In the summer of 1785, the parish clergy of the diocese of Kraków and archdiocese of Gniezno received a letter signed by Michał Jerzy Poniatowski, recently appointed primate of Poland and the king's younger brother.Footnote 1 Some priests may already have heard about the reforms Poniatowski had implemented in the diocese of Płock since 1773, but even for them this letter must have been utterly surprising.Footnote 2 Poniatowski demanded that the clergy see themselves as responsible for the people's health and requested that all landowners do the same. He set out some rules which were to be preached every year before harvest. Firstly, people were to be discouraged from eating unripe fruit and from baking bread or preparing gruel from unripe grain. Since the obvious reason for doing this was hunger, landlords were to provide their subjects with sufficient food. Moreover, people were to be told not to wear any form of headgear or to drink cold water while working in hot weather on the grounds that this would prevent sickness and death. Poniatowski asserted that priests were responsible not only for their people's heavenly life but also their earthly life. He also pointed out that serfs who became ill or died had an adverse effect on agricultural revenues.
Before the end of the eighteenth century, then, Polish and Lithuanian clergy were officially tasked with taking care of the health of the faithful. This request may therefore be treated as a sign of a deeper historical change, which raises several questions. Firstly, what other evidence is there for what Catholic elites thought about the health of the people, and what they were doing about it? Secondly, why did they start at this period to take an interest in healthcare? Finally, given that several of Poniatowski's proposals ran counter to both lived religionFootnote 3 and the social model of priesthood which had long defined clergy-parish relationships, to what extent were these proposals owned and adopted by the parish clergy?
Late eighteenth-century healthcare has been widely described in the literature on the social history of medicine. Emerging in the course of the Enlightenment, it encompassed the optimistic belief that health was natural state of the body and that diseases would eventually be eradicated, new physiological theories, the development of institutional healthcare and the mercantilist politics of bureaucratic states.Footnote 4 On the other hand, in the developing field of the study of Enlightenment religion, health issues are marginal. Historians of that movement tend to focus on political ideas such as freedom and equality, or on theological concepts such as toleration, moderation of ritual, rationalization of faith, and charity.Footnote 5
This article argues that health issues were an important aspect of the reforms proposed by Catholic enlighteners in the Polish-Lithuanian Commonwealth. Their programmes made clergy responsible for medical education, organization of healthcare and the reform of customs which might have been harmful to health. These reforms had a humanitarian and economic rationale and were facilitated by an optimistic belief in the benefits of medicine. However, many enlightened programmes failed because priests were unwilling or unable to implement changes that interfered with lived religion.
Catholic Clergy and Enlightenment
Individual Catholic priests influenced healthcare through holding a range of posts in the Polish-Lithuanian Commonwealth. Clergy were present in all divisions of the government. That is especially true of the Komisja Edukacji Narodowej (Commission of National Education), founded in 1773. Its first president was Ignacy Massalski, bishop of Vilnius or Wilno, and its second from 1786 was the primate, Michał Poniatowski.Footnote 6 Priests also formed the majority of school teachers.
