Bubonic plague in nineteenth-century China

century (tenuously, since, as the author does not state, only the plan for this example is known and there is no evidence that the building was ever erected) and still in use in the thirteenth century for hotels-Dieu and monastic hospitals, mainly Benedictine. Though Karassava-Tsilingiri does not say so, his conclusions-if accepted-are of very great importance for the history of medical institutions in Europe and the Middle East, since they would significantly undercut the role of the medieval Islamic hospital as an institutional model adopted by the Franks during the Crusades. Ann Williams follows the Knights of Malta in 1530 and assesses the significance of the shifting role of the new hospital in Valetta from xenodochium to Sacra Infirnaria (pp. 97-102). From the 1580s onwards the hospital's position expanded on all fronts: its activities became more ambitious, its demands for supplies were voracious, its role as an employer was vital, and its political domination extended from Valetta out into the villages via allocation of physicians and strict enforcement of quarantine regulations. Charitable services remained prominent, but the Knights used the Sacred Infirmary to achieve a "medicalisation of the state" that ensured the harmony of their domain and kept the bishop and inquisitor at bay. A final medical contribution by Susan Edgington examines Crusader sources, in particular her new edition of the Historia Iherosolimitana of Albert of Aachen, to establish what ideas about illness and treatment the Crusaders brought with them from Europe (pp. 320-6). Though the evidence is limited, it can be seen that the Frankish armies regarded their physicians as expert authorities and were successfully able to treat even very serious wounds and injuries. In seeking to explain disease, they overwhelmingly sought natural causes and displayed little interest in magicoreligious remedies; this seems to surprise the author, but it is consistent with recent findings refuting the once-popular notion that in Europe prior to the Crusades people were inclined to seek magical and religious rather than natural causes for disease. She concludes that "this practical approach may explain why the Crusaders learnt so readily from medical practice in the East", but it could also be suggested that her important findings call into question the proposition that Frankish medical practice was significantly inferior to that of their Muslim foes in the first place. Apart from the direct conclusions that emerge, these studies clearly reveal that if documentation remains limited for certain aspects of the medical historical study of the military orders, there yet remains considerable room for further investigation. For other aspects, however, the extant sources are very rich indeed, and one can only hope that this material will soon attract the detailed study that it so obviously deserves.