European Health and Social Welfare Policies

Laurinda Abreu (Ed.)

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 European Health and
Social Welfare Policies

Laurinda Abreu (Ed.)

3
Copyright © 2004 by the Compostela Group of Universities and the PhoenixTN, European
Thematic Network on Health and Social Welfare Policies

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system
or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or
otherwise, without the prior written permission of the publisher.

ISBN 84–607–3621–X

Prepared in cooperation with the Brno University of Technology/ VUTIUM Press

Printed by Reprocentrum, Blansko, Czech Republic

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Table of Contents

PREFACE OF THE SERIES EDITOR ................................................................................... 9

INTRODUCTION ............................................................................................................ 10
ABOUT THE AUTHORS ................................................................................................. 15

SECTION 1
HEALTH BETWEEN SELF-HELP, INFORMAL AND FORMAL INSTITUTIONS ........ 21

A History of Poverty and Poor Relief: Contributions from Research on the Early
Modern Period and the Late Middle Ages and Examples
from More Recent History ........................................................................................... 23
Martin Dinges

Poverty as a Resource of Territorial Power: The Case of Late Medieval Geldern ..... 51
Kay Peter Jankrift

Organizing Poor Relief and Health Care: The Specificity of the Portuguese Case
(16th!18th Centuries) ................................................................................................... 60
Laurinda Abreu

Medicine, Philanthropy and the State: The 1817–19 Fever Epidemic in Ireland ....... 81
Laurence M. Geary

The Introduction of a School Health Service in Stuttgart, 1904 ............................... 100

Sylvelyn Hähner-Rombach

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Table of Contents

The Development of School Health Services in Austria .......................................... 119

Martina Gamper

SECTION 2
SOCIAL WELFARE POLICY AND CHANGES IN THE HEALTH
OF THE P OPULATION ........................................................................................ 131

Health and Social Transitions: The Need for Comparative and Multidisciplinary
Knowledge ................................................................................................................ 136
Jan Sundin and Sam Willner

Lisbon in the Last Two Centuries: An Example of the Difficult Relations between
Urban Growth, Migration and Death ........................................................................ 169
Teresa Rodrigues Veiga and Maria João Guardado Moreira

Health and Living Standards in Portugal in the Early Twentieth Century ............... 183
Joaquim da Costa Leite

The Health of the Population and Health Policy in 19th-century Bohemia:

The Case of Asiatic Cholera (1830s1900s) ............................................................ 200
Petr Svobodný

A Persistent Regional Mortality Pattern in Sweden during the Industrial Age ........ 216
Sam Willner

Increasing Mortality Inequalities in Hungary ........................................................... 252

Janos Sandor and Mária Szucs

The State of Health in the Basque Autonomous Community: Future Strategies ...... 262
Emma Sobremonte

SECTION 3
INNOVATION IN HEALTH POLICIES AND THE INSTITUTIONAL LEVEL ............. 271

Charity Practices in the Portuguese Brotherhoods of Misericórdias

(16th!18th Centuries) ................................................................................................. 277
Maria Marta Lobo de Araújo

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 Table of Contents

Public Health and Poor-relief in the British-Mediterranean Colonial Context,

1800•1860s .............................................................................................................. 297
John Chircop

Mixed Motives: Improving the Health of Seamen in Liverpool 1875•1939 ............ 321
Sally Sheard

The Minor in Medical Care ...................................................................................... 337

Pilar León Sanz

French Cities and the Origins of Medical and Social Policy: Late 19th•20th Century
France ....................................................................................................................... 360
Patrice Bourdelais and Yankel Fijalkow

Public Hygiene as a General Concern in an Industrial 19th-century Town: Seraing... 374

Suzy Pasleau

Science, Institutions and Legislation: Aspects of the History of Public Health

and the State in Norway ............................................................................................ 414
Kari Tove Elvbakken

Sanitary Normalization in Portugal: Pharmacies, Pharmacopoeias, Medicines and

Pharmaceutical Practices (19th•20th Centuries) ........................................................ 434
João Rui Pita

SECTION 4
CHOICES OF WELFARE POLICIES AND THEIR CONSEQUENCES:
LOCAL AND REGIONAL ENVIRONMENTAL HEALTH EFFECTS ......................... 455

A Hard Row to Plough: A Historical Overview of Health Policy Dynamics

in Hungary.................................................................................................................. 458
Bence Döbrössy and Péter Molnár

The NHS Plan: A Healthy Rhetoric, But So Far an Unhealthy Reality .................... 485
Tony Warne, David Skidmore, Susan McAndrew

Community Medicine and Primary Health Care in Norway:

Competitors or Parts of an Entity? ............................................................................ 494
Øivind Larsen

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Organizing Poor Relief and Health Care:
The Specificity of the Portuguese Case
(16th•18th Centuries)

Laurinda Abreu (University of Évora, Portugal)

Introduction
One of the most outstanding characteristics of the Portuguese health and welfare
system was the maintenance of a model that started to be outlined at the end of the
fifteenth century and was kept without major changes for another three hundred years.
Although it had been established in the values of reformed Catholicism, it developed its
own specificities that made it stand out from the other models followed in Catholic
Europe. In this text I intend to present an overview of the main phases of the
construction of this process, trying to highlight how political choices, both in agreement
and in direct confrontation with the ecclesiastical authorities, shaped it.

The poor relief and health care reform mechanisms in the early
modern ages: the establishment of the Misericórdias
The effective reorganization of poor relief for the population in Portugal dates back
to 1479 when, accompanying the hospital consolidation that was being made in the
majority of European states,1 the future King D. João II obtained Papal authorization to

1
Fundamental studies on the subject: Michel Mollat, Études sur l´histoire de la pauvreté (Moyen Age-
XVIe siécle), Paris, 1974 and Les Pauvres au Moyen Age, Paris, 1978; Jean Pierre Gutton, La société et
les pauvres. L!exemple de la généralité de Lyon, 1534!1789, Paris, 1971; Michel Cavillac, Pícaros y
mercaderes en el Guzmán de Alfarache. Reformismo burgués y mentalidad aristocrática en la España
del Siglo de Oro, Granada, 1994; Bronislaw Geremek, A Piedade e a Forca - História da Miséria e da
Caridade na Europa, Lisboa, 1995; Sandra Cavallo, Charity and Power in Early Modern Italy.
Benefactors and their Motives in Turin, 1541!1789, Cambridge, 1995; Robert Jütte, Poverty and

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 Organizing Poor Relief and Health Care:
The Specificity of the Portuguese Case (16th•18th Centuries)

establish the Hospital Real de Todos os Santos in Lisbon, the first of the General
Hospitals created to replace the dispersed and decadent health care institutions which had
been founded by private devotion in the late Middle Ages.2 However, it would be King D.
Manuel I (1495•1521) who, in the context of an extensive programme of measures for the
centralization of political power, would intervene in a systematic way in poor relief
mechanisms, creating the foundations of the Portuguese public welfare system.

