The cure

In the words of the modern carol, “All we want for Christmas is some extra-strength Tylenol,” & sure enough, our little sister brought some up to the High Doganate, “on Christmas Day in the morning.” Since then, the quality of life has much improved up here. We specified acetaminophen, & neither aspirin nor ibuprofen, since in our understanding the former alone would be of any use in masking the symptoms of an unambiguously viral influenza. (Disclaimer: if you are taking medical advice from this website, you may already be beyond help.)

After just one gramme, the fever seemed abating, & the splitting headache had almost disappeared. Nearly three grammes later (at intervals, not all at once, you fool!) we feel almost well enough to run out & catch pneumonia. Isn’t medicine wonderful?

Indeed our first thought, on waking into this Feast of Stephen, was that we should start a charity to ship Tylenol to the Middle Ages. Maybe include some penicillin & basic antibiotics in the care packages; with instructions for their use in easy, colloquial Latin. We’ve all heard the stories about Mediaeval medicine. So why don’t we do something practical to help?

Already we imagine the wisacre query of some insufferable progressive. “How you gonna send that, by Pur-o-lator?” How wantonly these people expose their own ignorance & illogic. The courier companies only serve current addresses. Mediaeval Man is removed from us in time. Therefore Purolator can’t reach him. But that shouldn’t defeat the unwearying Yankee optimism. Instead, we could try digging down to the appropriate archaeological stratum, then leaving the boxes in a conspicuous place. Common sense would supply locations: say, the medical schools at Parma, Padua, Bologna, Montpelier, Paris, or Oxford.


Perhaps, had our ancestors been a little more robust, we could have avoided modernity altogether; & stood a little better against some other impositions, such as those plague-bearing Mongols.

For one of the little ironies of historical fact (as opposed to historical theory, which lacks irony) is that nomadic barbarians often show a quicker understanding of “empirical science” than more civilized peoples, whose practised decency obstructs their “vision.” Indeed, it is because we are becoming nomadic barbarians ourselves, once again, that we are understanding it better & better. But back in the days when we were quite settled, the Black Plague, “the greatest public health disaster in history,” spread from our encounter with the Mongols in Crimea. It was an exceptionally poignant illustration of this phenomenon.

We refer to the Mongol siege of the great Genoese trading colony of Caffa — in its heyday among the most cosmopolitan cities on earth, welcoming alike Genoese & Venetians, Greeks & Armenians, Jews & Muslims from all over, even visitors from far Ethiopia, & Cathay; as also every sort of Turk & Tartar who wandered the lonely Steppe. On his good days, the city enjoyed the contractual protection of the Khan of the Golden Horde, who derived considerable profit from it. On his bad days, however, it didn’t enjoy this.

To our backward, reactionary, & very roughly Mediaeval mind — unshared with contemporary historical scholars — Caffa’s problems really began with a moral, as opposed to physical, “issue.” The city had a very prosperous slave market, which dealt mostly in Turkic slaves, sold chiefly to the Mameluke Sultans for use as soldiers. From a Genoese or Venetian point of view, this was all to the good, not only remunerative in itself but beneficent, since otherwise the Sultan would be enslaving Christians. Too, the Mameluke soldier slave, selected for his height & virility, enjoyed a fairly good life. As the Sultan’s henchman he had the right to bear arms, & lord it over the general population. (The despot’s first act is invariably to withdraw the subject’s right to bear arms; for a half-armed subject is twice as obedient, & an unarmed one almost infinitely so.)

Slavery is intrinsically wrong, of course, but in this case the expansion of the trade turned out also to be a bad move, strategically, for it began to make the Mongols unhappy. They were indifferent when the slavers were capturing their enemies, perhaps even mildly approving. But soon enough it came round to their friends being captured & led away. (Poor Italians probably couldn’t tell the difference.) And no Khan of the Golden Horde is remembered by history for his phlegmatic disposition.

Sultan happy, Khan unhappy, was moreover a bad formula, for the Sultan could offer even less protection from an irritated Khan than could a distantly stretched Italian navy. Not that the navy should be scorned: for contrary to the general understanding, Italian “marines” did a number on the Mongols several times, while operating far away from home. Indeed, they lifted the first Mongol siege of Caffa at a cost of more than 15,000 lives, almost all of them Mongolian.

It was, however, the Mongols’ second siege that counted. Learning from Round One that they would need to up the ante, they suddenly re-appeared in 1345, in the usual Mongol way, from everywhere. They were as ever travelling fairly light, & quite brilliant in equine manoeuvre. But the one, incredibly unlikely, flaw in such a wide subscription of horsemen, announced itself. For at least one of the contributing exotic tribes was carrying the bacillus for the Bubonic Plague, which now began spreading through their entire ranks, decimating them daily, initially to the joy of the besieged within Caffa.

