The Black Death

But the windy nothingness of this somewhat unhelpful speculation was by no means typical. There was much shrewd observation and a certain amount of common sense and sound judgement in the recommendation of measures which, though no more than palliatives, still did more good than harm. Certainly there was a depressing readiness to stress that flight was the only possible defence against the plague or to argue that, if flight were impossible, there had better be immediate recourse to prayer. But the patient was also given a certain amount of guidance on how he should conduct himself. It seems unlikely that much confidence was inspired among those threatened or afflicted by the plague but some people must at least have been given a ray of hope and a feeling that they were not entirely helpless in the face of destiny.

Differences of opinion between the experts were frequent. Simon of Covino^{128} considered that the pregnant woman and, even more, ‘those of fragile nature’ would succumb and that no doctor could help them. The undernourished pauper would be the first to go – a reasonable conclusion which the Medical Faculty, however, rejected, claiming that those ‘whose bodies are replete with humours’ were the most vulnerable. Ibn Khātimah^{129} agreed with the Faculty. People of ‘hot, moist temperament’ were the most exposed; the ultimate in peril was to be a stout young woman with a taste for lechery.

There was more agreement on the best place to live so as to avoid the plague. Seclusion, obviously, must be a first priority. After that, the problem was how to keep out of the way of the dreadful miasma, the infected air which, borne generally by the south wind, carried death from land to land. A low site, sheltered from the wind, was of course desirable. The coast was to be shunned; with good reason because of the threat from shipborne rats though the danger was visualized by the tractators as corrupt mists creeping lethally across the surface of the sea. Marsh lands were not to be recommended for here too rose the killing mist. Houses should face north; windows preferably be glazed or covered with waxcloth.

Even in the most prosperous practices – and where there was no prosperity there was generally no doctor – the doctor recognized that many of his clients would not be able to flee to remote spots where they might hope to escape the plague. Rules had to be laid down for the conduct of life in a plague-stricken area. If infection was carried by corrupted atmosphere then what was needed was something to build up counter-bodies within the air. Dry and richly scented woods were to be burnt: juniper, ash, vine or rosemary. Anything aromatic was of value: wood of aloes, amber, musk, or, for the less prosperous, cyprus, laurel and mastic. A typical recipe for a powder to throw on the fire^{130} was one ounce each of choice storax, calamite and wood of aloes mixed in a mortar with rose-water of Damascus and made into small, oblong briquettes. The house was to be filled, whenever possible, with pleasant smelling plants and flowers and the floors sprinkled with vinegar and rose-water. If one was unfortunate enough to have to leave one’s house a prudent precaution would be to carry an amber or smelling apple. If amber was too expensive a cheaper but efficacious substitute could be contrived from equal portions of black pepper and red and white sandal, two portions of roses and a half portion of camphor. The resulting blend was then pounded for a week in a solution of rose-water and moulded into apples with paste of gum arabic.

It is doubtful if these precautions did anything to reduce the risk of infection with the possible exception of one recipe of Dionysius Colle for a powder, used for throwing on the fire, which contained sulphur, arsenic and antimony.^{131} The first of these is now recognized as being destructive to bacteria as well as to rats and fleas. The other compounds, in most cases, had the minor merit of making the usually smelly medieval house a little more agreeable to live in.

Vegetable inactivity was the ideal posture in which to meet the plague. If one had to move, at least move slowly; exercise introduced more air into the body and, with the air, more poison. Hot baths, which opened pores in the skin, were to be shunned for the same reason, though it was beneficial to bathe the face and hands from time to time in vinegar or the inevitable rose-water.