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  • Jenna Phillips

Medieval Wisdom for Mental Health in COVID-19

Jenna Phillips on Boccaccio in Quarantine

In the wake of the plague outbreak of the mid-fourteenth century, a Florentine physician named Tommaso del Garbo wrote a medical treatise on protecting the body and imagination from infection and fear. Some of his recommendations will sound familiar to the modern reader: “Spend your time in your house, but not with too many people, and at your leisure, in gardens.” He warned against occupying the mind with death “or anything likely to sadden or grieve you.” Tommaso and his contemporaries may have lacked the germ theory of disease, but they knew about caring for the psyche.

And it was another Italian, Giovanni Boccaccio, who penned the great medieval panegyric to human ingenuity in his Decameron. So what did Boccaccio, and other medieval survivors of the plague understand that we have forgotten in the present? People knew that the imagination, source of human ingenuity, was essential in preserving hope when facing the invisible enemy of the pestilence.

The plague pandemic of the High Middle Ages, simply called the “Great Pestilence” at the time but later termed the Black Death, began appearing in Mediterranean port cities in 1347. The fourteenth century gives us the word “quarantine,” from Venetian quarantèna: forty days of isolation that port cities began imposing on incoming ships to keep plague at bay. Although the word is Venetian, the practice of quarantine originated in the Adriatic city of Dubrovnik which introduced the first quarantine legislation in 1377. Venice adopted similar legislation by the early fifteenth century. Forty is a ritual, biblical number and was chosen as the length of isolation for that reason. Rain fell for forty days and nights during the great deluge of Genesis, and for forty years the Israelites wandered in exile. Forty was the number of days that Jesus fasted in the Judean desert, and comprised the interval between his resurrection and ascension. However, long before civic authorities began imposing quarantine legislation, people who had the means tried to distance themselves from contagion.

In 1352, five years after the plague’s onslaught through Italy, Boccaccio published the first part of his Decameron, arguably the best work of comedic literature ever born of an epidemic. The story follows ten young people who agree to leave Florence at the height of the pestilence and isolate themselves in a country house. (Would that we could all shelter-in-place in villas in Tuscany.) The ten days of leisure and storytelling that ensue provide the substance of Boccaccio’s work and explain its title (deca, ten, + hemera, days).

The Decameron begins with Boccaccio’s famous description of plague ravaging the city of Florence. “The deadly pestilence,” he says, “started in the East, either because of the influence of heavenly bodies or because of God’s just wrath as a punishment to mortals for our wicked deeds, and it killed an infinite number of people. […] This pestilence was so powerful that it was communicated to the healthy by contact with the sick, the way a fire close to dry or oily things will set them aflame. And the evil of the plague went even further; not only did talking to or being around the sick bring infection and a common death, but also touching the clothes of the sick or anything touched or used by them seemed to communicate this very disease to the person involved.” Florentine officials fruitlessly tried to stop the contagion by prohibiting the entry of sick people into the city, by cleaning the streets, and issuing health recommendations. As Boccaccio comments, none of these measures were efficacious.

The plague, which dealt a swift death to more than half of those infected, drastically upended the rituals of daily life, but its means of transmission were not well understood. Boccaccio visualizes it as a firestorm leaping through kindling. Another five centuries would pass before the French-Swiss physician Alexandre Yersin identified the bacterium that causes the bubonic, septicemic, and pneumonic forms of infection. The bacterium was named for him, yersinia pestis, “Yersin’s plague.” In the fourteenth century, a bubonic plague victim had a 30-50% chance of survival, while those with septicemic and pneumonic infections died nearly 100% of the time. Amid death at such a scale, people prayed. Some walked the streets carrying relics and chanting in processions, venerating Saint Sebastian, believed to be a holy intercessor, a protector against the pestilence known for miraculous acts of healing. In due course, songs would be composed praising him.

But for others, the suspension of the normal order was an invitation to excess. As Boccaccio reported, these people “believed that drinking too much, enjoying life, going about singing and celebrating, satisfying in every way the appetites as best one could, laughing, and making light of everything that happened was the best medicine for such a disease; so they practiced to the fullest what they believed by going from one tavern to another all day and night.” A similar impulse was on view this April, when amid our own pandemic, images of Florida beaches—pilgrimage sites of the twenty-first century college student on spring break—showed the shoreline swollen with gleeful young people.

