Although the history of medicine in Spain is flourishing, those who read English alone currently know too little about it. For centuries, English-language histories of Spain were tainted by the national rivalry for empire, made all the worse by the religious orientation that presented Reformation and Counter-Reformation as irreconcilable sides in an on-going struggle for the soul of Europe, or even the world. Today, the two European languages spoken most widely around the globe are Spanish and English, with both Cervantes and Shakespeare celebrated as founders of modern literature. Yet even that can be a cause for rivalry rather than for reflection about the commonalities of history. In the making of national identities, the Castilian discovery and conquest of much of the Americas and the enormous power of Philip II of Spain in the political and religious affairs of sixteenth-century Europe, together with the English victory over the Great Armada and its own foothold in the Americas, with armed clashes between the two in the Low Countries, Caribbean, and Asia, seemed to make the two countries into constant enemies. Despite innumerable interconnections between each other, the dominant picture of being at opposite poles was solidified by the struggles between the two empires on land and at sea during the Napoleonic wars, and by the efforts of the English-speaking United States to establish hegemony over the Americas, culminating in the Spanish–American war. Just when new standards of the professional study of history might have made for better understanding on both sides, the Spanish civil war and the period of Franco’s dictatorship did much to reduce the common bonds once more. Despite attempts by many English-speaking historians to change the attitudes of their compatriots, therefore, the “Black Legend” of Spanish despotism and perfidy (in presumed contrast to the Whiggish story of Anglo-American liberty and justice) has remained influential.

It is only relatively recently, then, that in the eyes of most readers of journals like this, early modern Spanish histories have begun to seem a perfectly ordinary aspect of European developments rather than worlds apart. This is true of medical history as much as any other kind of history, or even more so. Many accounts of the development of the modern world placed a story of the emergence of modern science and rationality at their centre, and often adopted a Weberian stance in arguing for the modernizing force of ascetic Protestantism. Since the political and religious orientation of early modern Spain was so often presumed to be mired in the Baroque superstitions of the Counter-Reformation and Inquisition, almost all accounts of the so-called scientific revolution gave attention to England and France, with a nod to Germany, and to Italy until the trial of Galileo, while Spain was among those other places in Europe that seemed to have nothing to do with science, or even to have fought against it. Once upon a time, it was thought that only when the Bourbons came to the throne in the eighteenth century did Spain begin to have something like an Enlightenment. Given that many developments in medicine are attributed to the realm of ideas, there seemed little point for English-speaking historians to examine the Spanish world. Given that other aspects of medicine—such as the decline in mortality rates, or the public organization of care for the sick poor—are associated with political and social developments, the picture of a monarchy out of touch with its people also led to a lack of interest. Strengthening such assumptions was the process of professionalization in Britain and North America, where historians might be expected to read French and German, and perhaps Italian, but not Spanish. Much of the medical history that began to be published in Spain—including the many studies of José María López-Piñero—was therefore slow to reach the attention of those who did not have the language and considered the real action to lie elsewhere.1

By the late 1970s, the situation was showing signs of change. By then, new trends in the history of medicine and science tended to place less emphasis on individual conceptual innovation and more on collective patterns, with the result that early modern Spain might be indicative of developments in Europe without having to have been at the forefront of the scientific revolution (although it was also turning out to be less benighted than presumed by outsiders). The shift in studies from “Renaissance and Reformation” to “early modern Europe” also worked to downplay the importance of changes in the mental landscape in favour of a fresh look at diverse religious, political, social, economic, and cultural histories. Interest in the history of Spain in the Americas was also growing in the lead-up to the 500th anniversary of Columbus’s first voyage. By the mid-1980s, a few studies in English started to appear on medicine in New Spain, most importantly a posthumous book on the office of the protomédico by John T Lanning, and an article by a Latin American of German heritage who obtained his PhD in the United States and settled there, becoming a leading figure in the history of medicine, Guenter Risse.2 David Goodman’s book on science in Spain under Philip II—which touched briefly on medicine and alchemy—also made a convincing case for folding the subject into new kinds of accounts of the scientific revolution.3 At the same time, the collaborations of Luis García-Ballester and North American and English colleagues like Michael McVaugh, Roger French and Andrew Cunningham helped to make better known his fundamental work on the medicine of “Spain” practised among the many who were neither Castilian nor Old Christian.4 By then, a post-Franco generation of PhD students were studying in other countries, while students and scholars from elsewhere were coming to Spain for research. More recently, the kinds of international intellectual and professional exchanges encouraged by the EU and its members have created a network of personal acquaintances that make it difficult to imagine Europe without the Iberian experience. All these changes have been reinforced by the travels of ordinary people and the place of English as the main medium of international communication. Consequently, many new studies of medicine in Spain are underway, more historians have at least some Spanish, and many other publications are available in English.