With the aim of responding to the needs of a growing population, devastated by

poverty and, consequently, by beggary, vagrancy and overpopulation in the prisons, the
monarchy oriented its social politics towards very concrete objectives. In order to
optimize the results, specific sectors of the needy were targeted, at least in theory, and
the responsibilities were divided among the civil society.3 For the first time, for
example, abandoned children had their right to assistance institutionalized by the new
code of laws, the Ordenações Manuelinas, which stated that, in the absence of the
children•s parents and relatives, they should be cared for, in order of priority, by the
local hospitals, the municipalities and the Misericórdia confraternities.4

But the sick, the prisoners and the poor were the main targets of D. Manuel•s
welfare policies. With regard to the first, and continuing the hospital reform previously
begun by D. João II, in 1499 D. Manuel ordered a general evaluation of the conditions
of all pious institutions, which included hospital and charitable institutions.5 The Crown
officials who were in charge of this task were to embark on an inventory of the
institutions• patrimony, analyzing the effective accomplishment of the testamentary
conditions imposed by the benefactors and punishing transgressors.6 Two years later,

Deviance in Early Modern Europe, 2nd ed., Cambridge, 1996; Ole Peter Grell, Andrew Cunningham,
Jon Arrizabalaga, (eds.), Health Care and Poor Relief in Counter-Reformation Europe, London, 1999.
2
Published by António Domingues de Sousa Costa, !Hospitais e albergarias na documentação pontifícia da
segunda metade do século XV", A Pobreza e a Assistência aos pobres na Península Ibérica durante a Idade
Média, Actas das 1ªs Jornadas Luso-Espanholas de História Medieval, Lisboa, 1972, I, pp. 259•327.
3
See our text !A especificidade do sistema de assistência pública português: linhas estruturantes" in the
Revista Arquipélago-história, volume VI (2002), pp. 417•434.
4
The Portuguese bibliography on this theme is endless. Among the main works, the following books are
highlighted: Isabel dos Guimarães Sá, A circulação de crianças na Europa do Sul : o exemplo da Casa
da Roda do Porto no século XVIII, Lisboa, 1995; Maria de Fátima Reis, Os expostos em Santarém.
A acção social da Misericórdia (1691•1701), Lisboa, 2001.
5
IAN/TT, Chancelaria de D. Manuel I, livro 14, fl. 78.
6
IAN/TT, Chancelaria de D. Manuel I, livro 1, fls. 4v•5.

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Laurinda Abreu

the movement towards hospital centralization, until then restricted to the bigger urban
centres, started to extend to smaller places. In a large number of cases it was the local
Hospital do Espírito Santo • which belonged to the most important medieval
confraternity, that of Espírito Santo, which was administered by the urban elites • that
received the attributions and incomes from the individual institutions that disappeared.

This patrimonial and administrative transfer and, consequently, hospital

reorganization, which was followed by significant developments in recruiting new
managers and health care professionals, seems to have proceeded quite peacefully.
There were two main reasons for this. On the one hand, the hospital reforms answered
to a popular desire, expressed by representatives in the 1498 Cortes. On the other hand,
the royal intervention was based on the defence of the memories of the deceased, which
made it easily acceptable. In fact, according to the civil laws, pious institutions that
were not run according to their founders• rules should have been incorporated into
Crown property, then handed over to whoever respected the wishes of the dead. And as
the royal inquiry showed, quite soon the interests of the living who managed the pious
institutes had become more important than the wishes of the dead.7

In the same year that the hospital survey was carried out, other emissaries left the
Court with a very specific aim: to convince the urban municipalities and the local elites
to establish confraternities of Santa Casa da Misericórdia in their communities.8

The first Misericórdia confraternity had been created the previous year (15 August
1498) in Lisbon, under royal protection • at the time, that of Queen D. Leonor, sister
and representative of D. Manuel, who was absent from the kingdom • and with the
support and involvement of the Court nobles. Presented as a charitable confraternity, the
Misericórdia•s statutes foresaw the relief of all human needs, both spiritual and
corporal, under the designation of the •fourteen works of mercy• • seven spiritual (to
instruct the ignorant; to give good advice; to punish those who make mistakes with
mercy; to comfort the afflicted; to forgive insults; to bear wrongs patiently; to pray to
God for the living and the dead) and seven corporal (to ransom captives and visit

7
Cf. Paulo Drumond Braga, •A crise dos estabelecimentos de assistência aos pobres nos finais da Idade
Média•, Revista Portuguesa de História, vol. 26, Coimbra, 1991, pp. 175•190.
8
José Justino de Andrade e Silva, Collecção chronológica da legislação portuguesa, (1613•1619),
Lisboa, 1854, p. 318.

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 Organizing Poor Relief and Health Care:
The Specificity of the Portuguese Case (16th•18th Centuries)

prisoners; to cure the sick; to clothe the naked; to feed the hungry; to give drink to the
thirsty; to lodge pilgrims; to bury the dead).

Although the early years of the Misericórdias still remain unclear, it seems that they
were open to a broad section of society,9 even though only a part of them could be
effective members • the confreres, who were supposed to represent the nobles and the
non-nobles (termed •officials•) in equal numbers. According to the statutes, the
confreres should be men, of pure blood,10 who enjoyed a good financial position and did
not perform manual work. The Misericórdia was managed by a committee of thirteen
people, elected indirectly within the confraternity, which was called •The Table•
(Mesa). This council consisted of the purveyor • a titled noble or one who had the
equivalent of noble status • six noble representatives and six •official• representatives;
one of them assumed the functions of clerk, another of treasurer and the others shared
the control and exercise of charitable and administrative tasks between them. The
council of thirteen had effective power inside the institution.

