The Epidemics of the Middle Ages

by J. F. C. Hecker; John Caius

The symptoms which followed the bite of venomous spiders were well known to the ancients, and had excited the attention of their best observers, who agree in their descriptions of them. It is probable that among the numerous species of their phalangium[55], the Apulian tarantula is included, but it is difficult to determine this point with certainty, more especially, because in Italy the tarantula was not the only insect which caused this nervous affection, similar results being likewise attributed to the bite of the scorpion. Lividity of the whole body as well as of the countenance, difficulty of speech, tremor of the limbs, icy coldness, pale urine, depression of spirits, headache, a flow of tears, nausea, vomiting, sexual excitement, flatulence, syncope, dysuria, watchfulness, lethargy, even death itself, were cited by them as the consequences of being bitten by venomous spiders, and they made little distinction as to their kinds. To these symptoms we may add the strange rumour, repeated throughout the middle ages, that persons who were bitten, ejected by the bowels and kidneys, and even by vomiting, substances resembling a spider’s web.

Nowhere, however, do we find any mention made that those affected felt an irresistible propensity to dancing, or that they were accidentally cured by it. Even Constantine of Africa, who lived 500 years after Aëtius, and as the most learned physician of the school of Salerno, would certainly not have passed over so acceptable a subject of remark, knows nothing of such a memorable course of this disease arising from poison, and merely repeats the observations of his Greek predecessors[56]. Gariopontus[57], a Salernian physician of the eleventh century, was the first to describe a kind of insanity, the remote affinity of which to the tarantula disease is rendered apparent by a very striking symptom. The patients in their sudden attacks behaved like maniacs, sprang up, throwing their arms about with wild movements, and, if perchance a sword was at hand, they wounded themselves and others, so that it became necessary carefully to secure them. They imagined that they heard voices, and various kinds of sounds, and if, during this state of illusion, the tones of a favourite instrument happened to catch their ear, they commenced a spasmodic dance, or ran with the utmost energy which they could muster until they were totally exhausted. These dangerous maniacs, who, it would seem, appeared in considerable numbers, were looked upon as a legion of devils, but on the causes of their malady this obscure writer adds nothing further than that he believes (oddly enough) that it may sometimes be excited by the bite of a mad dog. He calls the disease Anteneasmus, by which is meant no doubt the Enthusiasmus of the Greek physicians[58]. We cite this phenomenon as an important forerunner of Tarantism, under the conviction that we have thus added to the evidence that the development of this latter must have been founded on circumstances which existed from the twelfth to the end of the fourteenth century; for the origin of Tarantism itself is referrible, with the utmost probability, to a period between the middle and the end of this century, and is consequently contemporaneous with that of the St. Vitus’s dance (1374). The influence of the Roman Catholic religion, connected as this was, in the middle ages, with the pomp of processions, with public exercises of penance, and with innumerable practices which strongly excited the imaginations of its votaries, certainly brought the mind to a very favourable state for the reception of a nervous disorder. Accordingly, so long as the doctrines of Christianity were blended with so much mysticism, these unhallowed disorders prevailed to an important extent, and even in our own days we find them propagated with the greatest facility where the existence of superstition produces the same effect in more limited districts, as it once did among whole nations. But this is not all. Every country in Europe, and Italy perhaps more than any other, was visited during the middle ages by frightful plagues, which followed each other in such quick succession, that they gave the exhausted people scarcely any time for recovery. The oriental bubo-plague ravaged Italy[59] sixteen times between the years 1119 and 1340. Small-pox and measles were still more destructive than in modern times, and recurred as frequently. St. Anthony’s fire was the dread of town and country; and that disgusting disease, the leprosy, which, in consequence of the crusades, spread its insinuating poison in all directions, snatched from the paternal hearth innumerable victims who, banished from human society, pined away in lonely huts, whither they were accompanied only by the pity of the benevolent and their own despair. All these calamities, of which the moderns have scarcely retained any recollection, were heightened to an incredible degree by the Black Death[60], which spread boundless devastation and misery over Italy. Men’s minds were everywhere morbidly sensitive; and as it happens with individuals whose senses, when they are suffering under anxiety, become more irritable, so that trifles are magnified into objects of great alarm, and slight shocks, which would scarcely affect the spirits when in health, give rise in them to severe diseases, so was it with this whole nation, at all times so alive to emotions, and at that period so sorely pressed with the horrors of death.

The bite of venomous spiders, or rather the unreasonable fear of its consequences, excited at such a juncture, though it could not have done so at an earlier period, a violent nervous disorder, which, like St. Vitus’s dance in Germany, spread by sympathy, increasing in severity as it took a wider range, and still further extending its ravages from its long continuance. Thus, from the middle of the fourteenth century, the furies of the Dance brandished their scourge over afflicted mortals; and music, for which the inhabitants of Italy, now probably for the first time, manifested susceptibility and talent, became capable of exciting ecstatic attacks in those affected, and then furnished the magical means of exorcising their melancholy.

Sect. 3.—Increase.

