Medicine from the Black Death to the French Disease

Setubal was a fishing and garrison town to the south of Lisbon which from the early sixteenth century was heavily dependent on the production of salt in the Sado estuary. Prosperous families of the town often made pious bequests in the form of salt works so the churches and confraternities also became dependent on the fortunes of the salt trade. This interdependence of salt and piety allows Abreu to coin the evocative image of a people whose "Purgatory had the taste of salt" (p. 87). Most of her book, however, deals with the decline of interest in Purgatory from the late seventeenth century as Setubal experienced a series of natural and political disasters that ruined the salt trade, and attitudes changed towards charity and poor relief. The dead, whose memory the living were supposed to cherish, were forgotten as the clergy relieved themselves of the burden of masses, and families struggled to extract their property from the clutches of the church. Those in the Misericordia who had benefited-the sick poor, orphans and prisoners-saw charity towards them decline. A system of health care and public assistance which had been set up in the early sixteenth century became hopelessly inadequate for the social realities of the nineteenth century. Abreu's book is based on her two volume doctoral thesis and this probably explains its earnest and ponderous style and a certain lack of focus. There is very little information on the Misericordia itself and one is left wanting to know more about medical care in Setubal. Only the last part of the book-seventy pages out of over four hundred-deals with sanitation, mortality, disease, diet, and surgical and medical practice in the Misericordia. If the book is actually meant to be an analysis of religious rather than medical practices in the town, then this last medical section sits awkwardly with the rest. For a reader who might not be familiar with Portuguese history and geography, this book presents further difficulties. Although there are many graphs, there are absolutely no maps. When the author refers to confraternities in the region of Setubal or the foundation of convents across the town, the reader is none the wiser. Moreover, a great deal of knowledge about the history of modern Portugal is assumed. It is perhaps unusual for a social study of this sort to cover such a long period of time. This reflects the static nature of the system which funded the Miseric6rdia, but it produces a book bowed under by the vast amount of archival material available. Abreu's scholarship, however, is undeniable and this is an interesting regional contribution to the history of religion and charity.