The strong royal effort to spread the Misericórdias throughout the whole country had
two main aims: to promote, on a national scale and in a uniform way, relief for prisoners
and the control of beggars, and to encourage the involvement of the municipal oligarchies
in health- care and welfare issues. Actually, although the Misericórdias! statutes laid
emphasis on the fourteen works of mercy, they also made it very clear that the
confraternities! priority was to help poor, deprived prisoners in terms of judicial support
for their release, meals and medical care. So as to achieve this, the first privileges given by
the king to the Lisbon Misericórdia allowed the confreres to visit the prisoners and clean
the jails and facilitated them in their work to free the prisoners. These privileges were
given to each new Misericórdia that sprung up and accompanied its statutes, which were
copied from the Lisbon example, but they were nevertheless adapted to local conditions.

The competences regarding the beggars granted to the Misericórdias by the

provision of 8 July 1503 made them responsible for the distinction between true and

9
It is yet to be proved if the situation registered in the first book of the confreres of the Évora
Misericórdia, saying that people from all social levels, including slaves, could be admitted as confreres,
was observed in other Misericórdias, or if it was an isolated case. (Cf. Arquivo Distrital de Évora,
Registo de Irmãos da Misericórdia, 1499•1540, livro 49).
10
On the restrictions concerning Moorish and Jewish blood, see Isabel Mendes Drumond Braga, •Poor
Relief in Counter-Reformation Portugal•, in Health Care and Poor Relief in Counter-Reformation
Europe, p. 204.

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false poverty. From then on, only the Misericórdias were allowed to examine the poor,
distinguishing between the •undeserving• and the •deserving• • •the crippled, the weak
and the elderly with no means of self subsistence•. Only the latter were entitled to a
beggar•s licence.11

The involvement of the local elites was facilitated through the attribution of a
special status to the Misericórdias. This was a process that had the direct support of the
monarch, through privileges and benefits granted to the Misericórdias but also through
the attribution of some functions that had a symbolic capital that made them more
socially appealing. This applied particularly to the rituals that were connected to
assistance work and also to those where the confraternity was exposed to the public.12
As they were responsible for the burials of those condemned to death, the first official
public appearance of many Misericórdias was a solemn procession that, •with the coffin
raised•,13 went to the gallows to collect the skeletons of the executed and bury them.
Also very important for symbolic reasons was the fact that the confreres, especially
those of higher social standing, assumed the role of the poor for brief periods, collecting
alms that were later distributed among the real poor.

D. Manuel•s aims were gradually achieved and the Misericórdias started to attain
their place in society. From early on, participation in their governing body meant social
prestige and, in some cases, social ascendancy, the first step towards the municipal
council. For different reasons, the Misericórdias and the municipal councils became the
two main pillars of local power.

In fact the link between the Misericórdias and the municipal councils is a feature
that is present from the beginning and one that would definitely bind the destinations of
the two institutions • not only because the royal letters that contained the appeal for the
creation of the Misericórdias had been read in the municipal councils, being a direct
summons to the representatives of the civil society, but also because D. Manuel
exempted the Misericórdias• board members from some communitarian obligations and
fiscal charges, an honour that placed them above all institutions of the same type and

11
Cf. Fernando Calapez Corrêa, Elementos para a História da Misericórdia de Lagos, Lagos, 1998, p. 183.
12
On the importance of this theme, see Isabel dos Guimarães Sá, As Misericórdias Portuguesas de
D. Manuel I a Pombal, Lisboa, 2001, pp. 81•103.
13
Eurico Gama, A Santa Casa da Misericórdia de Elvas, Coimbra, 1954, p. 21.

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The Specificity of the Portuguese Case (16th•18th Centuries)

made them identical to the municipal councils. But it is important to emphasize that,
notwithstanding the fact that the individuals in question might be the same, the
Misericórdias were never under municipal control.

It is also important to mention that, although royal investment in the Misericórdias

was contemporaneous with the hospital reorganization, the king did not hand the
hospitals over to these confraternities. Indeed, the welfare system created by D. Manuel
I was based on a division between medical care and poor relief. In the system devised
by the king, taking care of the hospitals demanded specialized work that involved
employing medical professionals and organizing administrative matters, features that
were not compatible with institutions that had been planned to administer feelings and
affections. Owing to this, •devotion and alms• were enough. The devotion and alms of
the Misericórdias• confreres, of course, were strengthened by the general population,
who were now encouraged to give donations to the new confraternities, to whom the
king had granted a monopoly of alms in the geographical areas to which they belonged.
In this respect, the acquisition of properties was not considered a priority but rather
counterproductive, as the king indicated when he refused to annex the incomes of some
pious legacies to the Coimbra Misericórdia.14

To sum up, there is no doubt that the welfare reforms made by D. Manuel I followed
two distinct but complementary patterns. He tried to revitalize what the Middle Ages
knew as •the spirituality of beneficence•,15 guiding the religiousness of laymen towards
the Misericórdias, institutions created within the spirit of early Catholic Reform. On the
other hand, he continued the reorganization of hospital assistance, trying to face the
social problems of a society that was in the process of transformation. It was, in both
cases, a nationwide intervention, one that attempted to establish a standard in the area of
welfare, at the same time making communities and municipal lay elites responsible for
their poor.16

14
António de Oliveira, •A Santa Casa da Misericórdia de Coimbra no contexto das instituições
congéneres•, in Memórias da Misericórdia de Coimbra • Documentação Arte, Coimbra, 2000, p. 28.
15
André Vauchez, La spiritualité du Moyen Age occidental, VIII-XIII siècle, Paris, 1994, p. 118.
16
As can be concluded by the publication of the Regimento de como os contadores das comarcas hã de
prover sobre as capellas, ospitaes, albergarias, cõfrarias, gafarias, obras, terças e residos, of 1514.

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Laurinda Abreu

The Counter-Reformation and the reinforcement of the

Misericórdias’ competences
The second phase of the construction process of the Portuguese welfare system,
although it continued along the main lines defined at the beginning of the century, was
strongly moulded by the influence of the Counter-Reformation. This was a relatively
short period, in which Rome made various interventions in order to give the Church a
bigger lead where poor relief issues were concerned.

