¹ Mark Achtman, Giovanna Morelli, Peixuan Zhu, Thierry Wirth, Ines Diehl, et al., ‘Microevolution and history of the plague bacillus, Yersinia pestis’, Proc. Natl. Acad. Sci. USA, 2004, 101 (51): 17837–42. See also Kenneth L Gage and Michael Y Kosoy, ‘Natural history of plague: perspectives from more than a century of research’, Ann. Rev. Entomol., 2005, 50: 505–28; Dongsheng Zhou and 17 others, ‘Genetics of metabolic variations between Yersinia pestis biovars and the proposal of a new biovar, microtus’, J. Bacteriol., 2004, 186 (15): 5147–52; and the still useful review by Robert D Perry and Jacqueline D Fetherston, ‘Yersinia pestis: etiologic agent of plague’, Clin. Microbiol. Rev., 1997, 10 (1): 35–66.

² See the recent review by John Thielmann and Frances Cate, ‘A plague of plagues: the problem of plague diagnosis in medieval England’, J. Interdiscip. Hist., 2007, 37 (3): 371–93.

³ See David Nicholas, Urban Europe, 1100–1700, New York, Palgrave Macmillan, 2003, pp. 3–23; and Stephan R Epstein, Freedom and growth: the rise of states and markets in Europe, 1300–1750, London, Routledge, 2000, pp. 49–72.

⁴ “General” pestilence may have referred to the mortality occurring in all age groups, and I believe that it is more common among those places stricken before mid-1348. Studies of wills and testaments during this early period include Francine Michaud, ‘La peste, la peur et l'espoir: le pèlerinage jubilaire de romeux marseillais en 1350’, Le Moyen Âge, 1998, 104: 399–434; Shona Kelly Wray, ‘Speculum et exemplar: the notaries of Bologna during the Black Death’, Quellen und Forschungen aus italienischen Archiven und Bibliotheken, 2001, 81: 200–28; Richard W Emery, ‘The Black Death of 1348 in Perpignan’, Speculum, 1967, 42: 611–23; Christian Guilleré, ‘La peste noire à Gérone (1348)’, Annals de l'Institut d'Estudis Gironins, 1984, 27: 87–161; and Richard Francis Gyug, The diocese of Barcelona during the Black Death: the register Notule Communium 15 (1348–1349), Toronto, Pontifical Institute of Mediaeval Studies, 1994, pp. 3–74.

⁵ D'Agramont and medical theories will be discussed briefly below. For general discussion of Jacme d'Agramont's treatise within the contemporary medical framework, see Jon Arrizabalaga, ‘Facing the Black Death: perceptions and reactions of university medical practitioners’, in Luis García-Ballester, Roger French, Jon Arrizabalaga and Andrew Cunningham (eds), Practical medicine from Salerno to the Black Death, Cambridge University Press, 1994, pp. 237–88. The treatise is translated and published by M L Duran-Reynals and C-E A Winslow, ‘Regiment de preservacio a epidimia o pestilencia e mortaldats’, Bull. Hist. Med., 1949, 23: 57–89 (hereafter, d'Agramont, Regiment). Irma Naso surveyed medical aspects of plague literature, ‘Individuazione diagnostica della “Peste nera”’, in La peste nera: dati di una realtà ed elementi di una interpretazione, Atti del Convegno storico internazionale 1993, Spoleto, Centro Italiano di Studi Sull'Alto Medioevo, 1994, pp. 349–81. The strictly contemporary plague treatises of medical men are surprisingly few. Naso counts only twenty medical reports across western Europe, some of which were quite brief.

⁶ For contemporary Hebrew terminology, see Ron Barkai, ‘Jewish treatises on the Black Death (1350–1500): a preliminary study’, in Roger French, Jon Arrizabalaga, A Cunningham (eds), Medicine from the Black Death to the French Disease, Aldershot, Ashgate, 1998, pp. 6–25. On Arabic terminology, see Lawrence I Conrad, ‘Ta'un and Waba’: conceptions of plague and pestilence in early Islam’, J. Econ. Soc. Hist. Orient, 1982, 25 (3): 268–307. In general, see Arrizabalaga, op. cit., note 5 above, pp. 242–44. Epidemia and pestilentia did, however, take physicians to different bodies of medical literature.

⁷ Petrarca, Letters of old age [Rerum senilium libri], ed. and trans. Aldo S Bernardo, Saul Levin, and Reta A Bernardo, 2 vols, Baltimore, Johns Hopkins University Press, 1992, vol. 2, p. 372.

⁸ For example, a great plague in Florence in 1340 evoked traditional frameworks in the work of the chronicler Giovanni Villani. See Louis Green, Chronicle into history: an essay on the interpretation of history in Florentine fourteenth-century chronicles, Cambridge University Press, 1972, pp. 13, 37; many examples can be found throughout Alfonso Corradi, Annali delle epidemie occorse in Italia dalle prime memorie fino al 1850, 5 vols, repr. Bologna, Forni, 1972–1973.

⁹ Gabriele Zanella, ‘La peste del 1348: Italia, Francia e Germania: una storiografia a confronto’, in La peste nera, op. cit., note 5 above, pp. 49–135, rpt. online: http://www.gabrielezanella.it/Pubblicati/Todi93/Todi93.pdf, where the pagination begins with p. 1. I will use the pagination of the online version. To make his task manageable, Zanella omitted the Biblical and apocalyptical traditions and did not confront plague in medical texts, because a companion article by Irma Naso addressed that aspect of plague literature, op. cit., note 5 above, pp. 349–81.

¹⁰ Zanella, op. cit., note 9 above, pp. 16–17. I found too late Jussi Hanska's Strategies of sanity and survival: religious responses to natural disasters in the Middle Ages, Helsinki, Finnish Literature Society, 2002, with which study I might have made some correction to several particulars of my argument and examples.

¹¹ Arrizabalaga, op. cit., note 5 above. The few contemporary plague treatises of medical men are summarized and reviewed by Dominic Palazzotto, The Black Death and medicine: a report and analysis of the tractates written between 1348 and 1350, University of Kansas dissertation, Ann Arbor, University Microfilms, 1973, who translates substantial portions of each treatise.

¹² Arrizabalaga, op. cit., note 5 above, pp. 240–1. C-E A Winslow and M L Duran-Reynals, ‘Jacme d'Agramont and the first of the plague tractates’, Bull. Hist. Med., 1948, 22: 747–65, misunderstand the importance of d'Agramont's discussion of universal versus particular corruption of the substance of the air, so Arrizabalaga provides a necessary corrective. On Gentile of Foligno, see also Lynn Thorndike, A history of magic and experimental science, 8 vols, New York and London, Columbia University Press, 1923–58, vol. 3, pp. 241–6.

