Prof. Carole Rawcliffe was interviewed on Ideas: Radio for the Mind CBC Radio (Canada) about hospitality in medieval hospitals.
Listen to the interview here: https://www.cbc.ca/radio/ideas/hospitality-in-hospitals-is-a-moral-obligation-says-er-doctor-1.6489692
The Invisible Enemy’: Fighting Plague in Renaissance Italy
Humanities Society, Wolfson College, Cambridge
Professor John Henderson, Professor of Italian Renaissance History, Birkbeck College, University of London
Watch The Invisible Enemy’: Fighting Plague in Renaissance Italy
The study of plague remains as relevant today as in pre-industrial Europe, especially as we struggle to combat the threat of Covid 19. In this lecture, John Henderson will provide a timely reminder that present-day policies of ‘containment, mitigation and quarantine’ have long historical precedents, just as human reactions of fear and panic are shared across the centuries. He will show how early modern Italy, though well-known as the birthplace of the Renaissance, was also renowned for the precocious development of its public health policies. These have provided the model not just for nineteenth-century policies in combatting plague, but also more recent epidemics from SARS to Ebola and the Corona virus.
This lecture focusses on the development of public health policies in seventeenth-century Tuscany within a wider Italian and European context. The aim is to go beyond traditional oppositions between rich and poor by examining the impact of regulations at the level of the neighbourhood, street and family. Looking behind the optimistic gloss of official printed accounts, John Henderson will examine the often moving and tragic stories of the individuals who ran hospitals, the doctors who treated plague victims, and, above all, of the ordinary men and women left bereft and confused by the sickness and death of family members as they sought to adopt strategies to survive during quarantine and lockdown.
Coping with Plague: Public Health and Epidemics
Royal College of Physicians of Edinburgh
2nd June 2019
Professor John Henderson, Professor of Italian Renaissance History, Birkbeck College, University of London
Watch Coping with Plague: Public Health and Epidemics
Italy, though best known for the birth of the Renaissance, is also renowned for the precocious development of its public health policies in the 16th century. In this talk, Professor John Henderson argues that it is time to re-examine and reassess early modern Italian policies dealing with plague. Henderson’s approach is to examine the often moving and tragic stories of the individuals touched by plague from either side of the doctor-patient boundary. The way in which governments and individuals dealt with plague are as relevant today as they were 500 years ago.
Death in Florence: Plague, Prosecution, and the Poor in early Modern Florence
NYU Florence Acton Lecture
18th December 2017
Professor John Henderson, Professor of Italian Renaissance History, Birkbeck College, University of London
Watch Death in Florence: Plague, Prosecution, and the Poor in early Modern Florence
Plague remains a popular topic, as reflected in the continued popularity of the narrative accounts from Defoe to Manzoni to Camus which present vivid fictional recreations of what it was like to live through an epidemic. While it is the liveliness of this type of description which continues to fascinate, many histories of public health have traditionally tended to concentrate on chronicling government policies rather than the lived experience. The top-down approach also reflects the theme of contemporary political and medical rhetoric in surviving records, in which the lower levels of society were often blamed disproportionately as the spreaders and even cause of plague. In contrast, this lecture, which explores the last epidemic of plague to affect Florence in 1630-31, places less emphasis on official views. Instead it will seek to recreate the variety of experience and lively voices of the inhabitants in the city’s streets and neighbourhoods, as reflected in the wide range of trials against those who broke sanitary legislation. While analysing the extraordinary variety of ‘crimes’, from simply adopting survive strategies to robbing empty plague house, we shall also ask whether the draconian punishments prescribed in law were enforced as rigorously as in other Italian cities at the time.
