Surviving Plague in an Early Modern City – Florence Under Siege by John Henderson

Florence Under Siege cover (002)Professor John Henderson, a founding member of the International History of Hospitals Network, has  a new book published by Yale on the 9th July 2019. (Get a discount by downloading this form (PDF).

In Florence Under Siege: Surviving Plague in an Early Modern City, John Henderson examines how a major European city suffered, resisted and survived plague. This book provides a nuanced and compassionate interpretation of government policies in practice, going beyond traditional oppositions between rich and poor, by recreating the personal reactions and survival strategies of people and families at all levels of society.

Wider significance

Each age faces the challenge of new diseases from cholera to AIDS and Ebola, but plague remains the paradigm against which reactions to epidemics are often judged. This book, while focussing on seventeenth-century Florence, examines the Tuscan capital within a wider Italian and European context to assess the real impact of policies on the city, the neighbourhood, street and family. Writing in a vivid and approachable way, Surviving Plague in the Early Modern City unearths the forgotten stories of doctors and administrators struggling to cope with the sick and dying, and the reality of living in a time of plague through the personal diaries of the literate, and the personal testimony of the poor, in court cases.

Official Reactions

Many histories of public health concentrate on chronicling government policies, whereas here equal emphasis is placed on the lived experience. Underpinning this narrative is a vivid recreation of the stories and experiences of individuals who endured and survived the epidemic. Contemporary political and medical rhetoric often blamed disproportionately the lower levels of society as the spreaders and even cause of plague, but official measures are examined to establish their real impact on the whole population. These included the cordon sanitaire along the frontiers of the Tuscan state; sanitary surveys of the living conditions of the poor; inspection and locking up of infected houses. A range of treatments are examined from the plague doctor’s prescribing of the ‘miraculous’ drug of Theriac to the surgeons’ lancing of buboes to the complex recipes devised by empirics.

Plate 7.4 S. Miniato al Monte (002).jpg

Façade of the Church of S. Miniato al Monte, the Benedictine abbey, which became the main Lazaretto in Florence. (Photo by John Henderson)

Lazaretti or Isolation Hospitals

Lazaretti, vast crowded isolation hospitals, served to distinguish many Italian cities from their northern European counterparts. Some cities built new structures, but many took over existing buildings, as in the case of Florence, where the beautiful Romanesque convent and church of San Miniato al Monte on the hill overlooking Florence to the south of the river Arno became the city’s major Lazaretto. Together with the other Lazaretti around the city, San Miniato housed and treated over 10,000 people during the epidemic of 1630 to 1631, but did, as was claimed at the time, they lead to a reduction in mortality? or simply provide a convenient way for the poor to be enclosed?

plague at ashdod (002)

Pieter van Halen, ‘The Plague of the Philistines at Ashdod’ (1661), (Wellcome Collection. CC BY)

Religion

Religious strategies also form an important theme of this book, reflecting contemporary belief in the necessity to placate divine ire at the sins of Mankind, through prayers and public masses. But elaborate processions with holy relics were an integral part of the ceremonial response. How far did this lead to conflict with the health board officers given the perceived threat of the spread of disease when large numbers collected together?  The plague in Florence also led to the commissioning of major works of art and architecture from the Medici Grand-ducal family to the more and less affluent, as they paid for chapels, altarpieces, and silver and wax votive offerings. This truly inter-disciplinary study examines the representation of local saints, such as Saint Antoninus, as well as popular votive saints, such as St. Sebastian and San Rocco, in relation to their depiction in other parts of Italy.

Individual Experience and Survival Strategies

Florence Under Siege seeks above all to look behind the optimistic gloss of official printed accounts to examine individual experiences. It recreates the often moving and tragic narratives of the individuals who ran isolation hospitals, the doctors who treated plague victims, and the ordinary men and women left bereft and confused by the sickness and death of family members.

