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In the Camp and on the March: Military Manuals as Sources for Studying Premodern Public Health

  • G. Geltner (a1)


Historians tend to view public health as a quintessentially modern phenomenon, enabled by the emergence of representative democracies, centralised bureaucracies and advanced biomedicine. While social, urban and religious historians have begun chipping away at the entrenched dichotomy between pre/modernity that this view implies, evidence for community prophylactics in earlier eras also emerges from a group of somewhat unexpected sources, namely military manuals. Texts composed for (and often by) army leaders in medieval Latin Europe, East Rome (Byzantium) and other premodern civilisations reflect the topicality of population-level preventative healthcare well before the nineteenth century, thereby broadening the path for historicising public health from a transregional and even global perspective. Moreover, at least throughout the Mediterranean world, military manuals also attest the enduring appeal of Hippocratic and Galenic prophylactics and how that medical tradition continued for centuries to shape the routines and material culture of vulnerable communities such as armies.

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For their comments on earlier drafts, bibliographical suggestions and copies of works in progress, I am grateful to Mieke Aerts, Sander Govaerts, John Haldon, Jonathan Harris, Mayke de Jong, Samuël Kruizinga, Piers Mitchell, Carole Rawcliffe, Justin Stearns, James Symonds, Claire Weeda and the journal’s editors and anonymous reviewers. In citing primary sources in translation, the text follows the original text and therefore involves occasional orthographical discrepancies between US and UK English. Funding has been provided by the European Research Council (grant no. 724114) as part of the Premodern Healthscaping Project (



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1. Carl Von Clausewitz, Vom Kriege (Berlin: Dümmlers Verlag, 1832), Book 5, ch. 9. Quoted here from On War, Michael Howard and Peter Paret (trans.) (Princeton: Princeton University Press, 1976), 312–13. Contrary to the author’s implication, however, simple mud and straw huts rather than tents were arguably more common accommodations for soldiers on the move. See Sander Govaerts, ‘Mosasaurs. Armies and their Influence on Ecosystems in the Meuse Region, 1300–1850’ (unpublished PhD dissertation, University of Amsterdam, 2019), ch. 6.

2. See also Von Clausewitz, Vom Kriege, Book 5, ch. 14 (Subsistence).

3. Ibid., Book 5, ch. 12 (322).

4. Ibid., Book 3, ch. 12 (207). According to Richard A. Gabriel and Karen S. Metz, A History of Military Medicine, Vol. 2 (New York: Greenwood Press, 1992), 1:2, ‘Until the twentieth century all armies with few exceptions suffered far more casualties to disease acquired through contaminated food and water than they did on the battlefield’.

5. Peregrine Horden, ‘Regimen and travel in the Mediterranean’, in Renate Schlesier and Ulrike Zellmann (eds), Mobility and Travel in the Mediterranean from Antiquity to the Middle Ages (Münster: LIT Verlag, 2004), 117–31. As Horden shows (129–30), the genres logically overlap in the context of medieval crusading.

6. Key studies include Daniel R. Headrick, The Tools of Empire: Technology and European Imperialism in the Nineteenth Century (New York and Oxford: Oxford University Press, 1981), 58–79; David Arnold, Imperial Medicine and Indigenous Societies (Manchester: Manchester University Press, 1988); Philip D. Curtin, Disease and Empire: The Health of European Troops in the Conquest of Africa (Cambridge: Cambridge University Press, 1998).

7. Examples of the ecological turn in military studies include Alfred W. Crosby, Ecological Imperialism: The Biological Expansion of Europe, 900–1900 (New York: Cambridge University Press, 1986); Esther Blom, et al. (eds), Nature in War: Biodiversity Conservation during Conflicts (Amsterdam: Nederlandse Commissie voor Internationale Natuurbescherming, 2000); Richard P. Tucker and Edmund Russell (eds), Natural Enemy, Natural Ally: Toward an Environmental History of War (Coravallis, OR: Oregon State University Press, 2004); J.R. McNeill, Mosquito Empires: Ecology and War in the Greater Caribbean, 1620–1914 (Cambridge: Cambridge University Press, 2010).