Religion, Medicine and Art in the Time of Plague: Florence 1630-33
Bill Kent Memorial Lecture, Monash Centre, Prato
13th December 2017
Professor John Henderson, Professor of Italian Renaissance History, Birkbeck College, University of London and Monash University
Watch Religion, Medicine and Art in the Time of Plague: Florence 1630-33
The subject of religion and medicine, and indeed religion as medicine, has recently become an important topic of research, particularly within the context of the history of late medieval and early medicine. The relationship between these fields has emerged as a fundamental aspect in understanding the nature of the contemporary holistic vision of how the human body worked and was treated through the complementary role of the doctor of the body and the doctor of the soul. This lecture will analyse the role of religion as medicine in the treatment of the sick body of both the city and the individual during the last major epidemic of plague to affect the city of Florence, 1630-1. It will examine the main religious strategies adopted by Church and State first to prevent and then to mitigate the impact of plague and finally to give thanks for the cessation of the epidemic. The strategies centred around three main holy sites: the Cathedral, the miraculous shrine at the Servite church of SS. Annunziata, and the Observant Dominican church of S. Marco, which housed the body of the 15th -century Florentine archbishop, St. Antoninus. The increased devotion at these important ecclesiastical centres led, furthermore, to a wide range of artistic commissions, including chapels, altarpieces, frescoes, costly silver candlesticks, and more humble ex-voti. Given this artistic outpouring during and following the epidemic, this lecture will explore the themes of commissions and how they placed emphasis on the representation of saintly figures and patrons and how far on showing the ravages of disease on the body of the sick. Furthermore, how far did the religious reactions and subjects of the artistic commissions associated with plague in 17th -century Florence conform or differ from those adopted by other cities in early modern Italy.
Where does quarantine come from?
Professor John Henderson, Birkbeck College, University of London
13th July 2020
The new episode of our podcast features John Henderson, Professor of Italian Renaissance History at Birkbeck University of London, and author of Florence Under Siege: Surviving Plague in an Early Modern City and numerous other works of Italian history. We spoke with Professor Henderson about the history of quarantine itself and other aspects of how epidemic disease changed Italian society.
‘The History of Now: Plague in Early Modern Italy’, in conversation with Chris Clark, John Henderson and Jane Stevens-Crawshaw
History Faculty, University of Cambridge
20th April 2020
The Terrors of the Time: Lessons from Historic Plagues
Professor John Henderson, Birkbeck College, University of London
Professor Vanessa Harding, Birkbeck College, University of London
Aaron Columbus is a doctoral student examining how the London plague affected the poor in society at Birkbeck College, University of London
17th April 2020
As this latest battle rages on, historians are looking at similarities in individual and collective response. Regardless of our modern understanding of disease and its spread, historians point to the need to find blame.
Professor John Henderson, Birkbeck College, University of London
Birkbeck Arts Week: podcast
Listen to John Henderson on what an extraordinary image evoking what it was like to live through plague in Renaissance Florence, the subject of his new book Under Siege: Surviving Plague in an Early Modern City (Yale, 2019), and Yale have made a chapter available to read.
By Ellie Phillips
The Great Hospital has provided care for the local community continuously for almost 800 years. Few other charitable organisations in Europe can match this remarkable record and even fewer can boast such a rare combination of architectural and documentary riches. Although at the time of its foundation in 1249 the hospital of St Giles (as it was then known) was typical of many and far from unusual, the closure of most comparable institutions during or after the Dissolution of the Monasteries in the 1530s means that it is now unique in an English context. Indeed, because most other medieval hospital archives were then destroyed, that of the Great Hospital is now deemed to be so important that in 2011 UNESCO, the United Nations Educational, Scientific and Cultural Organisation, awarded it special Memory of the World status. Having in 1570 been transferred under lock and key to a special ‘treasury’ in the guildhall, it is now held in the Norfolk Record Office.
St Giles’ hospital was founded by Bishop Walter Suffield for sixty ‘infirm’ poor men sharing thirty beds, priests ‘broken with age’ and seven young scholars. Care for the soul was prioritised over that of the body and, as was then common, the regulations followed a monastic model based upon the Augustinian Rule. Unusually, however, the hospital was not only efficiently managed and free from scandal, but also closely integrated into the religious and political life of the city, which may in part explain why the rulers of Norwich were determined to save it from dissolution. They were also influenced by developments in communal health and welfare across the North Sea, and as a result took the radical step of acquiring the hospital from the crown in 1547 for conversion into an alms-house.
