Locus of Care: Families, Communities, Institutions, and the Provision of Welfare Since Antiquity (Studies in the Social History of Medicine)

298 Pages·1998·1.31 MB·English

by  P. Horden

THE LOCUS OF CARE
Much recent debate among historians, sociologists, and specialists
in welfare policy has been based on the assumption that the
quite recent past has seen an evolutionary shift from the family
to the state as the chief provider of health care. This is a shift
which ‘community care’ is supposedly beginning to reverse. The
Locus of Care challenges simple linear narratives, making it
difficult for future policy decisions in this area to be justified by
appeals to history.
Focusing on such themes as the limitations of household care,
the pervasiveness of institutions, support for the mentally ill, and
child care, eleven international contributors show how various the
‘locus of care’ has been in Europe and the Mediterranean world
since antiquity, and also how various it continues to be in other
parts of the globe such as China and South Africa. More wide-
ranging in time and space than previous studies of the connections
between informal and institutional care, this volume reveals that
there is nothing new about the ‘mixed economy’ of welfare
provision. Families, wider communities and institutions of many
kinds have interacted and complemented one another in complex
ways through the ages.
Peregrine Horden is Wellcome Trust Research Lecturer in the
History of Medicine, Royal Holloway and Bedford New College,
University of London. Richard Smith is Director of the
Cambridge Group for the History of Population and Social
Structure, University of Cambridge.
STUDIES IN THE SOCIAL HISTORY
OF MEDICINE
Series Editors: Jonathan Barry and Bernard Harris
In recent years, the social history of medicine has become recognized as a major
field of historical enquiry. Aspects of health, disease, and medical care now attract
the attention not only of social historians but also of researchers in a broad
spectrum of historical and social science disciplines. The Society for the Social
History of Medicine, founded in 1969, is an interdisciplinary body, based in
Great Britain but international in membership. It exists to forward a wide-
ranging view of the history of medicine, concerned equally with biological
aspects of normal life, experience of and attitudes to illness, medical thought and
treatment, and systems of medical care. Although frequently bearing on current
issues, this interpretation of the subject makes primary reference to historical
context and contemporary priorities. The intention is not to promote a
subspecialism but to conduct research according to the standards and
intelligibility required of history in general. The Society publishes a journal, Social
History of Medicine, and holds at least three conferences a year. Its series, Studies
in the Social History of Medicine, does not represent publication of its
proceedings, but comprises volumes on selected themes, often arising out of
conferences but subsequently developed by the editors.
LIFE, DEATH, AND THE ELDERLY
Edited by Margaret Pelling and Richard M.Smith
MEDICINE AND CHARITY BEFORE THE WELFARE STATE
Edited by Jonathan Barry and Colin Jones
IN THE NAME OF THE CHILD
Edited by Roger Cooter
REASSESSING FOUCAULT: POWER, MEDICINE AND THE BODY
Edited by Colin Jones and Roy Porter
MIGRANTS, MINORITIES AND HEALTH: HISTORICAL
AND CONTEMPORARY STUDIES
Edited by Lara Marks and Michael Worboys
FROM IDIOCY TO MENTAL DEFICIENCY
Edited by David Wright and Anne Digby
NUTRITION IN BRITAIN
Edited by David F.Smith
HEALTH CARE AND POOR RELIEF IN PROTESTANT
EUROPE 1500–1700
Edited by Ole Peter Grell and Andrew Cunningham
MIDWIVES, SOCIETY AND CHILDBIRTH
Edited by Hilary Marland and Anne Marie Rafferty
THE LOCUS OF
CARE
Families, communities, institutions,
and the provision of welfare
since antiquity
Edited by Peregrine Horden
and Richard Smith
London and New York
First published 1998
by Routledge
11 New Fetter Lane, London EC4P 4EE

This edition published in the Taylor & Francis e-Library, 2003.

Simultaneously published in the USA and Canada
by Routledge
29 West 35th Street, New York, NY 10001

Selection and editorial matter © 1998 Peregrine Horden
and Richard Smith
Individual chapters © 1998 the contributors
All rights reserved. No part of this book may be reprinted or
reproduced or utilized in any form or by any electronic,
mechanical, or other means, now known or hereafter
invented, including photocopying and recording, or in any
information storage or retrieval system, without permission in
writing from the publishers.

British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library.

Library of Congress Cataloguing in Publication Data
The locus of care: families, communities, institutions, and the
provision of welfare since antiquity/edited by Peregrine Horden
and Richard Smith.
p. cm.—(Social studies in the history of medicine)
Includes bibliographical references and index.
1. Public welfare—History. 2. Social service—History.
3. Public welfare—History. 4. Welfare state—History. 5. Human
services—History. 6. Institutional care. I. Horden, Peregrine.
II. Smith, Richard. III. Series: Studies in the social history of
medicine.
HV51.L63 1998
361´.009–dc21 97–15177
CIP

