The Medical Marketplace in Norway : Bente Gullveig Alver, Tove Ingebjørg Fjell & Teemu Ryymin, Vitenskap og varme hender. Den medisinske markedsplassen i Norge fra 1800 til i dag. Scandinavian Academic Press, Oslo 2013. 321 pp. ISBN 978-82-304-007

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crimination, from both home and host communities. In addition it is valuable to also read about the everyday life of women involved in migration pro-cess, meaning not just losses and displacement but also new interpretations, knowledge, empowerment and possibilities.

One disadvantage of the book is a lack of clear disposition. Several chapters start out with one ques-tion, but end up in something else. This might be the consequence of reusing material from former studies in a new context, adding a gender perspec-tive and focus on women. Another more general cri-tique is the gap between research and practice that sometimes appears in the texts. The lived experience of the women tends to disappear or become illustra-tions of already formulated theoretical truths. An-other thing, the lack of a gender perspective in mi-gration research does not really coincide with how it works among professionals. If we look back on the last 25 years we will find that the experiences of mi-grant women have been considered as a special problem in Scandinavian countries and have result-ed in an endless flow of genderresult-ed integration pro-jects. These kinds of projects have also caught the attention of researchers over the years, but it has mostly been considered as a problematic and stereo-type perspective on immigrant women.

Kristina Gustafsson, Växjö

The Medical Marketplace in Norway Bente Gullveig Alver, Tove Ingebjørg Fjell & Teemu Ryymin, Vitenskap og varme hender. Den medi-sinske markedsplassen i Norge fra 1800 til i dag. Scandinavian Academic Press, Oslo 2013. 321 pp. ISBN 978-82-304-0073-9.

In the 1950s alternative medicine in Norway van-ished, more or less, and it was only in the 1970s that it became more visible again. The post-war period was a time when the Norwegian welfare state was built, and alternative medicine was identified as something that did not belong to this modern socie-ty. Alternative medicine became something that was associated with the obsolete, the deviant “Other”, which should be relegated to the past. Instead mod-ern medicine, social security systems, health policy visions and new hospitals emerged and moulded what could be defined as modern society. This

dia-lectic relation between alternative medicine and modern medicine – or scientific medicine – is from a historical perspective a very fruitful input to un-derstand not only medicine, but also cultural per-spectives on the formation of modern society. The relation between scientific medicine and alternative medicine is always in transformation. This is an analysis that the culture researchers Bente Gullveig Alver and Tove Ingebjørg Fjell, together with the historian Teemu Ryymin, perform in their book Vitenskap og varme hender: Den medisinske mar-kedsplassen i Norge fra 1800 til i dag (“Science and warm hands: The medical marketplace in Norway from 1800 to today”). They start in the numerous medical markets at the beginning of the nineteenth century.

The main concept of their analysis is the medical market, as Marijke Gijswijt-Hofstra and her col-leagues have developed it. The term is a perspective for analysing the interaction between supply and de-mand for all types of medical services related to dis-ease and health. The starting point is to use the mar-ketplace as a metaphor, but not to take into account whether services are authorized or not in a specific historical context. Instead a central question is raised in relation to empirical material: Why do people select alternative medicine or modern medi-cine, or both? Further, the model is connected to what Arthur Kleinman sees as the health care sys-tem’s three overlapping parts: the popular, the pro-fessional, and folk sectors. It is, as Alver and her colleagues point out, the professional sector and folk sector that mainly forms the medical market. At the same time the popular sector will always be the big-gest one, representing individual self-care or help given by relatives. Based on this theoretical model, the analysis is focused on the dynamic in the sectors and the grey zones and distortions between them.

Chapter 2 – “The diverse medical marketplace: 1800 to 1900” – studies the actors that were central in the medical market and what options there were for the individual who had become sick. A central factor is that the concept of illness was closely relat-ed to magical thinking and where cause and effect were different from our days. The ritual practice with sacred implications was central. The wise therefore had a central position as the ones who could treat different diseases. During the 1800s, however, public responsibilities grew stronger and the government gradually become aware of the

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health of the population. As a consequence a more systematic health policy began to emerge and pro-fessional medicine grew. An explanation was that the government perceived some diseases as threat-ening. For example, the medical understanding of cholera contributed to changing the health policy in Norway. Health work became a central element in the construction of the modern nation and the doc-tors came to have a central role in enlightening and civilizing the population. Hygiene in particular, as a concept, was something that the population had to be made aware of. At the same time there was dis-trust of what the doctors could offer. Apart from surgery, the doctors did not have more help to give than the “quack doctor”.

Chapter 3 examines the time between 1900 and 1945. This was a period when new social political visions grew stronger in Norwegian society, mainly because the cost of poverty reduction had increased markedly under the end of the 1800s. A growing discourse at this time was that the weakest in society and the sick should get a form of protection from so-ciety, for example through health insurance. But there was also growing public health information that anticipated that there was a social duty to stay healthy. A form of self-discipline emerged, although the work in the early 1900s was concentrated on combating tuberculosis. In this health information hygiene was central, along with healthy eating. This period can therefore be seen as a period when the ideas that were to be the foundation of the welfare state were gaining ground. But it was also a time when greater control of the population was achieved and more hospitals were built. Alternative medicine also changed and tried to claimed niches where medicine at this time had not cures. At the same time medicine struggled to enlighten people not to use alternative medicine, but this was not as effec-tive and the population instead had more medical markets to choose from.