¹³ Arrizabalaga, op. cit., note 5 above, p. 247 and n. 36; and Naso, op. cit., note 5 above, pp. 356–61. Gentile of Foligno's ‘Consilium primum magistri gentilis de pestilentia’ is provided by Karl Sudhoff, ‘Pestschriften aus den ersten 150 Jahren nach der Epidemie des “schwarzen Todes” 1348’, Archiv für Geschichte der Medizin, 1912, 5: 332–5; to the point here: “… haec pestilentia sive epidimia sive quo nomine nominetur est multum verenda nec audita nec visa in libris …”, p. 332.

¹⁴ Best illustrating this claim is Melissa P Chase, ‘Fevers, poisons and apostemes: authority and experience in Montpellier plague treatises’, Ann. N. Y. Acad. Sci., 1985, 441: 153–69. Arrizabalaga, op. cit., note 5 above, allows the general argument that the philosophical framework of plague treatises changed after 1350.

¹⁵ Rosemary Horrox (trans. and ed.), The Black Death, Manchester University Press, 1994, p. 247.

¹⁶ Ibid., pp. xii, 4. “Verbal clichés” included unburied bodies and their overwhelming stench, entire families wiped out, survival rates under one in five, or even one in ten.

¹⁷ Arrizabalaga, op. cit., note 5 above, esp. pp. 248–59.

¹⁸ D'Agramont, Regiment, p. 62. Zanella, op. cit., note 9 above, makes a particular point of the fact that the plague did not strike all at once, and that some were blindsided while others were only receiving the news of plague far away, see pp. 53–4.

¹⁹ Horrox (trans. and ed.), op. cit., note 15 above, pp. 158–63.

²⁰ See John D North, ‘Astrology and the fortunes of churches’, Centaurus, 1980, 24: 181–211; and Bernard R Goldstein and David Pingree, ‘Levi ben Gerson's prognostication for the conjunction of 1345’, Trans. Am. Philos. Soc., 1990, 80 (6): 1–60; I am most grateful to Professor William Newman and Professor Gerrit Bos for these references. See also Arrizabalaga, op. cit., note 5 above, pp. 252–6, on the link between physicians’ use of astrological events when speaking of “universal pestilence” in 1348.

²¹ Horrox (trans. and ed.), op. cit., note 15 above, p. 158.

²² Gerrit Bos, ‘R. Moshe Narboni: philosopher and physician, a critical analysis of Sefer Orah Hayyim’, Medieval Encounters, 1995, 1 (2): 219–51, pp. 242–3. Narboni, a most learned physician, accepted the astrological framework and reconciled prediction with realities around 1350: “This disease already roams about in all parts of human settlement, but has not yet turned aside to the corners of the West. It started immediately after the conjunction of Saturn and Jupiter.”

²³ See the treatise edited by Sabine Krüger, ‘Krise der Zeit als Ursache der Pest? Der Traktat De mortalitate in Alamannia des Konrad von Megenberg’, in Festschrift für Hermann Heimpel. Veröffentlichungen des Max-Planck-Instituts für Geschichte, Göttingen, Vandenhoeck and Ruprecht, 1972, vol. 2, pp. 839–83, on pp. 865–6. Conrad argues that Saturn, the more malevolent planet, remains in a house for only two and a half years, and that the mortality lasted five to six years at least. Petrarca is far less generous to the astrologers, ridiculing them at every opportunity. See Petrarca, op. cit., note 7 above, vol. 1, p. 81.

²⁴ Dagmar Gottschall, ‘Scienza in volgare: Corrado di Megenberg e la peste del 1348’, in Nadia Bray and Loris Sturlese (eds), Filosofia in volgare nel medioevo, Atti del Convegno della Società Italiana per lo Studio del Pensiero Medievale, Lecce, 2002, Louvain-la-Neuve, Fédération internationale des instituts d’études médiévales, 2003, pp. 107–31. Conrad wrote a Latin treatise in 1350 or later, at the request of a cardinal in Avignon, and there more deliberately tried to accommodate and extend the Paris commentary. He was a canon in Regensburg who knew of the great earthquake and that plague deaths in southern German lands seemed to spread from the direction of the earthquake, rather than from the sea.

²⁵ Horrox (trans. and ed.), op. cit., note 15 above, pp. 163–72. See also Arrizabalaga, op. cit., note 5 above, pp. 252–4, who briefly discusses the astrological reflections of Alfonso of Cordoba and Jacme d'Agramont. Chase, op. cit., note 14 above, pp. 155–6, discusses Alfonso of Cordoba's reaction to the Paris masters in further detail. Discussion of the difficulty of fitting astrological explanations to the facts of the plague seems to have been particularly acute in Avignon and Montpellier.

²⁶ Petrarca, op. cit., note 7 above, vol. 1, pp. 80–1, to Boccaccio.

²⁷ “Stinking breath of the wind” comes from Petrarca's closest friend, Louis Sanctus [or Heyligen] of Beeringen, a musician in the papal court at Avignon. See the translated text in Horrox (trans. and ed.), op. cit., note 15 above, pp. 41–5, on p. 42, and note 36 below for a recent critical edition. He died in the second plague pandemic.

²⁸ Sylvie Bazin-Tacchella, ‘Considérations sur l'air, le temps et les saisons dans la Chirurgia magna de Guy de Chauliac’, in Claude Thomasset and Joëlle Ducos (eds), Le temps qu'il fait au Moyen Âge: phénomènes atmosphériques dans la littérature, la pensée scientifique et religieuse, Cultures et Civilisations Médiévales, XV, Paris, Université de Paris-Sorbonne, 1998, pp. 15–29.

²⁹ See here David Alexander, ‘Dante and the form of the land’, Ann. Assoc. Amer. Geogr., 1986, 76 (1): 38–49; Joëlle Ducos, ‘Théorie et pratique de la météorologie médiévale: Albert le Grand et Jean Buridan’, in Thomasset and Ducos, (eds), op. cit., note 28 above, pp. 45–58; and Stuart Jenks, ‘Astrometeorology in the Middle Ages’, Isis, 1983, 74 (2): 185–210. Though on a much earlier period, Barbara Obrist, ‘Wind diagrams and medieval cosmology’, Speculum, 1997, 72: 33–84, esp. pp. 75ff, is useful. The path of plague did not even work well with the traditionally understood movement of winds, but then both the diagrams of winds and their relationship to the physical world were problematic, because they both contributed to the stability of the greater cosmic order and, as in the case of plague, caused vast instability within the world; they breach the boundary between microcosm and macrocosm.

