‘Medieval city governments did not struggle with filth and stagnation because they were medieval, but because they were municipal’ (p. 39), states Abigail Agresta in Disease and the Environment, edited by Lori Jones. The volume incorporates two important new directions within the environmental history of disease, namely a more global and more interdisciplinary approach. Aiming at an audience of scholars and students, the authors draw comparisons across time and space in how societies have dealt with their natural and built environments to mitigate disease risks – which every community had to do, in one way or another. This book is an excellent entry into the growing body of scholarship on this topic. Jones has written a clear and concise introduction, after which three sections follow with nine chapters, written mainly by leading specialists in their respective fields.
One key concept used in several chapters is that of healthscaping. Peterson and Krolikowski confirm that a wide range of efforts to make health bloom was present in the Italian cities of Bologna and Siena. They argue for a link between physical and spiritual care, and that besides urban governments, religious institutions assumed healthscaping responsibilities. They also note, interestingly, the convergence of the charitable revolution and a surge in healthscaping activities in the later twelfth and early thirteenth centuries. Agresta, in her chapter on water management in Valencia, similarly emphasises healthscaping. Economic, political and health interests sometimes aligned, while at other times, tensions arose, with conflicting claims to the common good. Public health measures often had limited reach and funding, but the city authorities displayed a deep interest in managing water flows, drawing an analogy between canals and the body's arteries, and extending their engagement beyond the city to issues concerning the draining of marshes, rice agriculture, and flax retting. Lucy Barnhouse examines the practices of collective responsibility for environmental resources and their impact on health in three case studies of German cities with relatively weak centralised urban governments. These towns, each with variations, followed a decentralised approach to water infrastructures, including access to bathhouses. These practices are primarily visible in practical documents related to water resources, focusing on access and use.
Lori Jones discusses important adaptations of disease-environment theories in relation to plague in England. While these theories remained rooted in Galenic-Hippocratic environmental medical thinking, she identifies two significant shifts in the perception of plague outbreaks. Firstly, governing and cultural-medical elites associated disease-generating conditions with poverty, particularly in the sixteenth and seventeenth centuries. Itinerant poor were feared as vectors of plague, both in England and France. Secondly, there was a growing belief that plague outbreaks originated from outside Europe, leading to an intense focus on the health of newly claimed colonial territories. The Ottoman Empire and the Turks were often associated with the origins of plague epidemics. In sum, these shifts reflect a form of ‘othering’ against the poor and foreign entities. Cindy Ermus also examines plague, in this case the Plague of Provence in the eighteenth century, discussing the integration of centralisation, militarisation, and local initiatives. She also explores the anti-contagionist debate among medical experts. While the chapter provides valuable insights, a more comprehensive exploration of the continuities in response, even as medical reasoning evolved, would have enhanced the chapter.
Two captivating chapters delve into the African context. Guillaume Linte's research focuses on European travelers’ and traders’ health concerns regarding the so-called torrid zone. Initially associated with the combination of heat and humidity, which were believed to corrupt the humors, the torrid zone gradually became linked to specific health risks, particularly during the rainy season. The link between heat, rain, humidity, fever, and associations with corruption, rot, and worms highlights the intersection of medicine and geography and the attempts to control pathogenic landscapes in colonial environments. Gérard Chouin's chapter offers a highly insightful analysis of the enduring narrative that portrays Africa as a diseased continent. Comparing historical travelers’ reports with biomedical assessments reveals assumptions about potential diseases. For example, instead of attributing afflictions to sexual contact with local women, he suggests that contact with water, including worms, snails, and bacteria, may have been the cause. Chouin argues that premodern Africa was not more burdened by infectious diseases than Europe. Furthermore, the works of Pieter de Marees (1602) and Willem Bosman (1705) confirm the existence of indigenous medical practices and shared herbal knowledge within African societies. Consecrated healers played a vital role in assessing health and maintaining harmony across biological, social, and spiritual realms.
Nukhet Varlik highlights the dangers of a deeply rooted Eurocentric urban perspective in perceptions of plague. She first confirms the growing consensus that plague reservoirs existed within Europe during the Second Pandemic, and then moves on to explore possible reservoirs and changes in their impact on plague epidemics within the Ottoman Empire. Ottoman imperial governance had significant ecological implications due to increased circulation of people and goods. The presence of various potential reservoirs and rodent species in Anatolia, such as jerboas, suggests that the decline in rodent populations during the early modern period could be linked to the waning of plague in the region.
Sharon DeWitte's chapter focuses on the link between living conditions and crisis mortality. Drawing on bioarchaeological research, she examines the synergistic connection between famine and infectious diseases in England. Factors such as climate change, social inequality, and urbanisation contributed to famines and disease outbreaks. Health conditions worsened before the Black Death and improved for a few generations afterward, although conditions deteriorated again during the sixteenth and seventeenth centuries. DeWitte also highlights the influence of migrants on population health, suggesting that the influx of healthy migrants to London following the epidemic contributed to improved survivorship.
The merits of interdisciplinary research clearly come to the foreground in this volume, such as when combining Jones’ insights with Varlik's. While more cross-referencing between chapters would have been beneficial, the book effectively incorporates recent insights and showcases the fruits of adopting a global and interdisciplinary approach to the study of disease and the environment. Finally, covering various regions across the premodern globe remains a challenge. Yet this volume will help and inspire other scholars to undertake the task of filling in the gaps in insights on China, Southeast Asia, and the Americas.
