Medieval epidemics: “It felt as if the Apocalypse was nigh”

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The lecture series on “Infection and Disease, Healing and Recovery” (in German), organized by the Center for Medieval and Renaissance Studies at LMU, which begins on 21 October, sheds new light on the effects of epidemics in the past. In this interview, PD Dr. Johannes Klaus Kipf from the Institute of German Philology, joint organizer of the series, describes premodern efforts to treat the sick, the abandonment of villages and the dramatic loss of communal solidarity provoked by epidemics. Dr. Kipf, with what sorts of epidemics were European populations confronted in the Middle Ages and the Renaissance?

Johannes Klaus Kipf: Unfortunately – owing to the poor sanitary conditions and lack of medical knowledge – there were many. The most prominent was probably plague (Pest), which coursed through Europe in several huge waves, and is best remembered for the arrival of the ‘Black Death’ around 1348. Modern estimates suggest that it could have killed one-third of the population of Europe. The second example, which became endemic, was leprosy (Aussatz), which first appeared in Europe in the Middle Ages. For the victims of this infectious disease, which is caused by a pathogenic bacterium and can lead to mutilations, infirmaries were set up, which were often depicted in contemporary literature and art. Syphilis first came to prominence in Europe toward the end of the 15th century. In addition, infectious bacterial diseases such as typhus (caused by Rickettsiae) were widespread, typhoid fever (caused by Salmonellae) recurred until well into the 19th century, when cholera also appeared.

How did people try to account for these diseases?

The contemporary medical and scientific theories were derived from medieval concepts which had little or no empirical basis, and were in that sense prescientific in character – In our lecture series, the historian Katharina Wolff will deal with this topic. These were based essentially on the assumption that the body produced four liquids known as ‘humors’, which were maintained in a specific state of equilibrium in healthy individuals. In the specific case of plague, it was thought that poisonous vapors were responsible for disrupting this equilibrium. That is why city-dwellers were advised to retreat to their estates in the country, as Boccaccio explains in the foreword to his Decamerone.

The other major explanatory model was based on theological considerations. Priests drew parallels with stories in the Bible – citing the ten plagues of Egypt, for instance. Consequently, they interpreted these illnesses as divine punishments for sin, vice and other violations of God’s law. In addition, there were interpretations based on astrological notions. Comets or unfavorable constellations in the firmament were regarded as precursors or indeed causes of epidemics and wars.

How did they react to the emergence of these illnesses?

One reaction was to isolate the victims from the rest of society. – In the case of leprosy, they were sent to a ‘leper house’ (Siechenhaus). In the case of plague, the crews of ships arriving from ports in regions likely to harbor the disease were required to remain aboard their ships for a period of 40 days before they were allowed to land. – The term ‘quarantine’ originated from this practice.

From the point of view of modern medical knowledge, attempts to cure these infectious diseases were as pseudo-scientific as the putative explanations of their origins: Blood-letting was a popular treatment, but in the case of plague people were often advised to carry sources of fragrant scents on their persons. In addition, there were the religious remedies – church services, penitential rituals, pilgrimages, self-chastisement. These measures were justified in the light of the state of contemporary knowledge and the medieval mindset. But of course, physicians and the learned were effectively powerless in the face of these diseases.

How did these epidemics change societies?

First of all, the waves of depopulation that they caused resulted in dramatic changes in the structure of society. Whole quarters in cities, and entire villages, were left deserted. Crops were no longer sown or attended to, which in turn led to famines. And the fact that so many loved ones had died triggered – in addition to the burden of grief – a feeling that the biblical Apocalypse was nigh.

Especially in the era of the Black Death, chroniclers and literary figures noted and lamented a dramatic loss of social solidarity. People died of the infection so rapidly that, in the face of such widespread loss, the bereaved seemed unable or unwilling to fulfill their moral, religious and social obligations. Instead, they did everything they could to save themselves, or if that seemed hopeless, they tried to make the time that remained to them as pleasant as possible.

What makes historical epidemics interesting for you as a linguist philologist?

In the first place, many of the German terms used in the historical sources – Pest, Aussatz, Syphilis – are simply the words that were customarily used; they are not diagnostic in character. –And since most historical illnesses can no longer be diagnosed based on biological remains, medical historians can only hope to define them approximately. Moreover, the terms used for these infectious diseases varied from one country to the next. For example, syphilis was referred to in many European countries as “the French disease”, but in France it was called “mal de Naples” (the Neapolitan disease). The term “syphilis” itself is based on a mythological interpretation of the condition. In Greek, syphilos means “lover of pigs”.

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Your own contribution to the lecture series looks at epidemics as media events, based on the response to the first epidemic of syphilis in Europe. What did it take to create a media event in the 15th century?

The first large-scale outbreak of syphilis occurred around the time of the discovery of America, which coincided with the transition from hand-written texts to printed books. Prior to Gutenberg‘s invention, wandering minstrels, mounted messengers and traveling merchants were the principal bearers of news. But when the first cases of syphilis appeared, Europe’s printing presses began to produce pamphlets, often illustrated, that described the symptoms and dangers of the disease – in short texts, in verse, sometimes in Latin. By the turn of the century, first-hand reports were being printed, in which people described their own experience of the disease – including horrendous descriptions of “treatments” such as rubbing mercury into the skin.

That sounds like some of the posts on COVID-19 on social media. What can we learn from the responses to historical epidemics for our own current situation?

I can only answer that question from my own personal perspective, which is of course influenced by my research. When I take a break from my analyses of the historical sources relating to medieval epidemics, I feel above all a strong sense of gratitude – gratitude for the high standards of hygiene we now have, and for the advances in medical science, which not only enable us to identify infectious pathogens in the laboratory, but also to develop vaccines against them in double-quick time.

Further information on the lecture series “Infection and Disease, Healing and Recovery” (in German)

The lecturers include historians, literary scholars, musicologists and experts in Byzantine Studies – and the themes of the lecture series covered range from the Justinian plague and the epidemic that decimated the army of the Emperor Frederick Barbarossa to the semantics of late medieval discourses on the sacrament of confession.