The period 1500–1700 is significant in the history of the English language in terms of the definition and development of traditional genres and text types. Even though in Early Modern English linguistic variation does not stand out with regard to macro-level sentence-, clause- and phrase-level phenomena, in this period written discourse undergoes a number of changes, many of which are recorded in Late Modern and Present-day English.

This volume consists of twelve chapters describing theoretical and empirical research on a specific area of such discursive variation, namely that which can be subsumed under the umbrella term ‘medical writing’. This type of writing is not alien to the new cultural and scientific conventions of the time. Perhaps for commercial reasons, not least because printing technologies are cheaper, medical writings in early modern England become more reachable to people, with more and more people having access to the kind of writing which was simply unaffordable previously. Also, as Irma Taavitsainen and Päivi Pahta contend in the opening pages of the volume, English emerges in this period as a language of science and, as a consequence, a language of medicine. Such a background, then, serves as the basis for the various explorations of scientific thought and style included in this volume.

Although not all the chapters are corpus-based or corpus-driven, they all share the empirical support provided by the corpus of Early Modern English Medical Texts (EMEMT), as part of the Corpus of Early English Medical Writing 1375–1800. The opening chapter, ‘An interdisciplinary approach to medical writing in Early Modern English’ by Päivi Pahta and Irma Taavitsainen, provides an introduction to the corpus, and also to the type of research in which the core research group based in Helsinki is interested. They describe the social context which surrounds the production and distribution of medical writings in early modern England, and justify the need for interdisciplinary approaches focused not only on micro-level issues affecting the language as a grammatical system, but also on the producers (speakers and writers) and the audience (hearers and readers). The chapters which follow investigate authored and anonymous writings aimed at traditional learned readers and also at more ‘ordinary’ readerships, including the poor, women, etc.

Pahta and Taavitsainen contend that ‘macro-level variation’ in the 1500–1700 period is worthy of our attention, noting issues such as the organisation of texts. In this, both new models and old frameworks can be used to explain variation, as various chapters in the book attest. The research described in this volume, it might be said, constitutes just the tip of the iceberg of a far larger project on the evolution of English as the language of medicine in its recent history. In what follows I will deal briefly with the remaining contributions in the volume.

Chapter 2, ‘Medical texts in 1500–1700 and the corpus of Early Modern English Medical Texts’, by Irma Taavitsainen, Peter Murray Jones, Päivi Pahta, Turo Hiltunen, Ville Marttila, Maura Ratia, Carla Suhr and Jukka Tyrkkö, discusses the influence of print, as well as more basic modes such as speech and handwriting, on the circulation of medical texts, and serves as the pretext of a detailed introduction to the structure and components of EMEMT. According to the authors, this two-million-word database constitutes a representative corpus containing samples from approximately two-thirds of all the medical texts produced in the sixteenth century, as well as a small fraction of the texts dated after 1650, by which point, it is claimed, vernacular medical publishing had experienced a massive explosion. The classification of the texts in EMEMT is quite innovative and includes six text types or genres, including general treatises or textbooks, specific treatises, recipe collections, regimens and health guides, surgical and anatomical treatises, and extracts from the Philosophical Transactions.

This historical introduction to the way in which medical ideas circulated in the period under investigation explains the drift from the conservative publishing in the sixteenth century to the emergence and flourishing of vernacular medical publishing in the second half of the seventeenth. Perhaps most emblematic of such a change in the paradigm of medical publishing is the foundation of the Philosophical Transactions by the Royal Society of London in 1665. As Cook (1986) points out, whereas the year 1500 constituted the transition from Middle to Early Modern English, 1700 is the time of the ‘decline of the old medical regime’.

Chapter 3, ‘Medical literacies and medical culture in early modern England’ by Peter Murray Jones, develops what Fisell (2007: 113) called the ‘flowering of vernacular medical publishing’ and describes the impact of the popularity of the methods of circulation of medical writings in the context of a decline in illiteracy in early modern England, from 70 per cent of men and 90 per cent of women in the mid seventeenth century to an overall proportion of 75 per cent by 1714. He looks at types of illiteracy and how they can be measured through the use of historical sources (signatures, book distribution, etc.), focusing on the implied reading competence of the audience for medical texts, as well as on the evolution and emergence of related text types. He discusses issues such as the distribution of pamphlets available on the street, the ‘popularity’ of text types such as remedies and recipe books often found in household closets, and the provision of Latin texts and Latin translations in private libraries.

