Chapter 4 - Medical Care and Public Health

Summary

That the doctor is obligated to remind the sick in danger of dying that they confess and take the sacraments of the Church so that the hospital is administered according to God.

—Regulation for Doctor Employed in Santa Maria's Hospital (1455)

In the name of our Lord Jesus Christ, the Most Blessed Virgin Mary, Saints Mark, Liberale, Prosdocimo, Sebastian, Roch and all the saints. These are the regulations proclaimed for the preservation and health of the city of Treviso by me Francesco Rolandello chancellor of the commune of Treviso.

—Preamble to Lazzaretto Statutes of Treviso (1486)

Both the confraternity of the Battuti and the communal government identified the health and prosperity of their citizens as a common good. The Battuti provided medical treatment and supported public health policies as an extension of its charitable activities, which closely associated the care of the body with care for the soul. A home to orphans, a hostel to pilgrims, and a refuge for the sick and the poor, the hospital gradually developed an elaborate system of health care, ranging from routine bathing to complex surgical procedures. During the course of the fifteenth century the medical services and specialty care, such as for the insane, coalesced into a well-organized and well-staffed centralized system that the confraternity administered on behalf of the whole community. While the medical staff fought to preserve life, one of the most virulent diseases ever to attack humanity reemerged in Europe. The bubonic plague (in combination with other diseases) periodically ravaged communities on an unprecedented scale, eliciting increased government oversight of health-care providers and of public life in an effort to prevent disruption of lives and trade.

Northern and central Italy had some of the earliest communal doctors and hospitals in Europe. During the later Middle Ages, increased urbanization and changes in piety encouraged the growth of hospitals. As Katherine Park explains, “It is in the two centuries after 1300 that we see the emergence to preeminence of hospitals dedicated largely or exclusively to caring for the sick, and thus of hospitals with a large and growing demand for medical services.” A similar pattern developed in Treviso, where almost twenty medieval hospitals and hospices were consolidated or abandoned as new, larger institutions took their place. Medieval support of hospitals typically centered around monastic institutions and the crusading orders, two of the most powerful and omnipresent institutions in all of Europe.