The Secret Life of Teeth: How Dental Calculus Can Shed Light on Medieval Medical Treatments for Leprosy

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historic cemeteries offer an unparalleled opportunity to investigate medical treatments beyond what is written in historical documents.

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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.


Midland Road, Peterborough: Archaeological Excavation

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).

Book Review: Hospitals and Charity: Religious Culture and Civic Life in Medieval Northern Italy, by Sally Mayall Brasher


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

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)


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

Health Systems before Welfare States

By Guest Blogger, and INHH Board Member, Professor Barry Doyle

Cities in Europe

The programme has been announced for the European Association of Urban Historians (EAUH) Conference in Lisbon September 2014. This extensive event will include papers from over 500 participants from across Europe, North America and Australasia. Among the main sessions will be a panel headed by INHH Board member, Barry Doyle of the University of Huddersfield and his co-organiser Fritz Dross of Magdeburg, a well-known member of the Network. Their session will address the issue of Health Systems before Welfare States seeking to explore how health care provision, especially at an institutional level, changed in urban areas in the 150 years before the full scale development of centralized (and often nationalized) medical systems in the aftermath of the Second World War.

Following an excellent response to the call for papers we have been able to select a very strong panel which examines a number of important themes from industrial disability and the policing of prostitutes through the bases of urban public health to the transformation of hospital provision in a number of Europe’s important urban centres.

Health care for specific groups will be considered by Anne Borsay in a paper drawing on her coalfield disability project while Jörg Vögele and Hideharu Umehara address the extent to which cities made children healthy in an assessment of public health provision for the young in turn of the century Dusseldorf. Two papers will examine the role of the medical profession in urban settings. Mari Tanninen will assess medical practitioners’ participation as supporters and critics of regulated prostitution in late nineteenth century Vienna and Michael Toyka-Seid the involvement of local medical men in the development of an urban health care system in the small but important English provincial city of Durham. The concerns of these individuals and activist groups will be contrasted with those of nationwide institutions including central government, municipalities, insurance schemes and religious organisations. Thus, Bernard Harris will explore the financial basis for English urban sanitary reform, 1871-1914 and Margarita Vilar-Rodríguez and Jerònia Pons-Pons’ paper considers the way the Franco regime managed the construction of a network of public hospitals and outpatient clinics between 1940 and 1960.

The centrality of a mixed economy of welfare in the early twentieth century across Europe will be a recurrent theme in the session. It is apparent in Franco’s Spain, self-governing Ulster and Francophone Belgium with the Catholic church central to voluntary provision in each country. Sean Lucey’s presentation demonstrates the centrality of religion to the shaping of public health policy in the divided city of Belfast
between the wars while Hendrik Moeys’ consideration of the development of domiciliary and institutional care at a local level in Ghent, Brussels and Liège shows that much provision depended heavily on the contribution of religious orders and Catholic charities. In a similar vein, Lydia Sapounaki-Drakaki and Maria-Luiza Tzoya Moatsou are to investigate the way local actors in the Greek port of Piraeus struggled to meet their obligation to deliver adequate services, paying particular attention to the role of elite women in the management of a mixed system.

While hospitals will feature in many of the papers in the session those by Alexandra-Kathrin Stanislaw-Kemenah and Valeria Rainoldi deal specifically with the transformation of institutions in the nineteenth century. In a paper to be delivered in French, Stanislaw-Kemenah looks inside the hospital to assess the role of the clinic, clinician and patient in changing institutional care in Dresden while Rainoldi will analyse the role of donations in the modernizing provision of the Italian city of Verona.

Ospedale Infantile Alessandri, Verona

Ospedale Infantile Alessandri, Verona

We are very pleased to have the opportunity to present such a diverse panel showcasing the important new work taking place in health, and especially hospital, history across Europe. Scholars from the UK, Ireland, Germany, Spain, Greece, Belgium, Poland, Italy and Finland will be contributing papers covering seven different countries demonstrating both the similarities and differences which shaped their health care systems before the arrival of the welfare state.



New Museum Installation


The St John's Brugge Sint-Janshospitaal Bruges (Belgium) has recently opened a new museum installation: medical history of the Sint-Janshospitaal Bruges, from its origin till the 19th century. The museum is a cultural-historical museum that wants to show the equal importance of medical and spiritual care.

The Museumbulletin/musea Brugge has recently published an article on this new museological point of view (Sibylla Goegebuer, Het Sint-Janshospitaal, een continuïteitsverhaal, een evenwichtsoefening, Museumbulletin 2, 33e jaargang, april-juni 2013).

Sibylla Goegebuer

Here are some pictures from the new exhibition:

St Johns Exhibition 1 St Johns Exhibition 2 St Johns Exhibition 3