The popularisation of medical writings is not without risks, and Jones also deals with the danger of advertising by fraudsters and unlicensed practitioners, which was not extensively controlled by College authorities, illustrating this through the analysis of paratextual extracts.

Chapter 4, ‘Verbs of knowing: discursive practices in early modern vernacular medicine’ by Turo Hiltunen and Jukka Tyrkkö, is a piece of traditional corpus-based research within the domain of what Pahta and Taavitsainen refer to in their introduction as ‘micro-level’ analysis. Hiltunen and Tyrkkö undertake the syntactic and discursive study of verbs of ‘knowing’, and investigate grammatical variables such as the distribution of modal auxiliaries, the polarity and the type of the grammatical subjects of utterances, the type of ‘knower’ of the sentences (subject in the active, agent in the passive, etc.), and the ‘topoi’ of knowing.

The assumption that underlies this study is the heterogeneity of medial writing, in that whereas university-trained physicians are responsible for the linguistic expression of theoretical knowledge, surgeons, apothecaries and even midwives now author practical writings based on more everyday aspects of medicine. Such a spectrum of medical professions leads to the existence of different kinds of published texts, stemming from different approaches and aimed at different audiences. With this context clarified, the authors claim that the study of verbs of ‘knowing’ serves as an empirical illustration of the decline of didactic discourse and the emergence of a new assertive style in which argumentation is a key feature.

Hiltunen and Tyrkkö focus on the analysis of three knowing verbs, know (frequent), understand and wit (statistically rare) in two textual dimensions in EMEMT, namely didactic discourse and specialised treatises (including the Philosophical Transactions). Although the overall frequency of these verbs is significant (a total of approximately 1,900 instances), the number of examples of understand and, in particular, wit (only 16 examples) does not warrant significant conclusions, especially looking at an analysis of examples per text type in fifty-year time frames. It seems to me difficult to draw any general conclusions from the strikingly different findings per text type (and even per individual text). As regards the variable of modality, the authors explore the distribution of epistemic (may, might, can) and deontic (must, ought, should, shall) modal auxiliaries in the 385 sentences which contain modals across the database, concluding that deontic auxiliaries are more frequent in didactic discourse and that epistemic auxiliaries are commonly found in specialised treatises and in the extracts from the Philosophical Transactions. In the absence of raw figures, percentages reveal the decline of modals from 30 per cent in the period 1500–50 to merely 10 per cent after 1550. The type of grammatical subject constitutes the second research variable, and the authors reach the following conclusions: in 86 per cent of clauses subjects are pronominal, normally referring to the author or the reader; second-person singular pronominal subjects are more frequent in general treatises, and this is interpreted as evidence of the texts’ reader-oriented status; by contrast, the specialised treatises and the passages from the Philosophical Transactions contain more first-person singular pronominal subjects, which corroborates the presence of a self-reflective stance. Hiltunen and Tyrkkö also investigate clausal polarity and contend that the increase of negative polarity, particularly in passages of the type You will not believe this or You haven't seen this before, implies the ‘growing interest in the exploration of new phenomena for which no explanation was readily apparent’ (p. 57). Although the number of examples per textual dimension and time period seems insufficient to support any firm conclusions, a chi-square test shows that this variation is statistically significant. The third variable involves the classification of third-person knowers into the types ‘divine’, ‘authority’, ‘author’, ‘medical community’, ‘reader’ and ‘all’ (including animals, witches, conceptual entities). As part of the fourth variable, the authors classify the topoi into ‘assertive’, ‘practical’ and ‘epistemic’. They illustrate the taxonomy and undertake a more qualitative analysis of the examples, again per textual dimension and period. In general, they conclude that, although the differences across textual categories are small, there is considerable variation across texts. The conclusions from their analysis are linked to macro-level sociological innovations and changes at the time, and thus the study aims to show that linguistic analysis has a place beyond lexical research.