³⁰ D'Agramont, Regiment, pp. 64–6.

³¹ Horrox (trans. and ed.), op. cit., note 15 above, p. 161. Probably these larger weather patterns were not observable until evidence on tides and winds began to be compiled for maritime users in the later Middle Ages.

³² Laura A Smoller, ‘Of earthquakes, hail, frogs, and geography: plague and the investigation of the Apocalypse in the Later Middle Ages’, in Caroline Walker Bynum and Paul Freedman (eds), Last things: death and the Apocalypse in the Middle Ages, Philadelphia, University of Pennsylvania Press, 2000, pp. 156–87.

³³ Marco Battagli da Rimini (1312–1354), Marcha, ed. Aldo Francesco Massèra, Rerum Italicarum Scriptores (hereafter R.I.S.), new ed., vol. 16, part 3, Città di Castello, S. Lapi, 1912–13, pp. 54–5, though I here used the earlier edition: Breviarium Italicae historiae a temporibus Friderici II Augusti usque ad annum mcccliv ab anonymo Italo, sed synchrono, auctore consctriptum, ed. Ludovico Antonio Muratori, R.I.S., orig. ed., vol. 16, pp. 285–6; and see Green, op. cit., note 8 above, pp. 34–45, for extensive treatment of Giovanni Villani, who died in the plague, and the important post-plague chronicles of his brother, Matteo Villani, and of Marchionne di Coppo Stefani.

³⁴ Stuart Jenks, The Black Death and Würzburg: Michele de Leone's reaction in context [Yale University dissertation, 1976], Ann Arbor, University Microfilms, 1976, pp. 34–5, fn. 60. Jenks here translates a poem of Lupold Hornburg, in his ‘General Sermon about the world's cares and troubles: how or why they come to pass’, which he can precisely date between January and June 1348. Hornburg knows with some precision about the high mortality in Marseilles and Avignon, thus is probably writing no earlier than April. Diana Wood argues that Pope Clement VI publicly and officially emphasized the plague was caused by sin, but privately ordered autopsies and the reflections of astrologers; see Clement VI: the pontificate and ideas of an Avignon pope, Cambridge University Press, 1989, pp. 66–7.

³⁵ Guillelmi de Cortusiis, Chronica de novitatibus Padue et Lombardie, ed. Beniamino Pagnin, R.I.S., new ed., vol. 12, part 5, Bologna, Nicola Zanichelli, 1941–9, pp. 120–1: “De clade inaudita. Deus omnipotens qui non vult mortem peccatoris, sed ut convertatur et vivat, primo minatur, secundo vero percutit ad correctionem humani generis, non interitum. Volens affligere humanum genus plagis maximis, inauditis, primo in extremis partibus mundi, in orientis plaga cepit suum iudicium horrendum. Cum vero jam percussisset Tartaros, Turcos et genus infidelium universum …”, and then gave a second warning with the earthquake.

³⁶ Petrarca, Letters on familiar matters [Rerum familiarum libri], trans. Aldo S Bernardo, Albany, NY, State University of New York, 1975, book viii, 7, p. 417, another letter to his “Socrates”, Louis Sanctus. See here Jan Papy, ‘Creating an “Italian” friendship: from Petrarch's ideal literary critic “Socrates” to the historical reader Ludovicus Sanctus of Beringen’, in Karl A E Enenkel and Jan Papy (eds), Petrarch and his readers in the Renaissance, Leiden and Boston, Brill, 2006, pp. 13–30.

³⁷ Trans. by Green, op. cit., note 8 above, p. 44.

³⁸ Ibid., p. 45. For Gabriele de’ Mussis, see Horrox (trans. and ed.), op. cit., note 15 above, pp. 14–26; the Würzburg cleric Michele de Leone's Chronicle of the times of modern men was begun as pestilence raged all around Würzburg, but seems, like Matteo Villani's similarly started chronicle, to place plague within the larger context of lugubrious events. See Jenks, op. cit., note 34 abve, p. 12.

³⁹ Roland Hissette, ‘Albert le Grand et l'expression “diluvium ignis”’, Bulletin de Philosophie Médiévale, 1980, 22: 78–81. Marco Battagli is one of those who nevertheless believed that a destruction by fire (hence the great fever of plague) was predicted by Scripture; see Battagli, op. cit., note 33 above, p. 54.

⁴⁰ Before the Black Death, mortality associated with the great conjunction of Mars, Jupiter and Saturn (1345) was assumed to apply for only two years, at the most. That the conjunction was expected to have only short-term pestilence effects, see Goldstein and Pingree, op. cit., note 20 above.

⁴¹ D'Agramont, Regiment, p. 57.

⁴² Gentile, op. cit., note 13 above, p. 332: “… quae [pestilentiae] accidit Januae, quae venit de partibus orientalibus et meridionalibus et occupavit omnia loca marium et pervenit ad civitatem Perusinam …”.

⁴³ Two main stories, with some local embellishments, seem to have circulated around north central Italy during 1348. One was about the fate and itineraries of the Genoese ships and sailors, the other about a day of extraordinary mortality in Paris (where the plague had not yet hit). See the multi-authored ‘La peste nera, (1347–1350)’, in Ovidio Capitani (ed.), Morire di peste: testimonianze antiche e Interpretazioni moderne della ‘Peste nera’ del 1348, Bologna, Pàtron, 1995, pp. 99–168, esp. pp. 137–43, reviewing the chroniclers’ stories of the plague-bearing ships. Such stories do not fit cleanly within medical and religious constructions of a universal plague.

⁴⁴ Gilles le Muisit, Chronique et annales, ed. Henri Lemaître, series Société de l'histoire de France, vol. 322, Paris, Renouard, 1906, pp. 196–8. Gilles was abbot of the monastery of St Martin in Tournai, and completely blind from cataracts from August 1346 to September 1351, when an itinerant healer partly cured him. His extraordinary account of news of the plague, local flagellant processions and murderous rampages against the Jews, then finally the plague in Tournai, just happened to coincide with the three years when he wrote a chronicle. See Bernard Guenée, Between church and state: the lives of four French prelates in the Late Middle Ages, trans. Arthur Goldhammer, Chicago and London, University of Chicago Press, 1991, pp. 71–101.

⁴⁵ On the early views that plague could be outrun, see Ann G Carmichael, ‘SARS and plagues past’, in Jacalyn Duffin and Arthur Sweetman (eds), SARS in context: memory, history, policy, Montreal and Kingston, and London, McGill–Queen's University Press, 2006, pp. 50–1. On the plodding diffusion of the plague from Languedoc to Aragon over the spring and early summer of 1348, see Guilleré, op. cit., note 4 above, who provides cautionary evidence for those who believe that the plague actually spread much faster than rat-borne Yersinia pestis could have spread. Dire hunger in the countryside surrounding protected towns collected famished refugees and rats together in the places where grain stores were relatively more secure. Gerona was infected by spread of plague from Perpignan; just sixty-five miles away, Barcelona was just days before infected by maritime commerce.

