by Sean Martin
Paul the Deacon (c. 720–799) wrote a vivid account of plague in Liguria in the 560s. It’s one of the best Dark Age accounts of the Plague of Justinian – possibly based on a lost eyewitness account – and is worth quoting at length:
A very great pestilence broke out particularly in the province of Liguria. For suddenly there appeared certain marks among the dwellings, doors, utensils and clothes, which, if anyone wished to wash away, became more and more apparent. After the lapse of a year indeed there began to appear in the groins of men and in other rather delicate places a swelling of the glands, after the manner of a nut or date, presently followed by an unbearable fever, so that upon the third day the man died. But if anyone should pass over the third day he had a hope of living. Everywhere there was grief and everywhere tears. For as common report had it that those who fled would avoid the plague, the dwellings were left deserted by their inhabitants, and the dogs alone kept house. The flocks remained alone in the pastures with no shepherd at hand. You might see villages or fortified places lately filled with crowds of men, and on the next day all had departed and everything was in utter silence. Some fled, leaving the corpses of their parents unburied; parents forgetful of their duty abandoned their children in raging fever. If by chance long-standing affection constrained anyone to bury his near relative, he remained himself unburied, and while he was performing funeral rites he perished; while he offered obsequies to the dead, his own corpse remained without obsequies. You might see the world brought back to its ancient silence; no voice in the field; no whistling of shepherds; no lying in wait of wild beasts among the cattle; no harm to domestic fowls. The crops, outliving the time of the harvest, awaited the reaper untouched; the vineyard with its fallen leaves and its shining grapes remained undisturbed while winter came on; a trumpet as of warriors resounded through the day and night; something like the murmur of an army was heard by many; there were no footsteps of passers by, no murderer was seen, yet the corpses of the dead were more than the eye could discern; pastoral places had been turned into a desert, and human habitations had become places of refuge for wild beasts.110
Despite such accounts, scholarly opinion has fluctuated on just how devastating the Plague of Justinian actually was. The French historian Jean Durliat proposed that historians have relied too much on literary sources, which tend to portray the pandemic as a largely urban affair, and almost certainly exaggerated its impact.111 However, examination of non-literary sources does provide evidence for a dramatic depopulation in the second half of the sixth century. Archaeological evidence from Syria suggests that expansion of both rural and urban settlements abruptly ceased in the second half of the sixth century, which is ‘entirely consistent with a pandemic that caused massive loss of life on repeated occasions.’112
Other evidence comes from the Byzantine Empire’s fiscal records, in that the amount of revenue coming in from taxable land declined dramatically. ‘It is thus highly significant that, in spite of Durliat’s claims, the advent of the Justinianic Plague and its subsequent recurrences coincided with a period of major instability in the imperial coinage – our best measure of the condition of imperial finances.’113 There also appears to have been a rise in wages – a development that Justinian himself complained about. But this drop in revenue was real, and would have had an adverse effect on the main recipient of imperial revenue – the army. In 588, army pay was cut by 25 per cent, leading to rebellions on the empire’s eastern flank. Things came to a head in 602 with a coup against the Emperor Maurice, followed by a lengthy – and disastrous – war with the Sasanian Empire of Persia. Both the Byzantine and the Persians were weakened by the war, leaving the door open for invasion by the new power in seventh century politics – Islam.