8. Carole Rawcliffe, ‘Sources for the study of public health in the medieval city’, in Joel T. Rosenthal (ed.), Understanding Medieval Primary Sources: Using Historical Sources to Discover Medieval Europe (London: Routledge, 2012), 177–95.

9. An exception here is Lluís Cifuentes and Luis García Ballester, ‘Els professionals sanitaris de la Corona d’Aragó en l’expedició militar a Sardenya de 1354–55’, Arxiu de textos catalans antics, 9 (1990), 183–214. More typical, but for that matter no less accomplished, are several contributions in Larissa Tracy and Kelly DeVries (eds), Wounds and Wound Repair in Medieval Culture (Leiden: Brill, 2015).

10. To offer only a few recent examples dealing with several European regions: Barbara Harvey, Living and Dying in England, 1100–1540: The Monastic Experience (Oxford: Clarendon Press, 1993); Angela Montford, Health, Sickness, Medicine and the Friars in the Thirteenth and Fourteenth Centuries (London and New York: Routledge, 2004); Annemarie Kinzelbach, ‘Infection, Contagion, and Public Health in Late Medieval German Imperial Towns’, Journal of the History of Medicine and Allied Sciences, 61 (2006), 369–89; Kirsty Wilson Bowers, Plague and Public Health in Early Modern Seville (Rochester, NY: University of Rochester Press, 2013); John Henderson, ‘Public health, pollution and the problem of waste disposal in early modern Tuscany’, in Simonetta Cavaciocchi (ed.), Le interazioni fra economia e ambiente biologico nell’Europa preindustriale. Secc. XIII–XVIII (Florence: Firenze University Press, 2010), 373–82; Jane L. Stevens Crawshaw, Plague Hospitals: Public Health for the City in Early Modern Venice (Farnham, Surrey: Ashgate, 2012). For a fuller bibliography, see G. Geltner and Janna Coomans (eds), ‘The History of Public Health in Pre-Industrial Societies: A Bibliography’: (last accessed 26 August 2018).

11. Carole Rawcliffe, Urban Bodies: Communal Health in Late Medieval English Towns and Cities (London: Boydell, 2013). See also Leona J. Skelton, Sanitation in Urban Britain, 1560–1700 (London: Routledge, 2015); G. Geltner, Roads to Health: Infrastructure and Public Wellbeing in Later Medieval Italy (Philadelphia: University of Pennsylvania Press, forthcoming); Janna Coomans, ‘In Pursuit of a Healthy City: Sanitation and the Common Good in the Late Medieval Low Countries’ (unpublished PhD Dissertation, University of Amsterdam, 2018).

12. Agostino Paravicini Bagliani, Il corpo del Papa (Turin: Einaudi, 1994), 257–78. Integrating evidence from military tactics, however, challenges the author’s causal relationship and chronology, even with regard to Italy. See Geltner, Roads to Health.

13. Beatrice Heuser, The Evolution of Strategy: Thinking War from Antiquity to the Present (Cambridge: Cambridge University Press, 2010), 113–70; John Childs, ‘The military revolution I: the transition to modern warfare’ and ‘The Military Revolution II: Eighteenth-Century War’, both in Charles Townsend (ed.), The Oxford History of Modern War (Oxford: Oxford University Press, 2005), 20–40 and 41–54, respectively.

14. See, however, the pioneering work of Piers D. Mitchell, ‘Challenges in the study of health and disease in the crusaders’, in Marina Faerman et al. (eds), Faces from the Past: Diachronic Patterns in the Biology and Health Status of Human Populations of the Eastern Mediterranean, British Archaeological Reports (British Series, 1603) (Oxford: Archaeopress, 2007), 205–12; Piers D. Mitchell, ‘Combining palaeopathological and historical evidence for health in the crusades’, in Martin J. Smith and Megan B. Brickley (eds), Proceedings of the 8th Annual Conference of the British Association for Biological Anthropology and Osteoarchaeology, British Archaeological Reports (International Series, 1743) (Oxford: Archaeopress, 2008), 9–16; and Govaerts, op. cit. (note 1).

