Urban health in the Middle Ages and Today: Changing Community Politics and Environments

Janna Coomans

Through vaccination campaigns and lifting restrictions, authorities across the globe are promoting the idea of a return to normal, yet which form the ‘end’ of the COVID pandemic will take is uncertain. There may be celebrations and post-war-like baby booms, or public festivities, which are, in a way, secular versions of religious processions thanking God for lifting the curse of plague. Others foresee a more gradual liberation, with many relapses. The pandemic may also stay, and for a long time impact both physical and mental communal wellbeing – as did the Second Plague Pandemic, which lasted in Europe from the mid-fourteenth to the late eighteenth century. Moreover, historical comparisons reveal important links between crises and routine health practices.

The past two years have made it very clear that public health is as much about spaces, movements and economic and political stakes as it is about access to hospitals and doctors. There is, moreover, a new interest in long-term histories of health. Modern democratic states are no prerequisite to establish public health policies, which can entail any intervention to avoid disease and promote wellbeing at a group level. Preventative health was as pertinent and political during the later Middle Ages as it is today.

A recent effort has been made by historians to ‘clean up’ the Middle Ages. This was not an era characterized by urbanites spending their lives in an apex of dirt and chaos. Neither did things improve in any linear progression towards the ‘true’ birth of public health in the nineteenth century. My study of the medieval Low Countries subscribes to that important intervention. Yet the question ‘how dirty a medieval city was’ may not even be the most important one. Rather, concerns for sanitation and health were integrated into the routine governance of a medieval city. Urban community politics were negotiated and performed through daily activities, and dealing with routine health risks and organising sanitation were crucial arenas in which that happened.

Based on the foci and subjects that Netherlandish archival sources convey, the pursuit of a healthy medieval city can be divided into four main goals, namely: 1. well-functioning infrastructures; 2. sufficient and high-quality water and food; 3. organized (but not necessarily centralised) waste disposal; and, 4. finally, a morally healthy community. Managing all kinds of matter, including animals, waste, and people, was therefore also linked to an idea of social and moral union. Controlling those resources gave a sense of security, indeed secured power. In sum, balancing flows, in combination with balancing morality, defined communal health practices during the later Middle Ages. It was therefore at once more environmental and more spiritual than its twenty-first-century Euro-American counterpart. Further, responsibilities were divided differently. The water-rich lands of the late medieval Low Countries were populated by a large number of semi-independent towns and cities. This gave the region a distinct political profile, in which public health at an urban level played a key role. Besides regional and urban authorities, others such as guilds, parishes, religious orders and neighbourhoods also participated in health practices. Thus, facilities like sewage and waste collection, now in the hands of municipalities, were often organised among households or artisans.

There were also ‘shocks’ to routines: epidemic disease, famines, disasters such as floods and large fires, and political conflicts could impact public hygiene profoundly. Plague was one important factor and accelerator. However, it was not the start of thinking about communal health, as scholars earlier assumed. There is an important parallel to be made here: rather than perceiving the COVID crisis on its own, it is crucial to relate its experience and sense of collapse to structural everyday health practices, if we want to understand its societal impact, and think about future preventative efforts.

This post first was published on fifteeneightyfour.

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Call for Papers: Health, Environment and Urban Development in the Middle Ages

New Dates: 17-18 February 2022
Norwegian University of Science and Technology, University Museum, Trondheim

New Abstract Submission Date: 17 December 2021

(The COVID-19 pandemic has created a lot of uncertainty about travel activity, inland and abroad. However, it is our priority to conduct this conference physically to contribute constructively to network building within a research area in very rapid development.)

The aim of the conference is to share results and promote interdisciplinary debate amongst international colleagues who have worked across disciplines with research questions related to health, environment, and medieval urban development. We welcome papers from archaeology, history, ancient DNA, paleobotany, zoology/zooarchaeology, climate science, linguists, literary studies, and other relevant disciplines.

We welcome proposals for papers of 20 minutes in length (+ 10 minutes of discussion) engaged with the session themes. Abstracts should not exceed 200-300 words, and are to be sent to Elisabeth Forrestad Swensen, e-mail: elisabeth.swensen@ntnu.no by no later than 17 December 2021, and should contain the following information: name, institutional affiliation, email.

Keynote speakers: Prof. Guy Geltner, Monash University, Melbourne, and Prof M. Thomas P. Gilbert, Centre for Geogenetics, University of Copenhagen.

