In Visualizing Disease Domenico Bertoloni Meli presents himself as taking the reader down the proverbial road less travelled in the history of medical illustration by focusing on the formative history of the ‘illustrated pathology treatise’ (p. xi). Bertoloni Meli contrasts the relative lack of attention that pathological illustration has received from historians with the wide concern with anatomical illustrations. As he puts it in the preface, it is ‘almost inconceivable to investigate the history of anatomy ignoring illustrations’, yet that is precisely what has happened for the history of pathology (p. xi). The focus in Visualizing Disease is thus on providing a framework for the understanding and further exploration of the long and uncertain development of the ‘new medical genre’ of illustrated pathology treatises, as well as the broader relationship between pathological images and the understanding of disease in the period covered by the study.
The work begins – somewhat surprisingly – in the early modern period and ends with the famous work of Jean Cruveilhier in the nineteenth century, proceeding in roughly chronological order throughout. As a comprehensive study would be impossible, the work covers what Bertoloni Meli has identified as the key developments in the early history of pathological illustration, focusing in each chapter on a number of individuals’ work deemed especially significant in exemplifying or initiating important developments. In each case, Bertoloni Meli provides a short biography; an explanation of the specific work in question, including discussion of other contributors such as artists and engravers; and an analysis of the work's illustrations. This structure has the dual purpose of providing sufficient information on each of the medical practitioners and works discussed, some of whom and of which are obscure, and producing points of comparison that are revisited across chapters. Diachronic breadth, coupled with a biographical approach, is one of Visualizing Disease’s major strengths, as it enables Bertoloni Meli to bring out long-standing concerns and issues related to the making and conception of pathological images, whilst at the same time emphasizing the contingent and individual nature of the works and authors in question.
Bertoloni Meli is especially interested in practical, iconographic and cognitive themes that emerge from his analysis of the longue durée of the illustrated pathological treatise. For example, he is at pains throughout to list the artisanal practitioners (artists, engravers, lithographers) who made the images of concern in this study, providing useful, though limited, context in explaining the production of the specific illustrations in question. However, he also emphasizes that ‘not only expertise but also the ties between artists and anatomists were passed down across generations’ (p. 74), as in the case of the Leiden anatomists Govert Bidloo, Bernhard Siegfried Albinus and Eduard Sandifort collaborating with the Leiden artists Gerard de Lairesse, Jan Wandelaar and Abraham Delfos respectively – each a student of his predecessor, all thereby acquiring a practical heritage that was crucial for their respective publications. Bertoloni Meli also convincingly argues that the gradual emergence of colour images from the early nineteenth century, crucial to the discipline of pathological anatomy, stemmed from the specific problems related to producing an iconography of cutaneous diseases, especially in the work of Robert Willan, Robert Bateman and Jean-Louis-Marc Alibert. The classification of skin lesions necessitated colour, which in turn promoted colour as a classificatory marker and one that became central to pathological iconography (pp. 125–126). Relatedly, Bertoloni Meli also outlines a cognitive inheritance in the work of nineteenth-century British pathologists like James Wardrop, John Richard Farre and Robert Hooper, that stemmed from Matthew Baillie's earlier focus on the structure and texture of lesions (pp. 110, 158, 161).
Yet for all of Bertoloni Meli's superb work in bringing together a chronologically, geographically and theoretically diverse group of works that have in common their illustration of disease – and merely on those grounds it is a vital survey work – it is unclear that what is described in his book is genuinely unitary. This point is emphasized by the loose usage of the term ‘genre’ throughout the work. In the early modern period the illustrated pathology treatise was a ‘new medical genre’ (p. xiii) and is described as the focus of study throughout the work. However, the first chapter focuses on another ‘new genre’ of the Observationes (p. 27) where disease was illustrated. As Bertoloni Meli himself concludes, ‘The material we have seen leads one to question whether it is legitimate to talk of illustrated pathology as a genre to characterize early modern images of diseased body parts’ (p. 51). In itself this could be placed aside, but later works are described as ‘sub-genres with regard to contents and pathological iconography’ (p. 108) and as belonging ‘to quite a different genre’ (p. 159) without sufficient clarification. Though books have long shelf lives, their authors’ intentions and readerships’ perceptions do not. Grouping works based on their having illustrations of diseased parts is also problematic due to the sheer heterogeneity of approaches to this that Bertoloni Meli himself has described – not only in terms of iconography, but in the basic organization and epistemic understanding of the respective projects.
Nevertheless, Visualizing Disease is a vital starting point for the study of illustrations of disease. Given the scant attention that this has received, Bertoloni Meli's focus on hewing a path which future study of pathological illustration – and the history of pathology – can follow is welcome, though the path requires pruning and extending.
