Health Care and Poor Relief in Counter-Reformation Europe

Jon Arrizabalaga, Andrew Cunningham, Ole Peter Grell

• Publisher: Routledge
• Year: 2005
• eBook ISBN: 9781134684212
• Edition: 1
• Topic: History
• Subtopic: World History
• Index: History

The role of religion was of paramount importance in the change of attitudes and approaches to health care and charity which took place in the centuries following the Council of Trent. Health Care and Poor Relief in Counter-Reformation Europe, examines the effects of the Counter-Reformation on health care and poor relief in Southern Catholic Europe in the period between 1540 and 1700.
As well as a comprehensive introduction discussing issues of the nature of the Catholic or Counter-Reformation and the welfare provisions of the period, Health Care and Poor Relief sets the period in its social, economic, religious and ideological context. The book draws on the practices in different localities in Southern Europe, ranging from the Republic of Venice and the Kingdom of Naples to Germany and Austria. These examples establish how and why a revitalised and strenghtened post-Tridentine Catholic church managed to reshape and reinvigorate welfare provisions in Southern Europe.

1
THE COUNTER-REFORMATION AND WELFARE PROVISION IN SOUTHERN EUROPE

Ole Peter Grell and Andrew Cunningham

This volume offers a comparative survey of the welfare provisions available to the sick and poor in Catholic Southern Europe during the Counter-Reformation period, 1540–1700. It seeks to highlight the relationship between a revived and dynamic Catholicism and welfare reforms on one hand, and the changes in health care, that is ‘professional’ medical care, nursing and hospitals, on the other. It draws attention to the fact that the major context for health care in the early modern period was poor relief and that welfare provision has to be seen within the context of the predominant religious ideology, in this case the Counter-Reformation. Together the thirteen chapters in this volume provide ample examples of how and why a revitalised and strengthened post-Tridentine Catholicism managed to reshape and reinvigorate welfare provisions in Southern Europe, while simultaneously emphasising the extent to which this restructuring depended on, and based itself on, earlier reforms initiated as a consequence of the civic humanist and Catholic reform movements of the fifteenth century.

Geographically this volume deals with the Mediterranean Catholic countries of Italy and Spain, plus Portugal, France and southern Catholic Germany. From the outset the editors sought to include a chapter on Austria, covering the so-called Habsburg inherited lands, in order to achieve the fullest geographical coverage, but since no scholar, to our knowledge, is or has been working in this field recently, this unfortunately proved impossible. The little attention paid to health care and poor relief in the recent social history of Austria further emphasises the lack of scholarly interest in this area.¹

Within these geographical parameters the book will seek to establish how, why, and where, a revitalised and strengthened post-Tridentine Catholic Church managed to reshape and reinvigorate welfare provisions in Southern Europe. The use of the historiographically much debated and contested term ‘Counter-Reformation’ in the title of this volume is deliberate. Rather than opting for terms such as ‘Catholic Reformation’ or ‘Catholic renewal’, the term Counter-Reformation still seems the most appropriate and precise. This is a view which to some extent is borne out by the recent historiographical debate in Germany. Here Catholic historical scholarship, in the wake of the seminal work by H.Jedin, Katholische Reformation oder Gegenreformation?, published in 1946, rather than contesting the term Counter-Reformation has sought to elevate the concept to being on a par with that of the Reformation.² Today it is generally accepted that post-Tridentine reforms to a considerable extent were rooted in earlier moves towards reform generated by humanism and the Catholic reform movements of the fifteenth century. But so was the Reformation. The drive towards reform, reformatio Ecclesiae, had officially been a part of the agenda of the Catholic Church since the days of the Great Schism (1309–1417). These ideas were pursued by the conciliar movement first at the Council of Constance (1414–17) and later at the Council of Basle (1431–49) where a wholesale reform of the papacy as well as of local ecclesiastical forms and structures had been envisaged, but failed to materialise. The general urge and expectation of an immediate renewal of religious life and Christian society, with little hope of being fulfilled from within the Church, gave rise to a number of apocalyptic and millenarian movements in the fifteenth century. They, in turn, served to prepare the way for the evangelical reformers in northern Europe, while inspiring reformist preachers such as the Dominican Girolamo Savonarola in the south. For Savonarola and his followers Florence became the new Jerusalem, where a reform of piety and morals were urgently needed in order to prepare the way for the millenium. Vigorous campaigns against a variety of perceived sins such as gambling and prostitution were initiated, while repeated calls for reforms of the many lay confraternities were issued. But of a far more enduring nature and of considerably greater significance in our context was Savonarola’s contribution to welfare reforms. He was instrumental in creating a system of public health care and poor relief in Florence which brought together existing and newly founded institutions and hospitals, such as the Monte di Pietà, for the benefit of the city’s sick and poor.³

