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MEDICAL AND MORAL INTERPRETATIONS OF PLAGUE AND
PESTILENCE IN LATE MIDDLE ENGLISH TEXTS

By

Edwin M. Stieve

A DISSERTATION

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

DOCTOR OF PHILOSOPHY

Department of English

1988

ABSTRACT

Scholars have long recognized that the bubonic
plague was, to a greater or lesser extent, a cause of
various socio-economic changes in the later Middle Ages.
The degree to which these changes were perceived when
they were occurring, however, is less clear. This
dissertation argues that in popular awareness, at least
in England, plague was understood as part of a familiar
cosmology rooted in past authority, in ways that made -
the disease less catastrophically debilitating for its
survivors than is sometimes assumed. Using vernacular
English sources, the dissertation explores medical and
moral notions about plague available to Middle English
readers. Medical writers responded to plague within the
framework of past medical theory; literary and didactic
writers placed it within the framework of earlier
stories and admonitory advice. Although not susceptible
to treatment once contracted, plague was seen as being
at least potentially avoidable, through proper physical
and spiritual governance.

The first part of the dissertation (Chapters One
through Four) sketches medical and historical

backgrounds of plague and examines interpretations of

the disease in English medical works. In particular,
Chapter Three considers Middle English plague treatises,
especially those based on John of Burgundy’s De morbo
epidemiae. Chapter Four concerns more general medical
treatises containing plague references: John Arderne’s
surgical treatises, the Middle English translation of
Guy de Chauliac’s Cyrurgia magna, the Middle English
Liber de diversigimedicinis, the verse treatise "In
Hoote Somere," and the Middle English Libgg

uricrisiarum.

 

The second part of the dissertation (Chapters Five
through Seven) analyzes interpretations of plague found
in Middle English didactic and literary works,
interpretations which move from medical advice on
personal governance to more spiritually and morally
oriented commentary. Following a brief discussion of
ecclesiastical interpretations of plague (Chapter Five),
Chapter Six considers plague references in several works
by John Lydgate and other didactic and practical
writers. Chapter Seven examines the role of plague in
the Canterbury Tales (Fragment Six), Piers Plowman, and
Lydgate's Qance of Death. The dissertation concludes by
briefly comparing responses to plague in Middle English
with later literary uses of plague as an emblem of

social and moral crisis.

In memoriam

Patricia Klari Erdoss and John A. Yunck III

medievalists, scholars, friends

But nothing’s lost. Or else: all is translation
And every bit of us is lost in it

(Or found--I wander through the ruin of 8

Now and then, wondering at the peacefulness)
And in that loss a self-effacing tree,

Color of context, imperceptibly

Bustling with its angel, turns the waste

To shade and fiber, milk and memory.

James Merrill
from "Lost in Translation"

iv

ACKNOWLEDGMENTS

I wish to acknowledge the assistance of my guidance
committee, Professors John A. Alford, Jay B. Ludwig, and
Peter Vinten-Johansen, and especially, Professor M.
Teresa Tavormina, my committee chair, who cheerfully
read countless drafts of this study. In addition, I’ve
had much support from Drs. Tom Broman and Lynn Nyhart,
Mrs. Barbara Goretzka, and Mr. Matthew Nikkari. Thanks
are also due to Professor Elfriede Manning for
assistance with French translations.

TABLE OF CONTENTS

List of Figures . . . . . . . . . . . . . . . .
Abbreviations . . . . . . . . . . . . . . . . .
Introduction . . . . . . . . . . . . . . . . .
Chapter One: Backgrounds . . . . . . . . . . .

1. What is Plague? The Twentieth-Century
Interpretation . . . . . . . . . . . .

2. Words and Concepts Associated with
Plague Historically. . . . . . . . . .

3. Medieval Cosmology . . . . . . . . . .

Part I: The Medical Interpretation of Plague

Chapter Two: The Background of the Medical
Interpretation . . . . . . . . . . . . . .

l. Humoral Theory and Plague . . . . . . .
2. The Typical Academic Medical Treatise

as a Model for English Plague Treatises

Chapter Three: Fourteenth- and Fifteenth—Century

English Plague Treatises . . . . . . . .
1. John of Burgundy’s Treatise . . . . .
2. Advice from ”Some Men in Oxford" . . .
3. John Stipse’s Treatise . . . . . . . .

vi

ix

16

16

22
35

51

54

56

62
62
84
86

4. Bengt Knutsson’s Treatise . . . . . .

5. Conclusion . . . . . . . . . . . . . .
Chapter Four: References to Plague in General

medical works 0 O O O O O O O O O O O 0 O

1. The Surgical Treatises of Guy de
Chauliac and John Arderne . . . . . .

2. General Medical Treatises with Advice

on plague O O O O O O O O O O O O C O
3. ”In Hoote Somere" (A Popular Fifteenth-
Century Treatise) . . . . . . . . . .

4. The Liber Uricrisiarum (in Welcome 225)

5. Conclusion: Plague Treatises and Their
Readers 0 O O O O O O O O O O O O O 0

Part II: The Moral Interpretation of Plague

Chapter Five: The Church’s Interpretation of
Disease. 0 O O O O O O O O O I O O O 0 O 0

Chapter Six: From Medical to Moral
Interpretations of Plague: John Lydgate and
Other Didactic Writers. . . . . . . . . . . . .

1. Lydgate’s Dietary and Doctrine for the
Pestilence . . . . . . . . . . . . . .

2. Lydgate and Burgh’s Secrees of Old
Philosoffres .‘. . . . . . . . . . . .

3. Plague References in Other Late Middle
English Didactic Works . . . . . . . .

Chapter Seven: Allusions to Plague in Examples
from Medieval English Poetry . . . . . . . . .

1. Fragment Six of the Canterbury Tales .

vii

88

95

101

111

117
120

123

135

154

159

164

171

186
184

2. Pierg Plowman, B-text . . . . . . . . .

3. The Dance of Death . . . . . . . . . .

4. Conclusion:

of Plague

Epilogue . . . .

Works Cited . . .

The

Primary Sources.

Secondary Sources.

Works Consulted .

Literary Interpretation

viii

210

223

229

234

247
247
257
275

47:

48:

50:

LIST OF FIGURES

Mundus-annus-homo: Diagram from 8th C. Munich codex
(in Herrlinger 53).

Christ as Salvator mundi: 14th C., Bibliotheque
Nationale, Paris (in Herrlinger 57).

Uroscopic Charts: pre-15th C. (in Herrlinger 75).

ix

ABBREVIATIONS

 

 

D_M Bulletin of the History of Medicine
Diss. Dissertation

EETS Early English Text Society

es extra series

L. Latin

MED Middle English Dictionary

n note

ns new series

DDQ Notes and Querigs

as original series

QED Oxford English Dictionary

P Press

D_ Patrologiae Latinae Cursus Completus
Publ. Publishing, Publishers

qtd. quoted

rpt. reprinted

ser. series

U University

var. variation, variant

Abbreviations frequently used in text, notes, Works
Cited and Consulted are listed above.

Introduction

A great scourge never appears unless there is a
reason for it.

Henry Miller, The Air-Conditioned Nightmare (18)

A pandemic of plague from Asia struck continental
Europe in the mid-1340's and arrived in England early in
1348, killing more than half the population in some
places and depleting the entire population of England by

as much as one—fourth.1 The rapid spread of this disease

 

1Tbe seriousness of this disease has made it one of
the most devastating illnesses in European history,
especially in England, where, as George Deaux explains,
"the plague raged with its greatest ferocity, carrying
off, in the space of little more than a year, close to
half the total population" (116). Deaux provides an
excellent summary of the spread of plague through the
British Isles in The Black Death: 1347, Chapter 6 (117-
44).

Commenting on the effects of plague in England,
Charles F. Mullett writes: "A most striking
characteristic of the Black Death was its uneven
incidence and effect. Well-attested calculations have
put the mortality in some regions very high and in
others quite low, and though after 1349 it grew
progressively less fatal through natural immunity,
preventive measures, and limited extent, the deaths were
still sufficient to dislocate the life of the country"
(ngonic Plague 19).

Most medical historians now agree that the total
number of dead from Black Death in the later fourteenth
century was about one—fourth the population. British
microbiologist J. F. D. Shrewsbury (A History of Buggnic
Plague in the Britigh Isles) contests death rates of as
much as one-half the population of England given by
other medical historians; in his view, the bacillus

2
and its large death toll brought responses from
physicians, church officials, clerks, chroniclers,
poets, and others. These writers described and explained
plague outbreaks in medical treatises, ecclesiastical
records, sermons, prayers, chronicles, and poetry. This
broad range of responses can be tracked through a
variety of Middle English texts, permitting us to see
how plague was addressed in different genres and for
different audiences and purposes, a task made easier
through recent editions of Middle English medical texts
and recent scholarship on plague.

During the late fourteenth and fifteenth centuries,
the English language was increasingly used for
disseminating this medical information on plague and
other diseases to a growing audience of upper and middle
class English readers. By the late fourteenth century,
many writers were also using English to offer moral
interpretations of this disease, with special emphasis
on the perceived relationships between immoral living
and plague. Not surprisingly, interpretations of plague
found in Middle English texts reveal particular writers'
conceptions of plague as a specific practical or moral
problem. Taken together, these interpretations also

reveal a broader common concern of Middle English

 

became less virulent, resulting in a overall death rate
closer to 20% for the second half of the fourteenth
century.

3
writers on plague, whether practically or morally
oriented or both: namely, their recurrent need to make
sense of the chaos caused by widespread disease within
the framework of an orderly creation.

Unlike most previous plague scholarship, which has
focused primarily on Latin and Continental responses to
plague, this dissertation brings together a wide range
of vernacular English texts dealing in one way or
another with plague: translations and adaptations of
academic treatises on plague, general medical works with
sections on plague, advice on avoiding plague described
in didactic works, and references to plague in sermons
and literary works. In discussing these texts, my
principal concern will be not with social and economic
effects of plague that have drawn the attention of so
many historians of plague, but rather with the ways in
which medieval English people-—especially lay people--
understood the plague in their own times and in their

own language.

Before the discovery of the plague bacillus in
1884, most nonfictional writing about plague was

concerned with medical aspects of the disease.‘ Once the

 

3Until the discovery of the bacillus, medical
writers argued that plague resulted from various changes
in the atmosphere, often accompanied by earthquakes. As

4
medical cause of the disease had been established,
serious historical studies of plague became more common.
Plague scholarship in the late nineteenth and early
twentieth centuries tended to focus on the social-
historical and economic-historical effects of the
disease. Scholars in this period contended that plague
brought about the rise of the middle class and other
sweeping changes in social and religious life. Aiden
Gasquet, for instance, felt that the depopulation of the
monasteries led to a decline in monasticism (The Great
Pestilence), and that the Black Death marked the end of
the Middle Ages. Others made similarly broad claims for
the effects of plague; as Dominick Palazzotto observes,

some early plague scholarship asserted that plague

 

recently as 1865, in a commentary on Niebghr’g History
of Rome (a standard school text), Travers Twiss argued
that plague was related to atmospheric disturbances, and
possibly due to electrical interference:
No person would deny that pestilences have burst
forth without being preceded by volcanic phenomena,
and that volcanic convulsions have taken place
without being followed by epidemics, but it seems
well worthy of our attention, whether, on some
occasions, when all ordinary methods of explanation
are applied in vain to account for the spreading of
an epidemic, it may not have arisen from some
great change suddenly effected in the electrical
condition of the atmosphere. This by acting upon
the human frame through the medium of the nervous
system, may produce a general derangement of health
in the mass, whilst it is destructive to a great
number, who are unable from physical weakness or
constitutional idiosyncrasy to accommodate
themselves to the change, or at least to exist
under the operation of it, till the atmosphere is
restored to its ordinary condition (347).

5

brought about "a retrenchment of cities and the end of
European internal expansion" (The BIEQk DeathAQQQ
Medicine 22). On a more optimistic note, G. G. Coulton
(The Black Death) contends that greater per capita
prosperity for plague survivors brought about the
beginnings of the Renaissance and the Protestant
Reformation.3

In the middle decades of the twentieth century,
plague scholarship began refining this earlier
understanding of the social and economic effects of
plague. Scholars like Anna M. Campbell and Sylvia,
Thrupp focused on more specific social changes resulting
from the crisis of plague, including a new civic
concern for public sanitation (Campbell, Men of
Learning) and, in the economic sphere, the recurrent
demands for higher wages from the reduced pool of

laborers (Thrupp, "Medieval Economic Achievement"). More

 

3The most complete bibliography of plague
scholarship is Gottfried’s "A Bibliographical Essay"
(The Black Deggh 1983); but see also Philip Ziegler’s
bibliography in The Blagk:De§tD (1969) and Nancy
Siraisi’s "Introduction" to The Black Death where she
comments on changing emphasis in plague scholarship--
from medical and historical in the earlier part of this
century, to literary and cultural studies of plague in
more recent decades.

R. Pollitzer’s Plague sums up medical research on
plague and discusses outbreaks of the disease
historically. Jean-Noel Biraben’s Les Hommes et la peste
is probably the most comprehensive medical account of
plague in Europe, giving various explanations for the
disease from ancient sources to twentieth-century
medical theories.

6
recent historians of plague, notably Robert S. Gottfried
(The Black Deggg), have argued that the disease and its
effects must be understood in a larger temporal
framework. Gottfried speculates that plague was less a
turning point than earlier scholars had imagined, owing
to the resilience of human populations. Using
ecclesiastical and public records as a basis for his
argument, Gottfried concludes that plague can be
understood only in a framework of a 300-year period of
various ecological disasters, including famine, floods,
severe winters, and storms, all of which preceded
recurring outbreaks of plague in the fourteenth century.
Like Gottfried, Raymond Delatouche argues that the real
crisis of late medieval culture began in the thirteenth
century, and that outbreaks of Black Death in the
fourteenth century merely accelerated the collapse of
an already crumbling society. For Delatouche, however,
the crisis was less a matter of ecological stresses than
of philosophical and religious tensions already evident

in thirteenth-century life.‘

 

‘For other interpretations of the economic effects
of Black Death, see Edouard Baratier, Guy Bois,
Elisabeth Carpentier, and David Herlihy, who generally
agree that the depopulation caused by plague led to the
rise of the middle class, and M. M. Postan's Medieval
Trade and Fingpce, which suggests that the plague
resulted in decreased production and a decreased flow of
immigrants across northern Europe. A. M. Campbell's
earlier study, The Black Death and Men of Learnin ,
describes the effects of plague on several professions
and their concerns: lawyers (132), priests (138),

7

Another strand in plague scholarship since the
early twentieth century has been the discovery,
cataloging, and editing of medieval plague treatises and
other medical works that deal tangentially with plague
(e.g., Sudhoff, Singer and Anderson, Ogden, and Miller).
The German medical historian Karl Sudhoff, for instance,
edited a large number of Latin and Continental plague
treatises during the early part of this century in a
series entitled Daaaschriften nachtger Epidemie des
"Schwaraen Todeaflg1348. Dorothea Waley Singer and Annie
Anderson’s Catalog of Latin aad Vernacular Plague
Tractates in Great Britaia (1950) lists references to
plague in English vernacular works in addition to

identifying Latin sources which were available in

 

decline of monastic life (142), English in schools
(177n107). See also A. F. Leach Iae Schools of Medieval
England, esp. 201-03.

E. M. Thompson compares the psychological impact of
Black Death in its time with the impact that World War I
had on its survivors--particularly with regard to moral
and psychological crises after the War.

However, George Deaux claims that the plagues of
the later Middle Ages had a smaller effect on population
and culture than most previous scholarship has
suggested:

The Black Death did not bring the Middle Ages to an

end; it did not cause the decline of chivalry and

feudalism; it did not hasten in the Renaissance;
nor did it cause the rise of nationalistic spirit,
humanism, science, the passion of exploration,
realism in literature, national languages, or the
democratization and secularization of society which
we associate with the period that followed it. The

Black Death did not bring about these developments

in precisely the same way that no other single

event caused them (The Black Death 205).

8
England. The catalog contains excerpts both from plague
treatises and more general works with plague
references, including some literary works..

The work of editors and catalogers like Sudhoff,
Singer, and Anderson has borne fruit, especially in the
last fifteen years, in studies by scholars like Dominick
Palazzotto and Melissa P. Chase. In a dissertation on
the medical authority of plague treatises written
between 1348 and 1350, Palazzotto argues that while
medieval physicians generally "conformed to the highly
speculative method of scholastic medicine, in some
cases...they demonstrated a willingness to rely on the
empirical method of experience and observation and a
readiness to discard theories that rationally,
experimentally, or practically did not appear useful"
(The Black Death ananedicina 27). Chase contends that
medical explanations found in fourteenth-century plague
treatises demonstrate that medieval physicians at first
regarded plague as a disease which was already known,
but by the fifteenth century, through more direct
experience with the disease, physicians were able to
differentiate plague from other diseases and to label it
as a separate disease entity (”Fevers, Poisons, and
Apostemes" 163).

Studies of plague treatises by intellectual

historians like Palazzotto and Chase reflect yet another

9
concern of plague scholarship in the last decade or two:
the cultural effects of plague. Though some broad
surveys in this area were undertaken earlier in this
century (e.g., Gasquet on plague and the religious life,
Campbell on plague and men of learning, and Crawfurd on
plague in EurOpean literature and art), detailed and
sophisticated analyses have been relatively rare. As
Nancy Siraisi notes in the introduction to a recent
collection of essays on the cultural impact of plague,
"We are faced with the need for a new, more nuanced
interpretation of the cultural effects of the Black
Death in the light of current work on the intellectual
and spiritual life of the later Middle Ages"
("Introduction," Williman 12).

The goals of this dissertation are most closely
allied to the last of the three areas of scholarship
outlined above: I am primarily interested here in the
interpretations of plague which were available to lay
English readers, in texts ranging from technical medical
works to literature. Thus, the dissertation is narrower
in focus than those studies which combine Latin,
Continental, and English sources on plague for a pan-
European analysis (whether medical, historical, or

cultural).5 On the other hand, by examining a broad

 

“Studies with a broader focus and a linguistically
wider range of sources than this dissertation include
Bois--decline of feudalism; Campbell--variety of

10
spectrum of types of writings on plague, and by
concentrating more on texts that were accessible to a
lay audience, I hope to provide a somewhat wider
perspective than that found in editions of particular
English medical texts, studies of medical practitioners
alone, or specifically literary or iconographic
studies.“ The findings of the dissertation tend to
support the claims of historians like Gottfried,
Delatouche, and Deaux, that plague was less a specific
cause of sweeping social, political, and economic change
in the later Middle Ages than earlier scholars had
thought. English writers on plague--at least in the

vernacular--seem to have responded to it more

 

academic plague tractates; Chase--emergence of plague as
a separate disease entity; Crawfurd--the plague as
portrayed by European art and literature; Deaux--the
effect of plague recurrences over time; Girard--plague
as a persistent theme in literature and myth; Paisley--
plague’s effects on European consciousness from the
sixth to the twentieth centuries; Singer--various
studies of plague treatises across Europe and a
catalogue of plague references in Latin and English
sources.

“Recent editions of Middle English medical works
not specifically looking at plague or broader cultural
effects, but simply at medical writing in English
include Joanne Jasin’s edition of the English Liber
uricrisiarum and Elaine Martha Miller's edition of a
fifteenth-century medical manuscript. Studies with a
narrower focus than this dissertation include Beidler's
"The Plague and Chaucer’s Pardoner"; Gasquet--the
effects of plague on English monastic life; Mullett’s--
growing interest in plague prevention among English
medical practitioners during fourteenth and fifteenth
centuries; Palazzotto--analysis of plague tractates
written between 1348-1350; Polzer--fourteenth-century
iconography of death and plague.

11
conservatively than the physicians studied by Palazzotto
and Chase. The vernacular texts which I have examined do
not eventually see plague as something fundamentally new
and different; rather, they continue to read it as a
variation on an old theme, a serious problem to be sure,
but one to which traditional explanations and preventive
strategies can be applied. To turn the Wife of Bath’s
language on its head, "Auctoritee, though noon
experience / Were in this world, was right enough for
hem / To speke of wo that is in pestilence."

In the chapters that follow, I will argue that
Middle English plague references show us how English
writers and translators located plague in a familiar
context, as a familiar disease or as a familiar moral
problem, often in the light of past authority. In
contrast to their Continental peers, who frequently
observed and recorded contemporary experiences with
plague, English literary and medical writers borrowed
discussions of plague more exclusively from earlier
sources. When they translated material from Continental
writers, they naturally borrowed contemporary
observations of plague included in those works, but they
did not add observations on contemporary English

experience with plague.‘I This dependence on familiar

 

'Observations on contemporary plague experience are
more commonly found in Continental sources than in
English writing (of. Boccaccio's introduction to the

12

authorities provided stability from past traditions and
was an important strategy whereby English writers--and
their readers--made sense out of this dreadful disease.

Medical and moral responses to plague in the texts
examined in this dissertation emerge from distinct but
related traditions--the former essentially classical and
naturalistic, the latter essentially Christian and
biblical. What linked the two traditions was a common
worldview dependent on past authority for explanations
and on a cosmology that stressed order within the
universe. Thus, even though outbreaks of plague in the
fourteenth century elicited different responses from
medical, didactic, and literary writers, these
interpretations of the disease remained compatible, even
mutually reinforcing. Indeed, medieval plague writings
in English reveal a coherent and complex understanding
of plague within a Christian cosmology which embraced

both the body and the soul, the individual and society.

 

Decameron and Guy de Chauliac’s description of plague in
the Cyrurgia magna). It should be noted, of course, that
English chroniclers like Robert of Avesbury described
contemporary English outbreaks of plague and that
descriptions of contemporary outbreaks do appear in
ecclesiastical and public records; however, such
descriptions are virtually non-existent in the kinds of
writing examined in this dissertation.

13

The texts considered in this study are ordered by
genre and audience, beginning with the most technical
works, and then moving on to more general medical texts,
didactic works on personal governance, and finally to
plague references in the works of Chaucer, Langland, and
Lydgate. Chapter One explains words and concepts
associated with the plague, from ancient to modern
times. This chapter provides a context for understanding
the medieval notion of plague as part of a broader
cosmology. Chapter Two provides background for
understanding the medieval conception of disease and
health by examining the contents of a typical medical
treatise. Chapter Three considers academic treatises on
plague available in English translation. These gained
importance in the fourteenth century and were later
incorporated into treatises on other epidemics such as
English sweating sickness, but seldom found their way
into leechbooks and other popular medical works. In
Chapter Four, I discuss references to plague in general
medical works in English. The advice on plague found in
these works reached a wider audience than the plague
treatises themselves, and ultimately made its way into
nonmedical works as well.

Chapter Five introduces the second major division
of this study: the moral interpretation of plague. In

conjunction with other widespread diseases and troubles

14
of fallen humankind, plague was frequently described in
moral terms and as the result of poor physical and
spiritual governance. Chapter Six examines the
incorporation of references to plague in didactic
writings, primarily of the fifteenth century. Writers
like John Lydgate included advice on plague in their
more general didactic works, works which characterized
the prevention of illness as a part of the proper
governance of both body and soul.

Middle English sermons and poetry, which I examine
in Chapter Seven, also contain implicit and explicit
advice on personal governance. However, they present
plague primarily as an emblem for the general failure
of spiritual and political governance. Middle English
literature frequently describes plague in the context of
other divinely imposed catastrophes, often with
apocalyptic overtones; these disasters serve as a
warning for the individual soul and as an opportunity
for the community to reestablish social order by
overcoming sin.

Although remedies for plague found in medieval
sources are no longer taken seriously, the profound
effects of wide scale epidemics like plague remain in
human consciousness. The Epilogue suggests that these
effects are most tangible in literature, where plague

has retained its power over time as a metaphor for other

15
moral and social crises, which, in their own times, have
appeared as disastrous as outbreaks of plague in the

Middle Ages.

Chapter 1: Backgrounds

1. What is Plague? The Twentieth—Century Interpretation

The symptoms of plague have long been recognized
and were described at length in ancient and medieval
medical treatises, but its cause and mode of
transmission were not discovered until the late

nineteenth century.“ The plague bacillus, Yersinia

 

1Jean-Noel Biraben’s Les Hommes et la pests is
perhaps the most complete study of medical explanations
of plague given over the centuries. It is wise to
caution ourselves against judging medieval writing on
plague as simplistic or naive. Until recent times, the
medical interpretation of plague changed little from the
earliest sources. In the late nineteenth century, J. F.
C. Hecker, a noted German physician, is referred to by
B. G. Babington, the English translator of his Dag
Schwarze Tod, as "the most learned medical historian,
and one of the most able medical writers in Germany."
Yet Hecker’s own account reads much like the accounts of
plague in medieval plague treatises:
It is recorded that, during this earthquake [in
Greece and Italy, January 25, 1348] the wine in the
casks became turbid, a statement which may be
considered as furnishing proof, that changes
causing a decomposition of the atmosphere had taken
place; but if we had no other information from
which the excitement of conflicting powers of
nature during these commotions might be inferred,
yet scientific observation in modern times has
shown, that the relation of the atmosphere to the
earth is changed by volcanic influences.
(J. F. C. Hecker, The E idemics of the Middle A es,
Trans. B. G. Babington 15-16).
Hecker writes elsewhere in his book of the naive and
incorrect interpretation of plague found in the writings
of medieval physicians, though his own was no less so,

16

17
(formerly Pasteurella) pestis, was discovered almost
simultaneously by the Japanese Shibasaburo Kitasato and
the Swiss Alexandre Yersin during an outbreak of plague
in Hong Kong in 1884.“ Before the nineteenth century, it
was assumed that both rats and men died from breathing
the same "pestilential atmosphere." Yerainia pestis is
found in the parasites of rodents, "endemic in rats and
appearing in human beings only after the rat population
is decimated" (Campbell 34). Infection may occur by
inoculation, inhalation, ingestion, or by slight
abrasion of the skin. Once the body is infected, the
bacilli move into the lymphatic system where they

multiply and enter the blood stream. The action of the

 

an apt reminder that we ought to caution ourselves
against such arrogance concerning the past.

2Today, antibiotics are used in the treatment of
plague, usually with good results. But this development
is quite recent with respect to plague’s long history as
a medical enigma. George Deaux provides a frightening
deposition on the long search for the cause and cure of
plague:
...the bacteriological warfare experts of the U.S.
Army are reported to have developed a strain of
plague bacillus that is resistant to present
medicine and control measures. If it should ever be
released, the results would be unpredictable but,
considering the prognosis of the disease, probably
disastrous. The world is full of cruel ironies.
Barely have scientists liberated mankind from a
scourge as ancient as history than they employ
their technical skill to recreate it, in an even
more frightening form (68).

18
bacilli damages the walls of the blood vessels,
frequently causing hemorrhages.“

The microbe is "one of the most pervasive,
persistent, and dangerous life forms in the world"
(McGrew 37). It generally lives in the bloodstreams of
rodents, but most commonly in the rat. Rodent hosts
spread the bacteria to humans through an insect vector,

Xenopsylla cheo is, commonly known as the rat flea, but

 

“R. Pollitzer’s Plague sums up medical research on
this disease through 1954, describing in detail
outbreaks since the Middle Ages.

In 1970, British microbiologist J. F. D. Shrewsbury
published A Hiatory of Babonic Plague in thg Britigh
Isles in which he disputes claims that the death tolls
could be as great as from one-fourth to one-half of the
population during outbreaks of the disease in 1348-1349,
rates most medical historians accept. Shrewsbury argues
that the plague bacillus was not as virulent as medical
researchers had thought it to be during the Middle Ages.
He concludes that the death toll from Black Death in
Middle Ages was no more than twenty percent of the total
population of Europe.

Other medical historians have also reconsidered the
biological significance of Black Death in the Middle
Ages and after. Among the most spurious of these is
Graham Twigg’s (The Black Death: A Biological
Appraisal). Twigg makes an extreme claim for plague’s
infrequent occurrence, arguing that the disease was
unimportant in medieval Europe and that the Black Death
itself was probably anthrax. For a discussion of Twigg’s
doubtful claims, see Robert S. Gottfried's review,
"Graham Twigg, The Black Death." For the purposes of
this study, it really matters little whether or not
plague was actually anthrax or even some other epidemic
disease, as medieval people would have referred to all
these epidemics under the aegis of plague or pestilence.

In a recent article, Colin McEvedy argues that
later strains of the plague bacillus, Yersinia estis,
evolved in less virulent form than previous strains,
and, being less virulent, conferred "on infected animals
and humans a relative immunity to more virulent strains"
("The Bubonic Plague" 123).

19
the disease can be carried to humans by nearly 200 other
types of fleas, though with less efficiency. The
discovery of the flea as the carrier of plague bacillus,
from rodents to rodents and then from rodents to humans,
was made by Paul Louis Simond and M. Ogatia in 1897.4

Normally, the bacterium can live in rodents without
deleterious effects to them, but, for reasons not yet
fully understood, Yersinia pestis sometimes becomes
especially virulent and epizootic among rodents (i.e.,
attacking a large number of its animal hosts
simultaneously). When this happens, the rodents’ blood
is poisoned, and the mortality rate reaches nearly 100
percent. "Perhaps it is sufficient for our purposes to
say that plague is primarily a disease of rodents,"
Michael Dols explains, "and man enters only accidentally
into the cycle" (70).

The fleas, which normally live on rats, feed on the
rat’s blood, ingesting the bacterium from their host.
The organism multiplies in the flea’s stomach and plugs
its digestive system. When this occurs, the flea becomes
increasingly hungry but is no longer able to ingest
blood from animal hosts. The flea regurgitates, or less

often, as it attempts to feed, it defecates live

 

“Simond’s research was published in the Annals of
the Pastear Inatitute, October, 1898.

20
bacteria either into the blood of a new host or onto the
skin.

Rats are more efficient incubators of the bacteria
than humans. The bacteria can reproduce easily in a
rodent's blood, but apparently not as well in humans:
"Even humans dying of plague have too little of the
bacterial agent in their bloodstreams to continue the
infective chain" (McGrew 38).

Once plague has spread to humans, it can assume one
of three forms: bubonic, pneumonic, or septicemic.
Michael Dols remarks that "misleading use of the word
'bubonic’ has given rise to the erroneous idea that true
plague is necessarily bubonic and that non-bubonic forms
are a different disease" (The Black Death 72). The
bubonic form of plague is caused by flea bite, and
rarely transmitted from human to human. It affects the
lymphatic system first, causing the characteristic
plague buboes, inflamed lymph nodes usually appearing in
the groin and less often in the armpits, sometimes
becoming as large as an orange. Approximately 20 percent
of those infected recover. Since bubonic plague depends
on the insect vector, it subsides when fleas die out or
during the winter when they are in hibernation.

The pneumonic form of plague is a more virulent
form of plague. For reasons still unknown, the pneumonic

form arises from the bubonic form, often with symptoms

21
like those of secondary pneumonia, and can be
transmitted aerially, through coughing, from human to
human. The onset is sudden and includes symptoms such as
shivering, difficulty in breathing, and expectoration
which is often blood-streaked. Death usually occurs
within three days after onset with a mortality rate of
nearly 100 percent.

The septicemic form of plague is most virulent. A
victim may die suddenly with few visible symptoms. The
patient’s temperature rises rapidly, becoming very high,
and petechial hemorrhages may occur (i.e., small
hemorrhages in the skin or mucous membranes). The
septicemic form of plague results from the introduction
of the bacillus into the bloodstream. In this form, the
bacillus is injected by the flea and fails to localize
in the lymphatic system (bubonic form). In the
septicemic form, the human flea (Pulex irritans),
usually an inefficient carrier, may become a vector and
consequently an effective means of transmission from

human to human.

22
2. Words and Concepts Associated with Plague
Historically

The first plague pandemic appeared during the reign
of Justinian the Great (AD 527-65). According to Jean-
Noel Biraben, this pandemic swept across southern
Europe, but never reached England. He notes that an
epidemic disease which ravaged the British Isles in AD
664, described in the writings of the Venerable Bede,
could not have been the bubonic plague because the
plague never reached as far north as England ("The
Plague in the Early Middle Ages” 72).

The second plague pandemic, which constitutes the-
subject of this study, occurred in the mid-fourteenth
century. Outbreaks began near the Caspian region
sometime around AD 1346. From there, the disease swept
through Europe along trade routes, traveling across
southern Europe and then north, through France and
England in a horseshoe-shaped pattern, finally moving
through Scandinavia and Russia in the mid-1350’s.

Though the plague had occurred in sporadic
outbreaks before 1346, its first large-scale occurrence
took place in that year among Tartars attempting to
deport Italian merchants from the Crimea. The merchants
took refuge in a citadel at Kaffa (Feodosia), according
to the contemporary chronicler Gabriel de Mussis, but

when plague forced the Tartars to withdraw their siege,

23
the Tartars were reported to have catapulted the corpses
of plague victims over the walls of the citadel, thereby
infecting the itinerant Christians who later fled home
to Italy by way of the Mediterranean (McGrew 40). While
Gabriel de Mussis’ account cannot be taken as
unquestionable fact, mainly because the corpses of
those who had died from plague likely would not have
infected others, plague did follow a course along trade
routes, as de Mussis believed, arriving in England in
the spring of 1348. It recurred there periodically until
the early fifteenth century, but the initial outbreak of
1348-49 claimed the greatest number of lives.

The plague recurred again in less virulent
outbreaks during the late fourteenth century, and
outbreaks are reported throughout the fifteenth
century. George Deaux summarizes the number of plague
outbreaks occurring from the fourteenth century
onwards:

...the pestilence was to recur again and again:

there was plague in Europe for thirty-two years of

the 14th century, and forty-one years of the 15th,
for thirty years of the 16th; and Italy, which lost
at least half its inhabitants during the years

1348-50, like the rest of Europe, was not to regain

the population that it held before the Black Death

until the beginning of the 16th century (94).

England experienced several recurrences in the

fifteenth and sixteenth centuries. Plague broke out

between 1405 and 1407, killing 30,000 people in London

24
in 1407 alone. Another serious outbreak occurred in
1420. The petition of the Marches for 1421 noted the
"great numbers of persons dead by the great mortalities
and pestilences which have raged for three years past
and still reign" (Guthrie Vine xi). Plague appeared in
England again in 1430 and 1440, and yet again from 1464
until 1478, according to Guthrie Vine, "with little
intermission" (xii). The next major plague epidemic did
not occur until 1665. During that time, the disease
appeared in London with great force, where 68,596 deaths
were recorded. Just as rapidly, it disappeared, making
this the last major outbreak in the British Isles.“

In more recent times, epidemics of plague have
occurred in China, spreading to the rest of Asia between
1856-66; Europe remained untouched, in part, because of
higher sanitation standards, but also, some have argued,
because the bacillus had become less virulent and
natural immunity had increased (McEvedy 123). Sometime
between 1866 and 1894, it spread from Asian rodents to
rodents in the Western United States, probably along

Pacific trade routes from Asia. No major outbreaks have

 

“Daniel Defoe’s A Jogrnal of the Plague Yaap is a
documentary of the London Plague. Defoe was only a small
child during this outbreak, but his account is often
taken to be true, as it was in his own time. For a
description of the London Plague and its aftereffects,

see F. P. Wilson’s The Plague in Shakespeare’s London.

25
occurred in this country although isolated cases are
occasionally reported in the West.“

At the turn of the century, severe epidemics
developed in Manchuria (1899) and Fujian (1901).
Outbreaks of pneumonic plague occurred between 1910 and
1921 in Manchuria. Asian and African countries have
reported minor occurrences since, but none has been as
severe as the second pandemic of the fourteenth century.

Since the discovery of the causes and transmission
of this disease in the late nineteenth century, the
meaning of the word plague has generally narrowed over
time to cover a specific set of symptoms. In the Middle
Ages however, the term plague meant something broader
than it does in the twentieth century, though popular
usage today still retains some of the archetypal horror
of plague, frozen in popular expressions such as "She
was plagued with that problem."7

References to the fourteenth-century plague

pandemic can be understood, in part, through specific

 

“For a discussion of plague in the U.S., consult
Charles T. Gregg, Plagpe! The Shocking Story ofaa,Dread
Disease in Aperica Today and Plagpe: An Ancient Diaeaaa
in the U.S.

7Use of the word plague in this sense, its most
common use in contemporary English, appears in "The
Lost Cottage," a recent short story by David Leavitt,
which serves here as another example of plague in
contemporary English: "'Yes,’ Douglas says, 'we have
repaired the evil leak which has plagued this house for
centuries’" (66), and cf. "a plague on both your
houses."

26
terms writers in the Middle Ages chose to describe it.
Often they described plague in the same terms as
ancient writers.

As Penelope B. R. Doob explains, notions of
disease have traditionally been associated with sin and
guilt (Nebuchadnezzar’s Children 1), and words
associated with plague have been no exception. Plague
(Middle English plaga) in its oldest and most general
sense, referred to a "stroke, blow, injury, or disaster"
the meaning of Latin plaga from which it is derived.
Latin Llaga, in turn, derives from the Greek m,
"a blow," often in the sense of widespread disaster
(Skeat, Rt 010 ical Dictionar , s.v. plague). The
ultimate source of plague as this sign of God’s
chastening power over sinful man comes from the Old
Testament and ancient sources.“

Classical sources also mention wide scale
epidemics, but unlike the plagues of the Bible, not
always as scourges but as vivid reminders of the power
of death. Stephen D’Irsay traces the use of atra more
(black death) as a term for diseases with a fatal
prognosis in various ancient sources, which, he

speculates, may have begun with Homer. As Homer refers

to it, Atra mors (Greek [£6201 4EAZZQ’; ) could

“See Chapter Five (138-140) for a discussion of
plague in biblical sources.

 

27

denote "a sweet, soothing, silent brother of sleep,
descending as a 'brazen sleep,’" (qtd. in D’Irsay 329).
In this case, death appears like the blackness of night.
In the later Roman poetry of Tibullus, Horace, Silius,
Italicus, and Statius, the phrase atra mors signifies
"the horrors of death in general" (D’Irsay 331). Still
later, in Ennius and Livy, the term is associated with
epidemics of various sorts, and especially in
Thucydides’ description of the first plague pandemic
(D’Irsay 331).9 In classical poetry, while epidemic
diseases were described as horrible, they were described
as resulting from natural forces, an interpretation
also found in medieval medical treatises, rather than
from the scourging hands of the gods.

In Middle English, the term plaga appears in much
the same context as it did in biblical sources: to

'9

betoken "an affliction or torment, especially "one of
divine punishment or retribution" (QED, s.v. la e,
1.a). It occurs in this sense in The Golden Litany of
the Holy Magdalen:

I shalle take fro them alle tribulacions, sorowes,

and plages that thei in this world for ther synnes
and offences haue deseruyd to suffyr. (MED, s.v.

plage, 1.a)

 

“D’Irsay lists specific sources for the terms
sanguine:atro and atra more in the works of these poets
and those mentioned above (330—31).

28

In Middle English, plaga may also refer to a wound or
sore and, in a wider sense, to a morbid condition. Using
the word to mean "sore," a Middle English translation of
Lanfranc’s Surgery explains that, "Plage commounly is
taken for an oold wounde" (QED s.v. la e, 2.b).1°

In Old French, plaga became plaga (var. plague),
with plaia ("wound") as the normal phonetic descendant
of plaga (QED s.v., plague). Elaga and plague are
therefore variants based on the earlier Latin form.

