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We used a survey to characterize contemporary infection prevention and antibiotic stewardship program practices across 64 healthcare facilities, and we compared these findings to those of a similar 2013 survey. Notable findings include decreased frequency of active surveillance for methicillin-resistant Staphylococcus aureus, frequent active surveillance for carbapenem-resistant Enterobacteriaceae, and increased support for antibiotic stewardship programs.
Since 2014, and the deaths of Michael Brown in Ferguson, Missouri1 and Eric Garner in Staten Island, New York2 – both unarmed black men who died at the hands of police officers – the public has focused increasingly on police use of force against civilians, but especially against unarmed black men.
In a transformative period for London's political ideology, from c.1400 until c.1450, the common profit referred to the profits and liberties obtained by London's governing elite, which would then be distributed according to the principles of Christian charity. Good governance included obtaining these privileges for London's citizens, but it also included maintaining the peace and harmony upon which the prosperity of the city depended – or at least promoting (or trumpeting) this ideal. In this transactional relationship the two concepts were analogous: peace and harmony were maintained when the city benefitted politically and fiscally, and political stability enabled the city's leaders to invest in the spiritual lives of their citizens. Commemorating London's mayors for their contribution to the common profit represented a distinctive ideology: the establishment of a jurisdictional space neither exclusively political, nor specifically spiritual, in which the distinction between the sacred and the secular allowed for the development of new – real or imagined – communities united in love and with the shared goals of prosperity in this life and salvation beyond. By the middle of the fifteenth century, it appears that the phrase ‘common profit’ could be, at times, synonymous with the concept of ‘charity’. Here we see a political ideology acquiring a spiritual dimension, allowing London's governing elite to extend their jurisdiction over the devotional lives of those in their charge.
In 1991, Wendy Scase brought five manuscript books to the attention of the mainstream scholarly community. These manuscripts were affiliated with members of the mercantile and civil service of London – a circle of associates with connections to John Carpenter – as well as the secular clergy, including the common clerk's namesake, Bishop John Carpenter of Worcester, William Litchfield and the controversial radical, Reginald Pecock. These manuscripts were Cambridge, University Library MS Ff.vi.31; London, British Library MSS Harley 993 and Harley 2336; London, Lambeth Palace Library MS 472 and Oxford, Bodleian Library MS Douce 25.
The manuscripts are distinctive for their colophons rather than for their contents. These colophons have been reproduced on numerous occasions. Typically scholars tend to provide one colophon as representative of all. This can cause problems, however.
In fifteenth-century London, among certain of the city's governing merchants, professionals and clerks, the language of the ‘common profit’ had begun to acquire a specific set of values. These values imbued governors with a secular authority and legitimacy they lacked by birthright and a spiritual authority they lacked by vocation. London was portrayed in administrative documents and manuscripts disseminated by the city's ruling class as a Christian community that prospered when its citizens co-operated in business and loved one another in charity. Such ideas were interchangeable – citizens who contributed to civic infrastructure performed acts of charity, while those who worshipped strengthened polity. With John Carpenter as an important vector of transmission from earlier notions of the common profit he may have encountered in the documents within the London Guildhall, these values appear to have been communicated to scribes of the Guildhall, to circles of influential, wealthy and literate professionals and aldermen, as well as their friends and colleagues in the city's wealthiest parishes. Their common profit, while it shared a set of terms with older intellectual traditions and contemporary humanist discourse, remained distinctive, local. It helped forge a vernacular commonwealth and, as with other vernaculars, was concomitant with a strong sense of shared identity and tradition.
London's ruling class espoused a specific vision of governance in their control of the written word. The production of materials that articulated notions of the common profit went hand in hand with the sponsorship and dissemination of spiritual literature among members of the lay community and lower clergy – the ‘mighty men of good’. These materials endorsed the notion that moral edification was vital to polity; that those who ruled themselves were better placed to rule others. By linking spiritual welfare with economic prosperity, the status and legitimacy of those who espoused the values of the common profit became entrenched. The circulation and sponsorship of religious literature, for instance, as in the example of the Guildhall library, demonstrated that London's governing elite recognised the authority vested in shaping spiritual discourse; and the systematic remembrance of civic leaders in monumental epitaphs inscribed the values of the common profit into the very fabric of the city.
In the autumn of 1386, Nicholas Exton, fishmonger, was elected to his first term as mayor of the city of London (he would serve again, 1387–88). His election marked the end of a decade of radical – and at times violent – reform. Although his election did not bring about the end of violence in the capital (Exton's predecessor and close political ally Nicholas Brembre would be executed following his accusation and betrayal by Londoners at the ‘Merciless’ Parliament of 1388), Exton's election brought about relative stability and the city settled into a ‘comfortable but reasonably benign oligarchy’. Radical violence does not always take the form of physical harm or the loss of life and we might also consider non-cooperation, or change to systemic processes, as an alternative form of violence. In this sense, between 1376 and 1386, London's governors faced both forms of violence at the hands of the artisanal classes and minor guilds who supported the rebels of June 1381 and whose representative, the draper and mayor (1381–83) John of Northampton, challenged the monopoly of the traditional locus of power within the city.
