Katharina Wolff's monograph is an ambitious one, studying both medieval theories of plague and how the study of such theories was intertwined with the work of historians of medicine at the time of the bacteriological revolution. Wolff examines not only how medieval European societies coped with infectious disease but also the sociocultural significance of the historiography of medieval epidemics. “Sickness,” Wolff argues, “happens to individuals, diseases happen to societies” (18, 272). Linking the disparate elements of her study is the argument that epidemics are always defined by those observing them, whether those observers are medieval chroniclers, modern scholars of the humanities, or scientists in either period.
The work poses four questions: What concepts of disease did medieval Europe have? What advantages did each theory offer, and what, for people confronting the reality of plague in premodern Europe, were the advantages of ambiguity? How are concepts of plague and therapeutic regimens made visible in plague treatises? Finally, how can we explain the endurance of ancient and medieval theories of plague through the historical moment of microbiology? The wide scope of these questions would furnish material for several studies. Perhaps inevitably, combining them in a single volume makes for a work that, while impressive, is not fully cohesive.
Chapter 2, on medieval theories of disease, analyzes over half a dozen concepts of etiology and related methods for coping with illness, whether through empiric medicine, charms and amulets, or religious ritual and devotion. Commendably, this chapter pushes back against a narrative of medical theory that would move from religious towards rational and scientific models of explanation. Wolff argues that, rather, different models of explaining plague were employed according to contextual needs through the sixteenth century. Moreover, she reads plague treatises themselves as a genre of consolatio, providing comfort and security in times of trouble. It might have been helpful to have more explication of why Wolff draws the divisions between, e.g., magic and astrology that she does. This is particularly true since, as the book's second appendix makes clear, multiple modes of explaining and coping with plague might be advanced in a single plague treatise. Wolff's valuable appendix tabulates over thirty such manuscripts, analyzing both theoretical content and prescriptions. Chapter 3 turns to the question of how these theories affected individuals’ daily experience of plague as a social reality, regardless of their own status of infection.
A third of the book's main text is devoted to a case study of three southern German cities – Munich, Augsburg, and Nürnberg – with careful close reading of the archival sources and analysis of how ordinances and treatises were published and circulated. This kind of examination of the practical implications of medical theory, and how theories of disease affected life for individuals and urban communities, is very valuable. Much of the relevant documents’ text is reproduced in the book's text and footnotes. This fourth chapter also discusses how the hospital landscape of Nürnberg became denser in the long thirteenth century. The creation of dedicated plague hospitals that became more common in the late fifteenth and early sixteenth centuries, relying on miasma theory, continued to be the norm through the late nineteenth century. In a discussion of a rabies outbreak in Augsburg, Wolff points out the difference between the social and medical responses to a disease with clearly traceable infection patterns, and those to plague, more mysterious and therefore likely to have religious causation attributed to it. Although Wolff points out that miasma theory, not stigma, was responsible for the quarantine of convalescent residents of plague hospitals, she still treats segregation of the leprous as a norm from which Nürnberg departed.
Chapters 5 and 7, bracketing the conclusion, are more clearly linked to each other than to the rest of the book. Chapter 5 provides a brief history of microbiology “from idea to science” (225), via biographical sketches. It asks provocatively what it might mean for a self-consciously future-oriented discipline to look more thoughtfully to its past and to define that past more expansively. However, it occludes the history of the diffusion of ideas in favor of individual researchers and their discoveries. Max von Pettenkofer's ideas about hygiene are described as making him “a figure between eras” (247-248). This approach to periodization seems to me to limit and undermine some of the work Wolff does elsewhere in connecting ancient and medieval theories and ignoring divisions sometimes made between the medieval and the early modern. This section, in contrast, seems to focus on paradigm shifts despite not locating them in precise historical moments. Chapter 7 argues that broadly based social responses to plague and epidemic disease were more normative in premodern societies than in our own. Wolff avoids direct comparisons between past and present but seems to suggest that the modern quest for certainty in the face of pandemic disease may be less accommodating to the needs of individuals and societies than medieval acceptance of ambiguity was.
As the foregoing aims to make clear, Wolff's work is conceptually ambitious. And in its case studies using archival sources, it is extremely impressive. But it is weakened in places by its failure to engage with relevant scholarship. Despite the analysis of plague treatises in chapter 3, Ann Carmichael's work (“Universal and Particular: The Language of Plague, 1348–1500,” Medical History Supplement 27 (2008): 17-52) is not cited. In several places, Wolff treats medieval leprosy as an epidemic combated with policies of segregation. Such ideas are far more prevalent in the historiography than in medieval Europe itself, and much valuable work since the influential study of Carole Rawcliffe (Leprosy in Medieval England [2006]) has dismantled such narratives. Perhaps most strikingly, in a work centrally concerned with both plague and public health in medieval Europe, neither Guy Geltner nor Monica Green appears in the bibliography. In a field rich with scholarly conversations, this is a perplexing silence.