Middle English plaga is seldom applied in
descriptions of the fourteenth-century pandemic. Diaga
is, however, the preferred term for this epidemic in
fifteenth-century texts, possibly because it had a
stronger moral connotation than pestilenga, and didactic
religious works written during this time use plague as
an example of God’s punishment during evil times.
Occasionally, when writers use plaga to mean an
outbreak of Black Death, they combine the words plaga

and pestilence.11

 

1°The Old French plaie is used similarly in the
following passage from Henry of Lancaster’s Ea Livre da
Seynta_Medicinea (Ed. E. J. Arnould) where we see this
common use of the word in Old French:
Et pur ceo qe ascuns purroient dire qe eawe nest
mye bon a plaies laver... (144.32-33).
("And because some people might be able to say that
water is not as good [a medicine] to wash
wounds..." (trans. mine)).

11See, for example, The Vision of Edmund Leversedge
a1500(a1450): "...I the seyd Edmund in the monythe of

may, that is to sey the 3ere of our lorde god a

29

The Middle English words piaga (plague) and
pestilence were in use before the disease first struck
England in 1348. Pestilence is the most common term
Middle English writers use for the Black Death, probably
because it was the most general term for denoting
epidemic diseases and a term applied to them before
outbreaks of plague in the fourteenth century (QED, s.v.
pestilence, sb. 1).

Pestilence has two major uses in Middle English. In

 

its literal sense, the word could be applied to various
contagious diseases. Middle English pestilence has a
general meaning, often describing any fatal epidemic
afflicting man or beast and killing many victims. Its
use in the following incipit from the Vernon Manuscript
is typical:
be rysyng of be comuynes in londe, be
Pestilens,
and be eorbe-quake...Beo-tokenes pe grete
vengaunce
& wrake pat schulde falle for synnes sake.
(MED s.v. estilence, 1.b)

In a figurative sense, pestilence refers to various

manifestations of wickedness, as in the phrase "be

 

M.c.c.c.c.lx.v [1465]...by the hand and vysytacyon of
almyghty God was smyton with the plage of pestylence"
(23). Speaking of the disease as God’s punishment for
sin, later in the Vision Leversedge explains:
God had givin power and commaundment to persecute
and smyt the people for the synne that dayly renyth
a mong them with the infirmyte and plage of
pestilence, the whych synne and people gretly
displesith God (33).

30

pestilens of lecherye" (MED s.v. estilence, 2.b).n
Like la e, when used figuratively, pestiagnaa_meant
"wickedness, iniquity, or evil" (MED s.v. estilence,
esp. 2.a) as it does in Chaucer’s description of Circe
Boece:

But a1 be it so that the godhede of Mercurie, that

is cleped the bridde of Arcadye, hath had merci of

the duo Ulixes, bysegid with diverse yveles, and

hath unbownden hym fro the pestilence of his

oostesse...

(Boece, 4m3.16-21)u

"The foule deth," and the "first deth" are also
Middle English terms for bubonic plague.H In Piers
Plowman, B-text, Dame Study reminds the Dreamer that
even the threat of plague is not enough to humble
prideful mankind: "Ne for drede of the deeth withdrawe
noght hir pride" (X.81). "The deeth," in the context of
this passage, refers specifically to plague.““

Walsingham’s Chronicle (c1400(1379)) describes an

outbreak of plague in these terms: ”God and Seynt Mango,

 

1“Chapter Seven examines the relationship between
lechery and pestilence in Middle English sources,
especially in conjunction with Fragment Six of the
Canterbgry Tales and Piera Plowaaa.

1“Quotations from Chaucer’s works, here and
elsewhere in this study, are from The Riverside Chaucer,
ed. Larry D. Benson.

1“In Spanish, the plague is usually referred to as

la mortalega Grande, and in German, das grosse Sterben
(Deaux 5).

““Chapter Seven (210-23) discusses references to
plague in Piers Plowman.

31
Seynt Romayne and Seynt Andreu scheld us this day
fro...the foule deth that Ynglessh men dyene upon” (!E_
s.v. aapa, 6.a). Here, the author applies the metaphor
of feasting to describe the way in which plague
spreads, naturally and as frequently as the appetite
returns, urging the body to eat once again in what must
have appeared to be an endless cycle of sickness and
death.

A Middle English translation of Guy de Chauliac’s
Cyrurgia magna uses the phrase "bat grete dethe” in
describing the plague: "And we haue seyne pat openly
[many deaths] in bat grete dethe...which appered to vs
in Avyoun in be 3ere of cure Loord 1348, and in be sexte
acre of be popedome of sire Clemente be sexte, in whose
seruice I was” (EED s.v. aaaa, 6.a). "Grete dethe" and
"foule deth" appear less frequently in Middle English
than pestilence and plaga as terms for plague.

To our way of thinking, the terminology of Middle
English is often imprecise in references to the Black
Death, since the disease itself was not considered

separate from other epidemic diseases until the

fifteenth century.““ The various uses of plage and

 

1“In a discussion of plague treatises dating from
mid-fourteenth to the fifteenth century, Melissa P.
Chase comments on the understanding of plague found in
these treatises:

The fourteenth- and fifteenth-century practitioners

of Montpellier, confronted with a devastating and

complex disease, successfully explained this

32

pestilence in Middle English create certain problems
when attempting to interpret their meaning. Therefore,
where possible, this study relies on the consensus of
editors in determining whether the Black Death is meant
rather than some other disease when pEaga and pestilence
appear in Middle English texts. The context of certain
passages (e.g., their appearance in medical works on
pestilence) or the occasions for which specific works
were written also let us identify some of the instances
where plague was intended. For example, although plague
is not mentioned specifically in the Book of the
Duchess, it is generally agreed that Chaucer wrote it in
honor of Blanche of Lancaster, who had died from plague.

In English translations of Latin sources made in
the early fifteenth century, the original Latin source
may not always refer to Black Death when it mentions
pestilence (L. estilentia, pestis). Fourteenth- and
fifteenth-century works describing plague often
incorporate passages from earlier texts on epidemic
disease into commentaries on Black Death.” While it is
not always clear whether Middle English writers meant

Black Death when they used the term estilence, those

 

experience within the framework of the medical
tradition of their predecessors.
("Fevers, Poisons, and Apostemes" 163)

1'See, for instance, Lydgate and Burgh’s
translation of the gacreaa of Old Philosoffres in
Chapter Six (164-71).

33
who lived in the late fourteenth century would have
experienced the disease themselves or would have known
of others who had, since its occurrences were so
widespread. Therefore, we can assume, more often than
not, that the words pEaga and pastilence in Middle
English texts written between 1350-1450 are associated
with contemporary outbreaks of the Black Death, since
that was the most common and severe epidemic in the late
fourteenth and early fifteenth centuries.1“

From the fifteenth century on, pestilence widens in
meaning again and this term and the Latin forms
associated with it are again applied more commonly to
other epidemic diseases. The writings of Rhazes (AD
860-932) on smallpox and measles, for instance, were
given the title De peste when first published in a Latin
translation by John Channing in 1766 (Thornton, "Medical
Books" 9). In the works of writers before the nineteenth
century, the terms the estilence, the la ue, gpaap
pestilence, great death denote the plague pandemic of
the fourteenth century, or, in distinction from later

visitations, the mid-fourteenth-century plague is

 

l“Besides plague, other epidemics, including
typhus, malignant syphilis, and smallpox, spread through
Europe during the later Middle Ages, though plague was
the most severe among them, and caused the greatest
number of deaths (McGrew 108).

34

sometimes called 'the furste moreyn’ or 'the first
pestilence’" (QED s.v. Daapg I.6.b.).u

The terms Black Death, plague or bubonic plague are
commonly used today to describe the epidemic which swept
through medieval Europe in the mid-fourteenth century.‘
The later, virulent outbreak of the plague in London
(1664-65) is now referred to as The Graat Plagaa or 1;;
Diague of London. Not until the nineteenth century do
the terms plague and Black Death come specifically to
describe the plague of 1348-49 and its later English
outbreaks in the fourteenth century: 1361—62, 1369,.and
1375-76. In particular, The Black Death is a phrase used
only after the nineteenth century to refer specifically
to the bubonic plague of the fourteenth century.
According to the QED, "The name ‘black death’ is modern,
and was apparently introduced into English history by
Penrose (Mrs. Markham) in 1823, and into medical
literature by Babington’s translation of Hecker’s Day

Schwarze Tod in 1833.

 

1“On the origin of the term Black Death, see
Stephen D’Irsay, "Notes to the Origin of the Expression:
'Atra Mors.’"

35

3. Medieval Cosmology

While the specific denotations of the word plague
are wider in the Middle Ages than in the twentieth
century, its broadest medieval connotations extend its
meaning even further. To speak of plague or pestilence
was to suggest those forces which disrupt the workings
of an orderly universe, causing disease in the body and
social disruption outside. Medieval writers attempted to
understand plague in the framework of an orderly
universe. In imaginative literature, writers stress the
importance of order and balance. References to plague in
Middle English poetry serve as a metaphor for disorder
brought into the world by sin. As plague was thought to
disrupt the orderly workings of the body, so its causes,
rooted in sin, could disrupt the mind and spirit, and
cause further disorder in the human community.

The belief that God had created man in His image
served as a basis for medieval theories of man as a
microcosm of God’s universe. Medieval theories of
cosmology, influenced by ancient Greek and Hebrew
philosophy, demonstrated that the structures and
processes of one portion of the universe were analogous

to others on a greater or lesser scale.“° Most prominent

 

““Philip Grierson remarks that, "this inheritance
[of earlier cosmologies] was of a double character,
Greek and Jewish, but each was in certain respects

36

among these theories was the idea that "man is a
microcosm, or ’little world,’ in one way or another
epitomizing a macrocosm, or ’great world’ --i.e., the
universe or some part thereof" (Conger xiii).

Various medieval commentators point out
similarities not only between God and man, but among
all the components of creation. According to the
Midrash Bereahit Ragga, a Jewish commentary from the
third century AD, when God said, "Let us make man in our
image," He was speaking according to the counsel of "the
works cf heaven and earth" (in Conger 38).“1 A later
commentator, R. Natan, believed that God created in man
everything that had been created within the universe. In
the appp, Natan drew a number of parallels between man
and the particular objects in God’s creation. He
suggested, for example, that the forests correspond to
man’s hair, the wind to the nose with which man
breathes, the sun to the forehead, and the sky to the
tongue (Conger 38-39). In later commentaries, Joseph ibn
Zaddik (d. 1149) suggested that man’s body represented
the entire material universe, and his soul, the world of

spirits. Man therefore ought to know himself in order to

 

1,

modified by developments in early Christian theology"
("The European Heritage" 227).

H"And God created man to his own image: to the
image of God he created him" (Gen. 1.27a).

37
know the will of God and that God alone is truth (Conger
42).“3

While medieval Christian writers may not have been
directly influenced by the writings of these Jewish
commentators on Genesis 1: 27, they would have agreed
that the structure of the human body paralleled the
structure of creation. George Conger has observed that,
in the Middle Ages, "the microcosmic theory served as a
convenient and uncritical method of reconciling religion
with the natural sciences, which even then were
beginning to raise questions and difficulties for the
faithful" (52). Nevertheless, notions of parallels
between human beings and the universe persisted well
beyond the Middle Ages. Many of these notions are found
in the commentaries of the Church Fathers, but Latin
translations of Aristotle and Plato were also an
important and pervasive influence in the Middle Ages,
and the authority of these ancient writers can be traced
through the works of medieval thinkers.

Philip Grierson explains that the teachings of St.
Thomas Aquinas, the Epapa:Theolggiae (Quaest. 65-74),
and especially the commentary on Aristotle’s De Caelo,
defer to Aristotle’s conception of the universe

(255n20). In the Dream of Scipio, the concept of

 

nAnalogues can be found in ancient Islamic
philosophy (Conger 46-52).

38
crystalline and translucent heavenly spheres and the
ether found in the spaces between them also reflects a
strong Aristotelian influence (Grierson 238).

Plato’s cosmology was perhaps more familiar to
medieval writers than Aristotle’s. The only Platonic
dialogue known in the Latin West before the twelfth
century was the Timaeus, a work of substantial
cosmological interest (Grierson 231). In the Timaeus,
Plato argued that the cosmos was a model of divine
likeness, based on the premise that something greater
than the cosmos was responsible for creating the cosmos
itself:

Again, these things being so (i.e., the whole

application to the world of the three premises

given in Timaeus' commentary], our world must

necessarily be a likeness of something.

(Cornford, ed. 23.29b)

The arguments concerning the operation of the universe
set forth in the Timaeus follow the teachings of
Aristotle, but while Aristotle’s works contain a number
of microcosmic elements, "it can be said," George
Conger argues, "that Aristotle employed the term, but

not the arguments" (10).” G. E. R. Lloyd has further

argued that Greek cosmological theory shared several

 

““Conger explains that although Aristotle may not
have made use of arguments concerning the microcosm, he,
in fact, may well have "first used the expression which
afterward became the term microcosm" (of. Aristotle’s
Physics, Book 8, chap. 2) (ctd. in Conger 11).

39
distinctions: 1) that the cosmos was ruled by one
supreme being; 2) that the cosmos contained a balance of
equal and opposing forces; and 3) that within the
cosmos, war and strife were universal (204—05).

These notions emerge in two influential sources for
writers on cosmology in the Middle Ages: the Commentary
on the Dream of Scipio (Somnium Scipionia) of Macrobius
and the Marriage of Mercury and Philology_of Martianus
Capella. The authors of both were pagans, but, like
Aristotle and Plato, "their Neo-Platonism had many
elements in common with Christian philosophy and they in
fact dominated Latin cosmological thought throughout the
Dark Ages" (Grierson 232).

The Dream of Scipip depicts the experience of the
younger Scipio, who, while visiting Massinissa, was
taken in a dream to the uppermost part of the heavens.
There he learned of his future career and of the
structure of the heavens, including the spheres of the
planets. The spheres, concentrically revolving around
the earth, were thought to produce musical tones that
served as a model of harmony and proportion throughout

the rest of the universe.H Scipio learned that all

 

HChaucer describes the workings of the universe in
his summary of the Dream of Scipio in the Parliament of
Fowls:

Thanne shewede he hym the lytel erthe that here is,

At regard of the hevenes quantite;

And after shewede he hym the nyne speres;

And after that the melodye herde he

40
aspects of creation were orderly, proportional, and
interrelated.

The Marriage of Mercupy and Philolggy is an
allegorical work describing how Mercury, the God of
Eloquence, wedded Philology, who brought with her the
seven liberal arts as handmaidens: Grammar, Dialectic,
Rhetoric, Geometry, Arithmetic, Astronomy, and Music.
These disciplines, which concerned various aspects of
the created world, were themselves thought to be
interrelated.

Both the Dreap of Scipio and the Marriage of
Mercary and Philology explain the structure and shape of
the universe and the orderly system of learning which
reflected it, and the structure and shape of the
universe described in these works served as a model for
medieval writers concerning the appearance of plague in
the Middle Ages.

Not only were the non-living elements in this
universe balanced and proportional, but the living
creatures populating it also had their specific and

proportional locations. This divinely created order of

 

That cometh of thilke speres thryes thre,

That wells is of musik and melodye

In this world here, and cause of armonye.

(57-63)

See also Nancy Siraisi’s Taddeo Alderottiaand his
Pu ils, and "The Music of the Pulse" where Siraisi
explains that, in medical practice, the rhythm of the
pulse was thought to reflect the harmony of the spheres.

41
living things came to be known as the Great Chain of
Being, a term used to explain this natural hierarchy,
which served as a "scala naturae from the lowest
possible grade up to the apaaperfectissiapp" (Cuddon,
s.v. Greathhain of Being). At the top of this hierarchy
were various grades of superior beings, including God
and the angels. Man was beneath the angels but above the
creatures of the lower orders. Humans, therefore, stood
at the center of God’s creation, beneath the angels and
above fish, fowl, and beasts.““

This divine scheme of things in the universe was
taken for granted by medieval writers and even long
after their time. Philip Grierson remarks that "it is
necessary to remember that the traditional picture of
the universe was not just a matter of literary or poetic
allusion; it was thought to be hard matter of fact"
(243).

The medieval model of the world, as explained by C.
S. Lewis, Robert Burlin, R. W. V. Elliott, and others,
suggests that medieval writers found a sense of order in

the authority established by books, which they applied

 

““The classic work on The Great Chain of Being from
ancient thought onwards is A. O. Lovejoy’s The Great
QMain of Beiag. See also E. M. W. Tillyard, IMa
Eliaabethan World Picture, chaps. 4-5.

42
within the boundaries of cosmological framework.““ We
might imagine that the teachings of the Church would be
the principal authority for these writers. But as C. S.
Lewis explains, the overwhelmingly "bookish or clerkly
character of medieval culture" is to be found not in the
authority of the Church alone, but also in other
authorities (Discarded Iaaga 5), including those of the
literary and medical traditions. Adherence to a model of
an orderly world encouraged a reverence for conclusions
made by past authorities, like those to whom Chaucer

defers when he calls on "auctors" and "auctoritee." But

 

2“For a fuller discussion of this model and its
dependence on books and fondness for order, see C. S.
Lewis, The Discarded Ima e, Chapter 1. Robert B. Burlin
discusses the uses of "Experience and Authority" in
QMaucerian Fiction (3-22).

Additionally, Loren C. MacKinney emphasizes the
importance of the encyclopedic tradition within this
orderly world created from bookish sources, particularly
in the medical tradition ("Medieval Medical
Dictionaries").

A fondness for order may have encouraged a listing
of the sources of authority. As MacKinney explains:
"Most of the medieval medical compendia took one or the
other of two major trends; either the topical
organization of the original classical encyclopedia or
the alphabetical arrangement of the modern encyclopedia
or dictionary" (243). The order in which a subject is
presented becomes as important as the subject itself,
and as MacKinney concludes, "It may be said that
medieval compilers manifested conflicting tendencies;
very few were medically minded; their chief interest was
lexicographical" (266-67).

43

Chaucer is also aware of the limitations of authority
and of the demands of experience.“7

Chaucer’s references to "auctoritee" often
demonstrate the importance of books and the order they
helped create in the writings of medieval authors. But
Chaucer, like other writers, was not afraid to select
the best of past authorities as a means for creating
order based on his own experience:

By God, men may in olde bookes rede

Of many a man more of auctorite

Than evere Caton was, so moot I thee,

That al the revers seyn of this sentence,

And han wel founden by experience.

(Nun’afiPriest’s Tale 2974-78)““
In books, poets found sources for their stories as well

as a world view, but reworked their sources to fit new

schemes through the guidance of rhetoric, logic, and the

 

37Chaucer’s interests in a diversity of sources,
combined with his own experience, is evident in much of
his work. Robert B. Burlin explains Chaucer’s concern
with experience and authority in these terms:

For a man like Chaucer, with his evident curiosity

about scientific instruments such as the astrolabe,

his fascination with astronomy and alchemy, and his

wide acquaintance with natural philosophy, there

seems to have been available a tradition that

allowed ’experience’ a respectable place on the

epistomological ladder.

(Chaucerian Fiction 21)

”Robert B. Burlin discusses the dual role of
experience and authority and the tensions between them
in Chaucerian Fiction (5-22) and concludes that
twentieth-century critics have sometimes lost sight of
the importance of experience in medieval texts as a way
of knowing, and as important as authority in the
background of a particular work.

44

other disciplines which reflected divine order. Chaucer
describes this process as a metaphorical harvesting:

For out of olde feldes, as men seyth,

Cometh al this newe corn from yer to yer.

And out of olde bokes, in good feyth,

Cometh al this newe science that men lere.

(Earliament of Fowla, 22—25)“9

New wisdom, selectively derived by separating the
good wheat from the chaff, was also important for
physicians in Chaucer’s day, and the importance of this
order is reflected in medical treatises. Chaucer’s own
Physician in the Canterbury Tales was no exception. The
narrator describes this "Doctour of Phisik" in terms of
the ancient and contemporary authorities to whom the
Physician subscribes:

Wel knew he the olde Esculapius,

And Deyscorides, and eek Rufus,

Olde Ypocras, Haly, and Galyen,

Serapion, Razis, and Avycen,

Averrois, Damascien, and Constantyn,

Bernard, and Gatesden, and Gilbertyn.

(General Prologue 429-34)

Chaucer’s Physician is an example of the power of

authorities outside the traditional teachings of the

Church. As Chaucer’s narrator explains several lines

 

“’Chaucer’s Wife of Bath’s argument that women
ought to have mastery in marriage is based on her
experience, which she attempts to support with
quotations from various bookish sources.

45
after enumerating the Physician’s medical authorities,
"His studie was but litel on the Bible" (Q2 438).u
Nevertheless, even though various authorities
served as sources for orderly frameworks, one dominant
concept in medieval thought was the perceived

relationship between the internal workings of the human

 

nThe meaning of this passage has long been debated
among scholars. C. David Benson remarks that this line
seems to pair the Physician’s extensive learning about
the body with his ignorance of the God who created that
body (General Prologue 438n).

Walter C. Curry suggests that this passage points
to the Physician’s atheism, citing the following passage
from John of Salisbury’s Polycraticua 2.29 as support:
"While they [physicians] attribute too much authority to
Nature, [they] cast aside the Author of Nature" (Chaucer
and the Mediaeyal Sciences 30). But Curry also explains
that the portrait may not be entirely negative. The
physician, he argues, pay be a pious man who has no time
for reading the Bible or a rank materialist who contemns
religion--we are not sure" (36). Citing Curry’s
discussion in her interpretation of the portrait, Jill
Mann concludes: .

...just as the ambivalent vocabulary in the Friar’s

portrait showed us, the "human contradictoriness"

is something which belongs to Chaucer’s audience as
much as, if not more than to the Doctor. It is we
who have mental frameworks, which will admit
admiration both for the "verray parfit gentil
knight," and for this "verray parfit praktisour."
(QMaucer and Madieval Estates Satire 99)

Whether Chaucer is actually criticizing the
Physician in this passage appears yet open to question.
I would argue that Chaucer is also pointing out various
kinds of authority to which medieval people may have
deferred (i.e., the Church, ancient medical
authorities, and ancient philosophers), and perhaps not
with any intention of slighting the Physician. One may
ask how many people besides clerks actually studied the
Bible very much in the late fourteenth century. Most of
what people knew about the Bible was learned during
church services, and perhaps through attending cycle
plays and religious festivals, but not through a formal
study of Holy Scripture.

46

body and the external universe. In medieval medical
theory, the notion that the functions of the body
reflected the workings of nature provided medieval
physicians with a convenient model for organizing the
body and its functions into distinct categories.“1

The two illustrations below demonstrate the
perceived relationship between elements in the universe

and the human body, proportionately arranged.

 

“lFor a discussion of humoral theory and its
relationship to medieval cosmology, see Chapter Two of
this study.

The persistence of this tradition is shown by the
Renaissance physician Paracelsus (1493-1541), who, like
earlier Christian commentators, believed that man had
been created in the image of God, not in the image of
nature, but that there were many analogues between the
human body and the external world. And like medieval
physicians, Paracelsus believed that the workings of
nature directly influenced the inner workings of the
body. Both the universe and the human body were composed
of the same four elements: earth, fire, air, and water.
Just as there were four elements, so there were four
humors (blood, phlegm, black and yellow bile). An
imbalance of these humors, caused by outside forces
such as planetary movement and weather, resulted in
disease. For health to return, the balance of humors had
to be restored.

47

 

 

 

 

 

 

Figure 1: Mundus-annus-homo. Diagram from 8th C.
Munich codex (in Herrlinger 53), showing the
geometrical relationship between man and the four
elements. This illustration demonstrates the close
relationship between the inner workings of the body and
the external elements surrounding it. Each of the
elements is linked with one of the humors and with the
temperament controlled by that humor: air, hot and
moist, with blood (sanguine); fire, hot and dry, with
choler (red or yellow bile) (choleric); earth, cold and
dry, with black bile (melancholy); water, cold and
moist, with phlegm (phlegmatic).

48

 

 

Figure 2: Christ as Salvator mundi in the Zodiac (in
Herrlinger 57). Christ is surrounded by the twelve signs
of the zodiac with their respective symbols. The names
of the internal organs each astrological sign was
thought to influence are written around the
circumference of the circle. The four seasons are shown
in the corners (14th C., Bibliotheque Nationale, Paris).

49

The theory of parallels between the workings of
nature and the human body, and an emphasis on the
orderliness of creation are found in both medical and
moral interpretations of plague. In both these
interpretations, writers emphasized balance and
proportion, which were, in turn, reflected in their
writing. Medieval medical treatises emphasized the
restoration of humoral balance as a means for promoting
health. As the human body reflected the orderliness of
the created world, so medicine was an orderly model for
understanding the body. A sense of balance and
proportion is evident in illustrations found in medical
works depicting Bloodletting Man, Wound Man, and in
charts from uroscopies which emphasize degrees of change
in the color and texture of urine. Medical treatises,
including those on plague, were proportionate like the
body, whose workings they were designed to explain. The
illustration below demonstrates the fondness for order,
typical of illustrations in other medieval medical

treatises.

50

 

 

 

. u. .n.,. . WKV,#Q
swag“. $1.6?
. $3... an tfiéefimfifi a Vim
. “ 54.". mfimw.-,¢w/, “WK. ”W ”a”
. _. ...C in“... “mum... ... ..QJs
w... .

47 .
“vim.

 

       

    

as"

/,. /
Y

 

 

indicated by
inscribed

its color and texture, was thought to reflect an

imbalance in the humors of the body. Matulae (urine
(29).

An imbalance in the urine,

shaped diagrammatic form (pre-l5th C.) (in
flasks) of varying shades indicate nuances in the colors
These are linked to seven circles,

of urine.
with the terms of pathology. Herrlinger notes that one

Figure 3: Four examples of uroscopic charts (rotula) in
may easily associate this form "with the tracery in the

window rosettes of Gothic cathedrals"

Herrlinger 75).

rosette-

Part I: The Medical Interpretation of Plague

Chapter 2: The Background of the Medical Interpretation

When plague came to Europe again in the fourteenth
century, it was as incurable as it had been during its
earlier pandemic in the sixth century. As the medical
historian Jean-Noel Biraben has noted, "People see only
what they are able to understand, and they write down
only what they consider worthy of being passed on to
posterity" (”The Plague," trans. Elborg Forster 48).
What medieval people saw in the devastation left by
plague was human helplessness in the face of an
incurable epidemic, and they often turned to the past
for guidance as a source of wisdom and consolation.

The dependence of medical writers on past authority
is especially evident in Middle English descriptions of a
plague in which physicians offer explanations traceable
to ancient medical authorities. Hippocrates explained

epidemic diseases in relation to weather conditions

51

52
(1.142-44), as did Bede (ED 90, cols. 266-67).1 In the
sixth century, Gregory the Great wrote concerning plague
during its first pandemic. Obsessed with plague and the
coming of the Last Days, Gregory "was truly the Pope of
the Plague. For him, the sores of Job were buboes"
(Biraben "The Plague" 61). The most extensive
discussion of this first pandemic appears in Lucretius’
De natura rerua (6:1090-1246--Trans. Frank 0. Copley,
The Nature of Thiaga 173-75). Writing centuries later,

during another outbreak of plague, the celebrated Arab

 

1Hippocratic writings include a chapter on epidemic
disease in which the author relates epidemics to weather
conditions and planetary influence. See Robert Maynard
Hutchins, ed. Great Books of tha Weatern World, 10:
(Hippocrates and Galen) "Of the Epidemics," 44-63.
Hippocrates writes, "The whole constitution of the
season being thus inclined to the southerly, and with
droughts early in the spring, from the preceding
opposite and northerly state, ardent fevers occurred in
a few instances..." (44), later describing the weather
conditions preceding an outbreak of "ardent fevers" in
the following terms:
In Thasus, a little before and during the season of
Arcturus, there were frequent and great rains, with
northerly winds. About the equinox, and till the
setting of the Pleiades, there were a few southerly
rains: the winter northerly and parched, cold, with
great winds and snow. Great storms about the
equinox, the spring northerly, dryness, rains few
and cold. About the summer solstice, scanty rains,
and great cold until the season of the Dog-star.
After the Dog-days, until the season of Arcturus,
the summer hot, great droughts, not in intervals,
but continued and severe: no rain; and Etesian
winds blew; about the seasons of Arcturus southerly
rains until the equinox (47).
According to Hippocrates, a year of disruptive weather
conditions led to an outbreak of paraplegia (motor and
sensory paralysis) in the winter months following, which
"attacked many and some died speedily" (47).

53
physician Ibn Sina (Avicenna) (AD 980-1037) reported
that when the plague reached epidemic proportions among
animals during an outbreak at the beginning of the tenth
century, "the rats and all the other animals that lived
in the ground left their holes and reeled about like

drunks, as they were slain by pestilential atmosphere
(qtd. in Henschen 78). Avicenna’s Qanon of Medicine
attempted to order all medical knowledge handed down
from Aristotle and Galen, and in that work he wrote that
plague came from pestilential atmosphere and
decomposition of the air and soil, which could be
prevented by fumigations of "sedge, frankincense,
myrtle, rose, and sandalwood" (trans. Gruner 445),
ingredients described in medieval recipes for plague
preventives and remedies.“

The remedies for plague suggested by Avicenna,
Galen, and other earlier physicians derive from works
like those of the first-century medical botanist,
Dioscorides, whose Materia medica (A.D. 60) was well-

known to medieval people, often through a tradition of

folk remedies.“ Dioscorides, for instance, recommended

 

“Avicenna also wrote that "During the time when
pestilences are about, one may use vinegar in both food
and drinks, for this preserves one from danger” (trans.
Gruner 225), advice also found in the treatises of
medieval physicians.

“See John M. Riddle’s Dioacoridea;on Pharmacy and
Medicine for an extensive study of Dioscorides’
philosophy of pharmacy and his contributions to

54
mixing wine or vinegar with various herbs like betony or
myrrh (Riddle, Dioacorides 145-46). Medieval physicians
described such medicinal wine drinks as useful for
treating plague.

As Chapter Three of this study demonstrates,
medieval physicians turned to the writings of Avicenna,
Hippocrates, and Galen for advice on plague, and to
other standard medical treatises such as Johannitius’
Isagoge for explaining plague within the framework of a
well-established cosmology. Writers of general medical
treatises, also attempting to make sense out of plague,
provided complicated pharmaceutical remedies based on
the writings of Galen, Avicenna, and Dioscorides, but
rarely on the advice given in plague treatises

themselves.

1. Humoral Theory and Plague

Medieval people maintained a world view based on an
orderly and proportionate universe, as Chapter One of
this study explains (29-35). Medieval physicians
subscribed to the belief that bodily processes occurred
in an orderly manner, a notion established by ancient

medical authorities.

 

medicine.

55

The doctrine of the humors originated in the Greek
medical tradition. Pre-Hippocratic physicians based
their teachings on Greek cosmology, which explained that
disease resulted from a disturbance of the natural
balance of humors in the body (McGrew 142-43).
Hippocrates explained the humors systematically, and
Aristotle placed this doctrine in a larger,
philosophical system (McGrew 142). In the second century
AD, Galen applied the notion of humors to a variety of
diseases, believing that a balance of humors was
essential for health. Thus, humoral doctrine taught
that disease was a natural process not essentially
different from our modern conception of physiology
(Sigerist qtd. in Marti-Ibanez 126-27). Disease was
therefore seen as an imbalance in natural bodily
functions attributable to variations in the four
humors. Popular remedies and treatments for plague
explained in leechbooks and other practical guides
reflected the doctrine of humoral theory.

Physicians believed that plague vapors or miasmas
entered the body through the pores, which resulted in a
superabundance (superfluity) of humors in one or more of
the three principal organs: the brain, heart, and liver.
These organs, attempting to restore balance, expelled
superfluities through the emunctories or cleansing

places of the body, known today in terms of the

56
lymphatic system. Swellings in the groin, which
sometimes occurred in the course of plague, were
thought to be caused by an excess of humors in the
liver, swellings under the arm, by superfluities in the
heart, and swellings behind the ears, by superfluities
in the brain. Thus, the disruption of the atmosphere
caused by plague miasmas was repeated in the body

through a disruption of the humors.“

2. The Typical Academic Medical Treatise as a Model for
English Plague Treatises

English plague treatises often follow the
conventions found in Latin medical treatises from which
they were derived. The Isagoge of Johannitius became one

of the most influential of these Latin treatises in the

 

“Humoral theory was based on a perceived duplicity
between the human body and the four elements that
surrounded it. The four elements, air, fire, earth, and
water, were the most basic substances in nature and, in
various combinations, formed all living and non-living
things. A fifth element (quintessence) existed above the
sphere of the moon and was thought to be a combination
of the four "lower" elements. The most significant
aspect of this belief was in its perceived
understanding of the interdependence of the elements.
All things, animate or inanimate, were thought to be
related so that a change in one brought about changes in
another.

In the human body, the four humors corresponded to
the four elements: blood, like air was hot and moist;
choler (yellow or red bile), like fire was hot and dry;
black bile (melancholy) was, like earth, cold and dry,
and phlegm, like water, was cold and moist. The four
humors, in turn, affected both physical and mental, or
temperamental, states.

57
Middle Ages. In its original form, an Arabic commentary
by the Nestorian Christian Abu Zayn ibn Ishaq (Hunayn),
the Isagoge summarized important precepts from Galen’s
theories. After its translation from Arabic into English
in the twelfth century, it became known in Western
Europe as the Isagoge of Johannitius, a conduit through
which much of Galen’s teachings were known to medieval
physicians.“

The Isa o e, an attempt to codify medical
knowledge systematically, began by explaining the two
major divisions of medicine: theory and practice.h
Theoretical medicine includes the study of "naturals,"

"non-naturals," and "contra-naturals,’ with practical
medicine being derived from these theoretical divisions.
The study of the relationships between these three
categories constitutes the science of the causes and
signs of disease, health, and the neutral state, which
occurred in between.

Hunayn, the author of the treatise, divided the
"naturals" into seven categories: elements (which exist

outside the body but have influence over it),

temperaments, humors, parts of the body, faculties,

 

“L. J. Rather provides an outline of the Isagoge
and describes the contents of other important Latin
medical treatises such as Avicenna’s Canon in
"Systematic Medical Treatises," esp. 290-94. The outline

of the Isagoge given below is taken, in part, from
Rather’s outline.

58
operations, and spirits. Each of these subcategories
was further divided in the treatise. The "non-

naturals,’ the second major division of theoretical
medicine, included forces outside the body which
directly affect the "naturals:" various changes in the
air (due to seasons, stars, winds, earth, and their
exhalations), exercise and bathing, foods, sleep,
coitus, and affectations of the mind.“
"Contra-naturals," the final topic under the
category of theoretical medicine, occur as products of
the interaction between the naturals and non-naturals.
The contra-naturals are divided into three categories:
diseases, the causes of diseases, and the sequels of
diseases. The Isagoge further subdivides each of these.
The Isagoge continues with an explanation of the
causes, nature, and signs of disease in various organs.
The nature of disease depends on its origin, whether it
arises from a combination of cold, hot, moist or dry

elements. It may result from constriction or relaxation

of the pores, from an excess or lack of humors, from

 

“L. J. Rather traces the "Six Things Non-Natural"
in treatises from ancient times to the late nineteenth
century in "The Six Things Non-Natural.” He summarizes
the doctrine of the six things non-natural in these
terms:

There are six categories of factors that

operatively determine health or disease, depending

on the circumstances of their use or abuse, to
which human beings are unavoidably exposed in the

course of daily life (337).

59
informative virtue (i.e., from internal changes), or
from trauma. The treatise concludes with sections on the
practical divisions of medicine: the regimen of health,
treatment, removal of superfluities, changes in members
of the body, divisions of treatment, surgery, and an
explanation of various kinds: quality, quantity, time,
order, and the separation of good and bad.

Medical treatises like the Isagoge attempted to
codify the causes of and remedies for disease within an
orderly cosmology. In a sense, all diseases were really
variations of one disease resulting from lack or excess
of humors in varying degrees. Thus, the close
relationship of the internal workings of the body and
the external world could serve as a model for all forms
and degrees of disease and health. Newly appearing
diseases were considered as variations of diseases
already known. Accordingly, medieval physicians first
labeled plague as a form of fever, placing it in a
larger framework of fevers and pestilential diseases.7
The Isagoge and plague treatises modelled on this
ancient work described various agents responsible for

disease and health and their relationship to the human

 

7This development has been fully elaborated on by
Melissa P. Chase in a dissertation and subsequent
article. For a summary of the development of plague as a
disease entity separate from fevers or other forms of
pestilential diseases, see Chase’s "Fevers, Poisons, and
Apostemes: Authority and Experience in Montpellier
Plague Treatises."

60
body, which was often described in terms suggesting that
it was a microcosm of God’s orderly universe. Medical
treatises thus follow an order assumed to mirror Divine
order.

Although the standard medical treatise divided the
art of medicine into practical and theoretical
medicine, it also stressed the connections between these
two major divisions. In plague treatises, phlebotomy, a
procedure used for both prevention and treatment and
based on theory, was often provided as a supplement for
herbal remedies and other practical measures for
treating disease. A treatise often began by summarizing
the causes of plague, a theoretical concern, and
continued by listing remedies, a practical concern.

Lay people were more concerned with treatment of plague
than with its causes, and especially with less

technical treatments such as herbal remedies, instead of
with more technical measures like phlebotomy or
uroscopy.

By the end of the fourteenth century, treatises on
topics such as childbirth, gynecology, surgery, and
miscellaneous diseases appeared in English, suggesting
that advice on these subjects was more accessible to lay
people. But vernacular plague treatises continue to
occupy a proportion of this vernacular medical

literature well into the fifteenth century (R. H.

61
Robbins, "Medical Manuscripts" 406-07). By the early
fifteenth century, manuals on academic subjects like
uroscopy and phlebotomy had also been translated, so
that advice on these more theoretical matters was also
available in English sources. But as examples from
plague treatises reveal, procedures like phlebotomy were
often simplified in lay medical guides to the degree
that they were not practical for the untrained without

further instruction.

Chapter 3: Fourteenth- and Fifteenth-Century English
Plague Treatises

1. John of Burgundy’s Treatise

The need for medical advice during plague
outbreaks led to a number of treatises written in Latin
and later translated into every European language,
including Hebrew (Dorothea Waley Singer and Reuben Levy,
"Plague Treatises" 394). Dorothea Waley Singer describes
this broad variety of fourteenth- and fifteenth-century
plague treatises in a study centering on the plague

treatise attributed to John of Burgundy.“ According to

 

“Proceedipgs of the Royal Society of Medicine,
History Section, 9 (1916): 159-212.

Singer’s work on the classification of English
plague treatises is the most complete, although Karl
Sudhoff and others have also studied plague treatises in
England, and their contribution ought to be considered
briefly here.

In a study of treatises written between 1348 and
1500, Sudhoff found that only 9 of the 281 texts he
investigated were actually from England. Unfortunately,
Sudhoff’s opinion concerning the provenance of English
texts is somewhat limited; he had much greater access to
German collections than to British manuscripts. George
Sarton finds that "the fact that half are of German
origin is accidental, Sudhoff having naturally been able
to explore the German collections of M88 more thoroughly
than the collections of other countries" (Intro. to the
History of Science, 2: 1660). Much of Sudhoff’s work
was done before and during World War I, when access to
British libraries was difficult for German scholars.

