Medieval Medicines used during the Black Death

Medieval medicine during the Black Death, which ravaged Europe from 1347 to 1351, reflects a unique intersection of spirituality, superstition, and emerging empirical practices. The catastrophic impact of the plague, which resulted in the deaths of an estimated 25 million people—about one-third of Europe’s population at the time—prompted a desperate search for remedies in a society where scientific understanding was limited and intertwined with religious beliefs.

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The Context of Medieval Medicine

Medieval medicine was heavily influenced by the works of ancient authorities like Galen and Hippocrates, whose theories were integrated with Christian theology.

The dominant medical framework was the theory of humors, which posited that health depended on the balance of four bodily fluids: blood, phlegm, black bile, and yellow bile.

Disease was believed to result from imbalances in these humors, and treatment aimed at restoring equilibrium through methods such as bloodletting and the use of specific herbs.

The Vicary Method

The “Vicary Method,” named after Thomas Vicary, was an unconventional plague cure involving a chicken’s rump applied to the patient’s buboes, based on the mistaken belief that chickens breathe through their bottoms, thus drawing out infection.

This bizarre treatment not only lacked efficacy but likely exacerbated the patient’s condition by introducing additional bacteria, potentially accelerating the patient’s demise. The practice highlights the desperation and limited medical understanding of the time, leading to such improbable treatment methods.

Religious and Superstitious Remedies

Amidst the Black Death, many saw the plague as divine punishment for sins, leading to a range of religious responses. Flagellants, groups of people who publicly whipped themselves, believed that their self-inflicted suffering could atone for society’s sins and thus end the plague. Pilgrimages to holy sites and prayers for intercession to saints, particularly St. Roch, the patron saint of plague victims, were common.

Superstitions also played a significant role in the medieval approach to the plague. Amulets, charms, and talismans were widely used, often inscribed with prayers or magical symbols believed to offer protection against the disease.

The use of aromatic herbs and spices was partly rooted in the miasmatic theory of disease, which held that illnesses were caused by poisonous air; it was thought that pleasant smells could ward off the “bad air” carrying the plague.

This image portrays the inhabitants of Tournai laying to rest victims of the plague. 

Herbal Remedies and Pharmaceuticals

Medieval apothecaries and physicians employed a variety of herbs and concoctions to combat the plague. Ingredients like garlic, onion, and mustard were popular for their supposed antimicrobial properties. Theriac, a complex herbal mixture originally developed as an antidote to snake venom, became a catch-all remedy for the plague. It contained numerous ingredients, including opium, which may have provided symptomatic relief even if it had no effect on the disease itself.

Another common preparation was vinegar, used both as a disinfectant and a medicine. Vinegar concoctions, often infused with herbs, were thought to cleanse the body and the air of pestilential miasmas. “Four Thieves Vinegar,” a mixture reputedly used by thieves to protect themselves while robbing plague victims, is one famous example that has persisted in folklore.

Bloodletting and Barber-Surgeons

Bloodletting, based on the humoral theory, was a standard practice for a wide range of ailments, including the plague.

The goal was to reduce the excess of blood, believed to be one cause of fever and inflammation. Barber-surgeons, who performed a variety of medical procedures in addition to cutting hair, often carried out bloodletting.

They used tools like lancets and fleams to make incisions, sometimes applying leeches as a more controlled method of blood removal.

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Quarantine and Public Health Measures

As the plague continued to devastate Europe, some regions began to implement public health measures that, while not medicines in the traditional sense, were critical in managing the spread of the disease. The concept of quarantine, initially developed in Italian city-states like Venice and Ragusa (modern-day Dubrovnik), involved isolating ships and their crews for 40 days (quaranta giorni in Italian, giving rise to the term “quarantine”) before allowing them ashore.

Cities established pest houses or plague hospitals to isolate and treat the infected. Authorities also imposed restrictions on gatherings and funerals to limit the spread of the disease. While these measures were not based on an understanding of germ theory, which would not be developed until centuries later, they were pragmatic responses to the observation that the disease seemed to spread through close contact.


The medieval response to the Black Death was a complex tapestry of religious, superstitious, and emerging scientific practices. Without an understanding of the disease’s true cause—Yersinia pestis, a bacterium spread by fleas from rats to humans—medieval society relied on a mix of spiritual appeals, herbal remedies, and rudimentary public health measures.

While many of the treatments were ineffective or even harmful by modern standards, they reflect a pivotal moment in the history of medicine. This period marked a transition from a predominantly spiritual and humoral understanding of disease to one increasingly influenced by observation and empiricism, laying the groundwork for future advancements in medical science.

Frequently Asked Questions about the Black Death

In medieval Europe, where religion dominated life, many saw the Black Death as divine punishment for humanity’s sins, reflecting the era’s deep intertwining of faith and understanding of natural events.

What caused the Black Death?

During the Black Death, the bacteria Yersinia pestis spread via fleas and rats, unknown to medieval medics. Treatments ranged from herbal remedies, based on contemporary medical knowledge, to ineffective or superstitious cures driven by fear and lack of understanding of the disease’s true cause.

