Carole Rawcliffe's Urban Bodies develops a sustained and impressive national survey of urban communal health in late medieval England. Rawcliffe's ambitious project takes on an idea entrenched in the historiography and in popular culture: that late medieval English urban populations gave little thought to public health. By closely examining archival and archeological evidence, her work clearly demonstrates that urban communities of late medieval England exerted a much greater communal effort toward prophylactic measures than scholars have previously assumed.

In her first chapter she takes a deeper look at the roots of long-standing beliefs about medieval English public health, beginning with an assessment of the “Victorian legacy,” as she refers to the modern tendency to view premodern public health efforts as lacking by the standards of modern hygiene (19). Rawcliffe also argues that, contrary to a persistent bias in the scholarship, English towns and cities did not lag behind Continental, especially Italian, communities in matters of public health. On the thorny issue of England's seeming comparative lack of measures against the plague in the mid-fourteenth century in contrast to the quarantines implemented on the Continent, Rawcliffe shows that, although England appeared to have lacked a centralized policy for separating the infected, local officials ramped up their sanitary efforts in response to disease outbreaks. By using local records, Rawcliffe demonstrates that late medieval English towns and cities invested more effort into communal health than scholars have previously acknowledged (34).

The majority of the book is then devoted to contextualizing late medieval urban efforts at preserving communal health. In chapter 2 Rawcliffe reframes the idea of “public health” by examining the intricate connections between both individual and collective health and religion in late medieval England. As Rawcliffe argues, the rationale for medieval urban health efforts is located in the medieval Christian worldview that understood individual and collective sin as a source of disease. It is for this reason that efforts to control vagrancy and prostitution can be considered as efforts to improve urban health as much as those to deal with waste (115).

In the third chapter she spotlights efforts to clean up the streets in urban England, foregrounding these attempts against medieval concepts of disease causation. For instance, medieval men and women thought that miasma, or polluted air, caused disease as did the offense sight of waste, along with religious beliefs that associated dirt with moral impurity (126). Although their success may have been limited, medieval towns introduced measures to control environmental pollution. Municipal authorities expected individual householders to take a certain responsibility for their community's public health, as Londoners, for instance, were expected to repair fire-damaged buildings in order to protect against the dangers such as “miasmatic air” (174).

The fourth and fifth chapters are concerned with water and food, respectively. Despite challenges, including contamination from trade and industry, towns and cities constructed infrastructure such as aqueducts and wells to provide water to their residents and attempt to control contamination. Projects designed to provide clean water became not only a matter of public health but also a reflection of pious works performed as acts of Christian charity with an eye towards reducing a benefactor's time in purgatory. Late medieval urban communities also demonstrated a growing awareness of the potential health effects of consuming contaminated food and drink, and they attempted to curb the worst offenses and provide cleaner markets. Medieval guilds also played a role by inspecting the storefronts and products of their members (261).

The final chapter, “Sickness and Debility,” deals with urban medical services in late medieval England. Although this chapter may seem to be a bit of a departure from the ones that precede it, Rawcliffe effectively demonstrates that the efforts of civic authorities to provide oversight to professional medical provision, including efforts at licensing practitioners, were part and parcel of the concern for public health that drove regulations concerning such things as the provision of clean drinking water. This chapter also represents Rawcliffe's concern with the communal nature of public health, as she explores the provision of services for the sick and elderly poor who turned to institutions such as “common” hospitals and almshouses for care and shelter.

Urban Bodies will be of particular interest to historians of medieval health and medicine, and also to early modernists, as well as scholars of public health in general. Overall, the work is a significant achievement that reminds us to continue contextualizing our understanding of health and medicine in the past as reactions to public health issues were historically constructed in response to particular political, religious, and social concerns.