To the people at large there could be but one explanation—the wrath of God. Planets might satisfy the learned doctors, but God was closer to the average man. A scourge so sweeping and unsparing without any visible cause could only be seen as Divine punishment upon mankind for its sins. It might even be God’s terminal disappointment in his creature. Matteo Villani compared the plague to the Flood in ultimate purpose and believed he was recording “the extermination of mankind.” Efforts to appease Divine wrath took many forms, as when the city of Rouen ordered that everything that could anger God, such as gambling, cursing, and drinking, must be stopped. More general were the penitent processions authorized at first by the Pope, some lasting as long as three days, some attended by as many as 2,000, which everywhere accompanied the plague and helped to spread it.
Barefoot in sackcloth, sprinkled with ashes, weeping, praying, tearing their hair, carrying candles and relics, sometimes with ropes around their necks or beating themselves with whips, the penitents wound through the streets, imploring the mercy of the Virgin and saints at their shrines. In a vivid illustration for the Très Riches Heures of the Duc de Berry, the Pope is shown in a penitent procession attended by four cardinals in scarlet from hat to hem. He raises both arms in supplication to the angel on top of the Castel Sant’Angelo, while white-robed priests bearing banners and relics in golden cases turn to look as one of their number, stricken by the plague, falls to the ground, his face contorted with anxiety. In the rear, a gray-clad monk falls beside another victim already on the ground as the townspeople gaze in horror. (Nominally the illustration represents a 6th century plague in the time of Pope Gregory the Great, but as medieval artists made no distinction between past and present, the scene is shown as the artist would have seen it in the 14th century.) When it became evident that these processions were sources of infection, Clement VI had to prohibit them.
In Messina, where the plague first appeared, the people begged the Archbishop of neighboring Catania to lend them the relics of St. Agatha. When the Catanians refused to let the relics go, the Archbishop dipped them in holy water and took the water himself to Messina, where he carried it in a procession with prayers and litanies through the streets. The demonic, which shared the medieval cosmos with God, appeared as “demons in the shape of dogs” to terrify the people. “A black dog with a drawn sword in his paws appeared among them, gnashing his teeth and rushing upon them and breaking all the silver vessels and lamps and candlesticks on the altars and casting them hither and thither.… So the people of Messina, terrified by this prodigious vision, were all strangely overcome by fear.”
The apparent absence of earthly cause gave the plague a supernatural and sinister quality. Scandinavians believed that a Pest Maiden emerged from the mouth of the dead in the form of a blue flame and flew through the air to infect the next house. In Lithuania the Maiden was said to wave a red scarf through the door or window to let in the pest. One brave man, according to legend, deliberately waited at his open window with drawn sword and, at the fluttering of the scarf, chopped off the hand. He died of his deed, but his village was spared and the scarf long preserved as a relic in the local church.
Beyond demons and superstition the final hand was God’s. The Pope acknowledged it in a Bull of September 1348, speaking of the “pestilence with which God is afflicting the Christian people.” To the Emperor John Cantacuzene it was manifest that a malady of such horrors, stenches, and agonies, and especially one bringing the dismal despair that settled upon its victims before they died, was not a plague “natural” to mankind but “a chastisement from Heaven.” To Piers Plowman “these pestilences were for pure sin.”
The general acceptance of this view created an expanded sense of guilt, for if the plague were punishment there had to be terrible sin to have occasioned it. What sins were on the 14th century conscience? Primarily greed, the sin of avarice, followed by usury, worldliness, adultery, blasphemy, falsehood, luxury, irreligion. Giovanni Villani, attempting to account for the cascade of calamity that had fallen upon Florence, concluded that it was retribution for the sins of avarice and usury that oppressed the poor. Pity and anger about the condition of the poor, especially victimization of the peasantry in war, was often expressed by writers of the time and was certainly on the conscience of the century. Beneath it all was the daily condition of medieval life, in which hardly an act or thought, sexual, mercantile, or military, did not contravene the dictates of the Church. Mere failure to fast or attend mass was sin. The result was an underground lake of guilt in the soul that the plague now tapped.