Concerning fourteenth century plague tracts
particularly, of those composed when plague was most

 

62

63

Singer, there are four Latin and two English copies of
the earlier Burgundy treatise in the British Museum
alone, and several more in Oxford and Cambridge,
attesting to its popularity ("Some Plague Treatises"
177). In a later study, Singer and Annie Anderson
describe other plague treatises surviving in Great
Britain, many of them incorporating portions of the
Burgundy treatise.“

The plague treatise variously attributed to John of

Burgundy (ca. 1338-1390) has given rise to a complex web

 

imminent, only 77 of the 281 texts mentioned by Sudhoff
were written during initial outbreaks of the disease,
and of these, only three are in English. Twenty of these
fourteenth-century texts were written within five years
of the first outbreak.

Consult Winslow and Duran-Reynals, "Jacme
d’Agramont and the First of the Plague Treatises" 747-
65, esp. 747; and K. Sudhoff’s extensive collection of
plague texts in Pestschriften aus den ersten 150 Jahren
nach der Epidepie deg Schwarzen Todes.

“Catalogue of Latin and Vernacular Plague Tractates
in Great Britain and Eire in M88 Written Before the
Sixteenth Century. The catalogue provides extensive
examples of anonymous plague treatises and pestilence
passages in medical works and is especially useful
because it contains incipits, chapter headings, and
explicits from unpublished manuscripts (see esp.
Appendices A and B). The many unpublished treatises
mentioned offer much ground for future editors. As
Rossell Hope Robbins states concerning Middle English
manuscripts generally, "...the field of medical and
other scientific vernacular manuscripts is still a Yukon
territory crying out for exploitation. So little is
known, so much has to be discovered" ("Medical
Manuscripts 413).

64

of texts by various translators.“ Some of the treatises
in this family have been attributed to other medical
authorities contemporary with John of Burgundy: John of
Bordeaux and Bearded John of Liege. To add to the
uncertainty over authorship, John of Burgundy was once
thought to be John Mandeville, author of the Travels.“

The many redactions of the Burgundy plague treatise
and its distinction as the first published medical
manuscript in England (Singer "Some Plague Treatises"

177) further attest to its wide influence.“ No other

 

3For translations of Hebrew versions of the
Burgundy treatise from manuscripts located in the
Bibliotheque Nationale, see Dorothea Waley Singer and
Reuben Levy, "Plague Treatises."

“There is not enough space here to recount the
entire controversy concerning the original authorship of
the Burgundy plague treatise which gave rise to so many
others, although the history of scholarship on the
author of this treatise does present an interesting
piece of detective work. For an earlier view on the
identity of the author, see Singer and Anderson 26-27,
David Murray, John de Burdeuaror John ae Burgundiarana
the Peatilence, and especially Singer and Levy, 395-99.

More recent scholarship suggests that John
Mandeville and Bearded John of Burgundy, physician of
Liege, were not the same person. The editor of the
Oxford edition of Mapdeville’aaTraveEa, M. C. Seymour,
supports that notion.

Concerning the anonymous author of MandevilleLa
Travels, Seymour remarks, "None of the various attempts
to pierce the author’s anonymity, which began in the
fourteenth century at Liege and which have successively
associated the book with Jean de Bourgogne, a Liege
physician (d. 1372), and Jean d’Outremeuse, a Liege
notary (d. 1399), as well as with the author’s adopted
name, will bear critical examination" (xiii).

“The plague treatise by Bengt Knutsson, discussed
later in this chapter (88-94), is a distant heir of the
Burgundy treatise and bears the distinction of being

65
plague treatises survive in England in as many
versions.“ The original Latin treatise by John of
Burgundy (Tractatus Johannis de Burgundia de morbo
epidapiae) appeared around 1365, and a Latin recension
of the work attributed to John of Bordeaux appeared
around 1390.

The Latin versions of this treatise were longer,
with an astrological prologue explaining miasmas and the
causes of plague, useful for graduate physicians in
plotting the course of a patient’s illness.
Astrological knowledge was necessary for understanding
the course of disease, but would be of little use to
laymen who more often concerned themselves with

remedies.“ These long astrological prologues also serve

 

the first English book with a separate title page as
well as the first medical book published in England
(1485) (Keyes, "The Plague" 50).

“Rossell Hope Robbins and Dorothea Waley Singer
have placed the total number of fourteenth- and
fifteenth-century medical manuscripts in Great Britain
as follows:

Latin English
14th C. 1948 140
15th C. 3729 872

(Robbins, "Medical Manuscripts" 393)

These figures demonstrate the dramatic increase in
Latin, and especially in English medical manuscripts
from the fourteenth to the fifteenth centuries.

“Singer and Anderson do not mention any abbreviated
Latin editions of the treatise without the prologue.
Academic medical writing stressed the importance of
astrological forecasting as an important component in
academic medicine, but English readers were most
concerned with remedy and prevention, which these
treatises address extensively.

66

as evidence for physicians’ concerns with locating
plague in a larger cosmology. Though plague brought
widespread suffering and death, it could be understood
along with other diseases as part of a larger scheme.

English translations of the Burgundy treatise
offered English readers consolation as well as medical
advice by explaining plague in an accessible language.
But the most popular forms of the treatise in England
were shorter versions that summarized remedies and
directions for phlebotomy, omitting lengthy discussions
of the astrological causes of plague. Even though the
advice given in the Burgundy treatise was widely
available in English, it remained within the domain of
academic medicine, seldom working its way into general
medical treatises or later popular texts such as those
described in Chapter Four. The Burgundy treatise defers
to ancient medical writers, while general medical works
with advice on plague defer to an ancient pharmaceutical
tradition. Neither the academic nor the popular
tradition in English medical writing turns much to
contemporary sources in explaining plague.

Like the Isagoge, a medical treatise on the theory
and practice of medicine used by medieval physicians,
the Latin version of the Burgundy plague treatise

divides its subject into three major categories: causes,

67

prevention, and remedy.“ The Latin version of the
treatise and its heirs follow an outline of theoretical
and practical medicine explained in the Isagoge,
locating the causes of plague among "natural things"
(the effects of the elements on the humors) as they are
changed by "non-natural things:" distantly, as changes
in the planets. and nearer, as changes in the
surrounding air. Like other diseases, plague was a
"contra-natural thing," having its cause in the
interaction of certain non-natural elements within the
human body.“ Like other epidemic diseases discussed in
ancient treatises, plague’s causes were also thought to
be both particular and universal: involving internal
organs and their similar parts in the body, while at the
same time affecting great numbers of people.

The original Latin treatise by John of Burgundy
(ca. 1365), surviving in several British manuscripts,
reflects the concerns of ancient treatises, especially

in locating plague within the context of other

 

“The Isagoge is discussed in Chapter Two (57-61) of
this study as an example of a typical learned medical
treatise.

“As one translation of the Burgundy treatise puts
it, "ayer enters into a mans body and infectes his
flesche and his blude and sa engenders the pestilence"
(Oxford, Bodleian Library, Ashmole 1443.376-93; in
Singer and Anderson 44).

68

epidemics.“° In a personal introduction, its author
states that he writes about plague so that each man
might be his own physician: "sibi ipsi sit praeservator,
curator et rector" (62). It begins with advice on
preventing plague, explaining the importance of a
moderate diet and moderation in sexual activity (63).
English prose translations summarize this advice but
omit other, more complicated preventives like the ppppp
ambrae, explained in this treatise: an aromatic ball
containing a variety spices held together by resin and
worn around the neck to prevent plague; one of many
kinds of aromatics used to purify plague-infested air.““
The treatise gives recipes for other plague preventives,
stating that more common ingredients could be
substituted for uncommon or unavailable ingredients.
These remedies have analogues in ancient sources.

In the next section (64), the author outlines the
causes of plague, citing authorities like Rhazes (ca. AD
860-923) and Avicenna (AD 980-1037) in a technical

description that parallels the content of writings on

 

““Sloane 134. f. 31f-38'; Sloane 3566, f. 63V-87V;
British Museum K. G. IV, v. 158r-159'.

Tractatus Johannis de Burgundia dermorbo e idemiae,
edited by Karl Sudhoff in Pestschriften ape dem 150
Jahre nach der Epidemic 5 (1911-12): 62-69.
Parenthetical page references following quotations from
this treatise are from Sudhoff’s edition.

““The pomum apbraa was recommended as a
prophylactic measure for pestilence earlier in the
fourteenth century by physicians like Bernard of Gordon.

69
plague by earlier medical authorities, especially
Hippocrates (ca. 460-375 BC) and Galen (AD 129-99), who
survived an outbreak of pestilence himself in the second
century.““ The section on the causes of plague locates
them in general and remote sources, and then in ones
particular and near. Medical authorities on plague,
beginning with the faculty of medicine at the
University of Paris, had argued that the remote source
of this disease was a planetary conjunction of Saturn,
Jupiter, and Mars in 1345.1“ The Burgundy Latin treatise
states that this planetary conjunction had corrupted the

air, making it putrid, and in the next section describes

 

““Galen does not mention astrological causes as the
source of epidemics; Avicenna mentions them briefly (A.
M. Campbell, The Black Death 37n5). See also the
discussion of epidemics in the writings of Hippocrates
and Galen, Chapter Two (51-53, esp. 52n1).

““Planetary conjunctions were thought to signal
great events, not all of them harmful (e.g., the coming
of a great prophet) as Guy de Chauliac’s Cyrurgia
explains. But certain conjunctions could produce serious
illness.

A grand conjunction of the three superior planets,
Saturn, Jupiter and Mars, in the sign of Aquarius, took
place on March 24, 1345, according to Guy de Chauliac.
This, he argued, was the cause of the plague that swept
Europe from 1348 onwards. Guy comments extensively on
the cause of the plague in his Cyrurgia Magna, which was
later translated into vernacular languages. It became a
popular surgical textbook in England, and its
description of the causes of plague parallels the one
found in the Burgundy treatise, though with more detail.
Consult Chapter Four (95-103).

70
additional remedies for countering the effects of this
corrupt air in the body.““

The treatise continues by explaining how
pestilential air corrupts the three principal members,
or organs, within the body: the heart, head (brain), and
liver (65), causing each, in turn, to produce excess
humors.““ The treatise recommends phlebotomy for
reducing these excess humors, and explains this
technique in summary form in the next section (65-66).
The treatise then gives advice on treating plague with a
diet of several kinds of herbs, similar to those
prescribed by earlier authorities for fevers. Plague was
often accompanied with fever, and medieval physicians
placed it in the larger category of pestilential fever,
since ancient physicians like Hippocrates had classified
epidemics as forms of pestilential fever.““

According to the author, the best remedy for this

disease is tyriaca (theriac), an ancient remedy

 

““Et qui isto utatur regimine a pestiferi aeris
corrupcione mediante dei auxilio poterit
praeservari (64.68-70).

1“For an extended discussion of this concept, see
Chapter Two (54-56). The treatise explains the location
of the emunctories where these excess humors are
expelled: "Epatis vero emuctoria sunt inguinaria, et
emuctoria cerebri sunt ub auribus aut sub lingua...
(65.79-80).

1“Dieta in hiis morbis sit tenuis ut in

febricitantibus, quia huic morbo semper commiscitur
febris (66.136-37).

71

containing 70 ingredients in an opium base, first
suggested and described by Galen as a panacea for a
variety of illnesses (66), and commonly used by
physicians afterwards. Other, more simply compounded
herbal remedies appear in the next section (67), which
offers a series of recipes later translated word-for-
word in English prose versions but with substitutions
for rarer or more expensive herbs. Above all, the
treatise warns, one must not delay in applying these
remedies, as the disease not only progresses rapidly,
but is often fatal (67).“7

In the closing sections of the treatise, the author
gives further advice on diet, recapitulates on the
importance of phlebotomy, and lists several other
recipes. He concludes with a testimonial to the
authority of past physicians from Hippocrates onwards,
but in an unusual turn from the conventions of standard
medical treatises, gives contemporary physicians the

majority of the credit.““ Despite this testimonial to

 

““Etiam dico quod isti morbi pestilenciales breve
et subitaneum habent principium et cito determinacionem
unde illa, quae spectant ad curam, in his morbis non
deberent procrastinari, quare minucio, quae est
principium curae, non debet retardari nec expectetur
dies prima nec secunda (67.183-87).

l“Nichilominus tamen super hiis, quae dictus
Ypocras vidit, librum edidit de epidemia. Sed
Galienus, Diastorius, Rasis, Damascenus, Geber, Mesue,
Copho, Constantinus, Serapion, Avicenna, Algagel et
sequaces eorum nunquam viderunt ita generalem nec longam
epidemiam, nec curas eorum longa experientia

72
contemporary colleagues, the sources of medical
information in the treatise derive from a well-
established tradition, not from contemporary
observation.

Like other academic treatises, the Latin version of
the Burgundy plague treatise stresses the importance of
diet both in the prevention and treatment of disease. In
later academic treatises on plague, and in later
English versions of the Burgundy treatise, fewer plague
remedies appear, because the plague proved so often
fatal, and also, perhaps because complicated recipes
like theriac had to be compounded by trained
apothecaries. Hence, prophylactic measures like
phlebotomy and diet became crucial and were stressed in
later treatises as means for preventing a disease which
could not be effectively cured. However, plague
remedies remain an important part of general medical
works containing advice on plague, and appear in recipe
collections as late as the nineteenth century when the

bacillus was discovered.

 

probaverunt, sed quidquid plurimi dicant et tractent de
epidemiis a dictis Ypocratis exhauserunt. Unde magistri
huius temporis in illis morbis maiori experientia usi
sunt, quam omnes qui nos praecesserunt, unde dicitur et
verum est, quod experientia facit artem, et ideo ego
autem pietate motus et cladi hominum condolens et
compatiens hoc compendium edidi...

(68-69.239-50)

73

Several later versions of the Latin Burgundy
treatise have an English title and glosses.““ The
English glosses in these treatises summarize learned
advice and, therefore, could be read by laymen, or may
have served as a crib or quick guide for those who read
Latin, but not fluently, serving as a crutch for readers
unfamiliar with the language of formal medical
treatises. The practice of summarizing medical
information was more useful for academically trained
physicians, who often carried a vade mecum containing a
chart of favorable days for letting blood and diagrams
of rotula, urine flasks indicating the various colors of
urine. These charts and summaries aided physicians in
making accurate diagnoses and prognoses, in addition to
giving tables of days for letting blood, essential
information for treating patients.“0

A mixture of Latin and English in prose recensions
of the Burgundy treatise occurs in texts mostly after
the late fourteenth century. While Latin may have been
accessible to clerks and physicians, in English

versions it lends a degree of credibility to various

 

1“For example, "Here begynneth the tretis of John
of Burdeux the nobyll fecision ageyn the pestilence
ewyll as it is proved be doctores" (in Singer and
Anderson, nos. 17, 33).

““Consult Charles H. Talbot, "A Mediaeval
Physician’s Vade Mecum." Chapter One of this
dissertation (44) contains an example of a physician’s
uroscopy chart.

74
remedies and procedures explained in the treatise,
reminding the audience of the earlier authority on which
it is based.

The custom of using Latin also appears in other
vernacular works as the mark of authority and as a
reminder of the ancient sources from which the text is
derived. In the Canterburerales, Chaucer’s Pardoner
explains how Latin tags lend credibility to greedy
intentions when speaking to an audience of "gentile."
The Pardoner tells his pilgrim audience:

And in Latyn I speke a wordes fewe,

To saffron with my predicacioun,

And for to stire hem to devocioun.

(6.343-346)““
An English plague treatise with Latin glosses was not
necessarily the work of a charlatan, who, like
Chaucer’s Pardoner, had interest only in financial gain.

The English versions of the Burgundy treatise
appear in both prose and rhyme and were generally
shorter, often lacking the long astrological

prologue.““ Like the Latin treatises on which they were

 

““The Summoner is said to do the same "like a jay"
(Qaneral Prologue 637-46)). And Langland uses Latin in
many ways to suggest a dialogue between lay and learned
perspectives.

““Ed. David Murray, John de Burdeus or Jahngaa
Burgundia and the Peatilenca (Register Coenobii
Kalchoensis MS. Adv. Bibl.).

Ed. Karl Sudhoff, Pestschriften aus dem 150 Jahre
nach der Epidemie (Cambridge, Trinity College MS.
R.14.32).

75

based, they also divide their subject into four
chapters, but avoid lengthy or complicated recipes such
as Galen’s theriac. The English prose treatises on
plague, unlike later academic advice on plague,
continue to stress remedies, often substituting common
garden herbs for more expensive or complex ingredients
given in earlier versions.

One Latin version with an English title and
glosses (ca. 1390) refers to its author as a "gude
fisycyane." Like later English versions, this treatise
divides into four sections: 1) how to care for oneself
in times of pestilence, 2) causes, 3) remedies, and 4)‘
prevention.““ An English version of the same treatise-
begins by advocating a moderate diet. One should avoid
certain foods: "garlik, vuyons [onions], lakes [leeks]
en other suche metes [foods] that bringeth a man into on
vnkyndely hete" (qtd. in Sudhoff 73).““ One should also
avoid bathing or other physical activity that might
cause excessive body heat and open the pores, allowing

"venonys ayre to enter and distroyeth the lyfly spirites

 

““The order of these sections changes, however, in
some of the other Englished Burgundy treatises as
examples in this chapter show.

““Parenthetical references to page and line numbers
in the following quotations are from Karl Sudhoff’s
transcription of an English version of the Burgundy
treatise in Pestschriften nach der Epideaie des
"Schwarzen Todes" 1348. Archiv fur Geschichte der
Medizin 5.73-75.

76
in man and [thus] enfebleth the body" (73.14-16).
"Lecherye" should also be shunned because it weakens
"kynde" and, like bathing or perspiring, "enfebleth the
kynde and openeth the pores" (73.16-17).““

The prologue to many versions of the Burgundy
treatise, including earlier Latin versions, explained
that the treatise, though taken from professional
medical writing, was written for everyone’s use, so that
each might ably restore and preserve his own health.““
Writing shortly after the first outbreak of plague in
Lerida, Catalonia, the Continental physician Jacme
d’Agramont explained why he had recorded advice on this

disease:

 

““"Kynde" in the passage above might refer to semen
as it does in Chaucer’s Parson’s Tale:

For if the chirche be halwed, and man or womman

spille his kynde inwith that place by wey of synne

or by wikked temptacioun, the chirche is entredited

til it be reconsiled by the bysshop.

(965)

"Kynde,' on first reading, appears to refer only to
semen, particularly because sexual activity ("lecherye")
is involved. But "kynde" also may refer to spirit, or
simply to "physical nature," which, when weakened by
plague vapors entering the body, causes humoral
imbalance which, in turn, results in the characteristic
buboes (cf. also, MED, s.v. kynde).

““Sudhoff find the following prologue to a Latin
version of Burgundy’s treatise typical:
Ego Johannes de Burgundia divino auxilio invocato
praeservationem et curam epidemiae enucleare’
intendo, ut vix aliquis phisico indigeat, sed
unusquis que phisicus sibi ipsi sit praeservator,
curator et rector.
Pestschriften aus dem 150 Jahre nach der Epidemie 5:61.
(Cambridge, Trinity College, MS.O.I.77).

.'

77
Because in this [the task of producing a
plague tract] I am not incited by envy or iniquity
but by true love and charity having made this
present treatise principally for the benefit of the
people and not for the instruction of the
physician...““
But unlike the preface to the Burgundy treatise, which
set no restrictions on the users of the text, Jacme
goes on to explain that the treatment of plague itself
ought to be left for trained physicians:
Everybody can make use of the regimen of prevention
presented in the present treatise without a
physician and without danger. But the regimen of
treatment properly belongs to the physician, since
in this anybody without the art of medicine could
easily err, and in order to avoid this, no mention
of treatment is made here.
(in Duran-Reynals and Winslow 58)
The translator of the original Burgundy treatise
apparently believed his audience could understand and
make use of more complicated procedures, including
phlebotomy, as he added information on this technical
treatment, ostensibly allowing each man to become not
only a preserver of health, but a healer himself.
Phlebotomy was rooted in Galenic and Hippocratic
medicine, and was well-established as a treatment and
preventive for various diseases by the fourteenth

century. But the directions for phlebotomy in this

treatise and others in the Burgundy corpus are so

 

““Trans. M. L. Duran-Reynals and C.-E. A. Winslow,
in "Texts and Documents: Regiment de Preservacio a
Epidimia o Pestilencia e Mortaldats" 58.

78

greatly simplified that one would have to refer to a
more complete technical phlebotomy in order to carry
them out, suggesting that, with respect to phlebotomy at
least, one could hardly become his own "praeservator,
curator et rector" on the basis of this text alone.““
Latin treatises in the Burgundy corpus contain an even
less detailed description of phlebotomy than later
English versions, possibly because other Latin
phlebotomies were more available to those who read Latin
treatises and would be superfluous in Latin plague
treatises, but considered useful for English readers.

The translator of one English phlebotomy (ca.
1400), explains that he is translating a Latin text for
"myn dere gossip thomas plawdon, citiseyn & barbour of
london" (Voigts and McVaugh 15). He further states that
he will "write sum del of theorike & sum del of pratike
a borue be which 3e schulle be betir entre into be
worchynge of fisyk in tyme of lakkyng of wise

fysicians..." (Voigts and McVaugh 15).““ The longer

 

““Probably the oldest technical phlebotomy
available was the anonymous EpistuLaade phlebotomia
which dates from the ninth century.

For a discussion of the history of this procedure,
see Karl Josef Bauer, Qaachichte der Aderlasse, and for
a more thorough explanation of this tradition in Middle
English texts, see Linda E. Voigts and Michael R.
McVaugh, A Latin Technical Phlabotomy and Its Middle
English Translation.

““Voigts and McVaugh note that it is difficult to
determine the extent of training for barber-surgeons,
who generally used technical phlebotomies, especially

79

English plague treatise thus demonstrates a blending of
learned and lay perspectives which explain for a popular
audience useful measures for controlling plague from
both traditions, though the recipes seem the most usable
part.

The treatise emphasizes herbal remedies which could
be mixed with vinegar or white, but not red, wine
(75.107-08), but like its Latin source, concludes that

prevention is best:

Therfore whoo that dredeth hym of his sekenes, kepe
hym fro thynke envennemyd as in the frist chaptre,
and whoo so is [blerinne doo by tyme and rule hym
as the other capiters of this tretis techen hym,
and through the grace of god he shalle fro this

 

before 1451 when they were awarded a grant of arms, and,
later, in 1462, a royal charter, which contributed to
uniform codes for training physicians (A Latin Technical

 

Phlebotomy l7, esp. note 55).

However, they argue that we can probably assume
that many barbers read Latin, and that they may have
attended academic lectures in addition to their
apprenticeship and other practical training (A Latin
Technical Phlebotoay 16). This appears to be the case
with John Arderne, surgeon-author of Treatises of
Fistula in Ano, who apparently had some academic
training in addition to his apprenticeship as a surgeon.

Translating a Latin treatise on phlebotomy for
barber-surgeons, then, would not have been the same as
translating information on phlebotomy for a less
educated audience. While empirics had no university
training, unlike barbers-surgeons, they might have used
phlebotomy learned in an apprenticeship and not by
reading texts on phlebotomy. Sharing such information
with them, especially when it comes from a learned
physician like John of Burgundy, seems to be an unusual
situation. Many academic physicians did not advocate
sharing such learned procedures with empirics, as we
have seen in Jacme d’Agramont’s treatise on plague
quoted above.

80
seknes kept and delivered, for [bler is no sikenes
in kynde, that hat holpe it in kynde.
(75.115-20)

In English versions, recipes are simplified from Latin
originals, and advice on phlebotomy, though probably
difficult to use, is generally a summary of more
complicated techniques. Before the fifteenth century,
more technical procedures like phlebotomy, humoral

theory (i.e., a discussion of "cleansing places"), and

uroscopy rarely appear in lay manuals.“o

 

““English translations of uroscopies do not appear
until sometime during the fifteenth century, indicating
that prognosis or forecasting might be considered a more
technical strategy than phlebotomy, and of little use to
laymen in "great mortalities." By the fifteenth century,
even technical information on uroscopy. usually carried
out by physicians, was translated into the vernacular.

The English text of the Liber Uricrisiarua_(Welcome
225), edited by Joanne Jasin, is one example of the
growing availability of technical information for a
popular audience. The plainness of the English
manuscript in which it appears, when compared to more
ornate Latin versions, also reveals a gap between
wealthier physicians and the poorer leeches. The scribe
of the Uricrisiarum, as Jasin has noted, "apologizes for
his lack of access to certain authoritative texts for
’faut of pecunie’ (33r)" (5).

The rise of the medical guilds increased further
differences between "wise physicians" and poorer
practitioners and later, these guilds encouraged
medical licensure for physicians which was granted by
act of Parliament in 1423. Voigts and McVaugh (A Latin
Technical Phlebotgay) comment on medieval medical
practice with respect to the guilds: "In England in the
early fifteenth century surgeons and physicians seemed
to have been aligned with one another perhaps because
both groups were weak in relation to the politically
powerful guild of barber-surgeons" (16-17). According to
Voigts and McVaugh, guild records for the barbers
survive from 1308; they were awarded a grant of arms in
1451 and a royal charter in 1462; Guild records for
surgeons survive from 1368; surgeons were granted arms
in 1492 (17n55).

81
Several rhymed versions of the Burgundy treatise
dating from the fifteenth century also survive,
including one edited by R. H. Bowers with the Latin
title Degpestilencia.“1 Bowers places this tract in the
category of "mnemonic or functional verse" (119). Its
form is like that of other versified medical

treatises.““ But unlike other rhymed medical works, this

 

For a discussion of medieval medical practice, see
Vern L. Bullough, The Develqppent of Medicine as a
Profeaaion; John A. Alford, "Medicine in the Middle
Ages: The Theory of a Profession"; and Elaine Miller,
"In Hoote Sqaere" xxxiii-xxxix.

“IVersified medical writings are popular in the
Middle Ages. See examples in George Henslow, Medical
Worag of the Fourteenth Century or in Warren R.

Dawson’s A Leechbook or Collection of Medical Recipes of
the Fifteenth Century.

Many rhymed treatises give remedies for ailments
in head-to-toe order. The first 700 lines of one such
treatise describes the virtues of herbs, explaining, in
order, how each may be used for specific ailments
catalogued. See Robert Max Garrett, "Middle English
Rimed Medical Treatise" 163-93.

Compared to the rhymed version of the Burgundy
treatise, this herbarium and remedy book offers little
in the way of prevention. One typical remedy in this
treatise ("For to knowe the festers") describes several
types of festers, cold and hot, and then gives "Diuerse
medecynes for bem." The hot fester is more dangerous,
but "The colde fester schal be heled w“ hete." (Garrett,
191).

““Robert S. Gottfried has printed portions of a
rhymed treatise, which he explains "is a much-copied
Oxford manuscript from about 1480, later printed, which
included a segment entitled ’An Ancient Treatise of
Leechcraft on Medicine and Surgery’" (Doctors and
Medicine 70). Its rhymed couplets and meter are similar
to Bower’s rhymed plague treatise:

The man that well of leechcraft lere

Read one this book and you will hear

Many a medicine both good and true

To heal sores, both old and new

82
one avoids reference to charms, sometimes considered
useful for warding off disease and often mentioned in
popular works (Bowers 118).““

The translator of this rhymed version of the
Burgundy treatise explains several reasons for learning
this information:

Her begynys a tretis fyne,

Made in Ynglis owt of Latyne.

Hyt techis the helpe & the defens

Agaynys the seknes of the pestilens.

(Bowers, "A Middle English
Mnemonic Plague Tract" 120)
The rhyme is like doggerel, but its simple rhyme scheme
and meter would serve as a memory aid, though not a
complete explanation, as the following example
illustrates:

Blode lettyng I teche the:

Qwen thou prykkyng felis in thi bode

Thou lett the blade in that same tyde

In the next vayne on the same syde

With in the sext houre aftur the prykkyng.
(121)

 

Here are medicines without flew

To heal all acres that been durable

Of sword and knife and arrow

Be the wound wide or be it narrow

Of spear or quarrel or dagger or dart

To make him heal in likely part...
(Gottfried transcription 70)

““For examples of folk remedies containing charms
and other incantations, many of them handed down from
Anglo-Saxon sources, J. H. G. Grattan and Charles
Singer, Anglo-Saxon Magic_and Medicine.

83

The treatise promises both remedy and prevention
"agaynys the seknes of the pestilens." It is brief, like
English prose versions, omitting sections on the causes
of pestilence, but, like English versions of the
Burgundy treatise, stresses remedy as much as
prevention. Many lines are devoted to a description of
phlebotomy, but in a form that describes the location of
veins while omitting instruction on the procedure for
opening them or on the importance of seasonal and
astrological considerations when doing so. The academic
medical advice derived "owt of Latyne" in this treatise
is greatly simplified. In the course of this short,
117-line poem, readers could learn an outline of major
parts of the longer treatises: causes, diet, and
prevention.

Like the prose versions discussed earlier in this
chapter, this rhymed treatise mentions neither ancient
nor contemporary physicians, except in one place,
halfway through the text, where the translator describes
remedies taught by "Feissians of Oxinforth." The closing
couplet of this tract playfully attests to the
translator’s perception of his work:

Her ar medycyns many--ches 3ou of the best;

For I wyll trett no more bot now go to my rest.

(116-117)
Advice similar to the kind given in the Burgundy

tract appears in other English plague treatises in the

84
early fifteenth century--in John Stipse’s plague tract
and advice from "Some Men in Oxford," and in the late
fifteenth-century English version of Bengt Knutsson’s
plague tract, which parallels much of the information

given in the Burgundy treatise.

2. Advice from "Some Men in Oxford"

Dorothea W. Singer and Annie Anderson (Catalogue of
Latin and Vernacular Plague Texta) have printed
portions of one fifteenth-century manuscript that begins
with the phrase, "Sum Men in Oxynford." Advice on plague
in this work, while related to the advice found in the
Burgundy tract, is derived from a treatise with Latin
and Italian versions belonging to the Monastery of St.
Zeno at Verona, offering additional evidence for English
sources outside the Burgundy tradition. According to the
editors, this treatise "is mostly in one hand, but there
are exceptions (especially in ff. 5; 102'-02'; 115-23;
177?-77') and is written by a certain Leo" (Singer and
Anderson 81-82).

The advice on plague taken from a more extensive
treatise by Leo is attributed to "sum men in Oxynford
that beth greet physicions" (Singer and Anderson 82) and
appears in English translation in a separate manuscript.

Like the Burgundy treatise, the advice in this treatise

85
includes remedies for plague, mostly herbal, but without
an explanation of phlebotomy or other technical
procedures. Many of the remedies require costly

ingredients including "almowndis,' which are not native
to Britain but available to readers in Verona where the
work originated. Each recipe begins with the statement
"some take" or a variation of it.““ One recipe tells
the reader to ”seyyn therover y pater noster and ane
maria," religious advice found more commonly in recipes
from an earlier, pharmaceutical tradition, but rarely in
academic medical texts. One remedy states that "sum
seyen ywis and Saresynys in fer contreys beyonde the see
they usyn for pestylens this water...," adding to its
credibility by deferring to authorities in exotic
lands.““

This translated plague treatise differs from the
Burgundy treatise by providing a greater variety of
remedies, themselves taken from a variety of sources

(i.e., from Oxford physicians, folk remedies, and

charms, and remedies prescribed by "Saresynys in fer

 

““E.g., "some ley tansey opon and apirion ther as a
man woll have hym to feyee hymselfe; sum ley the poudyr
of muske upone the colis, and some take iv levvys of
sauge wtoute eny holys..." (Singer and Anderson 82).

““Anna M. Campbell quotes from a Paduan poet who,
instead of citing Saracens as authorities on plague,
curses them with pestilence. The poet prays that God
will preserve the Paduans, but "Let them [i.e.,
pestilences] come upon the Venetians, let Saracens too
be smitten" (The Black DeapM 112).

86
contreys"). The audience of this work is apparently
expected to know of these recipes, in much the same way
as the audience of the Burgundy treatise is expected to
know phlebotomy with only minimal instruction, as the
recipes appear in catalog form and directions for making
and using them are not provided.

"Advice from Som Men,‘ taken from a Continental
treatise, also serves as a reminder that Continental
writers deferred to ancient authorities for remedies.
But the English translation of this treatise, like
translations of the Burgundy treatise, gives credit to
contemporary physicians for remedies, in this case,
physicians from Oxford. As we will see in the next
chapter, recipes for plague medicines continued to be
popular in vernacular medical works, but plague recipes

were often deleted from or condensed in academic

treatises.

3. John Stipse’s Treatise

Singer and Anderson provide examples of later
plague treatises, including portions of a manuscript by
John Stipse of Oxford entitled "A redgement for a
pestilence oftene proved in Oxford and other places

moste. According to the editors, the treatise contains

long passages based on the longer Burgundy treatise with

87
an astrological introduction (50-51). The incipit and
explicit reveal the authority on which it was based.““
In one version of the Stipse treatise, the author
states that he is a surgeon at Oxford living in the
Parish of East St. Aldate [Aldgate] in 1472, further
stating that he has tried these remedies himself.““
Stipse’s references to personal experience in treating
plague are unique, as most English treatises lack
references to contemporary plague outbreaks. The style
of Stipse’s treatise is less didactic than most
treatises, and less a cataloging of recipes, as in the
advice given by "Some Men." The treatise is more

informal than other academic plague treatises,

 

““According to the editors, the excerpts reproduced
in their edition, quoted below, may be found in a
regimen belonging to St. Peter’s Monastery, Erfurt, and
were presented to Brompton Oratory by David Lewis.
Title: A redgement for a pestilence oftene proved in
Oxford and other places moste.
Incipit: A speciall water for the pestilence taken out
of an anciente writen books of Mr. Smales of Gadesdene.
Also yf there be made a water by distillation of
diptanye, pimpernelle....
Explicit: ...This poulder I the forsayd John proved
upon a man of Sunningwell in Barkeshere which was
called Richard Bradstocke and many more and now helped
by the might and grace of God thus endeth this tretes of
the pestelence.

““British Museum, Sloane 3866 ff.90-92; f. 91':
...and I, John Stipse, usinge surgerye within the
Universytie of Oxforde, dwellings in the paryshe of Est
St. Aldate in Fyshe strete at St. Olldys church style in
the yere of our Lord 1472. In the which the bouke was
gathered and made... (Singer and Anderson 51).

88
particularly in its references to personal experience
and to contemporary physicians.

The remedies in this treatise are simple, calling
for less expensive ingredients and common herbs, unlike
those given in the treatise from "Some Men." English
readers would be able to reproduce Stipse’s recipes
using common garden herbs without the help of an
apothecary. A reference to Mr. Smales’ "anciente writen
booke" in the treatise, containing a recipe for
"speciall water for the pestilence," might at first
suggest that the author had consulted contemporary
authorities on plague in his search for remedies. But
the remedies in this treatise, apparently used and
endorsed by Stipse’s contemporaries, are, in fact, taken
from much earlier sources, not from contemporary plague
treatises. Stipse’s treatise and the advice "from Som
Men in Oxford" are more traditional than the Burgundy
treatise in that they provide remedies rather than
preventive measures for plague and are based on ancient

pharmaceutical advice.

4. Bengt Knutsson’s Treatise

A late fifteenth-century plague treatise written by

Bengt Knutsson, Bishop of vasteras, provides one final

example of the influence of the Burgundy treatise on

89

later medical works written by physicians. The treatise
provides evidence for physicians’ growing emphasis on
plague prevention, as opposed to more popular treatises
like Stipse’s which continue to emphasize remedy.““

According to Guthrie Vine, editor of the John
Rylands Library copy of Knutsson’s treatise, two other
versions exist: one in the British Museum and the other
in the Cambridge University Library (xxiii-xxiv). This
treatise has the distinction of being the first plague
treatise published in book form. It was printed about
1510 by Wynkyn de Worde, and again in 1536 in a new
edition by Thomas Gybson of London. Thomas Phaer
included Knutsson’s advice on the plague in a postscript
to his translation of the Eagiaengaanitatis Salerni (IMa

Regyment of Lyfe) in 1546. The section on plague in

 

““Bengt Knutsson is described in the treatise
variously as "Kaminti (or Kamiti), episcopi Arusiensis
civitatis, regni Dacie, medicine expertissimi
professoris" (Vine xxxii).

vasteras is near Stockholm, Sweden. Guthrie Vine,
editor of the treatise, notes that Visteras has been
wrongly identified by some as Aarhuus, Denmark, because
the treatise mentions "regni Dacie" (in the Kingdom of
Denmark). But no bishop of that name can be traced to
Aarhuus. Since the countries of Sweden and Denmark were
under the same rule in the fifteenth century, and since
there are records of Bishop Knutsson in Arosia, Visteras
is most likely Arosia rather than Aarhuus. According to
Vine, little is known of Knutsson’s life, except for
what he says of himself in the treatise.

An edited version of Knutsson’s Latin treatise
appears with a parallel version of a treatise by
Johannes Jacobi in Karl Sudhoff, "Die Identitét des
Regimen contra pestilentiam." Pestschriften aus depil50
Jahre nach der Epideaaa 5:56-58.

90

Phaer’s treatise was published separately in London a
number of times after 1546, and until as late as 1722
(Vine xxxvi).

Though Knutsson composed his Latin treatise around
1461 (ca. 1461-63), it appeared in English translation
only after an outbreak of English sweating sickness in
1485-86, serving as a guide for the treatment of this
disease. Medical researchers have not been able to
determine with certainty the nature of this disease,
known medically as Sudor Angligaa, which appeared in
epidemic form in the fifteenth and sixteenth centuries
with a high mortality and then disappeared. Folke
Henschen remarks that "its nature as a virus disease

cannot be regarded as certain,‘ and that its symptoms
appear much like those of encephalitis with an acute
rash (62). These symptoms, coupled with a high
mortality, led doctors to assume that it was a form of
pestilential fever and thus amenable to the same
treatment as plague.

According to the medical historian Roderick E.
McGrew (Encyclopedia of Medical History), Polydore
Virgil, an Italian émigré who came to London in 1501,
described sweating sickness, appearing in 1485 and
1508, as "a pestilence horrible indeed, and before

which no age could endure" (107). Apparently, the

disease struck its victims suddenly, and even the

91
healthy, once infected, died within 24 hours (McGrew
107). John Caius, the eminent physician from Cambridge
and master of Gonville and Caius College, wrote a
comprehensive summary of the disease in 1552, in which
he set out to "declare the beginning, name, nature, and
signs of the sweating sickness" (McGrew 107). Like Galen
and Hippocrates, Caius determined that the disease was
caused by impure air and by "impure spirits by
repletion," a reference, McGrew explains, "to the
excessive consumption of beer among the English" (107).
English sweating sickness thus shares with plague high
mortality and a rapid onset, which comes as a "blow or

stroke. Its causes, like plague’s, are associated with

impure air and physical excess.
The English translation of Knutsson’s plague
treatise begins with a reference to the author:

Here begynneth a litil bake the whiche traytied and
reherced many gode thinges necessaries for the
infirmite & grete sekenesse called Pestilence and
which often times enfecteth us made by the most
expert Doctour in phisike Bisshop of arusiens in
the realme of Denmark, etc.““

The treatise continues with the author’s personal
preface:

 

““References to the English translation of the
Knutsson treatise ("A litil boke") are from Vine’s
edition, which has been compared with a transcription by
Ralph H. Major, Classic Descriptiona of Disease 82-84.

