Urban Bodies: Communal Health in Late Medieval English Towns and Cities by Carole Rawcliffe (review)

In this weighty, extensively researched, and important book Carole Rawcliffe shakes up many commonly held assumptions about the longue durée history of public health. She also directly challenges the most important late twentieth-century interpreters of the Middle Ages: Chapman, Cleese, Gilliam, Idle, Jones, and Palin. Mounted on the steed of archival scholarship, she sets out to slay the medieval muck dragon with a quiverful of facts gathered from a mighty armoury of manuscript and printed sources.

Late Medieval English towns, she argues, were nothing like the excremental vision of Monty Python and the Holy Grail (a text which provides the epigraph of her first chapter); nor were they marked by the filth and chaos evoked and emphasized in the accounts of Victorian and early twentieth-century sanitarians and popular historians. Rather, their archives abound with evidence of concern about collective health and with documents recording actions designed to inhibit or to punish insanitary conduct and to reduce the risk of disease. Such evidence, she argues, had been largely obscured by ill-informed prejudice, and by secular-minded modernists’ failure to understand the centrality of religion to medieval notions of good health. After a lengthy introduction that sets out her main arguments (a section time-pressed students will find exceedingly helpful) and a discussion of urban bodies and urban souls that draws out the links among medieval ideas of physical, political, and corporeal health, chapters on the environment and health, on water supply, on food and drink, and on the relief of the sick hammer away at these misconceptions. Examples from towns great and small are marshalled to depict “fruitful collaboration between secular and religious authorities for the provision of plentiful and readily accessible supplies of water,” to emphasize “the enforcement of food standards, the creation of cleaner better organised markets,” and to give credit to the level of effort expended on street cleaning and the removal of nuisances. Cumulatively, her arguments, especially when read alongside recent work by scholars such as Isla Fay, Peregrine Horden, and Dolly Jørgensen, indicate that the roots of public health lie much earlier than the reports of Edwin Chadwick, the prescriptions of Enlightenment police, or the injunctions of the Renaissance city state.

However, Rawcliffe’s material is more compelling than the analytical frameworks by which she explicates the beliefs and practices of late medieval townsfolk. First, because she couches her book as a refutation of modern condescension towards the Middle Ages in toto, she leaves unresolved just how far mores changed across the three centuries she covers. At times she suggests that communities’ sensitivity to filth and other potential sources of ill-health varied according to the demographic context: epidemics stirred rulers into action; less lethal decades reverted to environmental laissez faire if not laxity. On other occasions a progressivist narrative lurks beneath the surface of the text. The reader is left with a sense that institutions and patterns of care and regulation increased in sophistication over time. The author emphasizes how far “the spread of medical knowledge” (p. 148) underpinned magistrates’ actions. But is she thereby simply pushing the mythic era of complete sanitary insouciance back to what my early medievalist colleagues refuse to term the “Dark Ages”? How far does a rejection of stereotypes about the pungency of Plantagenets suggest that we should rather think of the vile Vikings or noxious Normans? The relation between the hygienic norms and forms and the development of the state and civil society is never spelled out.

Nor will everyone find her interpretation of the social and ideological significance of sanitary measures entirely satisfying. As the title suggests, this books links collective health and the history of the body. Rather than drawing on work shaped by Bourdieu, Foucault or phenomenology, it develops a 1970s and 1980s historiography strongly influenced by structural–functionalist anthropology. Rawcliffe argues there was a pervasive analogy, often, indeed, a...