History and literature in times of epidemic

Illness is a time of individual change and, in the case of an epidemic, also of collective change. It always affects people, but it can also affect societies as a whole. The significance of the disease causes a social cut, the importance of which will vary depending on the number of people affected and the severity of the disease.

The precise description and understanding of the medical characteristics of the disease correspond to doctors, biologists, chemists. But the comprehensive understanding of the true significance of disease for human beings, individually and collectively, is properly studied, in my opinion, by the social sciences and also by the humanities.

In the description of the various aspects in which individuals and society are affected bythe disease, sciences such as Psychology, Anthropology, Sociology and, naturally,Economics participate. History, for its part, one of the core subjects of theHumanities, provides the global analysis of phenomena, seeking their causes, their development and their consequences, both for individuals and for larger human groups and, potentially, for the entire humanity. And there are also philosophical, archaeological, and ethical approaches, in which the human sciences provide their own views on the effects of disease on different facets of life. Even language can be a way to understand some social aspects of the phenomenon, as proved by Susan Sontag's famous essay Illness as metaphor(1978).

My intervention will try to focus on another of the humanistic activities par excellence, which is not always present in the debates on the relations between the humanities and science, I refer to Literature, which is the perfect complement, in my opinion, of History.

There are numerous literary works that deal with disease as a fundamental element of the framework or plot of literary creations. There are masterpieces of literature dealing with individual illness, such as The Magic Mountain (1924), by the German writer Thomas Mann (1875-1955). But at the moment I am interested in those works that refer to collective diseases and epidemics.

The particularity of literary narration with respect to historical description or to more specialized analysis is twofold: on the one hand, literature is capable of transmitting images and sensations that can hardly be collected in academic treatises. It can account for aspects such as people's mood, personal attitudes, family relationships, hatred, acts of generosity, egoism etc. On the other hand, literature, free from the shackles of academic conventions, is able to focus on one aspect or another of historical phenomena, concentrating scattered events in a single moment or in a few characters and insisting on aspects that could remain out of the scope of scientific descriptions. And I think I can give an extraordinary example of this, which also was created in a moment of great collective upheaval, although not as a result of illness, but rather of war, but which I also find useful for present times. Can anyone think of a better description of what the confinement of individuals represents, the confinement of entire families, than the famous Diary of Anna Frank? There is no historical description capable of transmitting the horror, hope and survival capacity of human beings in such conditions as those few pages from a humble diary of a teenager. And this is the merit of literature; even more, I could think of that as its supreme function: to be able to reflect aspects of the human being that are often not of interest to scientific analysis and which are difficult to account for even with a purely historical description.

To focus on the literary works in which the epidemics appear as the main theme or as a framework in which other events occur, I will comment only a few works, but written by great authors, from different countries, in diverse times and using different languages. All of them deal with some aspect of the epidemic and serve as a key to understanding the present moment, in which COVID-19 has brought us back to times and sensations that only our grandparents or even previous generations could know. And I will begin with the oldest of all the texts that we have in the Western World referring to a plague: the description of the great plague of Athens of the year 430 BCE as recorded by Thucydides.

Let's remember the background. Athens and Sparta, which had maintained a great rivalry for decades, began open hostilities, the war, in the year 431 BCE. It is the so-called Peloponnesian War, although it affected all of Greece. The Spartans invaded Attica, the region of which Athens was capital, in the summer of the year 430 BCE. The rural populations took refuge in mass in the city. Then, in the midst of human crowds, with poor nutritional and hygienic conditions and the summer heat, the plague breaks out. By the detailed description of Thucydides, we can identify it with the bubonic plague. The plague affected a large part of the population and will even kill the ruler of Athens, Pericles one year later. And Thucydides, who tries to narrate the Peloponnesian War in his work, dedicates just three pages (book II, paragraphs 47-54) to the description of the plague; but he does it with such precision and intelligence, combining objective data with impressions and sensations, that, for centuries, it became the model to narrate this type ofsituation in the Western literary tradition.