There was trouble elsewhere in the empire. The Balkans and Greece experienced Slavic migrations, the Lombards invaded Italy and the Berbers made inroads into North Africa. While the pandemic’s long tail would see the rise of Islam in the seventh century, it would also see the rise of the Vikings in the eighth. Furthermore, as William McNeill has argued (reiterating the view of Belgian historian Henri Pirenne), the power balance of European culture shifted away from the Mediterranean towards the north.114
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The Dark and Middle Ages
The Plague of Justinian had burned itself out by about 550, but the first pandemic – of which it was the first, incendiary, phase – lasted until the mid-eighth century. Among the surviving records for the final stages of the pandemic is The Chronicle of Zuqnin, which details the calamities of the years 743–5 in Syria. Even at this late stage, the plague was still capable of burying five hundred people a day.115 The pestilence started with the poor, and then ‘the Destroyer struck those in positions of power’.116 The Chronicler notes that ‘this painful and bitter anguish reigned over the entire world. Just as the rain falls down on the whole earth, or as the rays of the sun spread out over everything equally, so did this plague at this time spread out.’117
… numerous villages and places suddenly became desolate, without people passing by them or settling in them. The stricken bodies, stretched out on the ground like litter on the surface of the earth, were groaning; and there was no one to bury them since not one of them survived. Thus people were discarded inside those places, swollen, putrid and stinking. Their houses were open like graves, and inside them the owners were rotting from putrefaction. Their furniture, gold and silver were thrown away, and all their goods were discarded in the streets but there was no one to collect them. Vile was gold and silver there! What is more, old men and women with honourable white hair, who had looked forward to being buried in great splendour by their heirs, were discarded in the streets, houses and palaces, burst open, stinking, with their mouths open. Graceful virgins and beautiful young girls, who looked forward to bridal feasts and elegant and precious garments, were discarded, exposed and rotting together. They became a pitiful lesson for onlookers. If only it had occurred inside graves! Rather, it occurred in houses and market-places! Handsome and cheerful young men turned dark, were discarded and rotted with their fathers.118
Loathly Stalkers and Leechbooks, or The Sparrow in Winter
After the mid-eighth century, the plague appears to have disappeared back to its rodent reservoirs in Asia and Africa. Arno Karlen notes that, after the first pandemic finally died down, the Dark Ages were relatively disease-free.119 This is because the pandemic had wiped out so much of Europe’s population – possibly halved it – that there simply weren’t enough people left for epidemic and crowd diseases to feed on. It’s as though disease, having fed, was sated for a few centuries, and didn’t need to gorge again until the High Middle Ages. This could help explain why archaeological finds from this period show mainly bone diseases, breakages and injuries, the kind of evidence paleopathologists have noted in earlier hunter-gatherer societies. Climate change also played a part: from about 800 there were five centuries of warmer weather, until the advent of the so-called Little Ice Age around the year 1300. This meant that the Dark Ages – from the fall of Rome in the fifth century to about the year 1000 – were actually a ‘more healthful, less violent era than those before and after.’120
It was still an era in which, to judge from evidence from burial sites, there was ‘a fairly short life expectancy, a high infant mortality, with women dying young, particularly in childbirth, and a fairly high incidence of bone and joint diseases, such as rheumatism, arthritis and rickets.’121 Dysentery was common, and the proximity of animals meant the usual susceptibility to zoonoses such as sheep liver fluke. Another relatively common disease was lencten adl (‘spring ailment’ or ‘spring fever’) – tertian malaria. Jaundice, pleurisy, pneumonia were also known to have affected the Anglo-Saxons, as well as something called seo healfdeade adl (the ‘halfdead disease’), which was probably hemiplegia, a form of partial paralysis often caused by a stroke. Housing, for rich and poor alike, was primitive: huts or hovels were heated by a central fire that meant they were smoky –
leading to possible eye infections – as well as being dark and damp.
