Hektoen International

A Journal of Medical Humanities

Giovanni Boccaccio on pandemics past and present

Constance Markey
Chicago, IL


The plague of Florence as described by Boccaccio
The plague of Florence, 1348; an episode in the Decameron by Boccaccio. Etching by L. Sabatelli the elder after G. Boccaccio. Credit: Wellcome Collection. Attribution 4.0 International (CC BY 4.0))

Giovanni Boccaccio (1313-1375) is universally celebrated for his masterpiece The Decameron, an appealing assemblage of one hundred loosely connected novellas, all designed, in part, to distract the fourteenth-century Italian audience from the Black Death plaguing the country. Some of the tales are slapstick misadventures to make the reader laugh, others are more sober. But none are as brutally realistic as the author’s introductory chapter.1

In it he describes the physical, emotional, and social situation of the pestilence that struck Europe in the fourteenth century, and often anticipates the current pandemic and the reactions of those of us living through it. Indeed, Boccaccio’s singular frankness exposes that, in dealing with COVID-19, some people have not updated their thinking medically, socially, or morally.

The plague struck Florence in the spring of 1348 while Boccaccio was in residence. According to the author, its arrival was not unforeseen. In fact, it was known to have appeared earlier that year in northern Italy, presumed to have originated in the East.2

With little available scientific knowledge, many of Boccaccio’s compatriots attributed la peste to the “wrath of God,” a punishment for man’s wicked ways. Others blamed it on the “miasma,” a newly popularized theory that putrid air was the cause.3 City officials, however, were wise enough to begin a cleanup of the city’s filth and to invoke quarantines that barred the sick from entering the city. But these steps, Boccaccio tells us, perhaps not without cynicism, were not of “any avail.”4

No one then, of course, could have known that the true origin of the pestilence was Y. pestis, a gram-negative aerobic coccobacillus. Disease developed when fleas, who normally fed on mice and rats, sought another host in humans when the rodents died. After ingesting blood tainted with Y. pestis, the fleas’ stomachs would engorge and cause them to die, yet the bacteria in the dried blood of their desiccated bodies could remain viable for weeks. While some creatures appear unaffected by contact with these fleas or their remnants, others, like human beings, can become infected and die. Such was the nature of the calamity facing Florence.5

Boccaccio did not know the cause of the mysterious pestilenza, but he was shocked by the course of the disease, the care (or lack of care) of the sick and dying, and the surprisingly bizarre behavior of the Florentines. In his introduction to The Decameron, he puts aside any notions of God’s intervention along with suggestions that miasmic air had caused the deaths of two-thirds of the Florentine population. Instead, the author plunges headlong into describing the illness and what he clearly recognizes as a contagious disease—one that will unfortunately be soon followed by grievous social disorder.

He begins with a concise description of the disease’s onset, correctly noting its variability. In the East, he reports that the pestilence manifested itself in “bleeding from the nose.” However, in Florence he sees it progress first “with certain swellings . . . in the groin or under the armpits, growths that soon grew to the size of . . . apples,” or “the size of eggs.” These, the people called gavoccioli (buboes). Soon after the buboes appeared, the body of the infected person became covered with what the author describes as “black spots” (purpura). Death, of course, was imminent.6

Medical care failed, says Boccaccio, either because there was no cure or because doctors were indifferent, just plain “ignorant,” or perhaps not even real doctors. Soon, however, it became clear that approaching those who were ill was dangerous. Even touching their clothing or bodies might be deadly. Between the lack of medical attendance and the virulence of the pestilence, many died who need not have done so, especially among the lower classes.7

The situation of the poor, and even that of the middle class, was dreadful. Once dead, victims’ bodies were simply dragged out the door. Quantities of decomposing bodies could be seen in the streets until the becchini (paid gravediggers) carted them off to any available unoccupied grave. For people who died in their homes alone, days could pass before their bodies were discovered, usually by the stench.

The normally fine funerals reserved for the upper class were also set aside. Few were honored or mourned with the traditional pomp. Without ceremony, and often unaccompanied by family, they were carried to the nearest churchyard where trenches were dug and the bodies unceremoniously and quickly buried. Before long, as Boccaccio dramatically states, the city was “full of corpses.”8

Because of fear, or maybe sometimes out of necessity, groups of the Florentine citizenry dealt with the plague in different ways.9 There were individuals in Florence who “lived entirely apart from everyone else . . . where there were no sick people at all.” Their wise decisions are suggestive of behavior practiced now by many facing the present pandemic.

