In Ill Composed Olivia Weisser endeavors to recover the words, expressions, beliefs, and behaviors of early modern patients—an aim in which she is successful. In the book Weisser reveals the ways in which understandings of disease causation, the progress of illness, sickbed experiences, and recovery were expressed in distinctly gendered ways. The book eloquently explains how religious beliefs and social interactions fundamentally shaped the experience of health and medicine at this time. Weisser draws on more than forty diaries and fifty collections of correspondence from the middling and upper levels of society. To illuminate the experiences of the sick poor these descriptions are compared to pauper petitions, which were designed to overturn decisions made by overseers of the poor and subsequently presented to magistrates at the quarter sessions.
Weisser begins by outlining how patients understood disease causation, predominantly through the humoral model, and the ways in which they prioritized the role of the six nonnaturals. These external factors, such as diet and sleep, caused obstructions and blockages that damaged health. In the first chapter Weisser also outlines patients’ means and methods of curing their bodily ailments. Then in chapter, 2 she explains how religion, personal experience, and witnessing the ill-health of others shaped the ways in which men and women spoke about illness. Men tended to focus upon their own bodily experiences, comparing current ailments with those they had experienced previously. However, women looked to the bodies of others to explain their distempers. Weisser does not simply trace these differences but considers the writing practices and social roles of men and women to explain the divergent expressions of gendered patients. Women's roles caring for others perhaps prompted their outwardly facing mode of thinking. Their experiences predominantly survive in the form of spiritual writings, these texts were used as a tool for self-fashioning, which in part was done by comparing personal experiences with the experiences of others. This again shaped their tendency to look to others.
In chapter 3 Weisser describes how emotional upheaval was understood by men and women to be a cause of illness. Patients utilized their bodily ailments to express Christian sorrow, revealing again that both gendered ideas of social roles and religion formed the framework for discussing ill health. Women tended not to describe the physiology of emotional illness—they did not, for example, dwell on the fact that grief and fear could shift the spirits away from the heart causing bodily imbalance. Conversely, men noted these mechanisms. They highlighted, for example, that emotional distress led to insomnia, which then produced a physical effect in the body. Women were in general far more prone to emotional illness because, as they understood it, their flesh was softer and more easily imprinted by emotions. Men's experiences were articulated differently. Rationality, one element of manliness, was supposed to allow men to control their emotions, and so men described how they overcame emotionality to regain control of their bodies and, implicitly, protect their health. Women's experience of illness was also tied to their social relationships as they experienced sympathetic illness, which on occasion diminished their ability to fulfill their duties.
Weisser further explores social relationships in the fourth chapter. It was a core duty of religious and social life in this era to visit friends and family on their sickbeds. Women and men shaped this encounter to present themselves in particular ways. As patients women highlighted to visitors illnesses that were lengthy or particularly dangerous in order to underscore their own piety and patience, key markers of Christian femininity. Visits could have a damaging effect on patients if their sympathetic sentiments were felt to be insincere. Likewise, the neglect of family members could exacerbate or lengthen an episode of sickness.
In chapter 5 Weisser outlines the ways in which men and women evaluated and experienced pain. Men, as with illness, measured the severity of their pain comparatively with prior experiences, while women compared their experiences with other people to articulate their pain. Surprisingly they rarely compared the pains of sickness to the pain of childbirth. Both genders used pain and suffering as a way to demonstrate their focus on spiritual matters over and above corporal concerns, again showing their conformity to the ideals of Christian piety. The ideal was to experience pain but not to express it excessively.
Weisser concludes by balancing these insights into the lives of middling sort and wealthy patients with an examination of the attitudes of the poor to sickness. Unlike the patients in the rest of the book, these men and women focused upon accidents as the central cause of disease, not humoral imbalance. Illness was the result of factors beyond the control of the patient and was as a force that disrupted a life of hard work and independence. Specific illnesses were rarely the focus of these descriptions patients instead noted their weakness and infirmity. This weakness caused dependency and suffering, which could be relieved by poor law assistance.
By moving beyond the voluminous medical literature produced between 1630 and 1730 Weisser has integrated social, religious, and gendered understandings of sickness to bring the reader closer to patients themselves. In places the gendered analysis seems to give way to detailed examinations of particular patients and their narratives of personal sickness and disease. These anecdotes are very engaging, but it is not always apparent if the book has been aimed at the trade or academic market. Yet this is also the great success of Ill Composed, as the experiences of early modern patients are vividly brought to life in a lively and compelling way.
