Book Review

Matters of Exchange: Commerce, Medicine, and Science in the Dutch Golden Age

N Engl J Med 2007; 356:2657-2658June 21, 2007

Article

Matters of Exchange: Commerce, Medicine, and Science in the Dutch Golden Age
By Harold J. Cook. 562 pp., illustrated. New Haven, CT, Yale University Press, 2007. $35. ISBN: 978-0-300-11796-7

Trying to name a defining national characteristic is perilous, since the variation between individuals is far greater than the variation between stereotypes. A person who, despite this stricture, ventures to find a single denominator for the Dutch might say they are pragmatic — and that historically their pragmatism often outweighed their adherence to principles. An apt example, elaborated in one of the last chapters of Harold Cook's Matters of Exchange, is the way in which the Dutch East India Company managed not only to establish but also to maintain a trading post in Japan, despite the strict isolationism of the shoguns. The company officers, always treading on eggshells, took pains not to impose or even show their Christian faith — a misstep taken earlier by the Portuguese that had led to their expulsion.

On the tails of the exchange of commercial goods was an exchange of knowledge — especially medical knowledge. Dutch physicians posted in Deshima, Japan, studied and wrote about Eastern medicine, such as “needling” (what we now call acupuncture) and the art of pulse taking, whereas the Japanese were highly interested in learning “red hair surgery” — “red hair” being Japanese slang for the Dutch. It is the relationship between commerce and science in the 17th century that is the central thesis of the book, and each of its 11 chapters provides a different perspective on this thesis.

The merchant class in European seafaring countries emerged as the leading force during this period, and the newly formed Dutch republic took center stage, introducing innovations such as paper money and the world's first major stock exchange. Expertise in shipbuilding and an accessible coastline led to a global economy. The import of tropical spices, plants, and animals triggered a general curiosity about the wonders of nature. Cabinets with exotic rarities could be found in the homes of wealthy burghers. Private and public botanical gardens were developed, with greenhouses and eventually hothouses. Anatomical surgeries served practical as well as religious purposes.

In this same age, René Descartes (who spent most of his life in the Netherlands) and Baruch Spinoza introduced a new, materialistic philosophy. Their views were highly controversial, causing rifts between Protestant factions and within the universities of the Dutch cities of Utrecht and Leiden, but they also prompted a general consensus among scientists that the search for truth should start with observations rather than theories. Facts came before causes, knowing before understanding. Herman Boerhaave in Leiden and Nicolaes Tulp in Amsterdam, both brought up as strict Calvinists, practiced and taught the art of observation in medicine and criticized the once sacrosanct theories of the Roman physician Galen. Parenthetically, what strikes the modern reader is the ease with which prominent medical scientists changed their country of residence. Not only was bureaucracy less restrictive in the 17th century, but a common language (Latin) facilitated international communication, an advantage that science is now regaining after some two centuries of linguistic parochialism.

Cook, who mastered the Dutch language to study original sources, tells many stories in great detail, with numerous plots and subplots. Some accounts that fill half a page might make for the subjects of entire books. It is only gradually that the reader sees the general pattern emerge from all the colorful threads that are woven into this book. This is altogether an enriching tome — though perhaps not recommended for a day at the beach.

J. van Gijn, M.D.
University Medical Center, 3584 CX Utrecht, the Netherlands
j.vangijn@umcutrecht.nl