HHH spring meeting 2020: ‘Public health’ in the Middle Ages

Irene Geerts

‘Public health’ in the Middle Ages: is there such a thing, and if so, how can it be relevant to the broader community of medical historians? These questions must have gone through the minds of many members of the working group History, Health and Healing (HHH) reading the invitation to this meeting about the Healthscaping Urban Europe research project of the University of Amsterdam on February 7, 2020. Those who had decided to join would not be disappointed. As Prof. Dr. Frank Huisman, chair of the working group, announced in his opening words, the work that the research group Healthscaping Urban Europe would present that afternoon, might even be considered paradigm changing.

Short update on HHH’s activities

But first Huisman briefly informed the members about the new plans of the working group. HHH is part of the Huizinga Institute, the research institute and graduate school of cultural history, and as such aims to promote the exchange of knowledge and inspiration between academics of all levels in the interdisciplinary field of medical history and medical humanities in The Netherlands. In addition to organising a meeting twice a year, the co-ordinating committee is currently working on a website and considering other ideas, e.g. a mentoring system that links early career researchers to more experienced ones. As the committee does not want to take initiatives in splendid isolation but make HHH a network of us all, all members are encouraged to come up with ideas (for the meetings, the website and other things we could do). Any thoughts or comments can be e-mailed to Dr. Timo Bolt, secretary of the working group, at t.bolt@erasmusmc.nl.

Public health in the Middle Ages?

After this opening, Prof. Dr. Guy Geltner of the University of Amsterdam took the floor to introduce the Healthscaping Urban Europe project. This is an ERC funded five year project that brings together scholars from various disciplines around the question how urban residents in two of Europe’s most urbanised regions (Italy and the Low Countries) thought about and pursued population-level health in the late Middle Ages. In doing so, they want to challenge traditional eurocentric and modernist perspectives that see public health as a uniquely modern phenomenon.

What was important

Historian Janna Coomans then took us to the medieval cities of Leiden, Deventer and Gent. By using a variety of archival sources – local government regulations, financial records, court records – she uncovered which health issues inhabitants and local governments considered important and how they dealt with them in order to govern cities well. She found that people strived for well-functioning infrastructures (such as water drainage), for sufficient and good water and food, for organised waste disposal and for a morally healthy community. The last item on the list illustrates how medieval people made no distinction between physical, moral and spiritual health. So when the Plague hit, not only did they take measures such as isolating the sick, they also held processions and prohibited gambling, cursing and prostitution.

What people did

Anthropologist Taylor Zaneri showed the rich information that archeology has to offer us. She collected archeological data about water and waste that were derived from 14th century excavations in Bologna and mapped them, combining GIS techniques with traditional historical sources. Her maps make daily life in the city tangible: what kinds of waste there where, how households, neighbourhoods and professionals managed them, where problems arose and how they dealt with them. The limitations of traditional historical research using sources such as rules and regulations become apparent when contrasted with the results of Zaneri’s research: now we come close to seeing what people actually did.

How knowledge spread

Historian Claire Weeda focussed on the question how urban communities in the Low Countries acquired medical knowledge from Greco-Arabic Galenism. For a long time we have known that people here had access to that knowledge and put it to practice, but little is know about how, by whom, why and in what context that happened. Weeda again draws from a rich variety of sources – from contemporary library catalogues to sources on religious health workers and town criers – and by doing so brings to light practices such as street dances organised to improve people’s blood flows. By studying instances of co-operation as well as resistance, she discovered a variety of communication channels: from armies and urban schools to monasteries and confraternities.

Theoretical ambitions

Fascinating though the stories of these researchers were already, their ambitions as a project group go beyond merely adding a new perspective to medieval medical history. In his closing remarks Guy Geltner stressed how they want to move away from a historical bias that tells us that prophylactics did not exist before early modern times, and a periodisation that they see as highly political and colonial. To that purpose, they develop a toolkit that offers researchers various concepts, scales and methods that help them avoid further epistemic violence.

Referents’ responses

That broad agenda made the presentations of the afternoon relevant for all historians, which is why not only medievalist Prof. Dr. Marietje van Winter was invited as a referent, but also Prof. Dr. Eddy Houwaart, who is well known for his work on 19th century public health. Marietje van Winter felt it was long overdue that medical historians should look over the boundaries of the traditional practices of their field and put this kind of interdisciplinary research to practice, even though it is not easy. The evidence the group presented for the existence of ‘public health’ in premodern cities, Eddy Houwaart felt, was convincing, but he also wanted to draw attention to how the boundaries between public and private constantly shift and to the importance of questions of power in that.

The building or the scaffolding

Healthscaping Urban Europe is a powerful project, Frank Huisman concluded at the close of the programme, although he wondered whether the focus was not too much on theorising. To him, theory functions as the scaffolding of the historical narrative that is under construction, and that is taken away when the writing is done, leaving the story to shine. But no matter what the position of the listener in this debate, the grand issues this research group is brave enough to take on stirred in many members of the audience enthousiasm as well as critical reflection – which made this HHH meeting an afternoon well spent.

Read more about Healthscaping Urban Europe on https://premodernhealthscaping.hcommons.org/