At the close of the fifteenth century we find that Tarantism had spread beyond the boundaries of Apulia, and that the fear of being bitten by venomous spiders had increased. Nothing short of death itself was expected from the wound which these insects inflicted, and if those who were bitten escaped with their lives, they were said to be seen pining away in a desponding state of lassitude. Many became weak-sighted or hard of hearing, some lost the power of speech, and all were insensible to ordinary causes of excitement. Nothing but the flute or the cithern afforded them relief[61]. At the sound of these instruments they awoke as it were by enchantment, opened their eyes, and moving slowly at first, according to the measure of the music, were, as the time quickened, gradually hurried on to the most passionate dance. It was generally observable that country people, who were rude, and ignorant of music, evinced on these occasions an unusual degree of grace, as if they had been well practised in elegant movements of the body; for it is a peculiarity in nervous disorders of this kind, that the organs of motion are in an altered condition, and are completely under the control of the over-strained spirits. Cities and villages alike resounded throughout the summer season with the notes of fifes, clarinets, and Turkish drums; and patients were everywhere to be met with who looked to dancing as their only remedy. Alexander ab Alexandro[62], who gives this account, saw a young man in a remote village who was seized with a violent attack of Tarantism. He listened with eagerness and a fixed stare to the sound of a drum, and his graceful movements gradually became more and more violent, until his dancing was converted into a succession of frantic leaps, which required the utmost exertion of his whole strength. In the midst of this over-strained exertion of mind and body the music suddenly ceased, and he immediately fell powerless to the ground, where he lay senseless and motionless until its magical effect again aroused him to a renewal of his impassioned performances.

At the period of which we are treating there was a general conviction, that by music and dancing the poison of the Tarantula was distributed over the whole body, and expelled through the skin, but that if there remained the slightest vestige of it in the vessels, this became a permanent germ of the disorder, so that the dancing fits might again and again be excited ad infinitum by music. This belief, which resembled the delusion of those insane persons who, being by artful management freed from the imagined causes of their sufferings, are but for a short time released from their false notions, was attended with the most injurious effects: for in consequence of it those affected necessarily became by degrees convinced of the incurable nature of their disorder. They expected relief, indeed, but not a cure, from music; and when the heat of summer awakened a recollection of the dances of the preceding year, they, like the St. Vitus’s dancers of the same period before St. Vitus’s day, again grew dejected and misanthropic, until, by music and dancing, they dispelled the melancholy which had become with them a kind of sensual enjoyment.

Under such favourable circumstances it is clear that Tarantism must every year have made further progress. The number of those affected by it increased beyond all belief, for whoever had either actually been, or even fancied that he had been, once bitten by a poisonous spider or scorpion, made his appearance annually wherever the merry notes of the Tarantella resounded. Inquisitive females joined the throng and caught the disease, not indeed from the poison of the spider, but from the mental poison which they eagerly received through the eye; and thus the cure of the Tarantati gradually became established as a regular festival of the populace, which was anticipated with impatient delight.

Without attributing more to deception and fraud than to the peculiar nature of a progressive mental malady, it may readily be conceived that the cases of this strange disorder now grew more frequent. The celebrated Matthioli[63], who is worthy of entire confidence, gives his account as an eye-witness. He saw the same extraordinary effects produced by music as Alexandro, for, however tortured with pain, however hopeless of relief the patients appeared, as they lay stretched on the couch of sickness, at the very first sounds of those melodies which made an impression on them—but this was the case only with the Tarantellas composed expressly for the purpose—they sprang up as if inspired with new life and spirit, and, unmindful of their disorder, began to move in measured gestures, dancing for hours together without fatigue, until, covered with a kindly perspiration, they felt a salutary degree of lassitude, which relieved them for a time at least, perhaps even for a whole year, from their dejection and oppressive feeling of general indisposition. Alexandro’s experience of the injurious effects resulting from a sudden cessation of the music was generally confirmed by Matthioli. If the clarinets and drums ceased for a single moment, which, as the most skilful players were tired out by the patients, could not but happen occasionally, they suffered their limbs to fall listless, again sank exhausted to the ground, and could find no solace but in a renewal of the dance. On this account care was taken to continue the music until exhaustion was produced; for it was better to pay a few extra musicians, who might relieve each other, than to permit the patient, in the midst of this curative exercise, to relapse into so deplorable a state of suffering. The attack consequent upon the bite of the Tarantula, Matthioli describes as varying much in its manner. Some became morbidly exhilarated, so that they remained for a long while without sleep, laughing, dancing, and singing in a state of the greatest excitement. Others, on the contrary, were drowsy. The generality felt nausea and suffered from vomiting, and some had constant tremors. Complete mania was no uncommon occurrence, not to mention the usual dejection of spirits and other subordinate symptoms.

Sect. 4.—Idiosyncracies.—Music.

Unaccountable emotions, strange desires and morbid sensual irritations of all kinds, were as prevalent as in the St. Vitus’s dance and similar great nervous maladies. So late as the sixteenth century patients were seen armed with glittering swords which, during the attack, they brandished with wild gestures, as if they were going to engage in a fencing match[64]. Even women scorned all female delicacy[65] and, adopting this impassioned demeanour, did the same; and this phenomenon, as well as the excitement which the Tarantula dancers felt at the sight of any thing with metallic lustre, was quite common up to the period when, in modern times, the disease disappeared[66].