Detail from a printed page in Latin in one column with handwritten initial letters in red.

Fifteenth Century Books: From the Cradle of Printing in the West

By Laura Hartman ~

Zodiac Man. Critical Days. Secrets of women. Chiromancy. Plague. Poisons.  Aristotle.  Hippocrates. You can explore these topics and many more common themes of late medieval medical philosophy and practice in the National Library of Medicine collection of incunabula.

Incunabula is a term coined in the 17th century to refer to books printed “in the cradle” or infancy of the Western printing press, generally from the early 1450s to 1500.  The root word derives from the Latin for the leather straps that were used by the Romans to bind or swaddle infants in their cradles.

A printed page in Latin in one column with handwritten initial letters in red.
De pollution nocturna by Jean Gerson (1363–1429) Printed in Cologne by Ulrich Zell, ca. 1466

The first works printed on the printing press were indulgences and Bibles.  Religious works were soon followed by secular ones.  Medical and scientific works started to appear in the late 1460s.  Initially they were simply printed editions of well-known (and frequently copied) manuscripts.

The earliest printed books resemble their manuscript predecessors in many ways: they typically lack title pages; are rubricated, meaning embellished in red ink (though they sometimes used blue); begin each major section with large initials; and frequently abbreviate the words of the text or replace them with marks of contraction.   A few of these marks, such as the ampersand (&), are still used today.   Illustrations, which began to appear in the early 1460s were rarely printed in color, but were hand-colored afterwards.

Book production was expensive.  A typical print run was only 200–300 copies.  Everything from the paper, to the ink, to the type, was made by hand.  The type was set by hand, letter by letter, upside down and backwards, generally by illiterate typesetters who were following copy they could not read.  The pages were printed on sheets, to be folded and bound together later.  When mistakes were made, the press was stopped and the errors corrected, but the sheets with the errors were not discarded.  Thus, minor differences in print settings between copies sometimes allow scholars to track the production history of a book.

Title pages were rarely used before 1485.  The first ones contained only a brief title and perhaps the author’s name.  Sometimes printers would add a device or mark, but there are many works printed during the incunable period that do not have a printer’s name or date.   Scholars study the paper, type fonts, and wood-cuts to identify these printers and establish printing dates for these books.


Of special interest to medical historians is Johannes de Ketham’s Fasciculus Medicinae. This was the first printed medical work that was illustrated.  A well-known collection of medieval medical texts, the incunable editions feature ten illustrations including a Urine Circle, Disease Man, Pregnant WomanVein Man, Wound Man, Zodiac Man, and a Plague Patient.   Complete copies of four incunable editions of this work (1493/1494, 1495, 1500, 1500/1501) are available in NLM Digital Collections.


The hand colored illustration of liquid in clear vessels includes two gilded examples difficult to appreciate from the scan.
Illumination on Urine Circle in Fasciculus medicine, 1500/01

As wonderful as it is to present the NLM copies of these treasures to the world, the digital images cannot completely capture their beauty.  For example, in the 1500/1501 Fasciculus Medicinae, two of the urine flasks are illuminated with burnished gold or gilt.  They appear as a flat tawny brown in the scanned image.

Incunabula are all unique. Because of the craftsmanship, the short print runs, and the long individual history of each surviving book as it passed from hand to hand through the years, each one has something different to tell us. NLM holds nearly 600 incunabula and approximately ten percent of this collection has been scanned and placed in NLM Digital Collections, with thirty more titles to be added each year.  We’ll be featuring some of these very special books here on Circulating Now, as we process them for digitization to share them with the world.

You can arrange a tour of the NLM and its incunabula collection by contacting the NLM Visitor Center. For information on access to the collections explore our website.

Laura Hartman is Rare Book Cataloger in the History of Medicine Division at the National Library of Medicine.


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