Journals of the plague years

Diarmaid MacCulloch on the epidemic that shocked a continent

The Great Pox: the French disease in Renaissance Europe by Jon Arrizabalaga, John Henderson and Roger French, Yale pounds 25

Italy had a bad year in 1495. French armies invaded, sparking military and political miseries which over a century extinguished much of Italy's civic vitality. A terrifying disease also arrived. Apparently as fatal as plague, unlike the plague it played with its victims for months or years, destroying their looks, their flesh and sometimes their minds, producing sores and scabs which stank and made the sufferers loathsome.

The disease rapidly set off on its travels, reaching as far as Aberdeen by spring 1497, a quincentenary which the Granite City is unlikely to commemorate this year. Naturally the Italians called the new disease the French pox, a name which caught all Europe's imagination, much to French annoyance. France's attempt to re-label the pox as the Neapolitan disease was not an especially successful piece of spin-doctoring.

We now call this pox syphilis. The three co-authors of this book deliberately avoid talking about syphilis, which 20th-century doctors know, diagnose and have the means of curing. They do discuss the poem by a 16th-century doctor whose title gave syphilis its modern name, because the very fact of this poem is part of the book's theme. What modern doctor would analyse an unknown disease by writing Latin verse about it addressed to the muse of astronomy? Yet no-one in the 16th century made fun of Girolamo Fracastoro when he did just that, and indeed what he said about the French Disease was marginally more sensible than most other contemporary medical opinion.

So do not look to this book for epidemiological analysis, or answers to the vexed question of where syphilis came from: ancient European spirochete with a sudden wanderlust, or novel import from America, the New World's revenge on the Old for Columbus's invasion? The book's title is over-comprehensive: apart from one brief German excursion, Italy is its focus.

We read about Renaissance scholars trying to use all their cultural resources to make sense of a baffling and terrifying disease. We are shown just how radically different from our own culture was an age which seriously debated whether the French pox could exist at all, since apparently it lacked a proper Latin or Greek name.

A killer plague which merely had an Italian nickname lacked respectability. If it could not be described by a word recognisable in the ancient world, then there was no basis on which to start working out a treatment. For humanists besotted with classical wisdom, it took a leap of the imagination to suppose that reality could extend past the knowledge of a dead philosopher.

Meanwhile, the disease went on maiming, killing and terrifying. Action had to follow straight away, if Italy was not to become a chaos of stinking, panic-stricken and contagious beggars. The book changes gear in its centre, becoming a detailed examination of the new medical institutions set up in Italy to deal with the pox. The flagship among these purpose-built hospitals was an impressive foundation in Rome; this has left a rich archive, enabling us to count the very rags clothing the wretches who turned up for treatment.

The hospitals were called Incurabili, a happily inaccurate name, since the death rate in them was surprisingly low. One treatment which seems to have worked was to use a wood called guaiacum, both for drinking and for battling skin problems. The wood had been discovered in America, so it had to be imported, and was reassuringly expensive. Charitable ladies held fund-raising drives ("World Pox Day"?) to pay for it, and for the work of the Incurabili generally. Still, many doctors resented guaiacum. How inconsiderate and indecorous for an unprecedented disease to have an unprecedented cure!

The authors engagingly admit that to discuss Renaissance doctors discussing the French pox is to describe "nonsense". The least barmy medical advice, from one Pere Pintor, was to run away from an outbreak. Those poor humanist intellectuals really didn't have a clue about the pox - nor did anyone until 1909, when syphilis became the first major disease to be conquered by a targetted drug. We are left to make the comparison with Aids, which also leapt class and geographic barriers before anyone noticed.

Like Aids, the pox developed its own literature, because it became the guest of the powerful and the articulate - in those days that meant noblemen and clergymen. The pox also sparked blind prejudice. We are at our most self-revealing when we try to give catastrophe a tidy space in our world. We define who we are by defining the outsiders who brought us the catastrophe. Will the tabloid journalists who blamed Aids on Haitians, homosexuals or heroin addicts find sympathetic chroniclers in half a millennium's time?