Plate 8.1 Milan punishment of Untori or plague-spreaders (002)

Anon (Orazio Colombo), ‘Punishment and Execution of Untori or Plague-spreaders in Milan’ (1630), after the engraving by ‘Bassano’ or ‘Francesco Vallato’ (Wellcome Collection. CCBY)

Plague on Trial

Analysis of the large corpus of contemporary court records provides fascinating evidence of the numerous survival strategies through which individuals coped with the very real fear generated by a city under siege from an invisible enemy and how they attempted to side-step regulations in order to preserve their possessions and their normal way of life. Examination of detailed trials reveals not just the extraordinary variety of ‘crimes’, but also reveals greater compassion than suggested by the draconian punishments prescribed in law and thus helps to break down the traditional picture of the opposition of rich and poor, the governors and governed.

Reviews of Florence Under Siege by Professor John Henderson

Henderson offers a holistic account of plague in seventeenth-century Florence and reaches important new conclusions about the impact and effectiveness of public health measures. The fine detail of the story makes for a brilliant realisation of devastation, resistance and survival.
Vanessa Harding author of ‘The Dead and the Living in Paris and London, 1500-1670’.

In this vivid account, Henderson brings to life the fearful experiences of Florentines as they prepared, dealt with, and lived through an early modern public health crisis … Essential reading.
Brian Maxson, author of ‘The Humanist World of Renaissance Florence’.

With a keen attention to gender, power and social networks, Henderson traces a vivid picture of resilience and survival through the complex interplay of plague and piety’.
Giulia Calvi, author of ‘Histories of a Plague Year.

Henderson draws on a striking range of sources to present a human-scale fresco. He shows how townspeople, eager to save their souls as much as their skin, strove to cope and survive each in their own way … Re-sets our understanding of what plague meant at every level of early modern society to those caught up in it.
Colin Jones, co-author of ‘The Medical World of Early Modern France’.

Chapter outline:

1. Plague and Public Health in Italy and Europe Plague and Italy’s Reputation in Europe Historians and Plague in Italy Plague in Florence: Themes and Sources

Part I, Florence Under Siege: Coping with Plague

2. The Invasion of Plague in Early Modern Italy Plague approaches Florence:

  • Border Controls and cordons sanitaires
  • Plague on the Outskirts of Florence, Summer 1630
  • Plague Mortality in the City, 1630–1

3. Medicine, the Environment and the Poor Doctors and Diagnosis: ‘A certain sickness with suspicion of contagion’

  • Preventive Measures and the Environment
  • ‘Filth is the mother of corruption’: The Sanitary Survey, August 1630
  • Marginalisation of the Poor: ‘It was not the time to make the body of the city worse with such malign humours, the most inclined towards putrefaction’
  • Poverty and Charity: The Growth of ‘misery, necessity and sickness’

4.  Plague and Public Health: Treating the Body of the City and the Body of the Poor

  • Official Reactions in August Public Health and Prevention
  • The Control of Plague Doctors and Medicine: Treating the Body of the Poor

5. Fighting the Plague

  • The Spread and Impact of Plague
  • Coping with Death
  • Quarantine and the City
  • Quarantine and the Countryside

Part II, Religion, Isolation and Survival

6. Religion in the Time of Plague

  • The Plague Approaches: The Church and Preventive Measures Plague at its Height and the Practice of Religion
  • Celebrating with Sant’Antonino: The Plague Relents
  • Plague, Religion and the Grand-Ducal Court: The Cult of Domenica da Paradiso
  • Religion and Quarantine: ‘Providing for the health of the soul is more important than [providing for the health] of the body’
  • SS. Annunziata and Plague
  • The Madonna dell’ Impruneta and the Return of Plague, 1633

