Der Dienst Am Kranken: Krankenversorgung zwischen Caritas, Medizin und Okonomie vom Mittelalter bis zur Neuzeit (review)

This collection of essays comprises papers given at a 2007 conference at the Hessian State Archive in Marburg, Germany, honoring the eight-hundredth anniversary of the death of St. Elisabeth of Thuringia. The volume focuses on the development of institutionalized medical care, mainly in German-speaking lands, from the Middle Ages to the twenty-first century. Many essays particularly emphasize charitable care of the sick poor, for which St. Elisabeth was known. As a whole, the collection gives a fascinating survey of hospital care through the ages, illustrated by numerous high-quality images.

Elisabeth of Thuringia herself appears chiefly in the introductory and concluding essays to the volume: Klaus Niehr’s study of the changing iconography of St. Elisabeth and Helmut Siefert’s survey of four very different leading figures in charitable care, beginning with Elisabeth and ending with Cicely Saunders. The links among institutional medicine, charity, and religion form the focus of three essays on the Middle Ages. Kay Peter Jankrift challenges the nearly exclusive emphasis on monastic medicine as a source of medical care in the early Middle Ages. Hubert Kolling provides an overview of institutionalized care of the sick in medieval Europe from its early medieval roots in the monastic tradition to the founding of hospitals by knights’ orders, lay confraternities, and civic authorities. He notes the importance of female healers to the charitable hospital tradition. Finally, Peter Dilg surveys the development of the apothecary trade in the Middle Ages, which he relates to the early medieval monastic tradition as well as to the regulation of apothecaries in European towns from the twelfth century.

The next two sections focus on the institutionalization of hospitals in the Renaissance and Enlightenment. Using the example of Augsburg, Claudia Stein disputes the thesis that newly founded institutions for the “French disease” in the sixteenth century were forerunners of late-eighteenth-century medical clinics, and Gerhard Aumüller provides a careful study of the organization of the hospital in the Hessian town of Haina. Frank Hatje examines the diverse types of institutional care in eighteenth-century northern Germany, demonstrating that differentiation did not always entail a systematic division of labor. Heiko Droste studies the increasing professionalization in hospitals, which took place within the framework of existing strict hierarchies. Irmtraut Sahmland contrasts the cloister-like statutes in the eighteenth-century Merxhausen hospital, which required that pregnant female carers be banned from the institution, with the more lenient treatment of pregnant carers in practice.

The essays on nineteenth-century hospitals return in part to the theme of charity. Gunnar Stolberg surveys the development of hospitals as institutions and their handling of the “laboring poor,” and Norbert Friedrich examines the continuing connection between deacons and deaconesses and medical care. Christina Vanja focuses on the care provided by sanatoria, which relied on the ideals of aesthetic living and self-discipline. The final three essays examine the modern hospital: they include Martin Dinges’s study of homeopathy in the hospital from the eighteenth to the twenty-first century; Kornelia Grundmann’s portrayal of the Marburg Surgical Clinic in the early twentieth century as an example of the increasing acceptance of hospitals (despite a continuing surplus of poor patients); and Michael Lingenfeder’s probing of the conflict between modern hospital management and health services.

The essays are of notably high quality and provide a substantial survey of the salient themes regarding institutional care and the development of the modern hospital. However, the book lacks a strong introduction or conclusion tying the essays together, which leaves the reader without a clear overview of the shifting meanings of the hospital or the changing relationship between hospitals and charitable healing. An essay specifically related to women and charity would have provided a nice link to Elisabeth of Thuringia. Nevertheless, this...