Politically it corresponded to the final years of the reign of D. João III, responsible
for the introduction of the Inquisition into Portugal (1536), the start of the Censorship
and the arrival of the Jesuits (1540),17 and to the political sphere of D. Henrique
(1557!1580), who accumulated the functions of Regent and King along with those of
General-Inquisitor (1539), Cardinal (1545), Pontifical Legate (1553) and Archbishop of
Lisbon (1564). This circumstance helps to explain the fact that the decrees of the
Council of Trent were immediately and integrally approved as state laws ! by the royal
provision of 24 November 1564 ! which resulted in a reinforcement of the authority
of the Church over the state, which was acknowledged and accepted by the provision of
2 March 1568 that, among other decisions, widened the aid granted to the ecclesiastical
courts by the secular courts.18 This was a unique period in terms of joint interests and
shared positions between the ecclesiastical and secular spheres (though some friction
did exist),19 and one that would never be repeated in the history of the relations between
Portugal and the Apostolic See.

The first sign of the renewed interest with which Rome faced welfare questions
came in a Papal brief of 20 August 1545, in which Paul III authorized the Hospital Real
de Todos os Santos to collect all the pious legacies instituted in Lisbon and its outskirts
that had not been fulfilled according to the conditions laid down by those who had
bequeathed them, and to use them for the sick.20 Nevertheless, it was the indulgences

17
King D. João III was also responsible for a new hospital survey and for legislative measures in order to
expel non-native beggars from the communities.
18
Marcello Caetano, "Recepção e Execução dos Decretos do Concílio de Trento em Portugal, Revista da
Faculdade de Direito da Universidade de Lisboa, 1965, 19, pp. 7!52.
19
Cf. José Pedro Paiva, "A Igreja e o poder#, História Religiosa de Portugal, dir. Carlos Moreira Azevedo,
Rio de Mouro, vol. 2, 2000, p. 150.
20
Abílio Augusto Monteiro, Direito Portuguez sobre Legados Pios, Porto, 1879, pp. 36!37.

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The Specificity of the Portuguese Case (16th•18th Centuries)

that were sent from Rome to the Misericórdias after 1546 that would be the main proof
of the dynamism of reformed Catholicism.21

The first indulgence dates from 30 March 1546 and was forwarded to the
Misericórdia of Lisbon. Although its text is unknown • we only have indirect reference
to •several privileges and benefits•22 • the indulgence was considered of primordial
importance by the confraternity and even excessive by the king, who refused to ratify
the whole Papal document.23

As was the case with other institutions, the reception of indulgences also meant
public recognition of the Misericórdias• work, both stimulating the adhesion of the
faithful and reinforcing the institutions• position in their communities. Magnanimous
with spiritual benefits to all those who visited the Misericórdia churches to confess and
who had holy communion on the most important days of the liturgical calendar, the
Popes promised dozens of plenary indulgences, many hundreds of thousands of years of
pardon, some partial remissions of sins, and even the possibility of removing some souls
from Purgatory, •to all brothers and confreres that are now and will be in the future,
men or women (...), and to all the ministers and servers of the confraternity and of its
hospital, and to its patients for the time spent there•.24

Among the indulgences we know of, the one sent to the Porto Misericórdia in 1558
by Pope Paul IV, connecting it with the •main charity confraternity• of Rome through
arch-confraternity links, deserves to be highlighted because it allows us to evaluate the
importance of these documents in the confraternities• economic structure. Effectively,
the Papal brief clarifies that the indulgences were also destined to all those who left the
Porto Misericórdia •properties for works of mercy in their wills, or in another way, or

21
About the role and characteristics of the arch-confraternities, see Bernard Dompnier, •Les confréries
françaises agrégées à l•archiconfrérie du Gonfalon. Recherche sur une forme du lien à Rome•, Cahiers du
GRHIS, Les confréries du Moyen Age à nos jours. Nouvelles approaches, Rouen, nº 211, nº 3, 1995, p. 41.
22
Cf. A. de Magalhães Basto, História da Santa Casa da Misericórdia do Porto, Porto, 1934, pp. 411•412.
23
Specifically, the exemption from the Bishop•s control, which the king considered harmful to the Church
as well as to the confreres. Cf. J. Quelhas Bigotte, Situação Jurídica das Misericórdias Portuguesas,
2ªed., Seia, 1994, pp. 93•94.
24
Summario das indulgencias e graças concedidas pelo Santo Padre Paulo IV à Santa Casa da
Misericordia do Porto, Porto, 1800.

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bequeathed or instituted the confraternity as their heir•.25 Through donations in wills or

other types of legacies, the support of the population increased the economic resources of
the Misericórdias, which had serious economic problems until the middle of the sixteenth
century. And to have an active role in the charity field it was necessary to have money.

It was according to the logic of this reasoning that the provision of 2 March 1568
incorporated into national law the distinction of pious legacies with such a broad
interpretation that all settlements with charitable ends, or ends serving the salvation of
souls, could fit into it.26 Pious legacies that, under the conditions established in the
Papal brief of 20 August 1545, were not respected would be delivered to the Hospital
Real de Todos os Santos. In effect, this meant delivered to the Misericórdia of Lisbon,
which had been managing the most important Portuguese hospital since 1564.27

As a matter of fact, the Misericórdias turned out to be the great protagonists of the
welfare process reform that was now underway. There were two main, apparently
contradictory reasons for this. The first one looks forward to the Council of Trent,
where the representatives of Portugal obtained for the Misericórdias the status of
confraternities •under royal protection•, which meant exemption from ecclesiastical
jurisdiction. In the future, only their church and cult activities were under the bishop•s
authority. The second reason is related to hospital administration. In fact, after the
handing over of the Hospital Real de Todos os Santos to the Misericórdia of Lisbon
(27 June 1564), the majority of Portuguese hospitals were transferred to the
Misericórdias• administration, giving them, almost as a monopoly, an assistance role
that until then they had rarely played.28

This movement occurred precisely at the moment when assistance was shifted to the
bishops• control and when the Church reinforced its authority over the social welfare
system, medical care included.29 How do we explain this? In my opinion, the best way

25
Cf. Indulgências Anexas às Estações de Roma, that the Oporto Misericórdia received in 1551, in Artur
de Magalhães Basto, História da Santa Casa da Misericórdia do Porto, Porto, 1934, p. 413.
26
Duarte Nunes do Lião, Leis Extravagantes e Reportório das Ordenações, Lisboa, 1987, p. 83.
27
Gabriel Victor do Monte Pereira, Documentos históricos da cidade de Évora, Évora, 1887!1891, p. 251.
28
Cf. Laurinda Abreu, A Santa Casa da Misericórdia de Setúbal entre 1500 e 1755; aspectos de
Sociabilidade e Poder, Setúbal, 1990, pp. 30!31.
29
Cf. João Baptista Reycend, O sacrosanto e ecumenico Concilio de Trento, s/d, s/l., pp. 640!641 and
pp. 704!705.

