Geltner, G., “The Path to Pistoia: Urban Hygiene Before the Black Death,” Past & Present (2019).

Abstract: When the Black Death struck Western Europe in late 1347, city dwellers across the region were already practising public health, in part by building, maintaining and monitoring infrastructures whose prophylactic value emerged from the experience of intensified urbanization. The demands of a new urban metabolism, evident from the twelfth century, prompted numerous cities, including Pistoia, to develop preventative health programmes in anticipation of and in response to diverse threats. The latter certainly included famine, floods, pestilence and war, but Pistoians and others were no less concerned by routine matters such as burials, food quality, travel and work safety, artisanal pollution and domestic waste disposal. All of these were recognized as impacting people’s health, based on the medical and natural-philosophical theories prevalent at the time, and their management took into consideration not only climactic conditions and multi-species behaviour, but also the smooth functioning of sites such as wells, canals, bridges and roads. The political value that municipalities and other stakeholders began to place on the upkeep of these sites exceeded their economic function and thus questions the seminal role that scholars tend to attribute to the second plague pandemic in public health history. It also demonstrates how a key aspect of Euro-American modernity continues to shape interpretations of urban and health histories and suggests a broader path for historicizing community prophylactics. (Open Access through Past & Present.)


Rawcliffe, C & Weeda, C., Policing the Urban Environment in Premodern Europe (Amsterdam: Amsterdam University Press, 2019).

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.


Geltner, G., “In the Camp and on the March: Military Manuals as Sources for Studying Premodern Public Health,” Medical History (2018).

Abstract: Historians tend to view public health as a quintessentially modern phenomenon, enabled by the emergence of representative democracies, centralized bureaucracies and advanced biomedicine. While social, urban and religious historians have begun chipping away at the entrenched dichotomy between pre/modernity that this view implies, evidence for community prophylactics in earlier eras also emerges from a group of somewhat unexpected sources, namely military manuals. Texts composed for (and often by) army leaders in medieval Latin Europe, East Rome (Byzantium) and other premodern civilizations reflect the topicality of population-level preventative healthcare well before the nineteenth century, thereby broadening the path for historicizing public health from a transregional and even global perspective. Moreover, at least throughout the Mediterranean World, military manuals also attest the enduring appeal of Hippocratic and Galenic prophylactics and how that medical tradition continued for centuries to shape the routines and material culture of vulnerable communities such as armies. (Open Access through Cambridge University Press.)



Geltner, G., Roads to Health: Infrastructure and Urban Wellbeing in Later Medieval Italy (Philadelphia: University of Pennsylvania Press, 2019).

This book “[…] proposes to examine public health from an emic (“insider”) perspective as a dynamic and historically contingent set of legal prohibitions, disciplining practices and subtle insinuations designed to improve health outcomes at the population level. It is decidedly not meant to set up later medieval cities as the antechamber of modernity, although resisting the teleology does not amount to suggesting that the period under consideration and eighteenth-century developments share no common ground whatsoever. For, if cities threatened to turn into Europe’s demographic black holes in the aftermath of industrialization, why not examine how governments and residents dealt with comparable pressures during western Europe’s first—medieval—widespread proliferation of cities and in one of its most urbanized regions, namely central-northern Italy? At this, by now well-documented level, my goal is to stimulate a different kind of conversation among health and medical historians and enable them, if not to reject, then at least to tread a little more carefully (and certainly less giddily) across an assumed pre/modern divide. Without dismissing the distinction’s analytical value tout court, it is important to ask more precisely what happened and more deliberately where lies the qualitative gap between two postulated (and all too often essentialized) eras, rather than assume and thereby perpetuate the notion of a pervasive hygienic ignorance among premodern urban residents.”


C. Weeda, ‘Reviewing Conduct Books: Galenic Medicine and the “Civilising Process” in Western European Households c.1100–1300’, in Christopher M. Woolgar (ed.), The Elite Household in England, 1100-1550: Proceedings of the 2016 Harlaxton Symposium (Donington, 2018), 167-184.

