A medieval castle on a hill surrounded by trees.

Pharmacy in the Middle Ages

Blog post by Keisha Gordon

The past can indicate future events. Pandemics such as the COVID-19 may be new to us but they are not new to the historical record. The 1918 Flu, or the Black Death of the Middle Ages, are familiar to some. There are others that seem entirely unfamiliar, like the Castilian Plague (present-day Spain) featured in Ruth MacKay’s Life in A Time of Pestilence. The Castilian Plague occurred at the end of the sixteenth century and killed half a million people or 10% of the population.[1] MacKay’s analysis of this event shows us that there are many lessons the world can still learn past epidemics (and pandemics), such as the importance of communication and cooperation and the intertwined economic impacts.

The image shows the Pictorial history of ancient pharmacy: with sketches of early medical practice / translated from the German, and revised, with numerous additions, by William Netter. Credit: Welcome Collection. Attribution 4.0 International (CC BY 4.0)

One of the most important lessons in Life in A Time of Pestilence reveals is the importance of communication and cooperation in areas where the disease is actively spreading and infecting people. There was a range of attempts to collect data regarding diseased people and mortality rates in different towns. However, in the sixteenth century, most of this data took days or weeks to collect and had to be done by hand and on foot or horse. Fast forward to the 21st century, and we can communicate with millions of people without physical contact. Reporting and communicating diseases, people and data was a priority around the beginning of the COVID-19 pandemic but has since tapered off. McKay showed the importance of local municipalities and their corregidores (magistrates) working to communicate the impact of disease on their town; they were able to organize reporting, as well as disease treatment and management. The structure reflects the system we have in the United States, as the federal government works with states to respond to the pandemic, although the response has been far from unified.

Mackay warns us, epidemics devastate economies, this impact is inevitable. During the Castilian plague, fishermen lost their source of income as fishing boats in some areas were ordered to be tied up. Violators could have their boats burned, and in turn, their businesses completely ruined. Other merchants were movement restricted as to what ports they could enter, and towns they could trade, all impacting of their businesses negatively.  Most devastatingly, areas in which there was not a high level of market activity or which had a lesser established economy suffered the most. “Castilians at the turn of the seventeenth century believed it was the lack of commerce killing them.”[2] This notion of “lesser developed economies” being impacted the most resonates with the small businesses of today. Many small businesses closed down partially in part to government-mandated shutdowns. Even when they were allowed to operate, some could only operate at a fraction of full capacity. There currently is a debate between people that recognized the economic impact as too much to bear, and some find it a necessary sacrifice to protect public health.

Communication and economic impacts are factors that will forever be a part of the fight against pandemics. As the world continues to navigate the current COVID-19 pandemic, we are actively adding lessons to the historical record; lessons future generations will hopefully heed.

[1] Ruth Mackay, Life in a Time of Pestilence: The Great Castilian Plague of 1596-1601 (Cambridge, United Kingdom: Cambridge University Press, 2019), i.

[2]Ruth Mackay, Life in a Time of Pestilence: The Great Castilian Plague of 1596-1601 (Cambridge, United Kingdom: Cambridge University Press, 2019), 117.

Keisha Gordon is a history MA student at Arizona State University.