Most members of the Catholic episcopate in the Commonwealth at the end of the eighteenth century were not reformers. Some, such as Wojciech Skarszewski (1743–1827; bishop of Chełm and Lublin 1791–1805, bishop of Lublin 1805–24, archbishop of Warsaw 1824–7), carried out ecclesiastical reform according to the principles of the Council of Trent. Others, such as Ignacy Krasicki (1735–1801; prince-bishop of Warmia 1766–95, archbishop of Gniezno 1795–1801), Józef Kossakowski (1738–94; bishop of Livonia 1781–94) and Adam Naruszewicz (1733–96; bishop of Smoleńsk [now in Russia] 1775–88 [coadjutor], 1788–90 [diocesan], bishop of Luts'k or Łuck [now in Ukraine] 1790–6), promoted the ideas of the Catholic Enlightenment but as writers and politicians rather than in their episcopal capacity. In contrast, Massalski and Poniatowski used their episcopal authority to apply their ideas to people's daily lives.Footnote 7
The success or otherwise of these reforms depended on the parish clergy. Most late eighteenth-century priests had been educated in seminaries. The younger clergy had graduated from the colleges of the Jesuits and the Piarists, which after mid-century reform were teaching modern languages, history, geography and natural sciences. These graduates were supposed to be patriotic citizens, aware of the need for political and economic reforms.Footnote 8 At the same time, parish priests had to take into account the reality of lived religion, often incompatible with reforms proposed by the enlighteners.Footnote 9 The polarization was not always between subjects and nobility but rather between theologically and philosophically educated individuals, mostly priests, and other Catholics. For peasants and nobility alike, lived religion was based on custom rather than on the Roman Catechism and the canons of the Council of Trent.Footnote 10
Most Catholic priests were not enlighteners, but Catholic clergy played a dominant role in the Polish and Lithuanian Enlightenment. This is one reason why the radical Enlightenment as defined by Jonathan Israel was represented in Poland-Lithuania only by individuals.Footnote 11 Enlightenment in the Commonwealth had different shades but almost all were religious. Richard Butterwick has proposed a distinction between Enlightened Catholicism and Catholic Enlightenment. The first refers to Catholicism which included some features of the Enlightenment. It was characterized by an emphasis on education, the reform of popular piety and a cognitive distancing from superstitions. The second encompassed all Enlightenment ideas formulated by Catholics, including those not directly related to religion or modifying the previously accepted functions of religion. Catholic enlighteners changed the social model of parish priesthood significantly by openly enjoining priests to be attentive to the earthly, physical wellbeing of their people.Footnote 12 In this way they imposed further duties on priests in addition to the wide-ranging responsibilities already imposed by the Council of Trent, which included not only worshipping God, securing the salvation of souls and promoting charity, but also keeping parish registers and guarding the church's economic interests.Footnote 13
This new social obligation had humanitarian as well as economic reasons. It was based on a new understanding of the value of human life and a conviction that there existed a moral necessity to provide support to those who needed it. The reformers were also concerned with improving the economy of the Polish-Lithuanian Commonwealth. Although this was growing during the second half of the eighteenth century, it had not yet fully recovered from the crisis caused by wars between 1648 and 1721. Agricultural underdevelopment was obvious to landowners, who included priests, and such men were often early adherents to physiocracy. For example, Ignacy Massalski established personal relations with the proponents of the new economic theories, visiting Honoré Gabriel Riqueti, count of Mirabeau, and inviting Nicolas Baudeau to Lithuania.Footnote 14
The Polish and Lithuanian nobility had traditionally believed that the wealth of nations derived solely from agriculture, but physiocrats elevated that belief to the level of a law of nature. The physiocratic economic school argued for free trade and provided a practical solution for increasing land revenues. This was attractive to landowners, whose income was generated from the sale, and often the export, of agricultural goods.Footnote 15 Physiocracy was preferred to mercantilism or cameralism which focused on the trade in manufactured goods and the role of central government and did not fit well with the highly decentralized commonwealth.Footnote 16
In Poland and Lithuania, there was an abundance of land, but the workforce was both scarce and unproductive. Physiocratic principles resulted in the pragmatic understanding that healthy serfs might be economically beneficial. Before the end of the eighteenth century this had few practical implications, since there was little faith in physicians. However, progress in medicine fuelled optimism about the effectiveness of healing and the utility of organized healthcare. The newest medical theories were summarized in an article ‘Uwagi o lekarskiej sztuce’ (‘Remarks on the Art of Medicine’) published in the journal Zabawy przyjemne i pożyteczne (Enjoyable and Useful Activities) in 1774.Footnote 17 It was most probably authored by Grzegorz Piramowicz, a former Jesuit and chairman of the Towarzystwo do Ksiąg Elementarnych (Society for Elementary Textbooks), which sought to provide such works for elementary schools.Footnote 18 Piramowicz presented the natural and optimistic concept of health as desirable and as achievable by secular means. Neither God nor any other sacrum was mentioned. Illness was presented as a natural abnormality which should be limited by prevention and might be eradicated with the help of professional physicians. A healthy lifestyle should therefore be taught to all people, peasants included. Piramowicz recommended proper nutrition and outdoor activities, emphasizing the need for fresh air and improved hygiene and cleanliness. His proposals were in line with the latest medical theories, which Piramowicz reviewed critically, arguing that the systematists who were developing general theories could not and should not exclude the achievements of nosologists who gathered empirical data, and vice versa.Footnote 19
Medical Education
New medical theories might have been accepted by individuals and described in the press, but before 1763 there was only one medical faculty in the whole of Poland-Lithuania: located in the University of Kraków, it had just two professors.Footnote 20 In 1774, Stanisław August Poniatowski initiated the establishment of the Królewska Szkoła Lekarska (Royal Medical School) in Гродна / Hrodna or Grodno (now in Belarus). It was organized by the French physician Emmanuel Gilibert and equipped with facilities which included a hospital, a botanical garden and a dissecting room.Footnote 21
The improvement of medical education was overseen by the Komisja Edukacji Narodowej (Commission for National Education). The University of Kraków was reformed by the rector, Hugo Kołłątaj, with the help and support of Poniatowski.Footnote 22 The University of Vilnius was transformed by the rector, Marcin Poczobut, with the backing of Massalski.Footnote 23 Both schools had similar facilities to those established in Grodno and employed well educated staff, mainly from abroad. Lectures covered anatomy, botany and chemistry, pathology, medical practice, midwifery and surgery.