While the Reformation was gathering momentum in northern Europe, where the mendicant orders and the lay confraternities were the prime target for some of the most venemous attacks by the evangelical reformers,⁴ the Catholic Church in Italy showed remarkable vitality, and a considerable number of new religious orders and confraternities were created, from where they later spread to Spain and France. Most, if not all, had their roots in the vibrant urban environment of the large cities of northern and central Italy. It remains somewhat of a paradox to historians why this renewal should have taken place in Italy far away from where the Protestant challenge was strongest, i.e. in Germany, central Europe and the Netherlands. That, however, may well be a typically anachronistic interpretation. It is, in our opinion, far more likely that the evangelical movement in northern Europe in the 1520s was ideologically much closer to the movement for reform in Italy which generated the new religious orders than we realise today, despite the different paths they eventually took. Take, for instance, the Capuchins, who began as a renegade movement within the Franciscan Observant community in Italy, eventually receiving papal recognition in 1528. They sought to renew the spirituality and piety of their Franciscan forefathers and endeared themselves to the urban population of Italy, through their charitable works, especially caring for the sick while preaching the Gospel. At the height of their success from around 1575 to 1650 they, together with the Jesuits, became the standard-bearers of the Counter-Reformation.⁵ However, it is noteworthy that the first Vicar-General of the Capuchins, Bernardino Ochino (1487–1564), became one of the most prominent evangelical Italian reformers when he together with another cleric, Peter Martyr Vermigli, fled Italy for Geneva in 1542.⁶ Thus one of the leading, new religious orders of the Counter-Reformation is intrinsically bound up with the Reformation through its first Vicar-General. Further evidence of how closely interlocked the Reformation and the Counter-Reformation remained until the 1540s can be seen from the fact that Pier Paolo Vergerio (1498–1565), the nuncio sent to Germany to meet Luther in 1535 by the first Counter-Reformation pope, Paul III, eventually followed Ochino and Martyr into exile in 1549 and publicly converted to Protestantism.⁷

Despite the fact that the Capuchins were transformed into an order in the service of the militant Counter-Reformation, especially in Germany, the order continued to distinguish itself in works of charity in Italy in particular, where it played a major role in caring for plague victims. In 1576–77 the Capuchins assisted the great Counter-Reformation bishop Carlo Borromeo in nursing many of the thousands who fell victim to the plague in Milan. Similarly in 1629 when Italy was hit by another major epidemic they stepped in, running charities, providing medical care while comforting the dying: a front-line commitment which saw droves of Capuchins die. However, their involvement in welfare provision was not restricted to periods of epidemics. In many cities they established so-called bottega di Cristo, shops where food and grain was sold to the poor at subsidised prices, or took over the running of the Monti di Pietà which provided cheap loans for the poor.⁸

The new orders and confraternities, such as the Clerks Regular of Somascha founded in Venice by the layman Girolamo Emiliani for the care of orphans in particular, shared certain characteristics. They sought to remedy the ills of the urban society where they emerged, ministering primarily to the poor, destitute women and orphans, not only spiritually but also materially, more often than not promoted by significant lay, noble and patrician patronage. Similar ambitions characterised the new female orders and sisterhoods, such as the Ursulines founded in Brescia in 1535, living in mixed lay-clerical communities or with their families, who concentrated their efforts on hospitals, orphanages and half-way houses for prostitutes. Initially they recruited their members from among artisan and mercantile families in the towns. These women then became patrons of poor and orphaned girls, gradually expanding their charitable work to hospitals and poor and sick women in general. Their active charitable work saved them from the post-Tridentine drive towards enclosure of female orders. The Counter-Reformation Church’s concern with improving the moral standards of the clergy caused it to see the enforcement of clerical celibacy as a central task. Linked to that it came to consider chastity as ranging above all other attributes for female religiosity, something which enclosure, or isolation from the world, sought to guarantee. This also helps to explain the post-Tridentine Church’s obsession with prostitutes as a group in need of a particular and determined effort on the Church’s part in order to possibly save the souls of such women who had squandered their chastity and whose souls were about to be lost.⁹ It is in this context we should see the two new types of religious houses for women or girls established in Rome by Ignatius Loyola—the Santa Marta and the Vergini Miserabili. As opposed to the already well-known nunneries for penitent prostitutes, these institutions offered half-way houses for women wanting to escape prostitution or poor girls who were thought at risk of falling into prostitution (see Chapter 2).

