HEALTH & MEDICINE: Changing Views on Disease

Section Author: Tracey J. Kinney, Kwantlen Polytechnic University


Learning Objectives

  • Identify varying responses to disease – its origins, causes, and impacts – in a number of different geographic locations
  • Examine how attitudes towards disease changed over time and across geographic space during the medieval era
  • Identify some of the impacts of successive outbreaks of disease during this period
  • Analyze visual representations of disease during the medieval period

Disease played a profound role in shaping societies throughout the medieval era. Reading contemporaneous responses to disease provides us with a unique window into medieval ways of thinking. Even though the documents in this section are all drawn from the early medieval era, they still cover a wide range of time and geographic space; yet, in each, the reader is able to discern key attitudes towards disease, its origins, and its impacts.

Illustration of bishop holding a book
Figure 3.1 Representation of Bishop Cyprian of Carthage, after whom the 3rd-Century outbreak of disease was named.

Each of the outbreaks of disease presented in this chapter is referred to by its author as a ‘plague’; however, the reader should be mindful that identifying the precise nature of any given outbreak in this period remains a difficult and contentious task. Most recently, epidemiologists have tended to argue that the 3rd-Century ‘plague of Cyprian’ was an outbreak of smallpox; yet others maintain it was hemorrhagic fever.[1] It seems more certain that ‘Justinian’s Plague’ (c. 540) was the bubonic plague; in this case, contemporary epidemiology aligns with the detailed description of the disease and its symptoms found in the work of Procopius. The ‘plague’ that decimated England around 664 may have been smallpox, yellow fever, or the bubonic plague. The cause of the 2nd-Century Antonine Plague, depicted in Sweerts’ painting “Plague in an Ancient City” was, for many years, misidentified as measles or typhus. Contemporary genetic analysis, however, points more strongly towards smallpox.[2]

Even as the biological causes of these outbreaks remain uncertain, their impacts can be assessed more fully. The pioneering environmental historian, Willam H. McNeill argued that the outbreak of bubonic plague that struck the Byzantine world during the reign of Justinian in the 540s was a key factor in the inability to reunite the eastern and western Roman empires.[3] Subsequent authors have gone so far as to argue that it was this outbreak of disease that made possible the survival of what we would come to identify as a distinct medieval West.[4]

Watch: “Placing the Plague of Justinian in the Yersinia pestis phylogenetic context.” Jennifer Klunk, McMaster University: Ancient DNA Centre.

Media Attributions

  1. Guido Alfani and Tommy E. Murphy, "Plague and Lethal Epidemics in the Pre-industrial World," The Journal of Economic History 77, no. 1 (March 2017): 316
  2. Jennifer Manley, "Measles and Ancient Plagues: A Note on New Scientific Evidence," Classical World 107, no. 3 (Spring 2014): 393-397.
  3. William H. McNeill, Plagues & Peoples (New York: Anchor Books, 1976), 124.
  4. William Rosen, Justinian's Flea: Plague, Empire, and the Birth of Europe (Carlsbad, CA: Brécourt Academic, 2007).


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The Ancient and Medieval World Copyright © by Adrianna Bakos; Barrie Brill; Niall Christie; Jessica Hemming; Aleksandar Jovanović; and Tracey J. Kinney is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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