Reformed universities were training increased numbers of physicians, but prevention was believed to be better than cure. In 1785, the Komisja Edukacji Narodowej published an Elementarz dla szkół parafialnych narodowych (Elementary Textbook for National Parish Schools), including a chapter about moral science by Piramowicz.Footnote 24 This presented the physiocratic notion that taking care of one's own health was a moral duty and a social responsibility, which guaranteed the effectiveness of labour. Children were instructed to seek help from physicians or educated landlords, and never from quack doctors or fairies. Pupils were also taught about proper diet, home ventilation, physical education and the necessity of smallpox inoculations, and provided with some basic rules for treating the sick.
Whilst the Komisja Edukacji Narodowej would have liked schools in every parish to base their teaching on this text, the reality was very different. Even in dioceses overseen by Poniatowski and Massalski, who fully supported educational reform, many parishes had schools which were not organized or barely functioning. Landlords and serfs alike opposed the reforms, worrying that educated children would not want to work in agriculture. In existing schools, teachers often used older texts, the content of which was limited to reading lessons and the catechism. Nevertheless, there were some parishes where children were taught according to the physiocratic ideas of Piramowicz.Footnote 25
Poniatowski not only supported the reorganization of parish education, but also made priests responsible for preaching about health. Before he sent the letter described above, as bishop of Płock (1773–85), he ordered priests to advise parents not to sleep in the same bed as an infant, in order to avoid the all-too-common risk of suffocation.Footnote 26 Poniatowski presented this medical knowledge in two pastoral letters; in contrast, Massalski as bishop of Vilnius made it an element of the diocesan preaching programme. In his persuasive book Kapłan Sługa Boży (The Priest, Servant of God), anonymously published in Vilnius in 1793, he tasked the clergy with the civic obligations of serving the Commonwealth and the people. Priests should not only teach the truths of faith necessary for salvation, but should also offer advice which would make earthly life happier and render individuals more useful to their fellow Christians and their country.Footnote 27 Kapłan Sługa Boży was published late in Massalski's career. However, it was a recapitulation of the programme he had been advocating for many years.
In 1776 Massalski organized the Jubilee which had been proclaimed for all Catholics by Pope Clement XIV in 1775. This had been envisaged by the pope as a traditional public expression of piety and a chance to gain an indulgence. In Massalski's diocese of Vilnius, it was turned into a programme of public preaching on centrally defined topics, set down by Wilhelm Kaliński at the bishop's request.Footnote 28 These topics included the obligation to take care of one's body, as well as rules to be followed during illness and convalescence. The sermons were supposed to encourage individuals to learn about the body as well as the soul; they also advised landlords about helping peasants to improve their diet, houses and clothing for medical reasons. In addition, the bishop required any religious order which wished to organize rural missions to preach about these topics during the Jubilee.Footnote 29 In 1785, he requested the deans of the diocese to submit reports on the realization of this educational programme.Footnote 30
The obligation to preach about health was not supposed to undermine belief in God's providence. During an outbreak of plague in 1771, Massalski issued a pastoral letter proposing standard preventative measures such as specific medications, the isolation of individuals and entire villages, the use of protection against the breath of those infected, and the cleaning of houses where people had been taken ill.Footnote 31 However, his practical advice constituted an appendix to a theological interpretation of the plague as a punishment for sin.Footnote 32 The primary way of ending the plague was to propitiate God. To this end, priests should focus on improving the morality of the faithful, organizing traditional rituals such as the Forty Hours’ Devotion, processions to village crosses and a voluntary three-day fast. Priests were also strictly forbidden to leave their parishes and instructed to provide sacramental ministry to the sick: this seems to have been a response to the common practice of avoiding contact with sick parishioners.
