In this study on how to create saints in post-Reformation Europe, Bradford Bouley makes a strong case for the importance of medical examination in canonization processes. Through each densely argued, erudite, and innovative chapter, Bouley traces the history of procedures leading to a declaration of sainthood in the early modern period. He does this by way of studying individual instances that arose for examination at the tribunal of the Sacra Rota, the administrative branch of the Catholic Church in charge of such cases. These inquiries show that, starting sometime in the late sixteenth century and in tandem with the new authority that university-trained physicians were acquiring (post-Vesalius) on anatomical dissections, popular hailing of saintly behavior became insufficient per se to further canonization efforts. In the medieval period, the cult of saints within the populace and the persistence of local, often moneyed sponsors could successfully foster cases of canonization, but when new Counter Reformation rules started to be enacted, miraculous cures had to be verified on the body of presumed holy individuals, male and female, by medical witnesses.

Fully aware that the Reformation had questioned the number of saints and the ease with which the Catholic Church canonized, early modern popes decided to certify holiness only after a series of demonstrable steps that required centralization of the process and confirmation by the ecclesiastical authority in Rome. The person who had died in odor of saintliness could still be examined locally at the place of death, but it had subsequently to be reexamined by experts to see whether the signs typically taken for holiness—such as irregular, wondrous body parts, incorruption of the body, and asceticism—could also be corroborated by the medical establishment. This procedure, Bouley stresses, could be quite long and expensive, but until approval came through from the Congregation of Rites and from the pope, visible signs of veneration had to be suppressed. The body of a supposed saint had, therefore, no fixed, inherent meaning, since it was subject to the interpretation of religious as well as lay people looking for the reality of miracles inside the cadaver. It goes without saying that the substantiation of sanctity implied the failure of science in cases when bodily phenomena could not be understood within a range that physicians deemed normal.

Doctors and believers had different agendas when examining holy bodies, Bouley argues. For the doctors, the task was to ascertain whether natural explanations could be responsible for what they saw in an autopsy; thus, they expected to learn something new from the examination, which also meant that their empirical observations, circulating sometimes in writing, could advance their reputation vis-à-vis their peers. For the hagiographers, the body of the saint was, instead, a place of wonder, and the presence in it, say, of kidney stones or of signs of emaciation were not to be explained away as natural biological phenomena but as reinforcements of the uniqueness of the cadaver under examination.

No matter how venerated the potential holy person was, the beatification process was inevitably politicized because medical examiners were all male, just like the doctrine-minded ecclesiastics in charge of the authorization to proceed. To be sure, saintly women whose bodies were found uncorrupted years after their death had almost the same chance as their male counterparts to be canonized, since a tenet of the Catholic Church was resurrection, which implied an imperishable body reuniting with the soul. But saintly women who denied their flesh—the anorexics and the visionaries that peopled early modern Europe—were more likely to be suspected of demonic influence than of being in communication with God. That is, a rigorous lifestyle could make saints of men, because self-abnegation and sacrifice were seen as increasing male reputation, but not of women, who were often denounced as faking saintliness and as being mentally challenged. Predictably, they were not often candidates for sainthood.

Bouley backs his reading of how the holy body could be certified as such with significant scholarship and a deft reading of primary sources. His appendix listing the postmortem of prospective saints—which distinguishes whether the procedure for canonization (successful or not) centered on an unusual anatomy, a state of incorruption, or a case of extreme bodily denial—is quite valuable for future research in the field. His exploration of the seeds of anxiety when the gender of saintly relics came to the foreground is indebted to studies of holy female bodies, such as those of Katharine Park, regarding the Middle Ages (“The Criminal Body and the Saintly Body: Autopsy and Dissection in Renaissance Italy,” Renaissance Quarterly 47, no. 1 [1994]: 1–33), and of Gianna Pomata, regarding the seventeenth century (“Malpighi and the Holy Body: Medical Experts and Miraculous Evidence in Seventeenth-Century Italy,” Renaissance Studies 21, no. 4 [2007]: 568–586). His interest in the development of medical publications called observations, in which doctors scrutinized patients for pathologies but did not interpret their symptoms, follows Nancy Siraisi's research (for example, Medicine and the Italian Universities: 1250–1600 [Brill, 2001], 356–380) and offers new sites of inquiry. Bouley significantly extends the picture of the relationship between body and self in his examination of a range of European cases of beatification that came up for review, especially those involving Spain. I would have liked the book to have a bibliography at the end and for chapters 4 and 5 to form a single unit, but these are quibbles in an otherwise notable and fresh contribution to the history of the power, politics, and gender relations informing the making of saints in the early modern period.