The Early Modern Medical-Military Complex: The Wider Context of the Relationship Between Military, Medicine, and the State1

In his final televised address to the American people in 1961, US President Dwight Eisenhower famously warned about the danger that the “military-industrial complex” posed to freedom, peace, and democracy. Although Eisenhower’s rhetoric proved controversial, the idea that a nexus of legislators, national security agencies, the armed forces, and weapons manufacturers wielded undue influence over the direction of US foreign and domestic policy complements scholarly investigations into the consequences of war on political, economic, and social developments in different kinds of states and societies across time and space. Recent research on the military-industrial complex referred directly to Eisenhower’s assessment with the aim to uncover the post-war relationship between arms industries, the US army and government.² Understood as a “confluence of profit and policy that undermines the public’s overall welfare,” the idea of a military-industrial complex was mainly adopted by critics of public spending in the interest of the military establishment and big corporations in the US during the Cold War era.³ Whether or not this concept is used to argue against the generally detrimental effect to the public good of combined corporate and establishment interests, it draws attention to the mutual dependency of government, military, and business interests. Although the idea of a military-industrial complex was shaped by US defence and social politics after World War II and rooted in the socio-economic realities of a highly industrialized democratic society, it resonates with previous developments in the complex relationship between economy, military, the state, and society. The notion of a military-industrial complex also raises questions about the long-term connections between the public sector, the military, and private business; the organization and administration of public spending and contracting; as well as corruption and the potentially dysfunctional nature of public-private partnerships.

I. MILITARY ENTERPRISE, BUREAUCRACY, AND STATE FORMATION

For the early modern period, the ongoing debate about the military revolution,⁴ discussions about the fiscal-military state,⁵ and research on military entrepreneurship and the role of the state are pointing in a similar direction.⁶ They all take the interconnectedness of warfare and the military, the state, and other economic and social actors for granted, but focus on different aspects of the connections. While the military revolution debate is underpinned by tactical and strategic concerns and emphasizes the importance of technological and administrative innovation in the military, discussions about the role of the fiscal-military state focus on models for collecting revenue and state spending, which were behind the expansion of armies and navies. They assume that both military innovation and the creation of new fiscal tools to finance warfare were crucial in the process of state formation and the expansion of the bureaucratic state into ever more areas of social and economic life during the eighteenth century.⁷

Scholarship on the business of war has a different focus. It is more interested in how resources were mobilized for early modern warfare, how armies were managed and their supply organized.⁸ This research shows that while the early modern state could act in entrepreneurial ways, private finance and suppliers remained crucial to war efforts. With regard to the Netherlands, Pepijn Brandon recently challenged the assumption that the growing demands of early modern military technology, tactics, and organization only allowed centralized states to carry out warfare at a large scale. He admits that the rather decentralized government of the Dutch Republic relied on the methods of the fiscal-military and the contractor state in financing and supplying its armies. However, this was only possible in a system where state and private interests went hand in hand, which lets Brandon characterize the Dutch Republic as “a brokerage state in its continuous involvement of economic elites in the execution of its warring tasks.”⁹ The continued involvement of private entrepreneurship with the military, the key role of civil administration in managing armies and navies, as well as for organizing campaigns, challenges modern concepts of the military, government, state administration, the economy, and civic...