Abstract: In western Europe conduct books offering advice to young students and aristocrats on how to behave in a social environment began to appear in the twelfth century. They played a substantial role in guiding and governing the behaviour of members of the elite and urban households and feature in historical discussions as an important accelerator of as well as testimony to the so-called civilising process in western European court society, structuring and disciplining the social behaviour of members of the body politic who were trying to gain access to power. However, as this chapter argues, an overlooked aspect of these fresh conduct manuals, which partly drew on the Latin Catonic tradition of teaching morals and manners to young students, was their concerns over health and hygiene. Engaging with the newly introduced medical theories in Graeco-Arabic texts translated in Spain, Sicily, southern Italy and Byzantium from the late eleventh century, clerics in the centres of learning such as Salerno, Paris or Bologna absorbed medical knowledge about healthy behaviour as part of the staple education, thereupon infusing it into manuals of conduct written for young men aspiring to be prudentes, good citizens. This chapter examines a number of these educational tracts from the twelfth- and early thirteenth-century and the presence of such arguments of health and hygiene in them, arguing they attest an understanding that health, hygiene and social status were intertwined.


Coomans, J., “The King of Dirt: Public Health and Sanitation in Late Medieval Ghent,” Urban History (2018), pp. 1-24.

Abstract: Taking the office of the coninc der ribauden in Ghent as a case-study, this article reconstructs the enforcement of urban sanitation and preventative health practices during the fourteenth and fifteenth centuries. The coninc managed a wide range of issues perceived as potentially polluting, damaging or threatening to health. Banning waste and chasing pigs as well as prostitutes off the streets, the office implemented a governmental vision on communal well-being. Health interests, as part of a broader pursuit of the common good, therefore played an important yet hitherto largely overlooked role in medieval urban governance. (Open Access through Cambridge University Press.)



Geltner, G., “Public Health,” in A Companion to Medieval Bologna, ed. Sarah Rubin Blanshei. (Leiden: Brill, 2018), 103-28 [PDF].


Geltner, G. “Finding Matter out of Place: Bologna’s ‘Dirt’ (Fango) Officials in the History of Premodern Public Health,” in The Far-Sighted Gaze of Capital Cities. Essays in Honor of Francesca Bocchi, ed. Rosa Smurra, Houbert Houben and Manuela Ghizzoni. (Rome: Viella, 2014), 307-21 (PDF).


Geltner, G., Healthscaping a Medieval City: The Curia viarum of Lucca and the Future of Public Health History,” Urban History 40 (2013), pp. 395-415.

Abstract: In early fourteenth-century Lucca, one government organ began expanding its activities beyond the maintenance of public works to promoting public hygiene and safety, and in ways that suggest both a concern for and an appreciation of population-level preventative healthcare. Evidence for this shift (which is traceable in and beyond the Italian peninsula) is mostly found in documents of practice such as court and financial records, which augment and complicate the traditional view afforded by urban statutes and medical treatises. The revised if still nebulous picture emerging from this preliminary study challenges a lingering tendency among urban and public health historians to see pre-modern European cities as ignorant and apathetic demographic black holes. (PDF)



Coomans, J., and G. Geltner, “On the Street and in the Bath-House: Medieval Galenism in Action?,” Anuario de Estudios Medievales 43 (2013), pp. 53-8.

Abstract: In this article we combine the perspective of medieval urban hygiene and the findings of medical and intellectual historians by tracing some ways in which medieval urban residents and governments attempted to limit disease and promote health by recourse to preventative measures. In both of the urban regions and domains in focus, namely Italian streets and Dutch bathhouses, considerable thought had been put into reducing the health risks perceived as attending upon them, at times devising arguments and procedures that possibly reflect insights from prevailing medical theories and the advice of practitioners. We suggest that the relation between medical learning and health practices was more complex than a trickle- down process, and analyze them in the context of pre-modern “healthscaping”: a physical, social, legal, administrative, and political process by which urban individuals, groups, and especially governments sought to safeguard and improve collective wellbeing. (PDF)



Geltner, G., “Public Health and the Pre-Modern City: A Research Agenda,” History Compass 10 (2012), pp. 231-45.

Abstract: How and to what extent did pre-modern people go about creating healthier environments? Can we reasonably talk about public health when it comes to earlier urban societies? This essay briefly surveys a few tenacious misconceptions about preventative (as opposed to curative) health care in pre-modern cities, and then proceeds to review a budding scholarly literature that explores how urban dwellers, organizations, and governments, especially in medieval Europe and the Near East, identified and addressed the particular health risks attendant upon their milieus. The article concludes by pointing out several fruitful directions in which this emerging historical field can develop. (PDF)