7. Lazaretti and Isolation: ‘More feared than death itself’?

  • First Experiments and the Hospital of Messer Bonifazio
  • The New Isolation and Quarantine Centres Lazaretti: Form and Function
  • ‘The medicines in this period play an important role’
  • Spiritual Medicine
  • Assessing Patient Mortality: ‘More feared than death itself’?
  • Life, Death and Serving the Poor Sick: ‘I desire that you pray God for me, because I am suffering under the heaviest of crosses’
  • Life in the Lazaretti: The Perspective of the Staff

8. Surviving Plague

  • Plague and the Law
  • Punishment and Enforcement
  • Prosecution: General Categories
  • Prosecuting the Popolo

Epilogue: The Return and End of Plague, 1632–3

Book Discount

You can get a substantial discount (£9.00) on the recommended retail price of £30 by using this form (PDF) to order your copy of Florence Under Siege.

John Henderson is Professor of Italian Renaissance History in the Department of History, Classics and Archaeology, Birkbeck, University of London, and Emeritus Fellow of Wolfson College, University of Cambridge. He has published a wide range of books and articles on the social, religious, and medical history of medieval and renaissance Tuscany. Major books include: Piety and Charity in Late Medieval Florence (Clarendon Press, 1994; Italian trans., 1998); Christianity and the Renaissance. Image and Religious Imagination in the Quattrocento, ed. with T.V. Verdon (Syracuse UP, 1990); Poor Women and Children in the European Past, ed. with R. Wall (Routledge, 1994); The Great Pox. The French Disease in Renaissance Europe, with J. Arrizabalaga and R. French (Yale UP, 1997); The Renaissance Hospital. Healing the Body and Healing the Soul (Yale UP, 2006; German trans., 2007; Italian trans., 2016); Plague and the City, ed. with L. Engelmann and C. Lynteris (Routledge, 2018); and Florence Under Siege. Surviving Plague in an Early Modern City (Yale UP, 2019).

The VIII Abrils de l’Hospital – INHH’s 12th International Conference

Ward at Santa Crue Hospital Barcelona

The VIII Abrils de l’Hospital – INHH’s 12th International Conference took place in Barcelona between the 24 and 25 of April. The Conference saw the participation of more than twenty scholars from a broad array of academic, cultural and institutional backgrounds, who presented papers on the interaction of hospitals and traveling. The topic, that gave its name to the conference, was approached from different, yet coherent, perspectives: from medieval pilgrimage routes, Christian or not, to 20th century medical tourism. This self-conscious attempt at diversity that was not only temporal, but also geographical, with study-cases centred on the Mediterranean, Northern Europe, Southern Africa, the United States or India, to name a few, besides those concerned with the transmission and circulation of models in wider contexts. Methodological concerns were also addressed, emphasizing the importance of network analysis and the potentialities of new digital technologies in the study of hospitals.

Both the paper presentations and the ensuing discussion proofed to be stimulating and fruitful, and, we hope, laid the foundations of something that goes beyond the conference itself.

Policing the Urban Environment in Premodern Europe, edited by Carole Rawcliffe, Claire Weeda

Amsterdam University Press
Publication Date 10th June 2019
Pre order your copy

Policing the Urban Environment Book Cover

A new book on Policing the Urban Environment in Premodern Europe is about to be published; edited by one of our founding members Professor Carole Rawcliffe, Professor Emerita of Medieval History at the University of East Anglia, and Claire Weeda, Assistant Professor at the History Department of Leiden University.
Tapping into a combination of court documents, urban statutes, material artefacts, health guides and treatises, Policing the Urban Environment in Premodern Europe offers a unique perspective on how premodern public authorities tried to create a clean, healthy environment. Overturning many preconceptions about medieval dirt and squalor, it presents the most outstanding recent scholarship on how public health norms were enforced in the judicial, religious and socio-cultural sphere before the advent of modern medicine and the nation-state, crossing geographical and linguistic boundaries and engaging with factors such as spiritual purity, civic pride and good neighbourliness.

