Beginning in 1347, Mamluk Egypt was decimated by the Black Death. This disaster was only the beginning of the second pandemic, which would recur in the region for another five centuries. As cities such as Cairo were witnessing staggering mortality rates, rural communities were being depopulated to the point of unviability, leading to mass migration towards urban centers. This stark change to the status quo proved difficult for the Mamluk system of government, whose reaction caused more suffering for the lower classes. Almost a century into the pandemic, the jurist Ibn Hajar al-Asqalani published Merits of the Plague, a legal and theological work detailing his understanding of the plague’s origin and correct responses to it. The book covers various topics, including medical advice, legal arguments, and historical anecdotes that make it useful for understanding how the plague shaped society during this period. The desperation brought about by the recurring plague, in conjunction with the crisis caused by the Mamluk government’s response to it, facilitated understandings of medicine previously considered taboo in Egypt.
Plague Origin and Spread
First, it is important to define what the plague in question was. The current understanding is that it was caused by the bacteria Yersinia Pestis.[2] Once the bacteria has entered a human host, there are three primary forms the disease can take. Bubonic plague, diagnosed by the presence of buboes, or inflamed glands, is transmitted through bites from infected fleas and attacks the lymphatic system.[3] This can lead to a second form, known as pneumonic plague. Cases of pneumonic plague attack the lungs, causing those affected to cough up blood containing the Yersinia Pestis bacteria, which can directly infect others.[4] This person-to-person transmission makes pneumonic plague especially dangerous. Finally, septicaemic plague occurs when the plague bacteria have reached the bloodstream, either as a result of bubonic or pneumonic plague, or directly from a flea bite.[5]
For centuries, the geographic origin of the Black Death has been a point of contention. Long before genetic analysis was possible, many theories existed for a point of origin. These were as varied as Mongolia, China, the Indus River valley, and even Ethiopia.[6] However, it is most likely that the strain of Yersinia Pestis that caused the second pandemic originates from the Central Asiatic plateau.[7] This claim has been reinforced by recent work in the region. In Kyrgyzstan, where the plague is endemic, multiple strains of Yersinia Pestis have been shown not to reduce nitrates, a trait that suggests some relation to the strain that caused the second pandemic.[8] From there, the plague likely spread westward through the Eurasian steppe.
In the mid-fourteenth century, the Eurasian steppe was host to a popular trade route, described by the Italian merchant Pegolotti as being “perfectly safe, whether by day or by night, according to what merchants say who use it.”[9] This path’s ability to connect the isolated Central Asiatic plateau to the Black Sea makes it the most probable route taken by the plague. Eventually reaching Crimea, the plague was then brought by merchant boats to Egypt, likely from infected fleas living on furs.[10] Once introduced in 1347, the plague would recur in Egypt twenty-eight times, or roughly every five and a half years, until the Ottoman Empire conquered the Mamluks in 1517.[11] A nearby plague focus likely caused these recurring outbreaks, but evidence for this is scarce. Only recently has evidence for one been found in Germany.[12] Through genetic analysis of the bacteria from skeletal remains, it was determined that a strain of Yersinia Pestis had become endemic to Europe, causing recurrences in Germany and England.[13] Egypt’s plague recurrences may have occurred from European merchants or its own local foci. Further genetic analysis across the plague’s range could greatly improve our understanding of its spread in the centuries following the beginning of the Black Death.
Figure 1. Spread of plague from Crimea to Egypt and the Mediterranean. Dols, Black Death in the Middle East, p. 85.
Understanding of Plague in Medieval Egypt
Once the plague had arrived in Egypt, there was a lack of consensus on how it spread. One popular theory was that of miasma, corrupted air that spread disease. This understanding came from the writings of Hippocrates, Galen, and Ibn Sina, which were common in medical education at the time.[14] Following this framework, the Egyptian physician Ibn an-Nafis claimed that:
The pestilence resulted from a corruption occurring in the substance of the air due to heavenly and terrestrial causes. In the earth the causes are brackish water and the many cadavers found in places of battle when the dead are not buried, and land which is water-logged and stagnant from rottenness, vermin, and frogs. As regards the heavenly air, the causes are the many shooting stars and meteorites at the end of the summer and in the autumn, the strong south and east winds in December and January, and when the signs of rain increase in the winter but it does not rain.[15]
Interestingly, this implicated rotting corpses and swampland, both now known to be teeming with bacteria that could cause illness. However, the celestial causes are inseparable from miasma theory; shooting stars, meteorites, and different wind directions were all considered important for predicting outbreaks. This is likely because miasma theory was built on centuries of medical doctrine. Correlations could be preserved regardless of whether or not they caused illness. While this understanding of plague pathology was widespread among physicians, it was not the only one present in Egypt. One notable skeptic of miasma theory was Ibn Hajar al-Asqalani, a high-ranking judge in Cairo.[16] Detailed in his book Merits of the Plague, he claimed that plague was the result of “the pricks of the jinn.”[17] The advantage of this approach was that it brought plague pathology into legal and theological studies. In Ibn Hajar’s view, this outlook was not necessarily in conflict with miasma theory, but “Physicians cannot object to the claim that the plague is caused by the jinn’s piercing because the pricks of the jinn cannot be grasped by reason or sensory experience; rather, we can only attain knowledge of it from the report of the Law Giver.”[18] Though perhaps not an outright attack on medical authority, this was still clearly an attempt by Ibn Hajar to sway well-read members of society towards a religious explanation of plague, for which he would be an authoritative voice. Much like how miasma was a product of medical doctrine, this jinn theory of plague relied on religious doctrine.
