quoted them in specific cases, especially if they had to dispel a doubt or endorse a hypothesis. By treating Margaret’s case, Partini disagreed with his colleague Pietro Merenda. The latter excluded an inflammation of the respiratory tracts, whereas Partini bestowed great importance to the blood expectorated, and he supposed it was deriving from lungs. Partini supported his hypothesis with a passage from the Galenic De locorum affectorum notitia libri sex, in which it is to read that, when accompanied by grip, blood did not stem from either stomach or the brain, but from the chest. 153 After recording all Bohuslav’s symptoms he had observed over time, Mattioli assumed that the boy suffered from a pathology affecting the kidneys, not the bladder. Not completely sure of his assumption, however, Mattioli discussed it with the surgeon who had inserted the catheter in the patient; eventually, he found a satisfactory answer in De locis affectis. Here, Galen argued that those who were affected by nephritis (‘nephritici’) initially emitted watery urines, which, in the following days, were filled up by fat matter and ultimately by stones. But once the stone had come out of the body, the patient no longer felt pain in the kidneys. 154 Partini and Mattioli’s relationship with ancient and medieval auctoritates is to be set in the context of a slow and trying evolution, which medicine was undergoing in the sixteenth century. Hippocratic–Galenic knowledge was constantly re-read, re-interpreted and even criticised with regard to particular statements. Medical Humanism certainly stimulated physicians to critically read ancient medical texts. For instance, Galen continued to be translated and commented on over the century. 142 The intensive study of his works brought physicians to criticise some of his opinions on specific topics. For example, the anatomic discoveries carried out by Andreas Vesalius contradicted Galenic anatomy with regard to various passages. However, as Andrea Carlino has emphasised, the renewal fostered by Vesalius entirely occurred within the humanistic culture which the Flemish anatomist himself belonged to. In fact, the Vesalian revolution was conducted in line with the humanistic model of re-foundation of medical knowledge, anatomy included. 143 As far as the therapies prescribed are concerned, Mattioli recommended a lifestyle completely in line with his diagnosis: although physical exercise was usually recommended to overweight patients, Bohuslav had to avoid it, since it could overheat his kidneys even more. Mattioli also prescribed a diet that was adequate for obese bodies: Bohuslav should eat whole grain bread or bread made by millet, since they ‘corpus exicant extenuantque’ (‘dry the body and make it thin’), whereas white bread was prohibited. Eventually, the patient was advised to eat the meat of small wild quadruped animals and volatiles, since they were ‘wetter’. 86 While writing the consultation, Partini wondered what the exact origin of the blood could be: if the blood had come from the trachea, the woman would have felt pain in that area, and a smaller quantity of blood would have been expectorated. But Margaret did not complain about chest pain, nor did she expectorate a small amount of catarrh. Hence, the physician assumed that the blood had invaded her lungs, but he did not have concrete evidence to prove it indisputably. The fact that he required more empirical information to validate his hypothesis is important from a methodological point of view, since it means that a sort of ‘demonstration’ was relevant to Partini. Furthermore, Partini attempted to identify a specific organ as being responsible for the expectorated blood, whereas, in a similar case related to the ‘sputum sanguinis ex pectore vel pulmone’, and treated by Taddeo Alderotti, the origin of the pathology was only approximately identified. Alderotti stated that blood could come either from the lungs or from the respiratory tract, 93 but he did not give any importance to this question and did not say any other word on it. A methodological difference also emerges between Partini’s approach and Antonio Cermisone’s one, another authoritative writer of consilia medica, and professor of medicine in the Studium of Padua from 1413 up to 1441, the year of his death. 94 Cermisone was active as a physician more than a century after Alderotti, and a century before Partini. Cermisone was not concerned with the origin of the pathology. At the beginning of one of his consultations, written for a patient suffering from a headache, the physician stated that the migraine could be engendered by the stomach’s vapours and/or the excessive heat of the kidneys, which went up towards the head and penetrated it causing pain. Further on in the text, Cermisone seemed to change his mind, stating that the altered spleen could also be the cause of the disease. 95 It is apparent that he did not consider the causes of the disease to be relevant to the diagnosis and therapy.

