Roads to Health: Infrastructure and Urban Wellbeing in Late Medieval Italy by G. Geltner (review)

In Roads to Health: Infrastructure and Urban Wellbeing in Late Medieval Italy, G. Geltner astutely argues for a public health history in which watershed moments, such as the Black Death and the Industrial Revolution, no longer mark so-called beginnings of urban public health. Through his examination of the medieval laws, legal documents, and fiscal registers involving the maintenance of roads—here encompassing waterways and any other paths for travel—and their road masters (variously termed camparii, viarii, and fango officials) between the early thirteenth century and the late fifteenth century, Geltner traces the intentional provision for the health and wellbeing of citizens in medieval communities of central and northern Italy and beyond. Central to this book is the notion that European medieval governing bodies, broadly defined, enacted and enforced public health policies, despite modern assumptions that European medievals were ignorant of medicine and public health hazards. These assumptions, according to Geltner, can be traced to the imperialist, colonialist, and nationalist agendas of the modern age that exalted sterile Westernized public health as a critical component of civilized modernity. Importantly, Geltner does not claim that medieval Italy facilitated the nascency of public health, but rather contends that public health policing existed across premodern societies in various forms, each valid in their community's own logic system.

Roads to Health works against scholarship that traces the ascendancy of public health and seeks to discover the birth of policies mimicking those developed in modernity. This scholarship celebrates medievals for anticipating modern public health policies, while simultaneously associating religiosity and poverty with health ignorance. Furthermore, Geltner positions himself against modernists who dismiss and stereotype medieval health policy and governing bodies as unsophisticated or negligent. The author approaches medieval public health policy in Italian urban communities as contextually bound measures for prohibiting unsanitary conditions and disciplining transgressors to improve health across the city's inhabitants. An example of the historical specificity of medieval public health policies that Geltner notes is the understanding of health comprising sound body, mind, and spirit in the medieval Christian worldview. In a system in which health encompasses spiritual wellbeing and in which the wellbeing of the community depended on its religious expression, Geltner contends that it is not sound to argue against the existence of rigorously conceived medieval public health practices.

Geltner opens with a prologue outlining a brief case study in early fourteenth-century Rome, wherein the author offers an example of the biopolitical acts constituting medieval Italian healthscaping that he finds firmly established in the urban centers of the peninsula at this point in time. Here and in the introduction that follows, Geltner expounds the theoretical underpinnings of Roads to Health, which he derives from the relationship of policy to policing and from health infrastructure to the environment. Geltner frames his study within Michel Foucault's concept of biopower, or biopolitics, in which biological life serves as a political object. For Geltner, the maintenance of roads and their cleanliness was a primary means of maintaining biopolitical control of urban communities. The actors engaging in biopolitics lead Geltner to consider the ramification of Bruno Latour's Actor-Network Theory for medieval public health; he suggests that a variety of stakeholders across urban and rural networks determined public health policies and their enforcement. The author refers to this determination of public health policies as healthscaping, a term borrowed from modern medical professionals who described the construction of environments where "health could bloom" (18–19). Geltner defines healthscaping more broadly to include physical, legal, administrative, social, and political processes of promoting the health and wellbeing of urban communities.

The first chapter introduces the significance of roads to public health, as well as the regular presence of road masters in medieval Italian cities. Through a brief survey of legal statutes across the Italian peninsula, Geltner argues that urban administrators understood street maintenance as vital to urban health and wellbeing, which in turn provided economic...