An edition of this treatise by Joseph Pickett is
forthcoming.

92

I the Bisshop of Arusiens in the wyalme [scil.

ryalme] of Denmark doctour of Phisique Wille Write

by the moost experts and famous doctours auctorised

in Phisike somme thynges of the infirmitie of

pestilence Whiche dayly enfecteth, & sone suffreth

be to departe oute of this lyfe.

(Vine, ed. 1')

The style and structure of the English version of this
treatise resemble English translations of the Burgundy
plague treatise. Knutsson’s treatise is divided into
chapters, one each on the signs of pestilence, causes of
pestilence, remedies, comfort for the heart and
principal members (as prevention), and phlebotomy.

In part one, the author is more specific concerning
the signs of pestilence (e.g, changes in the air) than'
are English versions of the Burgundy treatise:

Whan in a sommers daye the Weder often times

chaungeth, as in the morning the Wedyr appereth to

rayne, after Ward it apperith cloudy & atte last

Wyndy in the south...

Unlike other translations of the Burgundy treatise,
Knutsson’s specifies the signs of pestilence, such as
"Whan grete multitude of flyes ben Upon the eerthe." The
author mentions falling stars, lightning and thunder
from the South as signs of plague and prays that "god of
His mercy Wille remeve it." Knutsson also warns that
many physicians are deceived concerning the causes of
pestilence:

Sometime it cometh of dede careyn or corrupcion of

standing Waters in diches or sloughs & other

corrupt places & these things somtyme be Universall
& somtime particular...

93
Although the treatise derives from the Burgundy
treatise, its advice on remedies is recast from the
writings of Avicenna, as Knutsson explains.

The detailed explanation of causes points toward
Knutsson’s dual role as physician and bishop. As a
physician, Knutsson shows himself a keen observer of the
physical circumstances in which plague occurs, noting
especially rotting food and other substances, the
presence of flies, and wind direction during outbreaks
of plague. He places these observations in the context
of ancient terminology: "somtyme Universall & somtime
particular." Knutsson connects these causes with a
religious explanation by stating that God sends plague
through various physical agents, thus drawing on
biblical sources in a way that the Burgundy treatises do
not. One might expect that, as a bishop, Knutsson would
likely blame sin as the ultimate cause of plague, but
his explanation in terms of medical theory demonstrates
that interpretations taken from medical and moral

perspectives need not be mutually exclusive.““

 

““The author of The Book of QpinterEaaence (ca.
1460), also combines religious and moral
interpretations of plague, noting that there are two
kinds: one sent directly from God as punishment for sin,
and the other sent indirectly through the planets. It is
foolish to attempt to cure the first kind, he believes,
but the second kind may be cured by natural remedies
because it has natural causes: "Forsobe, holy scripture
seib bat summe tymes oure lord god sendib pestilence to
sle summe maner of peple, as it is seid deutronomium
28....Therefore a gret fool were he bat wolde presume to

94
The value of advice given in plague treatises was

established by the fifteenth century and general enough
to be applied to other epidemic illnesses similar to
plague.““ English treatises, whether written by
physician or layman, tended toward practical advice,
with a strong emphasis on practical rather than
technical measures for controlling disease, an emphasis
that Hippocrates and Galen had also endorsed for

controlling epidemic disease.

 

cure bese plagis of pestilence bat ben vncurable, bat
ben sent of god to ponysche synne" (23-24).

“lThomas Forestier wrote a treatise on plague in
1491 in Latin and dedicated it to Henry VII. Forestier,
a physician from Normandy and resident of London during
outbreaks of sweating-sickness in 1485, described
English Sweating Sickness as a form of pestilential
fever. The treatise contains a catalogue of medical
remedies for plague borrowed from earlier medical
writing on plague, and especially from the Knutsson
plague treatise. In the sixteenth century, Andrew Boorde
uses plague terminology in writing about sweating-
sickness in his Dyetary (1542): "When the plages of the
pestylence or the swetynge syckenes is in a towns, the
people doth fle" (QED, s.v. sweating-sickness).

Singer and Anderson comment on the influence of the
Burgundy tract on yet another plague treatise written
much later, in the sixteenth century: "We might mention
here that Thomas Moulton (f. 1540), English Dominican,
author of the "Myrour of Helthe” appears in an early
sixteenth century manuscript as the author of an English
treatise which again is lifted almost entirely from [the
longer Burgundy treatise] (London, British Museum,
Sloane 3489 ff. 44-51).

95

5. Conclusion

Luke Demaitre has observed that, in the Middle
Ages, "Medicine was to be taught from a philosophical
basis, with reasons governing theory and theory guiding
practice" (Rev. of Arnalduaade Villanova 118). The
Burgundy treatise and its heirs give evidence for the
relationship between the theoretical and practical
interests of medicine. With respect to plague, writers
drew on earlier theories as a way of explaining this
apparently new disease within the framework of an
established cosmology. They added practical advice on
plague remedies drawn from ancient sources.

The treatises themselves offer, as C.-E. A. Winslow
and M. L. Duran-Reynals have suggested, "Little in the
way of new theoretical knowledge to the writings of
Galen, Rhazes, Avicenna and other earlier writers"
(Jacme d’Agramont 747). On the other hand, as Winslow
and Reynals also suggest, vernacular plague treatises
"give a clear picture of the knowledge then available
with regard to the causation and control of epidemic
disease...and represent the first large-scale effort at
popular health instruction" (Jacme d’Agramont 747).

However, the usefulness of this "large-scale
effort" is questionable. Technical procedures like

phlebotomy, not found in vernacular medical treatises

96
before the late fourteenth century, were introduced in
translations of the Burgundy treatise. A practitioner
would have to know the basic technique before applying
the information given in these treatises. A summary of
phlebotomy would not be adequate. Other theoretical
matters such as astrology were also described in plague
treatises, but the shortened astrological prologues in
these treatises do not explain the causes of plague in
any detail, except to serve as a reminder that it had
come from distant causes (a planetary conjunction) and
nearer causes (foul air). A shortened description of
causes, like a summary of phlebotomy, assumes a
familiarity with astrological forecasting, technical
matters more familiar and more important to clerks and
physicians than laymen. However, directions for plague
preventives in these treatises, like the directions for
herbal remedies, were already familiar, and could be
carried out without formal instruction.

The influence of fourteenth-century plague
treatises remained strong among clerks well into the
fifteenth century. Knutsson’s plague treatise served as
useful advice for Thomas Forestier, who borrowed it
almost word-for-word in writing on English sweating
sickness. John Stipse turned to the Burgundy treatise
when writing on plague in the fifteenth century. As the

next chapter explains, lay medical writers like John

97

Lydgate turned to academic treatises for advice on
plague in the fifteenth century, using that advice as
council to kings in the Secrees of Old Philoaoffrea and
in a short, rhymed treatise he wrote on pestilence.““

Finally, plague treatises rarely suggest that
plague resulted from divine punishment or that the
consequences of sin directly influenced the course of
this disease. Instead, writers of plague treatises
turned exclusively to earlier medical sources which also
interpreted epidemics in medical rather than moral
terms. By doing so, medieval physicians incorporated
this seemingly new and unfamiliar disease into the

framework of an established cosmology.

 

““Practical literature was read far more widely
than belles lettres in the late Middle Ages, William
Crossgrove believes, adding the following passage from
the historian Gerhard Eis as support for his argument:
"The artes-literature was far more widely read than was
fiction, had a continuous tradition in all parts of
Germany, introduced many new forms and genres, is
important for the proper interpretation of medieval
fiction, and often is a significant part of the literary
production of an author also known for his fiction"
("The Forms" 14).

Chapter 4: References to Plague in General Medical Works

During later outbreaks of plague, advice of the
kind recorded in academic plague treatises was
incorporated into general medical works, often as a
separate chapter on the treatment of pestilential
disease. Before English plague treatises were available,
lay people relied on traditional recipes for plague,
which they continued to do for centuries after the
fourteenth-century plague pandemic.“ When plague came to
Europe in the mid-fourteenth century, physicians and .
empirics relied mostly on the writings of ancient
physicians and on traditional remedies for pestilential
diseases. When recorded, remedies were nearly always
traceable to ancient medical authorities like Galen and
Hippocrates.

One major difference between plague treatises
written by physicians in the late fourteenth century and

the English translations arising from them concerns

 

“See, for example, the Estate Book of Henry de
Bray and the Paston family letters, both of which are
discussed in Chapter Six (171-77).

For a discussion of the importance of literary and
oral transmission of medical remedies in the learned and
lay medical practice, see John M. Riddle, "Theory and
Practice in Medieval Medicine."

98

\\\\\-d

99
explanations for the cause of plague. Physician-writers
stressed astrological causes, which they often
explained in lengthy prologues to the treatises.
Translators and redactors generally omitted or condensed
these prologues, favoring simpler versions of the
astrological theories of plague.

This chapter examines interpretations of plague in
English translations of general medical treatises from
the fourteenth and fifteenth centuries. The first part
considers the English translation of Guy de Chauliac’s
surgical treatise written during the first outbreak of
plague in the fourteenth century. The chapter continues
with an examination of plague references found in two
general medical works from the fifteenth century: "In

7

Hoote Somere,’ an anonymous fifteenth-century medical
treatise (Trinity College, Cambridge, MS R.14.51), and a
Middle English translation of the Liber Uricrisiarum, a
treatise on uroscopy with advice on theoretical and
practical medicine, including astrology, child-bearing,
and the treatment of fevers. The chapter concludes with
several examples of plague recipes in general medical
works from later centuries as evidence for a continuing
tradition of plague advice in later sources.

The texts discussed in this chapter share several

common features. With the exception of portions of "In

Hoote Somere," they are prose translations from Latin

100
sources, not original works. Like the plague treatises
discussed in the last chapter, they provide examples of
the knowledgeability and interests of English medical
translators, who draw on past authority as a source of
solace and as a means for creating order. In addition,
these texts remind us that English writers were more
concerned with plague remedies from ancient sources than
with contemporary experience, unlike Continental
physicians like Guy de Chauliac and Jeuan Gethin, who
describe contemporary encounters with plague and its
victims.

By the beginning of the fifteenth century, the
number of medical tracts in English had increased
dramatically (Rossell Hope Robbins, "Medical
Manuscripts" 393). While we cannot assume that the
crisis of fourteenth-century plague directly or solely
encouraged more of these vernacular texts, the
appearance of English versions of various medical
writings provides an opportunity to observe certain
changes in the emphasis of medical works translated for

a popular audience.“ Fifteenth-century vernacular works

 

“It is worth reminding ourselves of the dangers of
the post hoc fallacy easily committed in the study of
the history of epidemics and their influence. Philip
Ziegler provides this important caveat:

Once again, as so often in the history of the Black

Death, one must remember that post hoc is not

necessarily propter hoc. The second half of the

fourteenth century was a time of spiritual unrest,
of pertinent questioning of the values and of the

101
display a continued interest in plague prevention and
remedies, and less concern with the uses of phlebotomy,
uroscopy, and astrological forecasting with respect to
plague, even though English uroscopies and phlebotomies
were more common in the fifteenth century than in the
fourteenth. These technical measures for treating plague
remained part of the academic tradition in the fifteenth
century but are rarely mentioned in vernacular texts
after that time. But fifteenth-century writers
continued to draw on accounts in early treatises for
advice, as sources of consolation and order, even when

the advice from those sources proved ineffective.

1. The Surgical Treatises of Guy de Chauliac and John
Arderne

Several English versions of surgical treatises
from the fourteenth century contain advice on plague.
These became popular in England in the later Middle Ages
and serve as examples of translated medical works

available to lay readers. Because plague was classified

 

conduct of the Church, of disrespect for
established idols and a seeking for strange gods.
Though the tempo of events would have been
different, changes would have taken longer to bring
about, resistance would have been more intense and
reaction more immediate; in the longrun things
would have followed the same course, even though
there had never been a plague.

(The Black Death 269)

102
as a form of pestilential fever before the fifteenth
century, discussions of plague in these treatises
usually occur in a chapter on fevers or apostemes,
swellings of the lymph nodes thought to be caused by
plague.
One popular surgical treatise is the English

version of the Cyrurgia Magna written by Guy de

 

Chauliac (1300-67) and known in English translation as
the Cyrurgie of Guy de Chauliap. It was translated
because of its importance as a textbook on surgery. The
work remained a principal text on the subject for
centuries after Guy de Chauliac’s death (Deaux 55).“
One of the first contemporary explanations of
plague’s causes occurs in the C rur is, and for that
reason scholars often cite this treatise as evidence of
contemporary interest in plague. Chauliac’s advice on

plague combines standard medical advice found in the

 

“Sixteen of its surviving editions are in Latin,
forty-three in French, five in Italian, four in Dutch,
several in German, five in Spanish, and one in
English (Major, Classic Deacriptiona of Disease 77).
Quotations from Chauliac’s treatise cited in this
chapter are from an edition by Margaret S. Ogden.

R. Theodore Beck (The Cutting Edge) comments
further on the popularity and esteem later surgeons had
for Chauliac’s work: "His great text book on surgery,
written in Latin, appeared about 1363, and edition after
edition was issued in manuscript form until it was
printed in French in 1478. It was translated into
English, Provencal, Dutch, and Hebrew. Chauliac’s book
on anatomy and surgery was to become the students [sic]
text book and to hold its place until the seventeenth
century" (26).

103

Burgundy treatises with the author’s personal
observations on the plague in Avignon where he served as
physician to several popes: Clement VI, Innocent VI, and
Urban V. Besides serving as papal physician, he was
also a Canon of the Church of St. Justus in Avignon,
where he spent most of his life (Beck, The Cutting Edge
25). During the plague, Pope Clement VI gave sanctuary
to Jews living near Avignon when popular accusations
held that they had poisoned the wells (John 271).“

Chauliac, considered one of the most erudite
surgeons of his day, completed the Cyrurgia Magna in
1363. The treatise, based largely on the teachings of
the Salernitan School of Medicine founded in the eighth
century, advocated such practices as leaving
contaminated wounds open to clean air to prevent further
contamination, a practice considered ahead of its time
(McGrew 321). Chauliac’s formal descriptions of various
case histories in the treatise represent his attempt at
cataloging the major areas of contemporary medical and
surgical knowledge. The author describes the divisions
of his treatise in its preface:

The firste [chapter] schal be anothomye [anatomic],
be secound of apostomes [apostemes], be bridde of

 

“In addition, the Pope also engaged doctors to tend
those stricken with plague and built extensions to the
papal hospitals and almshouses to care for them. He also
built a cemetery and engaged grave diggers and carters

to carry away and bury the huge numbers of dead (John
271).

104

woundes, be fourbe of bocches [blotches, various

skin lesions]. be fifte of brekynges and bones out

of ioynte, be sixte of alle obere sekenessis be
whiche beb noght propurly apostomes nober bocches
ne passiouns of bones for be whiche recourse is
ihad to a cirurgien. be seuenbe schal be an

antitodarie. (14)

Chauliac further explains that each book in the
treatise is precisely organized according to two
doctrines, or "lores": universal and simple members, and
particular and compound members. The author promises to
consider the three principal divisions of therapeutics
in each book: a description of the disease and its
causes, signs or "tokens" useful in prognosis, and
treatment or "curynges" for specific diseases. Dividing
therapeutics into these categories has precedent in
ancient medical writing such as the Isagoge of
Johannitius.“

Each category forms a separate "book" within the
treatise, and each book further divides into chapters,
according to a classification scheme found in other
academic medical treatises. The author explains the
division of chapters in these terms:

To be esy fyndynge of be matires of be whiche it is

itreted in bis book, it is profitable to sette

tofore be rubriches of be tretys and chapitres of
all bis book bat by be rasynge of name of a lettre

be book be noght iseie to byleue dowme [i.e., are
not said to downplay experience], bat happely is

 

“For a description of the Isagoge and its principal
features, see Chapter Two (57-61).

105
noght nedefull in speculatyf science, as Aueroys,
be Sotil Doctoure, schewede.
(14)
Accordingly, Chauliac promises to temper the authority
or "lore" on which his treatise is based with his own
experience, which he finds compatible with the teachings
of Averroés, "the skillful doctor."

The description of plague and its treatment in the
Cyrurgie, appearing in the second book (On apostemes and
pustules), combines a description of the author’s
experience with a medical description of the causes and
treatment of plague. He mentions that he did not flee
like other physicians, but remained to treat those who
suffered. The treatise continues with advice on
preventing plague:

And displese it noght bat I schal tells it for be

mervayle berof and for to be ware berof if it

schulde come a3en.
(148)
Chauliac continues the account as though it were a
lament:

The fader visited nou3t be sone, ne be sone be

fader. Charite was dede, and hope was browen downe.

(148)
The inversion of repeated words in this passage, known
in rhetorical terms as antimetabole, stresses the
hopelessness Chauliac felt during this incurable

epidemic. The author recounts his experiences and some

of the popular misconceptions on the causes of plague

106

(e.g., wells poisoned by Jews).“ Then, Chauliac
proceeds with a more objective interpretation of plague
concerning universal and particular causes:

Neuerbelatter what so euere be peple saide, be

trube was bat be cause of bis pestilence was

twofolde: one bat was vnyuersal doynge, and anober

bat was particuler suffrynge.

(148)

Throughout his account, he makes an ethical appeal to
his readers, ostensibly surgeons, although the English
version of the treatise could be read by others not
formally trained in medicine as well as by surgeons.

The importance of Chauliac’s description of plague
lies in its mixture of narrative with a standard medical
description of the disease which employs divisio, the
division of therapeutics and preventives into
subcategories, a more formal structure. The transition
between Chauliac’s narrative and his more objective
description occurs in the passage above: "...be trube

was bat be cause of bis pestilence was two folde." This

said, the text turns to a more objective explanation of

 

“Of be cause Many men couteden of be cause of bis
grete pestilence. And in some parties bai troweden
bat be Iewes had venymed be world, and so pore men
slow3 hem in some places and girde of her hedes and
made hem to flee away, and berfore bai dowteden to
goo by be worlde. And fynally it come to so moche
bat the kepers ofte in citees and in townes helde
be folks, and bai lete no man entre but [f.47'“]
hym bat was wel knowen. And if bei fonde vppon eny
man powdres or oynementes, dredynge leste bei were
made for drinkes of infeccioun, bay made hem for to
swelowe bayme (154-58).

107
causes, which are explained in greater detail than in
other Englished plague treatises.“
The personal account of plague in this treatise
would have appealed to an audience of English readers

who would find that its personal style leads naturally

 

“Chauliac’s description of causes, reproduced here
at length, parallels closely the description of causes
in the longer Burgundy treatises:

The vnyuersal cause doynge was be disposicioun of a

manere of grete coniunccioun of bre planetes, of

Saturnus, of Iupiter and of Mars, be whiche

coniunccioun come in be 3ere of cure Lorde 1345, on

be 24 day of Marche, in be 19 degree of Aquarie.

The grete coniunccions forsobe bytokeneb

mervaylouse binges, strong binges and terrible and

chaungynge of kyngdomes, comynge of prophecies and
grete debes, and I haue aside in be litel book the
whiche I made of astrologies. And boo coniuncciouns
ben disposed after be kynde of be signes and of be
aspectes of ham in be whiche bai be made. It was no
wonder berfore bogh bat grete coniunccioun
bytokened a wonderful and ferful deth, for it was
nou3t onliche of be grete gut as it were of be
moste. And for it was in masculyne signe, it
dressed harme vppon mankynde. And for bat be signs
was fix, it bytokened long lastynge. It bygan
forsobe in be Este a litel after be coniunccioun,
and it lasted 3it vnto be fiftube 3ere in be West.

It impressed forsobe suche a schap in be ayere and

in ober elementes bat, ri3te as be adamaunde moueb

yren, so bat fourme or schappe mouede grete humours
and brente and venymouse, and it gadre hem togedre
wibinforth, and it made apostemes. Of be whiche
binges ber folowed contynuel feueres and spittynge
of glode in be bygynngynge while bat be fourme was
strong and it confounded kynde. And afterward when
kynde was lower, it was nou3t so mykel confounded,
and it keste out as it my3te to be vttre memlf.
48““]bres, and most at be arm holes and to be
schares. And it causeded bubones an ober effectes
of be ynner apostemes.

The particuler cause and suffrynge was be

disposicioun of be bodyes in euel humour and

feblenesse and opilacioun (i.stoppynge). And for
bat, be comune peple deyde, trauayllynge and euel-

lyuynge (154-58).

108
into a more formal explanation of causes. But English
readers would not necessarily be familiar with the
experiences Chauliac describes: "the [gate]kepers" of
cities who refused entrance to anyone but residents; the
popular belief that Jews had poisoned the wells, also
mentioned in Chauliac’s account, while current in
France, did not occur in England.

The section on plague in the Cyrurgie continues
with medicinal remedies and preventive measures (balls
of aloes, triacle, and the "bole armonyak." Bernard of
Gordon (ca. 1258-1318) had recommended these in his own
writing on pestilential disease some 25 years before
1348, and they were commonly recommended in other
plague writing.

The author then interrupts his explanation of
medical treatment with additional autobiographical
information:

And for to eschewe euel lose, I durste nou3t
goo forth. Wib contynue dredes I kepte me wib be
forsaide binges als mykel as I my3te.
Neuerbelatter toward be ends of be pestilence, I
renne into a contynue feuer wib an aposteme in be
schare, as it were sixe wokes. And I was in so
grete perile bat alle my felowes trowede bat I
schulde be ded. And I scapede by the comaundement
of God when be aposteme was matured and heled, as I
haue saide. (157)

Chauliac’s comments on the futility of treatment and on

the tragedy of this disease lend credibility to his

medical explanation of pestilence, particularly for lay

109
readers, by providing a narrative style not found
elsewhere in the Cyrurgie. However, Chauliac’s
combination of a personal account of plague with a
standard medical description is rare in other surgical
treatises, and even less common in medical treatises
which maintain a more rigid structure based on ancient
treatises like the Isagoge.“ Like Guy de Chauliac, the
English surgeon John Arderne (1307-92) also included
several personal references in his surgical treatise,
but none on plague. According to D’Arcy Power, Arderne
worked as a surgeon in France during the early
fourteenth century; he was not in orders (Chronologia
Medica 64).

The ability to combine personal views with a more
objective account, as Chauliac does, is especially
evident in Arderne’s portrait of the good surgeon in the
introduction to his treatise and in his own case
studies, where he explains both success and failure in

treating patients.“ Arderne’s treatise offers no advice

 

“Another Continental writer, Jeuan Gethin wrote a
plague treatise before the plague arrived in Lerida,
Spain, where he practiced medicine. He described his
fear of the disease in a personal prologue: "We see
death coming into our midst like black smoke, a plague
which cuts off the young, a rootless phantom which has
no mercy for fair countenance" (ca. 1348) qtd. in Marks
1).

“Among other things, Arderne states that the good
surgeon must be sober:

And aboue al bis it profiteth to hym that he be

founden euermore sobre; ffor dronkenne3 destroyeth

110
on plague, and though Arderne lived through major
outbreaks of the disease during the fourteenth century
as Chauliac had, he refers to plague only in the
preface:
I, John Arderne fro the first pestilence that was
in the 3ere of our lord 1349 duellid in Newerk in
Notyngham-shire vnto the 3ere of cure lord 1370,
and ther I helid many men of fistula in ano.
(Power, ed. 1)
He continues with an account of his first patient, "Sire

V

Adam Eueryngham,’ whom he cured of anal fistula.

In terms of the audience of both Arderne’s and Guy
de Chauliac’s surgical treatises, the large number of
surviving manuscripts of both attests to their
popularity, presumably not only because of the technical
information they contain, but also because they outline
and explain current surgical knowledge in English
translation. Robert S. Gottfried has suggested that
surgical texts were more direct and straightforward than
the more obscure theoretical treatises, "indeed,
generally explicable, the kind of text a mercer or
draper could appreciate and understand" (Doctora_and
Medicine 69).

Arderne’s scarce mention of plague may suggest that

it left less of an impression on him than it did on Guy

 

al vertu and bringith it to not, so seith a wise
man, "Ebrietas frangit quicquid sapiencia tangit,"
[which Arderne translates]: "Dronkenes breketh
what-so wisdom toucheth."

(Power, ed. 4)

111
de Chauliac, who served a pope committed to those
suffering from the disease in Avignon. Despite the
contemporaneity with which Arderne describes and
explains surgical techniques--anal fistula were a common
problem for soldiers-~like other English medical
writers, Arderne avoids contemporary references to

plague.

2. General Medical Treatises with Advice on Plague

The Liber de Diversis Medicinis, a fifteenth-
century leechbook in the Thornton Manuscript, is a
popular medical text with a discussion on "medcynes for
be pestilence" (Ogden ed., 51-54).““ The Thornton
manuscript itself contains romances, sermons, mystical
writings, and religious lyrics, besides the leechbook.““
In this case, a plague treatise is incorporated with
general medical advice and with other forms of
literature: didactic, religious, and literary pieces.
Advice on plague in the Liber de Diversis combines

academic advice on its causes and treatment with several

 

““MS. Lincoln Cathedral A.5.2, Margaret Ogden, ed.,
EETS, 03 no. 207. Quotations from the Liber de Diversis
Medicinis are from Ogden’s edition.

 

““For a more detailed description of the contents
of the Thornton MS., see The Thornton Roaancea, ed. J.
O. Halliwell, xxv-xxxvi.

112

remedies for pestilential diseases borrowed from
ancient herbals.

The manuscript, probably dating from the first part
of the fifteenth century (after 1422 and before 1454),
is, Margaret Ogden believes, "more like the product of a
gentleman amateur than of a cleric" (xvii). By the
fifteenth century, English translations of religious,
literary, and medical works achieved some degree of
popularity among English readers, as these survive in a
large number of manuscripts. This "gentleman amateur"
was also apparently literate in Latin. According to
Ogden, the translation of John of Burgundy’s shorter
treatise appearing in this medical manuscript is likely
Thornton’s own, as it does not appear to be an exact
transcription of one of the other English translations
of Burgundy’s plague treatise (Ogden xxiv). Rather, it
is a shorter version of the Burgundy treatise, and the
only section in the Liber de Diversis translated
directly from a Latin source, as far as the editor can
tell. The material on plague in this work "is an
abridged translation of the shorter version of the tract
on the pestilence attributed in several manuscripts to

John of Burgundy" (104), suggesting that Thornton sought

113
advice on plague from academic sources rather than from
popular leechbooks.““

The Liber de Diverala begins with advice on
diseases of the head, providing advice on other diseases
in a head-to-toe arrangement. Unlike Guy de Chauliac’s
Cyrurgie, the patchwork sources in this treatise
suggest that much of its advice derives from popular
medical lore, usually more loosely organized than formal
medical treatises. The entire work is not a direct
translation of any known medical text (Ogden xxiv). Most
plague treatises mention ancient medical authorities,
but the translated advice on plague in the Liber de
Diversis contains neither Latin tags nor mention of
authority:

Here bygynnes medcynes for be pestilence: Here

bygynnes medcynes for be pestilence noble & fyne &

are departede in foure chapiters. The firste
chapiter tells how a man sal kepe hym in tyme ber-
of. The secounde how bis sekenes commes. The thirde
what medcyne is a-gayne it. The ferthe how he sall

be kepid in it. (51)

Testimonials to ancient or contemporary authorities,
common in the Burgundy treatise and its descendants,
were deleted by Thornton, who may have intended this
work for his own use or for his family, and not for a

wider audience who would have wanted some assurance of

the text’s credibility.

 

““The chapter on plague occurs in f.300V-f.302' of
the manuscript (Ogden 51-53).

114

The first chapter on plague, like the first chapter
in the Burgundy treatise, provides instruction on diet
as a means of plague prevention. The second chapter
describes "how this sekenes comes & what is be cause of
it is." Here, Thornton’s translation also parallels
versions of the Burgundy treatise in describing both
universal and particular causes of plague and their
effects on the humoral system.

The third chapter also describes herbal concoctions
useful for reducing heat in the internal members: "Than
the hert schulde be comforthede be calde letuaryse to
temper be grete hetis berof" (53). The herbal
concoctions described in this chapter on plague, unlike
the longer Burgundy treatises, contain more native
English herbs, providing evidence that Thornton added
these plague remedies to his translation of the Burgundy
treatise:

ben is gude to hafe water stilled of thiese foure

herbis: betony, pympernole, tormentill and

scabyous, for thies are gud medcyns bothe in
sekenes and to kepe the ther-fra.
(53)
Chapter three concludes with advice on diet.

The fourth and final chapter, a listing of various
treatments for plague, appears short for a work which
is based largely on popular medical advice. Leechbooks

often included long lists of herbal remedies, perhaps

suggesting that "the actual fact of the plague may not

115
have yet infiltrated the folk medical literature of the
period" (Elaine Miller, "In Hoote Somere" xxxi).““

The section on plague in the Liber de Diveraia ends
with several recipes for plasters and drinks not found
in the Burgundy treatise. Then the author abruptly
shifts to a discussion of ”a gude oynement for kiles,
wondes, broken bones, bolnynges, and to felon & to
gowte" (54). Thornton has removed academic language in
his translation. The only Latin portion of the Liber de
Diversis appears in the chapter on plague:

...bat febles be body, et super omnia alia nocet

coitus & accelerat ad hunc morbum...& destruit

spiritus vitales, also vse little froyte or none.
(51)14
Here, Latin serves not as a testimony to learned
authority as it does in some vernacular treatises, but
as a means of avoiding sexual language. The author,

concerned with decorum, quotes directly from his Latin

 

““Miller explains further that "by the time the
fifteenth century arrived, the plague, too, had become
part of the common folk heritage, and thus, it [the
plague] could appear easily integrated in the
literature. In the earlier period, however, more
confusion on the suspected origins and treatments of the
plague abounded,and finding a specific treatment for it
in a common folk document is more difficult" (xxxii).

““Translation: "...that enfeebles the body, and
above all other things, coitus increases this
disease...and destroys the vital spirit; also eat
little fruit or [else] none."

116
source.““ Rather than serving as testimony to learned
authority or even as support for the English text,
Thornton uses Latin to protect his audience, likely the
rest of his family, from what he considers offensive,
or, at least, from material requiring discretion.
Thornton employs academic medical terms concerning

the causes of plague, but defines them ...and ilkane of
thies hase his place whare he may put owt his
superflueties and are called in phiseke emundatoria
eorum" (51). His explanation of the uses of phlebotomy
in treating plague (the third part of the translated
plague treatise) follows the Burgundy treatises. The
third chapter explains "helpe agayne bis seknes & with-
in what tyme helpe may be." "Helpe" includes advice on
blood letting in even more condensed form than the
description of phlebotomy in longer versions of
Burgundy’s plague treatise, suggesting that the author
or those using the treatise knew this technique already
and might have used this summary as a crib. Thornton
thus has cast an academic plague treatise into familiar

terms as part of a larger leechbook. But despite the

idiosyncratic nature of Thornton’s translation, the

 

““Thomas O. Cockayne follows the same course with
passages on sexual intercourse in his nineteenth-century
translation of Old English Leechdoa§i_Wortcunning, and
Starcraft of Early England.

117
advice on plague itself derives from traditional rather
than from contemporary sources.

3. "In Hoote Somere" (A Popular Fifteenth-Century
Treatise)

A rather complicated remedy for plague is described
in an anonymous popular medical treatise from the
fifteenth century, referred to by its editor, Elaine
Miller, and in the following discussion as "In Hoote
Somere." Miller compares this complicated remedy to
others in the treatise: "Although no complete
description of the symptoms is made, the extremely
elaborate cure suggests that the disease is a rather
serious one, and not merely one’s every day ’fester’ or

3"

'canker (xxix). Miller further believes that it must

be intended as a remedy for plague. Most of the other
recipes in this popular treatise call for common
ingredients like garden herbs, as the following remedy
for fester demonstrates:

ffor be brennynge fester.

Of honye and rye floure bake a kake,

As harde as men may it make.

Lay it on be holyd festred sore,

Whan it ys nessche [moist] lay anobere bore.

80 schalle it hele, bus doctours seyne,

Nothynge elles berto bu leyne.

(Miller 11.17-23)

But the probable remedy for plague in the treatise

under the category of "fester" or "canker," in a

118
chapter on "bolnyngs" [tumorous swellings], requires a
complex set of ingredients not found in common herb
gardens (MED. s.v., bolnyng; QED. s.v., bolning).
Several required ingredients are, in fact, nonce words,

as the editor’s transcription of this remedy for plague,

known as "Sank Dragons,‘ shows:

Doo wassche be canker sone anone,
And caste be pouder ber upon,
3it take alempatike [garlic], myrre, francensence,
masake [mace], Cole freyne [cold fragne, i.e.,
ash], cole coyne grece, orpement, Royle aromonyak,
And a grece bat ys callyd Aristologe [the herb
astrolochia], Rounde Luppines,
Venathans [unknown plant], tartaran of drye gallys
bat men callen Oke apples, synynilles [unknown
plant], and brenne alle with blak pepir.
And loke that bey be alle of con weighte in
balaunce. And whan it ys alle wele bronte, caste be
pouder beron. Also take an cranes heed and be feete
and bray hem in a mortar; and take talongh and
virgyne wax, and temper alle togeder. And bis salve
ys clepyd sank dragons.

(Miller 12.8-20)““

According to Miller, part of this recipe has an
analogue in a fourteenth-century Middle English medical
manuscript found in the National Library of Sweden

(117n5'.5-9).““ The analogous recipe for canker in the

 

““Miller notes that "Sank Dragons," is a variation
of sangdragon or sandragon, "dragon’s blood," also
mentioned in Lanfranc’s Cirgurie 35 (118n5', 20).
Bracketed notes in the quotation above are the editor’s.

““For to hole y“ cankyr gpod Medicine--
Take aporcion of bacwn lene
And brene it al i powder clene,
And do wasche y“ cankyr sone ano
And caste y“ powdyr yeri ano.
Take y“ fayrest of y“ qwete
And do it smal to gedyr bete,

119
Stockholm manuscript calls for more common ingredients
than the recipe in "In Hoote Somere," suggesting that
more exotic ones were added later. This highly complex
remedy, more complex than others in this popular medical
treatise, demonstrates the practice of recording
elaborate treatments for serious diseases like plague in

popular medical works.““

 

And menge it w“ mylk of woma mylde
y“ hat boryn aknawe chylde.
(Miller 117n5', 5-9)

““A further analogue to the use of impossibly
complex or exotic remedies for treatment of plague
occurs in a spurious medical work from the fifteenth
century entitled Contra pestem. The tract was written by
Johannes Mercurius of Corregio, a charlatan who had the
work printed sometime between 1493 and 1512 in Rome
(Epgitive Leaves 2-). The work combines popular remedies
with exotic ingredients, probably unknown to laymen even
though the author claims to have written the tract for
their benefit. The following recipe for a plague
preventive in Contra pestea exemplifies the content and
style of recipes in the rest of the tract:

Likewise, certain experiments should be carefully

noted: which I forsooth bring forward openly, in

this unusual proclamation of mine, for princes,
prelates, and rich men, and yet for citizens, at
the same time, and the common people: ya. that

whoever carries around in his mouth and sucks on a

green crystal Jasper, stained with certain bloody

or ruby drops: for him it will not be possible to
be corrupted and infected by any corruption, either
of water or air or by contagion from corpses and
men: nor by the bite of serpents and snakes.
(Epgitive Leaves 2 (May, 1935): 5)
The use of various precious stones as plague
preventives were not uncommon among wealthier people.
George Deaux notes that Pope Clement VI "wore a magical
emerald ring on his finger which when turned to the east
reduced the possibility of infection, and when turned to
the south nullified the effect of any poison that might
just possibly be present" (The Blapg DeapM 104).

120

4. The Liber Uricrisiarum (in Wellcome 225)

Pestilence is mentioned in several places in a
theoretical medical treatise appearing in Wellcome MS
225, the Liber Uricrisiarum, a translation of the Latin
treatise De Urinis written by Isaac Judaeus, a
physician practicing during the late ninth and early
tenth centuries.““ Uroscopy was of chief importance in
the diagnosis and prognosis of various diseases, and
usually reserved for graduate physicians.““ An English
translation of this treatise made uroscopy and other

theoretical matters more available for laymen.““ The

 

““Background information and citations from the
Liber Uricrisiarua are taken from Joanne Jasin’s
edition. Her introduction to the text is especially
useful.

““Since ancient times, uroscopy had been associated
with academic physicians, and, in fact, became an emblem
of the medical profession (Jasin 2-3). The physician
shown in the Ellesmere Manuscript holds a urine flask,
which, along with his fur hood, distinguishes him from
the other Canterbury pilgrims.

Uroscopy or "water casting" was an important tool
for determining the course of a disease. Joanne Jasin
describes the importance of uroscopy in medieval
medicine in the following passage from her edition of
the Middle English Liber Uricrisiarum in Wellcope MS
EEE: "Middle Eastern and Western civilizations made the
practice of uroscopy synonymous with and emblematic
of the medical profession. Numerous paintings, woodcuts,
and illuminated manuscripts depict the physician
standing by the patient, solemnly examining the urine in
the urinal while holding it up to the light" (2).

““The traditional subdivisions of the study of the
urine include the engendering of urine, its colors and
contents (Jasin 7 ff.).

121

treatise contains information on astrology, humoral
doctrine, circulation, anatomy, and human reproduction,
topics of more concern to medical theoreticians than
laymen. But the treatise contains more than medical
theory, including practical advice on fevers, digestion,
gynecology, and even a charm against bleeding (483).

Whether or not laymen actually practiced uroscopy
is questionable, but the style the translator has chosen
makes it possible for those not formally trained in
medicine to understand this complicated diagnostic
procedure.““ "The style of the treatise," Jasin remarks,
"is simple and straightforward, as befits a work whose
purpose is to communicate technical knowledge as clearly
as possible" (14). In a number of instances, the scribe
provides English translations of technical terms, often
preceded by "id est." He frequently provides native
English terms for the diseases and ailments or
anatomical features described in the text with cross
references. The opening of Book One demonstrates his
approach:

Uryn is als mykyll for to say in Ynglysch as on

(in) be reynys (reynes) is Frensch. Reynes Latyn,

lendys in Ynglysch; & it is said "on be reynes"

because bat it is kyndly & formly caused & gendyrd
in be reynes; & if you wyll wewt wyttyrly what are

 

““There were, for instance, as many as fifty
different colors of urine which could combine with many

variations. See illus. of uroscopic charts, Chapter One
(50).

122

be reynes, se in be 2[nd] buk, be 5[th] chapater of
whyt colour. (51.1-6)

The Latin tags in the Liber de Diversis Medicinis and in
other works mentioned earlier in this chapter euphemize
sexual terminology or, in some cases, add a mark of
authority to the text. The translator of the Dipap
Uricrisiarum, however, explains Latin terminology,
rather than using it as the mark of authority or for
obscuring topics he deems unfit for an audience of
English readers.