That the mortality was accepted as God’s punishment may explain in part the vacuum of comment that followed the Black Death. An investigator has noticed that in the archives of Périgord references to the war are innumerable, to the plague few. Froissart mentions the great death but once, Chaucer gives it barely a glance. Divine anger so great that it contemplated the extermination of man did not bear close examination.
Efforts to cope with the epidemic availed little, either in treatment or prevention. Helpless to alleviate the plague, the doctors’ primary effort was to keep it at bay, chiefly by burning aromatic substances to purify the air. The leader of Christendom, Pope Clement VI, was preserved in health by this method, though for an unrecognized reason: Clement’s doctor, Guy de Chauliac, ordered that two huge fires should burn in the papal apartments and required the Pope to sit between them in the heat of the Avignon summer. This drastic treatment worked, doubtless because it discouraged the attention of fleas and also because de Chauliac required the Pope to remain isolated in his chambers. Their lovely murals of gardens, hunting, and other secular joys, painted at Clement’s command, perhaps gave him some refreshment. A Pope of prodigal splendor and “sensual vices,” Clement was also a man of great learning and a patron of arts and science who now encouraged dissections of the dead “in order that the origins of this disease might be known.” Many were performed in Avignon as well as in Florence, where the city authorities paid for corpses to be delivered to physicians for this purpose.
Doctors’ remedies in the 14th century ranged from the empiric and sensible to the magical, with little distinction made between one and the other. Though medicine was barred by the Church from investigation of anatomy and physiology and from dissection of corpses, the classical anatomy of Galen, transferred through Arab treatises, was kept alive in private anatomy lessons. The need for knowledge was able sometimes to defy the Church: in 1340 Montpellier authorized an anatomy class every two years which lasted for several days and consisted of a surgeon dissecting a cadaver while a doctor of medicine lectured.
Otherwise, the theory of humors, along with astrology, governed practice. All human temperaments were considered to belong to one or another of the four humors—sanguine, phlegmatic, choleric, and melancholic. In various permutations with the signs of the zodiac, each of which governed a particular part of the body, the humors and constellations determined the degrees of bodily heat, moisture, and proportion of masculinity and femininity of each person.
Notwithstanding all their charts and stars, and medicaments barely short of witches’ brews, doctors gave great attention to diet, bodily health, and mental attitude. Nor were they lacking in practical skills. They could set broken bones, extract teeth, remove bladder stones, remove cataracts of the eye with a silver needle, and restore a mutilated face by skin graft from the arm. They understood epilepsy and apoplexy as spasms of the brain. They used urinalysis and pulse beat for diagnosis, knew what substances served as laxatives and diuretics, applied a truss for hernia, a mixture of oil, vinegar, and sulfur for toothache, and ground peony root with oil of roses for headache.
For ills beyond their powers they fell back on the supernatural or on elaborate compounds of metallic, botanic, and animal substances. The offensive, like the expensive, had extra value. Ringworm was treated by washing the scalp with a boy’s urine, gout by a plaster of goat dung mixed with rosemary and honey. Relief of the patient w
as their object—cure being left to God—and psychological suggestion often their means. To prevent pockmarks, a smallpox patient would be wrapped in red cloth in a bed hung with red hangings. When surgery was unavailing, recourse was had to the aid of the Virgin or the relics of saints.
In their purple or red gowns and furred hoods, doctors were persons of important status. Allowed extra luxury by the sumptuary laws, they wore belts of silver thread, embroidered gloves, and, according to Petrarch’s annoyed report, presumptuously donned golden spurs when they rode to their visits attended by a servant. Their wives were permitted greater expenditure on clothes than other women, perhaps in recognition of the large fees doctors could command. Not all were learned professors. Boccaccio’s Doctor Simon was a proctologist who had a chamber pot painted over his door to indicate his specialty.
