The Black Death (11 page)

It was bad to sleep by day or directly after meals. Gentile
believed
that it was best to keep steady the heat of the liver by sleeping first on the right side and then on the left. To sleep on one’s back was disastrous since this would cause a stream of superfluities to descend on the palate and nostrils. From thence these would flow back to the brain and submerge the memory.

Bad drove out bad and a school of thought maintained that to imbibe foul odours was a useful if not infallible protection.
According
to John Colle: ‘Attendants who take care of latrines and those who serve in hospitals and other malodorous places are nearly all to be considered immune.’ It was not unknown for
apprehensive
citizens of a plague-struck city to spend hours each day crouched over a latrine absorbing with relish the foetid smells.

A tranquil mind was one of the surer armours against
infection
. Ideally one should retreat to Boccaccio’s enchanted glade, live beautifully, pass one’s time in dalliance and in practising the art of conversation. But dalliance should not be carried too far: sex, like wrath, heated the members and disturbed the
equilibrium
. One’s mind should be resolutely closed to the agonies of one’s fellow men; sadness cooled the body, dulled the intelligence and deadened the spirit.

It seems unlikely that the intelligent and enlightened men who worked out these preventive measures had any great faith in their efficacy. Essentially they were a morale-building exercise:
the morale of the physician, in that they made him feel at least remotely in control of the situation, and of the patient, in that they offered a slight hope of escape from death. But if the doctors lacked confidence in their capacity to keep the plague at bay, still more did they doubt their ability to cure it once it had struck. They knew too well how few of the sick recovered. But this
knowledge
of their helplessness did not stop them putting forward a host of remedies.

Bleeding was an even more important part of the cure than it had been of prevention. The blood that emerged from the
infected
would normally be thick and black; it boded even worse for the victim if a thin green scum rose to the surface. If the
patient
fainted, instructed Ibn Khātimah somewhat heartlessly, pour cold water over him and continue as before. Most surgeons bled for the sake of bleeding, not worrying much where the
incision
was made. John of Burgundy
33
was more scientific. He
believed
in the existence of emunctories, from which the poison could be expelled by bleeding. The evil vapours, having entered by the pores of the skin, were carried by the blood either to the heart, the liver or the brain. ‘Thus, when the heart is attacked, we may be sure that the poison will fly to the emunctory of the heart, which is the armpit. But if it finds no outlet there it is driven to seek the liver, which again sends it to its own
emunctory
in the groin. If thwarted there, the poison will next seek the brain, when it will be driven either under the ears or to the throat.’ Each emunctory had a surface vein which corresponded to it and a skilled surgeon could there intercept the poison on its devil’s progress around the body and draw it off before it did more mischief. A common and disastrous mistake was to make the incision on the wrong side of the body; this not only wasted good blood but meant that healthy limbs were corrupted by the degraded liquid which poured in to make up the loss.

As well as bleeding, it was useful to open and cauterize the plague boils or buboes. Various curious substances were applied to the boils to draw off the poison. Gentile used a plaster made from gum resin, the roots of white lilies and dried human
excrement
, while Master Albert was in favour of an old cock cut through the back. Ibn Khātimah believed that an operation on
the bubo was possible between the fourth and seventh day of the disease when the poison was flowing from the heart to the boils. But even a slight mistake in timing could lead to the escape of the vital principle from the heart and the immediate death of the patient.

Various soothing potions were prescribed, in particular a blend of apple-syrup, lemon, rose-water and peppermint. This must at least have been pleasant to drink. Even this consolation was removed when powdered minerals were added to the
mixture
. There was some belief in the virtues of emeralds and pearls and the medicinal qualities of gold were taken for granted by most authorities. Take one ounce of best gold – was Gentile’s recipe – add eleven ounces of quicksilver, dissolve by slow heat, let the quicksilver escape, add forty-seven ounces of water of borage, keep airtight for three days over a fire and drink until cure or, more probably, death supervened. At least the high price of gold ensured that not many invalids could afford to be poisoned by such medicines.