As we hinted above, the native cunning of the barbarian is more use, in grasping the implications of new “science & technology,” than is the reasoning of the civilized man whose judgement is diffused over a wider range of prudential considerations, & who therefore cannot match the “noble savages” for ruthless. The Mongols quite spontaneously grasped the principles of biological warfare. They began catapulting the bodies of their own dead & dying over the city walls.

It was not long before Caffa was losing the battle of attrition. Survivors of the Plague began evacuating voluntarily, even as the Mongols were losing interest in their siege. Those Italian ships that had come to supply food to the besieged, were now carrying the Christians back to their home ports: to Venice & Genoa & all over Europe.

We have for instance the remarkable account of Gabriele de’ Mussi of the homecoming at Piacenza, where the Plague exploded instantly upon the travellers’ return. It includes an account of the cause, crisp enough to satisfy any epidemiologist. It uses apocalyptic language in a convincing way, & adds a touching lament on behalf of distant foreigners: “the Chinese, Indians, Persians, Medes, Kurds, Armenians, Cilicians, Georgians, Mesopotamians, Nubians, Ethiopians, Turks, Egyptians, Arabs, Saracens, and Greeks — for almost all the East has been affected.” (Mediaeval Man kept in touch with world news, even without laptops.)


To the Mediaeval mind, a Plague on such a scale must surely involve Divine Judgement: that is what pertains to apocalyptic language. We retain the words, but the content has been discarded. We read such things & accuse our ancestors of superstition. Yet they were hardly unaware of proximate cause, & had long understood the principle of infection. They could be quite attentive to the hard factuals, when they were seriously interested. All men have always been. It is just that, being more humble & broad-minded than we are (as men generally were more amenable to reason before the Enlightenment), they did not exclude the possibility of Divine Wrath. Nor the hope, should that be the cause, that there might nevertheless still be something they could do to assuage it; such as, earnestly to repent their very real & terrible sins. They were certainly not so completely lacking in human intelligence & dignity as to run about shrieking, “Why why why?”

Consider: frequent private bathing, showering, & washing of hands & feet, were customary throughout the Middle Ages, in continuity from the ancient world. The old Roman systems of urban & rural sanitation had been, whenever possible, carefully restored & assiduously maintained; then gradually extended & improved upon. Episcopal condemnation of public bathing is often cited to refute this. It does nothing of the sort: for it was directed expressly against moral vices. Those fusty old bishops were acutely aware of what went on in bath houses — & of diseases spread not “through the water” but from sexual promiscuity.

It was rather in the Reformation era (on both Protestant & Catholic sides) that all this attention to washing was displaced by fastidious perfuming, & the steam bath — thanks to early modern superstitions about diseases spreading “through the water,” & the early modern belief that only water could carry infections through the pores. Hence, at least partially, the reason for the frequent reappearance of devastating plagues & other epidemics through the 17th century & beyond. Hence, as we have begun to establish from cumulative searching through parish records (we have Mormons to thank for much of this), the curious fact that life expectancy was substantially higher in the High Middle Ages than it ever was again until quite recent times. For as our mommy, a nurse, used to say, “Baby no wash, baby get sick.”

Which guides us to a theme to which we hope to return again & again. Mediaeval Man was not nearly so stupid, nor superstitious, as we hold him to have been today. His capacity for reasoning, in his circumstances, greatly exceeded our own in ours. Nor did he narrowly limit himself to making inferences based on “I feel.” And we, for our part, pay constantly for the contempt in which we hold our predecessors; whereas, Mediaeval Man benefited tremendously from the respect in which he held his. Ditto for our respective relations with foreign cultures. As soon as we meet a new furriner we start lecturing him on how to acquire the bacillus of “progress.” As soon as he met him, the Mediaeval Man began wondering what made him tick.

We remain, for instance, intellectually encumbered by a tremendous weight of foolish & malicious sectarian propaganda, adapted from Reformation pamphlets to our present secular need — which is to show how superior we are to our God-fearing ancestors, in the shadow of mountains of evidence. It cripples our capacity to learn elementary things, & confirms us in our attachments to some of the silliest nonsense any human beings ever believed. We mean really embarrassing, & totally implausible stuff, like Darwinism. Our self-confidence, in buying into such rubbish, is founded upon moronically false ideas about the past, such as “men believed the world was flat,” or “they had no idea of gravity,” or “they argued about how many angels would fit on the head of a pin.” Or, “they thought they were at the centre of the universe” — when actually they thought they were at the bottom of it (except for Hell), & were entirely free of that chronological vanity that attributes every boon to some spooky & murderous “spirit of progress” that we hail in tireless choruses of self-congratulation.