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The Specificity of the Portuguese Case (16th•18th Centuries)

is through the framework of the political-religious situation of Portugal at that time.

This way, the king and the Pope may have tried to strengthen the results where hospital
assistance was concerned, even though the role of the state prevailed over that of the
Church.

It is certain that this moment corresponded to a reorganization of the Misericórdias,

from which a change in their aims resulted. From then on they were strongly devoted to
hospital care. With the hospitals they also obtained, in addition to the inherent power to
manage medical care, the properties and incomes of the attached institutions. Moreover,
this strengthened the conditions that led to their being transformed into the privileged
recipients of funds for the celebration of perpetual masses, performed in accordance
with the spread of the idea that passage through Purgatory was almost inevitable for
whoever aspired to eternal salvation and that the saying of masses would be the best
way to achieve this salvation.30

In short, in the third quarter of the sixteenth century two of the three main elements
that characterized the Misericórdias were already connected: the domain of hospital
assistance and ownership of a patrimony of considerable extent, especially in the larger
urban centres. The conclusion of this process • an elitist and oligarchic form of
administration • would be achieved by the Habsburg dynasty (1580•1640), which put in
place an operative matrix that was maintained without substantive alterations for three
centuries.

It was also under the influence of the Council of Trent that there emerged a diversity
of welfare institutions which, in addition to trying to minimize the effects of poverty,
concerned themselves with the social moralization and salvation of those who were
sheltered there. We might mention here the wave of new foundations specifically
destined for women and children, considered risk groups and deserving of particular
attention under Counter- Reformation Catholicism. Special attention should be paid to
the female conservatoires, almost always organized according to the social condition of
their occupants, which limited their expectations for the future. This is a field that is still
practically unexplored in Portugal but the individual records of the conservatoires of
Nossa Senhora da Piedade and S. Mansos, both from Évora, show that those who

30
Cf. Laurinda Abreu, !As comunidades litorâneas de Setúbal e Lisboa em tempos de Contra-Reforma", in
O litoral em perspectiva histórica (sécs. XVI-XVIII), Porto, 2002, pp. 247•258.

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Laurinda Abreu

belonged to a higher social status waited for marriage, which would •free• them from
confinement, while those of a lower condition, although also awaiting marriage, generally
left the institution through integration in the labour market, almost always as servants.31

Évora had the only mixed conservatoire sheltering women, girls, boys and the aged
that we know of, as well as a home for prostitutes. The only indicators that we have
show that the first institution became a kind of asylum where old people waited for
death, while the House of Saint Marta • the prostitutes• conservatoire, established by
two ecclesiastics (a typical reflection of Charles Borromeo•s example in Milan) during
the 1560s • seems to have been an enterprise of little success, since the restorative
intentions of its founders seem to have been stronger than the will to redemption on the
part of the sinners, always ready to run away and fall into the temptation of the bad life,
•perverting other souls that could convert to Our Lord•.32

The foundlings and orphans mentioned above also began to receive a degree of
attention that had not hitherto been available to them. In fact, it is probable that the
resolutions of the Ordenações Manuelinas relating to the upbringing and assistance of
abandoned children were only put into practice after Trent. At any rate, the first
documentary registers that we have on foundlings date from this time,33 in most cases
linked with the foundation of orphanages that took in children who had no one to care
for them after their basic upbringing came to an end at the age of seven.34

An absolutely basic aspect that has also been neglected until the present in Portugal
is related to the role of the bishops as agents of charity in the context of the increased

31
According to current research work done under my orientation by the students Marco Loja, Sílva Mestre
and Marco Liberato, in the context of the History degree of Évora University. (For Italy see, Brian
Pullan, Poverty and Charity: Europe, Italy, Venice, 1400-1700, London, 1994, pp. 177•208, and John
Henderson, •Charity and Welfare in Early Modern Tuscany•, in Health Care and Poor Relief in
Counter-Reformation Europe, pp. 69•73.
32
Gabriel Pereira, Documentos históricos da cidade de Évora, p. 469.
33
Precisely when the Misericórdias received the hospitals, since several municipal councils had raised the
foundlings in the hospitals that they handed over to the confraternities.
34
Ana Isabel Marques Guedes, A assistência e a educação dos órfãos durante o Antigo Regime. O Colégio
dos órfãos do Porto, Porto, 1993. The author extended this to other cities in her PhD thesis, Les enfants
orphelins: éducation et assistance: les colégios dos meninos órfãos: Évora, Porto et Braga (XVIIe-XIXe
siècles), Florence, 2000.

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 Organizing Poor Relief and Health Care:
The Specificity of the Portuguese Case (16th•18th Centuries)

powers that Trent gave them.35 In this respect, the case of D. Teotónio de Bragança,
Archbishop of Évora • the richest diocese in the country • between 1578 and 1602
continues to have an exemplary character. A descendant of the leading Portuguese noble
house, the house of the Dukes of Bragança • the dynasty that replaced the Spanish in
1640 • D. Teotónio de Bragança, a novice of the Company of Jesus and doctor of the
University of Bordeaux in 1574, corresponded to the model of a Catholic bishop that
had been outlined in Trent.

Among the many activities he developed in order to reform his diocese, he tried to return
the Church to the faithful, investing in the teaching of the catechism and in the social
moralization of his parishioners, and he was a champion of the strengthening of episcopal
authority, recovering the jurisdictional and patrimonial powers that had been lost.36

But he was also responsible for a wide range of initiatives in the area of poor relief,
one example being the two above-mentioned conservatories (S. Mansos and Nossa
Senhora da Piedade). He described his functions as follows: •As prelate he had the
obligation to see to the spiritual and secular welfare of his subjects, and especially of the
poor beggars and the unfortunate.• He defended his unquestioned power over
institutions •doing pious work and being useful to the needy, [a power] that according
to the law belongs to the bishops•.37

Statements of this nature could only create conflicts with the royal measures put into
practice by the Spaniards newly arrived in Portugal. Initiators of very important reforms
not only in the state administration but also in many spheres of social life, the Habsburg
monarchs confronted the bishops• authority several times, the field of welfare being one
of the most open to the affirmation of the supremacy of the state over the Church.

