The most generally accepted theory at the time was that the epidemic came from a poisoning of the air.  This is why the most favourised classes were taken with a real frenzy for “purification” of the atmosphere, as Boccace recounts:

“Without locking themselves up, they came and went, some carrying flowers in their hands, others fragrant herbs, others again, different sorts of aromatic plants which they often placed under their noses, thinking that comforting the brain with such perfumes was the best prevention, as the air seemed to be poisoned and thick with the stink of dead bodies, sick people and medicines.”

This last word suggests fairly well in what little estime enlightened minds held the doctors.  Their remedies were fairly generally considered the surest ally of the disease.  In the aristocratic and middle-class houses of France and Italy, great consumption of aromatic plants, in the form of intensive fumigations, was made, to the point of making the atmosphere really unbreathable, killing the local birds by asphyxia…  And all for nothing.

It is true that medical prescriptions were combined with some recommendations full of good sense, but there were others which, in the light of today’s knowledge, appear absurd.  For example, in October 1348, the Faculte de medecine de Paris advised

“not consuming fowls, water-birds or piglets, no “ripened” beef nor fatty meat.  Broth is recommended with ground pepper, cinnamon and spices, particularly for people who do not eat much, but only choice food.  It is bad to sleep during the daytime.  Sleep must not be prolonged, or only very little, after dawn.”

They should drink very little at breakfast, according to the Faculty, but wine was authorised at lunch – which must be taken at 11 o’clock – diluted with one-sixth water.  Fresh or dried fruit were inoffensive accompanied with wine, for

“without wine, they may present a danger for the heart”.

Aromatic plants, such as sage and rosemary, were considered salutary and it was recommended to absorb a bit of theriac (electuary composed of different substances, including opium) during meals.  On the other hand, cold, spongy or watery foods and fish must be prohibited, as generally bad;  olive oil with the food was mortal.  It was dangerous to stay out at night until 3 a.m., because of the dew.  It was better to avoid any great physical activity, and protect oneself from the cold, humidity and rain by warm clothes.  Corpulent people needed to expose themselves to the sun.  These prescriptions, as well as being completely aberrant to some, are a strange mixture of strictly medical recommendations and purely moral counsels.  All excess of abstention, excitation, anger or inebriety was dangerous, diarrhoea serious and baths risky.  Intestinal functions had to be facilitated by a clyster.  Intimate relations with women were mortal and copulation must be avoided, as well as even sleeping in a woman’s bed.  This last recommendation finds it origin perhaps in the constatation that women, for reasons difficult to establish, appear to have been more greatly infected than men.

More serious, and obviously more efficient, were the prophylactic dispositions of an administrative character.  Unfortunately, they were hardly generalised in Europe before the XVIth Century, or even the XVIIth Century for Germany, when there were diverse recrudescences of the epidemic.  It was the Venitian Republic which led the way.  It established, on 29 March 1348, a Sanitary Council, which immediately decided to put into quarantine, on an island in the lagoon, any traveller and all merchandise coming from the Orient.  The choice of forty days of isolation bore a religious connotaion:  it was the time that Christ spent in the desert.  Comparable measures, although more sporadic, were taken in a few other European cities.  In England, the town of Bristol was authoritatively isolated from the rest of the country:  90% of its inhabitants were dead.  In England, the plague had made 1.5 million victims.

Preventive measures were never strictly medical.  Philosophical or moral considerations were added to them, like the idea that the plague punished excess, appetites, extreme pleasures.  Some Italian doctors of humanist temperament voluntarily mixed “scientific” notion and Platonician metaphysics:

“In the first place, no man must think of death;  neither should he conceive any passion for another human being, whatever.  Nothing must afflict him, but all of his thoughts should, on the contrary, be turned toward pleasant, agreeable and delicious things.  It is best to avoid mixing with other people.  You should visit admirable sites and beautiful gardens, particularly when odorous plants, but above all climbing or rampant ones, are in flower.  However, you must avoid remaining too long in the gardens, for the air there is a lot more dangerous at night.”

Marsile Fisin affirms that during a plague, it is better to totally avoid women of loose morals, and drunks.  Another inscription is rather astonishing:

“The contemplation of gold, silver and other precious stones is comforting for the heart.”

These recommendations, of course, could only comfort those who had gold and precious stones…

Medicine was sometimes more pragmatic.  Guy de Chauliac, notably, practised efficient surgery:  the intervention consisted in opening the boils and cauterising them with a red-hot iron.  Some patients were able to escape death when the boils, by drying out, opened on their own.

Uneducated populations treated themselves almost exclusively with familiar remedies or amulets sold by charlatans, begging monks, and sometimes even doctors.  This credulous public was ready to do anything to escape the disease.  Although endowed with a rational mind, Guy de Chauliac, himself, accepted certain superstitions of the time:  he believed in the influence of the stars and referred to hermetic doctrine.  He practised purges and blood-lettings in function of the planets’ positions.  For him, chronic illnesses came from a solar influence, while the others were attached to the moon.  So, he recommended, when the Sun was in the sign of Leo and the Moon was not turned toward Saturn, the wearing of a belt made from lion skin decorated with the representation of this animal sculpted in pure gold, which was obviously not available to any serfs…

To be continued.

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