In the city of Vilnius, the Jubilee programme was put into practice by Massalski's chosen preachers, among whom were Michał Karpowicz and Wilhelm Kaliński, who published books related to the programme, thus achieving national fame.Footnote 33 Kaliński's personal diary also provides evidence of how he internalized a naturalistic understanding of health. He recorded every illness or even discomfort he suffered; despite the high frequency of these entries, he always interpreted illness as an abnormality, and also as an excuse for not fulfilling his duties as professor at the University of Vilnius. He also speculated about the causes of his ailments, generally attributing them to bad diet.Footnote 34
Parish clergy reacted in different ways. The records of parish visitations reveal that some priests in the diocese of Vilnius bought and read collections of Jubilee sermons. In his memoires, Jędrzej Kitowicz, parish priest in Rzeczyca, in the archdiocese of Gniezno, and author of the Opis obyczajów za panowania Augusta III (Description of Customs during the Reign of August III) ridiculed Poniatowski's pastoral letters.Footnote 35 Moreover, in a survey undertaken by the bishop's officials in the diocese of Płock, none of the parish clergy reported preaching about healthcare, and none had purchased a medical book or even sermons with physiocratic content.Footnote 36 The single exception seems to be a sermon entitled ‘O obowiązkach lekarzów’ (‘Concerning the Duties of Doctors’), by Jan Kaczyński, of the parish of Gaworów.Footnote 37 This was printed in a collection of exemplary texts, by parish clergy as well as by the diocesan elite, chosen by the theologians appointed by Poniatowski, who shared the belief that disease might be an indicator of the divine will. Kaczyński condemned healers who had no professional training as immoral. He did not name them specifically, but he might have been referring to quack doctors. Against the backdrop of recent developments in medicine, he was particularly critical of those who, perhaps out of pride, did not listen to the advice given by younger but better educated colleagues. Noting the presence of a multitude of diseases, he demanded adequate specific treatments for each one, implicitly rejecting the effectiveness of alleged panaceas. At the same time, he did not interpret health simply as a natural phenomenon. Diseases were caused by air (the miasma theory), the weakness of the human body, a bad lifestyle, or, most importantly, the will of God. God, Kaczyński claimed, sends disease to punish, admonish and warn. Therefore the first prerequisite for recovery was for the sick person to turn to God, asking him for direct or indirect help, through prayer and treatment by physicians.
Healthcare and Lived Religion
The Council of Trent had several times discussed responsibility for the care of the poor and sick, which it recognized as one of the most important aspects of the Church's mission.Footnote 38 In the Polish-Lithuanian Commonwealth, King Zygmunt August accepted its decrees as early as 1564, and clergy did the same in 1577 during the synod of the province of Gniezno in Piotrków.Footnote 39 Later diocesan synods and bishops in pastoral letters required clergy to organize charitable provision in their parishes. These norms provided the basis for the development of parish hospitals during the seventeenth and eighteenth centuries, intended to provide food and shelter for the use of the infirm, aged and poor, but not to provide professional medical treatment.Footnote 40
During the late eighteenth century, between 40 and 45 per cent of Polish and Lithuanian parishes had such hospitals, but usually they were in a bad condition. Many were financed from separate benefices, including land and capital donated by rich benefactors. Benefice revenues were often irregular, or too low or devalued, or impossible to collect. Moreover, some hospitals had no property at all, leaving them completely dependent on the goodwill of parishioners.Footnote 41 Real change did not occur until Catholic enlighteners in the late eighteenth century proposed a new method of funding and tried to transform them into healing institutions.
