Public safety, hygiene and disease prevention

Heidi Deneweth

Bruges was a densely populated metropolis by medieval standards, numbering 45,000 inhabitants around 1340 within an area of 430 hectares. When Antwerp took over Bruges’s role in international trade and finance in the late fifteenth century, roughly a third of the population emigrated. All the same, Bruges remained one of the largest cities in the Southern Netherlands in the early modern period, with a population that varied between 25,000 and 38,000 inhabitants. That kind of population density inevitably generated problems in terms of safety, hygiene and health. The authorities could not intervene in citizens’ private lives, but when it came to threats to public safety and health, they imposed mandatory measures, or at the very least issued strongly worded advice. Most of these measures already existed in the late Middle Ages and were merely refined and developed in the early modern period.

security Medieval Bruges comprised a small number of stone buildings along with numerous wooden houses with thatched roofs. Following some major fires, the civic authorities took action in as early as the thirteenth century to improve fire safety. Thatched roofs were banned, but to avoid imposing significant costs on the population, their replacement was only required during renovation or repair work. Wooden houses were gradually replaced with stone ones, although many retained a wooden facade until the seventeenth century. Road safety was not tackled for the first time until around 1500. In a last-ditch attempt to keep the international trading communities in Bruges, they were offered all the facilities they desired, including a guarantee of a more efficient interface between the harbour and market zones. This entailed clearing away obstacles: protruding porches, cellar entrances, benches, shop signs and shutters were banished from the main thoroughfares. Building materials were transferred from quaysides, streets and squares to closed warehouses. Even loose pigs, horses, carts and carriages were dispatched from the public to the private space.

clean water The main problems in terms of hygiene were the water supply, drainage and refuse management. The early medieval settlement had drawn its drinking water from the Reie, which was also able to cope at that time with the limited amount of organic waste deposited in it, which it broke down naturally and carried out to sea. By the thirteenth century, however, industrial and residential activities had reached such a scale in the city that the discharge of sewage water and other waste meant the river water was no longer

Bloedput

Sint-Clara

Carmersstraat

Groot Vierkant

Eekhoutstraat

Ganzenstraat

6 Five pipes brought clean river water from beyond the city’s boundaries to its centre. An inventory of these moerbuizen was drawn up in the sixteenth century to ensure better maintenance. Source: E. Vandevyvere, Watervoorziening te Brugge van de 13de tot de 20ste eeuw (Bruges, 1983). © Heidi Deneweth; plan by Nico Insleghers, Raakvlak.

7 Joost de Damhouder, La practicque et enchiridion des causes criminelles, Leuven, 1554 Stedelijke Openbare Bibliotheek Brugge ‘De Biekorf’, inv. 1228 De dommage par iectement dehors Chamber pots were simply emptied out into the street until the sixteenth century. Rain then washed the sewage into the city’s canals. The civic authorities put an end to this problem by enclosing the drains below the surface of the road and urging people to clean up in front of their own houses.

Boeveriepoort

Koepoort

50m 200m 300m 400m

fit for human consumption. One ingenious solution was to tap the cleaner water upriver and to bring it to the city via lead pipes called moerbuizen. Clean water was taken from the Sint-Baafsvijver as early as the thirteenth century and from the 1380s onward, the external defensive ditches served as a reservoir. Five water mains distributed clean water from Boeveriepoort, Carmersstraat, Ganzenstraat, Bloedput (at the end of Beenhouwers-

straat) and Koepoort (near the Begijnhof) to the surrounding districts (Fig. 6). Only the richest townspeople and significant industrial complexes such as breweries enjoyed private connections to these systems. The majority of the population took their water from stedefonteinen: large, public wells connected to the moerbuizen. These were, however, vulnerable to accidental or deliberate contamination. For health reasons and to ensure the continued existence of an efficient water supply, the city closed the pipes once a year so that the wells could be emptied to allow easier cleaning and maintenance. Mechanical pumps were too vulnerable to frost and were an easy target for children and vandals, and so public wells were not fitted with them until the latter half of the eighteenth century.

miasmas The problem of refuse management was a bigger one. Bruges’s streets sloped down toward centrally located channels that served as open sewers. Householders emptied their chamber pots into them from their upper windows (Fig. 7). Offal, manure, rubble and other refuse was dropped by passing carts. Waste water from houses and stables was channelled directly into the open drains running along the street. Rainwater dripped directly onto the road from the protruding gutters above, further spreading the filth around. Heavy showers would wash most of the refuse away into the city’s canals. Plots adjacent to a wa

7

tercourse could discharge their waste water and even their toilets directly into it. All the refuse in the street attracted loose pigs, dogs and vermin, made the stones slippery and hindered pedestrians and traffic. The refuse that wound up in the canals was only partially carried away: much of it accumulated, forming a hindrance to water traffic.