The Re-foundation Charter drawn up at that time (transcribed in Appendix 1) established the remit of the new ‘Howse of the Poor on Holme Street’, otherwise ‘Goddes Howse’, any doctrinally suspect connection with a Catholic saint having been abruptly terminated. The hospital was henceforward to maintain forty resident paupers, both men and women, for whom professional medical services were provided. The paid staff comprised the master (a Protestant cleric), a minister to the poor, a cook, five female nurses described as ‘keepers’, a surgeon, a barber and various administrators. Since it was initially planned to house a school on the premises, a schoolmaster and usher also feature on the original payroll. The provision of physical care now became a priority as the liturgical role of the hospital ceased. This shift is underscored by the fact that the account roll for the year 1550-51 is bound in a page torn from one of the medieval service books: a widespread practice which allowed for the recycling of forbidden material. We should note, too, that the accounts were henceforward compiled in English, which the hospital’s new managers could read, rather than Latin, the language of the Church.
Despite the care taken to secure an adequate landed income from rental properties in Norwich and estates in Norfolk, the hospital got off to difficult start because of the devastation caused during Kett’s Rebellion of August 1549. The insurgents may have deliberately targeted ‘Goddes Howse’ as an institution controlled by the ruling elite, and the first surviving account roll, which covers the year ending 24 June 1550, records the losses that ensued. Although the sale of the ‘quere’ (choir stalls) and the stone paving of the chancel raised the considerable sum of £25, plans to house the city’s grammar school there had to be abandoned on account of fire damage. Instead, the female paupers were eventually accommodated in what had once been a sacred space reserved for religious observance, while the men occupied the former infirmary. The account roll for the year 1570-71 confirms that the hospital authorities were now on a sufficiently secure financial footing to undertake major rebuilding work for the enlargement of both male and female quarters, while continuing to offer residents what was, by sixteenth-century standards, a comfortable old age. In 1566, the master promised that they would ‘be fedd with no courser bread then whole wheat’ and that he would ‘gently use and intreate’ them ‘withowt eny correccion or beatyng’ (Appendix 2).
These two accounts provide a fascinating insight into the development of the post-Dissolution hospital, as well as the wider religious, economic and social life of Tudor Norwich. They record the salaries of senior employees and the less generous day wages of labourers, as well as outgoings on food, drink, clothing (such as ‘lether for shooes for the poore folkes’), bedding, laundry and end-of-life essentials, including ‘shetes to bury the pore in’ and a ‘shoovel to make graves with’. Detailed information about the cost of building materials (bricks, lime, clay, straw, timber) and other necessities, such as ‘nayles for dores’, appears alongside expenditure on the preaching of sermons, which played a notable part in delivering the new Protestant message. And, like any other institution involved in the acquisition and management of a portfolio of rental and agricultural properties, the hospital had to pay for legal ‘advyse’, ‘pennyng the bookes’ and the cost of obtaining ‘diverse and sondrye wrightinges’ as documents of title.
Some entries in the accounts are particularly poignant. In 1575-6 a payment of 2s 8d was made to ‘Mary Cole one of the pore women in th’ospitall for a stylt after her leg was sawen of”. The following year, the unfortunate but resilient Mother Cole was attended by John Cropp, a Dutch surgeon who received 20s for healing her remaining leg. The inevitable clash of personalities involved in running a large and prestigious institution sometimes gave rise to public confrontations: on one occasion an argument between hospital staff and the civic authorities about accurate record-keeping resulted in an exchange of ‘stowte words’ which were later ‘rehersed openly’ in the mayor’s court.
In accordance with an established medieval model, the primary aim of these documents was to show that the hospital was being efficiently and honestly run rather than to reveal profit or loss. Arrearages (uncollected receipts carried over from the previous year) were noted first, followed by charges (current receipts) and then expenditure, which would be noted in minute detail to prevent fraud. Any supplementary income, such as gifts or legacies, would be recorded separately. The accounts were audited annually by four surveyors (the aldermen and councillors charged with oversight of the hospital), who examined them for any errors or evidence of malpractice before signing off.
As might be expected given the complexity of the hospital’s finances and the extent of its outgoings, the account rolls grew larger: that for 1549-50 comprises 17 membranes measuring 31 x 34 cm, whereas by 1570-71 the dimensions had grown to 34 x 58 cm. The adoption of a clearer, more accessible layout devised by the city chamberlain, Robert Raynbald, made it much easier to locate individual entries, while the fine calligraphy and the elegant strap-work used as decoration by the scribe attest to the care that was given to the creation of these rare documents.
Health and Hygiene in Early-Modern Norwich: Account rolls of the Great Hospital, Norwich, 1549-50 and 1570-71 was edited by Ellie Phillips (published 2013) and is available from the Norfolk Record Society.
