Casanova and medicine

Casanovas’s Guide to Medicine, by Lisetta Lovett (Pen and Sword Books, 2021).

Forget the stereotype! Most people on hearing the name Casanova immediately think of a libertine and debauched figure, tropes peddled by numerous films (of which the 1976 Fellini version was particularly vicious), television series, plays, books and even music from the early 20th century. What would a man like that have to say about the serious subjects of illness and medical practice? ‘Is it all about venereal disease?’ was a common question from acquaintances during the six years or so that I was researching my book.

Whilst it is true that Giacomo Casanova was captivated by women and that he suffered with venereal disease several times in his life, his legacy is much more important than these reductive facts. He was a scholar, prolific writer, linguist, mathematician and philosopher, whose Memoirs have given researchers rich pickings on social, political and cultural aspects of his times. However, insights about medical practice and the lived experience of disease have been somewhat neglected, which is why I wrote this book. In doing so I grew to feel more sympathetic to the man even though I am a product of 1970s feminism. In particular I realised an important lesson, which is not to judge the behaviour of past eras by our current moral standards. This book is not about Casanova, which is why I have not focused on character judgements. Rather, this is a book about disease and medical practice in the 18th century, an era when contagious diseases were a frequent challenge to normal life. Although plague was less rampant than in previous centuries it was still much feared, as were smallpox, tuberculosis, typhoid and even influenza. The exact mechanisms of spread and how to treat them were both unknown. Life was a lottery, a situation that in a corona-virus world, we can all probably understand better.

‘The Gout’, by James Gillray (1799) (Wellcome Collection of Images CCBY).

Casanova wrote on a number of conditions apart from the pox. These range from duelling injuries to piles, skin complaints to stroke, cataract operations to gout; this last remains as painful now as was the case then. His descriptions provide alternately grim and amusing insights into public health measures, the doctor-patient relationship, medical etiquette and the dominant medical theories of the era. To help the reader understand the historical significance of the medical subjects covered, I have integrated throughout the book an extensive historical context drawn from contemporary sources of information and current literature on the history of medicine. I have also tried to make the book as jargon free as possible, taking care to explain medical terms when they arise because I wanted the book to appeal to a non-medical readership. It was my hope that readers would find these medical subjects animated and memorable thanks to encountering them through the prism of Casanova’s stories.

Casanova’s interest in medicine started as a teenager. He had wanted to study the subject at university in Padua, but his guardian the abbé Grimaldi and his mother would not hear of it. Instead he was directed to study ecclesiastical law and become a cleric. However, he maintained an interest throughout his life, kept himself informed and at times gave medical advice. Like most of contemporary society, he felt obliged to take an interest in his own health because ancient Greek medical theory, which still dominated medical understanding, stressed the importance of taking responsibility for one’s health through attention to life style, or regimen.

While Casanova was a librarian in Dux in the last years of his life, his doctor recommended that he write his Memoirs to control his black melancholy. It is thanks to this advice that we have his memoirs. They consist of 3800 folio pages organised into twelve bundles that start with his birth and continue to 1774, when they abruptly end because of his death in 1798 aged 72 years. The story of how the manuscript was preserved, edited and published subsequently is almost as colourful as Casanova’s life.

First page of Chapter II, Vol. X (later published as Vol. XII) of Giacomo Casanova’s manuscript of Histoire de ma vie (Bibliothèque nationale de France).

The lived experience of disease and medical understanding and practice in the 18th century may not seem to be of any relevance to us now. After all we have come a long way from the ubiquitous practice of bloodletting or purging patients. But on closer examination many of the episodes that Casanova describes relating to himself or others contain resonances. For example, avoidance of quarantine through foiling the Venetian cordon sanitaire, established to stop the spread of plague; support but also significant suspicion about inoculation for smallpox; the distress and stigma of having an itchy skin condition; the shame of suicide; the dangers of childbirth; patient ambivalence about their doctors’ advice; the absence of medical understanding about either the cause or mechanism of disease and therefore how to treat it. Of course medical science is so much more sophisticated today but the last year has illustrated that humanity can be as confused and vulnerable in the face of a disease as it was then. Medical hubris both from practitioners and a public that thinks medicine can treat everything has taken a tumble.

I have always been interested in history. As a medical student I persuaded my Medical School, then called Guy’s Hospital, to allow me to take a year off in order to study, amongst other things, a diploma course on history of medicine, run by the Worshipful Society of Apothecaries. A busy NHS career followed, eventually as a consultant psychiatrist, and a few years later I also took up an academic post in the medical school at Keele Univesity. There was little time to pursue my early interest although amongst the many psychiatric papers I published there were forays into history of psychiatry. One was a paper on Thomas Bakewell, who ran a small asylum on ‘moral therapy’ lines during the first decades of the 19th century. As a medical educationalist, I introduced into the undergraduate curriculum opportunities for medical students to undertake a project in a range of humanities subjects; many chose to do history, supervised by me or my colleague, an academic historian called Alannah Tomkins. Together we published a textbook on history of medicine with bite-sized chapters, designed to be easily accessible to busy medical tutors who wanted to introduce a historical perspective into their teaching.

Retirement has allowed me to pursue a second career as a medical historian. My interest in Casanova started whilst I was in Malawi on a volunteer psychiatric teaching programme shortly after I retired. The long, free evenings allowed me to read all of Casanova’s twelve volumes on my kindle, and thus the seed of an idea for a book was planted.

If you would like a foretaste of the book please go to my website.

– Lisetta Lovett

A version of this item was published on the Pen and Sword blog in February 2021.