⁴⁶ For example, Zanella further emphasizes that many chronicles make no mention of plague, or do so in the context of stressing other calamities, such as the widely felt earthquake or ongoing food scarcities or endemic wars. Milan, notably, was not stricken violently during the Black Death: see Giuliana Albini, Guerra, fame, peste: crisi di mortalità e sistema sanitario nella Lombardia tardomedioevale, Bologna, Cappilli, 1982, pp. 14–16, who nevertheless believes that plague and St Anthony's fire were conflated. Similarly for Jenks, op. cit., note 34 above, Würzburg is one of the places that escaped the plague altogether, but some there had considerable knowledge of the plague elsewhere.

⁴⁷ In less populated regions, it is important to acknowledge the lack of evidence as such. Most intriguing is Charles Halperin's Russia and the golden horde, Bloomington, Indiana University Press, 1985, pp. 83–4, describing the growth of Russian cities in the fourteenth and early fifteenth centuries as a “paradox”, if we are to accept the universality of the “plague” pandemic across Eurasia. Similarly Michael Burleigh, Prussian society and the German Order: an aristocratic corporation in crisis, c. 1410–1466, Cambridge University Press, 1984, suggests expansion until the fifteenth century, and Ole J Benedictow, The Black Death, 1346–1353: the complete history, Woodbridge, Boydell Press, 2004, pp. 209–10, 216–24, can find no evidence of the Black Death in the western Baltic regions. Not until the 1410s, for example, did the Teutonic Knights begin the slow process of economic and military decline within this vast region.

⁴⁸ Li Bozhong, ‘Was there a “fourteenth-century turning point”? Population, land, technology and farm management’, in Paul Jakov Smith and Richard von Glahn (eds), The Song-Yuan-Ming transition in Chinese history, Cambridge, Harvard University Asia Centre, distributed by Harvard University Press, 2003, pp. 134–75. Also see John Dardess, ‘Shun-ti and the end of Yüan rule in China’, in Denis Twitchett and John K Fairbank (gen. eds), The Cambridge history of China, vol. 6: Alien regimes and border states, 907–1368, ed. Herbert Franke and Denis Twitchett, Cambridge University Press, 1994, pp. 561–86, discussing the collapse of a bloated bureaucracy, in the face of harvest catastrophes, the flight of farmers from north to south China, and mortality stemming from the failure to maintain canals.

⁴⁹ Uli Schamiloglu, ‘The rise of the Ottoman empire: the Black Death in medieval Anatolia and its impact on Turkish civilization’, in Neguin Yavari, Lawrence G Potter, and Jean-Marc Ran Oppenheim (eds), Views from the edge: essays in honor of Richard W. Bulliet, New York, Columbia University Press, 2004, pp. 255–79, can offer only evidence for the depopulation in western Asia. Peter Jackson, The Mongols and the west, 1221–1410, Harlow, Pearson Longman, 2005, pp. 290ff, summarizes the evidence for a more southern passage of a great epidemic within the Muslim trade networks. The evidence for substantial incursions of a temporally limited, large-scale epidemic in India is similarly weak: Michael W Dols, The Black Death in the Middle East, Princeton University Press, 1977, pp. 44ff; and, more recently, Stuart J Borsch, The Black Death in Egypt and England: a comparative study, Austin, University of Texas Press, 2005, and Benedictow, op. cit., note 47 above. Cities cannot grow with rural demographic collapse: see the masterful work of John Landers, The field and the forge: population, production and power in the pre-industrial west, Oxford University Press, 2003.

⁵⁰ Zanella, op. cit., note 9 above, pp. 50–5; Michaud, op. cit., note 4 above. Pope Clement VI had designated 1350 as a jubilee year in 1343, long before the plague, thus many pilgrims could have set out believing the pestilence they survived was local or regional.

⁵¹ Battagli, op. cit., note 33 above, pp. 54–5. Marco narrowly escaped death himself: “Quidam minuit me sanguine et sanguis exiens eius faciem tetigit; et in ea die infirmatur et in alia moritur: et pro dei gratia ego evasi.” Battagli began his chronicle in the jubilee year; see p. xxiii of Massèra's introduction. Conrad of Megenberg also was clearly writing during the jubilee, trying to advance a different explanation for the universality of this plague; see Dagmar Gottschall, ‘Conrad of Megenberg and the causes of the plague: a Latin treatise on the Black Death composed ca. 1350 for the papal court in Avignon’, in Jacqueline Hamesse (ed.), La vie culturelle, intellectuelle et scientifique à la cour des papes d'Avignon, Turnhout, Brepols, 2006, pp. 319–32, and Krüger, op. cit., note 23 above; at the beginning of the treatise Clement VI is still living (thus it is written before 1352) and the years of plague are declared to be 1347, 1348, 1349, and “1350 ibileo” (at p. 863). Petrarca's association of the plague, the earthquake of 1348, and the jubilee is prompted by the earthquake in Rome, See op. cit., note 36 above, vol. 2, pp. 99–101 [Book ix, 7, to Louis Sanctus]: “What should I do first, lament or be frightened? Everywhere there is cause for fear, everywhere reason for grief…. Indeed whoever relates this state of human affairs to posterity, if there be any, will seem to be telling tales … an unusual tremor about which you probably still do not know shook Rome itself. It was so strong that nothing similar had occurred since the city's founding over two thousand years ago.”

⁵² Agnolo di Tura, Cronaca Senese, ed. A Lisini and F Iacometti, R.I.S., new ed., vol. 15, part 6, Bologna, N Zaniccheli, 1931–1937, is the best example; see pp. 551–57. Under the year 1347 he reported stories of the Genoese death ships, reports from friends in Pisa of a terrible pestilence there, and a rumour that a few families died of the pestilence in Milan, and their houses were completely sealed up, pp. 552–3. But when he actually saw the pestilence in Siena, beginning in May 1348, words could no longer describe just how horrible it was: “La mortalità cominciò in Siena di magio, la quale fu oribile e crudel cosa, e non so da qual lato cominciare la crudeltà che era e modi dispiatati, che quasi a ognuno pareva che di dolore a vedere si diventavano stupefatti; e non è possibile a lingua umana pareva che la oribile cosa, che ben si può dire beato a chi tanta oribilità non vidde”, p. 555.