35
Subject referred to by José Pedro Paiva, •D. Fr. Luís da Silva e a gestão dos bens de uma mitra: o caso
da diocese de Lamego (1677•85)•, Estudos em homenagem a João Francisco Marques, Porto, 2002, pp.
245•255.
36
See Federico Palomo, •La autoridad de los prelados postridentinos y la sociedade Moderna. El gobierno
de Don Teotonio de Braganza en el arzobispado de Évora (1578-1602)•, in Hispania Sacra, vol. XLVII,
nº 96, 1995.
37
Registered in the conservatoire•s statutes of 1702, according to the transcription done by Marco Loja.

71
Laurinda Abreu

The Misericórdias under the Habsburg government

The privileged instruments of this process were the Santas Casas de Misericórdia,
owing to their character as !confraternities under royal protection". Already definitely
shaped as local power centres when the Spanish kings arrived # at that time the
existence of a Misericórdia was already considered an indicator of the development of a
place and of the power and autonomy of certain social groups # the Misericórdias were
seen by the Habsburgs as having great potential as elements of a reorganization of the
social and political space. At the same time, they could serve as a means of increasing
control over a welfare system that was now clearly politicized.38

The Habsburgs introduced several initiatives along these lines, particularly by

founding new Misericórdias # at least forty of them were created between 1580 and
1640, reinforcing the net of confraternities that by then extended through the small rural
towns # and granting new benefits to already existing ones. By this means they tried to
prevent the constitution of very powerful centres, to strengthen local powers and to
increase their personal links with local populations, profiting from the fact that the
Misericórdias were in direct contact with the king. Meanwhile, the Misericórdias and
the municipalities were called upon to participate in the construction of the new social
and political order that the state intended to establish. This was accomplished by a
reform of access to their leading posts, which in the former case culminated in a law of
1611 and in the latter in statutes of 1618. Both had as their outcome the
institutionalization of similar procedures that led to the crystallization of a !group of
noblemen responsible for government",39 closing it off as a limited group of people that
controlled both institutions.

At the same time, and in addition to receiving the hospitals that had been outside of
their control,40 the Misericórdias were distinguished by new privileges that brought
additional competences. This procedure was followed by the functional emptying of the

38
Development on this subject is found in our text !As Misericórdias portuguesas de Filipe I a D. João V",
in the 1st volume of the Portugaliae Monumenta Misericordiarum, Lisboa, 2002, pp. 47#77.
39
Maria Helena da Cruz Coelho; Joaquim Romero Magalhães, O poder concelhio. Das origens às Cortes
Constituintes, Coimbra, 1986, p. 43.
40
At the same time that Philip II practically concluded the annexation of the hospitals to the Portuguese
Misericórdias, he moved ahead in Castile with successive provisions # 1581, 1583, 1586 and 1589 #
promoting hospital consolidation.

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 Organizing Poor Relief and Health Care:
The Specificity of the Portuguese Case (16th•18th Centuries)

other confraternities, which were gradually reduced to cult activities. Renewed or

founded after Trent, they were confined to spiritual assistance and their charitable
functions were also confined to their confreres and families, very often through dowries
for girls. Most of them were so poor that the alms and the annuities were not sufficient
to pay for the annual celebration of their patron saint. Throughout the period of Spanish
rule in Portugal, confrontations between state and episcopate over the confraternities
were frequent; these became particularly violent following the publication in 1604 of
the Quaecumque Constitution, the first codification of Church competences and rights
with regard to the confraternities. There is much documented proof of the affirmation of
the king•s power over confraternities founded by laymen, especially over the
Misericórdias and their hospitals • as was the case, for instance, in Arraiolos in 1619 41
• as well as threats to bishops who dared to interfere in areas beyond their sphere of
competence.

However, one cannot therefore conclude that the reinforcement of the Misericórdias•
power in Portuguese society occurred in an atmosphere of complete freedom and
autonomy. In fact, although they functioned in a decentralized system, during the period
of Spanish rule the Misericórdias felt the weight of royal intervention as it had never
been felt before.

Of the various measures that tended towards an increase in control over them, three
stand out: control of the accounts (the 1593 law was effective for ten years
retrospectively, and it was followed by similar laws); intervention in electoral processes;
and an end to the possibility of the Misericórdias autonomously modifying their statutes
without informing the central power.42

With regard to the structure of the welfare system, the most important fact to recall
from the time of Spanish intervention is the reinforcement of the central place of the
Misericórdias in the entire welfare system, and in medical care in particular. This did
not mean that the Misericórdias had the exclusive right to administer all the hospitals.
Indeed, there were some confraternities that managed to keep their hospitals, either
because they were of ecclesiastical foundation or because they had administrative

41
Santa Casa da Misericórdia de Arraiolos, Inventário do Hospital, 1619.
42
Collecção chronologica de leis extravagantes posteriores á nova compilação das Ordenações do reino
publicadas em 1603, Coimbra, 1819, pp. 245•246.

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Laurinda Abreu

autonomy. Other hospitals were built in periods when there were food shortages. There
the needy could spend the night and have meals. Normally, these hospitals were places
destined to resolve cyclical crises, or •to be a refuge for sufferers from the plague•,43
when the sick and the beggars, who arrived in •herds• in the great urban centres,
became serious threats to public health and the social order.44 They were not under the
Misericórdias• control but were rather administered by the municipalities and financed
by extraordinary taxes from the resident population, even though the citizens preferred
other alternatives such as the confinement of the undesirable in ghettos • •in a street or
a quarter they cannot leave• • or their removal to the colonies, as in a proposal that was
presented to The Lisbon municipal council in the crisis of 1598•99.45 Once the crisis
was over, these hospitals were closed down.46

These short-term hospitals appeared as a result of the limitations of the Misericór-

dias• hospitals. In fact, if their main targets were the poor, some studies carried out in
relation to the hospitals• admissions records show that those who benefited most from
medical care • even if this meant firstly food and shelter and only after that medication
• were servants and daily workers, mainly migrants without a family to look after them.
The latter could easily become poor, while the servants worked for employers who
refused to pay their hospital expenses. Beggars were only rarely taken care of in these
hospitals.47

Despite the burden, often suffocating, that hospital assistance represented in the
Misericórdias• budgets, they continued •their• other mercy works, even though they had
a less significant economic value. These included help to poor prisoners, a task that
was more and more contested by municipalities, which did not allow prisoners to be
freed unless their expenses had been paid by the Misericórdias; the orphans•

43
Eduardo Freire de Oliveira, Elementos para a História do Município de Lisboa, Lisboa, 1887, vol. III,
pp. 107•108.
44
On the importance of this subject, see Robert Jutte, Poverty and Deviance in Early Modern Europe,
pp. 178•190.
45
Eduardo Oliveira, Elementos para a História do Município de Lisboa, vol. III, p. 120, p. 122 and
pp. 124•125.
46
It was also in these situations that the religious orders, above all the Franciscan, became more important,
especially in domiciliary help to plague victims. This was because only in exceptional cases did the
Misericórdias accept pestilent and incurable diseases.
47
See examples indicated in the abovementioned text, •As Misericórdias portuguesas de Filipe I a D. João V•.