15. Conor Whately, ‘The genre and purpose of military manuals in late antiquity’, in Geoffrey Greatrex and Hugh Elton (eds), with the assistance of Lucas McMahon, Shifting Genres in Late Antiquity (Farnham: Ashgate, 2015), 249–61. See also David Whitehead, ‘Fact and Fantasy in Greek Military Writers’, Acta Antiqua Academiae Scientiarum Hungaricae, 48 (2008), 139–55.

16. Medieval Islamic Medicine: Ibn Riḍwān’s Treatise ‘On the Prevention of Bodily Ills in Egypt’, Michael W. Dols (ed.), Adil S. Gamal (trans.), Comparative Studies of Health Systems and Medical Care, 9 (Berkeley and London: University of California Press, 1984); Nancy Siraisi, Medieval and Renaissance Medicine: An Introduction to Knowledge and Practice (Chicago: University of Chicago Press, 1990), 128–30; Dorothy Porter, Health, Civilisation and the State: A History of Public Health from Ancient to Modern Times (London and New York: Routledge, 1999), 9–60; Peter E. Pormann and Emilie Savage-Smith, Medieval Islamic Medicine (Washington, DC: Georgetown University Press, 2007); Jacques Jouanna, ‘Air, miasma and contagion in the time of Hippocrates and the survival of miasmas in post-hippocratic medicine (Rufus of Ephesus, Galen and Palladius)’, in Philip van der Eijk (ed.), Greek Medicine from Hippocrates to Galen. Selected Papers of Jacques Jouanna, Neil Allies (trans.) (Leiden: Brill, 2012), 121–36; Justin K. Stearns, Infectious Ideas: Contagion in Premodern Islamic and Christian Thought in the Western Mediterranean (Baltimore: The Johns Hopkins University Press, 2011); Petros Bouras-Vallianatos and Sophia Xenophontos (eds), Greek Medical Literature and its Readers: From Hippocrates to Islam and Byzantium (Abingdon and New York: Routledge, 2018).

17. See, however, Guido Majno, The Healing Hand: Man and Wound in the Ancient World (Cambridge, MA, and London: Harvard University Press, 1975), 235, 242–43; A.M. Acharya, ‘Military Medicine in Ancient India’, Bulletin of the Indian Institute of History of Medicine, 6 (1963), 50–57; Thomas Cleary, The Japanese Art of War: Understanding the Culture of Strategy (Boston and London: Shambhala, 2005).

18. The same dynamism has been illuminated for other regions. See, for instance, Andrew Edmund Goble, Confluences of Medicine in Medieval Japan: Buddhist Healing, Chinese Knowledge, Islamic Formulas, and Wounds of War (Honolulu: University of Hawaii Press, 2011).

19. Of the two extant military manuals that predate both these texts, I was unable to access Arrian of Nicomedia’s Techne Taktike (136/37 AD), which has not been translated from the Greek into Latin or any other European language; and Aelianus’ second-century Tactics does not deal with any aspect of health or medicine.

20. Onasander, Strategikos8.2, in Aeneas Tacticus, Asclepiodotus and Onasander, ed. and trans. The Illinois Greek Club, Loeb Classical Library 156 (Cambridge, MA: Harvard University Press, 1928), 405.

21. Thousands of crusaders died from non-combat related afflictions according to Piers D. Mitchell, Medicine in the Crusades: Warfare, Wounds and the Medieval Surgeon (Cambridge: Cambridge University Press, 2004), 1–3. For comparable figures in Antiquity, see Nathan Stewart Rosenstein, Rome at War: Farms, Families, and Death in the Middle Republic (Chapel Hill, NC: University of North Carolina Press, 2004), 130–31. For further ramifications, see Friedrich Prinzing, Epidemics Resulting from Wars (Oxford: Clarendon Press, 1916).