In his opening survey chapter (Chapter 2), Brian Pullan emphasises that the Catholic reform movements remained localized geographically, as well as organisationally until the 1530s, and that only from the 1540s did any central, papally directed reform initiatives materialise. Pullan considers sixteenth-century Catholicism to have been composed of three ingredients, early Catholic reform, the Counter-Reformation, and an older, unreformed folk religion. This latter component appears to be similar to the magical paganism which Jean Delumeau claims characterised medieval Christianity and which Counter-Reformation Catholicism, according to him, sought to obliterate through its attempt to Christianise society.¹⁰ Post-Tridentine Catholicism was, in Pullan’s view, never concerned with tackling poverty per se, but only with poverty as a possible danger to people’s souls. As such, poor relief and welfare provision served as an avenue along which a considerable number of souls might be saved by the Church.

Catholic societies of the 1540s inherited two major welfare institutions created by the Catholic reform movement of the fifteenth century—the general hospital and the Monti di Pietà. These consolidated hospitals provided refuge for pilgrims and care for the sick and orphans. Their re-organisation and centralisation began in northern Italy in the mid-fifteenth century and spread to the rest of the peninsula, France and Spain during the sixteenth century. The Monti di Pietà, cheap loan shops for the poor generally supervised by local clergy and urban administrators, also spread across Italy from the cities in the north, and later to Spain and France, where they set out to impose morality on the process of lending.

Among the other institutions in the welfare domain inherited by Counter-Reformation Catholicism were the relatively new hospitals for incurables, dedicated primarily to the treatment of the pox—a new and frightening disease which had begun to make a dramatic impact from the mid-1490s. Many of these new hospitals for incurables were created by a new and different type of confraternity—the Oratory or Company of Divine Love—which, as opposed to the older confraternities, was not concerned with mutual support, except for the inner spiritual renewal of its members, but geared to serve the local Christian community through charitable work for the sick and poor. It spread rapidly from Genoa, where the first hospital for incurables was founded in 1499, to the other major Italian cities, and it also inspired the creation of other similar lay brotherhoods across Italy, such as the Roman Confraternita della Carita established in 1519, the confraternity of San Girolamo della Carità in Vicenza, and the confraternity of Saints Philip and Paul in Milan.¹¹ All these new confraternities with their new spiritual ethos and social commitment became essential servants of the Counter-Reformation Church, increasingly controlled and directed from Rome. Attending the sick in hospitals became an essential duty in the post-Tridentine Church not primarily for social and medical reasons, but in order to win the struggle for the endangered souls of the poor sick and dying, as Brian Pullan emphasises in Chapter 2.

In Chapter 3, Jonathan Israel claims that the introduction of a new mechanistic and experimental medicine and health care system was delayed by nearly a century in southern Catholic Europe, in Italy, Spain and Portugal in particular, as a consequence of the Counter-Reformation and general economic decline. Economically both Spain and Italy experienced a long and severe decline, beginning at the end of the sixteenth century and continuing until the beginning of the eighteenth century, which affected the major cities in particular, resulting in drastic falls in population sizes and commercial and financial stagnation, if not collapse. Thus the means needed to introduce the new medicine and health care were simply not available in the south. No new and enlarged teaching hospitals were built, nor other facilities such as anatomical theatres, botanical gardens, laboratories and medical museums and collections.

This retardation in medical and health care renewal in the Catholic south was undoubtedly ideologically affected by the Counter-Reformation. In this context it matters less whether this was a direct consequence of Counter-Reformation Catholicism which sought to root out all forms of heresy, or whether it was an indirect intellectual effect of ecclesiastical measures, as claimed by Israel in Chapter 3. Even if the influence in southern Europe of the reorganised and revitalised Roman Inquisition (1542) is still being debated, there can be little doubt it generated a climate of fear. The Church’s discouragement of Catholic students from attending universities in Protestant countries quickly took effect and Italian students stayed at home, while Spanish students only attended good Catholic universities in Italy.¹² Similarly, even if it is still debated how much the creation of the Roman Index of Prohibited Books in 1549 affected cultural life in Italy in particular, it is generally accepted that it had a negative effect especially over time: many books published in Protestant countries were simply not read and discussed by the intellectual elite in the south, while the lack of learned journals meant that an intellectual forum and exchange of new ideas was missing in Italy and Spain.¹³

Four chapters dealing with Counter-Reformation welfare provisions in Tuscany, Venice, Rome and the kingdom of Naples offer detailed examples of how reforms in health care and poor relief were initiated in the major Italian localities.