The Great Hospital online http://www.thegreathospital.co.uk/index.html (where a full transcript of the 1550-51 account may be found)
Carole Rawcliffe, Medicine for the Soul: The life, death and resurrection of an English Medieval Hospital (Stroud, 1999)
Space, in both its physical and conceptual manifestations, has been a part of how hospitals were designed, built, used, and understood within the wider community. By focusing on space, this conference will explore this subject through the lens of its architectural, socio-cultural, medical, economic, charitable, ideological, and public conceptualisations.
Download the Space and the Hospital Conference program.
Book your ticket for the Space and the Hospital Conference at Eventbrite
This conference is taking place online via YouTube.
View the conference information in Portuguese
This conference is in partnership with “Hospitalis: Hospital Architecture in Portugal at the Dawn of Modernity” and “Royal Hospital of All Saints: city and public health” research projects.
Jane Stevens Crawshaw
As governments and societies across the globe endeavour to curb the spread of the COVID-19 pandemic, the economic, political and social significance of hospital structures has likely never been more obvious. Statistics that detail hospital admission rates and chart the health of the patients within the institutions are being used as important mechanisms for gauging the health of the wider populace and the current scale of the epidemic. For all of the data and governments’ commitments to being led by the science, there has been a concurrent recognition that public health measures – of which hospitals form an important part – are a series of compromises between competing priorities. The current pandemic has also afforded a stark reminder that neither diseases, nor their healthcare responses, are experienced equally by patients.
A recently-published volume of collected essays from the INHH conference in Dubrovnik in 2015: Tracing Hospital Boundaries: Integration and Segregation in Southeastern Europe and Beyond, 1050 – 1970, explores the forces which shaped hospitals in the past and reveals that those same tensions surrounding opportunities and experiences of healthcare can be traced back across the centuries. The volume takes as its themes the concepts of integration and segregation and explores these in relation to the experiences of patients and the design and location of hospitals. Many of the essays draw on urban case studies, although Christina Vanja considers the healthcare facilities of eighteenth-century rural Germany and the treatment afforded to those with physical and mental illnesses.
The book uncovers the spatial, social and administrative divisions that were made between patients by class or race, with a vastly different standard of care provided to patient groups. Clement Masakure’s examination of hospitals in Rhodesia in the late nineteenth and early twentieth centuries reveals the intensity of debates regarding access to healthcare which pivoted around race. As he emphasises, these were complex and detailed discussions which affected patients and the nursing staff (who were drawn largely from the black, African population). The perceived danger associated with the presence and movement of Rhodesia’s Asian, ‘Coloured’ and African communities can be identified in earlier centuries in debates about the appropriate place for women in Renaissance Dubrovnik. The language of immorality or contagion was deployed in order to restrict the visibility of the city’s female population and prompted concern about households or institutions which lacked sufficient male oversight. In the same city, the foundlings (or orphans) which were accommodated in one of the city’s early hospitals faced financial hardship and, often, social ostracization. Throughout the period covered by this study, parts of society have been distinguished as particularly worthy of care or vulnerable whilst others have attracted fear, criticism or blame and these distinctions have informed healthcare policy and hospital structures directly.
Separation between patients was also often made on the basis of medical diagnosis. In the premodern period, dedicated institutions were developed to accommodate sufferers of leprosy, as explored vividly by Anna M. Peterson and Annemarie Kinzelbach. During the late nineteenth and early twentieth centuries in Italy, pellagra sufferers constituted a significant proportion of the patients within asylums. David Gentilcore and Egidio Priani consider the impact of hospital admission, treatment and discharge on patients by drawing on a rich database of patient case studies. During a similar period in Britain, the place of burn sufferers prompted reactions ranging from fear to compassion, which were used to justify separate structures and spaces for care. Jonathan Reinarz’s essay traces these debates alongside changing perceptions of burn injuries and the most effective forms of treatment which eventually necessitated the development of multi-disciplinary medical teams. In twentieth-century America, the place of chronic illness was a source of official oscillation and debate. George Weisz charts the dynamics of the economic and social forces which have shaped attitudes towards the long-term ill. The picture that emerges from the volume is of changing attitudes to illnesses and their patients: sometimes perceived as victims but at other times implicated as a drain on communal resources or a threat to their wider communities.