The Liber Uricrisiarum contains no specific
remedies for plague, but does mention pestilence in-a
section on planetary influences, explaining in general
terms that, when the planet Saturn is in Capricorn or
Aquarius, "he caues mykyll water & mony flodys, of whylk
comes derthes & hungyr and pestilence of folk & best"
(253.3068-70). In an explanation of "Inopos & Kyanos,"
two colors of urine, the first a reddish and the second
a darker red or purplish, the author mentions various
apostemes of the liver and kidneys, external or internal
swellings caused by a superfluity of humors frequently
associated with plague. Information like this could be
useful in understanding the causes of plague, but the

absence of plague remedies in this treatise indicates

123
that much of the treatise was taken from ancient
sources, which seldom mentioned plague specifically.““
Most of the information found in the Liber Uricrisiarum
was not often recorded in English before the fourteenth
century. The Leech Book of Bala (ed. Oswald Cockayne) is
an exception. This English Leechbook, written during the
ninth or tenth century, contains various remedies not
unlike those found in later vernacular works such as the

liber Uricrisiarup and "In Hoote Somere."

5. Conclusion: Plague Treatises and Their Readers

Especially in times of crisis, other people besides
university-trained physicians were called on to heal the
large number of sick. Lay practitioners included barber-

surgeons, who may or may not have been trained in the

 

““Part Nine of John Mirfield’s Breviarium
Bartholomei (ca. 1380) also contains information on the
pestilence, but the treatise cannot be described in
detail here as the English version of this work has yet
to be edited. According to Norman Moore, Mirfield
borrows his discussion of pestilence nearly word for
word from the writings of an earlier fourteenth-century
physician of some note, Bernard of Gordon (ca.
1258-1318), who wrote on pestilential diseases (a
Miatory of the Study of Medicine 38). Bernard died
before the outbreaks of plague in fourteenth-century
England, but his writing on pestilential fever became a
source of authority for some contemporary physicians,
according to Moore. Mirfield’s numerous remarks on
protection from plague "as well as the way in which he
leaves the reader to infer that treatment is of very
little use, points to actual experience 'tempore
pestilenciae’" (38).

124
universities; leeches, who practiced medicine with
practical training only; and clerics, parish priests and
others who may have practiced medicine partly on the
basis of reading medical works, but mostly through
apprenticeships.

Remedies, when mentioned in the treatises discussed
in this chapter, often called for common garden herbs.
These were useful for leeches who practiced medicine
without academic training, and traditionally, were less
concerned with theory than with practical doctoring.
Empirics applied remedies learned aurally, but later
these were recorded in leech books, often in verse.
These recipes usually prescribe herbal remedies in
addition to certain charms. Occasional references to
Hippocrates, Galen, and other ancient authorities
mentioned as a source for some recipes might suggest
that empirics were also familiar with some degree of
medical theory. But while many may have known the names
of the major theorists of antiquity and the early
Christian era, few knew the theories these men
endorsed.

Barber-surgeons, for instance, learned their trade
during an apprenticeship with a master-surgeon, a course
of study endorsed and later recorded in the charters of
the Guild of Barber Surgeons. As Lester King explains,

the empiric generally "expects that what has helped in

125
the past will help in the future. If he has good
training, his experience will probably make him a
reliable practitioner; poor training will make him
unreliable. But in either case he is contented with what
works and doesn’t worry about the theory" (191-2).““

The notebook of John Crophill, a fifteenth-century
empiric practicing in the English countryside, contains
information from academic sources, including
astrological prognostics, but, according to Ernest
William Talbert, "Although Crophill apparently knew that
astrology was the science which elucidated primary
causes, an analysis of his notebook shows that his
astrological knowledge was, at best,
superficial...Crophill’s cosmological system is a
medieval commonplace" ("The Notebook" 13). Like other

empirics, Crophill is more concerned with remedy than

 

““By the end of the fifteenth century, the barber-
surgeons had established a more "learned" tradition for
themselves through various acts of Parliament which
prohibited the practice of surgery to those without
training and endorsement by the Guild of Surgeons,
established earlier in the fifteenth century.

The sixteenth-century surgeon Thomas Vicary writes
in the "Epistle Dedicatorie" to the Anatomie of the
Bodie of Man (Eds. Frederick J. Furnivall and Percy
Furnivall):

And although we do lack the profound knowledge and

sugred eloquence of the Latin and Greeke tongues,

to decke and beautifie this vvorke, yet we hope the
studious Reader shal thereby reape singuler
commoditie and fruite, by reading this little
treatise of the Anatomie of mans body, the vvhich
is onely grounded vpon reason and experience, which
are two principal rootes of Phisicke and

Surgerie (7).

126
cause, and though his notebook contains no advice on
plague, expect for a recipe written in a sixteenth-
century hand (Talbert 7n7), its many recipes and summary
of prognostics suggest a strong concern with practical

rather than with theoretical advice.““

 

““According to Talbert, the manuscript containing
Crophill’s notebook includes two types of prognostics
and seventy cooking recipes, in addition to the
notebook. The notebook contains sections on evil days, a
brief discussion of bloodletting, leading to a
discussion of zodiac man, followed by an outline of the
cosmos, with information on the size of the earth and
the relation of earth to astral bodies and planets" (7-
8). In addition, the notebook discusses the four
complexions, the four elements, and uroscopy. While it
might, at first, seem that Crophill’s notebook includes
a fair amount of theoretical advice (on astrology or
uroscopy, for instance), this advice is actually
summarized or even distorted. Talbert explains that

Nowhere in his discussion of cosmology does

Crophill show that he was acquainted with texts

which represented the contemporary opinion of the

learned. There is, for example, no mention in

Crophill’s work of the doctrine that the four

elements are not found in a pure state in any

bodies perceptible to the senses. Nor does Crophill
show any knowledge of the aRistotelian doctrine of
the fifth essence [Quint Essence], even though that
doctrine is clearly enunciated in , for example,
the Introductoriap in Astronomiam by Albumasar--one
of the standard textbooks, written by the
astrologer most frequently cited in Western Europe
during the Middle Ages and early Renaissance.
("The Notebook" 16)
Further, the notebook demonstrates a superficial
knowledge of astrological calculations (Talbert 16). In
sum, rather than follow the advice of standard
theoretical authorities, Crophill prefers the authority
of standard, gnomic advice, especially regarding
practical measures such as diet. He mentions the "wise
physicians Hippocrates, Galen, Socrates, Isaac,
Herodicos, Theophilus, Gilbert and Constantine,’ calling
them "outstanding physicians and astronomers," but,
according to Talbert, "wisely refrains from attributing
to them any specific portions of the notebook" (21n46).

127

Despite different emphases, popular and academic
medicine traditionally relied on the authority of
ancient practitioners, although often in condensed form;
physicians relied on written sources for the theory of
disease and empirics on traditional pharmaceutical
advice for remedies. Many remedies described in
leechbooks were the same as those found in the works of
Galen and Hippocrates. Physicians were familiar with
remedies for plague, but would have likely depended on
apothecaries for compounding and administering them to
patients.““ While the authority of ancient
practitioners was important in both academic and
practical medicine, academic medicine held to the
authority recorded in medical documents, and empirics
traditionally referred to the authority of the spoken
word.

In England, the universities regulated the practice
of physicians through a course of medical instruction.
The number of academic physicians seems small, however,
when compared to the numbers of other practitioners.

Rossell Hope Robbins estimates the number of physicians

 

““Chaucer’s narrator describes the collusion
between his Physician and the apothecaries in this
passage in the General Prologpa:

Ful redy hadde he his apothecaries

To sende hym drogges and his letuaries,

For ech of hem made oother for to wynne--

Hir frendshipe nas nat newe to bigynne.
(425-28)

128

practicing in England in the fifteenth century to be
about 60 ("Medical Manuscripts" 408). Elaine Miller
observes that this number is "hardly enough to service
the entire island," adding that since many doctors of
physio had died in plague times, and since their
educational term was so long (in some cases up to
eighteen years), "there was definitely a shortage [of
academic physicians] which was not quickly replenished
in the fifteenth century" ("In Hoote Somere" xxxiv).

Physicians were available in the smaller towns of
Oxford and Cambridge, but Linda Voigts and Michael
McVaugh explain that "an English faculty of medicine was
not in a position to regulate and license the medical
practice of a large metropolitan area as were the
faculties of Continental cities" (13). Voigts and
McVaugh describe the situation in London: a population
of nearly 30,000 could not be treated by university
graduates, nor could its practitioners be controlled by
the medical faculties in rural university towns like
Cambridge and Oxford (13).““

Academic medical texts, which borrowed from older
treatises like the Isa o e, served as sources for

contemporary treatises like the Liber de Diversis

 

““A useful overview of academic medicine may be
found in Vern L. Bullough’s "Population and the Study of
Medieval Medicine," "Medical Study at Mediaeval Oxford,"
and "The Mediaeval Medical School at Cambridge."

129
Medicinia, often with few changes for accommodating the
ancient counsel of "wise physicians" to contemporary
outbreaks of plague. John Thornton, unable to find
satisfactory advice on the treatment of plague in remedy
books, turned to an academic medical treatise for
guidance, and for advice on plague specifically, to the
Latin version of John of Burgundy’s treatise.

English vernacular medical works therefore remained
largely derivative, even through the sixteenth century,
as Paul Slack argues ("Mirrors of Health and Treasures
of Poor Men" 237-73). Through English translations,_the
learned tradition was no longer reserved for those who-
read Latin. Those who read vernacular languages were now
able to learn this advice, though, as examples in this
chapter have shown, they would have to know something of
academic medicine in order to use the procedures
outlined in the treatises. Robert S. Gottfried believes
that English medical works might therefore have helped
to "'demystify’ physicians’ texts for an audience of lay
readers" (Doctors and Medicine 69).

In the fifteenth century, popular remedies for
plague were recorded along with academic medical advice,
as the examples in the previous chapters have shown. But
academic medical writing was often greatly simplified
or condensed, and translated into the vernacular for an

audience of English barbers and leeches, and, by the

130
end of the fifteenth century, for "a reading public that
consisted to a large degree of practical, hard-headed
merchants" (Robert S. Gottfried, Doctora_and Medicine
69). Advice became more popular in the fifteenth century
when dietaries and regimens of health were written for
the nobility and incorporated with other practical
advice in didactic works such as Thei§ecreea of the

Philosoffres, considered in Chapter Six.

 

Fifteenth-century vernacular medical writing was
often a collection of remedies, catalogued for
convenient use, but without the careful organization of
academic treatises. Despite a common source in the
Burgundy plague treatise, later treatises often
emphasized different means for making sense of plague.
Some recorded fairly detailed descriptions of
phlebotomy; others gave extensive lists of remedies with
complex ingredients. Plague references in academic
medical works like Guy de Chauliac’s Cyrurgie and the
Liber Uricrigiarua are found in longer treatises, more
formal and based more exclusively on the teachings of
ancient physicians. Texts by Continental physicians like
Guy de Chauliac, however, contain more autobiographical
and contemporary references than plague treatises
written by Englishmen.

Some of the information from English plague

treatises undoubtedly found its way into the homes of

131
English readers, and it is not surprising that literary
writers like Lydgate, Chaucer, and Langland employed
some of this advice in their own writings, but in
support of a moral rather than medical interpretation of
plague.

Academic treatises on plague, the basis of most
vernacular plague writing, have served as useful
evidence for scholars in explaining the rise of
professionalism and other developments, including "the
rise of surgery, new public health and sanitation, and
the development of hospitals designed not just to
isolate society’s sick but to try to cure them"
(Gottfried, The Black DaapM_110). As the opening to one
version of the Burgundy treatise states:

I, John of Burgoyn or John with the berd, burges of

Ledye and master of medecyns in this skrow with

Godd is helpe the preservyng and cure of pestilens

evelis pleynly y purpose to chewe that onnes eny

man schal a physion but eny man may be a phisician

a preserver a governer and a curater of hymself.

(qtd. in Singer and Anderson, no. 19.45)
As the examples in this chapter have shown, plague
treatises came increasingly to stress prevention, while
laymen themselves preferred remedies and recorded them
in leechbooks and other popular medical guides even
through the nineteenth century. Like plague remedies in
Middle English texts, those in later sources are often

long and complex, more than recipes for other diseases

appearing with them in leechbooks.

132

Plague remedies find their way into a variety of
later texts, including this recipe from a fifteenth-
century gynecological treatise:

Fro the pestilence: Take 12 drachms each of myrrh,

pimpernel, and fumitory, 6 drachms of Armenian

bole, 15 drachms of re, 6 drachms each of dittany,

and tourmaline, 10 drachms each of wood aloes,

sandalwood, madder, fleawort, origanum, round

birthwort, and laurel berries, and 6 drachms of

gentian, and let them be made into a powder.

(Trans. Rowland, Medieval Woman;a Guide 163)

Warren R. Dawson finds analogues in ancient sources

for medicinal recipes in his edition of a mid-fifteenth

century leechbook with analogous recipes appearing in

the Cairo Coptic Medical Papyrus and in the works of the

 

tenth century Jewish physician, Shabbethai Donnolo, who,
according to Dawson, "settled in Italy and wrote a

pharmaceutical work" (6).““

 

““Though related to Anglo-Saxon medical
manuscripts, this leechbook and surviving Anglo-Saxon
leechbooks (Ed. Cockayne) "had to a large extent a
common origin, but they developed along different
lines" (8). Warren R. Dawson lists the following sources
for specific remedies given in the leechbook: Anselm,
Galen, Bernard of Gordon, Henri de Mandeville,
Hippocrates, Peter Bonant [unidentified by Dawson], and
Peter of Spain. While these are the only authors noted
specifically in the text, Dawson has found elements of
the leechbook in the writings of Dioscorides, Pliny the
Elder, Cassius felix, Galen, Oribasius, Alexander
Trallianus, Pseudo-apuleius, or Apuleius Barbarus,
Sextus Placitus, Paulus aegineta, and Marcellus
Empiricus, a fifth-century empiric, whom the compiler of
the leechbook drew upon to a greater extent than to any
of the others above (A Leechbook 10-11).

The following remedy for pestilence appears in Dawson’s
leechbook:

A medicine for the pestilence. Take dittany,

philipendula (dropwort) and tormentil, of each

133
Concerning lay people’s use of theoretical medicine
in the later Middle Ages, John M. Riddle concludes, "As
seen in a practical medical guide, the lapidary I
literature, and the Pestachriften, the general
practitioner of the later Middle Ages reacted to the new

learned infatuation with theoretical medicine by largely

 

equally much, and bray them together, and temper
them with ale or with wine, and drink them.
(319).

Plague preservatives were endorsed by the King’s
Privy Council in a London newspaper on July 6, 1665: "To
the end therefore it may be publickly known, where the
said Remedies and Medicaments, with directions for the
use of them may be had, all persons desiring the same,
may hereby take notice, that he places appointed for the
sale thereof, are, At Mr. Drinkwaters an Apothecary at
the Fountain in Fleet Street..." (H. R. Plomer,
"Preservatives from the Plague" 493).

The following plague preventive and remedy
appearing in John Wesley’s Primitive Physickl or An
Early and Natural Method of Curing Most Diseaaaa,
provides a final example of the influence and
consistency of plague remedies long after the Middle
Ages:

The Plague (to prevent): Eat marigold flowers,

daily, as a salad, with oil and vinegar. Or, infuse

rue, sage, mint, rosemary, wormwood, of each a

handful, into two quarts of the sharpest vinegar,

over warm embers for eight days: then strain it
through a funnel, and add half an ounce of camphire
dissolved in three ounces of rectified spirits of
wine. With this wash the lins [scil. lips], face,
and mouth, and snuff a little up the nose when you
go abroad. Smell to a sponge dipped therein when

you approach infected persons or places (96).

The Plague (to cure): Cold water alone, drank
largely, has cured it. Or, an ounce or two of the
juice of marigolds. Or, after bleeding fifteen or
sixteen ounces, drink very largely of water
sharpened with spirit of vitriol.--Dr. Dover. Or, a
draught of brine as soon as seized: sweat in bed;
take no other drink for some hours. Or, use lemon
juice largely in every thing (96-97).

134
ignoring it" ("Theory and Practice" 159). Yet both
"general practitioners" and academic physicians turned
to earlier sources as a way of incorporating an

unfamiliar disease into familiar boundaries.

Part II: The Moral Interpretation of Plague

Chapter 5: The Church’s Interpretation of Disease

An emphasis on the moral implications of plague
rarely appears in English medical works, although some
imply that a connection between plague and sin exists.
Lechery, for instance, was explained as both a deadly
sin and a physical means by which plague miasmas could
enter the body, as sexual activity was thought to open
the pores, allowing plague vapors to enter. Several
English versions of John of Burgundy’s treatise,
discussed in Chapter Three of this study, warn that
lechery might weaken "kinde," thereby causing pestilence
(Murray, ed. 30). The section on plague in the Liber de
Diversis Medicinis, discussed in Chapter Four (111-17),
also warned that lechery and gluttony endanger body and

soul.“

 

“John of Burgundy’s explains that sexual causes
plague because coitus opened the pores, allowing the
plague miasmas to enter the body, in turn disrupting
humoral balance.

Parallel passages from the Liber:ge Diveraia_and the

135

136

Continental plague treatises more frequently
mention moral causes of plague than English versions,
perhaps because more Continental writers of plague
treatises served the dual roles of physician and
clergyman, as is the case with Bishop Knutsson. Even
before plague arrived on the Continent, the French
physician Jacme d’Agramont questioned its coming, which
he learned about from other writers, in religious and
medical terms:

If air is pestilential because of putrefaction and

corruption of its substance, one must consider

whether its corruption or putrefaction was sent for

our good, or for our sins, or whether it came from

the infection of the earth, or of the water, or of

allied things, or whether it came from higher or

superior causes such as by the influence of

conjunctions or opposition of planets.

(qtd. in Winslow 111)

Jacme furnished remedies appropriate for each cause of
plague, but warned that if plague had come from God’s

anger, there could be no physical remedy:

The pestilence of the air which involves contra-
natural change, or putrefaction in its substance,

 

Burgundy plague tract (English prose version) are shown
below:
Liber de Diverala: ...et super omnia alia nocet
coitus & accelerat ad hunc morbum quod maxime
aperit poros & destruit spiritus vitales..."
(Ogden ed., 51).
Trans.: Above all other things, coitus harms and
greatly accelerates this disease which enters the
pores and destroys the vital spirit.
Burgundy Treatise: ...quia tanc operti sunt pori
corporos, per quor aer intrat venenosus, qui
debilitat et destruit vitales spiritus corporales.
(Murray ed., 26.22-24).

137

can also come from various causes. Sometimes it is
sent by God because of sins. Thus it is said in the
Holy Scripture in the old testament, Deuteronomy,
Chap. 28 that God omnipotent promised to his people
very great and very marvelous benedictions if they
observed and kept his commandments. And likewise He
threatened and menaced them with powerful
maledictions in case they did not observe His
ceremonies and commandments, ubi sic dicitur.
(Duran-Reynals and Winslow 64-65)

Remedies in fourteenth-century Continental medical
works often combined physical remedies with a coda
explaining the need for spiritual healing.“ Klebs and
Droz, editors of a number of French plague treatises,
explain that a religious interpretation of plague was
often included with a medical one in French plague
treatises. According to the advice in many Continental
treatises, care of the body should be combined with care
of the soul, as the following excerpt from a French
treatise demonstrates:

Following are some preventive measures:

The sick will accomplish their religious duties,for

during times of pestilence, confession and penance

are to be preferred above all medicine; they will
follow a diet carefully, avoiding all emotion and

excitement, and they will look after their hygiene
and the conditions of their homes.“

 

“For examples of plague remedies in France
particularly, see A. C. Klebs and E. Droz, Remedes
Contre la Peste.

“Suivent quelques conseils preventifs: les malades
accompliront leurs devoirs religieux, ‘car en temps
pestilencieux, confession et penitence sont a estre
preferees davant toute medecine,’ ils suivront un
regime, évitant soigneusement toute émotion et toute
excitation et veilleront a leur hygiene et aux
conditions de leur habitation (Klebs and Droz 52).

138

Pestilential diseases were among those illnesses
thought to be caused by sin, and their remedy depended
on the restoration of spiritual wholeness. A moral
interpretation of pestilence encouraged those threatened
with plague to look beyond the physical world for the
causes of this scourge. Doing so also led them to look
beyond the physical world for remedies. Physicians
described physical remedies for plague in treatises, but
presumably, devout believers would assume that since God
controlled all things, His wrath over human sin was
responsible for a scourge of this magnitude, and when
disease was caused by sin, it was best to seek help from
spiritual rather than physical healers. The connection
between sin and disease was explicitly mentioned in
English didactic works in the fifteenth century as part
of general advice on plague. References to plague in
didactic works were therefore seen as warnings of the
dangers of sin, along with other troubles of fallen
mankind.

The belief that pestilence was sent by God to
punish a fallen mankind appears commonly in medieval
religious works, and is, ultimately, derived from the

Old Testament.“ When the Children of Israel committed

 

“See Philip Ziegler, The Blackaeath, 35-39, where
the author discusses Old Testament connections of sin
and pestilential diseases like plague.

The Augustinian explanation of the secret
punishment of evil provide an important background for

139

harlotry with the daughters of Moab (Numbers 25), they
were stricken with plague (Hebrew magefah), probably a
sexually transmitted disease (Rosner 30). Plague, in the
sense of "blow" or divine scourge, is a common term for
epidemic diseases described in the Old Testament.“
Widespread afflictions were thought to have come from
God as punishment, usually for idolatry or unbelief.

According to Fred Rosner, it is not possible to
establish with certainty whether or not the biblical and
talmudical diseases referred to [in Hebrew] as magefa,
aapar, paga, pagag represent particular diseases,
including plague (30). Since biblical times, a "rat-
fall," the sudden appearance of dead or dying rats, has
been associated with the presence of human epidemics
(McGrew 37), leading Rosner to the conclusion that an
account of plague mentioned in I Kings must have been
bubonic plague and that the term emerods probably refers
to buboes (6).

Medieval English religious writers drew parallels

between biblical plagues, and particularly the plague of

 

Chaucer and Langland’s moralistic interpretations of the
plague and other diseases brought on by sin. For a
fuller discussion of Augustine’s description of the
secret punishment of evil in the Pardoner’s Prologue and
Tale, see Alfred L. Kellogg, "An Augustinian
Interpretation of Chaucer’s Pardoner."

“In the New Testament, the word mastix (literally,
a lash), is a term used to denote various epidemics (cf.
Mark 3.10, 5.29, 34).

140
the Philistines, and the fourteenth-century plague,
ancient plagues serving as precedents for contemporary
events. The Philistines, who took the Ark of the Lord
and placed it in the temple of Dagon, were smitten with
"emerods" or buboes. In order to be healed, they had to
offer a sacrifice of five golden emerods, and five
golden mice, according to the number of the lords of the
Philistines. These golden replicas of plague swellings
and mice were placed in the ark, which was then returned
to the Israelites. The plague of the Philistines serves
as a warning for those who would violate the Ark 9f the
Covenant: The men of Ashdod associated the ark with this
plague of mysterious swellings and shipped it off to
Gath, another Philistine city; but there too, God smote

them (Deaux, The Black Death 11).“

 

“The story of the plague of the Philistines appears
in I Kings 5.6-9:
And the men of Azotus seeing this kind of plague,
said: The ark of the God of Israel shall not stay
with us: for his hand is heavy upon us, and upon
Dagon our god. And sending, they gathered together
all the lords of the Philistines to them, and said:
What shall we do with the ark of the God of Israel?
And the Gethrites answered: Let the ark of the God
is Israel be carried about. And they carried the
ark of the God of Israel about. And while they were
carrying it about, the hand of the Lord came upon
every city with an exceeding great slaughter: and
he smote the men of every city, both small and
great, and they had emerods in their secret parts.
And the Gethrites consulted together, and made
themselves seats of skins.
(1 Kings 5:6-9, Douay-Rheims)
George Deaux further explains some of the parallels
between the plague of the Philistines and the Black
Death:

141

Concerning the causes of illnesses, the Church
taught that the physical risks from sin were serious,
but that spiritual consequences from sin were even more
serious. Failure to repent would lead to eternal
damnation. Humans were punished for their disobedience
through Nature, who at God’s bidding, sent the plague to
chastise and force repentance. In the Etymologiea,
Isidore of Seville had explained that even though
epidemic disease "often springs up from air-borne
potencies [per aérias potestates], nevertheless it can
never come about without the will of God" (Sharpe trans.

57.17).“

 

The method of transporting the ark [containing
"images of your emerods and images of your mice
that mar the land"] is of some interest. It was to
be sent in a cart drawn by two cows. If the cows
chose to take the coast road to Beth-shemesh, it
would be understood that the pestilence had come
from God, but "if not, then we shall know that it
- is not his hand that smote us: but was a chance
thing that happened to us." The cows chose the
coast road and the arrival of the ark in Beth-
shemesh was the occasion for great rejoicing" (1M2
Black Death 11).
In this account, we may see that, according to biblical
precedent, plagues could take two forms as either
naturally occurring or divinely sent, a dichotomy also
observed by medieval writers like Bishop Knutsson (see
Chapter Four (88-94)) and in the B095 of Qpante Essence.

“Isidore interpreted plague in etymological terms:
It is termed "pestilence" as though a "little
pasture," pastulentia, or because it feeds like a
fire, as Vergil [Aeneid 5.638]: Toto descendit
corpora pestis, "The plague fell upon the whole
body." Likewise, it is called "contagion,"
contagium, from "touch," contingere, for whomsoever
it touches, it infects. It is also called inguina
because it attacks the grains, inguen.

142

A reciprocal relationship was assumed to exist
between man’s spiritual and physical nature. Sin
weakened the spirit, which, in turn, weakened the body.
As John A. Alford explains, "If all order is primarily a
participation in divine justice, then physiological
order is simply the working out of justice through the
medium of the body" ("Medicine in the Middle Ages" 386).
In literature, the metaphor of plague represented
disorder in a world filled with the disease of sin, just
as in medical writing, it represented humoral imbalance
in the world of the body. In religious terms, disease
could be interpreted in several ways. Penelope B. R.
Doob distinguishes among three kinds: the first as a
punishment for sin and a reminder of damnation awaiting
the unfaithful; the second, "monitory and purgative, at
once a visible token of sin, a punishment for sin, and a
means of expiation;" the third, "a test to prove the
elect and increase their merit" (6).

The tradition of separating bodily from spiritual

health was related to the tradition of separating

 

The same disease is also called lues, from
"destruction" and "grief," luctus, since its course
is so acute and rapid that one does not have enough
time in which even to hope for life or for death,
but a feeling of faintness comes on suddenly,
bringing death at the same time" (Sharpe trans.
57.18-19).

Ida B. Jones provides additional examples of the
Church’s interpretation of disease in "Popular Medical
Knowledge."

143

physical from spiritual healers. Cicero had
distinguished between aorbus corporia and morbus animi.
According to him, "the illnesses of the body...are the
domain of medicine, while diseases of the mind can only
be cured by philosophy" (qtd. in Ell, "Concepts of
Disease" 154). According to the Church Fathers, the
concern of medicine was the health of the body, and the
concern of the Church, the health of the soul. The
commentaries of the Church Fathers often pointed out
this connection based on the example of Christ, who was
"The Great Physician" of body and soul.“ Peter B.
Paisley explains that the Church Fathers interpreted
literally Christ’s healing mission, believing that
Christ’s mission included the healing of body as well as
soul: "Visiting and caring for the sick was one of the
central activities of the Christian life from the start;
we tend nowadays to think of the physician metaphors of
the New Testament as being just that--metaphors--but it
is clear that the Church Fathers interpreted them a
great deal more literally than this" ("The Idea of
Plague" 208).

Gregory I, commenting on the relationship of
physical and spiritual health, warned that illness
(aegritudo) was castigation of God (qtd. in Ell,

"Concepts of Disease" 157). When one became ill, one

 

“Cf. Mark 2.17, Luke 4.23; 5.31.

144
needed to consider whether or not the disease had been
caused by sin. St. Bede, who survived contemporary
epidemics himself (Blair, The World of Bede 178, 237),
described one "whole season of summer overturned in
violent winds and wintry storms" which resulted in an
outbreak of pestilence.“ Such excesses of nature, Bede
believed, were the breeding ground for pestilential

diseases (pestilentia or cwealm), but were ultimately

 

brought on through the wrath of God.

The idea that God chastised mankind with disease
sometimes was taken to extremes, especially in the
eremitical life. Sickness was even considered
desirable, in some cases, as a means for spiritual
growth. The author of the Ancren Riwle distinguishes
between two kinds of disease: first were those that man
brings on himself through foolishness, and second, those
sent by God, not as punishment, but as a means of
strengthening faith. The latter kind was to be seen as
a blessing, since it gave man an opportunity to
reestablish spiritual health before death so that
damnation, the ultimate castigation of God, would not
occur:

Secnesse is bi goldsmib be ibe blisse of heouene

ouerguldeb bi crune...be mei benne edstearten

[escape] bat ilke grisliche [dreadful] we. be
eateliche [deadly] binen bruh secnesse bat agead

 

“De natura rerum, ED 90, cols. 187-278. Trans. is
Blair’s (The World of Bede) 117.

145
[passes away] burh ei euel bat her is seliliche
[blessed] mei ha seggen [call herself].
(Tolkien, ed., 95.14-28)
In the eremitical life, the absence of illness could
warn of God’s displeasure:
3et he wepeb to me wiuene sarest, ond seib godd

for3et him for bi bat he ne sent him na muchel
secnesse.

(Tolkien, ed., 195.15-16)

Sickness could also serve as a reminder of the
agonies of the Passion. Christ had suffered physically
for the sins of mankind. So one who was sincerely
dedicated to knowing the ways of God would also
willingly accept the burden of physical illness as a
reminder of Christ’s blessed mission on earth.
Therefore, when sickness came, it was not always
desirable to lessen physical discomfort and illness with
medicines; rather it was best to seek divine
intervention. Since there were two kinds of disease, one
originating from natural sources and the other from
God’s chastising hand, it was natural to think that
there must also be two kinds of healers. As the author
of the Ancren Riwle explained:

Godd ond his desciples speken of sawle lechecreft.

Ypocras ond Galien of licomes heale...be wes best
ilearet of iesu cristes lechecreft seib flesches

wisdom is deab to be sawle.
(Tolkien, ed., 189.29-32)

146

Some of the penances prescribed for the religious
life encouraged illness and may have even directly
caused it. Fasting, dietary restriction, and deliberate
exposure to extremes of weather are examples. But such
extreme measures were seldom part of most Christians’
lives. When sickness came, however, one must recognize
that God had a hand in that illness as a warning of some
imminent danger to the soul, or as means for spiritual
growth. Individual cases of sickness sometimes came as a
warning or punishment for individual sins, but
widespread diseases like plague were thought to occur as
the result of collective sins, and thus often drew a
collective response from the Church and public
officials. The fourteenth-century Church, faced with
many deaths caused by plague, like medical writers,
turned naturally to the earlier teachings of the Church
and its Fathers and concluded that plague was a
spiritual problem and to be solved by spiritual means,
namely through contrition, repentance, penance, and
prayer.

Fourteenth-century Church records during plague
outbreaks stated explicitly that plague had come from
God through Nature. As the Bishop of Winchester reminded
the clergy in his diocese during the first outbreak of
plague in 1349-50, the healing of souls needed to come

before bodily health could be restored. His

147
interpretation of plague, based on the teachings of the
Church Fathers concerning epidemic diseases, emphasized
spiritual health over the health of the body.

The bishop explained the presence of plague in
moral terms: "Man’s sensuality which, propagated by the
tendency of the old sin of Adam, from youth inclines to
all evil, has now fallen into deeper malice and justly
provoked the divine wrath by a multitude of sins to this
chastisement." It was only through the "healing of
souls," the bishop explained a few weeks later, that
"this kind of sickness [which comes from sin] is known
to cease."““ When the disease continued to rage in
successive outbreaks after 1349, some thought that those
suffering from this illness had not been sincerely
contrite during earlier outbreaks. The Hereford Register
gives other examples of the Church’s response to this
collective disease. The parishes of Great and Little
Collington were combined by the Bishop of Hereford after
a severe outbreak of plague because, the register
explains, the disease had so greatly reduced the number

of parishioners. The register further explained that

 

““Victoria:Coanty History of Hampshire 2:32-33;
see also D. Knowles and R. N. Haddock, Medieval

Religioaa Houses in England and Wales.

 

148
plague had impoverished the land, creating "terrarum
sterilitas."““

The warning expressed in Trillek’s message and by
other representatives of the Church was that plague had
come as God’s scourge sent to force repentance and that
forgiveness had to be sought before the corporate body
could be whole again.““ Saints, especially Roch and
Sebastian, were invoked during plague times, and various
prayers to the Virgin such as the "De Sancta Maria
contra pestilenciam" were considered by some as more
powerful remedies for plague than any physical

measures.“3

 

““The Regaater of John de Trillek. Biahop of
Hereford (A.D. 1344-1361), Ed. F. C. Hingeston-Rondolph:
...pestilencie hominum jam transacte tempestas

gravis que universum orbem terrarum undique
invadebat adeo ecclesiarum predictarum populum
reddibit diminutum...terrarum sterilitas, et
paupertas notoria contigit et persistit.

The bishop himself died from plague in 1361.

““Such was the familiar message of Christ to those
whom he healed of bodily ailments. Healing of the soul
must occur before physical health could be restored.
Before Christ healed the body, he called on the sinner
to repent, as He did in the case of the man crippled
with palsy:

And when Jesus had seen their faith, he saith to

the sick of the palsy: Son, thy sins are forgiven

thee.
(Mark 2.5)

““apalecta hymnica 31:207. See R. Woolf, English
Eeligious Lyric, 282-83.

A later version of the poem is Robert Henryson’s
"Ane Prayer for the Pest," in Denton Fox, ed., The Poems
of Robert Henryagp, 167-69. Rosemary Woolf, Religious
Lyrics of the Fourteenth Centur , 206-08. Carleton
Brown (A Regaster) describes the refrain in one prayer:

149

The connection between sin and plague, emphasized
by the Church, was also found in contemporary writers
like John of Rupesicca, author of the Liber secretorum
eventuum, which gained wide popularity in England in the
later Middle Ages. John narrowly survived the Black
Death himself in 1349. Robert E. Lerner comments on
references to plague in the Liber secretoram eventuup:

[John] built the plague into his understanding

of present and future between 1348 and 1349. God

was punishing humanity in numerous ways that would

culminate in Antichrist’s triumph, but proper

understanding of the future offered a beacon of

hope and a guide for enduring through
tribulation.““

 

"A peste succure nobis" (Sloane 1584, f.14b). And see
also Robert Henryson’s "Prayer for the Pestilence).
According to Singer and Anderson: "Many prayers against
the pestilence addressed to Saint Sebastian and other
saints connected especially with this scourge are found
on odd pages of manuscript volumes containing secular
works as well as in books of Hours and other Prayer
Books. An extensive search would doubtless reveal many
[more] examples..." (158).

Among the examples reported by Singer and Anderson
are the "Collect, Secret and Post-Communion for the Mass
of St. Sebastian in the Time of Pestilence," the prayer
or hymn "Stella Celi," and a "Vision" by Edmund
Leversedge in the fifteenth century (18).

Sources above from Singer and Anderson, Appendix D,
in seriatim order: London, British Museum Additional
40,146; f. 82; Oratio contra pestem, printed Clemens
Blume and Guido M. Dreves, Analecta Hypnica:Medii Aevi
31:201; translated by John Lydgate as "Thu hevenly
queen, of grace our loodsterre [EETS, e.s., no. 107, H.
N. MacCracken, ed., Lydgate’s Minor Poems, 1:294-295];
printed E. M. Thompson in Somerset and Doraet Notes and

Queries 9.

““"Western European Eschatological Mentalities," in
Daniel Williman, ed., The Black Death 86.

150
Nature was the direct intermediary between God’s divine
plan and the working out of that plan in the sphere of
human life.

As Chaucer explained in The Parliament of Fowls,
Nature worked through the elements in carrying out God’s
intentions on earth:

Nature, the vicaire of the almyghty Lord,

That hot, cold, hevy, lyght, moyst, and dreye

Hath knyt by evene noumbres of acord...

(379-381)"

Religious poetry also mentions plague as one of the
three signs of God’s judgment which occurred during the
fourteenth century: the Peasants’ Revolt, the Black.
Death, and earthquakes. The poem "A Warning to Beware"
describes these signs in the context of a sinful world:

Thy Rysing of the comuynes in londe

The pestilens, and the eorthe-quake,

Theose threo thinges, I understande,

Beo-tokens the grete vengaunce & wrake

That schulde falle for synnes sake.
(57-61)

 

““Charles Muscatine discusses Chaucer’s sources for
this passage:

The personification of Nature was commonplace in

the Middle Ages. In his conception of Nature,

Chaucer was particularly indebted to Alanus de

Insulis and to Jean de Meun. Nature is

characterized as a queen and goddess, vicar of God

(DE 379), representing the forces of both

generation and order in the universe.

(Muscatine 999n303)

Nature is called the vicaire of God in Alanus, Da
planctu 13.224, 16.187, 18.44, and in The Romanga of the
Rose 16782, 19507, and in Chaucer’s PhysicianLa Tale,
V1.20 (cited in Muscatine 1000n379).

 

151

Another fourteenth-century poem, "Love and Dread
God," also explained that human sin was the cause of
pestilence. The poem states that the scourge of plague
was sent to earth by the arrows of God, a familiar
metaphor for the mechanism through which God chastened
sinners.““

Descriptions of the horror of plague in the
fourteenth century also added vivid detail to the
dramatic debate between the dead and the living in the
fifteenth-century Disputacione betwyn the Body apa
Wormes, which also reminds its audience that plague

resulted from sin.““

 

““Twenty-aix Political and Other Poems, EETS 0.8.
no. 124, esp. l. 81. The scourge of God’s arrows was a
familiar metaphor not only during plague times, but also
in conjunction with other scourges sent to correct
wayward sinners. Perhaps the most familiar of these was
The Flood, which was sometimes described as sent by
God’s sword.

In the Wakefield Noah, God explains his reasons for
sending The Flood:

...of veniance [out of vengeance] draw my swerd

And make end

Of all that beris [bears] life,

Sayf [except] Noe and his wife,

For thay wold never strife

With me, then [nor] me offend.

(David Bevington, ed. 294.103-08).
From biblical times, pestilential disease had been
described as God’s bow, as we have seen, and variously
as God’s angel (Donne, Poems, Grierson, ed. 1:346),
God’s arrow (Psalm 38.2), and as God’s hand stretched
out to destroy the wicked (Exodus 9.15). Chaucer’s
Pardoner refers to it as the spear of death (Canterbury
Tales V1.677).

““An early example of the debate form used to warn
of the consequences of a sinful life is the Old English
"Soul and Body;" see G. P. qupp: and E. V. K. Dobbie,

152
Plague references in English didactic and literary
works, discussed in Chapters Six and Seven, reveal close
connections between religious and medical
interpretations of plague. English didactic works
combined advice on care of the body (i.e., the medical
concern with plague) with the Church’s moral advice on

spiritual care of the soul.““ Literary writers

 

The Anglo-Saxon Poetic Recorda, The Exetar BooM, 3:174-
78.

In the fifteenth century Digputaaaone betwyn the
Body and Wormes, the poet enters a church during a
"ceson of huge mortalite, /...with the pestilence /
Hevely reynand," where he sees "a towmbe or sepulture /
Ful freschly forgyd, depycte, and depynte." He reads the
following epitaph on the wall:

Take hede unto my fygure here abowve

And se how symtyme I was fresche and gay

Now turned to wormes mete and corrupcone

Bot fowle erth and stynkyng slyme and clay

Attend therfore to this diputacione written here,

To see what thou art and here aftyr sal be.
Quotations from the Disputacione are from Philippa
Tristram, Figurea of Life and Deapa 160, from a
transcription of the poem by John Conlee (BM Addit.
37049).