The bishop of Livonia, Józef Kossakowski, in a novel published in 1786, Xiądz Pleban (The Parish Priest), depicted the ideal parish priest, who instructed his parishioners to employ a full-time physician, to build isolation homes for those suffering from infectious diseases, and to establish hospitals for invalids. The book's hero initiated the training of midwives, not only to assist women during labour but also to give smallpox inoculations. Kossakowski's ideal priest believed that prevention was the most reliable way of securing health. He encouraged parishioners to build new, dry and well-ventilated houses to prevent them from catching coughs, to make and wear boots and hats to prevent fevers, and to eat ripe fruit to prevent scurvy. In the novel, these improvements were all financed by parishioners, landlords alongside serfs.Footnote 42 That ideal was based on the programme of reforms realized by the priest Paweł Brzostowski in his estate village of Merkinė or Merecz. However, in the diocese of Vilnius this was an exception, albeit a well-known one.Footnote 43
Poniatowski tried to bring some of these ideas to life. In an ordinance of 1773, he required priests not only to offer their parishioners spiritual counsel and to perform the sacrament of the anointing of the sick, but also to provide any available physical treatment.Footnote 44 This general principle became enshrined in systemic reform in 1777. Poniatowski ordered that a Brotherhood of Mercy be organized in every parish, consisting of laymen under the supervision of priests, who were to maintain the parish hospitals by means of membership dues and alms. The Brothers were obliged to find the best medically educated person in the neighbourhood, and to use only his services. Sick people were to be transferred to the hospitals. If that was impossible, the Brothers were to help them at home. Severe cases were to be treated in one of three larger hospitals run by religious orders in bigger towns, and these became central diocesan institutions.Footnote 45 Moreover, Poniatowski subordinated all religious fraternities to the Brotherhood of Mercy. Members of these older fraternities were expected to continue their previous ritual duties, but the bishop declared that material help as an expression of charity was a more reliable way to achieve salvation than pure worship. He also banned the customary funeral receptions, instead encouraging people to donate food to the parish clergy, who were to distribute it to the poor and sick. Poniatowski introduced the same reforms in the diocese of Kraków in 1784 and the archdiocese of Gniezno in 1786.
Parish clergy from the diocese of Kraków reacted to this reform in various ways. A Brotherhood of Mercy was indeed created in most parishes, but parishioners often refused to contribute to its funding. In some parishes, contrary to the bishop's decree, the Brotherhood of Mercy was subordinated to already existing devotional sodalities.Footnote 46 The ban on funeral receptions had no effect, and the custom has remained very much alive to this day.
In rural areas, those who were ill often had to cope without the help of physicians, who were almost exclusively based in bigger cities or in courts. The best strategy, advocated by clergy of every rank as well as most doctors, was asking for God's help. There was, however, a multitude of ways to obtain divine assistance. Prayers in which the faithful relied humbly on God, as recommended in Kaczyński's sermon, were theologically the ideal. However, asking saints for help in exchange for prayers, pilgrimage or a votive offering was much more popular. In the case of the wealthy, this would often involve the endowment of an altar, chapel or church.Footnote 47 Evidence for the prevalence of such a transactional attitude to spiritual healing is provided by the growing popularity of miracle sites during the seventeenth and eighteenth centuries and a significant increase in the number of devotional books published by the guardians of such sanctuaries. Most were written by members of religious orders, but the existence of images depicting miracles and votive offerings in parish churches indicates that secular clergy also supported such practices. Clergy themselves sought the help of the saints. The parish priest of Słaboszów in the diocese of Kraków, author of an exceptionally detailed personal diary written between 1693 and 1701, went on pilgrimage to Jędrzejów each time he recovered from gout; there he expressed his gratitude to St Wincenty Kadłubek for his intercession.Footnote 48
The French Catholic Church of that time, in the words of Robert Muchembled, ‘redoubled its prudence concerning possible miracles tied to devotional sites and more generally to the very ancient cult of healing saints’.Footnote 49 By contrast, in the Polish-Lithuanian Commonwealth, the church disapproved only of the numerous unauthorized miracle sites, such as trees, fountains or other places where saints were said to have appeared and instructed sick people what to do in order to be healed. Usually, after detailed scrutiny, bishops or archdeacons forbade people from gathering at such sites under penalty of excommunication.Footnote 50 Until the late eighteenth century, bans were motivated by the fear of uncontrolled and potentially idolatrous popular practices, and by the assumption that unauthorized miracle sites were competing with official sanctuaries. Poniatowski warned against miracle sites that lacked official church endorsement, labelling them superstitious and unreliable.Footnote 51