22. Hippocrates, Airs Waters Places, VI and VII, in W.H.S. Jones (ed. and trans.), Ancient Medicine, Loeb Classical Library 147 (Cambridge, MA: Harvard University Press, 1923), 83 and 85, respectively.

23. R. Flavius Vegetius, De re militari, M.D. Reeve (ed.) (Oxford: Oxford University Press, 2004), I, xxii (25–26). Translations here and below from Epitome of Military Science, 2nd edn, N.P. Milner (trans.) (Liverpool: Liverpool University Press, 1996).

24. I am leaving aside another relevant form of knowledge, namely military veterinary medicine, which may well have served governments and butchers in establishing whether meat sold on the urban market was spoiled or not.

25. Vegetius, op. cit. (note 23), III, ii (67).

26. Galen, Hygiene, Book 1, ch. 4, Ian Johnston (ed. and trans.), Loeb Classical Library 535 (Cambridge, MA: Harvard University Press, 2018), 11.

27. L.J. Rather, ‘The Six Things Non-Natural: A Note on the Origins and Fate of a Doctrine and a Phrase’, Clio Medica, 3 (1968), 337–47; Luis García-Ballester, ‘On the origins of the six non-natural things in Galen’, in Jutta Kollesch and Diethard Nickel (eds), Galen und das hellenistische Erbe: Verhandlungen des IV. Internationalen Galen-Symposiums veranstaltet vom Institut für Geschichte der Medizin am Bereich Medizin (Charité) der Humboldt-Universität zu Berlin 18.-20. September 1989 (Stuttgart: Steiner, 1993), 105–15. García-Ballester attributes the emergence of a consolidated list to the Alexandrian school of Galenism, and credits its spread with medieval Arabic commentaries.

28. Galen, op. cit. (note 26), Book 1, ch. 5 (15).

29. Noelker, Linda S. and Browdie, Richard, ‘Sidney Katz, MD: A New Paradigm for Chronic Illness and Long-Term Care’, The Gerontologist, 54 (2014), 1320.

30. The literary tradition of military manuals in the Mediterranean world of the early and central Middle Ages seems to have gravitated around Vegetius, among Latin readers, and the Greek treatises examined in the next section, in Byzantine-controlled regions. On the former see the following note and, more broadly, Guy Halsall, Warfare and Society in the Barbarian West, 450–900 (London: Routledge, 2003), 134–62; Bernard S. Bachrach, Early Carolingian Warfare: A Prelude to Empire (Philadelphia: University of Pennsylvania Press, 2001); and Leif Inge Ree Petersen, Siege Warfare and Military Organization in the Successor States (400–800 AD): Byzantium, the West and Islam (Leiden: Brill, 2013), 299–359. As these volumes show, a conservative literary approach did not necessarily mean a lack of adaptation and creativity in practice.

31. Vegetius’ De re militariwas by all accounts a medieval bestseller, with more than 300 extant copies of the Latin text making it perhaps the most widely circulated secular treatise of the era. The status was only reinvigorated by the rise of vernacular languages. See Charles R. Shrader, ‘A Handlist of Extant Manuscripts Containing the De re militari of Flavius Vegetius Renatus’, Scriptorium, 33 (1979), 280–305; Phillipe Richardot, Végèce et la culture militaire au Moyen Âge (Ve-XVe síecles) (Paris: Institut de Stratégie Comparée : Economica, 1998); Phillipe Richardot, ‘L’influence de De re militari de Végèce sur la pensée militaire du XVIe siècle’, Stratégique, 60 (1996), 7–27; Phillipe Richardot, ‘La reception de Végèce au XVIIIe siècle: Turpin de Crissé’, Stratégique, 76 (2000), 17–51; Phillipe Richardot, ‘La tradition moderne du De re militari de Végèce (XVe-XVIIIe siècles)’, in P. Defosse (ed.), Hommages à Carl Deroux, V: Christianisme et Moyen Âge, Néo-latin et survivance de la latinité (Brussels: Latomus, 2003), 537–44; Christopher Allmand, The De Re Militari of Vegetius. The Reception, Transmission and Legacy of a Roman Text in the Middle Ages (Cambridge: Cambridge University Press, 2011).