““A moral interpretation of plague was more
commonly included in medical interpretations by the end
of the fifteenth century. This mixture of moral and
medical views appears even as late as the nineteenth
century, as the following example from J. F. C. Hecker’s
Der Schwarae Tod illustrates:

We must bear in mind also, that human science and

art appear particularly weak in great pestilences,

because they have to contend with the powers of
nature, of which they have no knowledge; and which,
if they had been, or could be comprehended in their
collective effects, would remain uncontrollable by
them, principally on account of the diaprdered
condition of human society [emphasis mine].

(The Epidepies of the Middle Ages, trans.

Babington 50).

153
interpreted plague as God’s punishment for collective
sin and, along with other warnings, as an emblem for

social disorder in the context of an orderly cosmology.

Chapter 6: From Medical to Moral Interpretations of
Plague: John Lydgate and Other Didactic
Writers

An increase in the number of vernacular medical
works in the late fourteenth and early fifteenth
centuries corresponds to an increase in more general
vernacular didactic works with advice on disease
prevention in the fifteenth century. By the fifteenth
century, dietaries and regimens of health became
popular, especially with the nobility. Like English
plague treatises from the late fourteenth century,
fifteenth-century didactic works with advice on plague
emphasize prevention. These writings also explain the
presence of plague in moral terms besides offering
medical information. The medical view of plague
explained that certain physical measures could be
carried out in order to avoid this disease. Advice for
preventing plague in fifteenth-century didactic works
stressed governance of the spirit through moral living,
in addition to governance of the body through preventive
physical measures such as proper diet and phlebotomy. By
the late fifteenth century, advice on pestilence from an
older, pharmaceutical tradition of recording and
reworking recipes supplanted academic medical
information given in plague treatises.

154

155

This chapter considers didactic works such as
Lydgate’s Dietary apd Doctrine for the Pestilence and
Lydgate and Burgh’s Secrees of Old Philosoffrea, as
well as other writing found in estate books and family
letters, and in Edmund Leversedge’s Vision.“ Readers of
these works would have wanted advice for themselves and
their families, not for patients. They needed practical
advice on plague, which they could understand without
formal training.

The texts considered in this chapter are usually
shorter and contain less medical information on plague
than those translated directly from professional medical
treatises. These shorter works might best be described
as "summaries of the knowledge in their fields...broad
in scope but limited in depth for those who were reading
for their own interest and self-improvement" (Mooney 3).

Authors of didactic writings with advice on health
were often literate laymen, not physicians. While these

authors agreed with learned medical authorities on

 

“The choice of Lydgate is based on the popularity
of his works, which were widely read in the fifteenth
century. For instance, R. H. Robbins finds that
Lydgate’s Dietar , a popular "informational work,"
survives in 46 manuscript copies, a number exceeded only
by manuscripts of poetic works: The Canterbury Tales and
Piers Plowman ("Medical Manuscripts" 404), and the Prick
of Conscience.

Many of the writers discussed in this chapter had
experienced outbreaks of the plague themselves. At
Lydgate’s own monastery, the Abbey of St. Bury, the
number of monks dropped from 80 to 47 after an attack of
the Black Death in 1381 (Pearsall, John Lydgate 24).

156
matters of plague prevention, they looked to religious
sources for an explanation of the causes of plague and
often preferred herbal remedies and physical preventives
to the longer, more complicated procedures and
explanations found in academic plague treatises. They
argued that poor governance of the spirit, in addition
to poor governance of the body, had caused plagues in
the past, and that poor spiritual governance could
result in further outbreaks. Their writings suggest the
importance of recognizing that pestilential disease had
behind it the chastising hand of God, an interpretation
rarely mentioned by physician-authors in plague
treatises.

An explanation of the dual nature of plague as a
moral and medical problem occurs in the Book of
Quintessence, written by the Franciscan Johannes de
Rupescissa, who was also an alchemist (fl. late
fourteenth century).“ As the English translator
explains, he translated the text from a Latin source,

"bat be wisdom and be science of bis book schulde not

 

“The English version is based on Johannes de
Rupescissa’s (Jean de Roquetalillade’s) Liber de
famulatu philosophiaa or liber de conaideratione gpintae
essentiae (libri II)--The Book of Quintessence (ctd. in
Singer and Anderson 142-44). Edited by F. J. Furnivall
from the London, British Museum, Sloane MS., 73 ff. 11-
25', EETS, 08 no. 16.

 

157
perische" (1).“ The treatise describes Quinte Essence,
the fifth element found above the other four, which,
according to the author, had the power to make the
corruptible incorruptible (2-3). The treatise explains
how to make Quinte Essence, which, like brandy, can be
distilled from wine (4-5), and when combined with gold,
served as a treatment for various illnesses, including
plague.

But the author warns that medicine for the
pestilence, compounded from Quinte Essence, would be
effective only in certain cases:

...forsobe holy scripture seib bat summe tymes oure

lord god sendib pestilence to sle summe maner of

peple, as it is seid deutronomium 28 in bis
maner....Therefore a gret fool were he bat wolde
presume to cure bese plagis of pestilence bat ben
vncurable, bat ben sent of god to ponysche synne.
(23-34)
In this passage, the author reminds his readers that
plague may arise directly from the wrath of God, as
punishment for sin, or that it may arise from natural

causes. The former is never curable; the latter, the

author claims, could be healed with Quinte Essence.

 

“According to Richard Firth Green, "The line
between pure medicine and such pursuits as astrology,
alchemy, and even necromancy was a thin one in the
middle ages" (Poets angrPrincepleasers 89). Green
explains the case of John Fauceby, royal physician to
Henry VI, who was granted a royal license to practice
alchemy, and, in addition, exempted from prosecution for
practicing it.

158

The ultimate source for this distinction, the
author explains, is Deuteronomy 28, which enumerates
the blessings given those who obey God’s commands and
warns of the curses awaiting those who are disobedient.
Johannes quotes relevant passages from Deuteronomy 28 in
his text as support for the notion that pestilence and
other physical ailments could occur as punishment for
sin:

May the Lord set the pestilence upon thee, until he

consume thee out of the land, which thou shalt go

in to possess. May the Lord afflict thee with
miserable want, with the fever and with cold, with
burning and with heat, and with corrupted air and
with blasting, and pursue thee till thou perish.
The Book of Quinte Essence continues by explaining
other causes of plague besides sin. Natural causes
include the perilous influence of evil planets (24), and
may be curable, "by be grace of god...partialy wib oure
5. essence [i.e., Quinte Essence)" (24).

The treatise concludes with a summary of Quinte
Essence’s ability to restore health in the case of other
diseases:

And bus 3e may wib bis 5 essencijs cure alle bese

siknesses aforeseid, and many obere, as it were by

myracle, if 3e worche discreetly as I haue tolld 3e

tofore. (25)

The examples from the Book of Quinte Eaaence show how

the medical interpretation of plague appears in

conjunction with a moral interpretation based on

159
biblical sources, as is the case with the other examples

from didactic works discussed in this chapter.

1. Lydgate’s Dietary and Doctrine for the Peatilence“

In most modern editions, Lydgate’s A Doctrine for
the Pestilence is appended to his Dietar , as the two
often appear together in many manuscripts (MacCracken).
MacCracken believes that the Doctrine and Dietapy is a
translation of a French ballade which appears in art.21,
Trinity College, Cambridge, R.3.20. R. H. Robbins has
noted that these two poems often appear in collections
of instructional poems for children, perhaps suggesting
an oral tradition of medicinal remedies handed down in

verse form from parents to children.“ The Dietary is

 

“"A Dietary, and a Doctrine for Pestilence." In
Henry Noble MacCracken, ed., The Minor Poeas of John
Lydgate, EETS 08, no. 192.

“Derek Pearsall places Lydgate’s Dietary under the
category of "didactic and practical verse" (John Lydgate
76). Other examples of Lydgate’s works which fit this
category are his Churl and Bird, Fabula duorum
aercantorup, and other animal poems: Goose and Sheep,
Horse, and Jak Hare (Pearsall 76). Lydgate’s Dietary and
Doctrine for Pestilence comes under the category of
"Religious and Didactic Works" in the revised Manaal of
the Writiags in Middle English because its concern is
morally admonitory rather than solely medically
informative.

For a brief explanation of the manuscripts in which
both the Dietary and Doctrine appear, see The Minor
Poeps of John Lydgate, ed. Henry Noble MacCracken, part
1 ("The Lydgate Canon and Religious Poems"), EETS, es
no. 107, xv. Both poems appear in The Minor Poeps of
John Lydgate, ed. Henry Noble MacCracken, part 2

160
composed of 11 stanzas of 8 lines each, and the
Doctrine, which follows, has 4 stanzas of 8 lines each.
The Doctrine has the refrain: "Walk in cleene heir,
eschew[e] mystis blake." Advice on plague was usually a
translation from an earlier medical work, as with the
Burgundy treatises.“ However, Lydgate’s Dietary and
Doctrine for the Pestilence, like many collections of
plague remedies, derives from a tradition of gnomic
wisdom.

Lydgate’s emphasis on spiritual and physical
governance has analogues in other, "general moral
advice, of the usual gnomic kind" (Pearsall 220), and
demonstrates Lydgate’s affinity for moralizing, as he
does in the following line: "Suffir in tyme, in thi riht
be bold" (MacCracken 149-52). Like other contemporary
didactic writers, Lydgate correlated astrology and
health, envisioning man as a microcosm of the larger
world. Charles F. Mullett has noted that Lydgate, like
many of his contemporaries, "reflected the constant
burden of the pestilence by his concern with sudden

death as well as with the disease itself. He composed

 

("Secular Poems"), EETS, as no. 192, 702-07. And for an
analysis of the two poems in the larger context of the
Lydgate canon, see Derek Pearsall, John L d ate, esp.
76.219-20, 285; Charles F. Mullett, "John Lydgate: A
Mirror of Medieval Medicine."

“Philippa Tristram remarks that "it is as if the
past could provide consolation adequate to present ills"

(Figures 13).

161
prayers against it and one versified doctrine" ("John
Lydgate" 404).

While the Doctrine contains few remedies for
plague, it stresses the importance of spiritual comfort
in preventing the disease, especially in its
conclusion:

Thuys in too thyngis stondith al the welthe

Of sowle & bodi...

Moderat foode yeueth to man his helthe

And charite to the sowle is dewe.

(MacCracken 707)
In this poem, medical advice serves as a metaphor for
spiritual advice: "Ther be thre lechees consarue a
mannys myht: "glad hert, temperat diet,” and "for no
thyng take no thought." Lydgate believed that avoiding
worry was the best means for preventing plague (704). He
also explained that one should be moderate in all
things, believing that "temperat diet, temperat

travaile, nat melencolius, encourages good attitude"

(705).“

 

“This echoes the plague description given in the
Boccaccio’s introduction to the Decameron:
...very few [of those dead from plague] were
granted the piteous laments and bitter tears of
their relatives; on the contrary, most relatives
were somewhere else, laughing, joking, and amusing
themselves; even the women learned this practice
too well, having put aside, for the most part,
their womanly compassion for their own safety.
(The Decaperon, trans. Musa and Bondanella 7)
Storytelling in the Decameron becomes a means for
avoiding the plague. As the Queen tells the young men
and women before they leave:
But if you take my advice in this matter, I suggest
we spend this hot part of the day not in playing

162

Other ways of preventing plague’s return include
the avoidance of spiritual weakness by refusing to hear
false rumors. Lydgate also warns of the dangers of
arguing:

With thre folk ben nat at debate,

thi bettir, ageyn thi felaw, with thi soget.

(MacCracken 705)
One should also avoid "dees pleiers & hasardours"
(706).“

Lydgate’s emphasis on plague prevention through
moral living as more important than physical remedy is
typical of the other fifteenth-century didactic works
discussed in this chapter. Most state that plague could
be avoided through proper diet in addition to righteous
living by governing the spirit. Lydgate’s Dietary aaa
Doctrine combines the Church’s moral interpretation of

plague with plague advice taken from popular medical

lore, and therefore follows biblical precedent in

 

games, but rather in telling stories, for this way
one person, by telling a story, can provide
amusement for the entire company.
(trans. Musa and Bondanella 17)
In Literature as Recreation, Glending Olson argues that
recreational activities such as story telling were
thought to be useful in preventing plague.

“The immorality of these sins is also part of
Chaucer’s Pardoner’s warnings concerning gluttony and
the other tavern sins:

In Flaundres whilom was a compaignye

Of yonge folk that haunteden folye

As riot, hasard, stywes, and tavernes,

Where as with harpes, lutes, and gyternes,

They daunce and pleyen at dees bothe day and nyght.

(Qanterbury Tales V1.463-67)

163

serving the needs of both body and spirit. As the Great

Physician, Christ had done the same in His miraculous

healing of the blind and palsied, whose sins He forgave

before healing.

As Chapter Five points out, traditionally, the

Church believed that spiritual health was not only more

desirable than physical health, but often its key. Thus,

governance of the spirit could prevent physical disease,

especially when that disease occurred as punishment for

sin.

In the sixteenth century, medical writers like

Thomas Vicary emphasized spiritual guidance even more

strongly, applying the advice on plague prevention as a

metaphor for the care of the soul.“

 

“Vicary combines spiritual and physical concepts

using medical terms in the following allegory written in

1613:

First, fast and pray, and then take a quart of
Repentance of nineve, and put in two hand-fuls of
Faith in the blood of Christ, with as much Hope and
Charity as you can get, and put it into the vessell
of a clean Conscience: then boyle it on the fire of
Love, so long till you see by the eye of Faith, the
black foame of the love of this world stinke in
your stomacke, then scumme it off cleane with the
sponne of faithfull Prayers. When that is done, put
in the powder of Patience, and take the cloth of
Christs Innocency, and straine all together in his
Cup: then drinke it burning hot next thy heart, and
cover thee warme with as many clothes of amendment
of life, as God shall strengthen thee to beers,
that thou mayst sewate out all the poyson of
covetousnesse, pride, whoredome, idolatrie, usury,
swearing, lying, and the like. And when thou
feelest thy selfe altered from the forenamed

vices, take the powder of Say-well, and put it upon
thy tongue: but drinke thrice as much doe-well

164

2. Lydgate and Burgh’s Secrees of Old Philosoffres

Lydgate and Burgh’s translation of the Secrets
Secretorua has as its principal source the treatise aa
Eaglmine Principua, attributed to Aristotle, and
translated into many languages: from Arabic into Latin
by Philip of Paris in the thirteenth century, and later
into French. After the thirteenth century, the work grew
in popularity and was expanded on by various translators
and redactors (Steele xi). As Robert Steele has noted,
"A work of this nature, so suitable to the habits of
thought of the writers of medieval times, naturally gave
rise to a host of imitations and emendations" (xii). Its
popularity increased in the fifteenth century when
dietaries and manuals of good governance (e.g., courtesy
books) became especially popular with the English court
(Green, Poets and Princepleaaera 73). But as Jonathan
Nicholls describes them, courtesy books in the Middle
Ages "are only a small part of a vast amount of
improving and didactic literature which is to be found
in all languages during that period," later adding that
in many of these courtesy books (e.g., on table
etiquette, speech, conduct in church, greetings,

travelling). "moral instruction is not necessarily

 

daily. (qtd. in F. P. Wilson, The Plague in
Shaaespeare’s London, 4n1).

165
absent, but usually takes a subordinate role" (gag
Matter of Courteay 14). The advice on good governance in
the Secrets Secretorua could be adapted for various
purposes. The work served as a source for later manuals
on good governance such as Lydgate and Burgh’s Secrees,
which, unlike most courtesy books, contains moral
advice.

English versions of the SecretaESecretorup include
Hoccleve’s Eagement of Princes, with the earliest
version translated by James Young and addressed to James
Butler, Earl of Ormond, Lord Deputy of Ireland (ca.
1420) (Steele xiii). Like Hoccleve’s Regement, Lydgate
and Burgh’s version was translated for royal patronage.
Written late in Lydgate’s life, possibly at the bidding
of Henry VI, the Secrees remained unfinished at his
death in AD 1449 or 1450.““ It is considered the last
of Lydgate’s works. The text was completed by Benedict
Burgh, another monk and one of his students (d. 1483).

As literature, the poem itself is not of great
interest, and, as Richard Steel bitingly remarks: "His
work [the Secrees] is scrappy, ill-ordered, and tedious
to a remarkable degree even for him" (Steele xviii).
More disparaging is Derek Pearsall’s deposition: "[the

Secrees is] a work as nearly worthless as any that

 

““For a brief summary of Lydgate’s life, see Lois
A. Ebin, John Lydgate 1-3. Quotations from the Secrees
in this chapter are from Robert Steele’s edition.

166
Lydgate penned" (Lydgate 296). Pearsall adds that the
poem is actually a series of "fragments of a
translation, perhaps done at different times, and
brought together after Lydgate’s death" (297).
Structurally, there are gaps and a lack of transitions
in places, showing an apparent lack of artistry. The
section on remedies for the stone ("How Aristotil
declarith to knyg Alisaundre of the stoonys"), for
instance, has little to do either with what goes before
(a section on the dispositions of kings) or after (a
continuation of the governance of kings) (Pearsall 298-
99).

Lydgate and Burgh’s version of the Secrees serves
as an example of popular interest in political and moral
instruction, besides containing medical advice on
plague. In addition, it transforms an earlier prose
work into poetry. Lydgate and Burgh were faced with the
task of rendering a prose work from Latin into English
rhyme which required a number of changes expressed in
the prologues. The translators’ prologues and the
sections on pestilence, additions to the original
treatise, also show something of the translators’
interest in audience concerns with later outbreaks of
plague in the mid-fifteenth century.

N. F. Blake remarks that in Lydgate’s other works,

the prologues are "diffuse and he inserts interpolations

167

and other remarks at various stages" ("John Lydgate"
76). Lydgate’s prologues often comment on the genesis of
the works he is writing and on his royal patronage.
Such features are, according to Blake, new in English
literature (276-77).

In the prologue to the Secrees, Lydgate explains
that one should "Taklenl at gre [will] / the Rudnesse of

7

my style,‘ a style produced by his rendering of the
Latin work into English (1.21). The poem, he also tells
his royal audience, is "of al good thewys [customs]"
(2.31); it conveys "a mene / atwen werre and pees"
(2.39). He states the purpose of the poem in its
introduction:

ffirst I that am / humble Servitour

of the kyng / with hool Affecyoun,
Voyde of Elloquence / I haue do my labour
To sette in Ordre / and execucyoun

ffirst my symplesse / vndir Correccioun,

With ryght hool herte / in al my best entent
ffor tacomplysshe / your comaundement.
(2.22-29)

The Secreaa of Old Philosoffres makes public what
is ostensibly "secree," because the audience of the
original work was limited to clerks, those literate in
Latin. With this translation, Lydgate and Burgh
permitted their royal patronage to share in the
"secrets" of learned clerks:

but the knowyng / is hyd fro many oon,

And not declaryd / to every Creature.
(17.514-515)

168
The "knowyng" should be kept from certain people, as
common people should not be told matters reserved for
clerks and nobles for the following reasons:

Ther is of ryght / a greet difference

Twen a prynces / Royal dignite
And atwen Comouns / Rude intelligence,
To whoom nat longith / to medle in no degre
Of konnynges / that shulde be kept secre;
ffor to a kynges / famous magnificence,
And to Clerkys / which haue experience...
(17.519-525)
Burgh expresses his views on the uses of the English
language in the prologue to the last section of the
work, which he completed after Lydgate’s death:
In modir tounge / this matere to Combyne
Which sauff Support / knowe not the musys nyne.
(51.1588-89)

Like the other fifteenth-century didactic works
discussed in this chapter, the advice on plague in the
Secrees combines information from the medical tradition
with a strong moral warning. Lydgate defends this
approach by stating that one must temper medical advice
with experience:

Suych as been prevyd / by experience,

And prevyd Auctours / as the phesyk techys,

Truste On the dede / And nat in gay spechys;

Woord is but wynd / leff woord and tak the dede...

(39.1221-1224)
In the section on plague, the Secrees recommends that

one should eat only "holsom" foods and avoid "mystes

blake," as other treatises had done based on earlier

169
medical sources.““ Besides medical care, the author
stresses certain spiritual defenses useful in warding
off plague, especially in cases where "phesyk lakke"
(41.1281). One should avoid pensiveness and should
maintain his household "After thy Rente" (41.1285).
Swearing could also indirectly bring on disease, as
could deceit (41.1284-1288). Moderate diet and "charyte"
were therefore effective in preserving health during
plague times. Thus, while acknowledging the importance
of physical governance of the body, the advice on plague
in the Secrees, like the advice given in Lydgate’s
Doctrine for the Pestilence, reminds its readers that
the care of the soul is as essential as proper diet in
warding off this illness.

Lydgate concluded the Dietary and Doctrine by
explaining that its advice was not reserved for clerks.
It could serve as useful advice for common readers:

This receiht bouht is of non appotecarie,

Off Maister Antony, nor of Maister Hewe;

To all indifferent richest dietarie!
(707.166-68)

 

““The references to black mists in this passage and
in the example from Lydgate’s Dietary and Doctrine (see
above), indicate that plague miasmas were often seen in
an atmosphere of moral pollution. John A. Alford emends
myte to myste in the following passage from Piers
Plowman, B-text, which refers to Haukyn’s coat, stained
with sin:

And Dobest kepeIth] clene from unkynde werkes.

Shal nevere mylste] bymolen it, ne mothe after

biten it,

Ne fend ne fals man defoulen it in thi lyve.

(XIV.23-25)

 

170
He translated the Secrees, however, for an elite
audience. Until this translation, its "secrets," the
proper governance of a king, both physically and
spiritually, were reserved for clerks and nobles. The
ability to read its learned language (i.e., Latin) was
reserved for clerks, who imparted its secrets to
royalty. But a vernacular language could not serve as an
obstacle to common readers in the way that a learned
language could, and Lydgate, in fact, explained his
reasons for translating this work into English:
Excellent prynce / this processe to Compyle
Takith at gre / the Rudnesse of my style.
(1.20-21)
Benedict Burgh, who completed the work, ended it with an
apology for this "Rudnesse":
Yf ony man / thy Rudnesse lyst accuse,

Make no diffence / but with lowlyhede

Pray hym refourme / wheer as he seth nede...
(86.2726-28)

Regardless of either collaborator’s wishes, the audience

could no longer be restricted to nobles and clerks.““

 

““R. F. Green argues that the court provided a
main impetus for literary creation which expressed the
"life and attitudes of the court" (Poeta and
Princepleasers 211).

A. S. G. Edwards would disagree, particularly with
regard to Lydgate’s works, often written expressly for
laymen. Edwards has suggested that the ownership of at
least some of the manuscripts in the Lydgate corpus
"extends beyond the social range of Lydgate’s initial
patrons. It suggests that his audience encompassed the
nobility, bourgeoisie, religious institutions and
individual clerics--in fact a full spectrum of potential
fifteenth-century readership" ("Lydgate Manuscripts:

171

Though the Latin version was intended for a learned
audience, in translation it communicated specialized and
private instruction to a wider audience. As is the case
with vernacular translations of medical treatises on
plague, didactic works, even those intended for noble
audiences, became increasingly available to those who
could read and write "rude" languages, but their advice
appears not to have penetrated many leechbooks, which
continued to stress recipes for remedies and
preventives, but had little to say about governing the

spirit with respect to plague.

3. Plague References in Other Late Middle English
Didactic Works

A remedy for plague is found at the end of Henry de
Bray’s estate book, written over a period of several
decades from the early to mid-fourteenth century.
According to Dorothy Willis, the book appears to have
been kept by de Bray himself, the lord of the manor,
which is unusual as such records were normally kept by a
bailiff or clerk. Willis notes that the estate book was
written in Latin "with occasional lapses into currently
spelt French" ("The Estate Book of Henry de Bray" 117).

The last folio of the manuscript contains a recipe

for the prevention and cure of pestilence. Although the

 

Some Directions for Future Research" 21-22).

172
recipe is in Latin, the author gives English equivalents
for Latin, French, and lesser known English botanical
terms mentioned in the recipe. Among them are goldwort
"which in English is rod [goldenrod]" and pied de lion,
"which in English is called crowsfoot" (138-39). Most
likely, the recipe itself was added to the estate book
sometime during the mid-fourteenth century, probably
during a major outbreak of plague. Perhaps Henry de
Bray, who survived early outbreaks of the plague
himself, wished to preserve the recipe for quick
reference. Like plague remedies in other fourteenth-
century popular English works, this one bears a
resemblance to those in the manuscripts of John of
Burgundy in its description of various symptoms of
plague such as buboes or fever, which could be treated
with herbal remedies.

Unlike the advice on plague in didactic works from
the fifteenth century discussed earlier in this
chapter, the advice on plague in de Bray’s book, like
many didactic writings by laymen, concerns remedy rather
than prevention. This situation is typical of earlier
vernacular plague writings where authors mention
remedies for pestilential diseases from earlier folk
remedies. As we have seen, most didactic works with

advice on plague in the fifteenth century stress

173
prevention, often directly stating that plague had come
about because of sin.

The Paston family letters provide yet another
example of popular writing on plague in the fifteenth
century. Although these outbreaks were less virulent,
fear of plague remained strong, as references to the
disease in the letters of this educated middle class
family demonstrate.““

The earliest reference to plague in the Paston
family letters appears in a letter from Agnes Paston to
her son John, dated 1453, in which she reports that
those who contracted plague died quickly (155).““ A
year later, William Paston reported to his brother John
that the plague was still prevalent in London: "here is

pestelens, and syd [scil. syth] I farid be better"

 

(155). He closes the letter by telling‘John, in even
stronger terms, "Here is gret pestelens. I purpose to
fle in-to the contre" (156). By August 1465, the plague
appeared again in Norwich. Margaret Paston, writing to

her son John on August 18 reported, "They dyy ryght sore

 

““Unless otherwise indicated, citations from the
Paston Letters are from Norman Davis’ edition, Volume 1.

Richard Firth Green notes that William Paston sent
many of his sons, to whom and by whom many of the
letters in this collection were written, to the Inns of
Court for their education (Poetsvand Princepleasers
191).

““Page references following citations from letters
by the Paston family are from Norman Davis, ed., The
Paston Letters and Papers, 2 vols.

174

in Norwych...for be pestylens ys so feruent in Norwych
that thay there no lengere a-byde there" (315-16).

Besides these brief objective descriptions of
plague, some of the Pastons relate their personal
experiences during plague outbreaks. Norman Davis
informs us that Agnes, Walter, and John Paston all died
from plague in 1479, also a plague year (2:411). John
Paston II, writing to his wife Margaret and his son
John III "in hast" (Sept. 15, 1471), asked for news of
friends or "well-wyllerys" who may have died while he
was away. John feared that plague might spread: "free I
feer bat there is grete deth in Norwyche and in other '
borowghe townese in Norffolk; for I ensure yow it is the
most vnyuersall dethe bat evyre I wyst in Ingelond"
(441). In the same letter, John asked Margaret to warn
his younger brothers that immoral behavior could cause
the plague. "My yonge brytheryn," John admonished,
"[ought not to desport] wyth noon other yonge peOple
whyche resortythe wher any sykenesse is" (441). Like
Lydgate, John Paston II may have associated plague with
"dees pleiers and hasardours," gluttony, and the other
excesses of youth.

Eight years later in a letter to Margaret, John
Paston II described his "feere of the syknesse" during
another outbreak, sometime before October 29, 1479. He

asked Margaret to send him "ij pottys of tryacle of

175
Jenne" by the next messenger from London as a plague
preventive (615).““ In a letter written to John Paston
II, John Peacock, one of his servants, explained more
about the seriousness of this outbreak: "And for deth,
Caster and Mawteby there deyd non son Michellmas, at
Bylby, Ormysby, and Scrowby and othir placys they dey
stylle" (412). According to Davis, "John II’s ’fear of
the sickness’ was justified: he died a little over two
weeks [after the letter was written]" (515). Writing to
his mother less than two months after the death of his
father, John Paston III reported that the number of
deaths from plague was declining: "And thankyd be God,
the sykness is well seasyd here; and also my besyness"
(618).

The fear of further outbreaks was not yet over in
1487, when Edmond Paston II, in a letter to his
brother, John III, reported that "she [his master’s
wife] woold this day haue made here cowntenance to haue
seyn here nes, [brothers dowtere], wyche is at Pallyngys
fore fere of the plage" (643). The best preventive was
to flee infected areas, as this and other letters

explain. In the letter, Edmond also reported that his

 

““The term Jenne (var. gene) could mean various
wares marketed by Genoese merchants, as it does in this
passage: "My mastyr toke his man to kepe a potte of
geene to put in grene gyngyr" (1466--Acc. Howapa in EQ
E1 369. Cf. MED, s.v., gene (b).

 

176
cousin Clere’s mother and his master’s wife both had
died of plague, which "reygnyth at Ormysby" (641).

Several of the Paston family letters acknowledge
the importance of knowing about contagion and of fleeing
as perhaps the best way to avoid the disease. These
letters also indicate the widespread effects of plague
in mid-fifteenth-century towns. John Paston II, who
eventually died from plague, reported that it "is the
most vnyuersall dethe bat evyre I wyst in Ingelonde"
(615). References to plague in these letters also
express a sense of urgency and doom, sometimes warning,
as John II had done, of the dangers of frivolity during
plague times. Dietaries written after the fifteenth
century emphasized the importance of plague prevention,
in part, because the disease rarely struck with as much
force as it had in the mid-fourteenth century.
Prevention also gained greater emphasis from those who
realized that remedies for plague were ineffective,
though, in some cases, those remedies might have seemed
effective. The virility of the plague bacillus weakened
over time so that recovery was more likely.

The advice on plague in fifteenth-century didactic
works combines medical and religious explanations of the
causes of plague by stressing governance of body and
spirit in addition to physical remedies as a means of

plague prevention. This perceived relationship between

177
the physical and spiritual self derives from biblical
sources and from later texts such as the Book of Quinte
Essence, which distinguishes between medical and moral
causes of plague. Both Lydgate’s Doctrine for the
Pestilence and the Secrees emphasize prevention based on
diet and spiritual governance. Those who could read a
"rude" language had access to these "secrets" and thus
could save both body and soul, both of which were
endangered by plague.

In the fifteenth century, members of the Paston
family had shown themselves familiar with advice on
plague given in contemporary didactic works: that "to
flee was best," and that moral living was important,
especially during times of pestilence. They were also
aware that remedies were available for preventing
plague. As we have seen, John Paston II asked his wife,
Margaret, to send him one such remedy ("tryacle of
Jenne") by messenger (Davis 615). However, not all
fifteenth—century didactic works were concerned with
both medical and moral aspects of plague. Other didactic
writers only mention the moral aspects of plague, as is
the case with Edmund Leversedge’s Vision, written in
1465 after he experienced a "plage of pestylence" (Ed.

E. Margaret Thompson 23).““ Leversedge’s personal

 

““Subsequent page references are from Thompson’s
edition of Leversedge’s Vision.

178

account of plague is unusual compared to other English

accounts of plague, as most consider plague along with

other corporate disasters as a warning to repent, rather

than as an opportunity for spiritual growth.

Leversedge’s Vision appears to be a contemporary

and personal account of an outbreak of pestilence in the

mid-fifteenth century. He mentions, for instance,

specific dates and describes physical symptoms:

The 3eere of our lorde god a M.c.c.c.c.lx.v [1465]
in the towne of Frame with in the Shyre of
Somersett, by the hand and vysytacyon of almyghty
God was smyton with the plage of pestylence, and in
suche wyse so fervently takyn j was strayght forthe
and lay as dede the space of iii hours of the
nyght, and my spyrit was raveschyd and departyd fro
my body and also my knyll rongon for my saule,
before ye wyche streychynge foreth and knyll rongon
I was so a vexed and trowbled with the syght of
fyer and temptacyons of ij deuellys, that my face
of wy3t colour was a blak as any cole, and my tonge
that was wont to be red was a blake as any pyche
and thrast out at my mouthe the length of halfe a
foote and more, that the rote of my seyd tonge and
the vaynes of the seyd tonge aperid and lay out of
my mouthe (23).

It may be argued that Leversedge did not experience

an attack of bubonic plague: he does not describe the

characteristic plague buboes or mention that others

around him also became ill. But like other fifteenth-

century didactic writers, Leversedge calls his disease a

"plague [i.e., "stroke, blow"] of pestylence," and

associates this disease with sins of excess, which he

claims he has committed: he has worn piked shoes and

extravagant clothes (25), and has had "liberte of

179
kissyne" (30-31), for which he should have "byn dampnyd
and shuld have byn in hell for ever" (25).““ Instead,
during an attack of plague, an angel leads Leversedge
through a vision where the consequences of his own life
of excess are vividly shown by the actions of various
devils.

Most of Leversedge’s account derives from William
Staunton’s Pilgrimage of the Soal (AD 1409), which
appears in the same manuscript as the Vision (Thompson
22). Staunton’s Pilgrimage derives from earlier accounts
of St. Paul’s vision, the ultimate source of which is

the apocryphal Visio Pauli itself.““ Leversedge is led

 

““Leversedge describes his extravagant manner of
dress before his illness, which he sees in the form of
devils paraded before him:

And for the sayd aray the going of the sayd

deuyllys, and as hit has pleasid my Lord God that

they shuld apere to me in suche wise, was in shorte
gownes and dowblettes, closse hosyn, longe heere,
vpon here browes, pykes on ther shon of a foot in
lengh and more, hygh bonettes I my selfe sume tyme
vsid, and this prowid peple that callis them selfe
galantes 3it vsid.

(25)

““Margaret Thompson comments further on the Vision
and its sources, 21-22. The original source for this
vision appears in 2 Corinthians:

If I must glory (it is not expedient indeed): but I

will come to visions and revelations of the Lord. I

know a man in Christ above fourteen years ago

(whether in the body, I know not, or out of the

body, I know not; God knoweth), such a one caught

up to the third heaven. And I know such a man

(whether in the body, or out of the body, I know

not: God knoweth): That he was caught up into

paradise, and heard secret words, which it is not
granted to man to utter.
(1-4).

180

by "a good angell" (27), an experience which forces him
to repent and become a hermit after his recovery. At the
end of the vision, the angel commands Leversedge to
study divinity at Oxford (32) under the name of William
Wrech:

"I charge the," she seyd, "that thou call the

William Wrech as longe as art within the vniuersite

of Oxforth, and when thou comyst whome a3en lett

call thy name Edmund Lyuersigge, as thou hast byn
euer called byfore this tyme."

(32)
Leversedge is not to marry, "but conteneu thi life as a
clarke" (32). In addition, the angel tells Leversedge
when "suche of my kynne that shuld die, as my mother,
and also that al my enymes shuld de dedd or that I come
home in to my contrey" (32).

Like other, earlier versions of the Magic Pauli,
Leversedge describes his own experience with plague in
terms which echo moral warnings concerning plague:

...then my good angell speke vnto me and told me

howe they wer spirites that God had gifin power and

commaundment to persecute and smyt the people for
the synne that dayly renyth a mong them with the
infirmyte and plage of pestilence, the whych synne

and people gretly displesith God.
(33)1o

 

““As Leversedge turned to a biblical account for
advice on this "plage of pestylence," which "dayly
renyth," so Bengt Knutsson, concerned with healing a
plague which "dayly enfecteth," turned to authorities
for advice:

I the Bisshop of Arusiens in the wyalme [scil.

ryalme] of Denmark doctour of Phisique Wille Write

by the moost experts and famous doctours auctorised
in Phisike somme thynges of the infirmitie of

181
The Vision concludes with a warning to others who might
commit the same sins as Leversedge had done in his
earlier life:

Wherfore j a synfull wrekche haue grestes [sic]

cause to gife laud and praising to God and euer to

dred hym, and people princypally of this realme
haue the more cause to dred almyghty God by this
ensample shewid in me wrecch, and not only for me
this example was sheuyd but for al synners, to take
exsample at me to be pinytant of ther synne and to
exchewe the occasion of the same, wher that holy
scripture sayth.

(34)

By the late fifteenth century, more English
translations of medical and religious works were
available for laymen able to read this "rude" language,
but, like Edmund Leversedge, they continued to turn to
older sources for both medical and moral
interpretations of plague, rather than to more
contemporary sources such as translations of plague
treatises. It appears that advice on plague in practical
works for laymen from the early fifteenth century
onwards consistently moves away from cataloging
remedies, as in the fifteenth-century Liber de Diversia
Medicinis or earlier, in de Bray’s estate book, toward
an emphasis on plague prevention through spiritual and

mental governance combined with physical remedies. ,

However, Laymen themselves continued to record remedies

 

pestilence Whiche dayly enfecteth, & sone suffreth
be to departe oute of this lyfe (Vine, ed. 1“).

182

for pestilence which had come down through a tradition
of herbal lore in the fourteenth century, much as Henry
de Bray had done by recording a plague recipe in his
estate book in the mid-fourteenth century, or as Robert
Thornton had done by combining a plague recipe with an
outline of the learned causes and prevention of plague.

A later example, written in the sixteenth century,
Andrew Boorde’s Dietary of Helthe, a descendant of
earlier didactic works like Lydgate’s Doctrineaapa
Dietary, stresses prevention almost entirely,
eliminating plague remedies and treatment.““ Concerning
advice on plague in the Dietar , Boorde explained that
such things as "myrth" were the best protection against
plague:

I do wryte wordes of myrth/ truely it is for no

other Intencyon but to make your grace mery, --for

myrth is one of the chefest thynges of Physycke,

the which doth aduertyse, euery man to be mery, and

to beware of pencyfulnes...

(228)

He believed that a cheerful mental state could

 

““F. J. Furnivall, ed. AndrewanordeLanyapary of
Helthe. EETS es no. 10. Thomas Linacre was formerly
thought to be the author of this manuscript. In an
article on the authorship of the Dyetary ("Andrew
Boorde, Thomas Linacre and the ‘Dyetary of Helthe’"),
John L. Thornton argues that the manuscript was
attributed to Linacre for some time, as Boorde had been
imprisoned on several occasions, the second time, "for
keeping three women of loose morals" (209). This alleged
impropriety, Thornton argues, was a principal reason for
discrediting Boorde with the authorship of this popular
treatise.

183
contribute greatly to health.““ By stressing prevention,
he downplayed the ineffectiveness of traditional plague
remedies as English translators of advice on plague had
begun to do in the fifteenth century.

Boorde admitted that one could not always prevent
this sickness, "for it is so vehement and so parlouse"
(290). Reminding us of the Bishop of Hereford’s comment
on the sterility of the land in plague times, Boorde
further remarked that the infection even lies in clothes
and in buildings. In one case, he reported that hogs
lying in straw cast out from a pestiferous home "dyed of
the pestylence" themselves. After these bleak
descriptions of this epidemic, he discussed the
importance of prevention, noting that it was the only
way to control this disease. He mentioned that fires may
help, and that other fumigations may prove effective at
times (291), but he promised no remedy. The emphasis of
plague advice in his work is on preventing the disease
by achieving "comfort for the brain" (291).