In many sanctuaries, priests encouraged the faithful to describe their experiences in a book of miracles.Footnote 52 Stories approved and written down by clergy (naturally) ended in miraculous recovery; other healing practices were presented as ineffective. Such accounts can, however, provide information about popular medicine. Usually, people would first try to heal themselves, or would turn to relatives, neighbours and local quacks, using not only herbal remedies but also magical rituals and spells. Such symbolic actions were considered practical and morally neutral by the laity but were not approved by the clergy.Footnote 53
Jan Wujkowski, author of the catechism most frequently used by parish clergy at the end of the eighteenth century, Chleb duchowny (Spiritual Bread),Footnote 54 interpreted magical healing as indirectly idolatrous. He believed that such practices were supernatural, and that since they did not draw power from divine or ecclesiastical blessing, they must result from an older pact with the devil. He did not see this as conscious idolatry, but rather as arising from ignorance, and advised clergy to warn about this rather than punish it. It was only direct dealing with the devil which Wujkowski interpreted as witchcraft and deserving of the death penalty.Footnote 55 Poniatowski and Massalski also criticized popular magical medicine, but for them rituals, spells and amulets were not idolatrous but simply expressions of ignorant superstitious belief.Footnote 56 Their view was similar to that of Ludovico Muratori in his Della forza della fantasia umana (Of the Strength of the Human Imagination), translated into Polish by someone in Massalski's circle.Footnote 57 It is clear that no eighteenth-century Polish Catholic priest openly undermined belief in witchcraft, defined as dealing with the devil. Enlighteners did, however, refute the idea that non-maleficent symbolic folk practices such as healing constituted witchcraft.Footnote 58
Fasting was another practice which reformers tried to modify for medical reasons. In the Polish-Lithuanian Commonwealth, it was treated as a national custom, distinguishing Poles from other Christians, who were accused of taking this obligation too lightly. It was a boastful stereotype that was propagated by seventeenth- and eighteenth-century preachers, but many Polish and Lithuanian Catholics, regardless of their social origins, refrained from eating meat and dairy, not only when it was required by the church, but also voluntarily on other days. Others, however, observed only formal restrictions, at the same time overeating on fish and confectionery.Footnote 59 Like other Christian enlighteners,Footnote 60 Poniatowski found both the overly strict and the merely formal observance of fasts to be unhealthy and impious. In the diocese of Płock, he lifted the prohibition on dairy consumption on 12 November 1777, arguing that a person's piety should be judged according to their willingness to limit the quantity of food they consumed, and required people to reflect on what their conscience was saying rather than to refrain from eating only one category of food. He also explained that in the Commonwealth of Poland-Lithuania, where olives were an expensive imported product, butter and cream were the most important source of fat, and necessary for health, especially that of hard-working peasants.Footnote 61 Poniatowski based his decision on the permission issued by Clement XIV in 1773. He claimed that consumption of dairy had been allowed in other dioceses, but no documentary confirmation is known to exist. Massalski did not lift the prohibition for the diocese of Vilnius as a whole, but he had been giving individual dispensations from dairy restrictions for nobility, monks and nuns throughout his episcopate.Footnote 62
In 1760 Primate Władysław Łubieński, on behalf of the bishops’ conference, had asked Clement XIII to lift the prohibition on dairy consumption throughout the Polish-Lithuanian Commonwealth, but was not successful.Footnote 63 One reason might have been a lack of unanimity among bishops. Wacław Sierakowski (1699×1700–80; bishop of Kamieniec 1739–40, bishop of Przemyśl 1742–60, archbishop of Lviv or Lwów [now in Ukraine] 1760–80), opposed liberalization in his book Prawo Święte Kościoła Chrystusowego o Postach (1759).Footnote 64 Wojciech Skarszewski, in pastoral letters as Roman Catholic bishop of Chełm and Lublin, recommended fasting as a mean of securing God's protection for the commonwealth.Footnote 65 At the same time, his Greek Catholic counterpart, Porfiriusz Skarbek-Ważyński (1730×32–1804; bishop of Chełm 1790–1804), took diocesan synods as an opportunity to defend strict fasting.Footnote 66
Parish clergy did not have a uniform attitude to fasting. In his bestselling catechism, Jan Wujkowski presented a nuanced attitude. Limitations on the quantity of food consumed did not apply to pregnant women, wet nurses or hard-working people. Sick people were even allowed to eat dairy.Footnote 67 Parish priests who used this catechism would have been lifting the prohibition of dairy consumption, an exception which had hitherto been reserved for the sick and which Poniatowski wanted to make into a general rule that would prevent weakness and illness among serfs. However, there is evidence that such liberalization of fasting was not successful: diarists and folklorists during the nineteenth century noted that dairy prohibition was strictly observed, and the custom was depicted again in the Nobel Prize-winning novel Chłopi (Peasants), by Władysław Reymont (1904–9).Footnote 68