The Literary and scientific stakes of transgender in eighteenth-century Italy and England: the case of Catterina Vizzani

The power of narrative prose to capture, represent, and inspire transgender lives bursts forth in the pages of the new anthology, Resilience, reminding us that identities remain invisible until they are featured in fictional enactments, documentaries, and life stories. At such moments, through narration, aesthetic and political spheres are collapsed, acquiring perspective-changing potential for readers who begin to imagine themselves and others in the participatory life of society, whether the intent of the narration is to be uplifting or condemning. By being present and performing their lives on the page, transgendered lives acquire agency, one of the purposes of a publication like Resilience, to name but one of the many LGBTQ+ publications that have rendered queer lives visible in the twentieth and twenty-first centuries.

Giovanni Bianchi, Breve storia della vita di Catterina Vizzani

Giovanni Bianchi, Breve storia della vita di Catterina Vizzani, romana, che per ott’anni vestì abito da uomo in qualità di servidore la quale dopo varj casi essendo in fine stata uccisa fu trovata pulcella nella sezzione del suo cadavero (Venice, Simone Occhi, 1744), title page.

Resilience is relatively new and reminds us of one of the most important publications in North America addressing the LGBTQ+ community, Out, in circulation since 1992. Out represents all aspects of LGBTQ+ life, including discrimination and the life-threatening scenarios to which the diverse, non-CIS community is subjected on a daily basis, with violence against those identifying as transgendered extremely high. As of September 2020, Donald Padgett reports in Out, 30 transgender people have been killed in the United States and Puerto Rico this year, the highest annual death toll ever. Reading through their stories of death and burial, the terms ‘misgendered’ and ‘deadnamed’ emerge often. In death there is no peace and their gender classification is often erroneous, with the wrong pronouns and forms of address being used, and with no care taken even to assure accuracy in the person’s name, with birth names often used instead of the names transgender people have chosen for themselves.

Closely mirroring our own twenty-first century narrative trajectory and debate about gender and sexuality are parallel publications appearing in eighteenth-century Europe about the transgendered Catterina Vizzani/Giovanni Bordoni, whose life story was interwoven into a medical novella penned by a professor of anatomy from Rimini, Giovanni Bianchi (1693-1775). His 1744 novella, Brief history of the life of Catterina Vizzani, Roman woman, who for eight years wore a male servant’s clothing, who after various vicissitudes was in the end killed and found to be a virgin during the autopsy of her cadaver (Venice, 1744), constitutes the first recounting of early modern transgender identity in Italy, and even Europe, with the intent of memorializing transgendered life and normalizing it for readers.

Giovanni Bianchi, An Historical and physical dissertation on the case of Catherine Vizzani

Giovanni Bianchi, An Historical and physical dissertation on the case of Catherine Vizzani, translated by John Cleland, 1st edition (London, printed for W. Meyer, in May’s-Buildings, near St Martin’s Lane, 1751), title page.

From the time Catterina Vizzani, a young Roman woman, began wooing the woman she was attracted to, she did so dressed as a man. Fleeing Rome to avoid the wrath of her friend Margherita’s father, and a potential trial for sexual misdeeds, Catterina Vizzani became Giovanni Bordoni, transitioning and becoming a male in spirit, deed, and body, through what was the most complete physical change possible in the eighteenth century for a transgendered man: the permanent use of a dildo, considered a true body part by Vizzani/Bordoni, and also Bianchi. The novella was also published in England, thanks to its English-language reworking by none other than John Cleland, author of the erotic 1748 novel, Memoirs of a woman of pleasure, better known as Fanny Hill. As can be seen from the title pages on the right and below, Cleland made significant, sensationalizing changes to the title in both the 1751 and 1755 editions of the novella that he published.

Giovanni, like the transgender people who were killed for their sexuality in 2020 as documented by Out, would also die for his gender, and upon his death would be ‘misgendered’ and ‘deadnamed’ exactly like transgender people some 276 years later, for the story is based on the autopsy of the body that Bianchi performed and his desire to undo the misgendering and deadnaming for posterity. However, when Bianchi’s slim volume made its way into Cleland’s orbit, he immediately seized upon the possibility of exonerating himself after the legal debacle that had ensued following the publication of Fanny Hill.

Giovanni Bianchi, The True history and adventures of Catharine Vizzani

Giovanni Bianchi, The True history and adventures of Catharine Vizzani, translated by John Cleland, 2nd edn (London, printed for W. Reeve, Fleet Street, and C. Sympson, at the Bible-warehouse, Chancery Lane, 1755), frontispiece and title page.

The Brief History of Catterina Vizzani, whose title he would sensationalize, offered him with a golden opportunity to present himself as a writer concerned with the public good by warning girls who passed as men of the stigma that awaited them were they to continue in their ‘lewd’ (Cleland’s term) behaviour. Indeed, Cleland’s intentions in reworking the story are completely different from Bianchi’s. Cleland blames Catterina as depraved, likening her to so many ‘female husbands’, who passed as men and about whom Henry Fielding had already written ominously in in The Female Husband, published in 1746.

Meanwhile Bianchi normalizes Vizzani/Bordoni by showing them in human interaction, building their lives, planning a wedding, and making a new life. Cleland, as we have seen, uses Vizzani as a cautionary tale of social disintegration and ruin, which naturally resulted in the most dire of consequences for Catterina, whom he never can ‘transition’ to accepting as Giovanni Bordoni, all of which is explained in the set of ‘needful remarks by the English editor’ he added to Bianchi’s Brief history, in which he explicitly argues his case for Catterina as negative exemplum. Nothing could contrast more starkly with Bianchi, who demands respect for all lives, seeing his role as doctor as that of succouring and saving every living being so that they could live the most fulfilling lives possible with whomever they wanted.