The conference is organized by the Norwegian Research Council funded project “Medieval urban health: from private to public responsibility” (2017-2020), whose goal has been to shed new light on how public health evolved from individual practices to public actions; what factors caused this ground-breaking development? The overarching methodological principle has been to compare the natural and built urban environment in medieval Trondheim with developments in health, diet, and mobility. The evidence has been gathered from large collections of well-preserved skeletons from medieval cemeteries in Trondheim. Biomolecular analyzes have also been applied to identify the character of infectious diseases in the urban population during the period c. AD1000-1600.

Organizing committee: Prof. Axel Christophersen (Department of Archaeology and Cultural History, NTNU University Museum), Prof. Hans K. Stenøien (Department of Natural History, NTNU University Museum) and senior research fellow Elisabeth Forrestad Swensen (Department of Archaeology and Cultural History, NTNU University Museum).

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Ethnicity in Medieval Europe, 950-1250

Claire Weeda

On 26 March 1215, the brash Bolognese rhetorician Boncompagno da Signa read aloud his manual of rhetoric, Rhetorica antiqua,in front of the college of professors of civil and canon law. If some of his students had nodded off by the time he reached book VI, about the art of writing letters of consolation, they might have jolted awake when laughter arose in the classroom. For at that point, Boncompagno injected some comic material into his lesson, ridiculing several ethnic groups in Europe. In the section on how to address peoples in mourning, he mocks the northerners and their typical drinking habits, claiming that ‘the English, Bohemians, Poles, Ruthenians and Slavs mix their tears with drink until they reach a state of drunkenness, and thus consoled, they retain their usual merriment’. On the other hand, he continues, the Germans lament in soft voices – which is a playful inversion of their stereotypically harsh voices, that were sometimes likened to barking dogs or rattling carts. The more southern people of Romagna and Lombardy typically use artifice, however, whereby ‘in order to simulate lamentation there are many who wet their eyes with saliva or prick their eyelids’. Thus, Boncompagno actively put into practice his own lessons on the art of rhetoric. The textbooks of rhetoric and poetry indeed advised writers to capture their audience’s attention, and to be convincing, by incorporating common stereotypes, alluding to the typological traits of women, peasants and noble men, old-aged persons or ethnic groups.

Following on from literary composition, I wanted to understand the functioning of those ethnic and racial stereotypes in social contexts and power relations, their construction and the meaning attributed to them outside of the nation-state. My research suggests that the stereotypes employed by monks, schoolmen, poets and historians in western Europe in the period 950-1250 certainly were not random. English drunkenness, for instance, was a widespread image attached to northern peoples that was used in multiple contexts. Thus, in 1213, Stephen Langton, the archbishop of Canterbury, suggested that English drinking was passed down from father to son and was hereditary. He did so in the context of the interdict pronounced by Pope Innocent III over England in 1207, thus attributing England’s woes to the collective guilt of gluttony and drunkenness. The Benedictine monk William of Malmesbury, writing a century earlier, claimed the English on the eve of the Battle of Hastings acted as drunkards, ‘eating till they were sick and drinking till they spewed’. Their drinking ushered in their defeat at the hands of the Normans. In fact, English drinking was such a ubiquitous trope that Walter Daniel (fl. 1150–67), a Cistercian monk at the abbey of Rievaulx who referred to himself as a medicus, in the Centum Sententiae portrayed the English drinker sitting, holding in one hand a siphon to his mouth to drink, and in his other hand his own pipe – his penis – to eject urine.

Ethnic stereotypes abound in all kinds of texts produced between the tenth and thirteenth centuries in Latinate Europe: poems, histories, lists, encyclopaedias, medical tracts, proverbs and letters. My research shows that besides in the classroom and in social relations, the rhetorical use of ethnic and racial stereotypes occurred foremost in the military sphere and in ethnographic description in the context of colonization, advanced by men in the rising schools and courts. The ethnic tropes were used to categorize the traits of fighters and labourers within and outside the Christian imperium, holding them up to norms of strength, manliness, courage, industry and rational thought – to levels of discipline. In doing so, schoolmen and courtiers were making arguments about who qualified to lead the defence of the sweet patria in conflicts within Europe’s Christian imperium, as well as justifying the expropriation of land outside it.

