Sources for the History of Medicine in Late Medieval England

The material contained here derives from a wide variety of printed and manuscript sources, chosen to give some idea of the rich diversity of evidence available to the historian of English medicine and its place in society during the fourteenth, fifteenth, and early sixteenth centuries. Latin and French have been translated into modern English, while vernacular texts have been slightly modified, and obsolete or difficult words explained. Middle English has otherwise been retained to give the past an authentic voice and to emphasize the similarities as well as the differences between the experience of modern readers and that of the inhabitants of late medieval Englandhttps://scholarworks.wmich.edu/mip_teamsdp/1001/thumbnail.jp

Introduction

As urban communities in Western Europe mushroomed from the twelfth century onward, authorities promptly responded with a plethora of regulations to facilitate, at least in theory, the orderly cohabitation of dwellers within the city walls. Many of these rules concerned public health matters, such as the disposal of waste, the protection of water supplies, and the sale of wholesome foodstuffs. In some cases, sanitary regulations drew from Ancient Greek and especially Galenic medical theory, which stressed the importance of a hygienic environment in safeguarding the urban body from disease. The effective execution of such measures relied in part on the active engagement and compliance of the population. Shared assumptions regarding physical and spiritual well-being, social cohesion, neighbourliness, and economic prosperity, as well as the pursuit of ideals of urbanity, fed into communal efforts to police the environment, the behaviour of others, and the conduct of the self. Nonetheless, conflicting interests and contradictory impulses abounded, and official bodies might wield the disciplinary stick when their efforts met with apathy, confusion, resistance, or evasion. This volume explores attempts to enforce rules and recommendations for the improvement of public health and sanitation in premodern Western Europe, while also seeking to establish how urban populations may have reacted to them. To this end, it draws upon a wide range of source material, including bylaws, court rulings, and official injunctions, together with the evidence of judicial inquiries, administrative records, urban chronicles, panegyrics, and medical texts. And in so doing it comprehensively challenges a lingering tendency on the part of historians writing for the academic as well as the popular market to employ the word ‘Medieval’ as a synonym for ignorance, superstition, and indifference to squalor

A Crisis of Confidence: Parliament and the Demand for Hospital Reform in Early Fifteenth and Early Sixteenth-Century England

This article examines attempts made by the Commons in the parliaments of April 1414 and 1512 to address the corruption, neglect and poor administrative standards deemed endemic in the nation's hospitals and almshouses, and to remedy a perceived lack of facilities for the care of sick paupers. Despite early (but short-lived) support from the crown, the first initiative failed, partly because of its association with heretical demands for the disestablishment of the English Church. Although the underlying reasons for institutional decline were often more complex than the reformers cared to suggest, their campaign did inspire a number of hospitals and their patrons to rectify abuses. At the same time, individuals and organisations throughout society invested in new foundations, generally under lay management, for the residential accommodation of the elderly and reputable poor. These measures sufficed until the arrival of endemic pox, along with mounting concerns about vagrancy and disorder, prompted another parliamentary petition for the investigation and reform of charitable institutions. Notable for its emphasis upon the sanitary imperative for removing diseased beggars from the streets, and thus eliminating infection, the bill of 1512 also attacked the proliferation of fraudulent indulgences, which raised money under false pretences for houses that were hospitals in name only. This undertaking also failed, almost certainly because the lords spiritual had, again, drawn the line at the prospect of lay intervention in overwhelmingly ecclesiastical foundations. Both bills are reproduced in full in an appendix, that of 1512 appearing in print for the first time

Both “illness and temptation of the enemy”: melancholy, the medieval patient and the writings of King Duarte of Portugal (r. 1433–38)

Recent historians have rehabilitated King Duarte of Portugal, previously maligned and neglected, as an astute ruler and philosopher. There is still a tendency, however, to view Duarte as a depressive or a hypochondriac, due to his own description of his melancholy in his advice book, the Loyal Counselor. This paper reassesses Duarte's writings, drawing on key approaches in the history of medicine, such as narrative medicine and the history of the patient. It is important to take Duarte's views on his condition seriously, placing them in the medical and theological contexts of his time and avoiding modern retrospective diagnosis. Duarte's writings can be used to explore the impact of plague, doubt and death on the life of a well-educated and conscientious late-medieval ruler

The view from the streets:The records of hundred and leet courts as a source for sanitary policing in late medieval English towns

Late medieval English leet court records have long been a staple for research by economic, social and legal historians. Yet, despite the wealth of evidence that they contain, they have rarely been used for the study of public health. This state of neglect is all the more surprising because they offer a rare, in many instances unique, insight into what might be termed ‘popular’ or ‘grassroots’ responses to insanitary nuisances and into the enforcement at a local level of regulations concerning the urban environment. Theoretically requiring the regular participation of all resident males over the age of 14 within a relatively small geographical area, these courts functioned at the very bottom of the judicial hierarchy. They served as a useful vehicle not only for the implementation of bye-laws and other directives but also for the dissemination of whatever basic information (such as the need to avoid contaminated air in plague time) that the ruling elite considered it necessary for ‘ordinary’ people to have. In turn, however, they gave local communities an opportunity to complain about perceived hazards that required official action and, indeed, to protest should the response prove tardy or inadequate. Much of the material presented in this paper undermines the still widespread assumption that the imposition of public health measures must have been difficult, if not impossible, in a society that depended heavily upon consensual policing. Far from demonstrating indifference or hostility to schemes for urban improvement, many leet juries (whose task was to report or ‘present’ specific offences) actively campaigned against perceived threats to collective wellbeing and were vocal in their denunciation of inertia or incompetence on the part of magistrates. Their approach was, nonetheless, pragmatic: minor nuisances might well be tolerated, especially when commercial interests were at stake; and there was a general readiness to compromise over the collection of routine fines. On the other hand, antisocial behaviour that might prove dangerous (especially during epidemics) could he harshly punished or, as frequently happened, subject to the threat of a draconian penalty should the offender fail to take appropriate action

'Great Stenches, Horrible Sights and Deadly Abominations': Butchery and the Battle Against Plague in Late Medieval English Towns

Focussing upon urban responses to the perceived hazards posed by butchers and butchery, this paper argues that sanitary measures promulgated throughout England from the 1350s onwards were based upon complex and sophisticated beliefs about human physiology and the dissemination of disease. The conviction that pestilence was spread by miasmatic air had widespread practical implications for a trade that generated large quantities of noisome waste and frequently stood charged with environmental pollution. Medical theories concerning the crucial role of diet in strengthening (or weakening) an individual's resistance to epidemics, as well as ideas regarding the transmission of toxins through the gaze, also prompted complaints about butchers, which in turn gave rise to the many regulations concerning their activities that feature so prominently in local and national records. These attempts to safeguard public health had a striking impact on the urban landscape, as new, purpose-built slaughterhouses were constructed on hygienic principles, and attempts were made to confine the worst aspects of butchery to peripheral areas. The disposal of offal and other noxious waste taxed authorities to the limit, and led to the development of special facilities for removal, which were designed to protect the urban water supply and keep the streets free of filth. At the same time, markets became cleaner and better organised with improved standards of supervision in order to ensure that poorer citizens could obtain cheap and uncontaminated cuts of meat