Henry Fielding, The Female husband

Henry Fielding, The Female husband, or the surprising history of Mrs Mary, alias Mr George Hamilton (London, printed for M. Cooper at the Globe in Paternoster Row, 1746).

Despite Cleland’s divergent representation of Catterina Vizzani/Giovanni Bordoni in his ‘translation’ of Bianchi’s novella, the work, nonetheless has made a tremendous impact on the representation of LGBTQ+ sexualities in the eighteenth century. Considered a salient example of Sapphic love and exclusive lesbianism prior to our reading of Vizzani/Bordoni’s as transgender, despite Cleland’s spin, the work proves what we set out to establish at the opening of this blog: narration of LGBTQ+ lives renders them visible. It is hoped that the availability of Giovanni Bianchi’s text in a faithful English translation for the first time in my volume will finally restore to Catterina/Giovanni all of the visibility, dignity, and agency to LGBTQ+ lives that the Italian author intended.

Clorinda Donato, California State University, Long Beach

Clorinda Donato is the author of the October volume in the Oxford University Studies in the Enlightenment series, The Life and legend of Catterina Vizzani: sexual identity, science and sensationalism in eighteenth-century Italy and England, published in collaboration with the Voltaire Foundation, University of Oxford. In this new volume Clorinda Donato analyses the medical, societal, and narrative transcultural stakes in the life story of the transgendered Catterina Vizzani, and the right to live free from social stigma and the resulting physical danger suffered by transgender people both yesterday and today.

This post is reblogged from Liverpool University Press.

Quarantine and Enlightenment: ‘Following the science’ in eighteenth-century Europe

Danilo Samoilovich (Samoïlowitz), Mémoire sur la peste

Danilo Samoilovich (Samoïlowitz), Mémoire sur la peste (Paris, 1783), title page.

‘Nous étions au XVIIIe siècle, qui est celui des Sciences et des Arts’, proclaimed Danilo Samoilovich in his Mémoire sur la peste (Paris, 1783, p. xviii). Dedicated to Catherine the Great, it was an account of his experiences as a physician during the great plague of Moscow in 1770-1771. It was also a tribute – in the most ‘enlightened’ of all centuries – to ‘the enlightened doctors of Europe’ who had discovered that plague was contagious, and could only be caught by contact with infected persons or substances. As a result, and under the guidance of an enlightened ruler, quarantine lines had been erected around plague-stricken Moscow. They had contained the disease there, and protected St Petersburg from infection. Once a cordon sanitaire had been established, Samoilovich concluded, plague ‘could not cross the limits fixed for it by the government’.  Containment worked when backed by ruthless political action.

When I came across this passage while working on plague in the eighteenth century, I thought it might interest historians of the Enlightenment; and I was reminded of it again when I read the recent blog by Cindy Ermus on ‘Leadership matters…’ (3 April 2020) which focuses on the plague epidemic of Marseilles in 1720-1721. The Moscow example certainly shows that leadership mattered there, but the Marseilles plague is also relevant because it demonstrated that Samoilovich was wholly wrong to think that all the enlightened doctors of Europe agreed that plague was contagious and quarantine necessary. In the 1720s physicians in France were deeply divided between contagionists and anti-contagionists, many of the latter from the famous medical school of Montpellier, and several of those who worked in Marseilles were eager to air their disagreements in print. Consequently, when Gabriel-François Venel came to write the authoritative article on ‘Contagion’ in volume 4 of the Encyclopédie (first published in 1754), he was compelled to declare that there was no issue more uncertain and divisive ‘in medicine than the existence or non-existence of contagion’.

Daniel Defoe, A Journal of the plague year

Daniel Defoe, A Journal of the plague year (London, 1722).

It had been equally divisive in England in the 1720s in debates between advocates and critics of a new Quarantine Act, introduced by Walpole’s government to be implemented if plague arrived from Marseilles. There should be a military cordon sanitaire around London, and the infected and their contacts were to be moved from their homes and isolated elsewhere. Under public pressure the most intrusive parts of the Act had to be repealed, but that did not stop a major controversy in the public press between contagionists and their opponents, in which Daniel Defoe proved his stature as journalist as well as novelist by not only writing a journal of an earlier plague year, but seeing the virtues and vices of both sides. It had to be accepted, Defoe insisted, that ‘a public good’ sometimes justified ‘private mischief’. In a plague, something had to be done by government to prevent more death and disorder.

It was the presumption of contagion, therefore, rather than the proof of it which provided political authorities with what ‘scientific’ justification they had for action in eighteenth-century Europe. It seemed plausible enough, given the concentration of disease in identifiable households and neighbourhoods, and that was sufficient to justify elaborate and expensive efforts at containment, not only in France and Russia, but in Germany and Scandinavia where there were major epidemics in the first decades of the eighteenth century. Like their predecessors in the seventeenth century, rulers of empires, kingdoms and city states were all eager to show that they were doing more than their neighbours and doing it more successfully. As in the present pandemic, subjects and citizens were assumed to need reassurance that their rulers were more effective, and indeed more ‘enlightened’, than their rivals.