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As far as the palpation of the body is concerned, it played a smaller role in early-modern medicine than in the late nineteenth; however, it was more widespread than historians have so far assumed. 139 In Mattioli’s consultation for Bohuslav, for instance, it is said that the patient’s belly was stiffened, which implies that the physician palped it. As Hannah Murphy has recently remarked, the Collegium medicum of learned municipal physicians founded in Nuremberg in 1592 based its identity on Galenic medicine. The reformation of medicine it undertook was heavily shaped on a conservative Galenic movement, but at the same time, it gave form to the turn to empiricism as a foundation for medical epistemology. 141 Such an epistemological combination was possible by virtue of the fact that the so-called Galenism was actually a system of doctrines susceptible to embracing relatively new concepts and methods, and exactly such fluidity was one of the peculiar features of Galenic medicine in the early-modern period. Partini and Mattioli’s medical practice was also characterised by both a strong continuity relationship with the past and an attitude to attach great importance to empirical data. What Partini and Mattioli observed and perceived was largely informed by the written medical tradition and, as university-trained physicians, they extensively relied on its theories to make sense of the patients’ diseases. The concepts adopted by both physicians and the terms used to express them prove that the Hippocratic–Galenic humoral theory and pathology, considered as fundamental by sixteenth-century academic medicine, framed the way in which they interpreted the data perceived by their senses. Furthermore, the patients’ reports could often be incomplete due to single or concurrent factors: embarrassment caused by disease, reticence in admitting intimate details concerning their bodies, fear of diagnosis and fear of not recovering. Omissive or even misleading patients’ declarations could influence the body examination made by physicians and ultimately their diagnostic conclusions. More importantly, the sufferer’s report did not imply per se the existence of a pathology: it was the physician who, with his interpretation, gave form and attributed significance to the patient’s sensations. Even if the patient exposed a clear idea of what was happening, his report was interpreted by the physician’s way of looking at an ill body. For this reason, the key to Galenic interpretation, which physicians relied on, is crucial in our analysis. The Learned Physicians’ Relation with Galenic Medicine, a Fluid System of Doctrines Nevertheless, with his 80 extensive consilia, Partini’s collection turns out to be an exceptional source for historians, at least with regard to the Italian scene. In fact, collections of handwritten medical consultations, which comprise such a large number of cases investigated in depth, have not hitherto come to light. Arguably, only few examples have so far survived, currently buried in archival repositories and not studied yet. As regards the rest of the European continent, I have already noted that some records—Finzel’s practice journal, Forman’s casebooks and Handsch medical notes—have been found out and researched. However, most of Finzel’s notes are short entries; though being a learned man, Forman was not a university-trained physician and his was primarily an astrological practice; as far as Handsch is concerned, he especially recorded those cases that roused his interest.An ultimate aspect has to be discussed. As briefly mentioned above, the sensory perception by physicians could be influenced by patients. Let us look at Bohuslav’s case. From the consultation, we can drive that the boy said to Mattioli that he felt pain in the kidneys area. The patient’s narrative might induce Mattioli to palpate the body region mentioned by him, although we have no written evidence of that. Subsequently, after administering certain remedies, Mattioli wrote that Bohuslav felt no longer pain: did the physician decide to palpate the kidney area again, exactly to elicit such patient’s response? Unfortunately, the consultation does not provide precise information about that either. However, that Mattioli wrote down Bohuslav’s perception implies that he considered it as relevant and, for this reason, it could influence the physician’s sensory survey. The way Alderotti established the therapy for his patient suffering from spittle of blood from the chest turned out to be completely different. In his advice, the physician reported the therapy, which was recommended by the medical theory for the pathology in question, 115 and a clarification of the vitae regimen, structured in the ‘Six Non-Natural Things’ ( sex res non naturales: climatic and atmospheric conditions, diet, exercise, sleep–wake rhythm, bowel evacuation and filling, emotional states), ensued. Thereafter, Alderotti suggested a treatment external to the body (an unguent). 116 In another consultation by Alderotti related to a patient with catarrh, a long exposition of the relevant therapy is to be found according to the Aristotelian method of classification into general cases and subcases: Complimentary child care is available through a stipend. Please reach out to [email protected] for availability and details. And later in the text: ‘After considering purgative medicines, let us look at medicines which alter and soothe’. 118