In his chapter on early modern Tuscany (Chapter 4), John Henderson underlines the fact that there were significant differences between the system of charity in operation in sixteenth century Tuscany as compared with the preceding century. The system may have become more hostile towards the poor and begging, as a consequence of the growing levels of poverty, but that reaction was supplemented by a moral and religious renewal generated by the Catholic Church, which actively sought to combat poverty because of its perceived negative moral consequences. Taking his departure from the many new orders and confraternities which nearly all had a significant lay input, such as the Company of Divine Love and the Ministri degli Infirmi, which came into existence in sixteenth century Italy, and their dedication to the care of the sick and poor, especially those seen to suffer from incurable conditions such as the pox, or the French disease as it became known in Italy, Henderson points towards the religious and moral imperative which lay behind this social involvement, namely the urge to save the souls of those imperiled by destitution and disease. The welfare reforms of the Medici Duke, Cosimo I, centralising and improving the administrative machinery through the appointment of the Buonomini—the twelve good men—served to solve some of the financial problems encountered by some of the major Florentine hospitals in the wake of the siege of the city, but it also served to streamline a system which was coming under increasing strain from the growing numbers of poor. Likewise, the creation of a hostel for abandoned boys in the 1540s may have been brought about by the explosive increase in the number of foundlings taken in by the hospital of the Innocenti, which made it impossible for that institution to cater for older children, but it was the religious rationale, first providing the boys with proper religious instruction and only secondly teaching them a useful trade in order to become God-fearing Christians, which was the driving force behind this scheme. In the second half of the sixteenth century, four conservatories for girls, dedicated to the moral protection, education and training of orphaned young girls, were established by committed lay Florentine Catholics, but supported by the Medicis as well as local clerics. This was a classic example of the Counter-Reformation obsession with female chastity, seeking to prevent young women from falling into prostitution which would endanger their salvation (see Chapter 4).

In Venice the ethos of the ‘new Catholicism’ was making an impact as early as the end of the fifteenth century, when the city leaders began regulating prostitution not only in order to control disease, but also to prevent souls from being endangered. From the start of the sixteenth century the city also benefited from the charitable work for the sick and poor undertaken by the new orders and societies which were motivated by this drive for piety. The Company of Divine Love, with its mixture of laymen and priests, established hospitals for incurables, mainly victims of the pox, during the 1520s, while other new orders such as the Theatines, founded in 1524, and the Somaschi were active in the Republic’s hospitals (see Chapter 5). In Venice this Catholic revival also included the episcopate, which otherwise remained unaffected in most of southern Europe until after Trent. ...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• List of Figures
• List of Contributors
• Acknowledgements
• 1 The Counter-Reformation and Welfare Provision in Southern Europe
• 2 The Counter-Reformation, Medical Care and Poor Relief
• 3 Counter-Reformation, Economic Decline, and the Delayed Impact of the Medical Revolution in Catholic Europe, 1550–1750
• 4 Charity and Welfare in Early Modern Tuscany
• 5 ‘Ad Una Sancta Perfettione’: Health Care and Poor Relief in the Republic of Venice in the Era of the Counter-Reformation
• 6 ‘A Fountain for the Thirsty’ and a Bank for the Pope: Charity, Conflicts, and Medical Careers at the Hospital of Santo Spirito in Seventeenth-Century Rome
• 7 ‘Cradle of Saints and Useful Institutions’: Health Care and Poor Relief in the Kingdom of Naples
• 8 Poor Relief in Counter-Reformation Castile: An Overview
• 9 Health Care and Poor Relief in the Crown of Aragon
• 10 Poor Relief in Counter-Reformation Portugal: The Case of the Misericórdias
• 11 Perspectives on Poor Relief, Health Care and the Counter-Reformation in France
• 12 Health Care and Poor Relief in Regional Southern France in the Counter-Reformation
• 13 Health Care and Poverty Relief in Counter-Reformation Catholic Germany