The production of such images was aided by already circulating texts, such as Vegetius’s military manual De re militari, biblical commentaries, and Latinate ideas about governance, embedded in Graeco-Arabic environmental deterministic theories about how climate determines physiology and character. The monks, schoolmen and courtiers thereby integrated various traditions of thought: religious ideas about sin and the fall of mankind, genealogy and prophesies of the translation of power and knowledge; medical environmental theory about bodies, minds and places; and rhetorical-legal discussions about ownership of land and the fruits of labour, governance and the organization of society. The ethnic self-representations that the schoolmen forged and appropriated reflect an idealized image of the social elite, emphasizing discipline, but also urbanity and eloquence. These were prerequisites for administering governance well, as laid out in the ubiquitous regimens produced at this time.

The stereotypes, crucially, give weight to legal arguments pertaining to property and dominium, set in an environmentally deterministic narrative of progress, offering a justification of the colonization of ‘squandered lands’. In ethnographic description, those fertile lands are populated by allegedly semi-pagan, irrational, lawless beings, on a sliding scale of human-animalistic traits. Images of the self and the other thereby work in dialogue, within the same framework, drawing from Graeco-Arabic, Roman and religious ideas. Negative tropes place others in a different space and timeframe, in a backward past, as a form of temporal and spatial othering.

In my view we can only begin to understand ethnic or racial stereotypes of others, if we understand how ideas of the self are constructed. The imagined nation, or ethnotype, stands in a long and fluid textual and oral tradition, whereby the relevance and power of those stereotypes depends on the context in which they are employed, the discourses on which their validity is based and the authoritative voices that wield them. This underscores ethnotypes’ status not as outcomes of political and cultural processes but, rather, as verbal ammunition to be used in negotiations over social status, property and power, along with intergroup bonding. My book thus presents a snapshot of how monks and schoolmen, in the period 950-1250, talked about ethnicity. I would like to add that it does not work with beginnings and outcomes of the development of nationhood, but instead looks at processes in which constellations of marks of distinction are negotiated. Hopefully, my book will contribute to understanding how such configurations influenced the colonization discourses in other regions as well, in yet other contexts and places.

This post first was published on Boydell & Brewer

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Matter into Place: Public Health and Urban Space in the Medieval Low Countries

Online Workshop

Friday, 9 July 2021, 9:00-13:00 CEST


09:00-10:45 Session1: Waterscapes

Janna Coomans, Léa Hermenault (University of Amsterdam)
Water infrastructures and public works as key elements of an economy of movement in Ghent (14th-15th centuries)

Frank Gelaude (University of Antwerp)
Controlling rivers in the medieval city of Ghent

Roos van Oosten (Leiden University)
Water management in a typical Dutch water-rich town

Discussant: Maaike van Berkel (Radboud University Nijmegen)

10:45-11:15: Coffee Break

11:15-13:00 Session2: Crafts, wastes and pollution in the city

Lola Digard (University of Amsterdam)
The influence of guilds and peace procedures on the social, moral and healthcare environment of the late medieval cities of Ghent and Douai, 1350-1500

Ward Leloup (Vrije Universiteit Brussel & Ghent University)
‘Walram the coryer, he stynketh’. The leather industry and the urban environment in late medieval Bruges and Mechelen

Barbora Wouters, Yanik Devos (Vrije Universiteit Brussel)
Open spaces, markets, waste management and post pollution in medieval towns through a geoarchaeological lens

Discussant: Marc Boone (Ghent University)

Organizers: Janna Coomans, Lola Digard and Léa Hermenault

Please email p.amiri@uva.nl to register and receive the zoom link.

You can watch the recording of this workshop here.

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Approaches to Life and Health in Medieval Cities – Online Workshop

Featuring the launch of the Healthscaping WebGIS

Friday, 25 June 2021, 15:00-18:00 CEST/ 9:00-12:00 EST


15:00 Introduction: Launching the Healthscaping Map
Guy Geltner, University of Amsterdam and Monash University

15:10 Mapping Public Health Measures in Late Medieval Bologna
Taylor Zaneri, University of Amsterdam

15:40 Pollution Issues in Late Medieval Bologna from the Fiscal Sources’ Point of View
Rosa Smurra, University of Bologna

16:10 The Demographic and Health Context and Consequences of Plague in Medieval London
Sharon DeWitte, University of South Carolina

17:00 Discussant
Nicholas Terpstra, University of Toronto

Please email p.amiri@uva.nl to register and receive the zoom link.

You can watch the recording of this workshop here.

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Pigs and Plague: Public Health and Community in the Late Medieval Low Countries – Online Lecture

Friday, 18 June 2021, 16.00 CEST

Janna Coomans will give a lecture for the digital lectures series organized and hosted every fortnight by Somewhere beyond the Sea, the Belgo-British Research Network. The talk is titled ‘ Pigs and Plague: Public Health and Community in the Late Medieval Low Countries’. To register and receive the zoom link, send an email to Stefan.Meysman@UGent.be.

