Leprosy & Charity in Medieval Rouen

9780861933396_67_1_2My review of Elma Brenner’s Leprosy and Charity in Medieval Rouen (Suffolk: Boydell and Brewer, 2015) has just appeared in Insights: Notes from the Coordinating Council for Women in History — but read the review here!

“In her recent monograph, Leprosy and Charity in Medieval Rouen, Elma Brenner, subject specialist in medieval and early modern medicine at the Wellcome Library, examines leprosaria in in medieval Rouen, paying special attention to the tension between the charity that linked leprosaria with their communities and the changing and imprecise notions of disease and contagion that led these communities to distance themselves from lepers. Brenner’s focus on two particular leprosaria, Mont-aux-Malades and Salle-aux-Puelles, both established in the twelfth century, follows the greater availability of documents for these institutions.

Chapters 1 and 2 are devoted exclusively to Mont-aux-Malades, with chapter one focusing on the twelfth century, when Normandy was held by England, and chapter 2 focusing on the thirteenth century, after Normandy’s annexation by the French in 1204. Mont-aux-Maldes enjoyed extensive royal patronage from the English in the twelfth century, including the establishment of an annual fair which financially benefitted both the leper community as well as the English king, and led to the creation of community and connections between lepers and non-lepers (see pp. 29-30). After Normandy traded hands in the thirteenth century, Mont-aux-Malades continued to enjoy aristocratic patronage, simply from the French rather than the English. Brenner suggetsts that high-status patronage demonstrates that charity stemmed from multiple objectives: piety, concern for personal salvation, a sense of responsibility for the needy, and political skill.

But Brenner is concerned with more than just the funding of Rouen’s largest leprosarium: she is also concerned with the community within Mont-aux-Malades. Beginning in the thirteenth century, the community at Mont-aux-Malades was interpreted by contemporaries as consisting of four categories: religious canons, healthy brothers, male lepers, and female lepers (48). Brenner argues that the community organization within the institution was in fact far more complex than this four-part division, although the perception of this organization persisted into the fourteenth century. Brenner notes that there were additionally healthy laywomen at the leprosarium, and — as Brenner argues — these women shouldered a great deal of responsibility for nursing the sick (p. 52). Brenner also points to a number of subcategories, which were primarily based on social class and religious status. Leprous monks and nuns were afforded the highest status within the institution. Lepers of high social status who gave large entrance gifts to Mont-aux-Malades were likewise particularly entitled within the institution. Mont-aux-Malades also provided care to the ‘passing sick,’ or vagrant lepers, who might stay at the institution for only a short time, and had relatively low status. As Brenner argues, these multiple subcategories each had ‘respective entitlements and duties’ (p. 55).

After devoting two chapters exclusively to Rouen’s largest leprosarium, chapter 3 turns to examining Rouen’s other leper houses, with particular focus on Salle-aux-Puelles because of its particularly large and rich number of extant records. Brenner argues that Salle-aux-Puelles is particularly unique as the only all-female leper house in Normandy (although, as Brenner notes, there were contemporary all-female leper houses in England; pp. 59-60). However, the institution only admitted women of aristocratic birth, and it seems that just as at Mont-aux-Malades, high social status was amore salient characteristic than gender. Indeed, at least one of the lepers at Salle-aux-Puelles, Isabel of Avènes, was healthy, although she was perhaps misdiagnosed with tuberculoid leprosy as a child (70-1). Surely both gender and social class were key identity markers of the women living at Salle-aux-Puelles; however, this reviewer wishes Brenner had paid more attention to the social class of its inhabitants — especially after her thorough consideration of the multiple classes and subcategories of patients and inhabitants within Mont-aux-Malades.

Chapter 3 further considers a number of smaller, and in some cases very short-lived, leper houses around Rouen. Brenner shows convincingly that these smaller leper houses had links to each other as well as to Mont-aux-Malades, and that their variety demonstrates the wide range of social statuses of the afflicted. Also key here is the geographical layout of these houses. As Brenner notes, the ‘arrangements made by Rouen parishes and suburban villages resulted in a ring of leprosaria around the city’ (134), a feature not unique to Rouen but also apparent in other medieval cities such as Toulouse and London. Brenner also demonstrates this on a map (unpaginated, facing p. 1). This layout of leprosaria around Rouen reveals the tension between the desire to provide charity and care for lepers with the desire to keep lepers outside of the city — and this is the crux of Brenner’s book.

Chapters 4 and 5 provide wider context for understanding the care of Rouen’s lepers: chapter 4 focuses on the medieval medical world, with particular attention to the medical care provided to lepers, and chapter 5 focuses on Rouen’s religious culture, with particular attention to charity and the material care of lepers. Here Brenner argues (in line with François-Olivier Touati) that understandings of leprosy and contagion did not simply change after the Black Death. Instead, these understandings changed gradually over time, and there was a wide variety of understandings about and attitudes toward leprosy the disease and lepers as persons. Brenner’s treatment of notions of leprosy is particularly judicious. Beyond her simple, yet critical, argument that medieval understandings of disease and contagion were imprecise, Brenner points to other factors that could lead to negative understandings and treatments of lepers, such as their “shocking physical appearance” due to manifestations of the disease (p. 81). This perhaps explains why medieval Normans kept leprosaria outside of their cities — the ‘ring’ effect noted above — but simultaneously attended the annual fairs of Rouen’s largest leprosarium, Mont-aux-Malades. Brenner also time and again notes the porousness of the walls of leprosaria: although people unassociated with leprosaria were supposed to keep out, Brenner provides many examples of non-lepers and non-leprosaria-personnel within the walls of the institutions and interacting with lepers (see pp. 70-2, 74, and 91).

Brenner’s monograph is clear, concise, and tightly argued. Her judicious consideration of understandings of disease and contagion and her explication of the roles of charity are the most important contributions of this work. It is a welcome inclusion in the historiography of disease, health care, and charity in medieval France. Students (both undergraduate and graduate) will find particular benefit from Appendix 2, an annotated bibliography of one hundred sixteen archival sources, mostly charters (pp. 142-81).”

Citation: Kristen C. Howard, review of Elma Brenner, Leprosy and Charity in Medieval Rouen (Woodbridge, Suffolk: The Boydell Press, 2015), in Insights: Notes from the Coordinating Council for Women in History 48, no. 4 (Winter 2017): 18-20.

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