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 Organizing Poor Relief and Health Care:
The Specificity of the Portuguese Case (16th•18th Centuries)

endowment, a welfare service that had proper funds, left as bequests by individuals who
stipulated that they be given to women from their family or from their servants•
families;48 support for foundlings, a welfare service that was sometimes financially
aided by the municipal councils; and alms to the humble poor, to widowers and to poor
women on their own.49 Also of some significance was outpatient medical assistance,
another addition to the budget of the Misericórdias• pharmacies, where the poor could
get free medications prescribed by Misericórdia doctors. In small communities, the
Misericórdias were the only ones to assure the basic structures of charity and welfare.

A system in crisis
Since they had exclusive or shared responsibilities for assistance to a variety of
groups, there is no doubt that more was demanded from the Misericórdias than they
were capable of providing. By the end of the seventeenth century the general contours
of the Misericórdias• problems had already taken shape: too many patients ! civilian
and military50 ! very high mortality rates, inadequate hospital facilities, an excessive
number of employees and enormous pressure from groups traditionally helped by the
confraternities, which saw a decrease in the amount of aid that had been promised to
them, and sometimes even its complete suspension. In addition to this, they had to deal
with bad financial practices, rents not charged, embezzlement of capital, extravagant
expenses, and the disappearance of most religious responsibilities.51 These were long-
term problems that were not solved, but were rather aggravated by the escape of the
elites, who had long since taken over the confraternities• incomes and did not now

48
See Maria Marta Lobo de Araújo, "Pobres, honradas e virtuosas : a distribuição de dotes de D. Francisco
pela Misericórdia de Ponte de Lima (1680!1850)#, 2000.
49
See Maria Marta Lobo de Araújo, Dar aos pobres e emprestar a Deus: as Misericórdias de Vila Viçosa
e Ponte de Lima (séculos XVI-XVIII), Barcelos, 2000, pp. 233!245 and pp. 607!630.
50
The contracts that the state signed with the Misericórdias for the treatment of soldiers in the
confraternities• hospitals, in the context of the wars with Spain, after 1640, which the Misericórdias
accepted in the hope of receiving state financial support, ended up by turning into a serious financial
problem as the state did not cover the expenditures for the soldiers.
51
The Misericórdias had a body of religious people (their numbers depending on the size of the particular
institution) to celebrate masses for the souls of their benefactors, in addition to one or more chaplains
who attended the sick and the dying in hospital. Nonetheless, as soon as the hospitals started to bring
pressure on the Misericórdias• budget, less and less investment was observed in the spiritual functions,
which meant the non-payment of salaries to the chaplains and the reduction of religious ceremonies to
the minimum.

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Laurinda Abreu

want to be compromised by institutions in debt, by the decline of the foundations of

perpetual masses and by the decrease of pious donations. It was in the context of
financial collapse that, from the second decade of the eighteenth century, an old
practice came to light • that of hospitals were being financed by the money left for the
celebration of masses for souls in Purgatory and that, consequently, the institutions
had tens of thousands of delayed masses to be celebrated.

The conditions for the commutation of pious legacies with regard to other charitable
works were established at Trent52 and it was on the basis of the wording of the Council
minutes that those in charge of the Misericórdias managed to legitimize their disregard
for the last testaments of the faithful and, simultaneously, to reduce the number of
masses instituted by them. Without much difficulty, the Pope authorized the first by
issuing briefs of pardon, and the second by agreeing to briefs of reduction.

In unison, the administrators of the Misericórdias justified their acts by claiming that
•large numbers of poor did not perish.•53 After all, they added, •the deceased did not
require patrimony in the land as they no longer lived in it,• and nobody could deny that
the interests of the living were more important than those of the deceased. In their
briefs, the Popes complied: to cure the sick was as meritorious as to pray for the souls of
the deceased.54

While the majority of the Misericórdias were authorized to devote money from
masses to caring for the sick and poor, the Misericórdias of Porto, Évora and Braga55
received the same privilege the Hospital Real de Todos os Santos had received on 20
August 1545: all the pious legacies instituted in the respective archbishopric that were
not fulfilled within the periods and according to the conditions imposed on the
executors of the wills were to be handed over to them.

If the trials related to disposing these incomes disclose fabulous amounts of money •
or in the words of the legal texts, •very profitable amounts• • they are reveal damning

52
Cf. João Baptista Reycend, O sacrosanto e ecumenico Concilio de Trento, p. 702.
53
Arquivo da Santa Casa da Misericórdia de Setúbal, Livro de Redução de Legados Pios, fls. 1•4.
54
Laurinda Abreu, Memórias do Corpo e da Alma. A Misericórdia de Setúbal na Modernidade, Viseu,
1999, pp. 153•178.
55
In 1693, 1712 and 1713, respectively. Cf. Abílio Augusto Monteiro, Direito Portuguez sobre Legados
Pios, Porto, 1879, pp. 36•37.

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 Organizing Poor Relief and Health Care:
The Specificity of the Portuguese Case (16th•18th Centuries)

evidence that exposes •agreements• between ecclesiastics, administrators and executors,

united in embezzling souls in Purgatory for their own pecuniary advantage. This is
perhaps why from the early eighteenth century in, for example, Modena56 as in Setúbal,
the opposing voices of those who had witnessed the malfunctioning of this system
began to be heard. A priest from the Church of S. Julião, Setúbal, said in 1745 that even
though he did not question the virtue of similar acts of mercy, he never advised his
parishioners to institute perpetual masses. Experience showed him that such acts did not lead
its originators to Heaven, but were also responsible for taking many souls to Hell • in
particular administrators of last wills and testaments who, through •negligence• or greed, did
not fulfil the wishes of the deceased, as well as the souls of priests who, also through
•negligence• or friendship, did not take the necessary measures to condemn the sin and the
sinners. Meanwhile, •the miserable institutor suffered in Purgatory without remedy.•57

The decline of the establishment of perpetual masses, already clearly visible from
the end of the seventeenth century, would affect, for the reasons mentioned above, the
performance of the Misericórdias, and in particular the hospitals• management. This
was due not only to bad administration, but also to an increase in the number of the
needy, especially after 1750.

