Book Review

The Great Pox: The French disease in Renaissance Europe

N Engl J Med 1997; 337:577August 21, 1997

Article

The Great Pox: The French disease in Renaissance Europe
By Jon Arrizabalaga, John Henderson, and Roger French. 352 pp., illustrated. New Haven, Conn., Yale University Press, 1997. $35. ISBN: 0-300-06934-0

In the last decade of the 15th century in Italy, there was an invasion by the French, recurrent bubonic plague, floods, famines, earthquakes, intemperate cold, and then a new disease, loathsome and incurable — the Great Pox, or French disease (Morbus Gallicus). It had, in its apocalyptic appearance, a great effect on European society, politics, the church, and of course medical thinking. The authors of this book are historians and write as such: they are reluctant to identify the Great Pox with modern syphilis, explaining that historical events should be examined in the context of the knowledge and mores of the time rather than in the light of what is known today. They are meticulous and thorough in their documentation and provide quotations from representatives of the towns, city–states, and church; politically influential people; and physicians, both academicians and empiricists.

Despite the caution not to equate events of the 15th century with current events, I doubt whether any modern doctor could read this book without drawing parallels between the reactions of the people of the time to the French disease and the responses of physicians and society in our own era to AIDS. Both diseases appeared toward the end of the century, have had apocalyptic penumbras, affect principally the poor (but may affect the rich and famous as well), are more common in men than in women, and are chronic, disfiguring, sexually transmitted, and laden with moral implications. Empiricism and charlatanry, with angry responses from academicians as well as public disputes on the origin, transmission, and nature of the disorder, are also common to both. Finally, conspiratorial theories of origin surround both, including the attribution of the disease to unpopular subgroups, such as (in the case of the Great Pox), the French, the Jews, and even inhabitants of the then recently discovered New World.

The authors' emphasis is not on the disease itself, although it is well described for the reader in the contemporary writings extensively quoted, but more on the reaction to the disease at multiple levels. They use the Great Pox to explore the time, the place, the people, and the effects of such a major event on the thinking and action of the period, and its sequelae.

The physician reader would have to be very, very interested in the Great Pox and its influence on Italian and Northern European society to read this book. The text is rich, detailed, and extensively referenced, with graphs, tables, and a number of photographs and prints. Substantial attention is given to setting forth the disputations of learned medical academicians, including their alliances with now discarded “schools” of medicine. For the meticulous historian, historian-physician, or anyone seeking a specific reference on the history of the Great Pox, however, the book may prove invaluable because of the same prolific detail that renders it somewhat turgid for the casual reader. It takes work to read this book, and it is therefore to be recommended more as a reference for scholars than as entertainment during an airplane ride or an evening's diversion.

Faith T. Fitzgerald, M.D.
University of California, Davis, School of Medicine, Sacramento, CA 95817