There were others in Florence, Boccaccio tells us, who followed a “middle course.” They did not “shut themselves up, but went around carrying in their hands flowers, or sweet-smelling herbs, or various kinds of spices; . . . Often they would put these things to their noses, believing that such smells were a wonderful means to purify the brain. . . .” This would have been an attempt to protect themselves from the miasmic pestilence in the air, as had been suggested by Vitruvius, Galen, and others. Would masks have protected these individuals, or at least minimized their infection? In a flea-borne disease, the answer is no.

The final group that Boccaccio bluntly labels bestiale is particularly relevant to our times because they seem familiar. They, like some individuals today, were not careful at all. Boccaccio writes, “they believed that drinking too much, enjoying life, going about singing and celebrating, satisfying . . . the appetites, as best one could, laughing and making light of everything that happened was the best medicine for such a disease. . . . Doing their best to avoid the sick, leaving them die unattended,” they did, however, often party in deserted houses, treating them as if they were “common property. . . .” This sort of behavior, Boccaccio says, left everyone “free to do as they pleased . . . while the revered authority of the laws, both divine and human law had fallen” by the wayside. Ultimately, many people died needlessly in Florence that could have been saved.

Boccaccio’s most distinguished critic, Vittore Branca, has rightly called The Decameron a masterpiece for the author’s use of vernacular prose, his middle-class attitudes, and his psychological approach to a “very human picture of a decisive period in history.”10 But for today’s informed reader, Boccaccio appears to be more than a man of his times, since his words, thoughts, and realistic observations still have relevance today in addressing the behaviors and approach to the present pandemic.


End Notes

  1. Giovanni Boccaccio, “Introduction,” in The Decameron. trans. and ed. Mark Musa and Peter E. Bondanella (New York: W.W. Norton & Company, 1977), 3-17.
  2. Boccaccio, “Introduction,” 3; Boccaccio knew that the Black Death originated in the East and that it had arrived in northern Italy earlier in 1348, moving east to “westerly” toward Florence.
  3. Boccaccio, “Introduction,” 3. It is now known today that the miasma theory actually originated in ancient times. See Joseph Byrne, The Black Death (Westport, CT: Greenwood Press: 2004), 42.
  4. Boccaccio, “Introduction,” 3. The author never mentions the miasma himself. But by traditional necessity he does briefly mention God and the “influence of heavenly bodies.” At the end of this discussion, however, he more realistically turns his attention to the city’s filth.
  5. For the medical history of the Y. pestis as the real cause of the Florentine plague we are dependent on the direct quotes and summary provided by: Jay Sanford, “Section 157,” in The Textbook of Medicine, ed. Paul B. Beeson, Walsh McDermott, and and James B. Wyngaarden (Philadelphia: W.B. Saunders Company, 1975), 462-63.
  6. Boccaccio, “Introduction,” 4. Here we find an admirable description of buboes.
  7. Boccaccio, “Introduction,” 4. Boccaccio is clearly suspicious of medical care in his era and is aware of the many charlatans pretending to be doctors
  8. Boccaccio, “Introduction,” 7-8. With multiple direct quotes by the author.
  9. Boccaccio, “Introduction,” 5-7. This section on Florentine behavior in the 1348 plague is easily the most significant part of the Introduction since today’s reader, enduring the 2020 pandemic, can in no way avoid relating to it.
  10. See Vittore Branca’s words in his brilliant study, Boccaccio. The Man and His Works, trans. Richard Monges (New York: New York University Press, 1976), 247.


List of References

  • Boccaccio, Giovanni. “Introduction.” In The Decameron, translated and edited by Mark Musa and Peter E. Bondanella, 3-17. New York: W.W. Norton & Company, 1977.
  • Branca, Vittore, Boccaccio. The Man and His Works, translated by Richard Monges. New York: New York University Press, 1976.
  • Byrne, Joseph, The Black Death. Westport, CT: Greenwood Press: 2004.
  • Sanford, Jay. “Section 157.” In The Textbook of Medicine, edited by Paul B. Beeson, Walsh McDermott, and James B. Wyngaarden. Philadelphia: W.B. Saunders Company, 1975.



CONSTANCE MARKEY, PHD, has enjoyed two careers. While working as a registered nurse (1957-79) she also studied Italian, and in 1970 earned an MA in Italian at the University of Chicago, and a PhD in Italian literature at the University of Illinois in Champaign/Urbana in 1980. In 1984 she accepted a position at DePaul University in Chicago where she was named head of the Italian Section. She continued to teach at DePaul until her retirement in 2004.


Fall 2020  |  Sections  |  Infectious Diseases

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