Many citizens of medieval Florence took a middle ground, adopting an air of caution by “isolating” with family or a group of friends at home, enjoying wholesome activities like bread-baking, taking their minds off the misery with a glass of vino:

They shut themselves up in those houses where there were no sick people and where one could live well by eating the most delicate of foods and drinking the finest of wines (doing so always in moderation), allowing no one to speak about or listen to anything said about the sick and the dead outside; these people lived, spending their time with music and other pleasures.

For people in fourteenth-century Florence, censoring the bad news was not mere escapism; it was a health and safety measure that protected a vulnerable organ: the imagination. As the early modern anatomist Niccolò Massa observed, “Many people, from fear and imagination alone, have fallen to pestilential fever; therefore, it is necessary to be joyful.” The imagination, or imaginatio, was the seat of higher cognitive function. It gave rise to either wholesome or destructive emotions—joy, love, rage, terror, and so on—influencing the balance of humors and the overall health of the body.

Ignorant of pathogens, many medieval physicians instead privileged the power of emotion to influence the body, and they give good advice for maintaining psychic equilibrium. “Rage shall not come into the regimen of health. Fury, sadness, fretting, worry, and fear are also to be avoided,” a plague treatise cautions, because such negative thoughts freeze, or immobilize the human spirit, quelling its talent for ingenuity and reason.

As Remi Chiu explains in Plague and Music in the Renaissance, “in the pre-Cartesian world, there was a psychosomatic two-way traffic by which the mind could affect physical health and vice versa.” People hoped to achieve “salutary joy” by joining their voices in song, or in other pleasurable activities, as when clasping one another’s hands in the graceful circle dances known as caroles. Musicians composed motets—choral arrangements with intricate harmonies—whose lyrics were prayers devoted to Saint Sebastian. They celebrated the miracles by which he helped free the land from the scourge of plague. The act of singing these songs, of hearing their stirring triple meter was in itself “medicine for body and soul.”

To safeguard citizens’ imaginations from incessant reminders of mortality, some cities tried to control the proliferation of bad news. The Tuscan city of Pistoia banned the knelling of church bells at funerals, “in order that the sound of bells does not attack or arouse fear amongst the sick.” In the fine print, the ordinance added that burials of a certain class of people were exempt from this rule: bereaved families of knights, lawyers, judges, or doctors, had the freedom to honor their bodies “in any way they please.” Even if the contagion showed no preference to rich or poor, the elites of that medieval commune maintained the privilege of honoring their dead with the pealing of bells, whose reverberations were felt to echo the voice of God.

As recently as a few months ago, I would have attached a certain quaintness to the idea of legislating against the toll of the passing-bell or abstaining from news reports. Not anymore. Fear in isolation is real, as current reports on mental health show. To coincide with Mental Health Month, Google and the Centers for Disease Control recently launched a campaign with the tagline, “Be Kind to Your Mind.” It suggests we reduce stress by taking breaks from bad news. The CDC’s language is less poetic than that of the Renaissance physicians, but the idea is similar.

In the Middle Ages, everyone knew that dangerous emotions like fear and panic—enemies of the human body and the body politic alike—should be countered by lighthearted pastimes like storytelling and singing, best done in gardens, where the senses are soothed by willows, and flowering vines. Why gardens? Think: Eden. Also think: Nature tamed by Man to represent symmetry, order, and abundance, opposite of wilderness, where man suffers the caprices of nature.

The medieval theory of lighthearted joy (gaudium) as a countermeasure to ailment and misery explains what otherwise is the jarring juxtaposition from plague-ridden Florence in the introduction to the Decameron to the one-hundred novellas that follow, teeming with humor, sex, and trickery. From the opening portrait of society in ruins—animals pawing at corpses in streets, grand houses emptied of all but specters and memories— enter the group of ten young people, the characters that serve as Boccaccio’s mouthpiece for the rest of the work. They are a group of courteous twenty-somethings, mostly women, with beautiful names like Filomena and Neifile. Meeting up after a church service, they agree to retreat from the diseased city to a countryside villa where they will pass the time with song, dance, and al fresco storytelling. The young men in the group commend the girls for devising the plan, “Ladies, it was your intelligence that guided us here,” they say, and agree to leave thoughts of sadness within the city walls they’ve left behind. “Make up your minds to enjoy yourselves and laugh and sing with me, as much as dignity permits,” they invite the women. Their self-imposed quarantine is one of pleasant pastime, literally, of “passing time” until the world order resumes.