A plague doctor, in Jean-Jacques Manget, Traité de la peste

A plague doctor, in Jean-Jacques Manget, Traité de la peste (Geneva, 1721), frontispiece. (Google Books)

This is not to say that they did not have some reputable medical authorities on their side, of course. In the 1720s, for example, the advocates of contagion included a major authority on plague, Jean-Jacques Manget of Geneva, who published a short treatise expounding his case. It had as its frontispiece one of the earliest illustrations of the protective uniform worn by plague doctors, in France and elsewhere. With its mask complete with a beak for holding herbs, it was a powerful statement about infection. According to Manget, it was worn by some of the anti-contagionist physicians from Montpellier in Marseilles, and something very like it was recommended for the confirmed contagionist physicians in Moscow in 1771. Like quarantine, masks as ‘personal protection’ against contagion have a long history.

As long as plague remained a real and present threat to Europe, the presumption of contagion and all it implied remained powerful. Early in the nineteenth century Russia was erecting land and maritime quarantine stations in the Black Sea region in order to defend its empire from infection from further East. In western Europe, which had scarcely seen plague for half a century, some governments felt better able to relax their vigilance, partly at least because they were under pressure from commercial interests wanting less quarantine not more. Even so, the relaxation was a very slow process.

Bonaparte Visiting the Pesthouse in Jaffa, by Antoine-Jean Legros

Bonaparte Visiting the Pesthouse in Jaffa, by Antoine-Jean Legros (1804).

One significant marker of changing perspectives is the famous picture of 1804 showing Napoleon in a plague hospital in Jaffa in 1799. He is portrayed touching the plague bubo of a patient, a gesture probably copied from one of the Montpellier-trained physicians practising in Marseilles in 1720, who wanted to prove that contagion held no terrors. In 1804 it was no doubt intended to show the superiority of Western science, and that plague presented no threat at all, at least to Europeans. Bonaparte had nothing to learn from modern world leaders about the political utility and propaganda value of a grand gesture, preferably supported by a little modern science.

In present circumstances some politicians in the UK claim to have been ‘following the science’ in their policies against a pandemic. That has never been as easy as it sounds. The history of plague is full of disputes where the experts – physicians in this case – were deeply divided. Since nothing at all was known about how plague was transmitted, about its dependence on rats and fleas, for example, argument was inevitable. In the case of Corona, the scientists know vastly more about their target. But even then they cannot always be unanimous in their judgements on the balance of probabilities when it comes to interventions whose outcome depends upon the behaviour of crowds as well as individuals. Then all action is political, and when the experts are divided about appropriate action, as they must often be, the quality of political leadership matters all the more.

– Paul Slack

Voltaire’s Letters on the English and the story of smallpox

‘It is inadvertently affirmed in the Christian countries of Europe, that the English are fools and madmen. Fools, because they give their children the small-pox to prevent their catching it; and madmen, because they wantonly communicate a certain and dreadful distemper to their children, merely to prevent an uncertain evil.’

Letters concerning the English nation

Title page of Letters concerning the English nation, London, 1733.

Here is Voltaire explaining inoculation to the French, quoted here in the translation Letters concerning the English nation, first printed in London in 1733 (published in French as the Lettres philosophiques). Voltaire lived in London between 1726 and 1728, and it is then that he learned at first hand about the English practice of inoculation. He decided, perhaps surprisingly, to include a letter on the subject in his Letters on the English, a work begun in London and published a few years later when he was back in France.

Letter 11, ‘On Inoculation’, is on the surface a description of how the English have embraced a modern medical technique then regarded with huge suspicion in France. But at its heart, this is a morality tale about the tension between empirical evidence and superstition, and that makes the letter seem a whole lot more topical. In her recent blog post, Leadership matters in the first days and weeks of an outbreak: lessons from the Great Plague of Marseille, 300 years later, Cindy Ermus wrote graphically about the outbreak of plague in Marseille in 1720, drawing uncomfortable parallels between the management of the crisis then and now. Voltaire’s letter on inoculation similarly acquires unexpected resonance in the context of the present crisis.

Le célèbre docteur Ane voulant introduire la mode de l'inoculation

Le célèbre docteur Ane voulant introduire la mode de l’inoculation, à Paris (c. 1784-1785). (BnF/Gallica)

The practice that Voltaire is describing is now strictly called variolation, and involves inoculating with the smallpox virus; inoculation with cowpox, that is vaccination, was a safer method introduced by Edward Jenner and others from the 1760s. Variolation was practiced widely in China, from where it spread to the Ottoman Empire and then to Europe. The first European country to take up variolation was England, where the practice became common from the 1720s, precisely the time when Voltaire was living in London.

Voltaire would have seen at first hand that even in England, inoculation was still mistrusted, and he uses what we would now call evidence-based argument to show the brute statistics of death. Modern journalists are currently talking a lot about the economic damage caused by the present pandemic, and the challenge of weighing human life against the health of the economy. Voltaire is in his time perhaps unusual in understanding that there is a link between a health crisis and a country’s commercial interests: ‘A trading nation is always watchful over its own interests, and grasps at every discovery that may be of advantage to its commerce.’

Lady Montagu in Turkish dress, by Jean-Etienne Liotard

Lady Montagu in Turkish dress, by Jean-Etienne Liotard (c.1756).