Rod McConchie and Anne Curzan, in the fifth chapter, ‘Defining in Early Modern English medical texts’, reflect on the way in which ‘definitions’ are materialised in Early Modern English medical writing. The taxonomy of definitional strategies which they apply to the data is as follows: ‘synonyms’, ‘categorisation’, ‘relation’ and ‘etymological relationship’. The empirical research is accomplished by retrieving the occurrences of 21 lexical items that generally occur in EMEMT (and MEMT) passages with definitions (for example, call, declare, define, demonstrate, explain), and the central part of this chapter is concerned with the qualitative analysis of a selection of the examples. Thus the authors comment on a number of examples individually, and discuss their referential properties along the four dimensions of the definitional taxonomy. Whereas the conclusions are not far-reaching, since they are intimately related to the specific examples under examination in the second half of the chapter, the study provides a qualitative contribution to the poorly explored area of the connection between the discursive strategies of definition and the textual varieties in which they operate. Since this study is exclusively based on the lexical distribution of a class of verbs, one misses the examination of other strategies of definition such as lexical and phrasal collocations (for example, that is, which means). Also, the reader is not provided with the rationale of this analysis in medical writing, since the conclusions do not justify either the relevance or the distinctiveness of the study of definitional strategies in medical texts as opposed other scientific productions.

Chapter 6, ‘Dissemination and appropriation of medical knowledge: humoral theory in early Modern English medical writing and lay texts’ by Irma Taavitsainen, constitutes what is in principle a narrowly focused study on the usage of the word humours in Early Modern English medical and other less technical texts. The starting point here is that humoral theory was derived from learned science, and in the course of the fifteenth century was modified for broader audiences. This assumption must be seen as having to do with the drift towards the popularisation of medical writings, already mentioned in this review. Taavitsainen argues that in the periods under investigation the texts exemplify the simplification of applications and ideas, with less specific details. The target is thus a more expository style in the texts, which are progressively more instructive and less specialised or learned. Taavitsainen departs from this position and investigates the occurrences of humours in EMEMT with the aim of demonstrating the drift from learned to ‘popular’ style by means of the close inspection of the lexical patterns in which humours occurs. Two types of textual material are selected for this case study: medical writings in EMEMT, and databases of unmarked discourse, namely the Parsed Corpus of Early English Correspondence and the Corpus of English Dialogues. The chapter offers a detailed list of publications where humours has been attested, as well as a fine-grained analysis of its meanings. The empirical dimension of this research leads to the following conclusion regarding the distribution of the keyword: humours is frequent in EMEMT, specifically in the general treatises and textbooks, in the specific treatises, in the recipe collections, in the regimens, and in the Philosophical Transactions; by contrast, humours is rare in the other corpora and is only found in the correspondence and drama. The occurrence of humours both in the medical writings and in text types such as drama and letters serves as the basis for Taavitsainen's philosophical thesis of this project: that lexical items (as instances of linguistic expressions/construals and cultural sets in general) are understood and ‘appropriated’ differently by different audiences. If we accept that science was not felt to be the exclusive domain of the learned population in early modern England and, as a consequence, became closer to the ‘unlearned’ social classes in this period, Taavitsainen argues that in 1500 ‘popular culture was not restricted to the “unlearned”’ either (p. 95), and so a bidirectional process takes place: both from learned cultural sets to the unlearned population and vice versa.

The impeccable and rigorous analysis of the lexical item humours in this chapter, in which Taavitsainen has made every effort to keep track of all the potential variables at stake such as collocational tendencies, textual variation, and situational and contextual circumstances, contrasts with the lack of concluding remarks integrating the so-called theory of appropriation and the usage of humours in medical and more unmarked writings. In this vein, maybe the most significant semantic and pragmatic finding is that, according to the results here, humours was used in negative linguistic contexts in the fourteenth century, for example, and that it then became a more positive notion, collocated with ‘pleasant ideas’ (p. 97) in Early Modern English.

Päivi Pahta in her study ‘Code-switching in Early Modern English medical writing’ looks at the poorly explored area of code-switching (or language alternation) in the medical texts of the period. After a detailed revision of the literature in the field, which commonly focuses on the coexistence of Latin and English and on the status of Latin as the lingua franca and its institutional discursive role, Pahta discusses the main findings in her previous research on the Helsinki Corpus and MEMT. In the main part of this chapter she goes on to explore the circa 1.7 million words of medical writings in EMEMT (except the Philosophical Transactions), selecting foreign words in the word lists produced by Corpus Presenter (she also discusses the problem of borrowings in this type of study) and concentrating on the coexistence of English and other languages. The main findings are as follows: although the vast majority of the foreign words are of Latin origin, examples are also found from Greek (usually in the Latin alphabet), Arabic, French and Italian; most of the foreign expressions are words or phrases, and occasionally clauses and sentences (perhaps more attention should have been paid to the type of expressions and their distribution across text types, as in Marttila's chapter in this volume); most switched expressions are intrasentential; the areas in which foreign expressions are more frequent are writings or passages of special terminology, quotations, and medical recipes (mostly the ingredients). Pahta also undertakes the qualitative study of the discursive functions of foreign phrases by analysing a number of examples. The value of this contribution is the account of the study's methodology and the brilliant way in which Pahta has accomplished the (time-consuming) corpus-aided task.