Mediaeval Man inherited astrological, alchemical, herbal & other quackeries (along with things not quack) from their own pagan ancestors, including especially ancient Romans & Greeks; then sifted for the efficacious over long tracts of time. Their notions of the Four Humours were derived from Hippocrates & Galen & many other classical sources towards which they were, perhaps, too credulously respectful. On the other hand, the system worked on its own rules. They were open to Arabic & Oriental influences, not from osmosis but from conscious systematic study. (This is why the motherlode of Mediaeval Islamic science & learning may be sought nowhere else but in European libraries, where so much of it was preserved from destruction: faithfully collected & transcribed, then translated & elaborately commented upon by both monastic & secular scholars.) Of error & prejudice they were quite capable, though on nothing like our modern scale; but also, to a rather greater degree, of empathy towards human suffering.


Our modern medical faculties descend from such medical schools as we listed above. Anatomy was studied with (Church-permitted) human dissections, & methods of surgery were advanced thereby. The use of clove & other herbal oils with anaesthetic properties was commonplace, along with methods of dressing & sterilizing wounds, & careful use of clean bandaging — whether or not on the correct germ theory. Monastic physic gardens were constantly exploring the properties & possibilities of medicinal herbs — goldmines of useful information lost & too often still awaiting rediscovery.

But beyond this the whole culture of medicine — the teaching colleges (in which it took ten years to become an M.D.), the specialized hospitals & hospices for such as cripples & the blind, those for sick children, for women, for the elderly & infirm, for those afflicted with various specific chronic diseases; the asylums for the mad, & for the lepers; the alms houses scattered everywhere; the dispensaries & surgeries for the poor which also distributed food & clothing; the networks of itinerant medical specialists of every description; the guild systems to enforce quality controls — from where would gentle reader think all these things came?

You are dead right, gentle reader! For all came without exception from that despised Mediaeval Catholic Church; & from her idle & corrupt clergy; & her crazy brooding monks & nuns; & from her scary dark theological notions; & from her antichrist Popes — such as Innocent III, who at the dawn of the 13th century launched a “crusade” to provide every little town throughout Christendom, no matter how remote, with its own medical hospital (as distinct from “hospitals” for pilgrims, which themselves provided medical assistance, & other charitable care). Towns of a size that would usually count as villages today. In so many of which, they also built cathedrals, with towers soaring into the sky.

And all this carried on the income of the great monastic houses, & by grand bequests & donations, & by guild & municipal charity & pride, & by voluntary & monastic labour, & by little old grandmas dropping their wee copper mites into small tiny boxes & lighting wee little candles for their loved ones in Purgatory — & yes, a portion through light but compulsory tithes, waived for paupers. Compare: the sprawling Kafkaesque bureaucracies & punitive taxation of our dysfunctional Nanny State, with its spectacularly overpaid union goons, & the powerpoint people whose fiscal footprints would swallow whole wards of nursing sisters (the real ones: the nuns). Who care about you like they care about their neighbour’s barking dog.

The city of Florence, population around 70,000 on the eve of the Black Death, had more than two dozen specialized hospitals; three-quarters of these Florentines perished all the same (fun facts that happened to burn into our brain many summers ago while reading Boccaccio, & Villani). But from a long fascination with old city plans, we may confidently tell gentle reader that, wherever he may want to go through the later Middle Ages — to London, to Paris, to Naples, to Milan — he will find eleemosynary institutions similarly thick on the ground. This remains true, incidentally, through to the eve of the Great War in 1914 — a much greater concentration of hospitals, pensioner’s reprieves, conventual establishments, schools, colleges, & every other sort of humane institution unlikely to pay its own way, than he will ever find in an equivalently populated patch of any urban landscape at the present day. And: supported by ecclesiastical & private philanthropy beyond the reach or audit of the state.


For we are not restricted to defending the honour of Mediaeval Man, & not interested in the view that his Middle Ages resembled Utopia at any point over their duration of a thousand years. This will especially not appear to anyone whose knowledge of Mediaeval history consists of the twenty worst things that ever happened over that whole time, compressed into six-&-a-half paragraphs. The most we would say, for most of this very long period, is that it formed a civilization that was morally, aesthetically, & intellectually, as well as spiritually, superior to our own. But perhaps even better Christendoms are possible, if by faith we should be inspired once again towards higher civilization.

That we cannot, alternatively, “return to the past” is a truth even a cat can understand, & only a progressive intellectual would try to explain. (Many have indeed tried to explain it to us.)

As journalist, we have several times patiently endured, in a television studio or wherever, an oily lecture from a little vacuum tuba on “the Mediaeval attitudes of the Catholic Church” towards e.g. public health. To which no short answer was possible. Given a sound bite to reply, we recently tried: “Have you ever noticed, Sunshine, that more than half the hospitals in this fine secular burg were named after some Saint?” But this was edited out, as tends to happen whenever a programme is pre-recorded, & before we are never invited back.

And we would not have it otherwise, for to interpret Saint Paul, there are chasms in nature no light may ever reach.