The prevalent ideas in the 1500s of what constituted health and disease, originated in Ancient Greece and Rome, with Hippocrates and Galen.
These same ideas would remain dominant until the end of the 1800s, after the discovery of bacteria.
Humours
The main idea was, that the human body contained four essential liquids, which in a healthy person are balanced.
They were called humours, and they were blood, black bile, yellow bile and phlegm.
Various associations were imagined of the humours with the four seasons, with the four basic elements in the ancient Greek world-view (earth, water, air and fire), with different internal organs and with types of personality or temperament.
For example, blood was considered hot and wet, associated with spring, air, the liver, and a sanguine disposition.
Disease
If the four humours became imbalanced, disease and sickness follow.
Different diseases corresponded to different combinations of excess or deficiency of each of the four humours.
The main skill of the doctor was to understand, based on the condition of the patient, which humours were in excess or in deficiency, and to devise a treatment to restore the balance.
For example, a patient with a fever, and therefore sweaty, was hot and wet, which corresponded to an excess of blood. A possible cure was bloodletting, to restore the correct balance of the blood with other humours.
Miasma
If a person had a wound or abscess, it was fairly easy to interpret what caused the imbalance of the humours. The cause was visible.
With contagious diseases, it wasn’t so simple, as persons could fall ill with no clearly visible cause.
What had then caused the imbalance of their humours?
This was explained by miasma, a Greek word which means impurity or pollution.
Miasma were something invisible or imperceptible, which, if it entered the human body somehow, would cause an imbalance of the humours and therefore disease.
Different kinds of miasma caused different types of imbalances, and therefore different diseases.
Consequently, if a space — say, a house or a ship — was full of miasma, those who spent time there were likely to get the same illness. This explained how entire households or ship crews could come down with the same disease, even in the absence of directly physical contact between some of them.
Contagion was therefore seen as a kind of environmental problem.
Naturally, the people of the past observed person-to-person contagion. They settled on the explanation that one person could pass a disease to another because the miasma had attached to the person’s body or to their clothes.
The origin of miasma
All this just led to the next question, of where did the miasma come from? Why were they sometimes there, and sometimes not.
The accepted idea was, that miasma generated spontaneously in certain conditions.
Such conditions were, for example, unburied cadavers in decomposition, or piles of rotting rubbish, or simply the foul smelling mud of a swampy area, which smells of rotten eggs (sulphur) if turned over.
More generally, the appearance of miasma became associated with things and places that smelled bad.
The disease of malaria, caused by a parasite spread through mosquito bites, was common around swamps and wetlands, where mosquitoes could easily breed. Such swamps also smelled bad, so people named the illness mal aria — literally ‘bad air’.
Fighting miasma
What could be done to prevent miasma from appearing and causing disease, or to remove miasma from a space where people got sick?
On a very basic level, ventilation. Simply have the miasma blow away, by replacing smelly air with fresh air.
To prevent miasma from appearing, remove the sources of stench and foul smells. Eliminate rotting rubbish and dispose quickly of the corpses of the dead.
The next step was to replace the bad smells with something more pleasant. The fumes of fires were commonly used, which was called ‘per-fuming’, hence the word perfume.
Other means of replacing foul smells were incense, vinegar, ambergris, herbs, scents of all kinds, and what we would call perfumes today.
How does this relate to Benedetti’s account?
The ideas of humours and miasma permeate the account of Rocco Benedetti.
He put a lot of emphasis on smells, taking about stench, fetor and malignant air repeatedly because he believed such bad smells caused contagion.
When somebody died, the entire household and the house itself, with everything in it, were quarantined and later cleansed. Since the miasma causing the plague could stick to both persons, objects and the building itself, everything had to be treated.
When persons returned from their quarantine, they didn’t wear their own clothes, which had been burned, as infected with miasma.
Their belongings were taken to islands in the lagoon, where they were exposed to the winds and the sun, or submerged in the salt water of the lagoon, in attempts to remove the miasma.
The Swiss Grisons used heavy smoke to ‘disinfect’ the houses because the contagion was believed to be associated with smells.
The apothecaries — which Benedetti ridicule for their useless remedies — used vinegar to wash the coins with which they were paid. Vinegar was believed to make the miasma disappear, by giving the coins a nice smell.
Wrong reasoning, but right results (sometimes)
Even though the line of reasoning applied by Benedetti and his contemporaries was entirely wrong — based on little more than ancient superstition — they still arrived at some remedies, which actually worked.
Washing coins and other metallic objects in vinegar reduces the contagion because vinegar is a disinfectant.
Isolating the sick and quarantining the suspect limits the spread of the contagion.
A bacterium like yersinia pestis can only survive for so long outside a living body, so quarantining objects also works. After some days, the germs on the objects die.
Exposing cloth, fabric and paper to sunlight also has positive effects, as ultraviolet light kills bacteria.
Rats and other small rodents had a secondary role in the spread of the plague, and the use of smoke in buildings could flush out the rats and mice living there, or kill them, as Benedetti also recounts in the little anecdote of the mouse jumping on the fire.
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