The Black Death is considered to be the first widespread epidemic of which sufficient documentary evidence can be substantiated.

The consequences of this violent catastrophe were many, and varied from region to region

Some people, shut up in their houses with the doors barred, would scratch a sign of the cross on the front door, sometimes with the inscription, "Lord have mercy on us."

In one place, two lovers were supposed to have bathed in urine every morning for protection. People hovered over latrines, breathing in the stench. Others swallowed pus from the boils of plague victims. In Avignon, Pope Clement was said to have sat for weeks between two roaring fires.

The plague spread from Sicily all up and down the Atlantic coast, and from the port cities of Venice, Genoa, and Pisa ;as well as, Marseilles, London, and Bristol.

A multitude of men and women, as Boccaccio wrote, "negligent of all but themselves . . . migrated to the country, if God, in visiting men with this pestilence in requital of their iniquities, would not pursue them with His wrath wherever they might be. . . ."

Some who were not yet ill but felt doomed indulged in debauchery. Others, seeking protection in lives of moderation banded together in communities to live a separate and secluded life, walking abroad with flowers to their noses "to ward off the stench and, perhaps, the evil that afflicted them."

It was from a time of plague, some scholars speculate, that the nursery rhyme "Ring Around the Rosy" derives: the rose-colored "ring" being an early sign that a blotch was about to appear on the skin; "a pocket full of posies" being a device to ward off stench and (it was hoped) the attendant infection; "ashes, ashes" being a reference to "ashes to ashes, dust to dust" or perhaps to the sneezing "a-choo, a-choo" that afflicted those in whom infection had invaded the lungs; ending, inevitably, in "all fall down".

In Pistoia, the city council enacted pages of regulations to keep the plague out; no Pistoian was allowed to leave town to visit any place where the plague was raging; if a citizen did visit a plague-infested area he was not allowed back in the city; no linen or woolen goods were allowed to be imported; no corpses could be brought home from outside the city; attendance at funerals was strictly limited to immediate family. None of these regulations helped!

In Siena, dogs dragged bodies from shallow graves and left them half-devoured in the streets. Merchants closed their shops. The wool industry was shut down. Clergymen ceased administering last rites.

On June 2, 1348, all the civil courts were recessed by the city council. Because so many of the laborers had died, construction of the nave for a great cathedral came to a halt. Work was never resumed: only the smaller cathedral we know today was completed.

In Venice, it was said that 600 were dying every day. In Florence, perhaps half the population died. By the time the plague swept through, as much as one-third of Italy's population was afflicted.

In Milan, when the plague struck, all the occupants of any victim's house, whether sick or well, were walled up inside together and left to die. Such draconian measures seemed to have been partially successful; mortality rates were lower in Milan than in other cities.

Medieval medicine was at a loss to explain all this, or to do anything about it. Although clinical observation did play some role in medical education, an extensive reliance on ancient and inadequate texts prevailed.

Surgeons usually had a good deal of clinical experience but were considered mainly to be skilled craftsmen, not men of real learning, and their experience was incorporated very little into the body of medical knowledge.

In 1300, Pope Boniface VIII had published a bull specifically inveighing against the mutilation of corpses. It was designed to cut down on the sale of miscellaneous bones as holy relics, but one of the effects was to discourage dissection.

Physicians, priests ,and others had theories about the cause of the plague. Earthquakes that released poisonous fumes, for example. Severe changes in the earth's temperature creating southerly winds were blamed for bringing the plague.

The notion that the plague was somehow the result of a corruption of the air was widely believed. It was this idea that led people to avoid foul odors by holding flowers to their noses or to try to drive out the infectious foul odors by inhaling the alternate foul odors of a latrine.

Some thought that the plague came from the raining down of frogs, toads, and reptiles. Some physicians believed one could catch the plague from "lust with old women".

Both the pope and the king of France sent urgent requests for help to the medical faculty at the University of Paris, then one of the most distinguished medical groups in the Western world.

The faculty responded that the plague was the result of a conjunction of the planets Saturn, Mars, and Jupiter at 1 P.M. on March 20, 1345, an event that caused the corruption of the surrounding atmosphere.

Religious beliefs and practices made some drastic changes, too

Ultimately, of course, most Christians believed the cause of the plague was God's wrath on sinful mankind. In those terms, to be sure, the best preventives were prayer, the wearing of crosses and participation in other religious activities.

In Orvieto, the town fathers added 50 new religious observances to the municipal calendar. Even so, within five months of the appearance of the plague, Orvieto lost every second person in the town.

There was also some agreement about preventive measures one might take to avoid the wrath of God. Flight was best: away from lowlands, marshy areas, stagnant waters, southern exposures, and coastal areas; toward high, dry, cool, mountainous places.

It was thought wise to stay indoors all day, to stay cool and to cover any windows that admitted bright sunlight. In addition to keeping flowers nearby, one might burn such aromatic woods as juniper and ash.

The retreat to the mountains, where the density of the rat population was not as great as in urban areas, and where the weather was inimical to rats and fleas, was probably a good idea; as well as, perhaps proof, of a kind, of the value of empirical observation.

Any useful notion was always mixed in with such wild ideas that it got lost in a flurry of desperate (and often contrary) stratagems. One should avoid bathing because that opened the pores to attack from the corrupt atmosphere, but one should wash face and feet, and sprinkle them with rose water and vinegar.

In the morning, one might eat a couple of figs with rue and filberts. One expert advised eating ten-year-old treacle mixed with several dozen items, including chopped-up snake. Rhubarb was recommended, too, along with onions, leeks and garlic.

The best spices were myrrh, saffron and pepper, to be taken late in the day. Meat should be roasted, not boiled. Eggs should not be eaten hard-boiled. A certain Gentile di Foligno commended lettuce; the faculty of medicine at the University of Paris advised against it.

Desserts were forbidden. It was recommended that people should not sleep during the day. One should sleep first on the right side, then on the left.

Exercise was to be avoided because it introduced more air into the body; if anyone had to move, he/she ought to move slowly.

Part 3 of 3.