Chapter 8, ‘New arguments for new audiences: a corpus-based analysis of interpersonal strategies in Early Modern English medical recipes’ by Ville Marttila, reconciles traditional lexical analysis with ideas already expounded in previous studies in this volume, specifically one-to-one associations between audience and text types or genres. In this chapter Marttila explores interpersonal (‘social, expressive and conactive’, p. 135) functions or strategies in a selection of 10,000 words from EMEMT, and focuses on the attitudes and interaction between readers and writers, as well as on the assignment of roles in the subcorpus. More specifically, Marttila investigates recipe books aimed at ‘lay’ people and medical recipe collections aimed at the medical community. The methodology employed is quite traditional: concordancing of the search items which are relative to a person, labelling of the words which refer to the different (first, second, third) persons, and tagging of the lexical items with respect to their semantic role (patient, hearer, author, etc.). The study, which at this point in the research is strictly quantitative, gains theoretical depth when the author turns to the interpretation of the findings, which can be summarised as follows: writing aimed at lay people contains frequent references to the reader; as a consequence of the detailed analysis of the strategies employed with the different persons, in the excerpts directed to lay people, second-person reference is quite common; in those texts aimed at lay people, the reader is identified with the patient (this is not the case in other texts); focus in the texts aimed at the medical community is not on a given person but on the malady, and the style of writing is thus more objective and scientific, and the text tends to be thematically focused on the treatment and not on the participants of the communicative act; the proportions of the references to authorities are quite similar in the two text types, which is surprising.

Marttila also deals with the issue of language switching in recipe books and collections, in particular with Latin and Greek occurrences. He suggests a classification of the expressions illustrating switching into classes such as set expressions, technical terms, complete phrases and complete clauses, and goes on to consider these text by text. Although the approach to the switching contexts is rigorous, its conclusions do not shed much light on the main topic of this chapter. As already suggested, Marttila's contribution to the study of linguistic switching could have benefited from Pahta's collateral findings here. Likewise, Marttila's taxonomy could have enriched Pahta's linguistic treatment of switched expressions.

In his chapter ‘Efficacy phrases in Early Modern English medical recipes’, Martti Mäkinen explores a selection of the EMEMT medical recipes for learned and lay people and reflects on the so-called ‘efficacy’ passages, that is, on those parts of the texts in which the authors emphasise the validity of the product or persuade the audience to use the recipe, treatment, etc. In what we can call the qualitative dimension of this investigation, Mäkinen offers an example-by-example analysis of these efficacy passages and comes to the conclusion that such strategies are normally found in recipe-final parts of texts and commonly carry tag phrases such as and it shall heale/staunche hym. In the quantitative part of the research, the author determines that diachronic variation is only observed in the texts directed towards lay people, with the number of efficacy passages increasing up to the mid seventeenth century, then dropping after 1650. The author concludes that this may be due to the shift towards empiricism in medical writings. In the case of recipes for a learned readership, statistical changes are not dramatic. However, as Mäkinen recognises, the number of examples is too small to be taken as statistically significant.

This is a well-formed piece of research and opens up new avenues for the intratextual analysis of medical recipes. Mäkinen has taken into account not only issues pertaining to text structure, but also discursive function and audience. The weaknesses of this chapter are, on the one hand, the limited number of examples on which the study is based and, on the other, the qualitative conclusions the author is forced to reach in the light of so few examples and the erratic statistical distributions.

Chapter 10, ‘Medical pamphlets: controversy and advertising’, provides an account of the emergence of pamphlets in early modern England. Maura Ratia and Carla Suhr maintain that pamphlets proliferated from the mid sixteenth century onwards. According to them, the main reasons for the popularity of these texts were their price and the breakdown of censorship in 1641. In the period under consideration, this new text type gained importance as an effective means of advertising medicines and of participating in medical controversies. For both of these functions the authors select a number of pamphlets from EMEMT and undertake a qualitative analysis. First, their analysis focuses on the use of personal pronouns in Early Modern English pamphlets, in particular first- and second-person pronouns. Their conclusions are: that in general, first-person pronouns are more frequent than second-person pronouns, which implies that both text subtypes (advertising and controversy) are strongly author-centred; that we is more frequent in the pamphlets including controversy than in those of an advertising nature. The authors also perform a micro-study of the interpersonal functions fulfilled by the pronouns in the texts, the results of which are not particularly instructive. Second, Ratia and Suhr investigate adverbial and nominal deixis in the subcorpora and conclude the study by claiming that the deictic elements are carefully integrated in the controversial pamphlets and are less necessary in those with an advertising role.