32. Michael R. McVaugh, ‘Arnald of Villanova’s Regimen Almarie (Regimen Castra Sequentium) and Medieval Military Medicine’, Viator, 23 (1992), 201–14: 207, acknowledges Arnald’s debt to Vegetius, a copy of whose De re militarifurnished his private library, specifically as regards prophylactics.

33. Giovanni da Legnano, Tractatus de bello, de represaliis et de duello, Thomas Erskine Holland (ed.) (Oxford: Oxford University Press for the Carnegie Institution, 1917), ch. 19 (96). See also da Legnano’s elaborate metaphorical use of war as a disease meant to cleanse a society suffering from humoral excesses in ibid., ch. 10 (85–90). The treatise was the basis for yet another key text on the art of war, namely Honoré Bonet’s The Tree of Battles, G.W. Coopland (ed. and trans.) (Liverpool: The University of Liverpool Press, 1949). For the parallel passages, see Book 4.1 and 9 (125–26 and 131–32, respectively).

34. Christine de Pizan, The Book of Deeds of Arms and of Chivalry, 1.14, Charity Cannon Willard (ed.), Sumner Willard (trans.) (University Park, PA: The Pennsylvania State University Press, 1999), 42–43. As the same chapter illustrates, De Pizan, an auto-didact as well as the daughter of a physician and astrologer, was familiar with humoral medicine. While she is hardly unique among medieval women in the latter respect, she remains the only known female author of a military treatise. See also Beatrice Heuser, Strategy before Clausewitz: Linking Warfare and Statecraft (London and New York: Routledge, 2017), ch. 2.

35. [Roberto] Valturio, De re militari, in Umanesimo e arte della guerra tra medioevo e rinascimento (Rimini and Milan: Guaraldi and Y. Press, 2006): ‘De medicina’ I (78).

36. Ibid.: ‘quam si propter locorum discrepantiam terrarumque dissimiles proprietates percipere haud quaquam poterant et phama et incolentium dispositione corporum atque eorum colore facile consequebantur’ (78).

37. Niccolò Machiavelli, I sette libri dell’Arte della guerra (Venice: G. Pasquali, 1769), 219.

38. Ibid., 243.

39. Ibid., 244.

40. A recent discussion on their influence takes place in the notes to John Haldon, A Critical Commentary on The Taktika of Leo VI, Dumbarton Oaks Studies 44 (Washington, DC: Dumbarton Oaks, 2014), 10–22, 31–36, 168–72 and passim.

41. Maurice’sStrategikon: Handbook of Byzantine Military Strategy, George T. Dennis (ed. and trans.) (Philadelphia: University of Pennsylvania Press, 1984), 160.

42. Anonymous, Treatise on Strategy, 10:6–11, 17–18, in George T. Dennis (ed. and trans.), Three Byzantine Military Treatises (Washington, DC: Dumbarton Oaks, 1985), 31. Dennis follows an earlier tendency to date the work to the sixth century, but the more recent consensus has pushed the work two centuries later. See Constantine Zuckerman, ‘The Compendium of Syrianus Magister’, Jahrbuch der Österreichischen Byzantinistik, 40 (1990): 209–24.

43. Constantine Zuckerman, ‘Chapitres peu connus de l’apparatus bellicus’, Travaux et mémoires du Centre de recherches d ’histoire et civilisation de Byzance, 12 (1994), 359–89: 372.

