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Samuel K. Cohn, Jr. The Black Death Transformed: Disease and Culture in Early Renaissance Europe. London: Arnold; Oxford: Oxford University Press, 2002. x + 318 pp. Ill. $65.00 (0-340-70646-5).
The Black Death Transformed has enjoyed considerable publicity—not surprising, perhaps, in an age where the threat of epidemic disease is so newsworthy. Nor has its author, Samuel Cohn, been modest about his claims. He contends that for a century and more historians have rushed to equate the magna mortalitas that first struck Europe in 1348 with bubonic plague, but have failed to consider the evidence carefully enough. All other historians have manipulated the facts to fit their theories, he insists, whereas by turning to the sources afresh and by comparing medieval and modern evidence he has been able to demonstrate that the Black Death cannot have been bubonic plague: its signs, symptoms, and epidemiologic behavior, he argues, are all inconsistent with descriptions of the twentieth-century disease.
Cohn does not offer his own diagnosis of the mortalitas (sometimes he suggests it was a fast-spreading airborne disease [p. 209], sometimes a disease of poverty like cholera [p. 210]), but his insistence that it absolutely cannot have been bubonic plague involves him in the same problems that any attempt at retrospective diagnosis must entail, problems that he simply does not appreciate. To what extent, for example, are the descriptive categories and characters of the fourteenth century really identical with those of the twentieth? Can one trust chroniclers and medieval physicians, Boccaccio or Guy de Chauliac, as accurate observers of a simple objective reality? Cohn seems to have little doubt that one can, and he uncritically accepts their writings as providing relatively unproblematic testimony of their practical experience (cf. pp. 67-68). Yet for someone who insists that medieval clinical accounts must be taken on their own terms and compared directly with modern descriptions, he is remarkably casual about the meaning of medieval technical terminology: carbunculus,antrax,pustula he refers to indiscriminately as "spots" (e.g., pp. 59-60), even though medieval physicians believed they referred to very different conditions that could be discriminated by the senses. On the whole, Cohn does not really appear familiar with modern scholarship on medieval medicine.
However, Cohn places most weight not on clinical descriptions but on "epidemiologic" evidence. By counting wills and other death records in various European cities, he believes that he has been able to determine general trends [End Page 212] showing that the high mortality of the first epidemic rapidly decreased in the second and continued to decline still further thereafter, so that epidemics had virtually ended everywhere by 1400. From this he infers (p. 216) that by that time plague must have been approaching the status of a disease of children such as measles, to which adults had gained immunity; bubonic plague does not confer immunity, he asserts, and therefore the medieval plague could not have been bubonic. As a result of the rapidly declining mortality, he concludes, physicians and European society in general gained new confidence almost immediately (by the 1360s!) in the power of medical knowledge: again he takes medieval medical texts at face value, accepting as further evidence of the disappearance of epidemics the claims of the first plague treatises to offer remedies that worked. This, he tells us, was the first sign of the "new sense of progress and even triumph over the natural world" (p. 244) that marks the Renaissance.
Yet Cohn's use of such testamentary data is selective and not always satisfactory. Take his analysis of plague trends in London (p. 197), which is based entirely on an analysis of the wills recorded in the city's Court of Husting: he counts 356 in 1349, 127 in the next epidemic (1361), and only 33 in 1375; from this point on until he stops his count in 1425, his data show a constant number of wills, and no epidemic years. But if...