When it came to the plague, sufferers were treated by various measures designed to draw poison or infection from the body: by bleeding, purging with laxatives or enemas, lancing or cauterizing the buboes, or application of hot plasters. None of this was of much use. Medicines ranged from pills of powdered stag’s horn or myrrh and saffron to potions of potable gold. Compounds of rare spices and powdered pearls or emeralds were prescribed, possibly on the theory, not unknown to modern medicine, that a patient’s sense of therapeutic value is in proportion to the expense.
Doctors advised that floors should be sprinkled, and hands, mouth, and nostrils washed with vinegar and rosewater. Bland diets, avoidance of excitement and anger especially at bedtime, mild exercise, and removal wherever possible from swamps and other sources of dank air were all recommended. Pomanders made of exotic compounds were to be carried on going out, probably more as antidote to the plague’s odors than to its contagion. Conversely, in the curious belief that latrine attendants were immune, many people visited the public latrines on the theory that foul odors were efficacious.
Sewage disposal was not unprovided for in the 14th century, though far from adequate. Privies, cesspools, drainage pipes, and public latrines existed, though they did not replace open street sewers. Castles and wealthy town houses had privies built into bays jutting from an outside wall with a hole in the bottom allowing the deposit to fall into a river or into a ditch for subsequent removal. Town houses away from the riverbank had cesspools in the backyard at a regulated distance from the neighbor’s. Although supposedly constructed under town ordinances, they frequently seeped into wells and other water sources. Except for household urinals, the contents of privies were prohibited from draining into street sewers. Public flouting of ordinances was more to blame for unsanitary streets than inadequate technology.
Some abbeys and large castles, including Coucy, had separate buildings to serve as latrines for the monks or garrison. The donjon at Coucy had latrines at each of its three levels. Drainage was channeled into vaulted stone ditches with ventilating holes and openings for removal, or into underground pits later mistaken by investigators of a more romantic period for secret passages and oubliettes. Under the concept of “noble” architecture, the 15th and later centuries preferred to ignore human elimination. Coucy probably had better sanitation than Versailles.
During the plague, as street cleaners and carters died, cities grew befouled, increasing the infection. Residents of a street might rent a cart in common to remove the waste, but energy and will were depressed. The breakdown in street-cleaning appears in a letter of Edward III to the Mayor of London in 1349, complaining that the streets and lanes of London were “foul with human faeces and the air of the city poisoned to the great danger of men passing, especially in this time of infectious disease.” Removed as he probably was from the daily sight of corpses piling up, the King ordered that the streets be cleaned “as of old.”
Stern measures of quarantine were ordered by many cities. As soon as Pisa and Lucca were afflicted, their neighbor Pistoia forbade any of its citizens who might be visiting or doing business in the stricken cities to return home, and likewise forbade the importation of wool and linen. The Doge and Council of Venice ordered burial on the islands to a depth of at least five feet and organized a barge service to transport the corpses. Poland established a quarantine at its frontiers which succeeded in giving it relative immunity. Draconian means were adopted by the despot of Milan, Archbishop Giovanni Visconti, head of the most uninhibited ruling family of the 14th century. He ordered that the first three houses in which the plague was discovered were to be walled up with their occupants inside, enclosing the well, the sick, and the dead in a common tomb. Whether or not owing to his promptitude, Milan escaped lightly in the roll of the dead. With something of the Visconti temperament, a manorial autocrat of Leicestershire burned and razed the village of Noseley when the plague appeared there, to prevent its spread to the manor house. He evidently succeeded, for his direct descendants still inhabit Noseley Hall.