44. In Dennis, Three Byzantine Military Treatises, 159. The anonymous, late tenth-century Treatise on Campaign Organization, 1.49–50 (op. cit. (note 42), 249) also recommends watering horses downstream ‘so the river may be kept clean further up’.

45. The Taktika of Leo, George T. Dennis (ed. and trans.) (Washington, DC: Dumbarton Oaks, 2010), 9.3 (195).

46. Cecaumeno, Raccomandazioni e consigli di un galantuomo [Stratēgikon], Maria Dora Spadaro (ed. and trans.) (Alessandria: Edizioni dell’Orso, 1998), ch. 29 (71).

47. A Tenth-Century Byzantine Military Manual: The Sylloge Tacticorum, Georgios Chatzelis and Jonathan Harris (trans.) (Abingdon and New York: Routledge, 2017), 39.

48. Ibid., 93–97 and 97.

49. European and Ottoman exchanges in the field of military prophylactics lie beyond this essay’s scope, but see Gábor Ágoston, ‘Where Environmental and Frontier Studies Meet: Rivers, Forests, Marshes and Forts along the Ottoman-Hapsburg Frontier in Hungary’, Proceedings of the British Academy, 156 (2009), 57–79. On Ottoman sultans’ manoeuvring of armies to avoid entering plague-afflicted areas, see Nükhet Varlik, Plague and Empire in the Early Modern Mediterranean: The Ottoman Experience, 1347–1600 (New York: Cambridge University Press, 2015), 140–44.

50. Shihab al-Sarraf, ‘Mamluk Furūsı̄yah Literature and Its Antecedents’, Mamluk Studies Review, 8 (2004), 141–200. See also Carole Hillenbrand, The Crusades: Islamic Perspectives (Edinburgh: Edinburgh University Press, 1999), 435–39.

51. Dols op. cit. (note 16); Pormann and Savage-Smith, op. cit. (note 16); Stearns, op. cit. (note 16).

52. Quoted here from Fielding H. Garrison, Notes on the History of Military Medicine (Washington, DC: Association of Military Surgeons, 1922), 82.

53. A Muslim Manual of War, Book 6, ch. 1, George T. Scanlon (ed. and trans.), rev. edn (Cairo and New York: American University in Cairo Press, 2012 [orig. pub. 1961]), 70.

54. Ibid., Book 10, ch. 1 (86–87).

55. Ibid., Book 10, ch. 2 (87–88). For a crossover between military and urban prophylactic insights, as seen through the eyes of one Muslim military leader as he moves from central Asia into India, see The Baburnama: Memoirs of Babur, Prince and Emperor, Wheeler M. Thackston (ed. and trans.) (New York: Modern Library, 2002), 7–8, 25, 56–59, 334–35, 363–65, 397 and 428.

56. The Seven Military Classics of Ancient China, Ralph D. Sawyer (ed. and trans.) with Mei-chün Sawyer (New York: Basic Books, 2007), 173.

57. Ibid., 214–15.

58. Miyamoto Musashi, The Book of Five Rings, Thomas Cleary (trans.) (Boston and London: Shambhala, 2000), 16.

59. Taira Shigesule, Code of the Samurai, Thomas Cleary (trans.) (Tokyo: Tuttle, 1999), 4 and 11, respectively.

60. To offer a final example from the region, among the medieval Mongols, once a soldier’s death was recognised as imminent, his yurt became off limits to all but a limited few, who in turn were prohibited from contacting high-ranking persons. Yurts themselves were placed widely apart, and armies were careful not to foul rivers upstream from their camps by only drawing water in vessels. See Timothy May, The Mongol Art of War: Chinggis Khan and the Mongol Military System (Barnsley: Pen & Sword Books, 2016), 67–68.

61. This is often done more by implication than direct assertion. See, for instance, Anke H. Schultetus, et al., ‘To Heal and to Serve: Military Medical Education Throughout the Centuries’, Journal of the American College of Surgeons, 202 (2006), 1005–16, whose chronological coverage, beginning in the sixteenth century, works within a modernist paradigm of formal education.