How many people died in Europe from the Black Death?

The Black Death was one of the most devastating pandemics in human history, caused by the bacterium Yersinia pestis. It struck Europe, Asia, and North Africa in the 14th century, particularly between 1347 and 1351, killing an estimated 25-50% of Europe’s population.

How long did it take for the infected person to die?

For those afflicted by the Black Death, the prognosis was grim, with the disease typically leading to death within three days of the first symptoms. This rapid progression instilled profound fear, driving some to the macabre practice of sewing themselves into their own funeral shrouds. This act was sometimes born of necessity, as the plague’s devastating toll often left survivors scarce, with few others available to undertake such preparations for the deceased.

What were the symptoms of the Black Death?

Symptoms included fever, chills, vomiting, diarrhea, terrible aches and pains, and then, in short order, death. Bubonic plague, the most common form, also caused painfully swollen lymph nodes, called buboes. Septicemic and pneumonic were other forms, both almost always fatal without treatment.

Why was it called the Black Death?

The term “Black Death” was first used in the 16th century and may refer to the blackening of the skin due to subcutaneous hemorrhages in some victims, or it may derive from the profound sense of doom and darkness that the plague brought with it.

How did the Black Death affect medieval society?

The Black Death had profound impacts on medieval society, leading to severe labor shortages, economic upheaval, heightened religious fervor, and widespread persecution of minorities like Jews, whom many unfairly blamed for causing the plague. It also prompted significant changes in art, culture, and public health practices.

Was there any cure for the Black Death during the medieval period?

There was no known cure for the Black Death during the medieval period. Treatments were largely ineffective and based on superstition or the limited medical knowledge of the time, including bloodletting, boil-lancing, and the use of poultices.

How did people try to prevent the Black Death?

Medieval people employed various methods to prevent the plague, many based on the miasma theory of disease. These included carrying flowers or wearing perfumed gloves to ward off the “bad air,” as well as public health measures like quarantines and the culling of stray animals.

What was the explanation in using onions as a cure for the Black Death?

In the midst of the Black Death, both doctors and patients turned to home remedies like onions, applying chopped raw ones to the plague’s characteristic buboes, hoping to draw out toxins. This practice was based on the belief that onions could not only detoxify the body but also counteract miasma, the term used then for harmful, disease-causing air.

While the concept of miasma was flawed, there was an implicit understanding that the disease could be airborne, as evidenced by the two forms of the plague: bubonic, known for its buboes, and pneumonic, spread through respiratory droplets.

Some religious figures, including Pope Clement VI, urged people to judge safety by the sweetness of one’s breath.

An image of Pope Clement VI, portrayed in a painting by Italian painter Matteo Giovanetti. Pope Clement, countering anti-Semitic violence linked to the Black Death, issued papal bulls defending Jews, noting their equal vulnerability to the plague. He provided sanctuary and urged clergy to do likewise, showcasing rare leadership and compassion.

Did blood-letting help in curing the infected?

Bloodletting, a common medical practice in medieval times, was not effective in curing those infected with the Black Death. This practice was based on the humoral theory, which posited that health depended on the balance of four bodily humors: blood, phlegm, black bile, and yellow bile. Bloodletting was intended to restore this balance by removing excess blood.

However, the Black Death was caused by the bacterium Yersinia pestis, and the illness resulted from the body’s response to this bacterial infection. Bloodletting could not address the underlying infection and, by weakening the patient through blood loss, might have even exacerbated the condition. Modern medical understanding and historical evidence suggest that rather than helping, bloodletting likely contributed to a higher mortality rate among those who were subjected to it during the plague.

Was flagellation one of the proposed cures?

During the Black Death, flagellants, believing the plague was divine punishment for sins, publicly whipped themselves in penance, hoping to appease God and end the suffering. Their whips, knotted with nails, symbolized self-inflicted atonement.

Conversely, some saw the rampant death as a sign of the world’s end and chose to indulge in earthly pleasures, leading to widespread looting, drunkenness, and promiscuity. This stark contrast in responses highlights the diverse ways people coped with the despair and hopelessness brought on by the catastrophic plague.

Galen, an ancient Greek physician, proposed that health hinges on the balance of four “humors”: black bile, yellow bile, blood, and phlegm. Medieval medicine embraced this idea, using food to adjust humoral imbalances and treat illnesses, reflecting Galen’s significant influence on healthcare practices of the time.

Did the Black Death lead to any positive changes?

While the Black Death was a catastrophic event, it led to several long-term positive changes, including labor reforms due to the scarcity of workers, which improved peasants’ livelihoods. It also spurred advancements in medicine and public health, and prompted a cultural shift towards more secular and humanist values in the aftermath of the crisis.

Could the Black Death happen again?

While bubonic plague still exists, the likelihood of a pandemic on the scale of the Black Death is low due to modern sanitation, antibiotics, and public health practices. However, small outbreaks do occur, emphasizing the need for vigilance and preparedness in disease control.

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