Households, consumption and the development of medical carein the Netherlands, 1650-1900

This article examines the development of the Dutch medical marketplace between 1650 and 1900 from a household’s perspective. Using debts for medical care recorded in probate inventories, we construct the first quantitative analysis of levels of demand for medical care and the types of medical provision in small towns and villages across the Netherlands – locations much more representative of most of Europe than its better-studied cities. We reveal substantial growth in the sick’s reliance on commercial medical practitioners between 1650 and 1800, measured by both the frequency and size of debts to practitioners. We also find large differences between the commercialised maritime areas of the Netherlands and the more autarchic inland regions, where households were particularly unlikely to have used medical practitioners circa 1650. These differences extended to the types of practitioner involved: surgeons were most prominent in the maritime region; apothecaries in the inland region. Patterns of medical consumption converged during the nineteenth century, as did the types of practitioner used, anticipating laws restricting professional activity in medicine. As we show, differences in households’ uses of medical care within and between regions reflected their income, level of monetisation and engagement in commercial activities and other forms of non-essential consumption. We conclude that the profound growth in commercial medicine experienced in the early modern Netherlands was linked closely to wider trends in consumer behaviour.