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Universal and particular: the language of plague, 1348-1500.

Carmichael AG - Med Hist Suppl (2008)

View Article: PubMed Central - PubMed

Affiliation: History Department, Indiana University, Bloomington, IN 47405-7103, USA.

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What disease or diseases caused the recurrent, demographically punishing epidemics that Europeans called plague? There needs to be evidence for such a claim... During the High Middle Ages Europe was thickly settled, but profoundly rural; great cities were exceptional, and regional markets were not well integrated. 3 In the early modern centuries, market centres were far better connected: a significant epidemiological difference... The plague that came had to be likened to the Biblical plagues of Egypt, King David, and Ezechiel, and that in the time of Pope Gregory the Great... But as this pestilence uniquely spanned the whole world, ultimately it would be compared to the Great Flood. 35 Petrarca was not convinced by such logic: “I do not deny that we deserve these things and even worse; but our ancestors also deserved them … why is it that the violence of [God's] vengeance lies so extraordinarily upon our times? To some extent the inadequacy of existing explanations in the midst of the multi-year epidemic made the Black Death ineffable for physicians: words failed them because the logic of the plague created serious anomalies within both the Aristotelian physical system and Hippocratic–Galenic medicine... Melissa Chase shows that three generations of physicians at Montpellier and surrounding regions struggled to pinpoint what the ancients had failed to understand and how the taxonomy of pestilences needed to be reconfigured. 56 Those who confronted this problem concluded that the greatest ancient authorities had no personal experience of comparable great pestilences to draw upon... Moreover, before the sixteenth century physicians did not confront the overall duration or spatial persistence of plague anywhere in Europe, unlike their lay contemporaries. 90 Thus we cannot look to late medieval physicians for analysis of this fundamental aspect of Yersinia pestis epidemics... When she died, the surgeon inspected the cadaver “diligently”, pronouncing plague the cause of death... He also decided—without giving grounds for his conclusion—that she had an “elongated” uterus... Similarly vomiting or other excretions served this purpose... Simply seeing a morbilliform rash—red, yellow, black or purple—did not necessarily lead to the conclusion that a specific communicable putrefaction was at work... Obviously all the great epidemics included deaths from many different infectious diseases, for urban sanitation was never a priority and cleanliness did not carry the same meanings that we understand today. 113 The claim that Yersinia pestis was the perpetrator of many late medieval plagues cannot rest solely on the language of plague... What is at stake in the retrospective diagnosis of Yersinia pestis as a cause of late medieval European plague is our understanding of the ecological changes that could have permitted that particular microorganism's survival and persistence in western Europe... Equally important, though much better understood historically, are the demographic and environmental accelerants fuelling late medieval and early modern plagues. 115 Plague created a legacy of public health mechanisms to deal with recurrent epidemics, which is an indisputable contribution to global history.

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New cases of plague: lymphatic swellings as proof of plague.
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fig1: New cases of plague: lymphatic swellings as proof of plague.

Mentions: Swellings in the areas where plague abscesses occurred evoked aggressive diagnostic inquiries, as did discoloration of the skin at the site of a swelling or in a generalized rash. We can see the importance of identifying swellings in the three main areas specified by plague treatises. Forty per cent of newly identified cases of plague cited evidence of one or more characteristic bubonic swellings. In contrast, 18.5 per cent of new cases showed only a pestilential rash (see Figure 1).


Universal and particular: the language of plague, 1348-1500.

Carmichael AG - Med Hist Suppl (2008)

New cases of plague: lymphatic swellings as proof of plague.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2630032&req=5

fig1: New cases of plague: lymphatic swellings as proof of plague.
Mentions: Swellings in the areas where plague abscesses occurred evoked aggressive diagnostic inquiries, as did discoloration of the skin at the site of a swelling or in a generalized rash. We can see the importance of identifying swellings in the three main areas specified by plague treatises. Forty per cent of newly identified cases of plague cited evidence of one or more characteristic bubonic swellings. In contrast, 18.5 per cent of new cases showed only a pestilential rash (see Figure 1).

View Article: PubMed Central - PubMed

Affiliation: History Department, Indiana University, Bloomington, IN 47405-7103, USA.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

What disease or diseases caused the recurrent, demographically punishing epidemics that Europeans called plague? There needs to be evidence for such a claim... During the High Middle Ages Europe was thickly settled, but profoundly rural; great cities were exceptional, and regional markets were not well integrated. 3 In the early modern centuries, market centres were far better connected: a significant epidemiological difference... The plague that came had to be likened to the Biblical plagues of Egypt, King David, and Ezechiel, and that in the time of Pope Gregory the Great... But as this pestilence uniquely spanned the whole world, ultimately it would be compared to the Great Flood. 35 Petrarca was not convinced by such logic: “I do not deny that we deserve these things and even worse; but our ancestors also deserved them … why is it that the violence of [God's] vengeance lies so extraordinarily upon our times? To some extent the inadequacy of existing explanations in the midst of the multi-year epidemic made the Black Death ineffable for physicians: words failed them because the logic of the plague created serious anomalies within both the Aristotelian physical system and Hippocratic–Galenic medicine... Melissa Chase shows that three generations of physicians at Montpellier and surrounding regions struggled to pinpoint what the ancients had failed to understand and how the taxonomy of pestilences needed to be reconfigured. 56 Those who confronted this problem concluded that the greatest ancient authorities had no personal experience of comparable great pestilences to draw upon... Moreover, before the sixteenth century physicians did not confront the overall duration or spatial persistence of plague anywhere in Europe, unlike their lay contemporaries. 90 Thus we cannot look to late medieval physicians for analysis of this fundamental aspect of Yersinia pestis epidemics... When she died, the surgeon inspected the cadaver “diligently”, pronouncing plague the cause of death... He also decided—without giving grounds for his conclusion—that she had an “elongated” uterus... Similarly vomiting or other excretions served this purpose... Simply seeing a morbilliform rash—red, yellow, black or purple—did not necessarily lead to the conclusion that a specific communicable putrefaction was at work... Obviously all the great epidemics included deaths from many different infectious diseases, for urban sanitation was never a priority and cleanliness did not carry the same meanings that we understand today. 113 The claim that Yersinia pestis was the perpetrator of many late medieval plagues cannot rest solely on the language of plague... What is at stake in the retrospective diagnosis of Yersinia pestis as a cause of late medieval European plague is our understanding of the ecological changes that could have permitted that particular microorganism's survival and persistence in western Europe... Equally important, though much better understood historically, are the demographic and environmental accelerants fuelling late medieval and early modern plagues. 115 Plague created a legacy of public health mechanisms to deal with recurrent epidemics, which is an indisputable contribution to global history.

Show MeSH
Related in: MedlinePlus