Plagues in World History (9 page)

in an earlier chapter. While subscribing to a very orthodox position that God is the sole author of disease, Khātima also advances the idea that contagion is a secondary (but not independent) cause. He thus follows in the footsteps of a long tradition dating back to at least the ninth century, which included not only the adherents of Prophetic medicine but also certain commentators on the hadith who were concerned with maintaining its integrity in the face of the challenging conundrum posed by contagion. But even Khatīb takes a (very brief and seemingly halfhearted) stab at trying to harmonize contagion with Islamic law, drawing on both selective quotations from the hadith that seemed to support his position and the principle of
maslaha
, or the privileging of what was for the good of the Muslim community over specific
fatwas
that might do it harm (such as not to flee the plague). In the end, however, Khatīb prefers to abruptly end the discussion by stating simply that it “is not among the duties of medicine,” in contrast to the way his colleague, Khātima, extensively grapples with the issue.90

The real innovation of Khatīb, and the one that stood most in contrast to the writings of Khātima and that has made him such an attractive figure to modern skeptics of the Prophetic tradition in both the Middle East and the West, is his insistence on a separation of the two realms of religion and science (in this case, medicine) should the interests and agendas of the two intersect and conflict.

Particularly important is his notion that, in a matter of science, that is, where the public health as threatened by the plague is concerned, empirical observation and proof should be privileged over religious authority. While this may not be entirely unprecedented, it is prescient in that it foreshadows one of the founding principles of the Scientific Revolution centuries later. It is also a very controversial position, one that would have raised eyebrows among contemporaries in both Islamic and Christian contexts. Toward the close of his short treatise, for example, Khatīb states the following: “One principle that cannot be ignored is that if the senses and observation oppose a revealed indication, the latter needs to be interpreted, and the correct course in this case is to interpret it according Plague y 41

to what a group of those who affirm contagion say.”91 This is not so different, after all, from what Galileo Galilei was saying in the seventeenth century, which resulted in his condemnation as a heretic before the Roman Inquisition in 1633.

By contrast, Khatīb’s trial, which ended with his death at the hands of a lynch mob in his prison at Fez in 1374, seems to have been primarily a politically motivated one relating to his time as vizier of Grenada during the 1350s and 1360s. However, one of the accusations at his trial, that Khatīb followed “the doctrines of the classical philosophers in questions of faith,” may be quite relevant to his views on contagion. Although what exactly his offense was in this matter is not entirely clear, if it was seen that Khatīb was privileging Greek rationalism where it conflicted with faith, then this would be quite similar in principle to what he expressed in his plague treatise.92

The difference between Muslim and Christian commentators on contagion was therefore not a straightforwardly simple one, in which one society or culture accepted the concept and the other did not, but rather one of degrees in terms of this acceptance. In this sense, Christian Europe was an unabashed subscriber to contagion, with little to no reservations, compared to the Islamic world. Out of the hundreds of plague treatises I have consulted from fourteenth-and fifteenth-century Europe, there are none that I know of that deny contagion, on religious or any other grounds. (This also applies to the two Hebrew treatises of Rabbi Isaac Ben Todros and Abraham Kashlari.) When European plague doctors specifical y discuss contagion, they do so largely in a theoretical way that almost seems to take the concept for granted and that precludes disagreement or challenge. For example, the famous Perugian physician, Gentile da Foligno, explains contagion in his Long Consilium
of 1348 as “poisonous vapors” that can pass “not only from man to man but also from region to region” by means of being breathed in or else absorbed through the pores of the body, which then generate a “poisonous matter” in the region of the heart and lungs. Rather than cite his own observation or contemporary empirical evidence, Foligno quotes the unimpeachable source of Galen and his theory of the “seeds of pestilence” from
De Differentiis Febrium (Concerning Different Types of Fevers), and he asserts, again on the authority of Galen, that anyone who stays in a neighborhood infected with plague and who converses with those “covered with sores” or “whose breath is putrid” wil be sure to get the disease “just as if they were cast into an oven like bread dough.”93 To justify plague contagion by sight (what the Muslims termed the “evil eye”), an anonymous practitioner from Montpel ier in 1349 quoted at length from Euclid’s theory of optics, but he also referred to legendary tales of the basilisk and of the “venomous virgin,” both of whom could kill by look alone, that would nonetheless be just as convincing to his readers since one could find them in respectable sources such as medieval bestiaries and the
Secretum Secretorum
(Book of the Se-42 y Chapter 1

