Medieval (about 476AD-1600’s)
19
Rachael Levine; Zoë Lovelock; and John Stephenson
introduction
The Black Death was a devastating bubonic plague that struck Europe in the mid 1300’s. The sickness came with boils and black skin that took over the body and slowly killed its’ victim. The plague killed two-thirds of Europe’s population after it entered Europe for the first time in October of 1347 through ships docked at the Sicilian port of Messina. The first countries to be hit with the plague included China, India, Persia, and Egypt (History.com Editors, 2010). The onset of the black death took medical practitioners by surprise including those who claimed to be experts in disease control. No plague to this degree had ever entered Europe and it quickly claimed the lives of those who seemed perfectly healthy prior to the outbreak. The outbreak of the Black Death in the mid 1300’s left most of the western European civilization in a devastated state, however, the medical response resulted in discoveries such as quarantine, and the creation of medicines that combated the deadly plague.
Quarantine
As the outbreak of the century began to tear through the European population, doctors were desperate to find a cure for the harmful epidemic. As the plague began to kill almost a third of the European population, medical experts developed some methods to try and stop the Black Death from spreading more. One of the tactics that was discovered and utilized was quarantine. Quarantine is the separation or isolation of those who are suspected of carrying a deadly disease. The act of quarantining was first put into action on a very large scale when seaports were blocked off, prohibiting any imports and exports to enter or exit the country. This started at the Italian ports because it was suspected that the plague had entered Europe from one of the ships that docked in Messina. This method was in theory successful, however, after the first infected person set foot on land, others were immediately infected. There was no way to completely stop the plague from moving farther inland by only closing off the seaports. In an effort to utilize this new tactic of isolation, quarantine began to develop more when Italian and modern-day Croatian officials created sections of town where people who were ill or suspected of being ill were forced to stay. These efforts only proved slightly effective, so more laws were put in places such as the “trentino or thirty days isolation period.” This required all infected persons to remain isolated for 30 days before they could enter Ragusa, the central town in Sicily (Mackowiak, 2002). This newly developed medical practice proved to improve the death toll and gave hope to doctors and practitioners that this method of containment would continue to work in the fight against the plague. Quarantine is still used around the world to control events such as the Ebola outbreak in the United States in 2014. When the first person was exposed to the disease, they went under observation and remained in quarantine until it was safe to leave the hospital. There were no other reported cases of Ebola since that person was released in 2014. Quarantine is continuing to be utilized in situations that parallel that of a massive disease outbreak and has proven to be just as successful as it was in the 1300’s when the Black Death struck Europe.
Medicine
Prior to the Black Death, medicine was in a very simple form, as it consisted of roots, flowers, herbs, etc, that apothecaries would combine to create remedies for certain illnesses or medical issues. Most people did not question the system until the Black Death came along. When patients came in with the symptoms of the plague, doctors treated them with the methods that they had used for years but soon found that those did not work. They came up with new, somewhat barbaric treatments to treat the severe symptoms. For example, doctors would burst open the puss bubbles that formed on the infected person and drain them of everything inside the wounds. As described in Gottfried’s (1983) The Black Death: Natural and Human Disaster in Medieval Europe, doctors said:
“If an ulcer appears… near the ear or the throat, take blood from the arm on that side, that is, from the vein between the thumb and the first finger… But if you have an ulcer in the groin, then open a vein in the foot between the big toe and its neighbor… at all events, bloodletting should be carried out when the plague first strikes. “At all events, bloodletting should be carried out when the plague first strikes.” By draining wounds, doctors felt it would rid the person’s body of any infections bacteria. Along with draining, patients were told to sit by a hot furnace or fire to “drove out the disease.” (p. 3).
This particular method of draining did prove to be beneficial in terms of getting the infectious bacteria out of the pus wounds, however, when the patient’s wounds were drained, they lost copious amounts of blood that only harmed them in their effort to recover. The method of draining does have some connections in modern medical practices as doctors today will draw small amounts of blood and run tests to determine what strains of bacteria are in the body. This helps doctors identify what sickness, disease, etc the patient has contracted and what medicines can be used to treat a particular strain.
medieval society and the plague
The part of society that the Black Death and its medical discoveries impacted the most was the common civilian, more than likely someone of low income and limited access to valuable resources. This demographic was targeted by the disease more than others because these citizens did not have access to resources such as private baths or clean water that upper-class citizens did. This lack of availability resulted in poor hygiene, leaving the lower class more susceptible to disease. The plague itself had the most impact on the European community in the 1300’s, however, the results of the plague had a global impact. Following the destruction of the Black Death, the discovery of quarantine provided a gateway for advanced medical practices to be used around the world inspired by the new technique. The science and technology that was prominent during and after the Black Death consisted of advancements in the medical field along with new ways of thinking that paved the way into the Renaissance. For example, ideas from intellectuals who studied the causes of the Black Death stemmed from ancient sources that said “Physicians could cast retrospective horoscopes to identify the configurations of the planets that had caused diseases and epidemics. Physicians also had to incorporate the astrological concept of the “medicinal month” into their plans for treatment of the patient.” (Astrology and Medicine, 2019). There was less of a tangible technological aspect involved in the aftermath of the Black Death, but more so scientific discoveries that contributed to the “general knowledge bank” for further doctors and medical experts to use in the future. The Black Death and its benefit to society are more closely related to science than technology because the medical practices that were created utilized scientific research more than technological advances.
