This innovative and imaginatively researched study more than fulfils its ambition to explore the relationship between physicians and the lay public in early modern Italy. Taking a fresh perspective on medical history, the authors focus on the texts and practices devoted to staying healthy rather than coping with illness and demonstrate the growing appetite for such knowledge. Although they highlight an important and neglected genre of printed health literature, the regimen sanitatis, in the years between 1500 and 1650, their study makes use of an astonishing breadth of sources ranging from seventeenth-century combs and drinking vessels to letters between noblewomen and their ecclesiastical kinfolk. Informed by wide reading in the historiographies of medicine, material culture, books and social history, Sandra Cavallo and Tessa Storey put sharp questions to this varied evidence. Each chapter addresses one of the so-called ‘non naturals’, factors other than diet that are understood in the Hippocratic and Galenic systems to influence health, and in each chapter they look critically at current scholarly views as well as describing the arguments of the doctors and the opinions of lay people on the topic at hand.

The ‘non naturals’ have not attracted the same attention from historians that food has, so the authors’ discussion of what early modern people thought about the effects of, respectively, air, sleep, exercise, emotional wellbeing, drink and excretion on their health is revelatory. Cavallo and Storey portray a discursive landscape undergoing change and full of contradictions in these years. For example, a lively debate erupted in the late sixteenth century over whether hot or cold drinks were good or bad for one’s health. Both extremes were novelties. The warm beverages of the new world had begun to enchant Europeans, and in Italy, at least, the emergence of commercial sellers of snow had made it possible to provide cold drinks in summer. Doctors were not sure what to think of these new tastes, and, as the authors point out, the ancient authorities (Aristotle and Galen in the original and in Avicenna’s version) upon whom they relied for their medical knowledge were not much help. So they argued fiercely with each other in their books. Meanwhile, lay people were voting with their feet and indulging in iced drinks as well as hot chocolate, not oblivious to the doctors, perhaps, but certainly not supinely accepting their conflicting precepts.

A dominant inquiry of the book is to what extent the physicians’ recommendations influenced the behaviour and opinions of their readers, and, by extension, the wider society. But how do we track the impact of the early modern health literature? The evidence of material culture, in conjunction with commentary in letters among the lay elite, is the basis for evaluating the response of the non-professional public. These sources have the added advantage of permitting the historians to compensate for the exclusive focus on the male body in the physicians’ tracts. Cavallo and Storey do a masterful job of integrating material culture into their analysis; indeed, in this respect, their book is a model for historians in general, not just historians of medicine. Using post-mortem inventories and contemporary paintings, they identify the new metal and glass containers needed to keep the ‘snow’ handily near diners and drinks cool. They enhance their discussion of the early modern belief that hair was excrement with photographs of the surviving combs felt to be essential for a healthy head. And they illustrate the conscious deployment of pleasant sights and sounds to improve health by promoting cheerfulness with examples of villa gardens and frescoed landscapes. Throughout the study, the authors emphasise the fact that medical concerns played a crucial role in the material culture of the late Renaissance Italian home.

Cavallo and Storey subject much received wisdom to scrutiny. They argue persuasively, for example, that early modern doctors and lay people were less obsessed with putrid air as a cause of disease than with the effects of the coldness and dampness of air. (Thus, the taste spread for canopies of thick curtains around the bed to protect the vulnerable brain.) The authors also revisit the accepted explanation for the decline of bathing in this period, which points to rising prudery resulting from religious zeal. Their close reading of the evidence suggests that anxiety about the loss of vital heat when stepping out of the bath and the pernicious impact of cold led people to abandon immersion. Cavallo and Storey also trace a growing aversion to routines of violent purgation and a preference for the removal of excrement, chiefly from the head, through grooming. Thus, the motivation for the multiplication of toilet articles, the larger number of servants and the increased time devoted to the master’s toilette is disease prevention.

This is a book in which the authors ask the hard questions. What happened to the ancient inheritance of medical knowledge based on the humours under the impact of new texts and new audiences? In granular analysis of the details of advice and practice, Cavallo and Storey show that the humoral understanding of health and illness had an elasticity that could accommodate new developments both in media and in taste. What explains this early modern surge of interest in health? The authors give credit to the printing press but are not satisfied with a simple, one-dimensional answer. Heightened attention to social distinctions and a lively consumer economy also played a role. Finally, what was the impact on the relations between doctors and the public of all this new reading matter? Cavallo and Storey give a balanced assessment. On the one hand, the health literature empowered lay people by giving them information about the body that they had not previously had. On the other, as Foucault would have argued without the wealth of empirical evidence mustered here, physicians also benefited as they extended their authority into new domains of knowledge and power.