Worse still was the stench emitted by all that fermenting garbage. Hippocrates had noted the link between fevers and stinking vapours or ‘miasmas’ as far back as antiquity. All manner of evils were ascribed to them until the second half of the nineteenth century, when the true causes of infectious diseases (viruses, bacteria and parasites) were discovered. The civic authorities introduced measures in the late Middle Ages to limit these miasmas as much as possible by keeping streets and waterways clean and optimizing road safety, mobility and hygiene. Intervention occurred at a number of levels: municipal cleaning, raising citizens’ awareness and combating waste.

The channels running along streets were set into the road surface or covered with special stones. Downpipes were added to roof gutters and – like other waste pipes – connected to this system underground. The combination of drains and rainwater pipes guaranteed an effective flow. Citizens were required to install finely meshed filters in their home drains to prevent large pieces of rubbish from entering and blocking the system. The same applied, incidentally, to toilets and drains emptying directly into the canals. Street drains followed the natural slope of the land, leading from several streets via collectors and large, brick-built sewers into the canals. Structures of this kind were recently uncovered during excavations at Verversdijk and the Prinsenhof (Fig. 8). Marked cover stones were installed in the collectors and large sewers in the sixteenth century so that local residents could, when necessary, perform cleaning work and ensure a smooth flow. The canals thus continued to serve as they had in the past as the main sewers. To prevent or restrict miasmas, the water was completely drained once a year or twice in the event of a heat wave. The sluices on the Minnewater were kept closed and those at Dampoort opened, allowing the water to flow to the sea. The owners of the adjoining land were required to clean the canal bed level with their homes and have the dirt taken away – a system that remained in force until the end of the eighteenth century.

Separate waste collection existed as early as the fourteenth century: building waste and rubble, for instance, were recycled as filler for public works. Muederaers, meanwhile, transported organic waste to dung heaps by the city walls, where gardeners and farmers could collect it for use as fertilizer. Preventive action also began to be taken around 1500 to deal with the growing volume of waste. The council ordered all citizens to clean their stretch of road each week and to take the rubbish to the municipal refuse heap. Illegal dumping and failure to clean up were severely punished. Fishmongers, butchers and surgeons were obliged to set aside the blood from slaughtered animals and patients who had been bled, so that it could be collected on a regular basis. To avoid losing any of their cargo, the carters had to cover their loads and to proceed carefully to the ‘blood pit’ at the end of Beenhouwersstraat, where they could then dump it all.

The general measures in terms of safety and hygiene dated from the late Middle Ages and were perfected around 1500, the primary goal being to accommodate the international merchant communities. So it was that Bruges came to be praised by foreigners in the sixteenth century as the model of an early Renaissance city, with wide and clean streets.

specific measures for epidemics Large cities were vulnerable to infectious diseases and epidemics: it remained unclear how diseases arose and how they spread was also frequently unknown. Civic authorities in the early modern era exchanged information about the first cases of potentially infectious diseases, so they could take timely precautions. They played an important preventive role by informing the public, quarantining the sick, eliminating potential spreaders of disease and taking additional hygiene precautions. Traders and travellers from infected cities, for instance, were denied entry at the city gates. For their part, Bruges people were summoned by the ringing of the bell to the Belfort, where they were notified about the impending epidemic. That enabled them to take the necessary steps and to remain extremely vigilant about the onset of symptoms among relatives or neighbours.

The Camer van Ghesontheyt (‘Health Chamber’) was founded in 1603, following several outbreaks of plague in the late sixteenth century. In it, three magistrates, the municipal physician and the municipal surgeon coordinated all the tasks and supervised all health workers during periods of epidemic. Plague victims had to carry white rods when travelling, although in principle quarantine was compulsory. Infected houses were indicated by two crossed rods. To combat infection, bodies were collected at night and buried, following which the house was thoroughly cleaned. The deceased’s possessions had to be destroyed. Even the cesspools of houses struck by plague were specially cleaned before the building could be reoccupied. More information about the rode meesters and the treatment of plague victims can be found in A. Clarysse’s article in this book.

During plague outbreaks and other epidemics too, the city appointed dog-catchers to round up and kill strays, which were viewed as possible carriers of the disease. Livestock trading was temporarily suspended and food was carefully screened too. Both unripe and overripe fruit and vegetables could not be brought into the city.

It was not until the nineteenth century that knowledge of pathogens and the transmission

of disease increased substantially. Early modern people did not know about viruses or bacteria, but they knew through observation how certain infections spread. In the eighteenth century the Austrian Habsburg rulers introduced additional, centralized measures to combat the spread of epidemics by means of more stringent quarantine measures and the provision of clear information. A national system of health care only arose in the nineteenth century, following fresh ravages inflicted by epidemics of typhoid (1846–48) and cholera (1849). 8 Large, brick sewers carried wastewater from the street drains via collectors into the canals, which continued to function as the main sewage system. Archaeologists have excavated a well-preserved sewer on the Prinsenhof site, which was also known from written sources, namely a sixteenth-century inventory of Bruges’s sewers (photograph: Raakvlak).