One could argue that Thucydides was more a historian than a writer and that his work is not properly a literary account. But it would be a mistake to think like this; in his time there was no clear distinction between historiography and literature. Thucydides' narration combines rigor with a high elaboration in linguistic and literary composition. It is pure literature. And in those few pages he transmits some of the features that will forever characterize any description of an epidemic.

It begins by establishing a framework, characterized by three main features, which are common in all epidemics: it can affect all citizens; doctors and people who care for the sick are the most exposed; the population goes through various states of mind that can lead to despair (paragraph 47). In other words, it introduces us to the physical part of disease, to the measures that can be taken against it and to the situation of the population. After this beginning, Thucydides develops these points, but he does not give the three equal importance.

It deals first of all with the origin of epidemic, which, he says, may have been in Egypt. There were also those who attributed it to the Spartans, who would have poisoned the wells (paragraph 48). But Thucydides has no evidence of these things; so he leaves open this aspect: "All speculation as to its origin and its causes, if causes can be found adequate to produce so great a disturbance, I leave to other writers, whether lay or professional; for myself, I shall simply set down its nature, and explain the symptoms by which perhaps it may be recognized by the student, if it should ever break out again.” These few words refer us to another aspect typical of the great epidemics: the hoaxes, the supposedly true news, but without any basis. It is one of the social aspects on which scientific, sociological, historical or epidemiological studies hardly insist, but which constitutes a fundamental element of the incidence of a great plague on a society and of the evolution of society itself during the period of its incidence and after. And, although very briefly, another typical aspect of social reactions is also mentioned: the search for personal, preferably foreign, culprits. Xenophobia is one of the most typical human reactions in times of great social catastrophe.

In the next paragraph (49) a detailed description of the symptoms is offered, one of the oldest we have in all literary records and extremely accurate for the only embryonic state of medical knowledge at that time. And Thucydides transmits a fact that we don't always know about: it also affected animals (paragraph 50).

In the following three chapters (50-53) the most interesting aspects of the epidemic are reported: how the population reacted. And here the author makes almost a whole catalog of attitudes: the egoism of some who locked themselves up at home and did not want to help anyone or even abandoned the corpses of the family; the generosity of those who, even at the risk of their lives, went to help their friends and family; the compassion of those who had already passed the disease and were immune; the misery of the less fortunate, the refugees, who died without any care. That is, a whole list of attitudes that could be recognized almost in any current situation. But among all this, there is a breathtaking phrase that is capable of transmitting on its own all the horror of an epidemic: "By far the most terrible feature in the malady was the dejection which ensued when anyone felt himself sickening" (51.4). With this short sentence Thucydides transmits to us something that has burdened all societies since Antiquity: the deep loneliness of the individual before his fate. It is the transition from the collective to the individual, which represents, in the end, the main origin of human fear: what will happen to me? It is the reflection of a perception of great psychological sharpness and, at the same time, of an enormous humanism.

Within this description of human reactions at the time of the epidemic, Thucydides describes in more detail two very significant phenomena that do not always occur, but that did characterize that moment: the fact that some people were wasted, searching of immediate pleasure, not knowing what fate was going to bring them; and the massive abandonment of religion when seeing that the prayers to the gods did not provide any relief.

It is remarkable, on the other hand, that he does not refer to official measures taken by the State, which undoubtedly existed, at least trying to preserve soldiers in a time of war. Actually, the only information is the mention of doctors dead in the exercise of their functions. And it is precisely this ability of literature to focus some aspects against others that I referred to earlier as one of the qualities of literature. Undoubtedly, in a current story we would have been interested, as a fundamental aspect, by the reaction of the public powers. But Thucydides focuses on human feelings and behaviors, painting them with extraordinary vivacity and thus transmitting a much more impressive and real image of what the plague represented for the citizens of Athens.

The story ends with rather erudite information about the possible predictions and oracles that would have announced the misfortune (paragraph 54).