Also writing more than two centuries after the
Black Death, William Bullein outlined various responses
to pestilence in A Dialogue Against the Fever

Pestilence (1564). In a preface "To the Reader,"

 

““Glending Olson’s Literature as Recreation (esp.
Chap. 5: "From Plague to Pleasure") contains an
excellent discussion of the uses of "literary delight"
as a means for preventing plague.

184

Bullein, like Andrew Boorde, emphasized the importance
of a moral life combined with physical preventives for
plague.““ By the sixteenth century, writers like Thomas
Elyot, author of the Castel of Helthe (first published
in 1539), felt qualified to write a dietary based not on
medical training or first-hand experience, but on
reading alone.““

English versions of Latin texts increased the
availability of medical knowledge which encouraged a
conflation of religious and medical interpretations in

didactic English works during the fifteenth century. The

 

““Good reader, when aduersitie draweth neare to any
Citie or Towne, and the vangeaunce of God appereth
either by Hunger, Sicknesse, or the Sworde, then mannes
nature is most fearefull, but yet worldlie prouidence to
helpe themselues: which in the tyme of prosperitie or
quietness is carelesse and forgetfull, neither myndefull
to feare God, not pitifull to helpe their neighbour in
adursitie. And when they are touched by the fearfull
stroke of the Pestilence of their nexte neighbour, or
els in their owne familie, then thei vse Medicnes, flie
the Aire, &c. Which indeede are verie good meanes, and
not agains Gods woorde so to doe; then other some
falleth into sodaine devuotion, in giuyng almose to the
poore and needie, which before haue doen nothing els but
oppressed theim and haue dooen them wrong: other doe
locke from their hartes Gods liuely worde, and refuse
grace offered by Christes spirite, thinkyng there is not
God. Some other are preuented by death in their
flourishyng yeres, which in the crosse of death haue
their onely consolation in Jesus Christe. All this is
described here in this plain Dialogue: praying you
paciently totake it in good parte.

(Bullein, A Dialogue 3)

““John A. Alford has noted this development in
"Medicine in the Middle Ages: The Theory of a
Profession," 384. Norman Moore also comments on this
situation in The History of the Study of Medicine 170.

185
Book ofaQuinte Essence, Lydgate’s Dietarylaad Doctrine
for the Pestilence, and Lydgate and Burgh’s Secrees of
Old Philosoffres serve as examples of didactic works
with advice on preventing plague regardless of whether
it came from natural causes or directly from God, as the
biblical example of the Plague of the Philistines had

taught.

Chapter 7: Allusions to Plague in Examples from Medieval
English Poetry

When Bishop Trillek of Winchester warned that
plague had come from sin, he did so on biblical
authority.“ As the example of biblical plagues had
shown, sin, and especially the sins of excess, resulted
from a lack of concern with governance of the spirit.
Humans were, like children, rebellious, needing to be
curbed when they lost control. This theme, familiar in
Middle English sermons, also appears in Middle English
literature, as this chapter will show. Middle English
ecclesiastics described epidemics in the context of
sermons and other moral advice, often with references to
biblical plagues, explaining that epidemics resulted
from corporate sin. Middle English poets,like sermon
writers, presented a moral perspective, adding plague
references to well-known fables, as further evidence for
the chaos resulting from poor governance of the spirit,
and often as examples of individual sin.

In a sermon preached at St. Paul’s Cross in London
on Quinquagesima Sunday, 1388 (MS. Hatton 57, ed. K. F.

Sundén), Robert Wimbledon warned that everyone must be

 

“For a lengthier analysis of Bishop Trillek’s
message, see Chapter Five.

186

187

accountable for the deeds of this life, and that each
person, like a steward in the vineyard (Luke 16), must
live so as not to deserve God’s vengeance on the Day of
Judgment. The preacher described God’s judgment as
taking place in two orderly stages, one occurring
immediately after death, the other on the day of
Resurrection. Every human being would eventually be
brought to judgment by three "summoners" or
"seargeants": sickness, old age, and death.“ The
preacher further explained the work of these three
"summoners" respectively: "be furst warneb, be secunde
bretib, and be bridde takib" (19.14-15). Sickness can,
according to Wimbleton, appear at any age, and strike
individually or "al man kynde, so bat euery man hab it"
(19.20-21). This second form of illness is "dowble" for
it strikes the soul within and the body without (19.22-
25). Consequently, epidemics were signs of a corporately
diseased spirit which could only be healed through good
governance, the responsibility of every faithful
steward.

Other Middle English sermons, such as those in the
Worcester Manuscript, warn that pestilence occurs as a
consequence of the sins of excess, such as "Excesse in

etyng’ & dryngkyng’" (Grisdale 30.261), much as the

 

“For a summary of Wimbleton’s sermon, see K. F.
Sundén ix-xii.

188
dietaries of the fifteenth century would do. The author,
citing John of Salisbury’s Polychronicon (8.7) as an
authority, retells the story of the "wikkid tiraunt
Dionysius, bat was kyng’ of Sicilie" (30.264-292).
Dionysius, filled with "lustis & likyngis of his flesch"
(30.272), turned to gluttony and lechery, which led to
blindness and sickness. The preacher warns that these
consequences await others who fail to govern themselves.
In a later sermon, the preacher warns of the collective
disasters which come about as the result of sins:

Her’ 3e wel se bat tie a kursed peple, vor’

hardeliche al be disese bat cumis e bis lond, as

resyng’ ob be peple, pestilens, derbe & erbe-
quakes’ cum for’ hir’ cursidnes & hir’ mysleuyng.
(78.917-20)
Citing various biblical and classical sources as
evidence for collective disasters brought on through sin
(e.g., Martial, and Alanus’ Anticlaudianus), the author
concludes that the only way to avoid such disasters is
through repentance and obedience (78-79).

One Middle English sermon from the late fourteenth
or early fifteenth century, written for Sexigesima
Sunday, cites the example of King David, whose people
were punished with plague until he repented for having

called a census:

Ensampull, loo, of Kynge Dauid, bat when he had
greved God for be synne bat he had down, God sent

189

down to hym an angell fro heven and smote with

pestilence many hundreb bousaundes on a day of is

pepull.

(Ross 178.9-12)

Only through prayer and penance was David able to stop
this pestilence. The preacher, using David’s story as an
example of the consequences of sin (2 Sam. 24.1-17; 1
Chron. 21.1-17), reminds his listeners: "Ryght bus
eueryman muste knalage is synne and prey God of mercy
and of is grace" (Ross 178.24-25).

Unlike references to plague as a physicality in
Middle English medical texts, references to plague in
sermons and literary works serve as emblems for a lack
of spiritual governance in an immoral world. On a
literal level, pestilence may be taken as an analogue of
the pain and suffering occurring as a consequence of
sin, which results in widespread suffering and death. As
the physical disorder of plague expresses itself through
fever and buboes arising from humoral imbalance, so the
social disorder caused by plague represents spiritual
disorder arising from imbalance caused by sin.

In Literature as Recreation in the Later Middle
Agaa, Glending Olson argues that "the relationship
between the Black Death and certain literary and social
recreations suggests a potent value to such mundane
joys, and the evidence assembled here [Chapter 5 of

Literature aa Recreation] may help redress the natural

190
tendency to dwell on only the most pessimistic kind of
medieval responses to pestilence" (164). Olson further

argues that, ...the Black Death did not promote only
increased morbidity in literature. Amidst all the work
that reflects the fear of death and that looks to last
things, there is some, at least, that reflects the value
of secular life and that looks to proximate things. For
the living, singing songs and telling pleasant tales are
important means of coping with the plague" (204).
Olson’s study considers largely Continental plague
writing. In Middle English poetry, plague takes on a
consistently grimmer picture, often in an atmosphere of
moral pollution, as this chapter will show. While
Chaucer, Langland, and Lydgate added plague references
to the stories they retold, the references themselves
have analogues in earlier works that appeared long
before the mid-fourteenth century plague.

While the plague itself was seldom a theme in
Middle English poetry, it serves as a background for
several English poems--as it does in some Middle English
sermons--including the disorderly world resulting from
poor governance in Fragment Six of The Canterbury Talaa,
the chaos of the apocalyptic world at the end of Elara
Plowman, and in The Dance of Death, the terror of a
world leveled by the power of death and plague. Plague’s

appearance along with other scourges warns of the

191

dangers of disobedience that disrupts the workings of
God’s cosmology. Since references to plague in
literature often appear with other diseases and
scourges, they are considered with plague in this
chapter. As in Continental plague treatises, plague in
Continental poetry often contain more references to
contemporary plague outbreaks than do English poems.“

Francis Petrarch (AD 1304-74), Chaucer’s
contemporary, survived several outbreaks of plague in
late fourteenth-century Italy, and, in a letter from
Parma in the early summer of 1349, wrote of the
devastation caused by the first outbreak of the disease.
Petrarch expresses a dark view of the state of mankind
in the Epistolae familiaria (esp. 8.290) and in Eclogue
Q. Plague, war, and other collective disasters during
the fourteenth century inclined him to write concerning
the general condition of his world: "0 miseris perplexum
ambagibus orbem" ("Oh, miserable are the perplexities of
this confusing world"). In the Epiatalae familiapia

8.290, in terms not unlike those of Guy de Chauliac and

 

“Edmund Pellegrino explains differences between
the work of literary writers and physicians in these
terms:

Physicians intervene to mitigate or relieve the

physical suffering and mental anguish they

encounter. They discern, classify, and treat
illness. Writers clarify and interpret--thus
identifying meaning in events. They may even
confront the reader with the meaninglessness of the
situation being described.

(qtd. in Joanne Trautmann, Healing Arts ix)

192
other Continental writers, Petrarch described the
contemporary ravages of plague:

Posterity, will you believe what we who lived

through it [i.e. the plague] can hardly accept? We

should think we were dreaming, had we not the
testimony of our opened eyes, encountering on our
city walks only funerals, and on our return finding
our home empty of our dear ones. Thus we learn that
our troubles are real and true. Oh how happy will
be future times, unacquainted with such miseries,
perhaps counting our testimony as fabulous!"
(Trans. Morris Bishop 74)

Reflecting on future generations and their
conception of plague, he suggested that, while the
memory of plague’s terror might remain after the disease
had ended, future readers of these accounts would
consider them "fable."“ In another letter written
during later outbreaks, Petrarch lamented the death of a
friend and his family, which reminded him of the
transience of life: "Oh mortals, strain, strive, and
sweat, range the earth and sea for riches you will not
attain, for glory that will not last" (Letters 75).

Like Petrarch, Boccaccio describes contemporary
outbreaks of plague. In the Decaaeron, Boccaccio details

the ravages of plague and terror of living in plague-

ridden Florence as cause enough for fleeing the city and

 

“Many personal references to plague appear in
Petrarch’s poetry and prose. No doubt, he was deeply
affected by the loss of friends and relatives, among
them his companion Franceschino degli Albizzi, Cardinal
Colonna, for whom he had worked, and Laura, whom he
loved dearly. For a further discussion of his experience
with plague, see Thomas G. Bergin, Petrarch 22-25.

193

telling tales. He describes the effects of plague on
Florence and its inhabitants in the Introduction:

Let me say, then, that thirteen hundred and forty-

eight years had already passed after the fruitful

Incarnation of the Son of God when into the

distinguished city of Florence, more noble than any

other Italian city, there came the deadly

pestilence. It started in the East, either because

of the influence of heavenly bodies or because of

God’s just wrath as punishment to mortals for our

wicked deeds, and it killed an infinite number of

people.

(trans. Muss and Bondanella 4)

As George Deaux explains, "The genuine anguish of
Petrarch’s letter is just as apparent as is the horror
of Boccaccio’s account. In both cases the formal
framework of rhetoric may have been the only thing
available to contain the emotion" (George Deaux, The
Black Death 93). The need to interpret the presence of
plague brings out an important distinction between
literary writers and physicians. Literary writers
interpreted the significance of plague and other
disasters like famine and earthquakes as emblems of the
disastrous effect sin in the framework of traditional
tales. Physicians, on the other hand, observed and wrote
about plague as a physicality in need of physical
remedy.

Medieval literary writers, following biblical
precedent, argued that epidemic diseases like plague

served as warnings of God’s wrath, as a means of forcing

obedience, and even as direct punishment. The high

194
mortality caused by plague encouraged them to see that
what their "auctors" had stressed about the
impermanence of life and the imminence of death was even
truer during pestilential times. Literary writers
commented on the transience of life in a variety of
ways, but most often in the context of other
apocalyptic warnings such as epidemic disease and
famine, common scourges during the late Middle Ages, but
also commonplaces in the writings of their ancient

"auctors."“

l. Fragment Six of the Canterbury Tales

In the Canterbury Tales, the pilgrims entertain
each other with stories on the way to the shrine of St.
Thomas Becket. The stories are to be told, one after
another, in an orderly fashion, with the Host, Harry
Bailly, as moderator. The Host reminds the pilgrims of
their pledge to tell tales along the way, stating "That
ech of yow, to shorte with oure weye, / In this viage
shal telle tales tweye" (QE 791-92), and warning them

that "Whoso be rebel to my juggement / Shal paye for al

 

“Cf. the horsemen of the apocalypse in Revelations,
who bring with them plagues and other scourges which
slay "the third part of men" (Revelations 9).

195
that by the wey is spent" (833-34).“ This orderly
"gaming" is disrupted in Fragment Six, which has as its
theme the struggle between order and disorder. In
Fragment Six, various sins described in the Physician’s
and Pardoner’s Tales are reflected by the tellers
themselves. As a microcosm, the two tales reflect the
pilgrims’ larger world where sins bring about such
scourges as famine and pestilence.

Pestilence in the background of Fragment Six serves
as an emblem for the disorder caused by sin in the two
tales. In the Physician’aalala, pestilence appears in a
gnomic phrase misapplied in a digression on the good
governance of children, but in the Pardoner’s Tale,
plague moves into the foreground as literal event.“ The
Pardoner tells of "a thousand slayn this pestilence,"
and in the tale itself, the large number of plague

fatalities serves as a reason for seeking Death in order

to slay him (675-79).“

 

“Quotations from the Canterbury Talea are from The
Riveraide Chaucer, ed. Larry D. Benson, and, unless
otherwise indicated, from Fragment Six.

“In addition to the use of pestilence in Fragment
Six, Chaucer uses pestilence to mean plague in the
Knight’s Tale (2469), in curses in the Nun’s Priest’s
Tale (3410) and the Wife of Bath’s Tale (1264), and in a
figurative sense in the Merchant’s Tala (1793).

“William E. Rogers argues that the major theme in
Fragment Six is the predominance of evil, "into [an even
more] stifling atmosphere of irremediable evil" (79),
and that governance or the abuse of the gifts of
Fortune, Nature, and grace, suggested by other critics

196

Fragment Six begins with the Phyaician’s Tale, a
moral story which warns that chaos results when wicked
magistrates violate the law, but that such wickedness
could be overcome by righteous living, as shown by the
example of Virginia.“ The evil actions of Judge Apius
arise from his lecherous desires for Virginia. These
desires interfere with a public responsibility which
requires him to maintain order among the people he
serves. He brings false charges against Virginia’s
father, Virginius, so that he can have Virginia for
himself. This situation causes Virginia, at her father’s
bidding, to choose death instead of giving in to the
lecherous demands of this judge. But this, in turn,
leads to more disruption, resulting in the unnatural
act of a father killing his daughter.

When the people in the tale learn of Apius’ crime,
the wicked judge attempts to bring Virginius to trial

and hang him for slaying Virginia:

 

as predominant themes in this fragment, are but
"particular manifestations of the major concern of both
tales--namely the problem of evil" (79).

“Anne Middleton remarks that Chaucer’s version of
the story of "Appius and Virginia" uniquely shifts the
"narrative emphasis and ethical interest [from other
versions of the story in Livy and Jean de Meun] toward
the virgin courage of the daughter, away from the other
two principal characters and their chief moral
attributes: the perversion of justice in Appius and the
stern patrician resolve of the wronged father" ("The
Phyaician’s Tale" 10).

197
And whan the juge it saugh, as seith the storie,
He bad to take hym and anhange hym faste.
(258-59)
But his further abuse of legal power results in further

breakdown of order, and a crowd of a thousand people

takes control (260):

But right anon a thousand peple in thraste
To save the knyght, for routhe and for pitee,
For knowen was the false iniquitee.

(260-62)

The intrusion of a thousand people "in thraste," is yet
another mark of disorder.““ Ironically, justice is
accomplished, at last, not through the legal order, but
at the hands of this angry mob:

For which unto this Apius they gon

And caste hym in a prisoun right anon,

Ther as he slow hymself; and Claudius,
That servant was unto this Apius,

 

““The movement of this crowd has the sense of
"pushing in" (Riverside Chaucer, gloss to 360) or of
"thrusting" (Norman Davis, A Chaucer Gloasary, s.v.,
threste(n).

Concerning the effects of this uprising, Jerome
Mandel remarks:

Virginius’ charity affirms God’s governance of a

frail and fallible world. It supersedes the

reaffirmation of order on the social and political
levels occasioned by the un-Chaucerian rising of
the commons. The 'peple’ create the physical
positions which each character should hold in an
ordered universe: Virginius in control, Apius
jailed and a suicide, Claudius condemned.
("Governance in the Physician’s Tale" 324)
Later in Fragment Six, the Pardoner’s "thousand slayn
this pestilence" (679) provides a faint, but ironic echo

of this lively and unruly crowd, "a thousand peple in
thraste."

198
Was demed for to hange upon a tree.

The remenant were anhanged, moore and lease,
That were consentant of this cursednesse.
(267-71, 275-76)

The lesson in this tale builds on the character of
Virginia, who is, first of all, physically flawless:
"For Nature hath with sovereyn diligence / onrmed hire
in so greet excellence" (9-10). According to the
Physician, Virginia’s disposition reflects the
excellence of her body: "In hire ne lakked no condicioun
/ That is to preyse, as by discrecioun" (41-42). The
Physician’s understanding of the body as a reflection of
Nature’s perfection has an analogue in the teachings of
Galen, whose works the Physician would have known:

Nature has not created matter, but she arranges the

material in a fashion which we cannot improve even

in our thought, and for this we must praise Her and
sing hymns to Her.

(qtd. in Temkin 25)

Galen elaborates on this theme in De usu partium (On the

 

Use of the Parts), where he argues that anatomical
knowledge gained from animal dissection (since human
dissection was rarely permitted) supports the notion
that each part of the body was constructed in the best

possible manner to serve the whole body (Temkin 25n).““

 

““Temkin cites Galen’s De usu partium, 3:10.17, ed.
Georg Helmreich, 1.168ff.

Commenting on Hippocrates’ advice to physicians,
Galen remarks that "the practice of certain physicians
is like playing at the dice, when what turns up may
occasion the greatest mischief to their patients."
Galen, however, informs us that in some of the M88.

199
The physician not only tells a pagan tale, but
interprets the function of Nature with a commentary that
parallels Galenic doctrine, a pagan medical source.
While the Physician believes that the body was created
by Nature, acting as the "vicaire general" of God, "the
formere principal" (19-20; of. Parliaaent of Fowls 379),
he further suggests that Virginia’s virtue reflects her
physical perfection:

No countrefeted termes hadde she

To seme wys, but after hir degree

She spak, and alle hire wordes, moore and lesse,

Sownynge in vertu and in gentilesse.

(51—53)

After an explanation of Nature’s work, the
Physician continues his tale with a digression on the
governance of children, where he employs the term
pestilence:

Of alle tresons sovereyn pestilence

Is whan a wight bitrayseth innocence.

Ye fadres and ye moodres eek also,

Though ye han children, be it oon or mo,

Youre is the charge of al hir surveiaunce,
Whil that they been under youre governaunce.

 

(91-96)““
"instead of 'art’ he found ’nature’; that is to say,
that the physician is 'the minister (pr servant) of
nature’" (trans. Francis Adams, ed. Robert Maynard

Hutchins 47n).

On the concept of Natura in medieval literature,
see C. S. Lewis, The Disaarded Imaga, 34-40; on God as
Divine Physician, see R. Arbesmann, "The Concept of
'Christus Medicus.’"

““C. David Benson summarizes the diversity of
opinions about the "unduly obtrusive" nature of this
digression on the governance of children. Some critics
have suggested that this digression is an allusion to

200
Pestilence in this passage, glossed as "wickedness" in
The Riverside Chaucer (gloss to V1.91), provides a clue
to the character of the Physician. The Physician’s
conclusion to the entire tale, "Forsaketh synne, er
synne yow forsake" (286), warns of the results of sin,
which betrays the sinner, no longer bringing the
pleasures it has. However, this conclusion is
misdirected, for it considers the fate of the wicked
Apius and his accomplices, and not Virginia’s perfect
nature, which enables her to resist lechery and retain
her virginity, which she dies in order to preserve. As
Stephen Barney observes, it would seem more in keeping
with the pathos of the tale if the physician had used
the conclusion to remind his listeners of "the conflict
between evils with which Virginia and her father

7

wrestle,’ and not in a digression.““

 

Chaucer’s sister-in-law, Katherine Swynford, "governess
to the daughters of John of Gaunt and also his mistress
before becoming his third wife" (The Riverside Chaucer
903nn72-104). But Benson argues that "there is no
necessity to seek an actual event behind sentiments that
are quite conventional, however awkwardly introduced"
(nn72-104).

““"An Evaluation" 85. Barney argues further that
the Physician has mistaken the work of Nature for the
purpose of rhetoric:

Nature’s speech is the principal "rhetorical"

ornament of the Physician’s Tala, in medieval

terms, being an extended figure of personification,
and even including classical allusions. The

Physician seems rather proud of it, ending it

plumply with "Thus semeth me that Nature wolde

seye" (29). It contains the terms "countrefete"

(twice), ”colour," and "figures." Nature uses these

201

The struggle between chaos and order, and the
victory of righteousness over evil, especially over the
sin of lechery, are a critical part of the tale and
remind us of the importance of right governance--by
judge, parents, and children. Equally important is
Chaucer’s emphasis on the victory of righteousness over
evil. When control breaks down because of sin, monstrous
events occur, such as a father beheading his daughter.
For a time, evil seems to triumph over goodness until
order is restored by God smiting down the sinner (cf.
278). The connection between good governance and the
"pestilential" consequences of sin, explained in the
Physician’s digression, are changes Chaucer has made in
his retelling of the traditional legend of Appius and
Virginia, which emphasizes Virginia’s ability to
withstand evil because of her perfect nature. In keeping
with the moral theme of the original tale, the Physician
might have made the connection between Apius’ sin and
the pathos of the tale more obvious, but his inability
to do so suggests that he understands the nature of bad

governance in terms that earlier pagan physicians like

 

terms to describe her own work in creating as God’s
"vicaire general" (19), but the terms are

all, as we see, especially rhetorical jargon, a
point which I first noticed because of the close
proximity of the phrase "countrefeted termes" (51)
to describe Virginia’s speech....the Physician
accidentally connects Nature’s skill at shaping
with the skill of an orator, in a passage which is
rhetorically deficient (87).

202
Galen would have endorsed. Thus the Physician’s
mistelling of a tale derived from pagan medical sources
reinforces the words of the narrator in the General
Prologue: the Physician’s study, and therefore his
sources were "but litel on the Bible" (438).

The Physician’s lack of emphasis on the moral
message in the original tale reflects his own moral
insufficiency in the world outside the Ealaa, Chaucer’s
Physician had treated plague, for, as the narrator of
the General Prolagaa states, "He [the Physician] kepte
that he wan in pestilence" (442). The Physician’s love
of gold especially (444), suggests not only financial -
gain during plague time, but his use of gold as a remedy
for plague, perhaps for his wealthier patients.““ The

Physician, probably acquainted with contemporary plague

 

““For gold in phisik is a cordial,
Therefore he lovede gold in special.
(QB 443-44)

Lydgate mentions gold as a treatment for plague in "How
the Plague was Ceased at Rome," although, like other
remedies, it proved ineffective:

Not gold potable, nor pure quintessence,

Not Rue barbarian, nor Alpharic Treacle,

Surmount the power of mighty pestilence

But God [through] his saints doth his miracle

To every person, by grace receptacle

Worshipping this martyr [i.e. St. Sebastian],

he instilleth his grace,
Most sovereign electuary, in all pestilence case.
(McCracken, Minor Poems of John Lydgate 1:159)

Walter C. Curry (Chaucer and the Mediaeval Sciencea),
citing Traill’s discussion in Social England, suggests
that John of Burgundy may have been the model for
Chaucer’s Doctor of Physik (317n5) though others have
suggested John of Gaddesden was Chaucer’s model.

203
treatises and perhaps even with John of Burgundy’s,
applies the metaphor of pestilence to poor child
rearing.““
The use of pestilence in a figurative sense in the
tale, is similar to the words of St. Augustine in this
mid-fifteenth century translation by Capgrave:

be grete lederes of be cristen flok...haue falle be
be pestilens of lecherrye.““

The chaos and deaths in this tale occur not because
Apius has failed to govern children wisely or because
Virginia has been unwisely reared, but because he has
failed to govern his own behavior, allowing the
uncontrollable "pestilence of lechery" to supplant
reason.““ The ability of the young virgin to withstand
the "fals cherl and fals justise," as the Host
describes Apius in the link between the tales in this

fragment, is possible because of her perfect nature,

 

““In the General Prologpa, we learn that
Hippocrates and Galen, who wrote on the treatment of
epidemic disease, are among the authorities the
physician would have known.

““(cl450) Capgrave’s St. Augustine 50.24. MED
pestilence. 2.(b). According to the MED, pestilence can
mean "evil; a sin, mischief, harm," and may be used in
the phrase "pestilence of lecherie,’ to describe the
vice of lechery itself.

 

““In "Governance in the Physician’s Tala, Jerome
Mandel has argued that the tale deals "with the matter
of how to respond to wicked government" (317), and that
at the end of the tale, order is restored. Virginia,
Mandel argues further, "most clearly represents the
theme at the level of the individual" (317).

204
which, like her body, is a divine gift. The emphasis on
Virginia’s perfect nature, added by Chaucer in his
retelling of the story, is muddled by the Physician in
the misplaced conclusion. The Physician presumably would
have studied rhetoric as part of his training, but
Chaucer has him downplay the importance of the pathos of
Virginia and Virginius in a tale which is "rhetorically
deficient" (Barney 87).““ The tale reflects the
Physician’s deficiencies, especially his greed during
disastrous plague times. The Physician’s Tale provokes a
strong reaction first from the Host, and then from the
other pilgrims, who are, as Stephen Barney argues,
"affronted in various ways by the Physician’s literary
failures" (86).

The "Introduction to the Pardoner’s Tala" prepares
the audience for another lesson concerning the
disorderly results of sin. When Harry calls on the
Pardoner to tell a "merie tale" so as to heal his near-
cardinacle, the pilgrims cry for "som moral thyng"
instead. Critics have suggested that the pilgrims fear
that the Pardoner, because of his unseemly character,

will tell a ribald story, consequently offending his

 

““See my article on the double meaning of in terme
in the link between the tales in Fragment Six: "A New
Reading of the Host’s 'In Terme’ (Canterbury Talea VI,
line 311).

205
listeners.““ It is not likely that the "gentils" would
be affronted by ribald tales at this point in the
pilgrimage as they have heard others and have, at least
ostensibly, enjoyed them.“0 Instead, they cry for "som
moral thyng." The Physician’s tale is a moral one,
though badly told, yet it is not clear that the pilgrims
see the moral purpose of the tale as lucidly as Harry
thinks he has. The Pardoner agrees to tell a moral tale,
though he must first "'thynke / Upon som honest thyng
while that I drynke’" (327b-28).

The Pardoner plays on the confusion created in the
Physician’s Tale by telling an carefully ordered tale
(cf. Owst, Preaching 99ff.). The Pardoner’s prologue and
tale are deceptively orderly, under rhetorical control,
when compared to the Physician’s Tale. Even the
Pardoner’s theme is clearly moral: "Greed is the root of
(all) evils" ("radix palorup est capiditaa" 334, 426; 1

Tim. 6.10). The moral of the tale is shown through the

 

““For a description of the Pardoner, see
QE 669-714. Peter G. Beidler argues elsewhere that the
Pardoner’s physiognomy corresponds to his moral
insufficiencies ("The Plague" esp. 263-64), which arouse
the suspicions of the other pilgrims.

““The narrator remarks on the pilgrims’ enjoyment
of ribald tales in the prologue to the Reeve’s Tale:

Whan folk hadde laughen at this nyce cas

Of Absolon and hende Nicholas,

Diverse folk diversely they seyde,

But for the moore part they loughe and pleyde.

Ne at this tale I saugh no man hym greve,

But it were oonly Osewold the Reve.

(3855—60)

206
Pardoner’s own greed. He rashly admits that he preaches
solely for financial gain:

Of avarice and of swich cursednesse

is al my prechyng, for to make hem free

To yeven hir pens, and namely unto me.

(VI.400-02)

In the tale itself, death and plague form a dark
background, serving as emblems for the Pardoner's own
material sins, thought to be the immoral causes of
plague. Though the Pardoner’s words are rhetorically
ordered, his actions reveal his disregard for
established order. He is a false preacher, which he
admits, and a rioter himself, considering his knowledge
of wines:

Now kepe yow fro the white and fro the rede,

And namely fro the white wyn of Lepe

That is to selle in Fysshstrete or in Chepe.

This wyn of Spaigne crepeth subtilly...

(562-65)
The Pardoner claims to have a "joly wenche in every
toun" (453, 448-53, but cf. QE 691-93). He is guilty of
avarice, gluttony, and lechery, which he perpetuates
through the artful use of language. It is not surprising
that a reference to plague appears in a tale told by one

who is so spiritually deficient, as plague itself was

traditionally thought to be caused by the very sins the

207

Pardoner commits. It is surprising that he has survived
the plague himself.““

In the tale of the rioters, the plague serves as a
grim reminder of the penalties of sin:

Thise riotoures thre of whiche I telle,

Longe erst er prime rong of any belle,

Were set hem in a taverne to drynke,

And as they say, they herde a belle clynke

Biforn a cors, was caried to his grave.

(661-65)

The man being carried to his grave, a friend of the
rioters, has died during a recent siege of pestilence:

Ther cam a privee theef men clepeth Deeth,

That in this contree al the peple sleeth,

And with his spere he smoot his herte atwo,

And wente his wey withouten wordes mo.

He hath a thousand slayn this pestilence.

(675-79)

After mentioning the incident of the passing corpse, the
Pardoner moves directly into the turning point of the
tale, where the rioters leave the tavern, vowing to

"sleen this false traytour Deeth," adding that, "He shal

be slayn, he that so manye sleeth" (699-701).““ The

 

““He would have been familiar with plague as he was
employed by the Church of Mary Ronceville at Charing
Cross, especially hard hit by plague in the mid-
fourteenth century (Galloway, The Hospital 24).

““Their decision to slay death eventually leads
them to the pile of gold under the tree, and there, as
the narrator explains: "No lenger thanne after Deeth
they soughte" (722). Charles A. Owen, Jr. reflects on
the importance of this line in these terms:

The gold has both a sobering and deflating effect.

It brings them back to the real world from their

illusions of brotherhood and of slaying Death. Yet

208

Pardoner’s digressions on the sins of avarice and
gluttony in the prologue serve as a gloss on the
actions of the rioters later in the tale as much as they
serve as a microcosm of his own immoral activities. The
rioters’ disorderly living makes them careless and
unconcerned with Death’s warning, and even with the
great force of "this pestilence" which carries off "a
thousand" in one outbreak alone. Commenting on the death
of their friend, "an old felawe of youres" (672), whose
corpse has just been carried by, one of the rioters
asks: "Is it swich peril with hym for to meete?" (693).

Like the rioters, who lack moral governance, the .
Pardoner violates the rules his fellow pilgrims have
agreed upon when he disrupts the game in a pitch for
pardons at the end of his tale. The Pardoner’s words to
Harry, "Unbokele anon thy purs" (945), result in
Harry’s angry outburst: "it shal nat be, so theech!"
(947). Harry’s anger builds further, until he hurls a
final invective at the Pardoner:

I wolde I hadde thy coillons in myn hond

In stide of relikes or of seintuarie

Let kutte hem of, I wol thee helpe hem carie;

They shul be shryned in a hogges toord!
(952-55)

 

their drunken intentions were closer to the final
outcome than their sober planning and counter-
planning to secure the treasure.

(Discuasiona of the Canterbury Tales 85)

209
The Knight, as a representative of order, must intervene
to re-establish harmony between Harry, host and
appointed judge of the game, and the Pardoner.““

As Siegfried Wenzel argues, the Pardoner’s
character is more noticeable than the moral of the tale
itself:

Beyond this story itself, the entire Pardoner’s

Prologue and Tale deals explicitly with the sin of

avarice, and no matter how modern readers may

evaluate Chaucer’s attitude towards the Pardoner,
it is clearly the Pardoner’s character, his moral
identity, that occupies the center of the poet’s
attention.

("Pestilence and Middle English Literature" 152)

The lesson learned from a tale like the Pardoner’s
could be useful in edifying the soul.““ The tale warns
against the dangers of cupidity and the tavern vices. As
plague threatens the rioters, so their sins result in an
atmosphere of moral pollution. But the Pardoner’s artful
use of language and his evil nature become so
intriguing that the warnings of plague and death seem

scarcely noticeable. The Pardoner successfully turns the

horrors of life into entertainment in order to deceive

 

““In the Knight’s Tala itself, Saturn the cold
finds "in his olde experience an art / ...[and] remedie"
against strife (2438-46, 2452). Furthermore, he controls
the cold maladies, warning that "my lookyng is the fader
of pestilence" (2469). Thus, in the Knight’s Tale,
pestilence is mentioned in the context of strife in much
the same way as it is in the Pardoner’s Tale.

““Like Lydgate’s A Dietary and Doctrine for the
Pestilence, the Eardoner’s Tale provides moral advice
for preventing disease.

210
the pilgrims for his own advantage. He knows that when
they have forgotten the moral purpose of his story
telling, their delight with the fabulous will make them
vulnerable, and likely to give up their money, yet they
and their spokesman aren’t actually fooled, though
there is a near breakdown of order.

Chaucer’s Physician and Pardoner tell their stories
to win a prize and, in the case of the Pardoner’s Tale,
especially to satisfy the pilgrims’ request for a moral
tale. However, the Physician tells a moral story with
the wrong conclusion in a tale that is rhetorically
deficient. Conversely, the Pardoner tells an artful
tale, using rhetoric elegantly, but misapplies it for
personal gain. Both tales aptly demonstrate the chaotic
effects of sin, for which the plague, alluded to in the
Physician’s Tale and explicitly mentioned in the

Pardoner’s Tale, serves as a warning. The immoral

 

activities of the rioters and the immoral desires of
Apius serve as microcosms of the Pardoner and
Physician’s immoral worlds outside the two tales in this

fragment.

2. Piera Plowman, B-text

References to plague in Piers Plowman appear more

frequently than in the Canterbury Talea, and on several

211
levels. First, passages referring to plague may express
contemporary medical views, which argued that the same
pestilential air that caused plague also caused certain
physical abnormalities in the offspring of survivors.
Second, plague references warn of the consequences of
sin. Third, in the concluding, apocalyptic Passus 20,
plague serves as an emblem of the chaos resulting from
that sin.

In the Prologue, the Dreamer learns that parish
priests have complained to their bishop that since the
plague, their parishes cannot support them. So they ask
permission to live in London where they might earn more
money singing masses:

Persons and parisshe preestes pleyned hem to the

bisshop

That hire parisshes weren povere sith the

pestilence tyme,

To have a licence and leve at London to dwelle,

And syngen ther for symonie, for silver is swete.

(Prol. 83-86)““
This passage expresses a familiar complaint of

Langland’s day, when priests were accused of abandoning

their parishes during plague for fear of catching the

 

““Unless otherwise noted, quotations from Piers
Plowman are from the Kane and Donaldson edition of the
B-text.

J. F. Goodridge explains the literal meaning of
this passage: to sing for simony, "i.e., the money
received for singing Masses for the Dead in the
chantries or side-chapels of St. Paul’s and elsewhere"
allows them to chime their voices to the sweet jingling
of silver (263n10). Cf. General Prologue to the
Qapterbury Tales 507-11.

212

disease, and afterwards, for lack of income. The
depopulation of parishes during plague outbreaks has
been well documented, and is used by Langland to
emphasize the notion that simony threatens to replace
true charity--even in the priesthood.““

In Passus 5, the Dreamer learns more about the
plague when Reason explains its ultimate cause:

For I seigh the feld ful of folk that I before of

seide,

And how Reson gan arayen hym al the resume to
preche,

He preved that thise pestilences were for pure
synne,

And the south-westrene wynd on Saterday at even
Was pertliche for pride and for no point ellis.
(V.11-15)

Reason’s sermon on the Seven Deadly Sins in this
passus stresses the connection between sin and
disease.““ Disobedience leads the sinner away from God
and closer to the kingdom of Antichrist. In his sermon,
Reason also alludes to particular, or near causes of
plague: a storm which occurred on January 15, 1362, St.

Maur’s Day, and lasted for five days, considered by

contemporary preachers as a warning from God (Schmidt

 

““Concerning the regular clergy, Aiden Gasquet’s
The Black Death argues that plague caused a decline in
monastic life, due to the severe depopulation of the
monasteries.

““A. V. C. Schmidt explains: "Langland agrees with
Brunton, Bromyard and other contemporary [sermon]
writers in seeing the plague and other disasters as

divine punishment for sin" (The Vialpn of Piers Plowman
315n13).

213

315n14). Contemporary medical accounts also explain that
southerly winds carried plague miasmas, and earlier
medical treatises like the Isagoge state that certain
weather conditions could result in disease.““ The plague
treatise written by Bengt Knutsson also mentions foul
weather and a southerly wind as a particular and near
cause of plague:

First I sayde the tokenes of this infirmite Vii

thynges ought to be noted in the same. The first is

Whan in a sommers daye the Weder often times

chaungeth, as in the morning the Wedyr appereth to

rayne, after Ward it apperith cloudy & atte last

Wyndy in the south.

(Vine, ed. 2')”

As Reason warns later in his sermon, it might be
tempting to spoil the few children who survived the
plague, so parents must guard against doing this:

And thanne he chargede chapmen to chastisen hir

children:
Late no wynnyng forwanye hem while thei be yonge,

 

““For a discussion of the Isagoge and the other
medical treatises discussed in conjunction with

Langland’s interpretation of plague, see Chapter Two of
this study (57-61).

““See Chapter Three (88-94) for a more extensive
discussion of the contents of Knutsson’s treatise.

In a digression on planetary influences in the
Liber Uricrisiarum (235-65), a general medical treatise
in Middle English discussed earlier in this study (120-
23), the author explains that Saturn, when in the
constellations of Capricorn or Aquarius, "causys mykyll
water & mony flodys, of whylk comes derthes & hungyr and
pestilence of folk & best, & hate & wrath & wykked
levynge, & it febles be chyld in be modyrs wamb. And 3if
it have mykyll my3t bereon, it scleis be chyld in be
modyrs wame" (253.3069-72).

214
Ne for no poustee of pestilence plese hem noght out
of reson.
(V.34-36)
Reason explains that pride is the principal cause of the
pestilence which comes by a southerly wind at Nature’s
bidding. Survivors may prevent plague through confession
and obedience, and by the good governance of children.
People begin living morally, and are set to work by
Piers (Passus 6), but the situation quickly changes, and
they fall into sin again. Hunger and famine are then
sent to chastise those who refuse to work.
Later, Wit lectures the dreamer on marriage, noting
that since the plague time, marriages of couples of .
widely differing ages have produced only foul words and

their only children, strife and nagging:

In jelousie joyelees and janglynge on bedde,
Many a peire sithen the pestilence han plight hem

togideres.