St. Roch, credited with special healing powers, who had died in 1327, was the particular saint associated with the plague. Inheriting wealth as a young man, as had St. Francis, he had distributed it to the poor and to hospitals, and while returning from a pilgrimage to Rome had encountered an epidemic and stayed to help the sick. Catching the malady himself, he retreated to die alone in the woods, where a dog brought him bread each day. “In these sad times,” says his legend, “when reality was so somber and men so hard, people ascribed pity to animals.” St. Roch recovered and, on appearing in rags as a beggar, was thought to be a spy and thrown into jail, where he died, filling the cell with a strange light. As his story spread and sainthood was conferred, it was believed that God would cure of the plague anyone who invoked his name. When this failed to occur, it enhanced the belief that, men having grown too wicked, God indeed intended their end. As Langland wrote,
God is deaf now-a-days and deigneth not hear us,
And prayers have no power the Plague to stay.
In a terrible reversal, St. Roch and other saints now came to be considered a source of the plague, as instruments of God’s wrath. “In the time of that great mortality in the year of our Lord 1348,” wrote a professor of law named Bartolus of Sassoferrato, “the hostility of God was stronger than the hostility of man.” But he was wrong.
The hostility of man proved itself against the Jews. On charges that they were poisoning the wells, with intent “to kill and destroy the whole of Christendom and have lordship over all the world,” the lynchings began in the spring of 1348 on the heels of the first plague deaths. The first attacks occurred in Narbonne and Carcassonne, where Jews were dragged from their houses and thrown into bonfires. While Divine punishment was accepted as the plague’s source, people in their misery still looked for a human agent upon whom to vent the hostility that could not be vented on God. The Jew, as the eternal stranger, was the most obvious target. He was the outsider who had separated himself by choice from the Christian world, whom Christians for centuries had been taught to hate, who was regarded as imbued with unsleeping malevolence against all Christians. Living in a distinct group of his own kind in a particular street or quarter, he was also the most feasible target, with property to loot as a further inducement.
The accusation of well-poisoning was as old as the plague of Athens, when it had been applied to the Spartans, and as recent as the epidemics of 1320–21, when it had been applied to the lepers. At that time the lepers were believed to have acted at the instigation of the Jews and the Moslem King of Granada, in a great conspiracy of outcasts to destroy Christians. Hundreds were rounded up and burned throughout France in 1322 and the Jews heavily punished by an official fine and unofficial attacks. When the plague came, the charge was instantly revived against the Jews:
… rivers and fountains
That were clear and clean
They poisoned in many places …
wrote the French court poet Guillaume de Machaut.
The antagonism had ancient roots. The Jew had become the object of popular animosity because the early Church, as an offshoot of Judaism striving
to replace the parent, had to make him so. His rejection of Christ as Saviour and his dogged refusal to accept the new law of the Gospel in place of the Mosaic law made the Jew a perpetual insult to the newly established Church, a danger who must be kept distinct and apart from the Christian community. This was the purpose of the edicts depriving Jews of their civil rights issued by the early Church Councils in the 4th century as soon as Christianity became the state religion. Separation was a two-way street, since, to the Jews, Christianity was at first a dissident sect, then an apostasy with which they wanted no contact.
The theory, emotions, and justifications of anti-Semitism were laid at that time—in the canon law codified by the Councils; in the tirades of St. John Chrysostom, Patriarch of Antioch, who denounced the Jews as Christ-killers; in the judgment of St. Augustine, who declared the Jews to be “outcasts” for failing to accept redemption by Christ. The Jews’ dispersion was regarded as their punishment for unbelief.
The period of active assault began with the age of the crusades, when all Europe’s intramural antagonisms were gathered into one bolt aimed at the infidel. On the theory that the “infidel at home” should likewise be exterminated, massacres of Jewish communities marked the crusaders’ march to Palestine. The capture of the Holy Sepulcher by the Moslems was blamed on “the wickedness of the Jews,” and the cry “HEP! HEP!” for Hierosolyma est Perdita (Jerusalem is lost) became the call for murder. What man victimizes he fears; thus, the Jews were pictured as fiends filled with hatred of the human race, which they secretly intended to destroy.