Tuesday, September 7, 2010

Cultures of Plague: Medical Thinking at the End of the Renaissance.  By Samuel K. Cohn, Jr.

Oxford: Oxford University Press, January 2010.  Cloth: ISBN 978-0199574025, $99. 340 pages.

Review by Scott Hendrix, Carroll University, Wisconsin

 Samuel Cohn’s mastery of the history of Renaissance Italy shines through in his latest work focusing on responses to plague—primarily during the years from 1575 to 1578—on the Italian peninsula. This is Cohn’s third book dealing with plague and disease in the West, drawing even more heavily on the social history that informs much of his earlier work than in his past considerations such as The Black Death Transformed: Disease and Culture in Early Renaissance Europe. In the process not only does he deliver a tremendously nuanced account of the impact of plague in Italy, but he certainly puts to rest the idea promoted by scholars such as E. La Croix that from “its first appearances in 1348, writing on plague was caged within intellectual systems devised in antiquity (principally Aristotle and Galen) and modified by Arabic physicians, philosophers, and commentators” remaining more or less fixed until the end of the sixteenth century or later (2).  Such a view is rooted in a larger conception of the intellectual stagnation presumably found in pre-modern scientific writings, giving Cohn’s effective demonstration of the vitality and evolving nature of medical writing in the sixteenth century importance beyond the realm of the history of medicine.
One thing that should be noted is that Cohn writes here of “plague,” not just the Black Death that has occupied so much of his work in the past. This is important, for his concern is with the way that epidemic conditions affected the culture and medical thinking on the Italian peninsula during the sixteenth century. Therefore, the precise nature of the illness—or the concatenation of illnesses—that made up these conditions is of little importance to the story that Cohn tells. This point is not immediately obvious, for he spends chapter two raising questions about whether or not the Black Death can be identified with the bubonic plague and the various terms referring to specific plague symptoms used in medieval and Renaissance writings. This chapter seems oddly out of place for someone who is primarily a social historian and the arguments, even if they do manage to cast doubt on the precise nature of the illness that first struck Europe in the 1345, seem tired and shopworn. However, the importance of this discussion becomes clear when the reader moves onto to chapters six through eight, “Plague Disputes, Challenges of the Universals,”  “Plague and Poverty,” and “Towards a New Public Health Consciousness in Medicine,” respectively. Through close attention to both narrative primary sources and the slender statistical data available for the period, Cohn is able to demonstrate that while prior to 1400 the plague seemed democratic in its effects, later visitations of illness in Italian cities were clearly most devastating in areas inhabited by the poor. The reason why seems clearly to be tied to the greater filth and crowding found in these areas, but the most significant factor seems to have been contaminated water supplies suggesting that diseases such as cholera and dysentery were the primary killers in the plague of 1575-78, even if Cohn does not name these illnesses.
However, Cohn’s two most important insights in this study deal with the nature of responses to plague. First of all, the rising importance of vernacular literature caused by increasing literacy among urban dwellers can be seen in Renaissance approaches to illness. When town dwellers in Italy began to die in large numbers after 1575 writers of plague literature emerged from a variety of societal ranks, from cobblers to bishops, to express themselves about the illness that preyed upon them. While the more educated among them made reference to authorities such as Aristotle and Galen, none seemed predisposed to either bow before the authority of medical professionals or to succumb to feelings of depression and fear in the face of wide-spread epidemic, as has been suggested by earlier historians such as Lynn Thorndike. Instead, writing in a variety of forms, from narratives such as that of the Venetian notary Rocco Benedetti’s Raguaglio minutissimo del successo della peste di Venetia (1577) to the epic plague poems clustering in Verona celebrating the overcoming of or liberation from illness, individuals with direct experience of the plague provided advice and statistics while discussing causes, all within a general framework of optimism.
Secondly, Cohn illustrates that medical professionals shifted their approach from one that focused on individual patients to a more general consideration of public health concerns. While remedies and discussions of causality that sound odd to modern readers abound in the medical literature of the period, so too do entirely rational discussions of the usefulness of boiling water, personal hygiene, and the link between proper diet and health. This shift made physicians the natural allies of governmental and church officials who put the ideas of these health professionals to work by providing food to the poor—due to a recognition of the relationships between poor nutrition and illness (210)—and cleaner conditions, as well as better education about how to avoid illness. While these Renaissance efforts may have been of limited effectiveness, Cohn’s account makes clear that this was due more to the limited resources at the disposal of pre-modern government and Church officials than to inherent ignorance on their part. Furthermore, the need for coordinated efforts in the face of plague led to increasing competence and reach on the part of both Italian regional governments and the institutions of the Church.
Cohn’s study does leave importance questions unanswered. For example, while he provides numerous charts showing the number of sixteenth-century works dealing with plague and the geographic distribution of authors and points of publication, he provides almost no information on who read these works or how they were read. Relying as he does on the very valuable Edit 16, the census documenting Italian books printed during the sixteenth century, this is understandable and should not be seen as a flaw in his study. However, the impact of the various works Cohn refers to cannot be fully known through a barebones recitation of publication information. For that, an analysis of copies of the texts themselves, including information such as that drawn from marginalia left by readers, would be necessary. Such an approach might make for an interesting future study, but for the present Cohn’s Cultures of Plague provides an intriguing and deeply insightful analysis of the effects of plague on the Italian peninsula during the late Renaissance.

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