Combating and Treating the Black Death
Annabell Farr
Imagine a deadly disease ripping through your town and the only hope of survival is in the hands of health workers who rely on established medical knowledge and practical methods in desperate attempts to save your lives. During the late Medieval period between 1347 and 1351, the Black Death stirred chaos across Europe including cities in France and Italy, killing millions of people who were in its deadly path. It brought out great fear and uncertainty in surviving resulting in the use of a variety of treatment methods, blending these practices with religious beliefs and supernatural beliefs. These different approaches reveal just how much medical knowledge at the time was shaped by pre-established knowledge, traditional theories, and practical methods from the past, raising the question: How did health workers attempt to treat and combat the plague during the Medieval period? During the medieval period, health workers attempted to combat and treat the Black Death by mixing established medical knowledge and practical methods together. Methods like theriac, bloodletting, air purifications and experimental treatments from the past like imperial powder, put together traditional healing treatments with evolving practices. This approach will show how past medical knowledge and evolving practices were used by health workers to treat and combat the Black Death. This will also show both the intellectual growth and evolution of medical treatments and methods.
These health workers were very diverse in their levels of medical knowledge; some were volunteers, nuns, inexperienced physicians and barber surgeons. Even though they had diverse levels of expertise, they all played the biggest role in the plague, giving treatments to those who fell victim to the Black Death. This approach highlights the play between practical methods, established medical knowledge, adaptation, and preventive measures in combating the plague.
Historiography
Health workers were trying to fight back at the Black Death using practical methods like bloodletting, which was brought up from past medical knowledge and public health rules growing at the time. As health workers were desperately trying to deal with the crisis the Black Death was bringing, the use of practical and hygienic measures were used as an attempt to help those falling ill. One attempt that was seen in treating the plague was the process of bloodletting. Neil Murphy’s article, “Plague Ordinances and the Management of Infectious Diseases in Northern French Towns, c.1450-c.1560,” goes into detail of the developments of public health systems and the ordinances that shaped the responses to the plague.[1] Murphy is arguing that these ordinances emerged from evolving strategies like those in Italy, were connected to cultural and intellectual contexts bringing together medical theories with practical actions. Murphy in this emphasizes the practice of bloodletting, which was performed by barber surgeons or surgeons. This procedure was aimed at removing contaminated blood, slowing down the disease in the body.2 This method shows the connection between the medical theories at the time and practical actions taken, which were shaped by the intellectual contexts of this time.
Past strategies were seen greatly in these attempts along with bloodletting, another we see is attempts in changing emotional and medical practices through survival stories. From survivors’ stories, we can understand attempts made during this time to stop the plague, especially through health workers trying to help based on past medical knowledge and practical treatments similarly to past knowledge on bloodletting. Nicole Archambeau in “Healing Options during the Plague: Survivor Stories from a Fourteenth-Century Canonization Inquest”, shows great emphasis in the intellectual context of medicines and its “miracles” on those it healed, showing how beliefs and medical practices intersected to shape the responses to the plague.[2] At this time, some people wanted healing methods combining religious and practical approaches, including methods of emotional changes. Archambeau argued that “Witnesses had healing options’… their testimonies reveal a willingness to try many different methods of healing, often all at once”[3] This shows how survivors were relying on any type of resources from family, friends and health workers connecting their beliefs and intellectual medical practices at this time. Health workers adapted their methods of helping based on the resources that were available as well as on the patients’ wants and needs. This highlights the adaptability and flexibility these health workers had for their patients and their commitment to help treat those suffering during this time of horror and devastation.
Similarly, through the past medical knowledge, health workers relied on giving treatments that blended intellectual medical knowledge with practical methods to attempt treating the plague. Another piece to these treatments we see is a compound called theriac. Christiane Nockels Fabbri’s article “Treating Medieval Plague: The Wonderful Virtues of Theriac,” shows the use of Theriac, a compound that has been used as an antidote since ancient times, being a crucial treatment during the Black Death. Fabbri argues that the use of Theriac in these treatments demonstrates how health workers applied this traditional remedy to this new disease showing conservatism of these medical practices. Fabbri states how “In plague medicine, theriac was used as both a preventive and therapeutic drug and was most likely beneficial for a variety of disease complaints.”[4] This shows how health workers relied on this because of its practical efficiency and its intellectual and cultural significance in the past.
From these three sources, it is clear to see how they all were similar in how health workers tended to link past medical knowledge with their practical methods to help suffering, showing how they attempted to go about treating the plague. Treatments like bloodletting, personal wanted miracle methods and theriac were just a few of the ways they attempted to help those who got sick. My analysis highlights how these treatments were based on public health measures that were put into cities to help maintain and stop the spreading of the plague. Ordinances aimed to help isolate the disease and keep calm over the chaos that the plague was bringing into town. These helped to create a framework that helped health workers approach how they would attempt to treat those who fell sick.
