Premodern Public Health

Professor Guy Geltner

About the project

My ongoing research reconstructs how earlier societies defined and defended their health as communities. It explores how diverse groups, including armies, miners and urban dwellers, identified risks to their health and intervened in various ways to improve health outcomes, wherever they were (including on the move), and whatever the resources at their disposal.

Many of these programs focused on monitoring (human) animal behaviors, for instance through attempts to reduce pollution, violence, crowdedness and work-related accidents, rather than emerged as a response to epidemic disease (such as plague). They also impacted their physical environments, for example by paving streets, burying sewers, locating camps and practicing zoning, interventions that shaped spaces and biopolitical relations for centuries to come. Furthermore, by working in a GIS environment my research spatializes, identifies correlations and charts continuity and change on the basis of surprisingly rich data that such attempts have left behind, especially in thirteenth- and fourteenth-century Italy. It helps us track behaviors seen as dangerous and harmful (miasmatic) and their proliferation or absence in certain urban areas such as market squares, strategic water sources or artisanal quarters (as shown in the map above).

While there remains much to be said about hygienic practices in so-called premodernity, what this research has already been able to demonstrate is the need to radically revise the accepted periodization when it comes to public health history. The oxymoron known as “premodern public health” or Michelet’s (in)famous characterization of the European Middle Ages as “one thousand years without a bath” simply cannot bear the increasing weight of evidence to the contrary, in a growing number of sub-regions across Europe. What is more, observing similar and parallel practices in other world regions before the so-called Age of Discovery, imperialism and colonialism lends itself to even broader challenges to accepted narratives of civilization. Here, the rise of the public health movement in the aftermath of Euro-American industrialization continues to be understood as a silver lining to the environmental degradation of the industrial revolution as well as the racism and violence of European expansion. My work is beginning to show, however, that from the Americas to the Middle East to Asia and beyond, community prophylactics were common and well attested well before the sixteenth century. The activities of the Islamic market inspector (pictured below), attested from the ninth century, is a case in point.

Related publications 

G. Geltner, “The Path to Pistoia: Urban Hygiene before the Black Death,” Past & Present 246 (2020): 3-33

G. Geltner, “In the Camp and on the March: Military Manuals as Sources for Studying Premodern Public Health,” Medical History 63 (2019): 44-60

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