In her study of the intertwining issues of poverty, poor relief and public health Laurinda Abreu places Portugal firmly within the larger European movement of reform of these sectors in the early modern era. Focusing on the late fifteenth through the seventeenth centuries, Abreu analyses the role of the Portuguese crown in creating and sustaining systematic reforms of poor relief and public health, demonstrating that these were also dynamic strategies in the centralisation of power. Drawing upon her own extensive prior work as well as new research, Abreu weaves together many connecting strands of charity (for prisoners, vagrants, the housebound), health care (epidemic controls, increased numbers of university-trained doctors) and poor relief (the old, infirm and ‘shamefaced’ poor as well as migrants or wanderers), demonstrating the crown’s interest in all aspects of social welfare. The study is divided into two parts, each of which takes a different perspective. Part One, Charity and Poor Relief in Portugal at the Dawn of the Early Modern Period: The Organization and Consolidation of Crown Authority, contains six chapters, while Part Two, Institutions as Social Actors Mediating Between Society, the Authorities and Individuals, contains an additional five chapters. Taken together, these show the Portuguese crown was in step with much of the rest of Europe in promoting welfare reform, although much of it was uniquely accomplished in Portugal through royal patronage of a new lay confraternity, that of the Misericórdia. In the first section, Abreu focuses on the crown’s intervention in charity and health care, examining such movements as hospital reform, the response to epidemics, and the foundation of the misericórdias as key components. She argues throughout for centralization of social systems alongside consolidation of royal power, beginning with the reign of Manuel I (1495–1521) whom she credits with ‘transforming scattered, incomplete initiatives into a coherent, structured system’ (p.4). Key to this consolidation became the establishment in Portugal of the misericórdias, houses of mercy. Lay confraternities sponsored and supported by the crown beginning in 1498, the misericórdias came to play a central role in royal reorganization of charity. These misericórdias helped establish more direct connections between the king and the peripheries where they were established. By the time of Manuel’s death in 1521, 80 misericórdias had been established across Portugal and the numbers continued to increase dramatically over the next century, reaching over 300 by the mid-seventeenth century. In addition to the growing role of the misericórdias, the Portuguese crown further consolidated its power by requiring municipalities to contribute funds towards scholarships for medical students and requiring individuals to contribute wheat to public granaries. Both had the same end goal, to create structure through which to bolster public health and welfare, providing food in times of need and qualified medical practitioners to people in need. These reflect the crown’s growing interest in multiple, intertwining aspects of social welfare and the need to be proactive in providing for citizens. In the second section of her work, Abreu examines several kinds of welfare institutions (or institutions of confinement), focusing principally on recolhimentos (cloistered houses for women which could be voluntary or not), hospitals and prisons. She argues that these institutions, many of which focused on education, moral regulation and social discipline, were part of an overall strategy for ‘resolving or preventing deviant behaviours associated mostly, but not only, with poverty’ (p.4). Abreu notes that over time, the misericórdias gained greater control and oversight power for many of these institutions, especially prisons and hospitals. By 1593, they had gained ‘a near monopoly in formal welfare’ (p.257). Abreu’s study pulls on many different threads of social welfare and health care to offer an argument for greater centralisation in the sixteenth century of both policies and institutions. She offers an interesting overview of the complex factors that both enabled and encouraged the crown to increasingly intervene many aspects of everyday life, which in turn helped shore up and centralise royal power. This work is a welcome addition to studies on early modern poor relief, social welfare and health care, which effectively situates Portuguese policies and structures into the larger sixteenth-century European milieu. © The Author(s) 2018. Published by Oxford University Press on behalf of the Society for the Social History of Medicine. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices)
Social History of Medicine – Oxford University Press
Published: May 10, 2018
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