Even so, recent English-language studies of medicine in early modern Europe still take less account of Spain than they might. For instance, the history of science in Spain and in the Spanish empire is currently far better known.5 As a consequence, I asked Jon Arrizabalaga and Teresa Huguet-Termes to work with me in organizing a conference at The Wellcome Trust Centre for the History of Medicine in June 2006 that would bring together a number of historians currently working on medicine in early modern Spain, to present papers in English that would give us a glimpse of current approaches to the topic. Some of those invited were not historians of medicine per se: María Tausiet mainly studies the history of witchcraft and Mónica Bolufer literature, for example. But the mix of fresh perspectives and expertise resulted in a lively day of presentations and discussion, introducing new questions and new information, clearly demonstrating the current vitality of the subject. Following the conference, then, Jon and Teresa agreed with me that they would work with the Spanish contributors to the conference, asking them to revise and expand their papers in English. Under their editorial control, with the usual assistance of the editors of Medical History, the results are published here for the first time.

In general, the papers confirm just how much Spain was a part of the common history of Europe in the early modern period. There is nothing particularly unusual about attempts to control extra-academic practitioners in a city like Valencia, or about the existence of male witch-finders who were thought to have healing powers, or the ways in which Spaniards debated questions about womanhood or breast-feeding, or the re-organization of a multitude of hospitals in Madrid into one general hospital and a few others, or even the keen support of a king for medicinal alchemy. One can find parallels in many other places in Europe. The case of Rodrigo de Castro’s exodus to the Low Countries and finally Hamburg certainly raises questions about how deeply the Iberian world was wounded by the activities of the Inquisition, which drained the region of so many people who had previously contributed vitally to its social, economic, and intellectual life. Yet even the Jewish De Castro praised the medical education he received in Salamanca. The terrors and iniquities resulting from self-righteous regard, and the generosity of spirit often evidenced by those targeted by the self-satisfied, were not limited to early modern Spain.

But the particular details are of course unique to the people and institutions of the places and moments explored. María Luz López Terrada presents a view of the city of Valencia, a great port and university town where—as usual at the time—many varieties of medical practitioners could be found. She notes that the many curanderos and empirics existed not because of a shortage of physicians, surgeons and pharmacists but because of opportunity and custom. The attempts by formal medical institutions to control the medical practitioners of the city was not, she argues, due simply to royal paternalism or the desire for power, but because of real and pressing needs. While the history of medical regulation has drawn attention to the Protomedicato, this body had limited powers even in Castile, she shows. In Valencia, the municipal authorities worked with the academic physicians, and extended their powers throughout the kingdom, although under Philip II the Protomedicato was imposed. From the records of these bodies of medical police it is possible to glimpse the variety of practices and practitioners in the city and kingdom. Interestingly, in 1589 King Philip charged a Paracelsian physician, Llorenç Coçar, to lead the Protomedicato, over the objections of the medical faculty, and the subsequent quarrels illuminate how the contemporary debates over Paracelsian medicine were played out in parts of Spain.

Philip II’s keen personal interest in Paracelsian remedies is also taken up by Mar Rey Bueno. She is among those who have rehabilitated the king as not just a promoter of the Counter-Reformation, but a promoter of science as well. Among the sciences given his personal support was alchemy. From careful study of the records, Rey Bueno is able to demonstrate that Philip’s interest in alchemy for the purpose of transmuting metals (to solve his financial needs) was only episodic, and accompanied by scepticism, whereas his interest in distilled waters and essences for medical purposes was, from at least 1570, programmatic and sustained. In the 1580s he also had a large and technically sophisticated distillery built at his residence, El Escorial. Like his cousin Rudolph, he was also interested in the Llullian use of alchemy to find the principles of nature that might overcome divisions and bind the world together, but this search seems to have been less important to him than the search for remedies. There can no longer be any doubt that he considered medical chemistry to be the science that would in the future yield the most benefit for humankind.

