Public health policy in the bailiwick of 's-Hertogenbosch in the eighteenth century
01 / 2010 - 10 / 2011
According to the traditional view, a national system of public health arrangements was introduced in the Netherlands in 1804. Extensive research in the archives of the Estates General, the Council of State, the Receiver General of the ducal demesnes in the Bailiwick of ?s-Hertogenbosch and the city government of ?s-Hertogenbosch, the capital of the bailiwick, has led to the conclusion that a system of supervision on epidemic diseases that worked well, developed as from 1719 in this part of the so called Generaliteitslanden, peripheral regions that were governed from The Hague directly. The motive to start a new policy was an outburst of a epidemic disease in the freedom of Hilvarenbeek in 1719. The authorities in The Hague were afraid it was the beginning of a new wave of pest, a disease that had cost ten thousands of victims in the seventeenth century. When the disease turned out to be a form of dysentery, panic dwindled soon, but the new policy was continued and developed into a system of supervision. The Council of State, which acted as the daily government of the generaliteitslanden, took the final decisions after having received and read the reports made up by civil servants and medical experts in the region about epidemic diseases. The medical experts emphasized in their reports that the disease was caused by extreme poverty of a large part of the population, especially in the southern part of the bailiwick. The Meierij was struck by a serious economic depression which culminated in around 1730. After ca. 1740, however, the physicians attributed the diseases to bad air and foreign troops that were marching through the region. When the costs, which were moderate by the way, increased at the end of the sixties too much in the eyes of the Council of State another system was introduced. A plan made by the Receiver General and Professor Bon, professor in medicine at the Illustere School (a second class university) in that town, to create the office of landsdokter [= country physician] was disregarded for unknown reasons. The new system left public health to the local government while the authorities in The Hague were willing to grant subsidies to villages, freedoms and towns that had been afflicted heavily. The way the new policy was introduced and disappeared again can be considered as typical for the governance of the Republic of United Provinces.
In het in 2011 te publiceren artikel wil ik nagaan welke beleid de overheden in de achtiende eeuw in de Meierij van 's-Hertogenbosch hebben gevoerd ten aanzien van de bestrijding en voorkoming van epidemieën van besmettelijke ziekten. Hoe kwam dit beleid tot stand, hoe en door wie werd het uitgevoerd, hoe werd het bekostigd en hoe ontwikkelde het zich? Het gaat om overheden, dus zowel de Haagse autoriteiten, als de regionale en zeker ook de plaatselijke. Eerst wordt de epidemie in Hilvarenbeek van 1719 besproken. Aan de orde komen de maatregelen van de overheden, de adviezen van de medische experts en de reacties van de bevolking. Het toen ingezette beleid werd daarna uitgebouwd en voortgezet. Diverse aspecten ervan worden besproken aan de hand van de epidemieën die na 1719 in de Meierij van 's-Hertogenbosch woedden. Rond 1770 ontstond er in Den Haag onbehagen over de stijgende kosten, wat tot een ander beleid leidde. Tenslotte volgt een conclusie met daarin ook enkele wensen ten aanzien van toekomstig onderzoek.