⁵³ Robert Sallares, ‘Ecology, evolution, and epidemiology of plague’, in Lester K Little (ed.), Plague and the end of Antiquity: the pandemic of 541–750, Cambridge University Press, 2007, pp. 231–89, at pp. 255–79.

⁵⁴ Geoffrey of Meaux, trans. Horrox (ed.), op. cit., note 15 above, pp. 167–72. Geoffrey accounted for all these cases astrologically, and thus came quite close to a full astrological determinism needed to tackle some of these difficult questions about the non-universal effects of pestilence. This treatise also provides support for those of us who maintain the association of Yersinia pestis with these great plagues: the pestilence wiped out whole families, but at the same time had a patchy distribution at the street, city, and regional level. See Sallares, op. cit., note 53 above, pp. 258–60.

⁵⁵ It did, after all, rarely move with the prevailing winds, one of the accommodations within the medical literature for addressing the non-simultaneity of plague occurrences throughout the “whole world”. See Naso, op. cit., note 5 above, pp. 374–5, on explanations in terms of winds.

⁵⁶ Chase, op. cit., note 14 above.

⁵⁷ Here see Smoller, op. cit., note 32 above, pp. 156–87. On the longstanding connections of apocalyptical predictions to pestilence I find these contributions additionally useful: Richard J Clifford, ‘The roots of apocalypticism in Near Eastern myth’, in Bernard J McGinn, John J Collins and Stephen J Stein (eds), The Continuum history of Apocalypticism, New York and London, Continuum, 2003, pp. 3–29; Robert E Lerner, ‘The Black Death and western European eschatological mentalities’, Am. Hist. Rev., 1981, 86: 533–52; and Faye Marie Getz, ‘Black Death and the silver lining: meaning, continuity and revolutionary change in histories of medieval plague’, J. Hist. Biol., 1991, 24: 265–89. Louis Sanctus, writing early in the pestilence (27 April 1348), also notes Biblical descriptions of the ten plagues of Egypt, but I have found no other use of this comparison; see Papy, op. cit., note 36 above, pp. 25–7.

⁵⁸ Zanella, op. cit., note 9 above, pp. 49–55. The great earthquake near Villach, felt throughout most of Italy, was particularly important. See Christian Rohr, ‘Man and natural disaster in the Late Middle Ages: the earthquake in Carinthia and northern Italy on 25 January 1348 and its perception’, Environment and History, 2003, 9: 127–49. In Venice, an inscription at the entrance to the cloister of S. Maria della Carità, written in Venetian dialect, in gold lettering, put the events recently past onto, if not into, the stone, summarizing the earthquake's destruction of bell towers and churches, the beginning of the pestilence forty days later (a nice touch), the death of people from “diverse maladies”—some spewing blood through the mouth, some showing glanduxe in the groin or under the armpits (“vegnia glanduxe soto li scaii soto e ale lenzene”) and others having “lo mal del carbo[ne] per la carne”. The long inscription continues with mention of person-to-person spread, abandonment of family, a duration of six months, and huge mortality. The deaths of some of the scola's leaders are recorded, as well as the plenary indulgence. For this and other inscriptions, see Corradi, op. cit., note 8 above, vol. 5, pp. 197ff (at year 1348).

⁵⁹ Green, op. cit., note 8 above, pp. 38–9.

⁶⁰ Ibid., p. 35. Giovanni died in the Black Death and his brother Matteo, continuing the Florentine chronicle, was disinclined to follow any astrological warnings; he was, as we have seen, strongly convinced that all the calamities unfolding were evidence of God's punishment for humans’ sins.

⁶¹ Rohr, op. cit., note 58 above. Still essential is Arno Borst, Il terremoto del 1348: contributo storico alla ricerca sulle catastrofi, Salerno, P Laveglia, 1988. The eyewitness testimonials of the earthquake are discussed on pp. 22–8.

⁶² Emanuel Curzel, Lorenza Pamato, and Gian Maria Varanini, ‘Giovanni da Parma, canonico della cattedrale di Trento, e la sua cronaca (1348–1377)’, Studi Trentini di Scienze Storiche, 2001, 80: 211–39.

⁶³ The larger context of the perception and management of disasters is finally beginning to receive the attention of medieval and early modern historians. From a cultural perspective, see Jacques Berlioz, Catastrophes naturelles et calamités au Moyen Age, Florence, Sismel, 1998, and François Walter, Bernardino Fantini, and Pascal Delvaux (eds), Les cultures du risque, XVIe–XXIe siècles, Geneva, Presses d'Histoire Suisse, 2006. Neither book addresses the Black Death or the Friuli earthquake, but both provide larger socio-historical context of the perception and management of risks and behavioural responses to disaster. Christa Hammerl's interdisciplinary study of the 1348 earthquake sifts through the historical evidence to separate spread of the news of this quake from the regions where the tremor was actually felt; see the summary of her article online, in the EC project website for ‘Review of historical seismicity in Europe’, http://emidius.mi.ingv.it/RGISE/ii_20ham/ii_20ham.html.

⁶⁴ Petrarca, op. cit., note 7 above, vol. 2, p. 373 (to Guido Sette, Archbishop of Genoa, on how times change).

⁶⁵ I omit here also an important strand in the Black Death topos, unifying medical and lay accounts to some degree: the appearance of unnatural events that served as signs of larger environmental disturbances. Getz, op. cit., note 57 above, sets this material in the foreground, linking it to apocalyptical narratives.

⁶⁶ Corradi, op. cit., note 8 above, vol. 1, pp. 216–21, and even more insistently with 1371–74, vol. 1, pp. 222–6. Corradi was also an Italian delegate to the recurring international sanitary congresses of the late nineteenth century, which began to focus on the international control of plague before it was observed in east Asia during the 1890s. Corradi was equally convinced that close attention to the language used by chroniclers could permit him to distinguish epidemics of typhus fever from plague.

⁶⁷ Naso, op. cit., note 5 above, pp. 366–7.

⁶⁸ The whole passage is provided by Zanella, op. cit., note 9 above, fn. 65. It is interesting that Giovanni Villani does not use the word bubo, which means “owl” in Latin. He did incorporate discussion of bubones when recounting one version of the story of Gog and Magog. That version held that Alexander the Great had devised a way to keep the Tartars, believed to be descendants of one tribe of Israel, in check. They were stupid brutes, who could be fooled into believing that Alexander's army was ever ready to pounce, should they move beyond the high mountains where Alexander placed trumpets. The trumpets cleverly caught the wind when it blew in one unique direction, and thus served as warning. But over time owls built nests in the trumpets, which were silenced, emboldening the heathens. See Green, op. cit., note 8 above, p. 35, and Andrew Runni Anderson, Alexander's gate, Gog and Magog, and the inclosed nations, Cambridge, MA, Mediaeval Academy of America, 1932, pp. 83–5. Some plague tractates, trying to explain the prevalence of plague in autumn when the worst of hot, humid air had passed, fix their attention on the subtle winds coming off mountains.