Just how little the doctors learned from the Black Death is shown by the Tractate of John of Burgundy or John à la Barbe, published in 1365.
34
It is true that the author had gained much of his experience and no doubt devised his treatments in 1348 and 1349 but he had lived through a second great epidemic in 1361 and, at the time he wrote, was distilling what should have been a lifetime’s learning. The same sterile analysis of causes appeared, the same catalogue of futile preventive methods and still more futile cures. Given the state of medical learning no great leap forward was possible but if Hippocrates had been alive he would at least have discarded a lot of dead wood of proven uselessness and made some sensible and valuable deductions about the
conditions
in which the epidemic seemed to thrive and the best means of removing them. Of this there was nothing; only the regurgitation of long discredited dogmas and, from time to time, the addition of some new mineral or vegetable gimmick to give the technique of the writer a flavour of modernity.

Fourteenth-century men seem to have regarded their doctor in rather the same way as twentieth-century men are apt to
regard
their priest, with tolerance for someone who was doing his best and the respect due to a man of learning but also with a nagging and uncomfortable conviction that he was largely
irrelevant
to the real and urgent problems of their lives. They were, of course, ready to believe almost anything which was told them with authority but their faith had been undermined by the
patent
lack of confidence on the part of the doctors themselves. Sometimes, under intolerable stress, scepticism would give way to something more primitive and violent, tolerance would crack and the doctor find himself execrated as the architect of the
disease
which he had proved so signally ill-qualified to check. But such moments of revulsion were rare and in general the doctor preserved a privileged position. Chaucer’s mockery and the
occasional
abuse of an aggrieved patient was the worst that he had to bear.

*

However little use the doctors may have been, the average Parisian at least had the comfort of knowing that he was far better provided with medical attention than his contemporaries. There were more doctors, predominantly Jewish, in Paris than in any other city of Europe and all surgeons had passed an
examination
and had been licensed by a panel of master surgeons trained at the Châtelet.
35
The fashionable course for study was based on the works of the Arab surgeon Razi and an ointment called ‘
Blanc
de
Razès
’ was on sale at apothecaries as a cure
recommended
for virtually any ailment. But no amount of
ointments
nor the wisdom of the august Faculty of Medicine itself could do much to help the Parisian when the Black Death broke about him.

It seems that the first authenticated cases of plague in the capital were noted in May or June 1348, though the full force of the epidemic was not felt until several months later. It did not die out until the winter of 1349. The chronicler of St Denis put the death roll at about fifty thousand,
36
a surprisingly conservative estimate for a city that may well have had more than two
hundred
thousand inhabitants.
37
Certainly there is no reason to think the figure exaggerated. An analysis based on church warden
accounts
for the parish of St Germain l’Auxerrois showed that seventy-eight legacies were bequeathed to the church between Easter 1340 and 11 June 1348.
38
In the next nine months the number rose to four hundred and nineteen – a rate forty times as high. ‘It seems,’ commented Mollat, ‘that the plague sent men to their lawyers as fast as to their confessors.’ On this, admittedly somewhat slender basis, he calculated that the plague was at its worst almost at the end, in September and October 1349, and that it ran an unusually protracted course. The Bishop, Foulque de Chanac, died in July 1349; the Duchess of Normandy, Bonne de Luxembourg, in October and her mother-in-law, Jeanne de Bourgogne, when the danger must have seemed almost over, on 12 December.

‘There was,’ wrote the best-known chronicler of the Black Death in Paris, ‘so great a mortality among people of both sexes, of the young rather than of the old, that it was hardly possible to bury them.’
39
This is not the only reference to the plague striking the young rather than the old, the strong before the weak.
Statistically
, as will be seen more clearly in the case of England,
40
there seems no reason to credit such a theory. The position is, of course, complicated by the tendency of the old to die from other causes without a major epidemic to speed them on their way, but, even after allowing for this, the young and fit, as was to be expected, proved the more likely to resist the disease. The death of a strong young man is naturally more shocking and more likely to be remembered: to this, perhaps, is due the conviction on the part of certain chroniclers that his chances of death were unfairly high.