62. Civic- and bioarchaeologists working in conflict areas, such as Piers D. Mitchell (see note 14), have pointed the way. See also James Symonds, et al., War and Peasants: An Archaeology of Village Destruction and Abandonment during the Thirty Years’ War in West Bohemia (Oxford: Archaeopress, forthcoming).

63. Gabriel and Metz, op. cit. (note 4), 1:29, 31, 58 (Sumer), 98–99 (Assyria), 110–14 (Israel), 131–32 (India), 165–66 (Rome).

64. Ibid., 1:181. See also ibid., 2:67, which mischaracterises the medical profession of even later centuries as ‘having forgotten the old Roman notion of preventative medicine’, which purportedly explains why ‘few commanders gave much attention to preventing disease and illness on military campaigns’.

65. Ibid., 1:204. Richard A. Gabriel, Man and Wound in the Ancient World: A History of Military Medicine from Sumer to the Fall of Constantinople (Washington, DC: Potomac Books, 2012), 185–204 and 215–17, is a reiteration of the same reductionist image, which also lurks behind Roy J. Shepard, An Illustrated History of Health and Fitness, from Pre-History to our Post-Modern World (New York: Springer, 2015), 307–308. See, by contrast, the somewhat more positive evaluation in Histoire de la médicine aux armées, Vol. 1, Jean Guillermand (gen. ed.) (Paris: Charles Lavauzelle, 1982), 275–81.

66. To offer just a few examples across genres: The Rule, Statutes and Customs of the Hospitallers, 1099–1310, E.J. King (ed. and trans.) (New York: AMS Press, 1981), 42, 47, 57, 77, 127, 169–70; The Rule of the Templars: The French Text of the Order of the Knights Templar, J.M. Upton-Ward (trans.) (Woodbridge, UK, and Rochester, NY: Boydell, 1992); Qustā ibn Lūqā’s Medical Regime for the Pilgrims to Mecca, The Risāla fı̄ tadbı̄r safar al-ḥajj, Gerrit Bos (ed. and trans.), chs. 1, 4, 8, 11, 13 and passim (Leiden: Brill, 1992), 22–27, 38–41, 56–59, 62–67 and 72–79, respectively; Adam of Cremona, Regimen iter agentium vel peregrinantium, in Fritz Hönger (ed.), Ärztliche Verhaltungsmaßregeln auf dem Heerzug ins Heilige Land für Kaiser Friedrich II. Geschrieben von Adam v. Cremona (c.1227) (Leipzig: Robert Noske, 1913); Thomas Aquinas, De regno ad regem Cypri, 1.14 and 2.1, ed. Joseph Kenny (Bismarck, ND: Divine Providence Press, 2014), 100 and 126, respectively. See also Karl Sudhoff, ‘Ärtzliche Regimina für Land- und Seereisen aus dem 15. Jahrhundert’, Archiv für Geschichte der Medizin, 4 (1911), 263–81. Premodern camp life is rarely depicted in detail, certainly as compared to the era’s battles and tournaments. Unique in this respect is Swiss chronicler and illustrator Diebold Schilling the Younger, whose elaborate images of sieges in the Lucerne Chronicle (1511–13) occasionally provide glimpses of non-combat routines, including cooking, washing and intimacy. The entire codex is viewable here: (last accessed 11 May 2018).