London in the fourteenth century was effectively governed by a mayor and twenty-four aldermen, drawn almost exclusively from five of the city's more than one hundred guilds. These men were predominantly involved in wholesale distribution and overseas trade, that is to say, they were vintners, fishmongers, grocers, mercers and goldsmiths. These men dominated the economic and political landscape of the capital and exercised influence over both trade and ideology. They saw their contribution as not only enhancing their own wealth, but also the prosperity of England. The status of these individuals – and the influence they could wield – meant that the office of alderman was greatly desired, though restricted to few. After 1469 those elected to the office were to have goods, chattels and recoverable goods of a value of no less than £1,000 – a sum prohibitive for all but the wealthiest citizens.
In c.1419 the common clerk of the city of London, John Carpenter, in his compilation of the ordinances and charters of the city, the Liber Albus, described the ideal qualities of an alderman. He was to be ‘without deformity of body, with wisdom and discretion of mind, wealthy, honest, loyal and free’.
The ideal of peace, love and harmony upon which the prosperity of the city of London was said to be contingent was threatened by a series of crises in the concluding decades of the fourteenth century. In many respects, Andrew Horn's vision for the city, which was later asserted by John Carpenter, was compromised by the disobedience displayed by the citizens of London towards their governors, and in turn those governors towards the crown. This, at least, was the view of those whose administrative reforms of the late fourteenth and early fifteenth centuries sought to restate the parameters of civic authority. The governing elite sought to establish and enforce the accepted principles of rule through the public space of the court of the common council. John Carpenter compiled, in the Liber Albus, a series of documents that celebrated the role of law makers and governors and helped to disguise their fragile position at the mercy of the crown, the craft and artisan guilds and the citizens of London. Carpenter portrayed London's aldermen as essential mediators – without them the privileges necessary for the success of the city could not be obtained from the crown and could not be distributed for common profit. London's common profit, therefore, resembled less a series of ideals of good governance and increasingly a social contract; it was a transactional polity in which London's governors acted in the interest of their citizens in exchange for loyalty and service.
London's common profit predicated that the city's aldermen had privileged access to the crown and were in a unique position to defend the interests of the citizenry. In 1392 Richard II removed these privileges and appointed a warden to administer the city on his behalf. The lasting effect of this denial of power would be traumatic for London's ruling elite but, in 1392, they faced an immediate need: to restore the city's liberties. On 21 August, with the king's court now – shamefully – relocated to York, London organised a royal entry for their monarch. The most significant account of this occasion is a Latin poem of 546 lines attributed to a Carmelite friar, Richard de Maydiston (Maidstone), surviving in Oxford, Bodleian Library, MS Bodleian E. Museo 94. Maidstone, a graduate of Merton College, Oxford, died in 1396.
The central premise of this book, that the governing elite of late medieval London sought to shape political ideology in order to strengthen their legitimacy at a time of social change, has not been untouched by our current political climate. Modern political practice involves competing for control over language – and contemporary theory recognises this. The tools of the political communicator in the twenty-first century include traditional media such as newspapers and television, as well as new media such as the internet and social media. Political messaging, carefully crafted and responsive to market testing and focus groups, can acquire a ‘technical meaning that's really very much divorced from [its] actual meaning, sometimes the opposite of it’. The general perception of political and public comprehension of a political ideology is, in a very real sense, shaped by those who write it. In the context of the late medieval city, although aldermen lacked the ability to communicate so widely, this book has argued that they nevertheless recognised the value of controlling political rhetoric and that they sought to invest their statutes, legal processes, public ritual, civic investment and commemorative practices with a deliberate emphasis that helped determine the meaning of a discourse that benefitted them. This book has argued that the phrase ‘common profit’ could have competing meanings. On one hand, it represented those values integral to a functioning society and beneficial to the many – values such as justice, fair taxation and mutual support. On the other hand, it represented a closed discourse that isolated and protected the few – who benefitted from a body politic that might be willing to overlook their oligarchic tendencies when phrased in the language of community.
Steve Rappaport's study of sixteenth-century London examined the lives and careers of some 530 men granted citizenship in the 1550s. His conclusions suggested that, although life in London could be prosperous for merchants working in the city, and opportunities existed for many to hold offices in the various ‘worlds’ of the city (the ward, the parish, the household, etc.), very few were able to exercise direct participation: ‘that is, their access to political power – was limited since they could be neither wardens nor assistants and also because they had no regular, institutionalised means of influencing the formation of economic and other policies’.
