Susan North's introductory chapter, “Digging the Dirt in the Pursuit of Cleanliness,” tantalizes the reader, and a close perusal of her book does not disappoint. North reminds us that dress history is an area of study pursued by a range of academics—dress, social, economic, and cultural historians—the breadth of which reveals the importance of body covering and adornment in human experience. She also argues that a study of the life of linen illuminates some of the edifying minutiae of everyday life in early modern England.

North is convinced that the assumptions of the very influential French social historian George Vigarello (whose prominent beliefs include the assertion that the denizens of early modern Europe eschewed the use of water for bathing) do not apply to early modern England. Having established that idea, North can offer a fresh interpretation of personal hygiene and sartorial habits in early modern English society. North's methodology is broad and deep: she undertakes the study of linen from the viewpoints of textile history, consumption, and dress history, as well as other concerns of social history. North holds that medical and etiquette texts insist that washing the skin was essential; “sweet and clean” is the expression that appears repeatedly to describe the desired state of bodies and clothing. This principle calls for rethinking early modern England's relationship with water, as well as a reconsideration of the function of linen. Having positioned herself as an innovative interpreter of the dirty linen of early modern English inhabitants, North divides her inquiry into two sections: “Advice” and “Practice.”

North's first section, containing the chapters “Manners and Health,” “Clothing and Disease,” and “Clean Bodies,” revisits attitudes that may be familiar to scholars of early modern conduct literature. For example, chapter 2's treatment of “Manners and Health” reminds us from the outset that underlying all principles of cleanliness in early modern literature was the connection to baptism and its washing away the physical dirt of the body with the spiritual ablution of sins. “Clothing and Disease” (chapter 3) describes the role of fabric (clothes, bedding) in spreading disease: plague literature dating as far back as 1348 held that clothing and textiles spread the disease, and prescribed clean linen, in particular, as a means to prevent it. Evidence from jails, ships, and army camps attested to the high mortality rate when the contagion was transmitted in close quarters. In addition to health manuals, official directives and royal proclamations addressed the need to destroy contaminated bed linens and garments. Acts and proclamations by Henry VII and VIII, as well as London aldermen and the Royal College of Physicians, ordered the burning, airing, and rigorous laundering of infected textiles. Cleanliness of the body, discussed in chapters 3 and 11, was also touted as a preventative against illness.

Reminders about washing the skin appear in a variety of medical texts—over one hundred between 1550 and 1800. The methodology of material culture helps determine if and how this advice was practiced. In the eight chapters that make up the second section of this book, “Practice,” North deals with topics that are less familiar—even erudite. Here she addresses the wearing, owning, sewing, manufacturing, and washing of linens, especially underlinens. Evidence from inventories, household accounts and manuals, and surviving linen garments tracks underclothes through their life cycle of production—making, wearing, laundering, and final recycling. Throughout the book, North offers a plethora of photographic evidence to illustrate her theories, and to satisfy her readers’ curiosity.

Susan North's final chapter, “Sweet and Clean,” reiterates the assertion that, in contrast to those in early modern Europe, the denizens of all levels of early modern English society valued clean linen. They recognized that frequent washing of one's underlinens might ensure one's health, while clean external linen spoke to the wealth of the wearer.