The most human note in Voltaire’s letter on inoculation is when he talks of the courage of Lady Mary Wortley Montagu, ‘a woman of as fine a genius, and endued with as great a strength of mind, as any of her sex in the British kingdoms’, who learned of inoculation in Constantinople (where her husband was British ambassador), and introduced the practice in England, with the active support of the Princess of Wales, Caroline of Anspach – ‘this Princess’, writes Voltaire, ‘born to encourage the whole circle of arts, and to do good to mankind’. The Letters on the English present a world of politics, science and literature that is predictably male-centred, and the letter on inoculation is a refreshing exception in presenting two remarkable female protagonists. And there have been journalists recently suggesting that many of the countries having most success in the fight against Covid-19 are those led by women…

Voltaire mentions in his letter the particularly severe epidemic that had swept Paris just a few years before he came to England: ‘Twenty thousand persons whom the small-pox swept away at Paris in 1723, would have been alive at this time’, he writes – no exaggeration, since modern historians put the figure at closer to 40,000 deaths. But what Voltaire does not say is that he experienced this epidemic at first hand. His close friend Génonville died of smallpox in September 1723, and in late October he went to stay with the président de Maisons at his house outside Paris, known nowadays as the château de Maisons-Laffitte (a beautiful baroque house designed by Mansart). From there he wrote to his friend the marquise de Bernières saying that ‘Paris is ravaged by this illness’ (30 October 1723), and listing their common friends who had died. Then Voltaire himself was diagnosed with smallpox, and he became dangerously ill, too ill to be moved. His friends feared for his life, a doctor was summoned from Paris (who apparently bled him copiously), and several weeks passed before he was out of danger. Finally, Voltaire was fit enough to leave the château de Maisons, and just as he left, a huge fire broke out, destroying a large part of the house: Voltaire’s visit to Maisons was not one his hosts quickly forgot.

Château de Maisons-Laffitte, by Jacques Rigaud

Château de Maisons-Laffitte, by Jacques Rigaud (1681-1754).

No sooner was Voltaire back in Paris than he got down to work. On the principle that you should never waste a good crisis, he wrote a poem addressed to Gervasi, the doctor who had, as he thought, saved him, and another poem to Mlle Lecouvreur, the great actress who had been present at Maisons when he was taken ill. He also wrote a letter to the baron de Breteuil (c. 5 December 1723), describing in fulsome detail the course of his illness; and then another anonymous letter appeared (c. 10 December 1723), apparently written to Voltaire by a fervent admirer, lauding the heroism of the poet, ‘truly the only poet’ in France, for having worked even during his illness. Voltaire could not have written a more glowing eulogy himself, and in fact that does seem to be what he did – forge a fan letter. These four pieces have long been known, but separately, and it was only when they were edited in the Oxford Complete Works of Voltaire (volume 3A, 2004, p.256-76) that we were able to understand for the first time that this amalgam of two prose letters and two poems was constructed deliberately as one single literary work, an epistle in prose and verse that Voltaire published in the Mercure de France in December 1723. The young ambitious poet had been out of the limelight for too long, and he was anxious to remind the literary world of the capital that he was back in Paris and in business – and his recovery from smallpox was a good story to tell.

What is interesting, to return to the Letters on the English, is that Voltaire does not tell that story here. This is a book written directly out of his experience of English life, but Voltaire never, ever, tells us everything. The Complete Works of Voltaire were begun in 1968, and the Voltaire Foundation plans to celebrate the completion of the 203 volumes at the end of 2020. When we chose the Letters on the English as the last major text to appear in the collection, we could not have known it would have this contemporary resonance. But Voltaire’s Enlightenment voice continues to resonate, powerfully, and often in ways we don’t expect.

– Nicholas Cronk

A (sacred) contagion

Les pestiférés de Rome by Alphonse Legros

Les pestiférés de Rome (c. 1855-1877), by Alphonse Legros. (BnF/Gallica)

You feel as though you are in danger. You know that what is threatening you is all around you and invisible. You feel precarious on this earth. When you look at the world out there, you are worried. Disorder makes you anxious, order reassures you. When you think of the days ahead, you find yourself in a state of bafflement; your mind vacillates between the fear of pain and disgrace and the hope for health and prosperity. At times of weakness or when your loved ones are exposed to risk, fear dominates. When they are safe, and you are feeling well, hope prevails. You are constantly suspended between opposite states of mind. Everything about your future and the future of your community seems unpredictable. You live in a constant state of emergency. Every day, you join your fellow citizens in lugubrious rituals where you remember the dead and celebrate the living, thank saviours and honour martyrs. You feel powerless. You do not understand; you know so little of the causes of your uneasiness. You wonder what they look like, where they reside, where they are from, how they affect you, when everything started, who was first affected, when misfortune will be over, and everything will be all right again. You have no answers.

Baron d’Holbach’s La Contagion sacrée

Title page of Baron d’Holbach’s La Contagion sacrée (1768).

But you realise that someone else knows more than you do. They do not have all the answers, but they do understand more than you, they are more acquainted with the invisible causes than you are, they have learned more. You trust them. You are scared. You have no choice. When their decrees are announced, you submit without a murmur; you adopt, without examining them, the prescribed ways of rendering the invisible agents harmless. You now follow their prescriptions methodically, ceremonially: you wear what they recommend, you purify your body according to their instructions, you move in the ways they endorse, in the places and times they have established. Sometimes, even those who have knowledge disagree, debate, fight battles, divide into sects. You doubt, sometimes. You do not like sects, perhaps. And yet you are scared. You do not know. You obey. You have no choice.

You are an inhabitant of this planet in the spring of 2020. You are also a believer from any time or place, according to the baron d’Holbach. Gods and goddesses may seem less real than viruses, but that does not mean they are less dangerous than a plague. The ghosts of religion and superstition can affect human life as much as a disease does. It is when fear meets ignorance and imagination, though, that the disease turns into an epidemic, a true ‘sacred contagion’: ‘fear is the most contagious of all passions’.

