Gesundbleiben, Krankwerden, Armsein in der fruhneuzeitlichen Gesellschaft: Gesunde und Kranke in den Reichsstadten Uberlingen und Ulm, 1500-1700 (review)

This large and detailed study is part of a continuous and rewarding trend to move German medical history into the social and empirical domain. Kinzelbach’s scope encompasses communal and individual health behavior, the role and definition of epidemics, and the social context of disease and treatment in two early modern southwest German urban settings. In both method and thematic reach, the author is indebted in more than one way to the framework of comparative urban studies established by Robert Jütte and his collaborators at the Robert Bosch Foundation. As in similar regional work, the possible drawbacks of generalizing from local studies are far outweighed by the advantage of obvious comparability in a number of areas: municipal charity and its scope and obligations to giver and recipient; the response to epidemics, which at the time under study drew explicitly on cross-country precedent; and the continuing struggle for patient care, ascendancy, and municipal regulation between different groups of healers.

It is an open question whether on some levels this comparability is real or due to reliance on the concepts and methods in the social history of medicine developed—under recognizably different auspices—in England and France; but those interested in cross-cultural study rather than in specific ethnography will gladly pay the price of some blurring of finer cultural and geographic patterns. The yield is in part the suggestion that some differences over time and by region may well have been due to levels of regional or municipal wealth rather than to strictly medical considerations. Kinzelbach notes that her study demonstrates the pervasiveness of nutritional strategies such as stockpiling and the price support of essential foods during frequent shortages; of environmental and personal hygiene measures by the municipal authorities; and of an astonishing level of medical assistance to maintain and restore child and adult health. In Überlingen and Ulm in the relatively prosperous sixteenth and early seventeenth centuries, these measures were reflected in the careful construction of bath houses and the pressure to employ midwives for birthing, to provide just two examples. Apparently, these and similar measures were supported by the population and not merely imposed from above.

Unfortunately, the author’s precision in using and correlating sources is obscured by her book’s title, whose linked existential nouns will translate poorly into more succinct languages. Staying well and getting sick are intrinsic to any history of medicine that deals with people and populations; poverty is not really Kinzelbach’s major theme, but rather a structural variable at a time when charity was the major vehicle of population assistance and self-help schemes were limited to some of the guilds.

By contrast, and notable in a study whose academic locus was the faculty of philosophy and history of the University of Heidelberg, the central section of the book deals with conceptual and measurement problems posed by the epidemiology and nosography of the recurrent sixteenth- and seventeenth-century plagues, and by related patterns of behavior and events. Here, the reader is well served by a refreshingly empirical and critical approach to the literature in the field that is informed by the author’s current and previous work in the archives of Überlingen and Ulm, both Free Imperial Cities—one Catholic, the other Protestant but both sharing in the flourishing north-south trade of the period. Kinzelbach is clearly a sound archival historian fully in command of her sources and well aware of their virtues and pitfalls (e.g., pp. 180 ff); these latter include not only the well-known danger of over-reliance on printed injunctions and descriptions (or their studied absence to hide the presence of an epidemic) by those in authority...