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Medicine in the Medieval North Atlantic World – Online Conference

13–15 May 2021
Maynooth University, Ireland

This interdisciplinary conference explores the reception and transmission of medical knowledge between and across England, Ireland, Wales, Scotland, and Scandinavia during the medieval period, and will draw on history, literature, philosophy, science, religion, art, archaeology and manuscript studies. It will interrogate medical texts and ideas in both Latin and vernacular languages, addressing questions of translation, cultural and scientific inheritance and exchange, and historical conceptions of health and of the human being within nature.

Plenary speakers: Dr Debby Banham (University of Cambridge); Prof. Guy Geltner (Monash University); Prof. Charlotte Roberts (Durham University)

Organising committee: Dr Sarah Baccianti (Queen’s University Belfast); Dr Siobhán Barrett, Dr Bernhard Bauer & Dr Deborah Hayden (Maynooth University)

The conference will be held online on Zoom. Please email us to confirm your wish to participate at: northatlanticmedicine@gmail.com

You can find the programme and presentation abstracts here.

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Social, Legal and Emotional Aspects of Conflicts in Western Europe, 1300-1600 – Online Workshop

Thursday. 13 May 2021 16:00-18:00 CEST

In premodern societies, the notions of honour and reputation helped to frame social interactions on different scales. On a personal and familial level, pursuing honour was a way to secure economic and social safety through the establishment of networks of professional cooperation and community support. On a communal level, claiming honour was a way to consolidate alliances between cities, states and professional groups. A challenged honour could be the basis for legal disputes or become conflictual, potentially leading to cycles of courtroom battles and violent retaliation that represented a threat to individuals and communities. However, violent retaliations, despite representing a threat to social cohesion on various scales, had the major advantage of restoring social positions, by reclaiming honour. Thus, in premodern societies conflicts around honour were part of a set of behavioural forms that helped define social structures of alliances and division. This set of behaviours, which has been termed an ‘economy of honour’, involved strategies in which the benefits and risks of challenging honour and using violence were carefully calculated, since these behaviours represented economic, social and political risks. In these strategies, legal contests occupied an important position, since the social standing of an individual, and the reputation of a group could help legal decisions to be made in their favour, while proving that the honour of an individual or a group that had been threatened could legally justify violent retaliations that were perceived as necessary to reclaim honour.

Honour and the practices surrounding it are also deeply embedded in social constructs, and the attitudes surrounding honour and violence have evolved across time. While historically minded sociologists such as Norbert Elias, Pieter Spierenburg and Steven Pinker have associated this evolution of attitudes to the ‘civilisation process’ and a subsequent decline of violent interactions surrounding honour, recent scholarship has challenged this view, and has been highly critical of the normative claims embedded in the concept of a civilisation process. Analysis of archival sources conducted by Barbara Hanawalt and Trevor Dean, for instance, has highlighted how court records, guilds and city statutes give a much more nuanced vision of the perceived violence of premodern societies, and demonstrated the many ways in which honour could be displayed, protected and strategically manipulated by individuals and governments to fulfil their agendas. Recent scholarship has also challenged views regarding the groups involved in conflicts surrounding honour, initially perceived as the reserved field of noble men. Manon van der Heijden and Cynthia J. Johnson have highlighted that women actively participated in honour-related conflicts, while Claude Gauvard, Andrea Zorzi and Kate MacGrath have shown how the pursuit of honour was applicable to every layer of society.

This workshop focuses on the way conflicts participated in defining interactions between individuals and groups in Western Europe between the 14th and the 16th centuries. It aims, first, to explore the similarities and differences between honour-related conflicts on different scales. Were honour-oriented conflicts used in the same way to navigate social interactions between individuals and groups? Next, it seeks to interrogate how legal systems were adapted (or not) to handle the honourable aspect of conflicts, and what paths did legal procedures create for the restoration of honour to litigants. Finally, it will investigate how emotions could influence claims to honour and conflictual interactions. On an individual level, how are some forms of violence that lead to loss of honour, if not bodily integrity, tied to self-esteem, self-perception and emotional reactions? On a group level, how can the sense of belonging to a professional association or an urban community influence the emotional and behavioural response to perceived threats to the honour of that group?


