Posttraumatic Stress Disorder in the Middle Ages
By Taylor Marvin
Last month Andrew Sullivan flagged a very interesting story on posttraumatic stress disorder among medieval knights. There is strong documentary evidence that medieval soldiers suffered from severe psychological problems, according to Thomas Heebøll-Holm of the SAXO Institute at the University of Copenhagen:
“Previously, medieval texts were read as worshiping heroes and glorifying violence. But in the light of modern military psychology we can see the mental cost to the knights of their participation in the gruesome and extremely violent wars in the Middle Ages.”
Warfare in the Middle Ages was truly horrific. Medieval single-handed arming swords were heavy (averaging roughly two to three pounds) and able to traumatically amputate limbs in a single cut. Blows to unarmored heads or torsos could be instantly fatal. Injuries that did not kill soliders on the battlefields would often become infected and, in the absence of antibiotics and sanitization techniques, turn gangrenous and end in horrible lingering deaths. Like modern combatants, knights and other medieval professional soldiers were not immune to psychological problems rooted in stress and horrible conditions of grinding warfare.
While the popular perception of the Middle Ages of period of endless warfare is inaccurate, it was a era of casual violence and widespread, horrific suffering far outside most modern humans’ ability to realistically comprehend. Of course, this is something we’re all aware of in the abstract: everyone knows that the Middle Ages were violent, and the entire epoch is best remembered the popular imagination as little more than a history of wars. But I think that few people actually appreciate just how violent mediaeval warfare was, and how horrific the injuries caused swords and other medieval weapons really were. Media is partially to blame: most of us get our knowledge of life in the Middle Ages from film, and movies often present a sanitized view of medieval combat. Think about, say, The Lord of the Rings: while Peter Jackson’s enormously popular trilogy doesn’t shy away from showing medieval combat, the necessity of a PG-13 rating means that Orc’s blood is black and the vast majority of sword strokes leave no visible injury and kill instantly instead of leaving a trail of screaming, slowly dying soldiers. While other films –Ridley Scott’s Kingdom of Heaven is a good example — do a better job depicting realistic traumatic injuries, most films about medieval warfare approach it from an adventure or fantasy perspective, meaning there’s less appetite for gritty, disturbingly realistic films about medieval rather than modern conflicts. This colors our modern perception of medieval warfare, and obscures the stresses knights faced and its effect on their psychologies.
The horrors medieval Europeans faced were not limited to casual violence — disease inflicted mass suffering modern humans outside regions affected by the AIDS epidemic have no real conception of. Medieval author Boccaccio describes the effects of the Black Death in the introduction to his 1353 allegory The Decameron:
“And it did not behave as it did in the Orient, where if blood began to rush out the nose it was a manifest sign of inevitable death; but rather it began with swellings in the groin and armpit, in both men and women, some of which were as big as apples and some of which were shaped like eggs, some were small and others were large; the common people called these swellings gavoccioli. From these two parts of the body, the fatal gavaccioli would begin to spread and within a short while would appear over the entire body in various spots; the disease at this point began to take on the qualities of a deadly sickness, and the body would be covered with dark and livid spots, which would appear in great numbers on the arms, the thighs, and other parts of the body; some were large and widely spaced while some were small and bunched together. And just like the gavaciolli earlier, these were certain indications of coming death.”
It’s estimated that the Black Death killed up to 50 percent of the European population in four years. Proportionately, that is comparable to over 150 million deaths in the modern United States. Some local death rate in the most severely affected parts of Europe — southern France and Italy — reached 80 percent, and many individual towns were completely depopulated. Modern inhabitants of the developed world have no conception of a disaster of this magnitude.
The scale of the Black Death’s destruction had a profound impact on the societies it affected. Again from Boccaccio:
“Because of all these things, and many others that were similar or even worse, diverse fears and imaginings were born in those left alive, and all of them took recourse to the most cruel precaution: to avoid and run away from the sick and their things; by doing this, each person believed they could preserve their health. Others were of the opinion that they should live moderately and guard against all excess; by this means they would avoid infection. Having withdrawn, living separate from everybody else, they settled down and locked themselves in, where no sick person or any other living person could come, they ate small amounts of food and drank the most delicate wines and avoided all luxury, refraining from speech with outsiders, refusing news of the dead or the sick or anything else, and diverting themselves with music or whatever else was pleasant. Others, who disagreed with this, affirmed that drinking beer, enjoying oneself, and going around singing and ruckus-raising and satisfying all one’s appetites whenever possible and laughing at the whole bloody thing was the best medicine; and these people put into practice what they heartily advised to others: day and night, going from tavern to tavern, drinking without moderation or measure, and many times going from house to house drinking up a storm and only listening to and talking about pleasing things. These parties were easy to find because everyone behaved as if they were going to die soon, so they cared nothing about themselves nor their belongings; as a result, most houses became common property, and any stranger passing by could enter and use the house as if he were its master. But for all their bestial living, these people always ran away from the sick. With so much affliction and misery, all reverence for the laws, both of God and of man, fell apart and dissolved, because the ministers and executors of the laws were either dead or ill like everyone else, or were left with so few officials that they were unable to do their duties; as a result, everyone was free to do whatever they pleased.”
While the Black Death was the most destructive of medieval pandemics, other diseases were also extremely destructive. Like victims of medieval warfare, survivors were unlikely to ever fully recover from the stress of pandemics that decimated their societies.