Curing and Insuring: Essays on Illness in Past Times: The Netherlands, Belgium, England and Italy, 16th-20th Centuries.

Scholars looking for points of comparison with English, French, German or American studies in the social history of medicine should take note of this useful anthology. It is the fruit of a 1990 conference on "Illness and History" held at the Faculty of History and Art Studies at Erasmus University, Rotterdam.

The essays are ordered chronologically and cover a wide range of issues. The first seven essays concentrate on illness, healers, and patients in the early modern era, most of them focusing on the Netherlands. Two of these articles focus on the plague. One by Giulia Calvi examines how individuals and groups battled against the plague in ways which reflected their social class, their gender, and their relationship to the sacred sphere. The other article on the plague by Leo Noordegraaf argues that the doctrine of predestination largely determined Calvinist theologians' and ministers' reactions to the plague. Attempts to avoid the plague through flight or secular remedies seemed useless and possibly irreligious. After briefly examining comparable studies on the same topic written by other secular scholars for England and France, Noordegraaf concludes that Calvinist writers in all three countries expressed "condemnation, disapproval, or reserve concerning the use of worldly means to fight the plague" (p. 30). In light of Calvi's analysis of plague in Catholic Florence, one wonders whether class or gender played a role in shaping the actions of ordinary Protestants in the Dutch Republic.

Willem de Blecourt calls for serious reconsideration of the argument, made by Barbara Ehrenreich, Deidre English and others, that female healers were the main victims of the witch hunts of early modern Europe. While not the first scholar to question this idea, Blecourt takes the "fundamentalist feminists" and "adherents of paganism" to task for faulty reasoning and lack of evidence. Using both his own research and that of other scholars, he shows that there is little evidence linking cunning women, female lay healers, and midwives with those persecuted as witches. This argument is important to rehearse because the myths surrounding the witch hunts, witchcraft, and healers for the early modern period are persistent among scholars and the educated public alike.

Other articles treat various aspects of sickness, health, miraculous cures, and healers for the early modern period in the Netherlands. For example, Waardt, in his article "From Cunning Man to Natural Healer," argues that a new kind of wonder-working doctor, the "empiric," arose in the eighteenth century. This new doctor benefitted from a decline in belief in witchcraft and "borrowed heavily from both the new scientific experiments and the traditions of the cunning folk" (p. 41). Their combination of skills and knowledge allowed these healers to compete handily in the medical marketplace with academically-trained doctors who lacked this attractive mix of expertise. This is a noteworthy thesis, though the term "empiric" has other meanings in other contexts.

An important theme in these early articles is the impact of commercialization and consumerism on professions and doctor-patient relations. Roy Porter summarizes these issues in a well-written article, "Health Care in Enlightenment England: Knowledge, Power, and the Market." Increased sickness, affluence, and leisure joined with the emergence of the modern stereotype of the hypochondriac to create a "buoyant free market in medicine." Patients controlled their relations with their doctors who in turn, contributed to the patients' power by publishing self-help literature. These newly-created medical consumers called upon the doctor more frequently than in earlier periods and self-medicated with greater regularity.

Wim Cappers' study, "Money and Medals for Saving the Drowned: The Financial Factor in Dutch Discourse on Apparent Death during the Second Half of the Eighteenth Century," owes much to earlier studies on the Enlightenment and medicine, but his subject - the growing concern with unnecessary death by drowning - is particular to the Dutch case. In a country criss-crossed with waterways, such a worry is not surprising. Cappers suggests that such concerns were similar to the more general eighteenth-century fear of being buried alive. In response to these fears ten Amsterdam inhabitants founded the Society for Rescuing the Drowned in 1767. The Society "focused on financial incentives as their primary means of encouraging a change in mentality toward the revival of apparently drowned victims." Cappers argues that the "commercialization of secularizing society" facilitated the use of monetary rewards to encourage saving the drowned (p. 85).

The last five essays are more disparate than the previous seven. Covering the period from the eighteenth to the twentieth centuries they all share an interest in examining various factors that shaped modern health institutions and policy debates. Hilary Marland describes the opportunities created by the broadening of medical services for women doctors and the impact of women as patients and physicians on health service for women and children in the Netherlands in the late nineteenth and early twentieth centuries. Her work follows in the path of American scholars such as Regina Morantz-Sanchez and Mary Roth Walsh. The interplay among state, the medical profession, and various kinds of medical insurance institutions is described in their nineteenth- and twentieth-century Belgian and Dutch settings by Rita Schepers and Caren Japenga and Henk van der Velden. These authors also examine the debate about medical relief for the poor within the context of the development of medical insurance. Other articles treat such diverse topics as shifting drug policies in the Netherlands, the Dutch East Indies Red Cross and its treatment of native inhabitants during the first Atjeh expeditions, and the unique qualities of military psychiatry in the modern era.

The strength of this collection lies in the fresh material these scholars present on the Dutch Republic in the Golden Age and on the Netherlands and Belgium for the modern period. While not theoretically innovative, it is a useful contribution to a maturing field of inquiry.

Alison Klairmont Lingo Berkeley, CA