67. Cifuentes and García-Ballester, op. cit. (note 9), 193–99, is an object lesson. An early blueprint for illuminating the sophistication of medieval military practices is J.F. Verbruggen, The Art of Warfare in Western Europe during the Middle Ages, 2nd edn, Sumner Willard and Mrs. R.W. Southern (trans.) (London: Boydell, 1997 [orig. pub. 1954]). Verbruggen dedicated several pages to discipline on the march and in the camp (77–83) as well as to the logistics of supplies, including food and equipment (331–38). Yet neither section discusses preventative insights, and the book generally refrains from engaging medicine. Harvé Martin and Marc Russon, Vivre sous la tente au Moyen Âge (Rennes: Ouest-France, 2010), 226–32, provide a brief and generally negative view of military camp hygiene, and generals’ attention to it, on the basis of some images and chronicle descriptions of sieges. Military archaeologists may be well positioned to shed new light on camp hygiene, although excavations of temporary camps are understandably rare. See Dawn Hadley and Julian D. Richards, ‘Viking Torskey: Inside the Great Army’s Winter Camp’, Current Archaeology, 18 (2006), 12–19; Ana Curto, et al., ‘Did Military Orders Influence the General Population Diet? Stable Isotope Analysis from Medieval Tomar, Portugal’, Archaeological and Anthropological Sciences (2018),

68. Caroline Shenton, ‘The Location of the Siege Camp at Berwick-upon-Tweed, 1333’, Archaeologia Aeliana, ser. 5, 29 (2001), 253–55: 254.

69. The Baburnama, op. cit. (note 55), 50. Jonathan Riley-Smith also memorably described crusading armies as monasteries on the move in ‘Crusading as an Act of Love’, History, 65 (1980), 177–92.

70. See notes 10–12 above.

71. Petersen, op. cit. (note 30), 300–7.

72. Godfrey Goodwin, The Janissaries (London: Saqi Books, 1997), 88–90 and 97–100.

73. Alberto Chiappelli, ‘Gli Ordinamenti Sanitari del Comune di Pistoia contro la Pestilenza del 1348’, Archivio Storico Italiano, ser. 4, 20 (1887), 3–24: 23 (IV).

74. William Caferro, ‘Petrarch’s War: Florentine Wages and the Black Death’, Speculum, 88 (2013), 144–65; Jean-Claude Maire Vigueur, Cavaliers et citoyens: guerre, conflits et société dans l’Italie communale, XIIe-XIIIe siècles (Paris: École des haute études et sciences sociales, 2014); Daniele Bortoluzzi, ‘Una città davanti alla guerra. Gestione dell’emergenza e comando dell’esercito a Bologna alla fne del Duecento (1296–1306)’ (unpublished PhD dissertation, Università degli Studi di Firenze and Univesità di Siena, 2018), ch. 2.

75. Janna Coomans, ‘The King of Dirt: Public Health and Sanitation in Late Medieval Ghent’, Urban History (2018),

76. Govaerts, op. cit. (note 1).

77. Michel Foucault, ‘The birth of biopolitics’, in Paul Rabinow (ed.), The Essential Works 1954–1984, Robert Hurley, et al. (trans.), Vol. 1, (New York: The New Press, 1997), 73–79: 73. And see Mitchell Dean, Governmentality: Power and Rule in Modern Society (London: Sage, 1999), 98–112.

78. Iona McCleery, ‘Medical licensing in Late Medieval Portugal’, in Wendy J. Turner and Sarah M. Butler (eds), Medicine and the Law in the Middle Ages (Leiden: Brill, 2014), 196–219; Varlik, op. cit. (note 49); Geltner, op. cit. (note 11).

79. See Kathleen Davis, Periodization and Sovereignty: How Ideas of Feudalism and Secularization Govern the Politics of Time (Philadelphia: University of Pennsylvania Press, 2008).

For their comments on earlier drafts, bibliographical suggestions and copies of works in progress, I am grateful to Mieke Aerts, Sander Govaerts, John Haldon, Jonathan Harris, Mayke de Jong, Samuël Kruizinga, Piers Mitchell, Carole Rawcliffe, Justin Stearns, James Symonds, Claire Weeda and the journal’s editors and anonymous reviewers. In citing primary sources in translation, the text follows the original text and therefore involves occasional orthographical discrepancies between US and UK English. Funding has been provided by the European Research Council (grant no. 724114) as part of the Premodern Healthscaping Project (


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