cret of Secrets) attributed to Aristotle.94 On occasion, Christian plague doctors do cite empirical evidence and observation in support of contagion, just like their Muslim colleagues: the author of an anonymous German treatise from the fifteenth century testifies that he saw two boys touch a dead woman’s bedding that had been thrown out into the street to dry in the sun, after which they both straightaway died of the disease.95 This is exactly analogous to Khātima’s witness-ing the deaths of people who used to traffic “in the clothes of the dead and their furnishings” at the old-clothes market in Almería, Spain.96

In contrast with the Christian West, the concept of contagion was a highly contested one in the Islamic world. While Khātima and Khatīb vigorously defended contagion, other contemporary authorities explicitly denied it. Chief among these was the fourteenth-century Granadan jurist, Ibn Lubb, who rejected contagion on a number of grounds, including theological objections (backed by a long line of commentators on the hadith) as well as claiming that it conflicted with the social and moral obligations of Muslims. He was joined by a number of other fourteenth-century authors from North Africa and al-An-dalus, including the famous Ibn Khaldun, who seemed to deny any role for secondary causes in the plague, and therefore of contagion. In the fifteenth century, the enormously influential plague treatise of the Egyptian scholar Ibn Hajar al-‘Asqalānī apparently turned the tide of majority Muslim opinion against contagion, largely by refusing to rely solely on the Prophetic tradition to make his case. Hajar claimed that plague had to have a nonnatural (i.e., noncontagious) cause because in his own times he observed that some people, even those within the same household as a plague victim, did not contract the disease and because doctors still hadn’t found a cure, which only God could ordain. (In response to both observations, most Christian physicians would probably have pointed to the individual complexions of patients that differentially predisposed them to disease and to the need to start a cure almost immediately, at most within twelve hours of the onset of symptoms, for it to be successful.) Hajar’s preferred explanation was the
jinn
, for which, incredibly to modern readers, he likewise advanced sure proofs in the form of testimony from no less a personage than the Egyptian sultan’s private secretary, who related how he had overhead two invisible demons arguing behind his back over whether to “pierce” him with the plague or not; in the end, they decided to strike out the eye of a horse instead.

This is really not so different from the Montpellier physician’s appeal to the basilisk and the venomous virgin in support of contagion by sight. Hajar thus provided a potent counterargument to those who would defend contagion, particularly as it marshaled doctors’ favorite weapon, empirical evidence and observation, against them. His writings and opinions changed the whole terms of the debate over contagion in subsequent plague treatises written in North Africa Plague y 43

down to the nineteenth century. By contrast, plague treatises in the Christian West showed remarkable consistency: their theoretical underpinnings were to remain essentially unchanged throughout Europe’s late medieval and Early Modern experience with the disease.

If there was debate or disagreement among Christian plague doctors, it was in terms of the role that God played in causing the disease, specifically as a punishment for human wickedness or sin. In their
Consultation
penned for the king of France in October 1348, the Paris medical faculty included a formulaic nod from medicine to religion along the lines of “an epidemic always proceeds from the divine will” and that “God alone heals the sick,” although they also did not “neglect to mention” that their profession was sanctioned by God and that prayer did not preclude consulting doctors, which was a paraphrase of the “honor the physician” passage from one of the apocrypha, Ecclesiasticus 38:1–14, attributed to Jesus ben Sirach. Earlier that year, the Lérida physician Jacme d’Agramont declared that, “if the corruption and putrefaction of the air has come because of our sins, [then] the remedies of the medical art are of little value, for only He who binds can unbind.”97 In 1448, the Apulian doctor Saladin Ferro de Esculo listed as his first cause of plague God’s desire “to punish the sins of men,” which he would not elaborate on because it was incapable of doubt.98 Yet, even these deferential doctors were making the point that God was only one of many possible causes of plague; more usually, Christian commentators preferred to argue over whether the disease came from a higher natural cause (such as planetary conjunctions) or a more local one (such as the stench arising from swamps, rotting corpses, earthquakes, etc.).