Maurizio Gotti's chapter, ‘The development of specialised discourse in the Philosophical Transactions’, constitutes an encyclopaedic paper, making some tentative connections with the more empirical studies earlier in the volume. Together with Gray et al.'s chapter, Gotti's focuses on the texts from the Philosophical Transactions and serves as an introduction to the taxonomy of the contributions published by the Royal Society of London in this periodical. As already pointed out, the Philosophical Transactions, which started life in 1665, was innovative in many respects. First, and indisputably the most important fact, the Philosophical Transactions was written in English. Gotti discusses the major problem which this decision brought about, namely that question of what to do with specialised terms, and the two solutions adopted: using terms which were already used in English, and borrowing terms from Latin or Greek. Second, the periodical accepted a number of what we could call new ‘genres’ which were alien to the publications of the time. More specifically, brief reports (‘new items’), experimental accounts, letters and book reviews were all accommodated within the pages of Philological Transactions, and were widely accepted as early as the eighteenth century by the scientific community. In the final part of this chapter, Gotti describes such genres and gives examples. This most informative chapter constitutes a perfect introduction to the study described in the following chapter. The samples provided by Gotti constitute valuable illustrations of both the vernacularisation of science and the drift which medical writing underwent from the Middle Ages to early modern times, that is, from exclusive distribution in learned circles to the enlargement of its audience.

Bethany Gray, Douglas Biber and Turo Hiltunen devote chapter 12, ‘The expressions of stance in early (1665–1712) publications of the Philosophical Transactions and other contemporary medical prose: innovations in a pioneering discourse’, to the study of ‘stance’ or ‘attitudes towards, evaluations of and level of commitment to’ what language users produce (p. 221). As a consequence of the assumption that stance is (also) important in formal written prose, the authors carry out a corpus-based study of stance expressions in medical prose from the mid seventeenth to the mid eighteenth century. More specifically, they analyse reports, letters and book reviews in the Philosophical Transactions and compare the findings with traditional medical texts from the same period. The methodology involves, first, the identification in each of the individual text types of stance certain wordings, such as modal and semi-modal verbs, adverbials (e.g. doubtless, surely), that-clauses controlled by stance nouns (e.g. claim), verbs (argue) and adjectives (remarkable); second, the part-of-speech tagging of such expressions; third, the production of word-lists and concordances. The different stance expressions are subclassified according to their meaning (e.g. ‘necessity’ and ‘obligation’ modals and semi-modals, attitudinal and likelihood adverbials, certainty that-clauses), and this leads to an itemised quantitative depiction of lexical stance strategies. The major findings are the following: variation is the keyword emerging from this empirical experiment since the results are quite heterogeneous between the traditional texts and those from the Philosophical Transactions, but also between the three Transactions textual categories; stance markers abound in book reviews and recipes and are less frequent in letters; among the different categories of stance expressions, those of modality and certainty are the most common.

This review has sought to underline the value of this volume as a demonstration not only of the worthiness of corpus initiatives such as EMEMT, but also of the success that multi-/interdisciplinary research can achieve when corpus methodology is used. The existence of a representative corpus which comprises a wide range of textual varieties of specifically medical writing opens up an avenue for comparison and contrast between older and current medical texts and the new Early Modern English compositions – and, why not, even Present-day medical writings. In this vein, Medical writing in Early Modern English constitutes a successful editorial effort to bring together micro-level research in areas such as the distribution of ‘knowing’ verbs as defining hallmarks of the type of discourse, the type of expressions used when the author wants to define a given concept, emphasise the efficacy of the medical product or make clear his/her stance position towards discourse, semantic change observed in specific lexical items such as humours and its connection with a theory of appropriation, the contexts which favour language alternation, and the uses of personal pronouns as carriers of interpersonality in recipes or pamphlets. But the scope of this volume does not end here, since it also includes thorough macro-level inquiries into illiteracy and textual-discursive innovation as social by-products of social change. In short, this book sells medicine which shall heale the reader without a doubt as if he had neuer had the disease.