Hospitals locations and design have long been influenced by ideals beyond health. David Theodore examines the influence of efficiency and cleanliness which shaped the Friesen Concept Hospital, drawing on technologies of automation in order to shape the movement of objects, patients and staff within hospitals. Valentina Zivković uncovers the frequently-interwoven dynamics of charity and healthcare, tracing the issues of symbolic space and movements through what she terms the ‘sacral topography’ of premodern Kotor. The decisions regarding where to situate hospitals and how to use the internal space is often driven by considerations beyond what might be narrowly termed ‘medical’.
As a whole, these essays reveal the changing boundaries around and within ‘community’ or ‘official’ hospitals, which reflected altered purposes of the institutions. In the past, many groups had limited access to hospitals or were believed to require segregated spaces if not dedicated institutions. The language and justifications of such policies undoubtedly changed but a recognition of the vital ways in which hospitals were shaped by their political, economic and social contexts might encourage us to ask questions of our contemporary public health policies which probe at the experience of different groups within our communities and, in particular, to raise the profile of those in society whose opportunity for, and experience of, healthcare is limited.
Hosted by: ‘Hospitalis: Hospital Architecture in Portugal at the Dawn of Modernity’ Research Project and the Hospital Real de Todos os Santos, Lisbon, Portugal.
Space, in both its physical and conceptual manifestations, has been a part of how hospitals were designed, built, used, and understood within the wider community. By focusing on space, this conference aims to explore this subject through the lens of its architectural, socio-cultural, medical, economic, charitable, ideological, and public conceptualisations.
This thirteenth INHH conference will explore the relationship between space and hospitals throughout history by examining it through the lens of five themes: (1) ritual, space, and architecture; (2) hospitals as ‘model’ spaces; (3) the impact of medical practice and theory on space; (4) hospitality and social space; (5) sponsorship. Below are more details about how the conference themes will address along with related questions. The themes and questions presented are by no means an exhaustive list; however, we encourage the submission of an abstract that examines any aspects of space and the history of hospitals in innovative ways.
Key Themes and Questions to be explored:
1. Ritual, Space, and Architecture
- How has the architectural designs of hospitals shaped their use? How has ritual impacted the built environment? How have these spaces been preserved and how are they presented to modern audiences? How were aesthetic changes integrated over time?
- Examples: architectural design, death care and burials, patient rooms, religious spaces in medical environments, archaeological and/or architectural reconstructions, material culture, heritage studies.
2. Hospitals as ‘Model’ Spaces
- How have hospitals, leprosaria, and other health care establishments been conceptualised as ‘model’ institutions, both architecturally and spatially? How were architectural models communicated and circulated? How did colonial ‘models’ inform both hospitals and the surrounding environment? How were these ‘models’ juxtaposed against pre-existing institutions and/or practices? Did bad ‘models’ exist, if so, what was the criteria for this categorisation?
- Examples: Using plans from pre-existing hospitals; the imposition of a non-indigenous ‘model;’ hospitals in transition (i.e. colonial to postcolonial).
3. The Impact of Medical Theory and Practice on Space
- How did prevailing medical theories influence the built environment? As these theories and practices changed, how were these changes made manifest?
- Examples: colonial medicine and its impact on architecture and space of existing and ‘new’ hospitals; changes in space creating inclusive or exclusive environments; bioarchaeological studies of hospitals and their patients; care versus cure.
4. Hospitality as Social Space
- How has the inclusion or exclusion of groups shaped care and space? How is this reflected in its architecture? How have hospitals been designed to be more welcoming? How were health and social activities balanced in a hospital’s built environment? How does the presence of hospitals and/or leprosaria impact urban planning?
- Examples: segregation within hospitals; concierge services and creating a ‘public face;’ the role of gender and hospitality; hospitality and socio-economic status; psychological responses to space in hospitals.
- How have founders and donors affected the creation and/or development of a hospital? Did their donation change the social or cultural environment? How does this impact the hospital’s reputation?
- Examples: Prioritising wings for specific illness or methods of care; perception of donors as individuals; impact of class and gender.
The Advisory Board of the INHH and the local organising committee wish to invite proposals for 20 minute papers or posters which address the conference theme. Potential contributors are asked to bear in mind that engagement with the theme of space and the hospital will be a key criterion in determining which papers are accepted onto the programme.
