Using a wealth of documentary and archaeological sources for the hospitals of the county of Champagne to the southeast of Paris, Adam Davis offers a valuable regional study of these charitable institutions for the twelfth and thirteenth centuries. As he says, demographic growth and the increasing importance of the region's expanding urban centers, especially in relation to their trade fairs, meant members of the aristocracy and mercantile elite were concerned to provide aid for the sick poor through the foundation and benefaction of hospitals. Setting his study primarily in a French context, but also drawing on other mainland European work on medieval hospitals and, to a lesser extent, the historiography of medieval hospitals in England, Davies provides further evidence of the complex roles undertaken by these religious houses and their place in the wider community, from offering places of spiritual and physical care to serving as landlords and being producers and consumers in the marketplace.

Before presenting his case study, Davis assesses contemporary ideas regarding charity circulating in thirteenth-century France, which often had their origins at the University of Paris. This informative summary provides ideas about the significance placed on the notion of purgatory, how and why alms should be given, and the place of penitential and redemptive giving within a marketplace economy. Seeing sermons as having special relevance to his discussion, Davis looks in some detail at issues of vocabulary used by preachers, returning on numerous occasions throughout the book to the ideas of Jacques de Vitry.

Using evidence primarily for the hospitals of the cities of Troyes, Provins, and Bar-sur-Aube within the context of the hospitals of Champagne during the High Middle Ages, in four thematic chapters, Davis covers topics such as patrons and benefactors, including matters of motivation by donors, through his analysis of sermons, wills, and charters. Other subjects investigated include the management of these institutions (drawing on an account book from the hôtel-Dieu Saint-Nicolas in Troyes), the personnel to be found at hospitals, and some indications of the groups and individuals as recipients, who were often designated the “sick poor” (see chapter 6). Interestingly, unlike many of their English counterparts, these hospitals were under the Augustinian Rule, which may have some bearing on the range of surviving archival material on which Davis has been able to draw. Furthermore, it seems the hospital statutes (for example, of the hospital of Provins), are often exceedingly detailed, including how the hospital brothers and sisters were expected to treat those seeking assistance. Sermons, too, demonstrate ideas about the ideal of care as envisaged by senior churchmen. While these sources only suggest what ought to happen, by deploying hospital accounts Davis was able to delve far deeper into the workings of these institutions. Consequently, we learn how certain hospitals sought to raise money through letting out lodgings and accommodating the longer-term donati (or corrodians), the giving of serfs as pious donations by local members of the nobility, and the sometimes active role a hospital, for example the hôtel-Dieu-le-Comte in Troyes, played in disputes between lay patrons and neighboring monasteries.

Other rich sources of evidence Davis uses include architecture in the form of surviving buildings and their decoration, especially wall paintings, and the findings from archaeological excavations regarding burial patterns and the potential profile of hospital communities. The employment of mass burial, perhaps in response to epidemics or famine conditions well before the Black Death, is especially striking, as at the hôtel-Dieu-le-Comte in Troyes. Such evidence highlights the presence of relatively young children at hospitals, while other burials indicate that hospital communities were in many ways similar to those buried in parish graveyards, which suggests that the sick (or at least not those where the pathology indicates infirmity or sickness) were not disproportionately likely to be interred at these charitable establishments.

Furthermore, in providing a detailed picture of the foundation and management of these mostly urban hospitals and life within them, Davis has unearthed some fascinating documentary sources covering the wider community in twelfth- and thirteenth-century Champagne. For, in addition to testamentary materials, the records of emancipation from guardianship when wards came of age sound wonderful, with their details of the furniture, land, and property due to the heir. Also interesting are the sources relating to credit relations between citizens and the various religious houses, thus offering further evidence of the integration of these establishments within society.

Overall, The Medieval Economy of Salvation is a welcome addition to the scholarship on the role and place of hospitals in medieval European society. Through the wealth of primary materials he has uncovered, Davis offers some valuable insights into the complexity of the networks within which these establishments operated in the High Middle Ages in the Champagne region. His ideas about what charity meant to contemporaries are interesting, but it would have been helpful to see reference to the debate on the “language of charity” that began in the 1990s in English hospital studies and the associated scholarship by Patricia H. Cullum (among others, “‘And Hir Name Was Charite”: Charitable Giving by and for Women in Late Medieval Yorkshire,” in Woman Is a Worthy Wight: Women in English Society c. 1200–1500, ed. P. J. P. Goldberg [1992,] 182–211; “‘For Pore People Harberles’: What Was the Function of the Maisondieu?,” in Trade, Devotion, and Governance: Papers in Later Medieval History, ed. Dorothy J. Clayton, Richard G. Davies, and Peter McNiven [1994], 36–54). However, that said, for historians of medieval hospitals and those interested in this critical period of economic and demographic expansion, the richness of Davis's sources means that he has been able to provide a detailed account of life inside and outside the hospital embedded in developments and ideas to be found in French society more widely.