Chapter Topics

Chapter 1: Cleanliness, Civility, and the City in Medieval Ideals and Scripts by Claire Weeda

Latin and vernacular urban panegyrics, describing the ideal city and its residents, mushroomed in the twelfth century. Painting a utopian view of the city that mirrors the heavenly Jerusalem, they rhetorically conveyed ideals of urbanity for aspiring members of the body politic to emulate. This chapter explores the ways in which the cityscape constructed in these texts, and residents’ behaviour (as influenced by conduct manuals and regimes of health), appear embedded in a natural environment reflected through the lens of Galenic medicine. Evoking the benefits of cleanliness and beauty, these concepts of health and hygiene accorded closely with issues of social status. The disciplined quest for moderation and balance offered spiritual and physical health, as well as enhanced personal repute.

Chapter 2: The View from the Street: The Records of Hundred and Leet Courts as a Source for Sanitary Policing in Late Medieval English Towns by Carole Rawcliffe

Late medieval English Leet Court records are an underused resource for the study of public health. Yet, as this chapter reveals, they offer a remarkable, often unique, insight into ‘grassroots’ responses to insanitary nuisances and the enforcement at neighbourhood level of regulations concerning the urban environment. They functioned at the very bottom of the judicial hierarchy, serving as a useful vehicle for the implementation of bylaws and similar directives, as well as the dissemination of whatever basic information (such as the need to avoid contaminated air during epidemics) the ruling elite wanted ‘ordinary’ people to have. In turn, they gave local communities an opportunity to complain about hazards that required official action and to protest should the response prove inadequate.

Chapter 3: Urban Viarii and the Prosecution of Public Health Offenders in Late Medieval Italy by Guy Geltner

Roads officials (viarii) were integral to many Italian cities’ strategies for combatting disease and promoting health. Yet their significance for the history of environmental policing remains largely unrecognised. This chapter begins by mapping the contours of the office in the peninsula’s centre and north between the thirteenth and fifteenth centuries. It then explores the activities of viarii in that period and region through recourse to the records of Lucca and Bologna. An examination of the Bolognese archival series throws new light on the resources that urban regimes dedicated to communal wellbeing, as well as the strategies required to implement their policies. These records offer a ‘bottom-up’ perspective on environmental health and the tensions underlying the exercise of premodern bio-power.

Chapter 4: Food Offenders: Public Health and the Marketplace in the Late Medieval Low Countries by Janna Coomans

In the Low Countries, market squares were the site of numerous threats to public health and efforts to contain them, notably by the officials who inspected, guarded, and protected these spaces. This chapter explores the ways in which urban authorities and other corporate bodies attempted to police markets, and improve levels of sanitation, environmental health, and food safety. It utilizes archival material from several Netherlandish cities, including financial records and public decrees, bylaws, and the statutes of trade and craft guilds (which furnish important evidence about the ways in which medical theories informed attitudes to food standards). An analysis of registered fines and information about the punishment of offenders highlights the tensions that existed between customers, vendors, guilds, and magistrates.

Chapter 5: Policing the Environment of Late Medieval Dordrecht by Patrick Naaktgeboren

An important Dutch trading centre, Dordrecht experienced considerable population growth and many environmental challenges during the later Middle Ages. Surviving administrative, financial, and legal records help us to establish the effectiveness of bylaws, and the extent to which conflicts reached the courts. We can document official policies regarding urban space, sanitation, and nuisances, while also determining the responsibilities of residents in matters of public health. Magistrates often reissued regulations concerning the construction of buildings, the disposal of rubbish and offal, and the reduction of noise, while a variety of officials monitored compliance, imposing on-the-spot fines when necessary. Since Dordrecht’s wealth derived from trade, disturbances, dirt, and the diseases, fires, and floods that suggested divine displeasure could threaten its prosperity.