The fruyt that thei brynge forth arn [manye] foule
wordes;

Have thei no children but cheeste and chopples] hem
bitwene.

(IX.166-69)
The advice given by Wit parallels the explanation of
plague given in the Liber Uricrisiarum and other medical
works warning of the physical consequences of plague.
Both Reason (Passus 5) and Wit (Passus 9) explain the
physical results of plague, stating further that the
risks to the soul were even greater, with sin, and

especially the sin of pride as the major cause of this

215
epidemic and other widespread scourges (e.g., storms,
hunger and famine).

Reason’s sermon and Wit’s explanation of the
consequences of plague with regard to fruitless
marriages also parallel explanations concerning the
aftereffects of plague in contemporary sermons which
contain, G. R. Owst explains, "the exepplua terribile"
(Preaching 207). Summarizing and quoting extensively
from a sermon delivered during the plague by Bishop
Brunton (scil. Brinton, MS. Harl. 3760, f. 191), Owst
notes that the sermon opens with an invective against
those who attribute plague to planets and constellations
rather than to the collective sins of the nation
(206).““ Brunton compares contemporary outbreaks of
plague with those in the days of Noah, in which God
"stretched and made ready his bow," (qtd. in Owst 207).
He reminds his listeners of the seriousness of
immorality.

Like Wit, Brunton, warns that the effects of plague
may extend even to children and other innocent people,
punished not for their own wrongdoing, but as a token of

a parent’s or neighbor’s sin:

 

““"...illi qui talia ascribunt certis planetis et
constellationibus" (qtd. in Owst, Preaching 206).
Brinton’s sermons have been edited by Sister
Mary Aquinas Devlin; see "Sermon 70" 322-26, esp.
322-23. Owst’s translation of references to plague
in Brinton’s "Sermon 70" appears below.

216

But you say, ’If sin was the occasion of the
aforesaid [i.e., plague], by the just judgement of
God the notorious sinners should perish, not
children, or the just who have not sinned in this
way!’ I make reply and say that the children are
dying not for their own sins, but for those of
their parents....The little ones would have wished
to follow in their steps, after all; and in truth
God does them no wrong, when death may be the way
out from the prison-house...0r let us say that God
punishes the innocent that he may chastise us who
are the worst, and the offenders [nocentes]. For in
the manner of the bowman, God who "hath stretched
and made ready his bow" sometimes shoots the arrow
of death beyond the mark, that is, in striking the
sinner, whether father or mother, or some older
person, sometimes "on the near side of the mark,"
by smiting son or daughter or someone younger,
sometimes on the left side, by smiting their
neighbours, sometimes upon the right side by
smiting brother or sister. But at length he hits
the mark itself, when he carries off the sinner
asleep in sin, from the midst, by awful death.
(qtd. in Owst Preaching 207)

Brunton concludes that confession is the only remedy for
this scourge. His explanation, like Reason’s sermon,
warns against attributing plague only to atmospheric
conditions. While planets and winds may bring this
disease to earth, the force of God lies behind them.

As his pilgrimage continues, the Dreamer learns
more about salvation, and, incidentally, more about
plague through allusions to this disease, a biblical
commonplace occurring in the context of widespread and
persistent sin. In Passus 10, Dame Study reproaches her
husband, Wit, for trying to teach this ignorant Dreamer,
whom, she claims, only wants to impress others with his

new-found knowledge. She warns of the dangers of pride,

217
explaining that plague is one result of it. However,
Study also argues that not only in the religious orders,
but among rich and poor, pride and greed have grown to
such proportions that prayers are ineffective remedies
against pestilence:

so is pride woxen

In religion and in al the reme amonges riche and
povere

That preieres have no power thise pestilences to
lette.

For God is deef nowadayes and deyneth noght his
eres to opene,

That girles for hire giltes he forgrynt hem alle.

And yet the wrecches of this world is noon ywar by
oother,

Ne for drede of the deeth withdrawe noght hir
pride,

Ne beth plentevouse to the povere as pure charite
wolde,

But in gaynesse and glotonye forglutten hir good
hemselve,

And breketh noght to the beggere as the Book
techeth...

(X.75b-83)

Dame Study mentions other sins responsible for plague:
the idleness of "gaynesse and glotonye" become more
important than active works of charity such as giving
bread to the poor. In this passage, pride and cupidity
are associated with plague, and obedience and confession
are again thought the best way of appeasing God’s wrath.
Dame Study’s reference to "the Book" reminds us that
scourges come as punishment for sin, as they had to the
Philistines in the biblical account of plague.

In Passus 13, Haukyn, the Active Man, explains that

he is the enemy of idleness, providing waferbread for

218
all honest workers (XIII.238-40). He claims to give
bread to all who are in need, to beggars and Pope alike,
though he receives no reward, even from the Pope. Using
the imagery of plague salves as an emblem for spiritual
healing, Haukyn says that, if he had a clerk, he would
ask the Pope for a pestilence salve:
Hadde ich a clerc that couthe write I wolde caste
hym a bille
That he sente me under his seel a salve for the
pestilence,
And that his blessynge and hise bulles bocches
myghte destruye.
(XIII.247-49)
The Pope’s pardon "mighte lechen [heal] a man," Haukyn
claims, "for sith he [the Pope] hath the power that
Peter hadde, he hath the pot with the salve" (XIII.253-
54). But like ineffective remedies for plague, the
Pope’s remedies for sin are useless among prideful
people who, like Haukyn, feign charity and humility, and
continue to sin (XIII.255-59). While Haukyn’s words and
intentions seem generous, as Conscience reminds him, his
coat is stained with "moles [spots] and spottes" of sin

(XIII.313-14). Haukyn confesses that he has besmirched

his coat of baptism with the Seven Deadly sins.““

 

““John A. Alford emends "moste" to "myste" in
XIII.314, adding further plague imagery to this passus,
as plague was thought to be caused by foul air, which,
in the figurative terms of this passus stains the soul
with sin. Consequently, the plague mist staining the
coat prevents Haukyn from being healed by the Pope’s
salve (i.e., pardon) until he has washed it (i.e.,
confessed and done penance for his sin).

219
The imagery of healing, used in a literal and
figurative sense, appears in later passus in Elapa as in
Passus 16, where Christ learns the practice of medicine
from Piers Plowman:

And [Piers] lered hym lechecraft, his lif for to
save,

That though he were wounded with his enemy, to
warisshen hymselve;

And dide hym assaie his surgenrie on hem that sike
were,

Til he was parfit praktisour, if any peril file;

And soughte out the sike and synfulle bothe,

And salvede sike and synfulle, bothe blynde and
crokede,

And commune wommen convertede [to goode]:
Non est aania opus medicus, set male
habentibus.

(XVI.104-1108)

Using the biblical story of the Good Samaritan, the poet
again employs physical healing as a metaphor for
spiritual healing in Passus 17, where the man beaten by
thieves is healed by the Samaritan’s salve of charity

(XVII.65-81):

May no medicyne under molde the man to heele
brynge--

Neither Feith ne fyn Hope, so festred be hise
woundes,

Withouten the blood of a barn born of a mayde.

And be he bathed in that blood, baptised as it
were,

 

In the C-Text, Langland moves the description of
Haukyn’s lechery to Patience’s discussion of Lechery in
Passus 5. Haukyn is described in the B-text as
prideful, his coat stained with the foul mists of sin.
The addition of a description of his lecherous behavior
corresponds to contemporary emphasis on material sins,
especially, as a cause of plague. Cf. Alford, "Haukyn’s
Cost," for an explanation of biblical and patristic
sources for the coat and Haukyn’s role in the poem.

220

And thanne plastred with penaunce and passion of

that baby,

He sholde stonde and steppe...

(XVII.93-98b)
References to healing in Passus 16 and 17 contrast with
the ineffective salves Friar False Flattery brings into
Holy Church later in the poem in Passus 20.

Will’s last dream in Passus 20 is a partial vision
of the coming of Antichrist. In this dream, during the
assault on the Barn of Unity, Holy Church summons Nature
for help in bringing people to defend Unity. Nature
responds by sending Old Age, Death, and pestilence along
with other ailments against the enemies of Holy Church.

Kynde cam after hym, with many kene scores, 1

As pokkes and pestilences--and muche peple shente;

So Kynde thorugh corrupcione kilde ful manye.

(XX.97-99)
Even the learned physician cannot help against the
scourges, falling prey to palsy himself (XX.175-179).
Yet unlike the sinister plague that forms a dark setting
in Chaucer’s Pardoner’s Tale, pestilence in the last
Passus of Piers Plowman works as the servant of Nature
in forcing repentance. The plague becomes an instrument
that God uses to purify sinners. It arrives in response
to Antichrist. Here, as elsewhere in Elara, Langland
draws on a biblical commonplace: God’s use of physical
disease as punishment for disobedience:

But the nation and kingdom that will not serve

Nabuchodonosor king of Babylon, and whosoever will

not bend his neck under the yoke of the king of
Babylon: I will visit upon that nation with the

221
sword, and with famine, and with pestilence, saith,
the Lord: till I consume them by his hand.
(Jer. 27.8; of. 14.12, 24.10)

As with the famines of Passus 6, after "pokkes and
pestilences," people obey, but like the Children of
Israel, they are soon disobedient. Lechery comes as the
first sin after plague as Fortune flatters the
survivors:

Fortune gan flatere thanne tho fewe that were

alyve,

And bihighte hem long lif--and lecherie he sente

Amonges alle manere men, wedded and unwedded,

And gaderede a greet hoost al agayn Conscience.

(XX.110-13)

Conscience sends for a doctor skilled in healing
the soul through confession, but this Doctor named
Shrift:

...shoop sharp salve, and made men do penaunce-

For hire mysdedes that thei wroght hadde,

And that Piers [pardon] were ypayed, redde quod

debes.

(XX.307-09)

But penance is too harsh and people begin to ask if
there is some physician who "softer could plaster." Sir
Leef-to-lyve-in-lecherie ("Love-to-live-in-lechery") is
particulary miserable from the sharp plasters of penance
given by the physician--"he lay there and gronede"
(XX.312). Contrition explains the situation to
Conscience:

There is a surgien in this sege that softe kan

handle,

And moore of phisik bi fer and fairer he plastreth-
Oon Frere Flaterere, is phisicien and surgien.

222
(XX.314-16)

So Conscience, acting on advice contrary to the
teaching of the Church, mistakenly admits this false
physician-friar into Holy Church. The Friar’s salves
make penance so easy that people fall into a stupor,
unable to withstand the power of Antichrist. Instead of
healing ailing souls, the friar’s remedies only make sin
easier:

The frere with his phisyk this folk hath

enchaunted,

And plastred hem so esily [that hii] drede no

synne!

(XX.379-80)
Conscience warns that a parish priest, a confessor, or
bishop would be the best choice of physicians for
curing sin. However, the treatment Friar Flatterer
prescribes for the patient dying of lechery and gluttony
is painless, unlike confession and repentance.

The connection between disease and sin becomes
stronger in this passus when the friar’s companion
introduces the false physician to Peace as "Sire
Penetrans-domos" (XX.341). This reminds Peace of a
physician he once knew who "salved so cure wommen til
some were with childe" (XX.348). Finally, at the end of
the passus, Conscience leaves in search of Piers the
Plowman and the poem ends (XX.381-87).

Though they persist in the popular tradition,

medical recipes proved useless against catastrophic

223
disease, providing Langland with a useful emblem for
false penance, described as salves for the ailing soul,
administered by a false flatterer. Traditionally,
physicians and clergy were charged with the task of
healing disease: the physicians with the cure of bodily
ailments, and the clergy with the cure of the diseases
of the soul. But like so many physical remedies, Friar
Flatterer’s remedies for sin do nothing to heal the

diseased soul.

3. The Dance of Death

Plague’s indiscriminate attack on all of society
during the late Middle Ages made the Church’s claim that
all were equal in the sight of God seem unquestionably
true (Tristram, Figures 8). Thus, it is not surprising
that popular interest in the dramatic presentation of
the Dance of Death, which portrays the levelling of all
sinners, increased after the Black Death. This increased
interest may not have directly resulted from the plague,
but must have been at least partially influenced by the
sheer numbers of dead during plague times. Scholars
believe that plague brought about certain changes in

mural painting and tomb sculpture.““ These, in turn,

 

““See Raymond Crawfurd’s Plague and Pestilence in
Literature and Art; Philippa Tristram’s Figuraa of Life
and Death.

224
were seen by writers like Lydgate, who translated the

Dance of Death from French into English in 1424, the

 

theme of which is the power of death over all people,
regardless of their social standing or piety. "Most
written accounts of plague," René Girard observes,
"insist monotonously on this leveling of differences"
("The Plague" 834). During outbreaks of plague, death
was ever present and grotesque, much as it is portrayed

in the Dance of Death, or Dance Macabre.

 

The Dance of Death as a dramatic poem has as its
source church murals depicting, with appropriate moral

verses, the Dance Macabre in the late fourteenth

 

century. Later, printed editions of these verses

emphasized the inevitability of death (Warren, The Dance

 

of Death ix-x). The idea of the Dance was most popular
during the fifteenth century, especially in France, with
the earliest literary version at Linngenthal, Little
Basel, in 1312 (Warren x). The origin of this dance
motif is obscure, although it was likely first invented
in Latin by an ecclesiastic (Warren xv), perhaps in a
sermon on the theme of death’s warning (G. R. Owst,
Preaching in Medieval England 340).““ In England, its

best-known representation is Lydgate’s Dance of Death,

 

““Philippa Tristram remarks that the theme of the
animate dead was a popular one in medieval sermons,
which could include general references to the abstract
figure of death (Eigures of Life and Death 161).

225
preserved in twelve manuscripts, in one printed version
(Guyot Marchand in 1488), and in one published version
from Tottel’s press (1544) (Warren xxiv).““

In all versions, the subject of the Dance of Death

 

is the inevitability of death. Like the Dance, the poem
has a dramatic quality--"more the character of a
procession than a dance" (Warren x). Death leads all
dancers, from Pope to peasant, as unwilling captives,
and accuses each of certain sins, warning that the time
has come to join him. Each character responds
individually to Death’s speech, often indicating great
fear of death and remorse at having wasted life on the
pleasures of sin rather than with preparations for
eternal life. The number and names of characters vary
from manuscript to manuscript, but most versions have
characters representing the nobility (e.g., Emperor,
King, Baron, Knight, Lady of Great Estate), the clergy
(e.g., Pope, Cardinal, Archbishop, Bishop, Abbot and
Abbess, Parson), commoners (e.g., Poor Man, Minstrel,
Laborer, Merchant, Child), and characters representing

the professions: Man of Law and Physician.

 

““The term Dance Macabre is synonymous with the
French Danse des Morts and the German Totentanz and is
used to describe certain mural paintings with
appropriate moral verses warning of the power of death
(Warren, The Dance of Death ix n1).

Warnings of the Three Ages appear as motifs derived
from the Legend or the Dance and the abstract
personification of Death itself. It is difficult to
distinguish among them (Tristram, Figures 167).

226

References to plague appear in Lydgate’s version of
the Dance of Death, which he translated shortly after
visiting Paris where he observed murals depicting the
Danse Macabre and their accompanying verses.““
He refers to plague in the translator’s preface, and
later, in the dialogue between Death and the Physician.
Death calls the Physician, describing, as he does,
contemporary medical practice in a portrait very much
like Chaucer’s physician—portrait in the Canterbury
Tales, and similar to the representation of ineffective
medicine drawn in Passus 20 of Piers Plowman:

Maister of phisik / whiche on 3owre vryne

So loke and gase / & stare a-3enne the sunne

For al Bowre crafte / & studie of medicyne

Al the practik / & science that 3e cunne

30wre lyues cours / so ferforthe ys I-runne

A3eyne my myght / 30wre crafte mai not endure

For al the golde / that 3e ther-bi haue wonne

Good leche is he / that can hym self recure.
(Warren, ed. 53-54)““

 

““Charles F. Mullett submits that the "the
pestilence excited more varied attention from Lydgate
than any other ailment. Indeed it alone received
specific treatment, for [besides his Dietary and
Doctrine for the Pestilence and Secrees of Old
Philosoffres], it inspired his translation of The Dance
of Death, the historical poem, 'How the Plague was
ceased in Rome,’ and several prayers" ("John Lydgate"
408).

For a discussion of Lydgate’s Dietary and Doctrine
for the Pestilence and Secrees, see Chapter Four (159-
63, 164-71).

 

 

 

““QE 411-44. There are further connections between
the Canterbury Tales and Lydgate’s version of the Dance
of Death in that both appear in the Ellesmere MS. Cf.
Piers Plowaaa B.XX.165-79.

227
The Physician, helpless against the power of Death,
recalls his own helplessness against the power of
plague:

Ful longe a-gon / that I vn-to phesike

Sette my witte / and my diligence

In speculatif / & also in practike

To gete a name / thurgh myn excellence

To fynde cute / a-3ens pestilence

Preseruatifes / to staunche hit & to fyne

But I dar saie / shortli in sentence

A-3ens dethe / is worth no medicyne.

(Warren, ed. 54)

Before he carries off the dancers, Death reminds
each of his or her sins, and in some cases, not without
a struggle. The Usurer must give up his gold, the Noble
Woman, her fine clothes and possessions. The Knight even
attempts to battle with Death, for in life, he was
especially fond of the glories of war. The Physician
must confront his medical failures, perhaps his
greatest: restoring the health of plague sufferers,
though he tried "thurgh myn excellence / To fynde oute
a-3ens pestilence / Preseruatifes to staunche hit & to
fyne" (428b-29a). Now, however, even the most powerful
medicine cannot prevent his own death. In the poem,
only the Hermit welcomes Death, and with the least
amount of fear (Tristram, Figures 170) because he has
spent life preparing for this moment.

In his translation of the Physician’s encounter

with Death, Lydgate suitably incorporates plague

references which serve as a reminder that physical

228
medicine was not sufficient during plague. By doing so,
Lydgate connects this section of the poem with the
preface, where he has also added a reference to plague:

O 3ee folkes / harde herted as a stone

Which to the world / haue al your aduertence

Like as hit sholde / laste euere in oone

Where ys 3oure witte / where ya 30ure prouidence

To see a-forne the sodeyne / vyolence

Of cruel dethe / that ben so wyse and sage

Whiche sleeth allas / by stroke of pestilence

Bothe Bonge and olde / of low and hie parage.
(Warren, ed. 2)

The phrase "Stroke of pestilence,’ often applied to
plague itself, serves as a reminder of Death’s power
over young and old, noble and commoner.““ But in this
passage, we are also reminded of the moral circumstances
in which plague occurs--to those "harde herted as a
stone," a biblical commonplace adopted by English
literary writers almost to a tedious degree. The
narrator gives a final deposition concerning the

transitory nature of life:

Man is nowght elles / platli for to thenke
But as a wynde / whiche is trasitorie
Passyng ay forthe / whether he wake or wynke
Towarde this daunce / haue this yn memorie
Remembrlingle ay / ther is [no] bette victory
In this life here / than fle synne atte leste
Than shul 3e reigne / yn Paradyse with glorie
Happi is he / that maketh yn heuene his feste.
(641-48)

 

““Elsewhere in his poetry, Lydgate employed
pestilence in various figurative descriptions: "plague

of pestilence," "ghostly pestilence," "sword of
pestilence," "stroke of pestilence," and "eternal
pestilence," especially in prayers he composed to the

Virgin (qtd. in Mullett "John Lydgate" 410-13).

229
The advice to the living, "fle synne atte leste" (646)
echoes the Physician’s concluding words in Chaucer’s

Physician’s Tale: "Forsaketh synne, er synne yow

forsake" (286).

4. Conclusion: The Literary Interpretation of Plague

The agony of death caused by plague has been
described by both physicians and poets alike, but, as
Raymond Crawfurd believes, "While plague was an affair
of the body for physicians, for literary writers, it was
an affair of the mind" (The Plague 1). On a literal
level, plague was immeasurably horrible, according to
contemporary chroniclers who reported on the spread of
this disease and its destruction. But these vivid
descriptions of contemporary events appear more often in

Continental writing than in English literary works.““

 

““One such chronicler, Robert ongvesbury,
describes the plague as it reached the coast of England
in 1348:

It began in England in the neighborhood of

Dorchester, about the East of St. Peter ad

Vinculas...immediately spreading rapidly from

place to place....Many persons who were healthy in

the early morning, before midday were snatched from
human affairs. It permitted none whom it marked
down to live more than three of four days, without
choice of persons, save only in the case of a few
rich people. On the same day of their death, the
bodies of twenty, forty, sixty and many times more
persons were delivered to the church’s burial in
the same pit.
(Trans. Roger Hart, English Life 84-85)
This passage is typical of others which describe plague

230

Most references to plague in English literary works
derive from earlier medical and religious sources and
not from contemporary experience with the disease. Even
Langland’s references to a Saturday wind carrying
plague, which appears to describe a contemporary storm,
is analogous to descriptions of plague-bearing winds in
the writings of Hippocrates who, like other ancient
physicians, attributed plague to south western winds.““

In fourteenth-century English poetry, plague
references are often placed in the context of moral
tales where they serve as an emblem of disorder, an
archetypal horror experienced by rebellious humans.
English writers like Langland see the plague as another
event in a series of apocalyptical warnings. After the
fourteenth century, writers of belles lettres continued

to use the metaphor of plague in this way, long after

 

rather than interpret its presence. Interpretations of
plague are more common in didactic works and belles
lettres.

““See Chapter Two, n1.

Avicenna also mentions the connection between foul
air and pestilence: "Very often, too, the air itself is
the seat of the beginning of the decomposition changes--
either because it is contaminated by adjoining impure
air, or by some 'celestial’ agent of a quality at
present unknown to man" (A Treatise on the Canon of
Medicine 445).

231
the physical threat of the disease had ceased, but while
it was still vivid in memory.“°

Whether or not future generations would see the
plague as an historical event was of less concern to
literary writers. Their main concern was with moral
values, and with elaborating on and interpreting the
moral stories they had learned from previous "auctors."
R. W. V. Elliott explains the importance of the past for
literary writers like Chaucer:

The Middle Ages placed no great premium upon

invention of plot; what mattered was rather the

manner of the telling than originality of the tale,
so that Chaucer was by no means alone in turning to
new use what he found in his books.

("Chaucer’s Reading" 51)

The truth of fables was to be found in their
immutable moral value, even during crises, and not in
their accurate rendering of life’s events. As Petrarch
had assumed, even when the physical threat of plague had
gone, future generations would read accounts of the
disease as though they were stories, and not real
events. Yet Petrarch also predicts, and quite

accurately, that the memory of plague’s horror would

remain with future generations. While the disease itself

 

““See, for instance, references to plague in
Albert Camus’ The Plague, written during the mid-
twentieth century, where plague serves as metaphor for
political tyranny.

232
might be forgotten, in time, it would be generally
associated with human misery and evil times.

The three major literary works considered in this
chapter contain warnings for those who would abuse the
body through sin, as the body is a microcosm of God’s
orderly universe. Violations of this divine scheme occur
in the Physician’s misuse of rhetoric and the actions of

characters in his "pitous tale,’ and in the Pardoner’s
abuse of rhetoric and the actions of the rioters in his
tale. Violations also occur in the words and actions of
the "field of folk" in Eaara, who repeatedly turn from
sin to obedience and then back to sin. In the Dance of
DaapM, Death interrupts the procession as he calls on
each chorisant. Each, in turn, must account for his or
her sins before being led from this life.

These poems include characters who ignore the
imminence of death even during such obvious warnings as
plague. In Fragment Six of the Canterbury Tales, plague
is associated with the sins of lechery and avarice, and

with the other tavern sins of the revelers in the

Pardoner’s Tale. In Piers and the Dance of Death, plague

 

is associated with the cardinal sin of pride and other
sins arising from it. But references to this new disease
are not new themselves, except in the context of older
stories where they appear. Each of these poems explores

the meaning of disorder in the context of an orderly

233
cosmology, providing a moral solution for the problem of
disorder in the world through righteous living and
obedience, the best remedies for plague and other
scourges, and the best means for preventing their

return.

Epilogue

Thus the poets of England themselves become figures
of Life, Death, and enduring, Life.

Philippa Tristram, Figures of Life and Death (19)

The major connection among the examples of plague
writing in this study concerns the idea of order, a
concept of great importance to medieval authors. Medical
writers explained that plague had come about as the
result of distant and near causes, from the conjunction
of planets and pestilential atmosphere. Moral writers,
whose interpretation was rooted in the Bible and
explained by the Church Fathers, stressed that human sin
caused God to release plague on earth through natural
forces. The difference between these two positions was
not so much a difference between truth and error as it
was an expression of the two traditional causes of
plague: the spiritual forces of sin and the physical
forces of nature. Clerks like John Lydgate, who saw both
natural and divine forces at work in contemporary

outbreaks of this scourge, took advice from plague

234

235
treatises, which he incorporated into a moral
interpretation.“

Although medieval writers tended to embrace one or
the other explanation, the medical and moral
interpretations of plague were themselves rooted in a
common cosmology which emphasized connections, with
neither interpretation being exclusive. Consequently,
the texts considered in this study may be looked at as a
microcosm of medieval thought, not only with respect to
medical and moral interpretations, but also in terms of
the social, historical, and philosophical interests of
their writers. Both interpretations served as a means
for understanding the devastating results of plague,
whether those results, like the causes, were medical or
moral.

The medical tradition taught that the workings of
the body reflected a divine plan as a mirror of
creation. Medical authorities had taught that plague

imbalanced the humors and unless this balance was

 

“Medical and moral interpretations were yoked long
after the fifteenth century. Three hundred years later,
when an outbreak of plague raged in Florence, the Prior
of the Monastery of St. Marco was unable to sleep
because he worried that men failed to understand that
the disease had come "from the treasury of His [i.e.
God’s] wrath." The epidemic persisted, the Prior
reasoned, because of "the blindness of men who think
they can remedy this loss of life that is sent from
Heaven, solely with human care [i.e., medical care]
contra consiliup:Altissipl [contrary to the Almighty’s
purposel" (qtd. in Carlo M. Cipolla, Faith, Reasonylapd
the Plague 7).

236
restored through phlebotomy or remedies, death would
result. Earlier physicians like Galen regarded Nature,
which formed the body, as a divine instrument. The moral
tradition taught that the body housed the soul; both
should work harmoniously as part of a larger, divine
plan. Writers who held a moral view believed that
plague resulted from poor governance of both soul and
body. Generally, literary writers applied the metaphor
of plague to religious and social health, and didactic
writers, being more practically oriented, tended to
locate plague in a religious and medical context.

In the Secrees of Old Philosoffres, discussed in
Chapter Four, Lydgate and Burgh explained plague with
advice from both medical and moral traditions. Following
the advice of learned medical authorities, they stressed
the physicality of plague and, accordingly, offered
advice on physical remedy and prevention. Following the
Church’s official explanation of cause, they warned of
the dangers of immorality. Health could best be restored
by attending to the needs of the body through diet and
bloodletting, and to the needs of the soul through
prayer and proper behavior.

Literary writers were also concerned with medical
and moral aspects of plague, but in varying degrees.
Piers Plowman, for instance, gives credence to the

medical interpretation of plague in references to

237
astrological causes and their effects on the offspring
of plague survivors, primarily in the context of
biblical teaching. But, stripped of remedies and
preventives, the medical interpretation of plague in
Eiara functions as a moral warning, not because plague
has great power over the body, but because it threatened
the eternal soul.

Medical writing therefore considers physical
causes, while literature explores the meaning of plague
in a wider cultural perspective. It searches for
answers to the questions Arcite raises in Chaucer’s

Knight’s Tale:

 

What is this world? What asketh men to have?

Now with his love, now in his colde grave,

Allone, withouten any compaignye.

(2777-79)

Literary writers have traditionally questioned
catastrophes, often in the context of similar disasters
from the past, explaining that social upheaval produces
conditions ripe for disease as often as disease occurs
as the result of upheaval. When plague came, they saw in
it what René Girard has described as "a reciprocal
affinity" between disease and social disorder ("The
Plague" 834), not only as a way of making sense of
plague, but as a means for incorporating it into a
larger and well-established cosmological framework.

Though plague treatises occupy a sizeable

proportion of medical writing in the Middle Ages, the

238

scarcity of plague references in English literary works
is puzzling, especially when compared to the magnitude
of this disaster. Nancy Siraisi believes that by the
time plague arrived in Europe in 1347, medieval people
had developed certain mechanisms for coping with
widespread disasters.“ The magnitude of this epidemic,
however, was recognized by some literary writers in
England, though usually in passing references.

In Illness as Metaphor, Susan Sontag explains that
"the medieval experience of plague was firmly tied to
notions of moral pollution..." (71), earlier noting that
"the whole point of Boccaccio’s description in the first
pages of the Degaperon of the great plague of 1348 is
how badly the citizens of Florence behaved" (41). The

metaphor of plague consequently became useful for

 

“The few surviving references to this disease in
medieval English literature might, at first, suggest
that people in the Middle Ages were able to cope
successfully with disasters, and were therefore less
likely to be affected by them in their day-to-day lives
and in the production of literature particularly. Nancy
Siraisi speculates on fourteenth-century people’s
ability to cope with the disastrous effects of epidemic
disease:

Both the harsher realities of medieval life, even

in such relatively good times as the twelfth and

thirteenth centuries--high infant mortality,
extensive malnutrition among the poor, ineffective
therapeutics--and the teachings of Christian
tradition on the transitoriness of human life had
combined long before 1347 to provide people with
very adequate psychological and cultural mechanisms
for dealing with the shock and horror produced by
sudden death from foul and unexplainable disease.
(in Williman, The Blagk Death 17).

 

239
writers who wished to warn their readers of moral
corruption. In Middle English literary works
particularly, not only the warning of plague itself, but
the catastrophic circumstances in which it occurred were
derived from biblical commonplaces rather than from
examples taken from the ravages of contemporary life.
Why did these English writers prefer biblical and pre-
medieval sources to contemporary events as a means for
creating order? Literary writers’ response to the crisis
of plague is analogous to the response twentieth-
century writers have had to the devastation of World
Wars.“ One result of global disaster (and plague was
perceived that way in the fourteenth century) is to
force its survivors to come to terms with the value and
permanence of life and the cultural forms which give
integrated meaning to that life.

During worldwide crises, tension develops between
life as it is and the re-creations of that life in
cultural forms like art and literature which claim to be
permanent records of human experience. But in a global

crisis such as a World War or the fourteenth-century

 

“"The Great War," G. G. Coulton remarks, "if we may
judge from several indications around us, has done a
great deal to revive public interest in the Great
Pestilence, which, in its own day, exercised an equal
influence, or perhaps even greater, upon European
development" (The Black DeapM 9). For other parallels
between WW1 and Black Death, see also J. W. Thompson,
"The Aftermath of the Black Death and the Aftermath of
the Great War."

240
plague pandemic, even culturally permanent forms, like
ineffective physical remedies for plague, may appear
less durable, less able to provide stability and
consolation in time of disaster. Humans do have certain
mechanisms for coping with large-scale disasters, as
Nancy Siraisi explains, but when those mechanisms fail,
survivors search for stability and comfort in
established frameworks. Whether in the fourteenth
century or the twentieth, it is not surprising that
writers should turn to disasters described by earlier
authors and the resolutions proposed by those authors as
a way of coping with contemporary crises.“

In The Theater and Its Double, which employs
plague as a metaphor for crisis leading to cultural
change, Antonin Artaud comments on the relationship
between crisis and culture during World War II:

Either these [philosophical] systems are within us

and permeate our being to the point of supporting

life itself (and if this is the case, what use are
books?), or they do not permeate us and therefore
do not have the capacity to support life (and in
this case what gggs their disappearance matter?).

Some fourteenth-century physicians did question their

books, finding in experience more useful ways of coping

 

“Hence, the persistence of Henry Miller’s remark in
The Air-Conditioned Nightmare, quoted as the epigraph to
Chapter One, referring to the blight of poverty in the
America of the 1940’s as a scourge, almost in the
commonplace biblical sense of punishment for political
misrule: "A great scourge never appears unless there is
a reason for it" (18).

241
with crisis: to flee plague-infested areas became an
important means for coping with plague, more effective
than any remedy or explanation. Yet literary writers
consistently, and in England especially, attempted to
avoid the terror of plague, not by turning firpa books to
personal experience, but by questioning, like Artaud and
Miller, the meaning of crisis itself with regard to
established authority. For literary writers both then
and now, plague as a physicality in itself was not so
useful as a theme in itself, but rather as a metaphor
for disorder, an echo of the crisis caused by physical
disease within the microcosm of the body. Like Artaud,
medieval writers were drawn to explain the fracture
between what is permanent--books and their stable
authority--and what is transitory--human life,
especially during pestilential times.“ Rather than
understand plague as an existential crisis robbing life
of meaning, and eventually forcing the creation of new
cultural forms as Artaud, Miller, and Camus have done in

the face of twentieth-century crises, late medieval

 

“Chaucer’s narrator in the Parliament of Fowls
explains the consolation he finds in reading:

Of usage, what for lust and what for lore,

On bokes rede I ofte, as I yow tolde.

But wherefore that I speke al this? Nat yore

Agon it happede me for to beholde

Upon a bok, was write with letteres olde;

And therupon, a certeyn thing to lerne,

The longe day ful faste I redde and yerne.

(15-21)

242
English writers saw in the crisis of plague an
opportunity to question a lifestyle they perceived as
immoral, which, like biblical plagues, disrupted God’s
plan for an ordered universe.

The near-hysteria of Artaud’s plague-ridden world,
where bodies are portrayed in heaps with rats gnawing at
the ragged edges, appears overdrawn when compared to
medieval plague and its effects as Middle English
literary and medical writers describe them. Though it
cannot be said of Continental Europe, in England, few
people took measures as extreme as those of the
flagellants, who sought to prevent pestilence by
flogging themselves publicly in a penitential frenzy.“
However, a concern with the power of pestilence did
encourage moral questioning in England.

Siegfried Wenzel draws the following conclusions
concerning the influence of plague on medieval
literature:

As the analysis of the Grimestone verses has shown,

the experience of the Black Death and succeeding

plagues cannot be credited with producing anything
new in English lyrics on death. [Instead]...the

 

“In Europe, and especially on the Continent, groups
of flagellants roamed about, whipping themselves while
pleading for God’s mercy. Various flagellant sermons
tell of Christ’s anger over sin, and warn of great
punishment as they admonish the sinners to reform and do
penance.

Consult also George Deaux, The Black Death: 1347
180-85, and Philip Ziegler, The Black Death 86-97. Cf.
the use of plague as a social and political metaphor in
Peter Barnes’ Red Noses.

243
plague experience invariably led to criticism of
papal failures.
(150-51)

Wenzel points out that the "moralistic tendencies" of
Langland and Chaucer led them to a criticism of these
moral failures (151-52). Therefore, while these writers’
references to plague are few, their concern with its
impact was strong.

In the twentieth century, popular conceptions of
life in the Middle Ages tend to characterize medieval
people as barbaric and superstitious, far removed in
time and culture from our own, so-called age of high
technology. A study of contemporary medical and moral
writing about Black Death, however, indicates that
medieval English authors consistently turned neither to
panic nor magic, but rather to a logical and orderly
cosmology capable of reconciling the horrors of this
disaster within the framework of other experiences. As
overwhelming as plague may have been in the fourteenth
century, the lack of references to it in literature
supports the notion that these peOple were not only more
resilient than popular twentieth-century beliefs about
the Middle Ages might suggest, but as capable as any
age of interpreting the meaning of calamity. As
examples from the moral interpretation of plague have
shown, English writers turned to the Bible as a source-

book. Even today, as George Steiner observes, twentieth

244
century writers continue to use the Bible as a pattern
book, reflected in the style and structure of their
writing ("Good Books" 94-95).“ Rather than disrupt
order, plague became part of a well-established order: a
disease among others in need of treatment and, like
other collective disasters, a metaphor for disorder.

In both Middle English and twentieth-century
literature, art endures through crisis, unlike the
mutable civilizations it represents. In this respect,
the work of literary artists serves future generations
along with the records of medical inquiry, transforming
the horror of epidemics into a more stable and permanent
picture. Images of plague in Middle English writing
become records of the biblical and ancient precedents on
which they are based. The only distinction plague
references claim is their addition to older tales retold

by contemporary writers, reworked for a contemporary

 

“Steiner explains the persistent force of biblical
patterning on modern writers in these terms:
The shaping universality of the scriptural code
significantly outlasts the general force of
religion. The God of the philosophers and of the
enlightened laity may have died in the nineteenth
century. The Biblical God and the idiom and the
world image generated by his narrative presence
continue formidably alive and instrumental in the
writings of Thomas Hardy, of Thomas Mann, of Gide,
of Proust. We would not have the prose cadences of
Hemingway without Ecclesiastes, or the dynastic
sorrows of Faulkner without Chronicles and the
Books of Kings" ("Review" 94).

245
generation of readers as Chaucer has artfully done in
the Pardoner’s Tale.

In time, of course, permanent cures are found for
great epidemics; but the power of those epidemics is not
forgotten by literary writers. Since the Middle Ages,
plague has served as metaphor for later writers who also
wished to comment on the depravity of the human
condition. While the disease of plague was transient,
the horror that lingered from it survives. The
disastrous effects of sin could spread, causing evil
times, in much the same way that the plague bacillus
hides in the background of Albert Camus’ The Plague as a
metaphor for the spread of political tyranny:

And, indeed, as he listened to the cries of
joy rising from the town, Rieux remembered that
such joy is always imperilled. He knew what those
jubilant crowds did not know but could have learned
from books: that the plague bacillus never dies or
disappears for good; that it can lie dormant for
years and years in furniture and linen-chests; that
it bides its time in bedrooms, cellars, trunks and
bookshelves; and that perhaps the day would come
when, for the bane and the enlightening of men, it
roused up its rats again and sent them forth to die
in a happy city.

(Trans. Justin O’Brien 250)
Yet, as the examples from Middle English medical and

moral writing on plague demonstrate, neither medical

nor moral interpretations solved the problem of

246

plague.“ It disappeared, not as the result of medical or
moral remediation, but through the work of Nature, which
survives in the framework of a larger cosmology. The
words of the nineteenth-century epidemiologist J. F. C.
Hecker, cited in Chapter Five, provide a fitting
deposition for this study:

We must bear in mind also, that human science and

art appear particularly weak in great pestilences,

because they have to contend with the powers of

nature, of which they have no knowledge.

(The Epidaaics of the Middle Ages, trans.
Babington 50)

 

“Ivan Illich thus questions the mid-twentieth
century popular belief in medical utopias in these
terms:

After a century of pursuit of medical utopia, and

contrary to current conventional wisdom, medical

services have not been important in producing the

changes in life expectancy that have occurred. A

vast amount of contemporary clinical care is

incidental to the curing of disease.

(Medical Nemesis 5)

The discovery of the plague bacillus and its effective
treatment with antibiotics came about long after any
major outbreak of the disease, not through medical
intervention, but through an increase in natural
immunity and a decrease in the virility of the bacillus
(consult Colin McEvedy, "The Bubonic Plague," and J. F.
D. Shrewsbury, A History of the Bubonic Plague).

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