Pandemic then and now (part 2)...

My current series of historical novels is set in the middle of the 14th century, a period (in)famous for its devastating plague. The events of the first novel occur just after the Black Death has passed on, and so don’t concern the plague itself but rather its consequences for a community that lost so many of its members. But I have recently published the fourth novel in the series, which, sadly, is at least partly “about” plague, which returned to England in 1361 (and many times thereafter).

I was still writing this fourth novel when the world was plunged into chaos by the arrival of COVID-19. Although it was unsettling writing about a pandemic when we were in the midst of one, it did give me food for thought, comparing the two events.

My last post on The History Girls blog, in May, related something of medieval people’s understanding of the reasons for the plague, focussing on the idea that “lewd” fashion, and indeed lewdness in general, might be responsible.

In today’s post, though, for what I think may be my last on The History Girls concerning plague, I thought I’d talk a little more about how medieval people responded to plague. It’s particularly interesting because there are a few fascinating parallels with our own responses to the 2020 pandemic.

In the 14th century, people had some curious (to us) notions about the causes of the disease. Death was of course everyday – accidents were commonplace, illnesses mostly incurable, and even untreatable, life generally subject to manifold risk. Medieval people had a tendency to credit adversity of any kind, be it the loss of a child, dead cows, a bad harvest, or the failure of the butter to churn, to God’s will or the Devil’s work.

Part of a mural in a church in Hrastovlje, Slovenia, painted at the end of the 15th century,

showing people of every rank and station being led by grinning skeletons towards a grave. 

National Gallery of Slovenia. Public domain, via Wikimedia Commons

We know well enough the medieval notion that the coming of the Black Death, or indeed any disaster, was the result of mankind’s sin. That was what the Church promulgated. However, even if this was the generally accepted view, ther were scientific explanations too. Various complicated theories about the movements of the planets were proposed, and also ideas that miasma, or foul air, was to blame. Foul air was thought to be a cause of disease in general, and plague was no different.

But, if medieval people had some notions of the cause of the disease (even if they were wrong), I imagine it was far trickier for them to work out how to deal with it.

Isolation, keeping oneself to oneself generally, was certainly understood. The value of social distancing, as we now call it, was recognised. The premise for Boccaccio’s Decameron (completed in 1353) is the isolation of a group of young people who flee Florence to escape the plague. And a 14th century French physician, Jean Jacmé, wrote in a treatise on the plague:

“In pestilence time nobody should stand in a great press of people because some man among them may be infected” *

So close contact with a victim was to be avoided. People did go into “lockdown”, confining themselves and their families to their homes, only going out “if absolutely necessary”, presumably to fetch water, buy food, tend to their animals or manage their land.

But Doctor Jacmé had some other familiar-sounding advice. He advocated the washing of hands “oft times in the day”*, though he recommended using water and vinegar, rather than soap.

Touch, then, was certainly to be avoided, but another physician posited that looking into a plague victim’s eyes was also risky, on the grounds that disease could be transmitted via the “airy spirit leaving the eyes of the sick man”*, which does seem somewhat less than plausible. But something much more familiar is avoiding a victim’s “foul air” – the emissions resulting from coughing or even breathing. The “plague doctor” bird beak masks of later centuries hadn’t yet been invented, but I can well imagine that those who attended victims might have covered their nose and mouth.

The 17th century equivalent of a “hazmat” suit?

Though these sorts of beak masks weren’t used in the 14th century.

(Copper engraving of Doctor Schnabel (Dr. Beak), a plague doctor in 17th century Rome.

Published by Paul Fürst (1608–1666) who was perhaps also the engraver. Public domain.)

What medieval people didn’t seem to know about, for I have seen no reference to it in the sources I have been reading, was the role of rats and fleas. Rats have long been implicated in the spread of plague, though some scientists now think the speed of spread was, in practice, too rapid and too far for transmission by rat flea alone to be viable. Others have it that the rat fleas jumped host to people, and then human fleas and body lice were infected, making it easier for rapid people-to-people transmission. Yet the situation is unclear. The World Health Organisation, speaking of the present time, says, “human to human transmission of bubonic plague is rare”. Yet, the 1361 outbreak was in the summer months, in which bubonic, as opposed to pneumonic, plague, was in principle more common. Whichever it was, it spread very quickly, and was undoubtedly hideous and terrifying.

Perhaps not quite the culprit he’s been made out to be? But not this cute either!

(Etching by W. S. Howitt, 1808. Wellcome Library, London. http://wellcomeimages.org. Public domain.)

And of course doctors in the 14th century really didn’t know how to treat the disease, though some undoubtedly thought they did. Some would probably have tried their favourite cure-all, blood-letting, or applied a variety of substances to the suffering body, from herbs and vinegar, to urine and excrement, none of which were beneficial. In my novel, I have a barber-surgeon lancing the buboes, a practice that wasn’t necessarily carried out in the 1300s, though it was a couple of centuries later. But I can imagine eager medieval surgeons trying various methods to save their patients, just as the university-trained physicians ceaselessly sought answers in the heavens. And, even in the 14th century, catching plague wasn’t absolutely a death sentence, for some people clearly did survive it – even people who had been close to, or even nursed, victims.

It’s been a strange year for all of us, and of course it’s not over yet. When I embarked upon writing the fourth novel, back in 2019, I could never have imagined how close to home the events I wrote about might seem. As the 2020 pandemic took off, I recoiled a little at that “closeness”. Yet, since then, I have welcomed the opportunity once more to compare experiences then and now, finding, as so often, that, despite the centuries between us, there is much that we share.

* Quotes are from The Black Death, translated and edited by Rosemary Horrox. If you’d like to read more about plague in the 14th century, I really do recommend it, for it has a wealth of fascinating detail, and uses contemporary texts to reveal the thinking of the time.