Chapter 4 considers the “monopoly of the white coat”, as scientific medicine in the 1950s and 1960s became more effective in treating the diseases that existed in society, which meant that alternative medicine had a smaller market to act on. But the re-construction of the welfare state also meant that medicine often became a cheaper option for people than alternative medicine. The concept of the wel-fare state was first used in Norway in 1945, with a focus on universal social security. At the same time

the welfare state was closely related to medical sci-ence, with new advances such as penicillin and vac-cination. Also, the expansion of large specialized hospitals as well as specialization among doctors changed the role of medicine in society. This devel-opment meant that the acute infectious diseases de-creased and medical scientists directed their interest towards more chronic and degenerative diseases in-stead. There was an epidemiological transition from combating infection to checking health. But the rela-tionship between medicine and the patients also be-came more paternalistic, with the doctor speaking to the patient. This was strengthened by the growth of the so-called “equipment failure model”, where the doctor focused on what was wrong with the biologi-cal body, and ignored more sociocultural perspec-tives.

Chapter 5, – “Individual Responsibility on the Health Market: 1970 to 2010” – takes its starting point in some immense changes at the beginning of the 1970s. One was the oil crisis of 1973–1974 which interrupted the more or less constant econom-ic upturn since the post-war period. It was no longer obvious that the welfare state would expand. An-other was the ideological criticism that became widespread in society and also affected medicine and its paternalistic authority and dominant value system. Medicine as an expert system now came un-der criticism too, not least from international critics such as Ivan Illich. The preventive health work of the 1970s also changed, with a greater demand that the population take more responsibility for their own health. These three different themes are dis-cussed in the chapter and how they developed from the beginning of the 1970s to today. Obviously these are very big questions, each of which would require its own book, but the authors manage to make a good summary of the most central lines in the development. A crucial issue is of course the greater focus on risk factors to prevent illness. The development that is highlighted is that the greater responsibility the population must take for their own health developed in parallel with the medical identi-fication of new risk factors. This is a development related to the sociologist David Armstrong’s term surveillance medicine, in which every individual in a society becomes the supervisor of their own bodies.

It was also a time when the “natural” was an im-portant discourse in society, and from the end of the

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1960s it became a part of the ideological criticism against the society. Alternative forms of life and healthy food became important and also linked to the individual’s responsibility for their own health and for the environment they live in. This provides an opportunity for alternative medicine, which now enjoyed a renaissance. Some examples that are high-lighted in the book are acupuncture and chiropractic. An interesting discussion in the book concerns how this growing market also created porosity between the sectors. From 1970s the medicine monopolies began to dissolve, giving alternative medicine greater possibilities to market itself and giving the patient a stronger position in relation to medicine. Simultaneously patients’ rights were strengthened.

The book ends with a short conclusion where the authors capture the two issues: Why have people chosen different ways of dealing with sickness and health from a historical perspective? How have the different sectors of the medical marketplace related to each other from the mid nineteenth century to the present day? From these questions the authors re-capitulate what has been discussed but do not do much more. It would be interesting to adopt some larger perspective and discuss it in relation to the many perspectives presented in the book. For ex-ample, the welfare model developed in Norway could be related to the welfare models in the other Nordic countries; there are many similarities and differences that could be highlighted and analysed. Also, a more global perspective could have broad-ened the discussion, showing how the welfare model has always evolved in relation to an international context. In this final chapter trust as a concept is also considered. This term is present throughout the book but never analysed very much; a more theor-etical discussion would have been appropriate in this chapter.

But the criticism is negligible. Bente Gullveig Alver, Tove Ingebjørg Fjell and Teemu Ryymin have written a very interesting book that not only provides a good understanding of the historic devel-opment in Norway, but may also say something about the welfare developments in the Nordic coun-tries. It gives us important historical perspectives on how medical markets evolve, coexist and are chal-lenged over time.

Kristofer Hansson, Lund

Swedish Seamen’s Tattoos

Svenska sjömanstatueringar. Mirja Arnshav (ed.). Sjöhistoriska museet. Medströms Bokförlag, Stock-holm 2014. 183 pp. Ill. ISBN 978-91-7329-117-0.

It must be said straight away: this book about Swedish seamen’s tattoos from the Maritime Mu-seum in Stockholm is a magnificent volume, with well-chosen and beautiful pictures, a nifty layout, and easy-to-read texts. The designer Ludwig Hals-berger therefore deserves a mention for the roman-tic, nostalgic feel of the book, which suits the con-tent very well. The fact that the book will embellish any coffee table does not detract in any way from the high quality of the content.

The different texts in the book are by twelve au-thors. Several of them are Swedish ethnologists, ar-chaeologists, and historians, but some also represent art history or fashion studies. The aim has thus been to approach the subject from different angles, but despite the many different authorial voices, the texts have a surprisingly uniform and homogeneous style. Presumably this is mostly thanks to the editor, Mirja Arnshav. She is also behind the well-written intro-duction and several of the texts.

The book has five main chapters, each divided into sections. In the introductory chapter, “Seamen and Tattoos”, Arnshav, who is an archaeologist, pre-sents the tattoo collection, in the form of photo-graphs and drawings of tattoo designs, maintained by the Maritime Museum – the tattoos on which the book is mostly based. The following chapters are structured according to motifs that have occurred in tattoos, and the headings speak for themselves: “An-chor, Star, and Ship”, “Eagle, Geisha, and Dragon”, “Women, Butterflies, and Hearts”, “The Handshake, Homeward Bound, and The Sailor’s Grave”.

The book describes how tattoos – which have be-come incredibly popular today among people of both sexes, young and middle-aged alike – were an alien element in Swedish society a hundred years ago, signalling difference, deviance, and sometimes even criminality. Yet tattoos were common among sailors, and the world of images that developed “in dockside pubs, on the decks of cargo ships, and in the encounter with foreign cultures” has set the style for today’s tattoos, known as the old-school style. The authors ask how this happened, and how we should understand the original context and purpose of the historical tattoos. Unfortunately, the large