However, a significant handful of Christian Europeans resisted the notion that God had anything at all to do with the disease. The German science writer (and priest), Konrad of Megenberg, in a treatise of c. 1350 on “whether the mortality of these years comes from divine vengeance on account of the iniquities of men, or from a certain natural course [of events],” came down in favor of the latter conclusion on two grounds: first, if God “made this plague for the correction of men” then he did so “to no purpose” (which is not to be admitted), because “experience teaches us that His people have in no way amended themselves of any vice”; second, God in his vengeance “would have struck down all mortal sinners,” but again, experience shows this not to be true. He then goes on to make a positive case for his preferred, natural explanation of the plague, earthquakes.99 Around this same time, the Naples doctor Giovanni della Penna urged his colleagues to investigate “natural causes” for plague, “since [only] unskilled and ignorant physicians say that it proceeds from God or from the heavens.”100

A century later, an anonymous Bohemian treatise of c. 1450 complained that patients often gave in to a sense of despair and lost hope during a plague because 44 y Chapter 1

they believed “that it’s God’s vengeance or anger over them” and this belief engendered a fatal sense of guilt over their sins. This was one of six “contributory causes” of plague that defied the doctor’s best efforts to help people avoid or cure the disease.101 All this skepticism about God’s role in the plague finds no parallel in the medieval Islamic world.

Closely related to the issue of contagion was whether to flee or avoid persons and places infected with plague. On this question, Christianity and Islam emerged on opposite sides by the end of the Middle Ages even more clearly than in the case of contagion. From the very beginning, Islam seems to have decided firmly against sanctioning flight from a plague-infected region, dating back to at least the eighth-century rendition of the Plague of ‘Amwâs during the First Pandemic. As we have seen, this established a rule, said to have come from the mouth of the Prophet himself, that if a plague is “in a land, do not approach it; but if it breaks out in a land and you are already there, then do not leave in flight from it.” At the same time, in the Christian tradition, Anastasius of Sinai hedged on this issue, allowing for flight if the disease originated from corrupt air instead of directly from God’s will. However, in one Muslim interpretation of the ‘Am-wâs incident from the twelfth century, that of the Moorish jurist Ibn Rushd al-Jadd (grandfather to the more famous Averroes), the Prophet’s dictum against flight was to be interpreted not as a blanket prohibition but rather as “humane guidance and advice,” so that it was permissible (if not preferable) to enter or leave a plague-infected region so long as “one’s intention is correct and one relies on God.”102 But this interpretation seems to have been a unique one that was not widely accepted in the Islamic world. It could be said that Khatīb also advocated flight from the plague in his treatise of c. 1349, but this is by inference only (since he so strongly espouses the concept of contagion); nowhere does he actually come out and
say
that people should flee. The examples he gives of those who successfully avoided the plague are those who quarantined themselves rather than availed of the option of flight: one Ibn Abū Madyan of the city of Salé, who walled himself up along with his whole family after hoarding enough food to live on, and the thousands incarcerated in the prisons of Seville who also miraculously survived.103 Khatīb’s advocacy of flight was therefore rather ambiguous, even as he condemned those who would deny Muslims this course of action.

On the other hand, fourteenth-century Islamic Spain also witnessed a highly influential
fatwa
that was issued in no uncertain terms
against
any kind of seeking of refuge from the plague. This came from the quill of the jurist Lubb, who was a contemporary of Khatīb and who like him was based in Grenada, Spain.