Guy Geltner. Roads to Health

Since the COVID-19 pandemic, no one can overlook how government policies around disease and the diseased have reconfigured peoples’ daily lives, nor can we overlook the wide variance of opinion around what should be done to manage health among populations. Geltner’s Roads to Health, published just before the global outbreak, innovatively explores these concerns and their solutions in later medieval Italy. With outstanding insight, Geltner offers an entirely new way of analyzing the values people accorded to order and balance in their environment: healthscaping. Recent events have proved his point that top-down economic policy and law work alongside local-level practice to change community health. This is a fast-paced, sharply argued book that reveals medieval cities in constant negotiation between authority and everyday needs, ideals and practical realities, and order and muck. A thoughtful introduction wrestles with the tentacular nature of the topic: this book is about urbanism, premodern governmentality, nonhuman agents, socially produced spaces, historicized sensory experience, and shifting authorities of medical knowledge. The first chapter lays the framework for understanding the critical role played by urbanism in medieval Italian societies; urban planning and maintenance gave rise to architectural commissions and detailed legislation affecting citizens. The urban form was developed and improved not only with a view to ordered civil society, but also to improving well-being, and so urban organization is a discourse of health throughout the Middle Ages. This discourse is explored in a survey of 154 statutes from 118 cities, towns, and fortified rural sites from northern and central Italy; these statutes stipulated what should happen where, when, and by whom: at which times (and with which shouted warning) could nightsoil be thrown out an upper window? Who cleaned the roadways and squares of a city? Where might by-products from artisanal crafts and other smelly or foul waste be kept or discarded. These were procedures that allowed for urban amenity and, explicitly, prevented health problems through sanitation—well before the onset of the Black Death around 1348. Subsequent chapters develop case studies in the practical application of ideals and statutory regulations through the analysis of records of the officials responsible for maintaining roads, in particular the Viarii of Lucca, the Fango offcials of Bologna, and the Camparii of Piemontese villages. At Lucca, statutes outlined the roles of the viarii, who pursued cases and issued fines for illicit waste disposal and for damage to roads and waterways, and whose lack of vigilance in these matters might result in a fine to them. Geltner examines several disputes detailed in the officials’ records, which make clear the government’s application of miasma theory and galenic principles of health through measures to reduce stench and prevent certain “putrid” wastes like feces, butchery waste, and industrial waste from the city’s textile workers in waterways and public roads. The city of Bologna expanded in the thirteenth century, and its commune developed a range of officials who facilitated order and well-being, including the “supervisors of dirt” who swore to ensure the functioning of sewers and gutters, the cleaning of public squares, and the appropriate maintenance of latrines. The officials’ responsibilities were stipulated in statutes and required negotiating the hierarchy of municipal authorities. The registers of this office detail where the officials went and how often (frequently, in artisanal and industrial spaces) to root out filth or foul matter that might cause offense to sight or smell, and thereby risk contamination that would transmit disease and further offense. Geltner has considered these actions and the charges assessed by the officials in chronological, seasonal, and spatial terms, identifying rhythms of city life as mutable and flexible. Over the long term, “health boards” emerged, but generally well after the Black Death. Health concerns were addressed by vigilant agents on the ground (and in the waterways), and the key point is that these processes were prophylactic—to prevent ill health not to remediate crisis. A final case study looks at the patterns identified in urban contexts as they translated into rural environments in Piedmont. Camparii were field masters who took on some of same concerns that urban officials did, toward the same aims. The small-walled town of Pinerolo preserves the registers of camparii, who served fines for loose animals, trespassing in fields, or stealing crops; as in cities, the officials were tasked with ensuring that waterways remained clear inside and outside the walls. Geltner points to their concern for an imagined equilibrium between private ownership and public activities, field and town. A fifth chapter traces the intellectual interest and architectural efforts toward so called healthscaping. These interests and efforts were structural and practical, involving walls, barriers, and desired topographies of well-being. They were implemented in religious houses as well as in cities, imposed onto ancient structures and laid out in newly planned ones. Attention to what we might call “public health” emerges especially in the evidence from medieval Italy, where cities were the preferred mode of settlement from antiquity and where record-keeping practices were well established in this period. Geltner shows that the patterns he traces in Italy can also be found in England, Iberia, and the Low Countries, as well as in Byzantium, the caliphate, and East Asia. Appendixes provide texts and translations of sources that will be rich tools for teaching.

Environmental health · Geography · Historical Studies and Socio-cultural Analysis · History · Medicine · Vietnamese History and Culture Studies