The Venerable Bede (672–735) recounts a story in his Ecclesiastical History of the English People that encapsulates both the drafty conditions in such dwellings, and also something of the Anglo-Saxon view of life. At the court of King Edwin of Northumbria (reigned 616–633), when he was considering converting to Christianity in 627, Bede has a noble describe the frailty and brevity of human life:
The present life of man on earth, O king, in comparison with the time which is unknown to us, seems to me as when you sit at dinner with your commanders and ministers in winter time, with a fire burning on the hearth in the midst in a good warm dining-hall while everywhere outside the rains or snows of winter are raging, a sparrow should come in and fly quickly through the room, who when it has entered by one door soon leaves by another. While it is inside it is not touched by the winter storm, but after a short time of calm gone in a moment, at once it slips from your sight returning from winter to winter.122
As the biologist ML Cameron noted in his study of Anglo-Saxon medicine, ‘When people lived under such conditions, it is not to be wondered at that their resistance to disease must have been impaired.’123
As with the ancient Egyptian belief that disease was ‘something entering from outside’ which is ‘the breath of an outside god or death’, and the ancient Chinese pictogram for disease showing a human figure shot with arrows, so the Anglo-Saxons ‘had some idea of infective disease; the frequent references to flying venom, to elfshot and to the loathly one that roams through the land can best be explained as showing an understanding of communicable diseases.’124
To combat these outside forces, doctors of the time consulted what texts were available. Latin and Greek literature was known to Anglo-Saxon doctors, such as Pliny’s Natural History, the De Medicamentis (Book of Medicaments) of Marcellus Empiricus (fl. 400), and Isidore of Seville’s Etymologies (probably written towards the end of Isidore’s life and he died in 636). Very little of Hippocrates’ and Galen’s work was available to Anglo-Saxons in the original, but much of their teaching was available second (or third) hand, in the paraphrased work of others. Among the most influential of these writers were Oribasius (c. 320–400), who hailed, like Galen, from Pergamon; St Augustine of Hippo’s personal physician, Vindicianus (fl. 364–375); Cassius Felix of Numidia (fl. c. 450); and Alexander of Tralles (c. 525 – c. 605).
Original material was also written, the so-called leechbooks, a mixture of the practical and the magical. (Although, for someone living in the Europe of the eighth or ninth century, the magical frequently was the practical.) The most well-known are Bald’s Leechbook, possibly written for King Alfred (871–899), and the Lacnunga. Bald’s Leechbook is arranged in the traditional head-to-foot format (a method of organising medical texts that dates back to the Edwin Smith Papyrus, if not earlier) but uniquely, separates the diseases into those whose manifestations are mainly external (Book I), and those whose manifestations are mainly internal (Book II).
Jaundice, chilblains, impotence and even aching feet, amongst others, are to be treated with various plant remedies. Perhaps partly because of the lack of chimneys in houses and halls, as noted above, Bald’s Leechbook contains nineteen remedies for eagena miste (‘mistiness of the eyes’, ‘dimness of vision’). Cameron suggests this ‘mistiness’ might be due to astigmatism, injuries or infections.125 One remedy for night-blindness involved eating roast buck’s liver, after first anointing the eyes with the meat’s juices. Although this might sound like hocuspocus, it actually worked because the liver would supply vitamin A, ‘a deficiency of which is the chief cause of night blindness.’126 Among the internal diseases in Book II are ‘pains in the side’, in which ‘pleurisy and perhaps pneumonia may be recognized.’127
‘When all else failed,’ Cameron comments, ‘the Anglo-Saxon physician could resort to charms, in themselves of no effect, but probably of great psychological benefit to the patient.’128 The physician could call upon the magical recipes and charms in Leechbook III, which appears in the same manuscript as Bald’s Leechbook, and Lacnunga. ‘There are conditions which resist treatment even today. It is interesting to find that these are the ailments for which remedies most often have a magical component, as in the one for migraine.’129
The Lacnunga (‘Remedies’) is a collection of 200 or so remedies in somewhat haphazard order. It represents the folk magic of the time, including ‘two outstanding pagan charms, one for sudden stitch caused by the assaults of witches, elves and Æsir, the other for dweorh, a fever with delirium.’130 Interestingly, as Stephen Pollington notes, amid Lacnunga’s magic were some ideas that we would recognise:
Many Lacnunga recipes specify the use of clean materials… which clearly indicates the recognition that tainted or contaminated materials could and would affect the outcome of the treatment. It therefore follows that the importance of cleanliness in medical treatment had at least begun to be recognised. The corollary was also true – that dirty or foul materials had to be avoided to ensure the effectiveness of the treatment. Contagion may also have been recognised, since Bede records the practice of segregating the sick into separate apartments.131
Bede also records clear overlaps between Christianity and magic. When Bishop John of Hexham (better known as John of Beverley) was told a young nun in the convent he was visiting had been bled on the fourth day of the moon, he said ‘You have acted foolishly and ignorantly to bleed her on the fourth day of the moon; I remember how Archbishop Theodore [Archbishop of Canterbury, 668–690] of blessed memory used to say that it was very dangerous to bleed a patient when the moon is waxing and the ocean tide is flowing.’132 Bleeding charts have survived, which show the best days of the month for bleeding a patient.
