That few figures in early eighteenth-century Madrid were as unconventional as the physician Diego Mateo Zapata makes his professional and social success all the more remarkable. He was, to begin with, of Jewish background. What is more, the Inquisition tried him twice, in 1691 and 1721, for secret observance of rites such as Purim. Despite the weighty evidence against him, he nevertheless managed to get off lightly and eventually returned to practice medicine close to court circles. (These episodes of persecution would not be forgotten; a century later one of Francisco Goya's drawings sympathetically depicted Zapata as a prisoner in chains.) The physician's marrano background and occasional crypto-Judaism were so far from being a secret that they gave rise to another source of public embarrassment. Madrid's rumour mill assured that it was known about town that a botched circumcision had left him virtually castrated. The delight that his many enemies took in taunting him as a “capon” was merely part of the rougher side of early modern medical polemics. And in this no holds barred context, Zapata gave as good as he got.

It was indeed thanks to such exchanges that Zapata forged his reputation. He arrived in Madrid around 1686 as a licentiate in medicine—his lack of “pure blood” ensured that he would never receive a higher degree, nor certification by the Protomedicato (royal licensing board). Thanks to help from fellow “New Christians”, he found work at the city's general hospital. He quickly began to make a name for himself by publishing attacks on several senior physicians, including prominent figures at court. His early work defended Galenist physiology, and roundly opposed belief in the circulation of blood, a doctrine that was slowly making headway in Spanish medical circles. By 1701, however, Zapata had gone over to the opposite side. Lauding the “new medicine”, including the circulationist theories he had previously rejected, his works now trumpeted “practical studies of diseases” through recourse to “experience” (viz. anatomical and “chemical” experiments). At the same time they promoted a vaguely Baconian programme critical of the Galenist and Aristotelian syllabus then taught in the universities. The rest of his career—he was active until his death in 1745—was marked by further controversies. In addition to his struggles with the Inquisition, he also tangled with his fellow physicians over a host of practical and theoretical problems, ranging from the protocol of consultations among medical personnel to the theological dilemmas posed by caesarean sections.

Pardo highlights numerous general lessons that one can learn from this admittedly singular case. First, his careful reconstruction of the intricacies of the debates in which Zapata participated shows how hard it is to draw clear lines separating different schools of medical opinion. Earlier interpretations that pitted a handful of quixotic novatores against the traditionalists overseeing the windmills of the academic establishment are here revealed to be at best an over-simplification of a much more complex situation. Specific public arguments—including Zapata's own shifts of opinion—often disguised bids for favour and protection from equally voluble patrons. The more important among these included not just the heads of leading aristocratic families, but also the coterie of royal physicians that controlled licensing as well as most of the major medical posts. The monarchy's role in promoting the “new” science is another myth that Pardo takes on. The arrival in 1700 of the new French dynasty did indeed introduce some fresh air into the brackish backwaters of Spanish medicine. However, this book provides fresh evidence in favour of the growing consensus that this change was well under way before the Bourbons reached Madrid, and that Italy was just as important as France as a source for the innovative currents with which Zapata eventually cast his lot. Finally, the author has especially illuminating things to say about the nature of medical practice during this period of transition. Of particular interest is his analysis of the consultas, or formal opinions, whose abundant circulation in manuscript or print form constituted the most important form of debate among physicians in larger cities such as Madrid or Seville.

This is a thoroughly researched and highly suggestive study of a wide range of significant issues. It deserves a wide readership.