Abstracts should be a maximum of 300 words in length, in English and accompanied by a brief biography of no more than 200 words. Proposals should be sent to firstname.lastname@example.org by 30 September 2020. As with previous INHH conferences, it is intended that an edited volume of the conference papers will be published. Submissions are particularly encouraged from researchers who have not previously given a paper at an INHH conference.
Upon provision of full receipts, we hope to be able to support attendance at this conference, particularly for postgraduates and early career researchers. Speakers will be asked to make use of alternative sources of funding where these are available. Any queries may be directed to email@example.com.
Leprosy was an iconic disease in medieval Europe during what has been defined the ‘golden age of bacteria’. From the eleventh century onwards, several leprosy hospitals were founded as a mitigating response to the risk of infection, and medieval treatises and chronicles suggest that leprosy, and other diseases related or often confused with that condition, were treated with medicinal plants and other ingredients of mineral and animal origin. However, very little is known about the methods used to diagnose and treat this disease within leprosaria, and, to date, medical treatments of leprosy have very rarely been put in their physical context.
Through the analysis of dental calculus (tartar), my project: ‘Medical treatments in medieval leprosaria: Exploring healing remedies through dental calculus analysis’ (MEDICAL), will explore medical care offered to people who experienced leprosy and lived in leprosaria in Northern Europe from 1100 to 1550. The research will focus on two leprosaria’s cemeteries: St. Leonard at Peterborough in England, and Saint-Thomas d’Aizier in France. To date, medical treatments for leprosy have never been analysed directly through archaeological human remains (in this case dental calculus) and skeletal remains recovered from selected historic cemeteries offer an unparalleled opportunity to investigate medical treatments beyond what is written in historical documents.
Although archaeologists have long recorded tartar on teeth, it is only in the last decades that its importance has been widely recognised by the scientific community as evidence that can inform the past. This deposit on the teeth, which continued to form throughout the life of an individual, represents a unique archaeological record. It provides evidence for health and hygiene, dietary and non-dietary habits, and the lifestyle of past populations. Within the calculus we can detect traces of food and environmental micro debris including starch grains, phytoliths, pollen, and fungal spores, as well as plant fibres and animal micro-remains such as bast fibres and fish scales. Critically for this study, the analysis of these microfossils also permits the identification of plant species, which may be directly linked to medicinal uses rather than to food consumption.
Under the supervision of Dr. Emanuela Cristiani (Sapienza University) and Professor Charlotte Roberts (Durham University), I will create a reference collection of modern specimens of plants mentioned in historical texts in association with leprosy. I will then interpret bone changes associated with leprosy in medieval osteological collections, and analyse the dental calculus employing cutting edge techniques (i.e. optical microscopy, inductively coupled plasma mass spectrometry). This novel methodological approach promises to shed new light on the history of medieval medicine, particularly the treatment of leprosy, but also on dental calculus research.
Thanks to a stimulating a link between different European institutions, MEDICAL aims to provide a platform for future research on medical care in the Middle Ages. The project is still in its early phases, but findings and resources will be made available on the MEDICAL website. Please do not hesitate to contact me if you are interested on this topic or you might want to suggest some ideas!
Dr. Elena Fiorin is a Marie Skłodowska-Curie Fellow based in the Department of Oral and Maxillo Facial Sciences, Sapienza University (Italy). She is currently working on the MEDICAL project (Medical treatments in medieval leprosaria. Exploring healing remedies through dental calculus analysis) which aims to investigate diet and medical care given to the people that lived in leprosaria in Northern Europe during the late medieval period (1100-1550).
The medieval hospital is a vexing institution, as it fits into so many categories that it can frustrate a researcher. This is why James Brodman has accurately described their history as ‘something messy’, while Miri Rubin, in her Imagining Medieval Hospitals: Considerations on the Cultural Meaning of Institutional Change (1991), laments about the fragmentary nature of the extant sources. Despite the difficulties posed by these institutions, they present a unique opportunity to explore several cross sections of medieval society: sick and healthy, poor and wealthy, secular and ecclesiastical.
