This article addresses the question of the limits of literate medicine in Europe, through an examination of the Russian literate medical world of the late seventeenth and early eighteenth centuries. Russian courtly medicine had been dominated by Western Europeans from the 1480s, but in the early eighteenth century new licensing arrangements solidified the presence of these foreigners in the wider Russian medical world. Foreign medical practitioners took advantage of this development, aiming works at an increasingly large proportion of Russian literate society. These works, along with satirical and religious works emulating or deriding medical texts, show how by the 1720s the limits of literate medicine in Russia lay not at the edges of official court medicine, but rather at the edges of literate society.