Chapter 6: Muddy Waters in Medieval Montpellier by Catherine Dubé and Genevieve Dumas

Medieval Montpellier occupied an aquatic setting, which gave rise to numerous sanitary and environmental problems. Summer storms caused heavy floods; drains became blocked, filling the streets with filth; and the ditches that encircled the city often overran with stagnant water. Magistrates had to ensure that there was an adequate supply of uncontaminated water for domestic and industrial use, while keeping the hydraulic infrastructure in working order. They had also to maintain the river that conveyed merchandise to the town centre, provide for the effective disposal of dirty water, and guard against pollution. Using Montpellier’s rich civic archive, this chapter examines the strategies and regulations developed by the authorities in order to minimise the health risks arising from these issues.

Chapter 7: Regulating Water Sources in the Towns and Cities of Late Medieval Normandy, by Elma Brenner

This chapter examines the ways in which water supplies were maintained, and their cleanliness regulated, in fifteenth- and early sixteenth-century Normandy, focusing particularly upon the region’s chief city, Rouen, for which rich manuscript sources survive. Concerns about the quality and availability of water had strong religious associations, which reinforced the moral and medical imperative to prevent the contamination of sources. Wealthy citizens made the provision and protection of hydraulic infrastructure a focus of their Christian charity; but the use and conservation of rivers, streams, piped water systems, sewers, ponds, and ditches, also operated in the context of late medieval ideas about health and disease, especially regarding the threat posed by toxic air and the need to avoid polluted water.

Chapter 8: Policing the Environment in Premodern Imperial Cities and Towns: A Preliminary Approach by Annemarie Kinzelbach

Recent historiographical studies of the Holy Roman Empire reveal that policy focused on defining and redefining the relationship between governors and citizens, largely through negotiating practices. Historians have applied these discoveries in limited ways when discussing public health policies in German-speaking areas, ignoring questions of compliance, resistance, or enforcement. Some lacunae result from archival losses, but survivals enable us to fill many gaps. In this chapter, relevant premodern statutes are first identified. Secondly, textual analysis uncovers implicit associations (for example, parallels between dirt and prostitution), while highlighting explicit relationships between communal health and such general issues as religion, morality, and the common good. Modifications to the statutes are also noted. Thirdly, contemporary chronicles and diaries are examined for background information.

Chapter 9: Official Objectives of the Visitatio Leprosorum: Ambiguity, Ambivalence, and Variance by Luke Demaitre

Until the eighteenth century, authorities regularly responded to reports of leprosy by ordering a formal examination, resulting in a certified judgment on the health and future of the suspect. This chapter is part of an ongoing project involving the collation of 600 certificates, recorded between 1250 and 1807, and preserved in Western European archives, set in the wider context of urban regulations, institutional statutes, and royal or imperial edicts. Contrary to prevailing stereotypes, public responses to leprosy varied quantitatively, qualitatively, regionally, and chronologically. A wide range of dynamics beyond the issue of contagion, which monopolizes retrospective discussions of Hansen’s disease, is apparent. Public order was more often the paramount concern of examiners, while separation did not necessarily equate with exclusion.

Looks like a very useful volume – don’t forget to ask your library to order one

INNH 12th International Conference – Barcelona – 24th to 26th of April 2019

Ferrer Bassa paintingMedical tourism is an increasingly popular feature of health care today. Yet it is not always recognised that, throughout their history, hospitals have attracted patients from afar seeking cures, both spiritual and physical, not available at home. While much work has previously focused on the institution as a fixed place, often closely associated with a specific locality, the hospital’s role as a focus for a wider network of health needs and health consumers has been largely overlooked. This neglected topic will be the focus of this conference.

From its inception the hospital provided care and cure for pilgrims, either en route to, or on their arrival at, shrines, as well as for patients from beyond the urban centre, some from local areas and others travelling great distances to access treatment. These institutions were also distinguished by their architectural and artistic heritage, being decorated with paintings and sculptures, some of which still survive today and depict pilgrims, the poor and the sick. Although many buildings have disappeared or been transformed over time, others remain that reflect their original size and beauty and are important destinations for tourism.