ISBN 0-203-42804-8 Master e-book ISBN

ISBN 0-203-73628-1 (Adobe eReader Format)
ISBN 0-415-11216-8 (Print Edition)
CONTENTS
List of figures and tables vii
Notes on the contributors ix
Acknowledgements x
INTRODUCTION 1
Peregrine Horden and Richard Smith
Part I Informal care: from ethnography to ancient history
1 HOUSEHOLD CARE AND INFORMAL NETWORKS:
COMPARISONS AND CONTINUITIES FROM
ANTIQUITY TO THE PRESENT 21
Peregrine Horden
Part II Networks and institutions in western Europe
c. 1500–c. 1800
2 NETWORKS OF CARE IN ELIZABETHAN ENGLISH
TOWNS: THE EXAMPLE OF HADLEIGH, SUFFOLK 71
Marjorie K.McIntosh
3 FAMILY OBLIGATIONS AND INEQUALITIES IN
ACCESS TO CARE IN NORTHERN ITALY,
SEVENTEENTH TO EIGHTEENTH CENTURIES 90
Sandra Cavallo
4 SELF-HELP AND RECIPROCITY IN PARISH
ASSISTANCE: BORDEAUX IN THE SIXTEENTH
AND SEVENTEENTH CENTURIES 111
Martin Dinges
v
CONTENTS
5 COMMUNITY SPONSORSHIP AND THE HOSPITAL
PATIENT IN LATE EIGHTEENTH-CENTURY
ENGLAND 126
Amanda Berry
Part III Beyond the asylum: mental health in Britain
c. 1700–1939
6 THE HOUSEHOLD AND THE CARE OF LUNATICS
IN EIGHTEENTH-CENTURY LONDON 153
Akihito Suzuki
7 FAMILIAL CARE OF ‘IDIOT’ CHILDREN IN
VICTORIAN ENGLAND 176
David Wright
8 COMMUNITY CARE AND THE CONTROL OF
MENTAL DEFECTIVES IN INTER-WAR BRITAIN 198
Mathew Thomson
Part IV Children and the elderly in the twentieth century
9 SAFEGUARDING THE HEALTH OF THE
COMMUNITY: MATERNAL AND INFANT
WELFARE SERVICES IN FOUR LONDON
BOROUGHS 1902–1936 219
Lara Marks
10 COMMUNITIES, ‘CARING’, AND INSTITUTIONS:
APARTHEID AND CHILD CARE IN CAPE TOWN
SINCE 1948 239
Sandra Burman and Patricia van der Spuy
11 DEMOGRAPHIC CONDITIONS, MICROSIMULATION,
AND FAMILY SUPPORT FOR THE ELDERLY: PAST,
PRESENT, AND FUTURE IN CHINA 259
Zhongwei Zhao
Index 280
vi
FIGURES AND TABLES
FIGURES
4.1 The position of need between reciprocal help and
help from outside 113
5.1 Corporate patrons as percentage of all patrons,
Northampton General Hospital and Bristol Infirmary 130
5.2 Percentage of in-patients by mode of admission to
the Bristol Infirmary, the Devon and Exeter Hospital,
and the Northampton General Hospital 138
5.3 Northampton General Hospital, 1771: age group of
in-patients by recommender 143
11.1 (a) Mean number of surviving parents by age of
male ego 265
(b) Percentage of males with no surviving parent
by age 265
11.2 (a) Mean number of surviving spouses by age of
male ego 267
(b) Percentage of males with no surviving spouse
by age 267
11.3 (a) Mean number of surviving siblings by age of
male ego 268
(b) Percentage of males with no surviving siblings
by age 268
11.4 (a) Mean number of surviving children by age of
male ego 270
(b) Percentage of males with no surviving children
by age 270
vii
LIST OF FIGURES AND TABLES
TABLES
4.1 Annual expenditure on poor relief in Bordeaux
(1660–70) 112
4.2 Reasons for supporting recipients of alms in
Bordeaux 117
4.3 Examples of long-term payments to the poor 118
4.4 Examples of changes in payments to the poor when
head of household ill 119
5.1 Sex ratios of hospital in-patients by recommender 141
6.1 Means by which ‘settlement’ gained 159
9.1 Health levels, demographic profiles, and the types of
maternal and infant welfare provision in the four
boroughs 223–4
11.1 Demographic rates in three simulated populations 263
11.2 Percentages of males having the given number of
married sons 272
11.3 Mean numbers of surviving kin of specified type by
age of ego 274
viii
CONTRIBUTORS
Amanda Berry, Wellcome Unit for the History of Medicine,
University of Oxford.
Sandra Burman, Centre for Socio-Legal Research, University of
Cape Town, South Africa.
Sandra Cavallo, Department of History, Royal Holloway and
Bedford New College, University of London.
Martin Dinges, Institut für Geschichte der Medizin der Robert
Bosch Stiftung, Stuttgart.
Peregrine Horden, Department of History, Royal Holloway and
Bedford New College, University of London.
Lara Marks, Imperial College, University of London.
Marjorie K.McIntosh, Department of History, University of
Colorado at Boulder, USA.
Richard Smith, Cambridge Group for the History of Population
and Social Structure, University of Cambridge.
Akihito Suzuki, School of Economics, Keio University, Japan.
Mathew Thomson, Department of History, University of Sheffield.
Patricia van der Spuy, Centre for Socio-Legal Research, University
of Cape Town, South Africa.
David Wright, School of Nursing, Postgraduate Division, University
of Nottingham.
Zhongwei Zhao, Graduate School of Demography, Australian
National University, Canberra.
ix