⁶⁹ Cortusio, op. cit., note 35 above, p. 120.

⁷⁰ Agnolo di Tura, op. cit., note 52 above, p. 555: “E morivano quasi di subito, e infiavano sotto il ditello e l'anguinaia e favellando cadevano morti.”

⁷¹ Giovanni Boccaccio, Decameron, ed. and trans. by Mark Musa and Peter E Bondanella, New York, W W Norton, 1977, p. 4.

⁷² An example from the Cronaca Pisana is especially rich: “Chi morì d'anguinaija, che d'uno infiato, che apparìa al ditello; e ad alcuno apparìa alla coscia uno infiato: si chiamava tincone; e chi sputava sangue, e altri sozzi mali …”. This chronicler's description of the return of plague in 1374 reports even more local words for the buboes, col. 1065B: “… morendone alcuno per dì d'anguinaja, tincone, di soditelli, di faoni, ed altri sozzi mali”. See Lodovico Antonio Muratori (ed.), R.I.S., orig. ed., vol. 15, p. 1021. The Grande dizionario della lingua italiana translates “tincone” as an archaic word for abscesses or tumours of venereal origin; figuratively it referred to a disgusting, unwholesome person. The English physician John of Burgundy incorporates the vernacular “bocche” into his treatise: Sudhoff, ‘Pestschriften’, Archiv für Geschichte der Medizin, 1912, 5: 73–5; the Latin treatise uses gibbus (as a noun): ibid., pp. 75–80. See also the collection from various authors made at the University of Florence in 1969/1970, and reprinted in Capitani (ed.), op. cit., note 43 above, pp. 41–104; pp. 112–117 cull and re-present the texts that mention bubonic swellings. for inguinaria in 1270–71, see Corradi, op. cit., note 8 above, vol. 5, pp. 187–8.

⁷³ In 1374: Cronaca Pisana, in Muratori (ed.), R.I.S., orig. ed., vol. 15, p. 1065B.

⁷⁴ Jean Glénisson, ‘La seconde peste: l’épidémie de 1360–1362 en France et en Europe’, Annuaire-Bulletin de la Société de l'Histoire de France, 1968–1969, pp. 27–38; and Véronique Pasche, ‘Les épidémides de peste en Suisse Romande, vers de nouvaux comportements?’ in A Paravicini Bagliani and F Santi (eds), The regulation of evil: social and cultural attitudes to epidemics in the Late Middle Ages, Florence, Micrologus, 1998, pp. 125–36.

⁷⁵ Curzel, Pamato, and Varanini, op. cit., note 62 above, pp. 236–9, provide a recent critical edition of the canon of Trent's memoir. On the second epidemic Giovanni says (ibid., p. 238, ii. 81–4): “Item millesimo cclxi fuit alias pestis et mortalitas in universo mundo non minor prima peste, sed eiusdem naturae secundum quantitatem personarum quae illo tempore non erant tot quot in prima peste, sed sic subito et eodem modo quo primo moriebantur.” Instead, Matteo Villani was one of many who observed the high mortality among children and adolescents, but claimed vaiuolo, smallpox, took many of them. See M Villani, Cronica, con la continuazione di Filippo Villani, ed. Giuseppe Porta, Parma, Fondazione Pietro Bembo, 1995, vol. 1, pp. 455–6.

⁷⁶ Bartholomeo della Pugliola, Historia miscella Bononiensis, ab anno mciv. usque ad annum mcccxciv, ed. Ludovico Antonio Muratori, R.I.S., orig. ed., vol. 18, pp. 464, 466. “In questo anno [1362] fu una gran morìa in Bologna, grande e forte, ed era tutta una malattia, come fu l'altra mortalità, che nasceva una glandola sotto le ascelle, e sotto l'inguinaglia. Molta gente si partì, e andarono a Ferrara, dove non moriva persona. In questi dì incominciò questa mortalità, e andò sino al Gennaijo così leggermente, e venne montando, e finalmente crebbe sì forte di Maggio insino a parte di Ottobre, che quasi si diceva, che era morto tanto di gente come morì nell'altra, che fu in 1348. Di Maggio ancora comminciò la detta mortalità in Ferrara e per la Toscana, grande e forte, e per ogni parte …”. Under the year 1361 (col. 464), della Pugliola noted the plague's beginning in the Piedmont, in the countryside, moving to Milan “e morironvi oltre da 100000 Cristiani”. Similarly brutal in Parma, it moved to Rimini and throughout Romagna's towns and “finally everywhere”.

⁷⁷ Fons memorabilium universi, cited in Muratori (ed.), R.I.S., orig. ed., vol. 15, pp. 123–4: “Egrotantes autem parvis diebus continua febri patiebantur glandulas in altero duorum emunctorium, ascellis scilicet, aut inguine.” After noting his mother and father by name, he added, “Quid autem moror in lacrymis? Obierunt illa tempestate fratres, & omnes sorores meæ. Ego autem cunctorum minimus solus infantulus supervixi in magno gurgite.”

⁷⁸ Naso, op. cit., note 5 above, pp. 353–5, 358–60.

⁷⁹ Sudhoff, ‘Pestschriften aus den ersten 150 Jahren nach der Epidemie des “schwarzen Todes” 1348’, Archiv für Geschichte der Medizin, 1910–1925. I first excluded any treatise written before 1360. I then tabulated only Latin (omitting all vernacular) treatises provided in Sudhoff, ‘Pestschriften’ volumes: 4: 191–222 and 389–424; 5: 36–87 and 332–396; 6: 313–379; 7: 57–114; 8: 175–215 and 236–89; 9: 53–78 and 117–67; 11: 44–89 and 121–76; and 14: 129–168. I did not retrieve Latin texts which Sudhoff noted, but which were edited and published elsewhere, such as Pietro di Tossignano's important text from 1399.

⁸⁰ The exceptional, post-1400 treatise was written by a physician in Lübeck who trained in Montpellier during the 1380s. He also boasts his thirty years’ experience with plagues, which is highly atypical: Sudhoff, ‘Pestschriften’, Archiv für Geschichte der Medizin, 11: 144–63, on p. 148.

⁸¹ Since there is debate about whether or not he and others could have intended a livid or pustular eruption, I leave some words in the original.

