Public Health in Milan

Public health (salute pubblica) in Renaissance Milan encompassed ideas as well as practices of how to maintain the health of the metaphorical (and physical) body of the community during epidemic and non-epidemic times. The term salute pubblica has a long lineage: it connects to the Roman and Ciceronian origins of the salus publica, and thus to political theories surrounding the preservation and protection of the body politic and the attainment of public wellbeing, the epitome of civic humanism. Salus publica also appears in relation to the term sanitas, which indicates, more prosaically, a state of physical health. The Milanese Health Board, founded in 1534 (supposedly one of the first permanent institutions of this kind) was entrusted, as a state institution, with preserving both salute pubblica and sanitas. It had a very well-organized administrative and pyramidal hierarchical structure. Its functioning relied on specific officials, each of them entrusted with specific tasks. At the top of the pyramid stood a senator and a secretary; at the bottom, the so-called keepers, members of the College of Physicians who were in charge of reporting potential threats to public health to the senator and secretary, and various functionaries, who surveyed urban spaces. Through the help of a clerk, the health board recorded its activities, from official quarantines to the number of deaths, to petitions and court cases. Most importantly, even though its foundation followed a plague epidemic, the health board in Milan did not deal exclusively with epidemic containment measures, but also with more mundane and sometimes environmental questions, such as the management of water, the disposal of organic waste, and the cleanliness of streets and dwellings. The health board’s overall goal was to preserve public good (bene pubblico) and maintain the integrity of the community. It is through an examination of these moments of historical normality, rather than of epidemic emergencies, that we can develop a clear idea of what public health was as a system of everyday practices involving an organic combination of legislative, administrative, and enforcement initiatives.