‘In the Hôtel-Dieu at Paris,’ continued the chronicler, ‘so great was the mortality that for a long time more than five hundred
corpses were carted daily to the churchyard of St Innocent to be buried.’ Cardinal Gasquet has suggested that this is a misprint for fifty.
41
Certainly the latter figure is probably nearer reality but there seems little reason to doubt that William of Nangis would have preferred the larger, more imposing total. ‘And those holy sisters,’ he continued, ‘having no fear of death, tended the sick with all sweetness and humility, putting all honour [sic ?fear] behind their back. The greater number of these sisters, many times renewed by death, now rest in peace with Christ, as we must piously believe.’ Such examples of self-abnegation were rare enough to deserve special mention; for the most part, in Paris as in every other city, the rule of the day was
sauve-qui-peut.
Charity, if it was to be found at all, began at home and ended there. Even the priests ‘retired through fear’, leaving the sick to shrive themselves or, if they were lucky, to gain the attention of a mendicant friar.

When the pastors set such an example it was hardly surprising that their flocks should follow suit. In the benighted city, where it seemed death to wander abroad, only those servants of death, the grave-diggers, felt themselves free to travel where they would. The rich and privileged fled, the poor remained to drown their fear in looted liquor and die in their hovels. Under the surface scum of terror and disorder ordinary decent men continued to behave in an ordinary, decent way; the life of the city fitfully continued. But to the casual visitor it must have seemed that society had disintegrated, that the plague must rage until there was not a home inviolated, not a Parisian alive. If it was not to be the end of the world, it seemed at least the end of the
established
order.

*

From Paris the plague moved northwards to the coast, which it reached in or a little before August 1348. In this area,
exceptionally
, the winter checked the violence of the epidemic but with the spring it returned, evidently in its more virulent pulmonary form. The King had fled from Paris to Normandy but the plague was quick to follow him. At Rouen, where an over-excited
contemporary
calculated the dead at a hundred thousand, the Duke of Normandy donated land for a new graveyard. At Bayeux the
Bishop and many canons died. At La Graverie, about four miles from Vire, ‘the bodies of the dead decayed in putrefaction on the pallets where they had breathed their last.’ A black flag flew above the church as it did in all the worst affected villages of Normandy.
42

La Léverie was a village within the parish of La Graverie. The lady of the manor died and her relatives wished to bury her in the churchyard. But no priest of La Graverie remained alive to conduct the service and there was no sign of a new incumbent being appointed. The relatives appealed to the priest of
neighbouring
Coulonces who was happy to bury the deceased but drew the line at visiting La Graverie, because of the danger of
infection
, and was equally reluctant to accept the corpse in Coulonces for fear of contaminating his so far inviolate village. So this lady was buried in the park of her own manor and the grateful
relatives
arranged the transfer of La Léverie from the parish of La Graverie to the parish of Coulonces.

St Marie Laumont in the same area lost four hundred people, or over half the population. The epidemic there raged for three months and had ended by September 1348. Amiens, it seems, must have suffered a second attack or perhaps, as occasionally happened in the larger cities, wasted away gradually over a year or more rather than succumbed to a brief but shattering
epidemic
. As late as June 1349 the King authorized the Mayor to open a new cemetery on the grounds that: ‘The mortality … is so marvellously great that people are dying there suddenly, as quickly as between one evening and the following morning and often quicker than that.’
43
Meanwhile the Black Death seeped across every corner of France. Bordeaux it had reached in August 1348 and there caught and killed Princess Joan, daughter of King Edward III of England, on her way to marry the son of the King of Castile. The news of her death reached England at much the same time as the plague itself.