⁸² Guy de Chauliac, Inventarium sive chirurgia magna, ed. Michael McVaugh, 2 vols, Leiden and New York, Brill, 1997, vol. 1, p. 119: “Post vero, anno 60°, pontificatus domini Innocencii sexti anno octo, retrogradando de Alamania et de partibus septentrionalibus, revenit ad nos mortalitas. Et incepit versus festum beati Michaelis, cum febribus, bochiis, carbunculis, et antracibus, paulatine augmentando et aliquociens interpolando usque ad medium anni sexagesimi primi; et postea ita furiose usque ad tres sequentes menses duravit quod non dimisit in multis locis medietatem gencium. Differebat tamen ab alia preterita quia in prima plures recesserunt populares, in secunda vero plures divites et nobiles et pueri infiniti et mulieres pauce.”

⁸³ Samuel K Cohn, Jr, The Black Death transformed: disease and culture in early Renaissance Europe, London, Arnold, 2002, pp. 55–67.

⁸⁴ Or: apostema perniciosa, or apostema antrosa, or apostema solidum.

⁸⁵ Yersinia pestis is “lymphotropic”, which means that this particular pathogen in a mammal finds its way to the lymph nodes, see Joan-Miquel Balada-Llasat and Joan Mecsas, ‘Yersinia has a tropism for B and T cell zones of lymph nodes that is independent of the type III secretion system’, Public Library of Science: Pathogens (http://www.plospathogens.org), 2006, 2 (9): 816–28.

⁸⁶ The most consistent advice offered in the tractates is that venesection be performed immediately after the patient senses a swelling's beginning, and the vein opened differed according to the site of the bubo. Differences emerge in the subsequent management of the bubo, with some recommending plasters and unguents using theriac, others insisting that theriac should never be used on axillary buboes. Examples from my sample of Latin plague treatises (Sudhoff, ‘Pestschriften’, Archiv für Geschichte der Medizin, 1910–1923) include extensive discussion of the management of plague buboes: 4: 209–22 (Henry Rybbinis of Wartislava, 1371–72); 6: 344–9 (Giovanni of Santa Sofia, late fourteenth century); 6: 369–73 (John Aygels of Korneburg, early fifteenth century); 7: 102–3 (an anonymous 1430s treatise from Prague); and 14: 158–62 (an anonymous Tractatus de febribus pestilencialibus, compiled around 1450).

⁸⁷ Naso, op. cit., note 5 above, pp. 366–8.

⁸⁸ Dangerous fevers were typically held to arise from corruption of one of the four humours, and because plague could not be securely identified with any one humour, its place within nosological schemes was anomalous.

⁸⁹ In my sample of Latin treatises, the ones who claimed first-hand experience with plague were Guy de Chauliac, from Montpellier, Johannes Jacobi, and an anonymous Lübeck physician in 1411.

⁹⁰ Modern scientific investigators forged an understanding of Yersinia pestis as an historically important disease only by simultaneous consideration of clinical appearances of victims and environmental perspectives of epidemics. The laboratory linked these two bodies of observations; it did not create them. The combined clinical/microbiological and epidemiological/environmental synthesis of plague was forged by a global scientific community confronting plague's epidemic spread over a similarly rapid time frame; see Myron Echenberg, Plague ports: the global urban impact of bubonic plague, 1894–1901, New York University Press, 2007. But despite the important later and better-known contributions of Institut Pasteur researchers, the synthesis of microbiology and plague ecology/epidemiology geographically most relevant to recurrent plague in Europe was worked out by Russian and Soviet scientists, from 1895 to the late twentieth century. See Sonia Ben Ouagrham-Gormley, Alexander Melikisvili, and Raymond Zilinskas, ‘The Soviet anti-plague system: an introduction’, Crit. Rev. Microbiol., 2006, 32: 15–64.

⁹¹ Cohn, op. cit., note 83 above, pp. 40–56.

⁹² Agnolo di Tura, op. cit., note 52 above, p. 555: “… ed era tanta la oribilità, che io scrittore vengo meno a pensare; e però non conterò più. E così durò in fino a settenbre, e sarebe troppo’ longo lo scrivare.” With striking archival evidence William Caferro shows how punishing warfare was during the Black Death; see his Mercenary companies and the decline of Siena, Baltimore and London, Johns Hopkins University Press, 1998.

⁹³ Guy de Chauliac, op. cit., note 82 above, vol. 1, pp. 117, 119: “Incepit autem predicta mortalitas nobis in mense Ianuarii, et duravit per septem menses. Et habuit duos modos. Primus fuit per duos menses, cum febre continua et sputo sanguini, et isti moriebantur infra tres dies. Secundus fuit per residuum temporis, cum febre eciam continua et apostematibus et antracibus in exterioribus, potissime in subassellis et iguinibus, et moriebantur infra quinque dies. Et fuit tante contagiositatis, specialiter que fuit cum sputo sanguinis, quod non solum morando sed eciam inspiciendo unus recipiebat de alio, in tantum quod gentes moriebantur sine servitoribus et sepeliebantur sine sacerdotibus; pater non visitabat filium, neque filius patrem. Caritas erat mortua, spes prostrata…. Et ego propter diffugere diffamiam non fui ausus recedere; cum continuis timoribus preservavi me cum predictis quantum potui. Nichilominus, versus finem mortalitatis incurri febrem continuam cum apostemate inguinali et egrotavi quasi per sex septimanas, et fui in tanto periculo quod omnes socii mei moriturum me crediderunt. Et maturato apostemate et curato, ut dixi, evasi iussu Dei.”

⁹⁴ Nicolas Weill-Parot, ‘La rationalité médicale à l'épreuve de la peste: médecine, astrologie et magie (1348–1500)’, Médiévales, 2004, 46: 73–88, viewed online: http://medievales.revues.org/document884.html.

⁹⁵ For examples, Jacques Daleschamps (actually Raymundus Chalmelli de Vivario (of Viviers), who lived in the 1380s at Montpellier), De peste libri tres, Lyons, Gulielmus Rouillius, 1552, p. 11: “Veteribus quidem pestis natura haud prorsus incognita fuit, sed nondum tam comperta, & explicata, ut ea cognitio ad curationem instituendam sufficeret”; and Johannes Jacobi, Sudhoff, ‘Pestschriften’, Archiv für Geschichte der Medizin, 5: 56–58, and 17: 16–32.

⁹⁶ For example, the Florentine Nicolo de Burgo's 1382 treatise: “Et summopere cavendum est, ne aer a dictis infirmis ex[s]piratus inspiretur et praecipue in hora mortis alicuius eorum, quoniam tunc ultimata putredo expiratur ab eis.” See Sudhoff, ‘Pestschriften’, Archiv für Geschichte der Medizin, 5: 354–65, at p. 355.