– Laura Nicolì

Laura Nicolì (Voltaire Foundation / LabEx OBVIL, Sorbonne Université) is currently working on the born-digital critical edition of Paul-Henri Thiry d’Holbach’s La Contagion sacrée ou Histoire naturelle de la superstition (1768), in the context of the Digital d’Holbach project.

The Taste of deception: plague, food, and medicine in seventeenth-century England

Today we are making a foray into the seventeenth century with Claire Turner. Claire is a first-year PhD student at the University of Leeds. Her research, which builds on her recent MA dissertation, focuses on how people experienced and perceived the plague through their senses in seventeenth-century England.

Butcher’s Row, London, 1800

Butcher’s Row, London, 1800. (Wellcome Images)

How well do you know your food, drink, and medicines? Do you trust their ingredients, appearance, and their taste? Recent research has demonstrated the importance of a balanced diet for convalescents in the early modern period. These concerns were equally prominent during London’s seventeenth-century plague outbreaks. People have always used their senses to decipher whether foods are pleasant or unpleasant, safe or unsafe. However, the senses could be easily deceived, no more so than in seventeenth-century discourses of food, drink, and medicine.

A cart for transporting the dead in London during the Great Plague

A cart for transporting the dead in London during the Great Plague. Watercolour painting by or after G. Cruikshank (1792-1878). (Wellcome Images)

In 1665, the plague visited London for the final time. Known as the Great Plague, this outbreak was arguably the most severe to visit the city in the seventeenth century. Concerns over the quality and wholesomeness of foodstuffs were paramount. In particular, Margaret Dorey has noted how contemporaries of plague outbreaks were suspicious of food traders such as butchers. A tract published in response to the outbreak included a warning to its readers. Roger Dixon highlighted the dangers of consuming meat which had been modified by the butchers who were selling it. The meat was blown into by the butchers with their ‘…filthy Pockey, Stinking, Putrified Breath, whereby they putrifie the flesh’. The practice of blowing meat was used by butchers in the early modern period to make their meat look plump, healthy, and fresh. In this way, butchers were deceiving the sense of sight. By making their foul meat look healthy, they actually further contaminated the meat by depositing their foul-smelling and potentially contagious breath into it.

Another significant outbreak occurred in London in 1625. At around the same time, Lady Frances Catchmay completed her compilation of medical recipes in A booke of medicens. One of these recipes concerned the plague. It advised the use of sugar to counteract the unpleasant taste of the remedy. Here, the use of sweet-tasting substances disguised the bitter and unsavoury taste of the medicine. As well as deceiving the sense of taste, the author of the recipe invoked the sense of sight by encouraging the addition of ‘three spoonefulls of white vinegar’. Derived from ancient European thought, the colour white was associated with purity. Research by Sidney W. Mintz has outlined that substances such as sugar and vinegar were deemed particularly effective when they were especially white. By influencing the colour and taste of the remedy, the author made the medicine appear even more effective and wholesome.

People strolling and buying plague antidotes in old St Paul’s Cathedral, London

People strolling and buying plague antidotes in old St Paul’s Cathedral, London. Etching by J. Franklin (1800-1861). (Wellcome Images)

Issues concerning sensory deception in diet and physick were evident across numerous plague epidemics. In both 1625 and 1665, authors of plague tracts focused on the hazards of consuming pleasant-tasting food and the benefits of eating seemingly unsavoury food. In 1625, London physician Stephen Bradwell advised his readers not to consume sweet-tasting foods because it ‘betrayes their vnfitnesse in times of Contagion’. Similarly, in London, in 1665, an anonymous tract encouraged the consumption of sharp-tasting sauces and juices alongside meats which did not putrefy and were easily digestible.

This awareness of the benefits of sharp-tasting foods was also present in tracts relating to plague outbreaks outside of London. In Oxford in 1644, Lionel Gatford informed his readers that often the most unsavoury and sharp tastes were ‘undoubtedly the most wholsome’. Therefore, these writers warned their readers not to let their sense of taste deceive them. To a certain extent, theories of food consumption and plague in the seventeenth century reinforced the notion that sensory ‘opposites attract’.

Ideas about illness and taste are once again at the forefront of our minds in the current COVID-19 pandemic. Health experts have reported that a proportion of COVID-19 sufferers experience an absence of the senses of taste and smell. It is clear, then, that the sense of taste will always remain a key indicator in experiences of illness and recovery. Alongside the other senses, taste in the seventeenth century was deceptive and hazardous. Today, its absence is just as menacing.

– Claire Turner

Leadership matters in the first days and weeks of an outbreak: lessons from the Great Plague of Marseille, 300 years later

It seems as though American society has all but ground to a halt: all sporting events postponed or canceled, Broadway shuttered, entire states closing schools and businesses, and issuing stay-at-home orders. While these tactics may seem extreme, the goal is to “flatten the curve”, or prevent local outbreaks of the COVID-19 from overwhelming our medical system and exacerbating a once localized crisis.

This year, we mark the tricentennial of an important event in the history of infectious disease, one that carries many lessons for us today as we assess the threat of the novel coronavirus in the United States, and debate the extent to which we must impose such social distancing and interrupt the daily routines of millions of Americans.

On May 25, 1720, a ship named the Grand Saint-Antoine, which had journeyed for nearly a year in the eastern Mediterranean, arrived back at the port of Marseille, France carrying bales of cotton, imported fine silks and other valuable goods destined for the foire de Beaucaire, one of the most important trade fairs in the Mediterranean. Unbeknownst to those on board and on land, it also carried the bacteria that causes plague. Within two years, as much as half the population of the port city had succumbed to the infection.

