The Lost Executioner: Medical practitioners in an early modern pandemic
In the winter of 1494-1495, a new pandemic began sweeping across Europe. By 1497, it had crossed the sea to Scotland, the following year it arrived in India.[i] In a world where travel was much slower than today, this was a frighteningly fast spread. Initially, no one knew how the disease was transmitted, some medical practitioners suggested it moved through the air, through sex, and/or items used by infected persons like clothes, money or spoons. What was certain, however, was that this illness brought horrific suffering. Victims displayed an array of symptoms, including outbreaks of ulcerations and pustules on their bodies and agonising pains in their limbs, especially at night. In its most horrifying form, the disease rotted away the bones of its living victims. In western Europe this illness became known by many names, including ‘the great pox’, ‘the French pox’, and ‘the sickness of Naples’.
In 1496, the great pox arrived in Nuremberg, a German city where economy, science and culture were flourishing. The disease threatened the health of the approximately 20,000 inhabitants and their ongoing ‘golden age’.[i] One of the city’s physicians, Theodoricus Ulsenius, published a poem about the pox with an illustration (possibly by Albrecht Dürer) of a person suffering with the sickness (Image Two, below). The poem is written in perfect Latin and filled to the brim with references to classical mythology. But for all of his style, Ulsenius’s poem rings with concerns that we have become all too familiar with in recent times. ‘Nobody’, he wrote, knows how to cure this disease.[ii] Instead, his colleagues spent all of their time and energy arguing with each other but never moving closer to a solution. And despite claiming that those who became sick could be healed, Ulsenius had no ideas to offer for a remedy, just a half-hopeful hint that one would come along. Perhaps he hoped to encourage his colleagues to divert their energies away from arguments and to more productive collaboration.
Certainly, not everyone was involved in the kind of futile disagreement that Ulsenius describes. Doctors and surgeons across Germany and beyond worked tirelessly to try to cure the sick. A new type of medical specialist even emerged in Germany, the so-called ‘French pox doctor’ (Franzosenarzt). At the same time, governments of many of the German cities implemented new laws and established new hospitals to aid the sick and protect the healthy. For example, on 9 August 1496, the city council that governed Frankfurt am Main recorded in its book of minutes and decisions that the great pox had arrived and, in order to protect the healthy community, an announcement was to be made, instructing the sick to proceed to an isolated area in the city.[i] Two days later the council decided to prepare the city’s plague hospital to provide care for pox victims.[ii]
On a peaceful Autumn morning, a little over 520 years after the council first witnessed cases of the pox, I sat in the reading room of Frankfurt’s Institute for City History. On the desk in front of me sat a pile of plain folders, each stamped with an archive reference number and containing the council’s fifteenth-century letters.
Amongst orders to doctors and petitions from the sick, I flipped open a file and found a lost executioner. On 5 November 1496, the government of the southwestern city of Trier sent a letter 173 kilometres, asking whether a man named Master Peter had been seen in Frankfurt.[i] Peter was one of Trier’s executioners but had recently disappeared. Now, according to Trier’s authorities, he was travelling around Germany and working – or posing – as a medical specialist in the great pox. Indeed, it seems from the letter that he had won considerable popularity and had, according to Trier, recently attended the popular Frankfurt fair.
The letter from Trier is very carefully worded, deliberately vague and open-ended. The authorities do not explicitly call Peter a fraud, but the letter heavily implies that he had not received any medical training. Thus this seems like a neighbourly warning to Frankfurt to watch out for a quack doctor. Yet, Trier was also very keen to get Peter back. It may sound strange today, but in the fifteenth century, making the transition from executioner to medical practitioner was not a very far-fetched idea.[ii] Many practitioners, especially surgeons, barber-surgeons, and other specialists like the French pox doctors and eye doctors, were trained by apprenticeship, through practical experience working with a master of their trade. Only physicians usually held university degrees. Moreover, executioners already had relevant experience for procedures like amputations. In the late fifteenth century, there were multiple incentives for Peter to become a pox specialist. It may be that he had a genuine skill and wish to help the suffering. If his desires were more material, these specialists had ample opportunity to earn considerable sums of money and win substantial fame.
Trier’s council wrote that they had received reports that Peter had healed several people in Frankfurt. Moreover, they continued, they had heard that the Frankfurt council was going to make Peter a citizen, and they asked if this was indeed the case. This letter then was perhaps not so much a warning, but an attempt to locate Peter and get him back to Trier to help the city’s suffering pox victims. If Frankfurt made him a citizen, it would be almost impossible for the Trier authorities to get Peter to return, as he would have legal protection.
On 15 November the Frankfurt council wrote back. According to their letter they had conducted an investigation and had not discovered anyone called Master Peter. And with that he disappears from the historical record. So far, my research has not uncovered any further documents on this elusive executioner. It may be that he had already left Frankfurt, many medical specialists travelled from place to place. Or perhaps he remained in Frankfurt, with or without the council’s knowledge.
While Peter disappeared from the historical record, the great pox did not. By the early sixteenth century it was endemic in European society; indeed, it never really went away. Though research continues into the exact development and relationship of the bacteria,[iii] the great pox would eventually become the disease today known as syphilis. Long after the fifteenth century and Ulsenius’s frustrations, this illness continued to challenge medical practitioners. And citizens and authorities continued to seek those, like Peter, who offered the most effective and gentle cures. From the fifteenth century onwards herbs, sweating therapies (wrapping people in blankets and leaving them near hot stoves) and, notoriously, mercury were all used. Indeed, the highly toxic mercury remained the dominant treatment until 1909, when the Nobel laureate and physician Paul Ehrlich, working in Frankfurt, developed Salvarsan and then the more stable Neosalvarsan. While this treatment still came with some nasty side-effects, it was a considerable improvement on mercury. This therapy continued to be used until the 1940s, when penicillin was finally identified as the most effective (and least aggressive) cure.
References
[i] Samuel Klein Cohn, Epidemics: Hate and Compassion from the Plague of Athens to AIDS (Oxford, 2018), 95.
[ii] Gerald Strauss Nuremberg in the Sixteenth Century: City politics and life between the middle ages and modern times (London, 1976), 36.
[iii] Theodoricus Ulsenius, Vniuersis Littera[Rum] Patronis in Epidimica[m] Scabiem Que Passim Toto Orbe Grassat[Ur] Vacitiniu[m] Dicat (Nuremberg, 1496).
[iv] Institut für Stadtgeschichte (hereafter ISG), Bürgermeisterbuch (hereafter BB) No.66 (1496), f.32v.
[v] ISG, BB.66 (1496), f.33v.
[vi] ISG, Reichssachen, Nächtrage Nr.1363 (1496).
[vii] See for example, Joel F. Harrington, The Faithful Executioner: Life and Death in the Sixteenth Century (London, 2014).
[viii] See for example: Robert J. Knell, ‘Syphilis in Renaissance Europe: rapid evolution of an introduced sexually transmitted disease?’, Proceedings of the Royal Society of London. Series B: Biological Sciences, 271 (2004), S174-S176; J. G. O’Shea, ‘Two minutes with venus, two years with mercury – mercury as an antisyphilitic chemotherapeutic agent’, Journal of the Royal Society of Medicine, 83 (1990), 392. Molly Kathleen Zuckerman, ‘Sex, Society and Syphilis: A Social, Ecological, and Evolutionary History of Syphilis in Late Medieval and Early Modern England (c.1495-1865)’ (PhD Thesis, Emory University, 2010).