⁹⁷ Naso, op. cit., note 5 above, pp. 362–3.

⁹⁸ Daleschamps, op. cit., note 95 above, pp. 15–21, and for 1383, pp. 50–2. Chalmelli of Viviers struggled to explain why the ancients described nothing comparable to the plagues he had seen (pp. 11–14); he called the swellings tubercula and struggled to link them to other exanthems—carbunculi, herpetes, phlegmonae, erisipelata, gangrænæ (pp. 30–2, 147–50). Of the treatises that I read for this essay, he is the only author to note Pope Gregory the Great's plague. He holds that apostemes without fever are not pestilential, and that plague is a contagious disease, the contagion coming from the breath of the patient. He, too, gives extensive guidelines for management of buboes, pp. 160–8, and at this point begins to call the lesions bubones and glandulae.

⁹⁹ See, for example, Sudhoff, ‘Pestschriften’, Archiv für Geschichte der Medizin, 14: 145: “Cauebis etiam multorum conuersacionem precipue etiam in locis suspectis viuencium, quia vnus frequenter multos inficit”.

¹⁰⁰ Darrel W Amundsen, Medicine, society and faith in the ancient and medieval worlds, Baltimore and London, Johns Hopkins University Press, 1996, pp. 289–309; see also Danielle Jacquart, ‘Le difficile pronostic de mort (xiv^e–xv^e siècles)’, Médiévales, 2004, 46: 11–22, online: http://medievales.revues.org/document782.html.

¹⁰¹ Mario Ascheri, I giuristi e le epidemie di peste (secoli xiv–xvi), University of Siena, 1997.

¹⁰² Pestis manufacta theories during 1348 reinforced popular notions that plague contagion could be carried with impunity from one place to another, and thus that plague could be caused by a substance akin to poisons. On the survival and development of these ideas, see Paolo Preto, Peste e società a Venezia nel 1576, Venice, Neri Pozza, 1978; and William G Naphy, Plagues, poisons and potions: plague-spreading conspiracies in the western Alps, c. 1530–1640, Manchester University Press, 2002.

¹⁰³ Chiara Crisciani and Michela Pereira, ‘Black Death and golden remedies: some remarks on alchemy and the plague’, in Bagliani and Santi (eds), op. cit., note 74 above, pp. 7–39; Michela Pereira, ‘Mater medicinarum: English physicians and the alchemical elixir in the fifteenth century’, in French, et al. (eds), op. cit., note 6 above, pp. 26–52. Earlier work includes Robert Halleux, ‘Les ouvrages alchimiques de Jean de Rupescissa’, Histoire littéraire de la France, 1981, 41: 241–84; and, always, Thorndike, op. cit., note 12 above, vol. 3, pp. 347–69.

¹⁰⁴ Weill-Parot, op. cit., note 94 above.

¹⁰⁵ Marilyn Nicoud, ‘Médecin et prévention de la santé à Milan à la fin du Moyen Âge’, in Assainissement et salubrité publique en Europe méridionale à la fin du moyen âge—Epoque moderne, Clermont-Ferrand, Presses universitaires Blaise Pascal, 2000, pp. 23–37.

¹⁰⁶ Ann G Carmichael, ‘Contagion theory and contagion practice in fifteenth-century Milan’, Renaiss. Q., 1991, 44 (2): 213–56; and idem, ‘Epidemics and state medicine in fifteenth-century Milan’, in French, et al. (eds), op. cit., note 6 above, pp. 221–47.

¹⁰⁷ See chapter 5 of Ann G Carmichael, Plague and the poor in Renaissance Florence, Cambridge University Press, 1986. See also Carlo M Cipolla, Public health and the medical profession in the Renaissance, Cambridge University Press, 1976; idem, Miasmas and disease: public health and the environment in the pre-industrial age, New Haven, Yale University Press, 1992.

¹⁰⁸ In addition to my own publications on Milan's Necrologi, see Nicoud, op. cit., note 105 above, and Albini, op. cit., note 46 above, pp. 158–72.

¹⁰⁹ For example, catarrh and asthma were effectively the same disease phenomenon (same age distribution, no inter-annual variation, etc.) All the diagnoses before the calamitous 1510s and 1520s were made by university trained physicians, reporting in Latin. Most individuals over the age of two were assigned a cause of death.

¹¹⁰ Archivio Storico Milano, Fondo popolazione, parte antica. The general contents of the Necrologi are described by Emilio Motta, ‘Morti in Milano dal 1452 al 1552’, Archivio Storico Lombardo, 1891, 18: 241–86. I will cite individual death reports by date.

¹¹¹ Sudhoff, ‘Pestschriften’, Archiv für Geschichte der Medizin, 4: 404–6.

¹¹² Salvatore Spinelli, La Ca’ Grande. L'Ospedale Maggiore di Milano, Milan, Consiglio degli istituti ospitalieri, 1958; and G C Bascapé, ‘L'assistenza e la beneficenza a Milano dall'Alto medio evo alla fine della dinastia Sforzesca’, in Storia di Milano, Milan, Treccani degli Alfieri, 1953–1962, vol. 8, pp. 391–420. Giuliana Albini, Città e Ospedali nella Lombardia medievale, Biblioteca di storia urbana medievale, University of Bologna Press, 1993, pp. 114–8; and Evelyn S Welch, Art and authority in Renaissance Milan, New Haven, Yale University Press, 1995, pp. 117–43.

¹¹³ Douglas Biow, The culture of cleanliness in Renaissance Italy, Ithaca and London, Cornell University Press, 2006.

¹¹⁴ The age structure of plague mortality within my Milanese data set would be relevant to such a claim. Plague retained its ability to harvest its victims from all age categories, and did not display in Milan any evidence suggesting immunity to the pathogen within the population.

¹¹⁵ A useful recent overview is Patrice Bourdelais, Les épidémies terrassées: une histoire de pays riches, Paris, de la Martinière, 2003. See also Jean-Noël Biraben, Les hommes et la peste en France et dans les pays européens et méditerranéens, Paris, Mouton, 1975–1976; Mirko Drazen Grmek, ‘Le concept d'infection dans l'antiquité et au moyen âge, les anciennes mesures sociales contre les maladies contagieuses et la fondation de la première quarantaine à Dubrovnik (1377)’, RAD Jugoslavenske akademije znanosti i umjetnosti, 1980, 384: 27–54. On the modifications to plague-generated public health provisions, see W F Bynum, ‘Policing hearts of darkness: aspects of the international sanitary conferences’, Hist. Philos. Life Sci., 1993, 15: 421–34; Peter Baldwin, Contagion and the state in Europe, 1830–1930, Cambridge University Press, 1999.