Eighteenth-century engraving of the Foire de Beaucaire. Musée de Nîmes.

Eighteenth-century engraving of the Foire de Beaucaire. Musée de Nîmes.

The Great Plague of Provence, or Great Plague of Marseille, brought southern France to its knees, and led much of the rest of the world to impose strict measures to prevent its spread. Understanding how the outbreak was mismanaged in its earliest days reveals that human actions and inactions can turn what begins as a local outbreak into a rampant pandemic. The key lesson for us today: we must demand more from our leaders than we have received to date, and they must prioritize containing the pandemic over everything, including economic well-being.

About two months prior to the arrival of the Grand Saint-Antoine in Marseille, a passenger died of what appeared to be bubonic plague days after boarding the vessel at Tripoli. Soon thereafter, another seven or eight men, including the ship’s surgeon, are said to have died on the route from Tripoli to Livorno, where Captain Jean-Baptiste Chataud made an emergency stop before heading back to Marseille. In this time, another three likely perished from plague.

Even so, local Italian doctors inspected the ship and declared the illness a case of pestilential fever rather than plague. As a result, authorities in Livorno allowed the ship to depart for Marseille with a patente nette, or certificate of health, that declared it free from infection, and the ship’s captain – who was reportedly in a hurry to get back to Provence in time for the trade fair – was more than happy to depart.

Upon the vessel’s arrival in Marseille, the ship endured an unusually short quarantine – only a few days, rather than the full term of about six weeks – despite the deaths that took place on board. Jean-Baptiste Estelle, the city’s premier échevin, or municipal magistrate, who owned part of the ship and a large portion of its cargo, had used his influence to arrange for the premature unloading of his shipment into the city’s warehouses – already infected with the bacteria, Yersinia pestis – so that they could be sold soon thereafter at the trade fair.

Dramatic scenes of suffering along Marseille’s Cours Belsunce during the Great Plague of Provence.

Dramatic scenes of suffering along Marseille’s Cours Belsunce during the Great Plague of Provence. Vue du Cours pendant la peste de 1720, by Michel Serre (1721). Musée des Beaux-Arts de Marseille.

Meanwhile, however, the signs of plague were becoming unmistakable as it claimed more victims. Several porters who had reportedly handled the ship’s merchandise fell ill and perished within two to three days. At this time, a local surgeon was called to inspect the bodies and determine the cause of death. Only then was the ship redirected to the quarantine station on the island of Jarre. But it was too late – plague had arrived in Marseille.

And yet, despite people purportedly “dropping like flies” according to one local eyewitness, rather than undertaking emergency measures to contain the plague, officials instead launched a major and elaborate campaign of misinformation. Local authorities hired doctors (for a large sum of money) to diagnose the local distemper as merely a malignant, pestilential fever, and thus, not plague. The reason? Money and feckless leadership. At stake was both the reputation of the city’s leaders, and more importantly, the livelihood of this ancient port city, which by the 18th century had become a major commercial capital.

Another representation of the plague in Marseille by Michel Serre. It depicts the city’s hôtel de ville with scenes of death and dying in the foreground.

Another representation of the plague in Marseille by Michel Serre. It depicts the city’s hôtel de ville with scenes of death and dying in the foreground. Vue de l’hôtel de Ville de Marseille pendant la peste (1721). Musée des Beaux-Arts de Marseille.

Amidst rumors throughout Europe, and fearing the consequences that a plague epidemic could have on Marseillais commerce, the city’s leaders and the Bureau of Health sent letters in July 1720 to the Regent in Paris, as well as to health officers in ports all over Europe, stating that local authorities had managed to contain the contagion. But they hadn’t. A full two months after the beginning of the outbreak, when plague in Provence could no longer be refuted, French authorities finally suspended all commerce out of Marseille, quarantined the city (and later the entire region), and put a number of measures in place to prevent the spread of the epidemic.

Unfortunately, however, thanks in part to the lies of local officials, it was too late. The epidemic had already begun to spread throughout the region of Provence, where it ultimately took as many as 126,000 lives.

In those first crucial weeks after the start of the outbreak, Marseillais authorities prioritized economic interests over public health. As a result, what began as a few dead aboard a ship became a virulent epidemic that raged in southeastern France for two years.

Such negligent misdeeds are all too familiar to us today. The first several weeks of the current health crisis saw the President of the United States, and his backers in the conservative media, refer to the novel coronavirus as a hoax, part of a conspiracy to destroy his presidency. Much like Marseille’s officials in 1720, the current administration claimed, incorrectly, that the virus has been contained. The president has also wrongly insisted that sick people should go to work, and that “anyone who needs a test gets a test.”

In an effort to downplay the pandemic, he ignored the advice of the CDC that the elderly avoid large crowds and long trips. And on March 11, his Oval Office speech – key parts of which his administration later scrambled to clarify – all but proved to the American people, and the world, that the president cannot be trusted to sensibly and effectively manage the current crisis.

Much as in 1720, the administration’s failure to act prudently in the earliest days of the coronavirus outbreak has resulted in an emergency that is now more difficult to predict, to track, and to contain.

Not for the first time, we are witnessing a breakdown of institutions that we would otherwise trust in times of crisis. Inept leadership and a campaign of misinformation helped turn yet another disease outbreak into a full-blown emergency.

In times of public health crises, and especially in those crucial early days of a new outbreak when concentrated, steadfast measures are essential, the quality of leadership matters.