Maria Tausiet examines the saludadores as both healers and witch-finders. As the name implies, the saludadores were considered to possess healing virtues, most especially against rabies. The powers of these men were often expressed through their mouths in the form of words, breath or saliva (and since they were often given municipal appointments, López Terrada notes how one of the tasks of the medical boards was the examination of their ability to heal rabies with their spittle and to extinguish hot irons with their tongues). They set themselves against the mainly female category of witches, whose powers to harm were mostly expressed through their eyes. Because the saludadores were thought to be able not only to heal but to confirm when spells had been cast, they also took on the important function of witch-finders, although it could be personally dangerous if they came under scrutiny themselves and were discovered to be dishonest, as many of Tausiet’s examples show.

Teresa Huguet-Termes investigates more institutional attempts in early modern Spain to relieve the problems of poor and ordinary people. By the end of the fifteenth century, like many small municipalities, Madrid had a number of small foundations endowed for the salvation of their patrons and for the care of the poor. New concerns about poverty and the duty of municipalities to relieve it became manifest in the 1520s. But it was not until the royal court decided to take up residence in Madrid in the 1560s that a massive transformation occurred, with the eventual consolidation of the many hospitals into a General Hospital in 1587. The new institution became a symbol of the monarchy. Although replete with the trappings of Counter-Reformation piety, ironically enough the formation of the new institution led to the end of many confraternities, and greater power for municipal governance and courtly patronage than for the Catholic church. Huguet-Termes follows the story into the 1660s, showing how there developed self-conscious similarities with policies in France, where royal authority assumed the mantle of defender of the true faith. But perhaps, she suggests, it was only then that a hospice for the confinement of healthy beggars was mooted, because begging by the healthy poor allowed alms-givers to show their personal charity in public, helping to maintain the display of good works that distinguished Catholic from Protestant.

Women figure in many of the accounts already mentioned, but Mónica Bolufer confronts the varied literature on their gender, much of it medical. It would appear that the move away from Galenic physiology—in which presumptions about temperaments argued for the bodily inferiority of women—toward the new science of the eighteenth century—with its equality of organs—helped authors find reasons for writing about the dignity of women. At the same time, however, medical authors began to understand the differences between men and women as essential and bipolar rather than accidental and graduated. Many started to argue that motherhood was the natural state of women, and that even ladies should breast-feed their infants. She shows that these authors did not so much create new views as give explanations for the changing cultural values of the day, but equally that changing medical ideas made a great difference in placing families at the centre of a new moral and social order. In tracing the literary debates on the subject in Spanish with sensitivity, she also shows how much they were a part of the European conversation.

By closely examining the life and writings of Rodrigo de Castro, Jon Arrizabalaga explores the formation of someone associated with early modern “medical ethics”. Arrizabalaga makes it clear that De Castro’s concerns were not the same as those of modern ethicists, but his views are nevertheless important as an example of the medical ideals of his day. He detested the Paracelsians, as well as the empirics. His ideal of the physician as a wise man illustrates how much he considered the science and art of healing to be shaped by education. For those like himself, who valued the classical tradition, philosophy yielded knowledge of the good as well as the true. The irony is that his personal story suggests other forces were more powerful, since because he was from an elite Jewish family, those who thought theological doctrine to be more important than philosophy caused him to move from Portugal (where he was born) and Spain to northern Europe, ending in Hamburg. Perhaps his exile strengthened his convictions about the value of the classical view, since he not only thought highly of Arab physicians but also of his scholastic education at Salamanca. His life and work shows again that while differences among people are the grist from which history is made, their personal views cannot be predicted from simplistic categories such as De Castro’s religious heritage. One never knows quite how someone will play the cards they are dealt.

This supplement is therefore offered to our readers in the spirit of a common humanity, in which the particularities of medicine in early modern Spain help us to understand the people and events here discussed as one collection of experiences among the multitude of the age. How the medical professions and occupations sought their own and the public interest, how the settlement of a court brought centralized hospital services and great alchemical laboratories to Madrid, and how medical ideas were expressed by physicians and non-physicians, had their own particularities, which are given illuminating expositions in these contributions. That these processes were generally similar to those under way in other places is a reminder that medicine in Spain was intimately involved with medical developments elsewhere in Europe, too. Future work will no doubt make the connections and entanglements clearer. For now, it is important to offer a glimpse into the medical environment of this region as one among the many unexceptional places in early modern Europe.