Bulletin of the History of Medicine

Writing a comprehensive history of a disease entails, particularly for the early centuries, the risk of misrepresenting its identity by the omission of essential details and by the application of “an unconscious but powerful ontology of disease derived from the identification of pathological microorganisms in the [End Page 319] nineteenth and present centuries”—a risk exemplified in a book by Claude Quétel, Le Mal de Naples: Histoire de la syphilis (1986), according to a review in the Bulletin. ¹ The reviewer, Roger French, has now done his share to redress the balance and to complement certain angles of Quétel’s already entrenched monograph. ² French has added his vast knowledge of medical thought to Jon Arrizabalaga’s thorough understanding of plague literature and John Henderson’s methodical studies of Renaissance charity and public health, to probe the reactions to a “new” disease.

The Great Pox interweaves the old-fashioned exegesis of treatises, spurned by Quétel, with the reconstruction of their contexts (in medical faculties, ducal and papal courts, and urban society) and with the quantification of hospital archives. Fixing their gaze on the period between the 1490s and 1600, the authors studiously avoid retrojecting current scientific knowledge or projecting progress toward modern medicine. Their concern with historicity, together with an appreciation of the importance of nomenclature, leads them to exclude “syphilis” from their discussion. The subject matter is what most contemporaries called the “French Disease” (morbus gallicus), although there were attempts at medical designations (lues venerea, pudendagra); even though however, Arrizabalaga and his coauthors emphasize the nosological irrelevance of national labels and the chauvinism of insisting on “le mal de Naples.”

The sharp focus on Italy (with less sustained attention to Northern Europe) and the allusions to the religious framework (without systematic elucidation) may have allowed some oversights to slip past all three authors. In one stumble, a well-known woodcut from Augsburg is said to show “the Christ Child as the instrument of God’s wrath throwing bolts at women who were regarded as the main transmitters of disease and at their unfortunate victim” (p. 88)—whereas, in fact, healing rays are emanating over two praying pox victims (one of whom may be a young male). In this surprising misreading, both of iconography and of Christology, the authors contradict their own observation that the incunabulum with this frontispiece presents the pox “as one of the weapons hurled at man, not by God, but by the gods of the classical pantheon” (p. 98); most important, the interpretation reinforces overstated notions of plague as punishment and women as agents. In a similarly minor slip with broad implications, Venetian patricians performing a Holy Thursday ritual were supposedly “imitating Christ’s action in washing the feet of the leper” (p. 167). Jumbling the Gospel reports of the Last Supper and two incidents in Bethany, this vignette is turned into a demonstration not only of charity and humility but also of the hope to fight contagion—thus reflecting the mixed motives behind the humanitarian movements.

A central thesis of The Great Pox is that the epidemic—and, subsequently, the popularity of guaiacum—played a crucial role in the spread and function of [End Page 320] hospitals degli incurabili. This thesis should stimulate further inquiries into several aspects, including the changing definitions and implications of “incurability.” In any event, the chronic nature of the disease accounted for both its growing social impact and the slow official response, while the mystery of its spreading contributed more to intellectual discourse than to preventive measures. Debates about contagion loosened the reliance on qualitative and complexional etiologies and introduced physical and material concepts. In the process, attention shifted from the patient to the disease, while the latter changed from a mere condition to a “thing” with its own genesis and life cycle. The most dynamic insight of the humanists who discussed the Great Pox, and the most convincing conclusion of this book, is that disease...