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Logo of medhistThe Wellcome Trust Centre of the History of Medicine (UCL)Medical History
Med Hist. 2010 October; 54(4): 550–551.
PMCID: PMC2948697

Book Reviews

Negotiating the French pox in early modern Germany
Reviewed by Jon Arrizabalaga

Claudia Stein,  Negotiating the French pox in early modern Germany,  The History of Medicine in Context series, Farnham, Surrey, and Burlington, VT,  Ashgate,  2009, pp.  xi, 241, illus., £60.00 (hardback  978-0-7546-6008-8). 

During the last three decades or so the new social and cultural history of medicine has deeply renewed its gaze on human diseases in past societies and on the care given to the sufferers from them. This renewal has entirely transformed the views about pre-modern disease by releasing historians’ agendas from disciplinary concerns such as retrospective diagnosis of past conditions, and by expanding scholars’ scope towards new issues with the help of alternative research strategies and methodologies.

Claudia Stein's Negotiating the French pox in early modern Germany falls entirely within this refreshing new wave. This monograph is a thoroughly revised English version of her original German doctoral thesis Behandlung der Franzosenkrankheit in der Frühen Neuzeit am Beispiel Augsburg (Stuttgart, Franz Steiner Verlag, 2000). She deals with the socio-cultural construction of the French pox in the early modern imperial city of Augsburg by claiming that the identity of the pox was flexible, temporary and locally defined. Stein has sought to represent “sixteenth-century pox as both ‘real’ and ‘constructed’ on the grounds that ‘reality’ itself is an ongoing negotiation”, and to capture—in accordance with Andrew Cunningham's idea of “disease concepts in action”—what she defines as “the pox concept in action” by integrating two areas that have often been kept separate in historico-medical studies, namely “the world of medical semiotics and the daily practice of diagnosing and treating disease within a particular local context” (p. 176).

Stein's documented and suggestive monograph is articulated through four broad chapters that successively deal with four areas. Firstly, she analyses how the early modern Germans understood the physical reality of the French pox from a core of ten pox treatises and pamphlets originally published in German between 1496 and 1620 (some of them at Augsburg itself), on the assumption that vernacular medical literature is close to laypeople's knowledge. Secondly, she depicts the Germans’ socio-cultural reactions to the pox and, most particularly, Augsburg's poor relief system and the treatment of the sufferers from this condition at the three hospitals there established for this purpose—the municipal Blatterhaus (its founding in 1495 makes it the first pox hospital in German lands), and the two Holzhäuser that the Fugger family of bankers founded there in 1523–24 and 1572—by mainly resorting to the rich historical archival records for the period 1495–1632 that have been preserved at these institutions. The third chapter reconstructs the negotiations over the identity of the pox among the different agents (medical doctors, barber-surgeons, patients, bath masters, municipal authorities, and so on) who were involved in defining it at Augsburg, by paying specific attention to patients’ narratives, the experts’ preceptive physical examination of patients asking for hospital admission, and medical practitioners’ possible diagnostic verdicts (unsuitable, suitable and dubious). Chapter 4 describes the different treatments for the inmates in the three Augsburg pox hospitals: guaiacum (including the procedures for acquisition, preparation and administration to patients), mercury, surgery and the life regime based on the six non-naturals.

Stein's focus on the relevant case study of the French pox in sixteenth-century Augsburg has led her to tackle a number of suggestive historical processes, such as the increasing power of local learned physicians during this period over diagnosis and treatment of the French pox, in parallel with their gradually dominant role over other kinds of health practitioners in Augsburg's marketplace which reached its culmination in 1582 when the city council founded the health board (Collegium Medicum), on which they presided. Also investigated is the gradual transfer of Augsburg's hospitals from the hands of benefactor citizens and the Catholic Church to the city council's administration in parallel with their reorganization, all in the context of a city and a time that were central to the German Reformation. Additionally, she studies a temporal progression with regard to the French pox's embodiment in the “diseased body” from the outer body (barber-surgeons’ competence) to the inner body (doctors’ authority), in parallel with a gradual change in its therapy from mercury to guaiacum. Last but not least, this study has allowed Stein to undo two well-established historical myths concerning the early history of the French pox, namely Karl Sudhoff's view that the Fuggers secured for themselves a monopoly of the importation of guaiacum wood from the New World, and of its sale in Europe (pp. 101–4); and that the pox provoked the gradual collapse of public baths through the sixteenth century, which in the case of Augsburg she attributes mainly to a “dramatic increase in the price of firewood” (p. 139).

Stein's book, which is solidly structured and very enjoyable—its translation, by the way, is splendid—is completed with a suggestive introductory historiographical review of German scholarship on venereal diseases (pp. 1–21), and an extensive bibliography (pp. 179–225), which, its usefulness aside, evidences the solidness of her study and the breadth of her intellectual concerns. Otherwise, this is an indispensable study to approach the highly relevant part of the early socio-cultural history of the French pox that took place in German lands and was played by German actors.

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