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In closing, medical practice required a great ability to find a balance between theoretical and empirical levels to fulfil a factual purpose, the patient’s recovery. Empirical data were supposed to have epistemological value themselves but were interpreted within a context in which the study of the ancient and medieval medical literature remained open to new elements and interpretations. In this context, data driving from observation could be used to better comprehend, further explore and even enrich Galenic doctrines. As flexible and adaptable, these latter were steadily being discussed, and the diagnostic process based on empirical observation could urge physicians to make new inventive interpretations of them. The woman suffered from acrimonious catarrh whose formation, in Partini’s view, was favoured by her physical complexion, warm and moist. All body parts tended to be hot, and at a certain point, the heat had started to increase due to the overheating of the liver. The heat, in turn, was produced by the fatty foods eaten by the lady and typical of the Tyrol area. The vapour coming from the warm liver had then reached the head, which, being hot, had produced more warm vapour, which was causing the formation of catarrh (‘pituita’). An excessive amount of this humour in the brain, combined with the heat, could not be entirely retained by the head, and therefore reached the respiratory tract, causing violent cough. 88 Furthermore, the pituitous humour would reach the stomach and, being altered, superabundant and mingled with yellow bile (‘cholera’), it would cause humour and food vomit. 89 The patient expectorated humours and blood, which, according to Partini, came from the chest. The blood was caused by the erosion of the respiratory tract, which was in turn damaged by the biting humours. 90 Due to the presence of blood sputum, the physician feared that it could be consumption (‘tabes’). 91 In particular, there was the risk that the disease might degenerate into that kind of disease called ‘Ptissia’, 92 a term that indicated a pathology affecting the lungs. Partini became the personal physicus of Ferdinand I’s son, Maximilian, King of Bohemia and future Emperor in 1557. He managed to obtain this prestigious role thanks to his friendship with Mattioli and the imperial physician Giulio Alessandrini (1506–90). 36 Like Mattioli, Partini was granted a noble title with an imperial diploma from 1561. 37Enjoy a classic dry martini. This is a good example of how ice is an ingredient in its own right. Take time stirring and tasting it until it’s to your liking

Consilia by Learned Physicians Pietro Andrea Mattioli and

As far as Mattioli’s consilia are concerned, the range of choice was limited, since, as mentioned above, only a few consilia in a strict sense have survived. Among them, I will present two consultations that can illustrate Mattioli’s medical practice in great detail (cases a, c). The second one is a joint consilium, which Mattioli drafted together with other two physicians. As for Partini, the situation is slightly different. Since he compiled 80 consilia, I have been offered the opportunity to look at them as a whole series of consultations and analyse them from a comparative perspective. However, such a task does not correspond to this article’s aim, not to mention that it would require a separate piece of research. Rather, I will focus only on one of Partini’s consultations (case b), which is however one of his most extensive consilia in terms of body examination and hence allows us to study Partini’s diagnostic process better than the other ones.Touch, taste, smell and sight were all involved in uroscopy. As noted above, this practice was extensively adopted and can be defined as a diagnostic tool in its own right. The two consilia do not seem to be directly linked, that is Alessandrini, Mattioli and Heyperger did not seem to have answered a specific consultation request from Brasavola, or vice versa. In fact, the physician from Ferrara is not mentioned in the joint consilium, nor does Brasavola mention Mattioli, Alessandrini and Heyperger. However, both the joint consilium and Brasavola’s consilium focus on Ferdinand’s headache. As mentioned above, the sixteenth-century medical practice involved the making of the senses by learned physicians, who generally followed Da Monte’s approach. 16 Sensory examination is a complex issue, and deserves further consideration: to what extent did physicians resort to their senses? Which senses were specifically used and for what purposes? The mix of theatre (in the serving of two separate drinks) and the eye-catching name shows why it’s such a hit. Just don’t ask us what to do with the fizz! While most martinis are stirred, here we shake it up to open up the flavours. We've used a Bordeaux-blend vermouth, with aromas of fruit, honey and pines