Hospitals and charity grapples with this problem as it emphasises how in Italian cities there was always friction between ecclesiastical and municipal authorities, with many of the bishops’ powers being chipped away by the local government. It is against this backdrop that hospitals emerged in the twelfth century and struggled to maintain their institutional identity throughout the High and Late Middle Ages. This ultimately ended with many of these hospitals being consolidated or outright replaced by larger, more centralised hospitals.
Brasher’s book is divided into six chapters and includes an appendix which lists the cities and their hospitals. The first chapter provides an overview of charity and poverty in the Middle Ages, highlighting how changes in personal piety, wealth, and urban demographics created an environment ripe for a surge in hospital foundations beginning in the twelfth century. This transitions into the second chapter which explores the political, social, and local reasons behind these establishments of these institutions in the twelfth and thirteenth centuries, as well as an analysis of the provisions written into their foundation charters. Chapter three focuses on the administrators and internal management of these houses, while the fourth chapter focuses on the hospitals’ physical locations, daily life, the social status of the familia, and internal statutes. The final two chapters examine jurisdictional issues, and the centralisation and bureaucratisation of these hospitals respectively.
Previously, Brasher’s work has focused on the role of women in the Humiliati, a group which had close ties to urban hospitals and charity in medieval Italy. She has indeed played to her strengths by continuing to focus on the interplay between ecclesiastical and civic life in these cities, as well as the charitable works of the laity. Her decision to focus on Lombard hospitals is also a welcome one, considering that, historiographically speaking, the most studied region for Italian hospitals is Tuscany, particularly Siena and Florence.
Brasher’s work is solidly argued, clearly written, and the cases she chose are very illustrative. Her book is an excellent survey of the function, development, and role of hospitals in medieval Lombardy, as well as a strong introduction into the study of medieval hospitals in general. The final two chapters, ‘Jurisdictional disputes’ and ‘Reform and consolidation’, are the most instructive in regards to how these institutions interacted and adapted to shifts in secular and ecclesiastical authority. She also highlights the role of women in these institutions, a group who are often overlooked. The appendix is very helpful for keeping track of the various hospitals mentioned in the texts, which is also a beneficial tool for those who wish to further investigate these establishments. Ultimately, this book’s focus on the Northern Italian hospitals and their examination through the usual framework of charity makes this work extremely accessible and a useful companion to Guiliana Albini’s own work on this topic and region.
There are some points, however, which deserved further analysis. The discussion of charity is valuable, although the absence of Vauchez’s historiographical concept of the ‘Charitable Revolution’ to help situate the sudden increase in hospital foundations is puzzling. Furthermore, terms such as medicalisation and secularisation should have been clearly defined, and in the case of the former, outline the varied approaches to their use vis-à-vis hospitals. Additionally, the first chapter would benefit from a discussion of the more recent studies on the themes of charity, such as the role of preaching in hospitals — which is touched on very briefly— and voluntary poverty. For example, Adam J. Davis article, ‘Preaching in thirteen-century hospitals’, and Jessalynn Bird’s book chapter, ‘Medicine for Body and Soul: Jacques de Vitry’s Sermons to Hospitallers and their Changes’, both explore this phenomenon. Additionally, Sharon Farmer has edited volume entitled, Approaches to Poverty in Medieval Europe: Complexities, Contradictions, Transformations, c. 1100-1500, which provides some new avenues of discussion regarding the poor in this period. Considering this book is billed as a survey, it would have been beneficial to the reader if Brasher had placed this study within the wider historiography of medieval hospitals, or at the very least Italian hospitals for this period. There are few large-scale historiographies of medieval hospitals. To my knowledge the most recent is Brodman’s 2009 book chapter ‘Hospitals in the Middle Ages’ Finally, the section on medicalisation focuses largely on the ecclesiastical response to medicine, which somewhat downplays the state of medical knowledge in the wake of the twelfth-century medical renaissance. Nevertheless, Brasher’s Hospitals and charity is a well written and comprehensive introduction to medieval hospitals in Northern Italy.
Sally Mayall Brasher. Hospitals and charity: Religious culture and civic life in Medieval Northern Italy. Manchester: Manchester University Press; 2017, 224 p. ISBN: 978-1-5261-1928-5. £70
Reviewer: Anna Peterson Pontifical Institute of Mediaeval Studies, Toronto
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.
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.
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.
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?
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.
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’.
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
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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).