In the Care of Saints and Citizens: Microhistories of Madness in Late Medieval ’s-Hertogenbosch, 1382-1500

Abstract

By using a microhistorical approach — defined by István M. Szijártó as “micro-analysis, agency, and the intention to answer a ‘great historical question’” — this thesis moves beyond the debates surrounding the systems of care for the mad in private and institutional spheres. The main research goal has been to trace the lived experiences of the mad in the late medieval city of ’s-Hertogenbosch within these systems of care by offering a thick description. The lived experiences are analyzed using the fourteenth-century Miraclebook of Our Sweet Lady for the private sphere and the fifteenth-century archival sources on the Reinier van Arkel madhouse for the institutional sphere, which together form a significant source set within the Low Countries. The Reinier van Arkel madhouse emerged as a novel care model, blending medieval hospital traditions with Geel’s foster care system. By integrating these perspectives, this thesis challenges historiographical tendencies to treat institutional and private care in isolation, instead revealing a spectrum of care strategies. The mad retained social ties, exercising agency through financial contributions, familial negotiations, and participation in cures. However, agency was unevenly distributed, constrained by gender and age. Micro-analysis of the madhouse environment revealed varied living conditions — ranging from confinement to relative freedom — alongside adequate nutrition and hygiene, despite material hardships. By bridging institutional and private sources, the study rejects dichotomies of medieval cruelty versus modern benevolence. The madhouse was neither a proto-modern asylum nor a mere dumping ground, but a contested space where care and coercion coexisted. Similarly, miracle cures were not just pious tropes but socially embedded recoveries. This research challenges linear narratives of institutionalization, highlighting adaptive, pluralistic care systems.