This first record of an epidemic was composed in the 5th century BCE, and it will be the model, as I said, for many others who will come later, and, in particular, in Roman times. In this long period, two great plagues caused devastation, one in the 2nd CE, the so-called Antonine Plague, and the other in the 3rd CE. They will be described, respectively, by authors such as the great doctor Galenus (129-216 CE) and Ammianus Marcellinus (325-400 CE), the first, and by Cyprianus (200-264 CE) and Dionysius de Alexandria (according to the testimony of Eusebius of Cyrene, 263-339 CE), the second. It is possible that the epidemics were, in both cases, of smallpox. The model of these narratives, sometimes explicitly, was Thucydides. However, these records where not really interested on general aspects of the epidemics, but were technical, in the case of Galenus, and focused in the comparison between Christians and pagans in relationship to charity and help to the ill, in the case of Cyprianus and Dionysius. The description by Ammianus is lost except from some quotations. Probably, the most interesting information we can get from those texts is the great importance that population movements had in the spread of the epidemics. In the case of the Antonine Plague, the Roman legionaries, infected on the eastern border of the Roman Empire, in Seleucia, on the Tigris river, carried the infection to the Rhine border and from there it spread to Gaul and Germany. The second epidemic probably arose in Egypt and must have been transmitted through the trade routes that linked Alexandria with Rome and the western part of the Roman Empire.

We have also testimonies of the great medieval plagues, mainly from historical sourcesand contemporary documents. The two worst epidemic were the Justinian’s Plague (541-542 CE) and, over all, the Black Death (1347-1351), which killed between one third and one half of the European population. Of the second one we have and indirect, but very interesting, literary testimony, in the Decameron, by Giovanni Boccacio (1313-1375). The work does not properly describe the plague, but it does use it as an excuse to introduce the delightful stories told by a group of people fled from Firenze escaping from the epidemic. And it can serve as a reflection on two other universal characteristics of epidemics. The first is the disparate way in which the most humble and the most powerful are affected, as the latter can seek refuge far from the focus of the disease. The second, the need for human beings to look for spaces of normality to escape from the horrors of the disease.

But we have to wait until the great plagues of the 17th century to find literary works comparable to the brief but very rich record of Thucydides. Probably, the most interesting piece is the Diary of the Year of the Plague, written by Daniel Defoe (1660-1731), the author of the famous story of Robinson Crusoe. Defoe published his work in 1722, but referred to events that had happened almost sixty years earlier, when he was a child. The book refers to the great plague that ravaged London in the years 1665 and 1666 and that, probably, killed a quarter of the population of the city. It is a work of fiction, with a protagonist who goes through various situations. Nevertheless, the argument is rather superficial, since the book is mainly designed to record the lived horrors and, above all, the human reactions in such a situation. In the Diary of the Year of the Plague there are references to the origin of the disease, which probably arrived by boat from the Netherlands, forcing the authorities to take measures to establish rigorous quarantines. We also find news of the decisions of the city officers, in this case very active, to try to alleviate the personal and commercial catastrophe. And the scenario is completed with descriptions of the actuation of the doctors, almost always heroic, of the damages suffered by businesses and workshops, of the fundamental participation of the parishes, as a basic unit of social structuring in such large city, and, of course, of all kinds of human reactions such as those described twenty centuries earlier by Thucydides, from egoism to the most absolute altruism.

And again here literature is shown as a magnificent instrument to know the past, capable of transmitting with a brushstroke a set of sensations and attitudes that the enumeration of statistics of deceased or the economic data cannot tell. The possibility of choosing moments and situations through fictional characters, who move where the author wants, often manages to summarize in a paragraph what we would be unable to capture through scientific descriptions. It is something that many years later will reappear in a work of absolute fiction, the novel Ensaio sobre a cegueira (Blindness) (1995), by the great Portuguese writer José Saramago (1922-2010), Nobel Prize for Literature 1998. In this novel, free of all historical anchor, Saramago studies the human reaction in a dystopian world, where a universal plague blinds almost all human beings, except one. The author's interest is here in human relations and in the power structures that are built in the midst of the great social upheaval that an epidemic represents.