Monks’ charts could have done nothing, however, to predict the coming of epidemics. The plague reached England in 664, where it was known as the Plague of Cadwallader’s Time (after the King of Gwynedd, who himself died of plague in a recurrence in 682). It’s possible that increased contact with Europe after St Augustine’s mission to Christianise Britain in 597 led to plague and other diseases reaching England before 664: ‘Anglo-Saxon records mention no fewer than forty-nine outbreaks of epidemics between 526 and 1087’133, although many of these were minor. Irish chronicles record an epidemic in the 540s – probably the Justinian plague – but it’s unclear whether it reached Ireland at that time. Given the lack of other evidence, it’s probable the first pandemic didn’t reach the British Isles at all until the 660s, when various chroniclers described the plague ‘in terms that varied from the briefly factual to the nearly apocalyptic.’134 According to Bede, the plague reached England in the spring of 664, where it first consumed ‘the southern regions’ before travelling to ‘the province of the Northumbrians’ where it ‘brought low in grievous ruin an infinite number of men.’135 Recurrences of plague continued on and off, petering out towards the end of the century.
Famines and other maladies
In his classic study A History of Epidemics in Britain, Charles Creighton noted that ‘The history of English epidemics, previous to the Black Death, is almost wholly a history of famine sicknesses’.136 Writers were so accustomed to the famine-pestilence cycle that they often assumed outbreaks of the latter to have been caused by the former. Broadly speaking, famines either occur naturally (due to inclement weather – drought, floods, earthquakes, insects) or through human intervention (war, economics). Frederick F Cartwright and Michael Biddiss succinctly summarise the cycle:
Pestilence, famine and war interact and produce a sequence. War drives the farmer from his fields and destroys his crops; destruction of the crop spells famine; the starved and weakened people fall easy victims to the onslaught of pestilence. All three are diseases. Pestilence is a disorder of the human. Famine results from disorders of plants and cattle, whether caused by inclement weather or more directly by insect or bacterial invasion. And even war may be regarded, though more arguably, as a form
of mass psychotic disorder.137
Pestilence, famine and war are, of course, three of the Horsemen of the Apocalypse. The fourth, death, follows in their wake. All four were active in northern Europe in these centuries of ‘all quiet on the epidemic front’, courtesy of the Vikings. That there were Viking raids at all, William H McNeill suggests, is evidence of a ‘substantial swarming of population’138 that had been able to grow due to the European disease pool reaching a state of maturity and balance. In other words, after the plague, people’s immune systems and the various diseases doing the rounds of Dark Age Europe were in something like balance. No new epidemiological disasters appeared on the horizon, enabling people to develop resistance to the diseases of the time.
Despite McNeill’s proposed stability of the European disease pool, recurrent Viking raids and the warmer climate, the Middle Ages certainly suffered from famines. There was a saying prevalent in the High Middle Ages that England was notorious for famine. Bad harvests could be caused either by too much water (floods, heavy rainfall) or not enough (drought). Late thirteenth and early fourteenth century England, perhaps unsurprisingly, suffered from the former. The Great Famine of 1315 was one of the worst the country ever suffered, being preceded by seemingly endless rain, beginning with a series of unusually wet summers in the mid 1290s. People were reduced to eating grass, dogs, even each other. Death from starvation was accompanied by diseases such as typhus, a disease ‘intimately associated with wars, famines and human misfortunes of all kinds.’139