In the eighteenth century, new ideas about cleanliness and its relation to sickness also emerged.Footnote 69 Human corpses were considered particularly unclean and dangerous to health. Catholic enlighteners therefore began to oppose the custom of locating cemeteries around and under churches. In the Polish-Lithuanian Commonwealth, this debate can be traced back at least to 1770, when the Grand Marshal of the Crown, Stanisław Lubomirski, proposed that churchyards should no longer be used as burial grounds. Another supporter of this policy was Massalski, who proposed similar measures during the 1771 plague epidemic. During the Jubilee of 1776, he announced that both the commonwealth and the church were planning to put an end to ‘improper’ cemeteries in churchyards, and obliged priests in his diocese to support this.Footnote 70 This order was strikingly opposed to lived religious practice. Sanctity of space was believed to be dependent on proximity to holiness, and the holiest objects in the parish were the relics kept in the churches. People wanted to be buried as close to the centre of the sacred space as possible, but this depended on a person's social position. The richest were buried under the church floor, the less well off in the churchyard close to the church walls, and the poorest next to the churchyard fence. Nobody wanted to be buried outside the churchyard, let alone outside the village. Massalski was aware of this and did not seek to render the division between sacred and profane obsolete; indeed, he emphasized that the new graveyards would be blessed. In 1792, these measures were incorporated into law by the newly established Komisja Policji Obojga Narodów (Police Commission for both Nations), but they did not become a reality until shortly before the collapse of the Polish-Lithuanian Commonwealth in 1795.Footnote 71
Conclusion
Public health was an important concern of Polish and Lithuanian Catholic enlighteners. Numerous theoretical works by Catholic priests argued that medical education and the organized provision of healthcare were moral obligations as well as necessary steps for improving agricultural productivity. Their conviction was derived from humanitarian as well as physiocratic principles and was facilitated by an optimistic belief in benefits of medicine. They were aware of recent advances in science and believed that diseases could be prevented and even eradicated with the help of professional physicians. Without that confidence, reform would not be worth the effort.
Belief in medicine did not mean that Catholic enlighteners rejected the possibility of divine intervention in health matters or denied that diseases might be indicators of the divine will. It was God who established the laws of nature, and it was God who acted through these laws and who could suspend their operation. Prayer remained the best strategy for securing health, and it was advocated by clergy of every rank, including the reforming bishops Michał Poniatowski and Ignacy Massalski. Belief in the healing power of the saints’ intercessions remained intact; however, enlighteners were sceptical of the authenticity of new miracle sites, particularly those reported by local people.
Massalski and Poniatowski, as well as the Komisja Edukacji Narodowej, tried to organize healthcare and medical education by enforcing new rules for parish clergy. Priests were made responsible for organizing parish schools with medical knowledge as part of the curriculum, teaching about health in sermons, supporting sick parishioners and changing the status of parish hospitals from charitable to healthcare institutions. In addition, enlighteners attempted to modify elements of lived religion which were detrimental to health. Some customs, such as rigorous fasting and churchyard burial, came to be considered harmful. Others, such as healing with magic or spending money on a funeral wake rather than on helping the poor and sick, were condemned as ineffective, superstitious or impractical.
The parish clergy did not form a homogeneous group, and it is difficult to generalize about their attitude to these reforms. Some preached with the help of collections of physiocratic sermons as recommended by Massalski, and others organized the Brotherhood of Mercy as intended by Poniatowski. Many renewed or established parish schools according to the principles of the Komisja Edukacji Narodowej. However, numerous priests did not do any of these things. Some simply rejected additional, often burdensome, tasks, while others encountered obstacles, such as lack of funding or resistance from nobles or peasants. There is little direct evidence of individual priests rejecting the idea that charity is more important than devotion. However, the fact that many reforms failed or were only realized much later suggests that parish clergy either did not want to interfere with lived religion or generally failed in doing so.