The way in which the welfare system developed, keeping the municipalities at a
distance, meant that they were free from responsibilities in this field. The weakness of
their finances and the idea that the Misericórdias had economic means to support the
hospitals contributed to distancing the local authorities from a problem that they should
have shared. The same happened with the state, which did not even contribute to the
enlargement or remodelling of the hospitals, which practically came to a standstill
during the first decades of the seventeenth century.

However, these were not the only reasons for underdevelopment in Portuguese
medical practices and overall public welfare. The dominant role of the Jesuits in public
education and, in the wider vision of Jonathan Israel, "the indirect >and negative@
intellectual effects of the Counter Reformation•,58 also played an important role.

56
Brian Pullan, Health Care and Poor Relief in Counter-Reformation Europe, p. 33.
57
Arquivo da Igreja Paroquial de São Julião, Livro das obrigações das missas desta freguezia de S. Julião,
anno de 1740.
58
Ibid., p. 45.

77
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A rigorous and very critical picture of the state of medical training and faculties and
the education of medical experts in Portugal in the first half of the eighteenth century
was painted by Luís António Verney in 1746 in his Verdadeiro Método de Estudar
(True Method To Study).59 A well-travelled man of the Enlightenment and connoisseur
of the realities of other European countries, Verney ! like the Valencian doctor Juan de
Cabriada, writing in 1687 60 ! ran up against the practice of medicine based on the
humours, which was rooted in the ideas of Hippocrates and Galen, and in its place
proposed structural changes that opened the country to research and to an eminently
practical education.

However it would be necessary to wait for the expulsion of the Jesuits (1759) and
for the secularization of education until major reforms could be initiated, embodied ! in
terms of university education ! in the Statutes of the University of Coimbra in 1772.
These reforms were initiated but not completed, partly because the political career of the
governor who gave rise to them (Marquês de Pombal, 1777) came to an end, but also on
account of the particular political circumstances, which necessitated postponement of
major reforms in the field of the Portuguese health and welfare system for another
century.61

Final considerations
In conclusion, the only coordinated activity carried out in Portugal with regard to the
system of poor relief during the entire early modern period occurred between the end of
the fifteenth century and the beginning of the sixteenth century. During this period, the
foundations were laid for a relatively centralized and unified system that established
well defined borders between poor relief and proto-medical assistance. In the second
half of the sixteenth century, especially after the end of the Council of Trent, political
power, in agreement with the religious power, reoriented the "programme# delineated
by D. Manuel I, joining what the king wanted to keep separate. The hospitals were
handed over to the Misericórdias at the same time as their economic conditions were
strengthened to enable them to fulfil the fourteen works of mercy. This path was shortly

59
Luís António Verney, Verdadeiro método de estudar, Lisboa, s/d.
60
Jonathan Israel, Health Care and Poor Relief in Counter-Reformation Europe , p. 41.
61
See Maria Antónia da Silva Figueiredo Lopes, Pobreza, Assistência e Controlo Social em Coimbra
(1750!1850), Viseu, 2000.

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The Specificity of the Portuguese Case (16th•18th Centuries)

afterwards closed by the Habsburg monarchy, which was largely responsible for
minimizing the role of the other confraternities in fields related to material welfare by
curtailing access to alms of the population while at the same time reinforcing the
competences of the Misericórdias in this sector.

Among the specificities of the welfare model created in Portugal is the fact that,
although it was in principle controlled by the state, the local elites were accorded
conditions which meant that they could manage it in a decentralized way, with a high
degree of autonomy. This meant at the same time that the municipalities, as power
centres, were not involved in this process. Another particularity is related to the sources
of financing. Excluding taxing of the population • only authorized to assist foundlings
or to cope with situations of extreme crisis • Portugal, following the guidelines
provided by Trent, limited health care and poor relief strictly to the field of charitable
provision. And in this sense, the commutation of the pious legacies to incomes for the
hospitals was an old practice that allowed the Misericórdias greater audacity, later
ratified by the Popes through briefs of pardon and briefs of reduction.

With such a fragile economic base, the badly constructed system soon collapsed. At
the beginning of the eighteenth century the Misericórdias already showed difficulties in
replying to the welfare needs of the population, and during that century they continued
to weaken, without support from the state.

However, we cannot evaluate the whole welfare system from the Misericórdias•
perspective alone. The role of complementary and non-official structures of charity and
welfare, for instance, still remains unknown. The competences of the municipalities in
the sector of public health and poor relief have not yet been clearly identified. The same
applies to the mechanisms of self-help and the various manifestations of private
charity.62 There is slightly more light concerning the role of the churchmen who, during
the Counter-Reformation, created a multiplicity of conservatories and orphanages
directed to a larger sector of society. In this sense, only researching more deeply into to
the matter will allow us to evaluate what type of influence the Portuguese bishops had
in the application of state directives. For example, we do not have any information on
the role of the Misericórdias as controllers of beggary, a function given to them by the

62
On the importance of these types of assistance, see Martin Dinges, Health Care and Poor Relief in
Counter-Reformation Europe, pp. 240•279.

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above-mentioned law of 8 July 1503 but one that they may never have exerted.63 And it
may not have been mere chance that the project for welfare system reform proposed by
Pérez de Herrera was not implemented in Portugal, although the author had advised
Philip II to extend it to all territories under the Spanish crown.64

In addition to these legal and administrative aspects, a great deal of research is still
necessary if we are to achieve a complete view of how the Portuguese health care and
welfare system functioned at the level of everyday practices.

Acknowledgement
This paper resulted from research carried out as part of a project financed by the
Fundação da Ciência e Tecnologia (POCTI/1999/HAR/33560): !The Role of the
Misericórdias in the Portuguese Society of the Ancient Regime: The Case of the Évora
Misericórdia".

63
In fact no cases of forced internment of the poor have been discovered to date, and the proposal
presented in the Lisbon municipal session to ostracize the beggars, referred to above, seems to have been
an isolated case, without any attendant consequences.
64
Cf. Jon Arrizabalaga, Health Care and Poor Relief in Counter-Reformation Europe, pp. 161#164.

80