– Cindy Ermus

Cindy Ermus is assistant professor of history at the University of Texas at San Antonio, and executive editor for the online journal, Age of Revolutions. She is currently completing a book on the Great Plague of Provence. Follow her on Twitter @CindyErmus.

A version of this article first appeared in The Washington Post under the title, “The danger of prioritizing politics and economics during the coronavirus outbreak: Three hundred years later, the lessons of the Great Plague of Provence are sounding an alarm.”

Un voyage fantastique dans les archives de la Société Royale de Médecine

‘…Trois figures allégoriques qui représentent le zèle du bien public, l’observation et l’étude, contemplent le portrait de sa Majesté et lui rendent hommage comme au Fondateur et au Protecteur de la Société royale de médecine’ dans Histoire de la Société royale de médecine…, t.1 (Paris, 1779), frontispice.
BIU Santé (Paris)

‘Qui voudrait faire un voyage fantastique, celui-ci ira plonger dans les archives anciennes de la Société Royale de Médecine.’[1] Jean-Pierre Peter formulait ce conseil il y a quarante-cinq ans dans Medecins, climat et épidimies à la fin du XVIIIe siecle. Il avait participé à l’étude quantitative par un groupe d’historiens de l’enquête météorologique et nosologique laissée inachevée par ‘la dernière-née des grandes académies parisiennes’.[2]

Marquée par le renouveau de l’hippocratisme, l’enquête devait permettre d’expliquer les épisodes épidémiques à partir de l’observation des phénomènes climatiques. Elle mobilisait le réseau des correspondants de la Société à l’échelle du royaume dont elle rassemblait les observations. Ce dossier a fait l’objet d’un récent projet de numérisation accessible en ligne.

Ce chantier n’est que l’un aspect des travaux de la SRM, compagnie à l’identité incertaine et aux activités foisonnantes. Les soubresauts institutionnels et les relations avec l’Etat de la Société sont bien connus, ainsi que son Secrétaire perpétuel, Félix Vicq d’Azyr. Incarnation d’une médecine éclairée et renouvelée, la SRM est aussi étroitement liée aux dynamiques de la Cour et à l’essor du commerce et de la consommation pharmaceutiques. Outre l’enquête météorologique et nosologique, ses activités concernent les eaux minérales et les remèdes secrets et leur régulation. Les lettres reçues des correspondants provinciaux et étrangers conservées dans les archives concernent l’ensemble des enjeux médicaux des dernières décennies du XVIIIe siècle dans le domaine des pathologies, de la thérapeutique, de la police médicale ou de la réorganisation des professions de santé.

Au carrefour des recherches sur les liens entre atmosphère et santé et prérogatives dans la règlementation des remèdes, la SRM s’est appropriée l’évaluation d’un moyen de guérir spectaculaire et en vogue durant les années 1770: l’électricité.

Pour documenter les pratiques et les parcours médicaux des malades analysés dans L’Electricité médicale dans la France des Lumières, j’ai pu profiter de la richesse des observations des médecins correspondants de la SRM. Dans les archives des essais orchestrés par Pierre Mauduyt de la Varenne s’accumulent les ‘dossiers médicaux’ de malades dont l’histoire de la maladie et du traitement est soigneusement compilée. Ces histoires mettent en lumière la diversité des recours thérapeutiques mobilisés pour les malades du ‘peuple de Paris’ et les négociations qu’ils mènent avec les personnes qui les soignent en réclamant ou refusant des remèdes ou des traitements particuliers. Les obstacles physiques, linguistiques ou sociaux à la rencontre de soin apparaissent nombreux.

Abbé Joseph Sans, Guérison de la paralysie par l’électricité (Paris, Cailleau), 1778, pl.4. Wellcome Library, Londres.

La cohabitation des malades dans le cadre du traitement au domicile du médecin est parfois problématique. C’est le cas notamment lors du traitement d’un compagnon maçon nommé Le Noir pour lequel Mauduyt note:

‘Il est venu saou où au moins ivre 2 a 3 fois: il étoit horriblement mal propre et puant des pieds; les autres malades s’en étoient plaint, ils m’avoient assuré qu’ils avoient vu des pous courir sur lui et Schmal qu’il en avoit gagné. je le pris en particulier, pour lui parler sur tous ces objets. je le fis avec beaucoup de ménagement: il me répondit fort insolement; revint trois ou quatre jours après avec sa femme et tous deux me dirent d’un air insolent qu’ils venoient chercher ses pantoufles et que le roi sauroit comment il avoit été traité chez moi; je lui répondit de prendre ses pantoufles et de se retirer’ (SRM 118, dr. 26)

Des enjeux institutionnels et politiques aux vicissitudes des interactions thérapeutiques, les archives de la Société Royale de Médecine fournissent une documentation riche à qui s’intéresse à la société de la fin de l’Ancien régime. Ces ressources sont bien connues et mobilisées par les historiens mais on pourrait souhaiter une réévaluation globale du fonctionnement de l’institution en articulant les échelles de ses activités et la diversité de ses acteurs. Ce que les moyens informatiques rendaient utopique il y a un demi-siècle est désormais réalisable.

– François Zanetti

[1] On peut trouver un inventaire en ligne des archives de l’Académie nationale de médecine.

[2] Voir l’article de Daniel Roche, ‘Talents, raison et sacrifice. L’image du médecin des Lumières d’après les Eloges de la Société royale de médecine (1776-1789)’, dans Annales, Economies, Sociétés, Civilisations (1977), 32:5, p.866-886.