The late medieval epitaph of Bishop William the Norman
Following the tumult of the closing decades of the fourteenth century, the governing elite of London, as well as the caste of professional and semi-professional clerks who supported them, sought to reassert their authority and control over the mechanisms of government within their city. Efforts to preserve certain civic rituals, such as the punishment of wrongdoers in the court of the common council and regal entry ceremonies, in civic documents, such as the Liber Albus and the city's Letter-Books, helped ensure that the governors of London managed the dissemination of its central messages. Such messages, however, were not to be constrained by the walls of the archive of the London Guildhall, nor the pages of the volumes within. The men who governed, and those who supported them, understood the value of inscribing their deeds on far broader canvases, in more enduring media. The rituals, themselves lost to us, imagined the city as a parchment upon which the values of these governors might be written. Urban renewal could be an opportunity for circulating important concepts of governance. But one message that has received minimal attention is that which resonated within the worshipful spaces of London: the city's churches.
One of the most prominent monuments in old St Paul's Cathedral recognised Bishop William the Norman (d.1075), bishop of London and chaplain to Edward the Confessor. Although Bishop William died in the eleventh century, a memorial was commissioned much later. From the information provided by Sir William Dugdale in The History of St Paul's Cathedral in London (1658), however, it is not possible to satisfactorily date the monument. Dugdale recorded two epitaphs. One was written in 1622 by the Lord Mayor of London, Edward Barkham. The other we cannot date; however, it is pre-Reformation. Henry Holland in the second, expanded, edition of his Ecclesia Sancti Pauli Illustrata (1633) tells us that the monument was in brass and that it lay in the central aisle of the nave. It appears to have been one of the monuments furthest west in the nave, and may have been the first monument to be encountered by those entering through the great western door. Situated between the chapel of St Gregory and the Court of Convocation, the monument occupied a highly visible and well-trafficked location within the cathedral.
According to the chronicler Robert of Avesbury, employed in the court of the archbishop of Canterbury at Lambeth, the Black Death arrived in London on, or around, the feast of All Saints (1 November) 1348. Between Candlemas and Easter 1349, the virulence of the plague necessitated the building of three new burial grounds, one at East Smithfield, another, much larger, on the site of Charterhouse Square and a third at Tower Hill. The population of the city, which had been 70,000–100,000 in 1348, declined by between a third and a half during this time. The impact of the Black Death in London, as elsewhere in Western Europe, was transformative, ushering in a period of social realignment. In the aftermath of the plague, London experienced a series of financial and political crises. The Statute of Labourers (1349), for instance, forced urban craftsmen to sell goods at 1347 prices, even though workers’ wages were on the increase. In 1351 the franchise of the city was revoked in retaliation against the misconduct of the city's governing elite, intensifying conflict between London and foreign merchants. Tensions grew between the urban workforce and the city's most powerful guilds – Vintners, Fishmongers, Grocers, Mercers and Goldsmiths – who comprised the majority of the capital's aldermen, sheriffs and mayors. This was a period that saw the brief ascendancy of John of North-ampton, draper and mayor (1381–83). Northampton and his faction claimed to represent the interests of the city's lesser guilds and, with the support of powerful allies at court (including John of Gaunt), secured a number of short-lived reforms to the governance of London that threatened the hegemony of the victualling companies.
Yet this was also a period in which the capital began to dominate national finances and trade. We see an increased role for London at the heart of the English economy, a growing reliance of the crown on London merchants and an increased prominence of London representatives in parliament. The establishment of the staple at Calais in 1361 buoyed the London economy and, as an example, between 1366–67 and 1402, London's export of cloth rose from only 18 per cent of Bristol's to 51 per cent of the national export.
In the meeting of the court of the common council of London, held on the Feast of St Hilary (13 January) 1387, one William Hughlot, a servant of the king and citizen of London, was asked to make answer for a trespass committed against the city. Hughlot was accused of making his way to the house of John Elyngham, a barber of the parish of St Dunstan in the West, and assaulting him with a knife. The cause of this disturbance is not recorded; however, we are told that Elyngham's wife called upon John Rote, skinner, alderman and former sheriff (1381–82) to intervene. In order to maintain the peace, Rote attempted to break up the quarrel between Hughlot and Elyngham. After notifying Hughlot that he was both an alderman of the city and an officer of the king, Rote was attacked and forced to ‘manfully’ defend himself and disarm the perpetrator. A constable was wounded in the scuffle.
Remanded in custody in Newgate prison, Hughlot evidently did not know when to stop. Still raving, he made specific threats against Rote as well as the mayor, Nicholas Exton, before declaring that the court of the Guildhall of London was the ‘worst and most false court in the whole of England’ for condemning him without trial. Two days later, Hughlot was brought before Exton and representative aldermen in the court of the common council to answer this charge. At the beginning of his trial, a deposition against Hughlot was read explaining the severity of his crime. The mayor and aldermen, it was declared, had a precept, vested in the king's authority, to maintain the peace in their city. In London especially, more so than any other city in England, this was to be maintained judiciously. For London was ‘the capital city and mirror of the whole realm and this same place [sets] an example for the business of government with respect of the cities and other important places in the realm’.
The circumstances of this deposition must be approached with caution. The clerk of the court may simply have been exhibiting the rhetoric of civic pride. In addition, the scribe recording this trial may have exercised a certain creative licence – we cannot say for certain if the trial unfolded in the manner precisely described.