Practical Methods
One of the main and well-known treatments given by health workers during this time was a drug called theriac. This type of medicine was extremely popular in its effectiveness and was wanted by victims once they fell ill or were scared that they would fall ill. In “The real Theriac – panacea, poisonous drug or quackery?” by Raj, Danuta, Katarzyna Pękacka-Falkowska, Maciej Włodarczyk and Jakub Węglorz, talks about this compound and its ability to remove diseases and poison from the body and how it was a well-known and used drug during the medieval period; “Consequently, Theriac was being prepared during epidemics, especially the plague (Black Death), in large quantities as a form of emergency medicine (Griffin, 2004).”[5] Relying on theriac as a direct treatment, health workers showed their commitment to using this accessible great drug that was well known, to make people confident that this treatment would work during a time of uncertainty and devastation.
Correspondingly, we see another direct form of treatment that health workers used to treat those who had the plague, bloodletting. Health workers would prick veins to do this. This was a way of extracting bad blood from the body to restore its balance. We see this in document 62 “The Treatise of John of Burgundy, 1365” written by John Burgundy. It projects the practical medical knowledge at the time that health workers were applying to treat those who have been hit with the Black Death. Burgundy continues to talk about the use of bloodletting, informing that “If, however, the patient feels prickings in the region of the liver, blood should be let immediately from the basilic vein of the right arm (that is the vein belonging to the liver, which is immediately below the vein belonging to the heart)”[6]. He is giving a specific technique to address this issue, giving us a practical method of treatment that shows how health workers used these hands-on treatments to combat the plague
These two methods were greatly known during the medieval period. They both offered hope to those who were desperate and wanting treatment so they would not die. These treatments at this time offered the feeling of control to the scary situation for its victims and gave a sense of hope to get better. Knowing theriac and bloodletting were used as treatment for victims, it helped to feel less overwhelmed and made it seem like health workers would be the redeeming feature to their deadly crisis.
Established Medical Knowledge
During the medieval period, health workers were able to recognize and understand that miasma, contaminated air, was the main causing factor of why the Black Death was spreading so much and killing everyone in its path. Due to this understanding, they implemented environmental purification strategies to end exposure of miasma. “The dangers of corrupted air” by Bengt Knutsson, shows great emphasis on this fear of the contaminated air and goes into methods that were used and done to cleanse the space and environment people were living in. A practice that health workers implemented to stop the miasma from taking over was to “Therefore let your house be clean and make clear fire of wood flaming. Let your house be made with fumigation of herbs, that is to say with leaves of bay tree, juniper…”[7] while also explaining opening windows at certain times and remedies if you feel sick.[8] These techniques reflect how established medical knowledge can be used in order to come up with ways to treat and combat the plague. Including the purification methods into the plague’s prevention by health workers, they were able to adapt with their knowledge on air quality and turn that into strategies to combat the Black Death.
Through the fears of the Black Death, health workers were relying on past medical knowledge, practices and strategies to manage the spread of this disease and to treat those who have been infected. The “Ordinances against the spread of plague, Pistoia, 1348” elaborates on how these workers used their past medical knowledge to reduce the spread and create a safer environment to go about treatments. This chronicler explains limiting your exposure to those who are ill by completely restricting people and patients’ interactions.[9] This will provide health workers with the safest opportunity to apply these treatments, like bloodletting or giving theriac, in a more controlled environment. This approach further reflects the combination of traditional medical knowledge and practical adaptations so then health workers could attempt to combat the plague’s destruction.
Health workers relied heavily on past medical knowledge and theories during this time of uncertainty to combat the Black Death, bringing together adaptations with established knowledge. The understanding of bad air being the cause helped them greatly in purification techniques like burning the herbs to mask the miasma. The ordinances stressing the need for isolation and restriction for interactions to give a safer environment for the health workers showed their adaptability to meet the demands of the plague as well as their preservation of historical medical theories of those in the past doing it. This shows the continuity and innovation that came during this period when trying to understand and combat the plague.
Adaptation and Preventative Measures
One way that health workers attempted to treat and combat the plague was through the development of treatments that were adapted from past medical knowledge. An example of this was imperial powder, in John Burgundy’s “The Treatise of Burgundy, 1365” being known as a “powerful preventative” that was thought of to be stronger than theriac. Burgundy explains how “gentile emperors used it against epidemic illness, poison and venom, and against the bite of serpents and other poisonous animals”[10] This powder was made from some herbs like St John’s wort, medicinal earth from Lemnos and dittany which shows us the diverse ingredients to kill off poison that were believed from the past and venoms that were inside the body. To use this powder, they would either apply it directly to the skin or by mixing it with a drink like wine for ingestion purposes. This shows the health workers willingness to experiment with past medical treatments to adapt it to the current plague they were going through, to find a better treatment for the Black Death.