A vision not very different from that provided by Defoe and Saramago can be found in another of the great European novels, I promessi sposi (Betrothed) (1827), by the Italian writer Alessandro Manzoni (1785-1873). It is a true masterpiece that relates the terrible plague that between 1629 and 1631 affected all of northern Italy, in particular Lombardy and Veneto, and then spread, by the movement of merchants and soldiers, to all the possessions of the Spanish Empire in Europe. In this case, the plague is only the background, the setting in which a love story unfolds. However, for what interests us here, the most important thing is the extraordinary reconstruction, carried out on original documentation by Manzoni, of the scenes of collective panic, heroic dedication and miserable egoism that occurred during that terrible plague. It is also interesting to recover the stories about the possible guilt of foreign spies. In fact, this epidemic was known in Spain as “the Milan powders”, because it was supposed that either French spies or monks had disseminated the illness through some secret powder. In other words, we have again reference to two those two typical social phenomena in times of epidemic: the appearanceof hoaxes and xenophobia.

The most interesting thing about this work, in my opinion, is that it is capable of recovering for us an aspect that is rarely recorded or even mentioned when describing epidemics, the way in which life continues. Indeed, in historical terms, we should not only be interested in the development of the epidemic and its consequences, but also in the other aspects of daily life that are necessarily maintained and must survive. Those aspects, partially reflected in the medical, psychological or economic reports, can be admirably reconstructed through fiction. In the case of the Manzoni it is the love of a young couple what survives. And love is also behind some other interesting literary works which refer to plagues. Among others, we could remember, first, Der Tod in Venedig (The Death in Venice) (1912), by the aforementioned Thomas Mann, Nobel Prize 1929, where the infatuation of an adult professor by a young man is narrated. El amor en los tiempos del cólera (Love in the Time of Cholera) (1985), by the Colombian writer Gabriel García Márquez (1927-2014), Nobel Prize in 1983, tells about the passion maintained throughout life, even in the worst circumstances. We can also mention La quarantine (The Quarantine) (1995), by the French novelist Jean-Marie Gustave Le Clézio (1940), Nobel Prize in 2008, who, besides a love story, describes the recovery of nature and the simplicity of life in times of great tension and confinement. In the same sense, La lunga atessa del’angelo (The long wait for the angel) (2008), by the Italian writer Valeria G. Mazzuco (1966), is also interested in love, but in this case within family relationships in times of epidemic. All of those books bring us, through fiction or fictionalized history, to terrible moments of epidemics and plagues, but provide us with new insights into aspects of human life under those circumstances that might otherwise have been hidden under scientific data and descriptions.

And I will finish with the novel Peste et choléra (Plague and Cholera) (2012), by the French writer Patrick Deville (1957). This work reconstructs, under a literary cover, the biography of the Swiss doctor Alexander Yersin (1863-1943), discoverer, together with the Japanese Kitasato Shibasaburo, of the bacillus of the bubonic plague, named in his honor Yersina pestis.. Deville's story reconstructs the extraordinary life of this researcher, always drawn to practical medicine and finding solutions to great human sufferings.

Throughout this quick review, I have tried to make clear how scientific and specialized studies and descriptions of the phenomenon of the epidemic can be complementized, to be fully understood, by and humanistic view, which can come from philosophy, from history and also from literature. Phenomena such as the relationship with religion, the emergence of hoaxes, xenophobia, feelings of hope and despair, the manifestation of the best and worst human qualities in times of pressure, and the maintenance of daily life during epidemics are reflected in an especially rich and complete way in literary texts. This tradition began in the Western World with the description of the plague of Athens by Thucydides in 5th CE and continues to this day.

Jesús de la Villa

Prof. of Ancient Greek Philology

Universidad Autónoma de Madrid, Spain