The topic of conversation is not affliction of the body and society, but the afflictions of lovesickness, and the turning wheel of fortune. Each day, the storytellers choose a theme. Day Two is devoted to stories of people who have been subjected to various adversities, but come to a happy ending that defies their expectations. Consider the fate of Andreuccio. Traveling from Perugia to Naples to buy horses, he arrives with five hundred gold florins that he carelessly parades in the marketplace. After being conned out of his money and clothes, wandering the Neapolitan streets at night, he falls in with a group of grave-robbers, and finds himself trapped inside a sarcophagus with the remains of a newly-buried bishop. For a grim moment, it looks like his fate is sealed there, but when a second band of thieves arrives, the heavy stone lid is lifted, and Andreuccio seizes his moment of escape, taking with him the dead man’s ruby ring. “So he returned promptly to Perugia, having invested his money in a ring, though it was horses that he had set out to buy.”

Here’s a parable about society in ruins and the necessity of adapting, with wit and action, if one is to survive. At first an easy mark for swindlers, it seems that Andreuccio’s foolishness and passivity will lead to an unpleasant death. Just as despair is overtaking him, he is given an unexpected chance, and as he finally becomes alert to the reality of the world around him, he leaps into action.

This piece of black comedy invites us to enter the thought-world of a society that had survived the plague, and having done so, it tries to make us laugh. Andreuccio’s is a world turned upside-down, where the pillars of society have crumbled. He comes to the marketplace expecting fair dealings, but he is cheated. When he enters the church, resting place of the bishop, instead of sanctity, he discovers a nest of thieves. His wanderings through Naples are “a parody of the spiritual dark night,” commented the Italianist Giuseppe Mazzotta in The World at Play in Boccaccio’s Decameron. “The only order in such a world of dissemblance and instability is the regularity of Fortune’s shifts.”

These shifts in fortune that structure many of the Decameron’s one hundred stories are often its source of surprise, illustrations of what philosophers call “the incongruity theory of humor.” Here, the punchline works because of its incongruity: all of Andreuccio’s misadventures are collapsed into a simple, profitable acquisition.

Philosophers and poets have, for a long while, mulled over the relationship between comedy and tragedy. “The tragic and the comic are the same, in so far as both are based on contradiction, but the tragic is the suffering contradiction, the comical, the painless contradiction,” said Søren Kierkegaard, responding to Aristotle’s writings on the basis of humor. Painless contradiction is comical: Andreuccio almost died, but, surprise! he finds a way out of the tomb. Tragedy, on the other hand, “sees the incongruity, but despairs of finding a way out.” The creative drive to author one’s own fate despite bad odds is a central preoccupation of the Decameron. The Italian word for this capacity is ingegno (ingenuity). It is the union of wit and action.

Over the past nine months, we have all felt the dizzying effects of Lady Fortune turning her wheel, as predictable rhythms of life have given way to a new reality defined by contradictions. The fates of thirteen million jobless Americans appear even less predictable than that of Andreuccio. Yet the stock market rises. Today, the rites of passage that traditionally bind our society together in gatherings of friends and relatives— holidays, graduations, Bar- and Bat-Mitzvahs, weddings, births, and now a legion of deaths and funerals—must be performed without the human touch of relatives to hug, kiss, to lay on hands in acts of blessing and communion. The contagion still flows, invisible as breath, among us.

Uncertainty is a part of living in the human sphere, the sublunary world, a medieval person might tell us. Saint Augustine, weighing the inequities in the fallen world of men, called it a “land of disparity.” Yet Boccaccio crystallizes an optimistic outlook: a declaration of faith in the human capacity to overcome tribulation. In reading the Decameron, we are reminded that the imagination needs to be nourished with joy, song, and laughter. And that escaping catastrophe is best done along with friends, outside, in the garden.


Jenna Phillips is an Andrew Mellon Foundation postdoctoral fellow at the Huntington Library. She is at work on her book, Sound, Violence and the Period Ear in Thirteenth-Century France. She has taught courses on medieval history at Princeton and Johns Hopkins Universities. Tweets: @jennarphillips


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