Looking past medical treatments, to do them, health workers were implementing strict isolation strategies in order to combat and limit the spread of plague while also keeping the environment safe in order to treat those who fell ill. “The plague in Avignon” by Louis Heyligen shows emphasis on this isolation of staying away from neighboring areas and people so then health workers can do what they needed to do to help. This was an attempt made to manage the spreading of the disease through the town. It states how “…avoid getting cold, and refrain from any excess, and above all mix little with people – unless it be with few who have healthy breath; but it is best to stay at home until the epidemic has passed”[11]. Having this advising gives the reflection of the public health strategies that were employed in the cities being tied to medical treatments, because limiting the exposure would directly allow more health workers to safely treat those who were sick and in need of treatments. Trying to minimize contact with one another was a great strategy in controlling the transmission to get the disease to slow down in spreading. From the emotions brought on from the Black Death, it shows the willingness people were taking, to make it safer conditions outside for families and health workers.
Combining both the experimental treatments like imperial powder with the isolation policies, it opened the view of just how much health workers were combining the preexisting medical knowledge with their preventative measures to successfully combat the plague while treating it. Having this adaptability further influences medical practices and lays a greater foundation for future prevention strategies for diseases that come.
Conclusion
In conclusion, we have explored several ways in which health workers attempted to treat the plague and combat it through pre-stablished medical knowledge and practical methods. These health workers, being remarkably diverse in who they were, applied many strategies and methods that were used including enforcing strict public health ordinances, the practice of bloodletting by barber surgeons, air purifications, use of Theriac and experimenting with the use of the imperial powder to attempt treating the plague. These health workers showed great standing adaptability to what was going on while building off the existing knowledge of medical treatments to address the deadliest crisis in history. This analysis gives a deeper understanding of medical knowledge and how they used their past resources to understand and try to save those who contracted this disease. Also, this shows how these attempts were deeply rooted into the intellectual history of these times through health workers drawing information from past medical scholars and past knowledge to gain a better understanding in how to perform their practices and methods. Involving themselves in this intellectual history, they were putting a building block on top of centuries of their medical knowledge through experimenting with it and adding new responses to how they attempted to treat their new disease. These contributions to the Black Death only strengthens our understanding of past medical history during the Black Death and past centuries.
References
Archambeau, Nicole. “Healing Options during the Plague: Survivor Stories from a Fourteenth-Century Canonization Inquest.” Bulletin of the History of Medicine 85, no. 4 (2011): 531–59. http://www.jstor.org/stable/44452234.
Burgundy, “The Treatise of Burgundy, 1365” pp.184-193
Chiappelli, A. “Ordinances against the Spread of Plague, Pistoia, 1348.” pp 194- 203
Fabbri, Christiane Nockels. “Treating Medieval Plague: The Wonderful Virtues of Theriac.” Early Science and Medicine 12, no. 3 (2007): 247–83. Retrieved from http://www.jstor.org/stable/20617676. Heyligen, “The Plague in Avignon.” pp.41-45
Horrox, R., ed. The Black Death (Manchester: Manchester University Press, 1994).
Knutsson, “The dangers of corrupted air” pp.173-177
Murphy, Neil. “Plague Ordinances and the Management of Infectious Diseases in Northern French Towns, c.1450–c.1560.” In The Fifteenth Century XII: Society in an Age of Plague, edited by Linda Clark and Carole Rawcliffe, 139-160. Woodbridge: Boydell & Brewer, 2013
Raj, Danuta, Katarzyna Pękacka-Falkowska, Maciej Włodarczyk, and Jakub Węglorz. 2021. “The Real Theriac – Panacea, Poisonous Drug or Quackery?” Journal of Ethnopharmacology 281 (December): N.PAG. doi:10.1016/j.jep.2021.114535.
[1] Murphy, Neil. “Plague Ordinances and the Management of Infectious Diseases in Northern French Towns, c.1450–c.1560.” In The Fifteenth Century XII: Society in an Age of Plague, edited by Linda Clark and Carole Rawcliffe, 139-160. Woodbridge: Boydell & Brewer, 2013 2 Murphy, 146.
[2] Archambeau, Nicole. “Healing Options during the Plague: Survivor Stories from a Fourteenth Century Canonization Inquest.” Bulletin of the History of Medicine 85, no. 4 (2011): 531–59. http://www.jstor.org/stable/44452234.
[3] Archambeau, 537.
[4] Fabbri, Christiane Nockels. “Treating Medieval Plague: The Wonderful Virtues of Theriac.” Early Science and Medicine 12, no. 3 (2007): 247–83. http://www.jstor.org/stable/20617676.
[5] Raj, Danuta, Katarzyna Pękacka-Falkowska, Maciej Włodarczyk, and Jakub Węglorz. 2021. “The Real Theriac – Panacea, Poisonous Drug or Quackery?” Journal of Ethnopharmacology 281 (December): N.PAG.
[6] Burgundy, “The Treatise of Burgundy, 1365” in The Black Death, ed. And trans. Rosemary Horrox (Manchester: Manchester University Press, 1994), 189.
[7] Knutsson, “The dangers of corrupted air” p.176
[8] Knutsson, “The dangers of corrupted air,” p.176
[9] Chiappelli, “Ordinances against the spread of plague, Pistoia, 1348,” p. 195
[10] Burgundy, “The Treatise of Burgundy, 1365” p.190
[11] Heyligen, “The Plague in Avignon” p. 45
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