Ferrer Bassa paintingOver the centuries major man-made crises such as war have prompted the introduction of many forms of mobile hospital. Among them were the first ambulances, the medical units that traveled with troops on campaign, and the sophisticated network of treatment stations developed by the combatants of the First World War, including hospital trains with more patients than a London teaching institution. Hospitals have also featured at the heart of migration stories – with staff moving around empires and across borders to acquire medical training and to assist a growing body of patients, whose access to hospital medicine has been limited by poverty, race, lack of citizenship, or the unavailability of specialist services locally. In many parts of the world, and especially in areas with limited healthcare infrastructure or widely dispersed population, hospitals came to the patients, with a variety of mobile institutions being developed to serve the sick in Africa, Russia, Central Europe and across Asia. These many activities reflect the variety of topics that can be included in our theme of Travel and the Hospital.

Read the April 2019 INHH Conference Program (PDF format 900kB)

Book your place at the conference and your accommodation

The conference will take place at: Faculty of Geography and History (UB), c. Montalegre, 6 Universitat de Barcelona and Amics de l’Art Romànic / Institut d’Estudis Catalans and, Biblioteca de Catalunya, c. Carme, 47

Fees for the conference are:

a) Partial registration fee: 30€ until the 31st of march of 2019. Starting this same date, the registration fee will be 50€. This registration will grant the right to participate in the conference, take part in the planned tours, the coffee-breaks and two brunches.

b) Full registration fee: 60€ until the 31st of march of 2019. Starting this same date, the registration fee will be 100€. This registration will grant the right to attend the conference dinner on the 25th of April.

For details of how to register please email abrils.hospital@ub.edu

Master’s students and PhD candidates, as well as doctors who have defended their thesis between 2017-2019 can ask for free registration, provided that they present a paper or a poster. Those who might be eligible should send an e-mail to abrils.hospital@ub.edu before the 15th of February 2019.

Accommodation costs will be assumed in their entirety by the attendees. Since the University of Barcelona does not have an agreement with any of the city’s hotels, we suggest booking early.

Organizing Committe: Antoni Conejo (University of Barcelona), John Henderson (Birkbeck, University of London, UK), Barry Doyle (University of Huddersfield, UK), and Joana Balsa de Pinho (University of Lisbon)

Collaboration: Meritxell Simó, Marta Sancho, Salvatore Marino, Pol Bridgewater, Jaume Marcé (University of Barcelona), Núria Altarriba (Biblioteca de Catalunya), Mercè Beltran (Recinte Modernista del Sant Pau), and Francesca Español (Amics de l’Art Romànic, IEC)

L’Institut de Recerca en Cultures Medievals logo INHH logo Abrils Hospital logo

Call for Papers

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************************Call for Papers********************************

The Chinese Journal of Social History of Medicine and Health is organising a special themed issue on the history of hospitals over time. The issue will be edited jointly by Professor Jonathan Reinarz (Birmingham) and Dr Fanxiang Min (Nanjing). The journal is interested in articles between 8,000-10,000 words in length. These may be sweeping surveys of particular periods (medieval, early modern, modern), or chart recent work in particular national contexts, but also map out new directions and themes in hospital history, from architecture and funding to colonial and comparative contexts. Please send one page abstracts to Jonathan Reinarz (j.reinarz@bham.ac.uk) by 30 April 2017. For a history of the Nanjing Drum Tower Hospital, visit http://www.njglyy.com/en/An-Introduction/An-Introduction.asp

Call for Papers: Cultures of Harm

The History department at Birkbeck University, London, are organising a conference titled ‘Cultures of harm in institutions of care: Historical and contemporary perspectives,’ in April 2016. There is currently a call for papers, and a colleagues from the History of Hospitals Network might be interested in attending or submitting a proposal.

More details can be found here.