Cultures of Plague

The sixteenth century was a key period of change for European medicine: doctors were confronted with previously unknown diseases, peoples and commodities; printed editions of medical texts came into wide circulation and new genres emerged, such as ‘books of secrets’; new commercial opportunities opened up for operators within and outside the establishment. Yet despite these changes and the diffusion of new ideas about anatomy, contagion and chemical medicine, the prevailing picture of medical practice remains one of rigid adherence to the inherited Galenic/Hippocratic tradition, a position that was further reinforced by the humanist emphasis on returning to the sources. Cohn’s study of published plague tracts in sixteenth-century Italy challenges this static picture by demonstrating an important change in the way that the medical establishment responded to plague, and specifically to the epidemic of 1575–8. One of the key decisions that doctors had to take concerned the diagnosis of ‘plague’ in any particular case. Through critical readings of a wide range of sources, including not just theoretical texts but also the Milanese death registers compiled 1452–1523, Cohn draws out the key features of plague for contemporaries, with its characteristic trio of symptoms (fever, headache, vomiting), and the probable death of the patient within two to four days. These features differed in significant ways from the ‘typical bubonic plague’ identified in nineteenth- and twentieth-century data. For sixteenth-century plague victims, large buboes appearing in the lymph areas were frequently also accompanied by black ‘carbuncles’ and most dangerously by black or red lentil-sized pustules that might cover the whole body. The evidence strongly suggests that although ‘plague’ was probably the same disease as Yersinia pestis, its symptoms changed significantly over time. Cohn also shows that pneumonic plague, for which there is fourteenth-century evidence from the period of the Black Death, had disappeared by the mid-fifteenth century

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