ANECDOTAL AND HISTORICAL BELIEFS DURING THE TIME OF THE BLACK PLAGUE
In some ways, unscientific or anecdotal ideas held their place as common beliefs during the centuries that the Plague had influence in Europe. One mainstay idea was the theory of Miasma. Miasma was viewed as a type of air that could infect a person with any number of diseases and plights caused by divine providence or other-worldly powers (Slack 433). Viewing miasma as a result of godly intervention plays into the polarizing nature of religion at the time, where some chose to forgo the burdens of past tradition religious beliefs in the face of the fleeting nature of plague life while others became extremely pious, seeking refuge in Christianity as a means of salvation. At the time, it also served as an explanation for why some towns saw a greater impact from plague compared to others; the plague was god’s punishment for sins committed by the town/city folk.
Of course, the transmission of the plague was due to plague-carrying fleas who would jump from person to person or animal to person and vice-versa. However, some ideas pertaining to miasma did lend themselves to model the transmission of the plague via some sort of host. For example, it was common knowledge that miasma could be transported by sick persons from place to place, not only on the sick persons themselves but also their belongings and people and objects around them (Slack, 435). In this way, notions of avoiding sick persons (quarantine) as well as attempts to curb the spread of plague via travel restrictions or other spatial restrictions were adopted and employed. While Miasma was not a real occurrence, it did somewhat model the dynamics of the actual transmission of the plague. Miasma wouldn’t largely be disproven until the foundation of Germ Theory, largely attributed to the work of French scientist Louise Pasteur in the mid-19th century (Louis Pasteur, 601).
While some improvements in medical practice and knowledge did occur during the time of the Black Plague, regimens to prevent plague and other pestilences that took influence from pre-plague practices largely stayed the same for the next few centuries. For example, the practice of bloodletting, or the practice of cutting a patient to allow blood with bad “humours” or disease to be released from the patient continued into the Victorian era. This is in spite of the fact that this practice ultimately weakened the patient, making them more susceptible to the disease they were inflicted with and other diseases due to blood loss (Fabbri, 248).
Increasing the ventilation of an area was also thought to reduce the spread of plague since at the time the plague was thought to be spread via miasma. Practices such as creating outdoor fires and using incense were also employed (Fabbri, 249). These practices were ultimately ineffective since the plague was spread by fleas. Other means include religious practices. Joshua Mark states in his article Medieval Cures for the Black Death that “Religious cures were the most common and, besides the public flagellation mentioned above, took the form of purchasing religious amulets and charms, prayer, fasting, attending mass, persecuting those persons thought responsible, and participating in religious processions” (Medieval Cures for the Black Death, 2020).
Ultimately, some of these practices were done away with over time, such as the public flagellation after the pope decried its usage and the purchasing of religious artifacts during the reformation of the Catholic Church. Some practices such as bloodletting continued for a long duration after the plague first appeared. However, previously discussed methods such as quarantines and medical isolation did come to prominence and were widely used and are still used today to curb the spread of disease.
Chapter Questions
- Multiple Choice: Which of the following medical advancements was not mentioned as a result of the Black Death outbreak?
a) Health-facilitating hygiene practices
b) Amputation
c) Blood testing
d) Quarantine - Short Answer: List at least three methods doctors used to manage the outbreak of the Black Death.
- Short Response: Which medical practices used during the Black Death show to be similar to modern practices? How are they similar?
references
Astrology and Medicine. (2019, November 13). Encyclopedia.com. Retrieved from https://www.encyclopedia.com/science/encyclopedias-almanacs-transcripts-and-maps/astrology-and-medicine.
Gottfried, R. S. (1983). The Black death: natural and human disaster in medieval Europe. San Diego, CA: Lucent Books.
History.com Editors. (2010, September 17). Black Death. Retrieved from https://www.history.com/topics/middle-ages/black-death.
Mackowiak, A., P., Sehdev, & S., P. (2002, November 1). Origin of Quarantine. Retrieved from https://academic.oup.com/cid/article/35/9/1071/330421.
Slack, P. (1988). Responses to Plague in Early Modern Europe: The Implications of Public Health. Social Research, 55(3), 433-453.
Conn, H. (1895). Louis Pasteur. Science, 2(45), 601-610.
Fabbri, C. (2007). Treating Medieval Plague: The Wonderful Virtues of Theriac. Early Science and Medicine, 12(3), 247-283.
Mark, J. (2020, April 15). Medieval Cures for the Black Death. World History Encyclopedia. Retrieved November 13, 2021, from https://www.worldhistory.org/article/1540/medieval-cures-for-the-black-death/.
images
Figure 1: “The plague of Florence in 1348” is licensed under CC BY 4.0