  • Scorned honour and ill repute: Emotional, social and legal implications of honour in the pacification office (Ghent, 1350-1400). Lola Digard, Phd Candidate, Universiteit van Amsterdam
  • More things are necessary for a household than four naked thighs”: Honor, material culture and late medieval marriage. Dr. Anna Boeles Rowland, Research Fellow, KU Leuven
  • Trust issues: reputation in conflicts around trade and debt in Northern European cities (c.1400-1550). Christian Manger, Phd Candidate, Universiteit van Amsterdam, and Ester Zoomer, Phd Candidate, Universiteit van Amsterdam

 Respondent: Dr. Daniel Lord Smail, Professor of History, Harvard University

Please register with l.digard@uva.nl to receive an invitation to the zoom meeting.

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Infectious Disease and Public Health: Lessons from History – Webinar

Thursday, 22 April,  17:00 AEST

In 2020 Covid-19 reminded us all that we can learn valuable lessons from the history of infectious disease. This webinar brings together three historians of public health in very different eras and contexts, presenting historical research which can help us better understand and manage infectious disease in the 21st century.

Guy Geltner (Monash University), ‘Public health in the premodern world: The end of an oxymoron’: The new field of premodern public health has rose to some prominence during the outbreak of Covid-19, as health professionals, policy makers and ordinary citizens became aware of the efficacy of ‘low tech’ solutions often associated with earlier, ‘unhygienic’ eras. This presentation will summarize some of the field’s key insights and how they challenge entrenched narratives of modernization and common practices of cultural othering today.

Warwick Anderson (University of Sydney) considers ‘Crisis in the Herd: A Short History of R0 and Disease Modelling’: Statistical models and simulations have recently come to dominate the framing of epidemic disease, giving us concepts of ‘waves’ and ‘flattening the curve’ – but where do they come from, and where are they directing us?

Geraldine Fela (Monash University), ‘From Condoman to Community Control: Indigenous public health, nursing and HIV in the 1980s’: As HIV spread through Australia’s gay community in the early 1980s many predicted that the virus would cause a public health crisis of unprecedented proportions in Aboriginal and Torres Strait Islander communities, but this never eventuated. This paper will examine the extraordinary public health approach that was responsible for this success, an approach led by Indigenous nurses and healthcare workers and informed by the politics of self-determination and community control.

Presenter Bios 

Warwick Anderson, MD, PhD, is Janet Dora Hine Professor of Politics, Governance and Ethics in the Department of History and the Charles Perkins Centre, University of Sydney; and a honorary professor in the School of Population and Global Health, University of Melbourne.

Geraldine Fela is in the final year of her PhD candidature at Monash University. Her thesis examines the experiences of HIV and AIDS nurses in Australia prior to the introduction of anti-retroviral therapy. Her research looks at the intersection of oral history, labour history, histories of gender and sexuality and social movement studies.

Guy Geltner is a social historian of health, cities and punishment at Monash University and the University of Amsterdam. His work can be explored at www.guygeltner.net.


Al Thomson, Professor of History at Monash University, will host the evening and HCV Executive Officer Alicia Cerreto and Monash University’s Dr Susie Protschky will facilitate the discussion.

You can register here.

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Salutaria! Perspectives on Health and Wellbeing in Medieval and Early Modern History

Friday, 23 April,  9:00 to 16:30 AEST

The preservation of health and the pursuit of wellness were major preoccupations during the Medieval and Renaissance period. This was not limited to just the body but also to the mind, the soul, the community and the environment. As a complex subject that affected everybody, the quest for wellbeing was understood and experienced in a multitude of ways. This symposium aims to explore both the changing and continuing perceptions of wellbeing during the medieval and early modern period as well as the various strategies people employed to pursue it for themselves and for others.


Professor Guy Geltner (Monash University)
“Health and the Environment Beyond the Simplex of the Pre”


Elizabeth Burrell (Centre for Medieval and Studies, Monash University)
Dr Merav Carmeli (Australian Centre for Jewish Civilisation, Monash University)
Nat Cutter (School of Historical and Philosophical Studies, University of Melbourne)
Dr Aydogan Kars (Centre for Religious Studies, Monash University)
Rosa Martorana (Centre for Medieval and Studies, Monash University)
Dr Melissa Raine (School of Culture and Communication, University of Melbourne)
Dr Kathryn Smithies (School of Historical and Philosophical Studies, University of Melbourne)
Dr Richard Tait (Centre for Medieval and Renaissance Studies, Monash University)
Gordon Whyte (Faculty of Medicine, Nursing and Health Sciences, Monash University)

You can find the programme and register here.

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