While miasma and the jinn were seemingly popular understandings of plague pathology and were both acceptable in the eyes of religious authority, it is important to stress that these were not the only ways people viewed the spread of plague. In the past, literature surrounding the Black Death would often contrast the Christian world–which had an understanding of contagion–with the Islamic world, which did not. Justin Stearns calls this out in “New Directions in the Study of Religious Responses to the Black Death,” where he criticizes this tendency in The Black Death in the Middle East, by Michael Dols.[19] An example of this can be seen where Dols discusses Ibn Khatimah, who he claims constrained his writings on contagion to conform with Sharia law, and Ibn al-Khatib, who took a brave stance by explicitly arguing in favor of contagion.[20] While certainly in the minority, Stearns argues that there were jurists in the Islamic world who believed in the concept of contagion, calling into question the unpopularity and illegality of that belief.[21] There are also examples of physicians recommending the isolation of the diseased, which suggests an understanding of contagion. For instance, Al-Subki said that:
In our opinion, the public should be prevented from mixing with the plague-stricken, such that they even stop visiting them. We say that if two knowledgeable, virtuous Muslim physicians, or someone who reaches that level, testify that there is harm caused when the healthy mix with the plague-stricken, then it is permissible to keep them from mixing.[22]
Despite not being mentioned by name, the idea that harm could come from the healthy coming into contact with the sick is an example of contagion. Also, outside of scholarly circles, there was likely some intuitive understanding of contagion among the common people. One group that Ibn Hajar bemoaned was those who avoided funerals, suggesting that enough people were staying away from dead plague victims for him to consider it a social ill worth mentioning.[23] This may also indicate that these people avoided funerals against the government’s wishes, which Ibn Hajar was influential within. Despite theories regarding miasma and jinn indeed being widespread and sanctioned, it is important not to dismiss belief in contagion in Egypt.
Rural Decay and Governmental Reaction
When the plague arrived, it was devastating. The Egyptian scholar al-Maqrizi offers a vivid example in his account of an outbreak in 1412:
Alexandria was laid waste [by these troubles] and so was [the Nile Delta province of] al-Buḥayra. The greater part of [the Province of] al-Sharqīya was ruined, and the majority of [the two Provinces of] al-Gharbīya and Giza were desolated. The [Province of] the Fayyum was devastated. Destruction was widespread in Upper Egypt as well – so much so that more than forty sermons that were held on Fridays were abrogated. The port city of Aswan was destroyed, and it was once one of the greatest of Muslim port cities; now nothing remains in it of amirs, influential people, marketplaces, or houses. Most of the cities of Upper Egypt have been obliterated. Cairo and its outskirts have lost half their wealth. And two-thirds of the population of Egypt has been wiped out by famine and plague.[24]
This apocalyptic description helps to visualize the destruction of Egypt’s cities and countryside. Long-term recovery would be an uphill battle if such devastation could come from one of the plague’s many recurrences. With the decline of many rural communities, famine constantly threatened the region. This can be seen, for example, in the cultivation of sorghum, a crop associated with desperation that was not widely grown in Egypt before the Black Death. [25] It might make some intuitive sense for a mass-death event, such as plague, to result in famine, but this was not the case in regions outside Egypt. This example stands in opposition to the “well-known European pattern of falling prices, rising wages, social mobility, and improved nutrition discernible in the aftermath of the Black Death.”[26] For this reason, it is important to understand how Egypt was particularly susceptible to long-term damage from the plague.
One factor affecting Egypt’s plague outcomes was the structure of the Mamluk government. The Mamluks, freed slaves imported from the Eurasian steppe, were the elite military class in Egyptian society.[27] This privileged position was legitimized over time by their victories against the Crusaders, and later the Mongols.[28] For their military service, they were paid in iqṭās, a type of land grant.[29] Once freed, Mamluks had many opportunities that other parts of society lacked. For example, they could purchase their own contingent of Mamluk soldiers and work their way upwards in government, with the most ambitious having a chance to become sultan.[30] To be near centers of political power, Mamluks overwhelmingly lived in major cities, such as Cairo, causing an imbalance where agricultural goods from iqṭās came into the cities, but urban goods and services were not given to the countryside in return.[31] This was a highly stratified society in which a ruling military elite siphoned resources from rural communities, which were taken for granted.
Another factor of plague devastation that cannot be ignored is the geography of Egypt. Unlike in Europe, Egyptian agriculture relied on the Nile River for irrigation. This required a complex series of canals, dikes, dams, and weirs to be maintained.[32] There was also a distinction between the regional sultani canal system, which connected villages to the Nile, and the baladi, or village canals, which were used for agriculture.[33] In Mamluk Egypt, the maintenance of these systems was the responsibility of each province’s governor and his staff.[34] The governor would help organize the massive undertaking of irrigation maintenance. The sultani canals alone required the labor of about 120,000 men each year, and cost about one quarter of annual iqṭā revenue.[35] While this system was robust when properly maintained, the cost of irrigation maintenance proved to be an issue as plague spread across the region.
The exact mortality rates in the Nile Delta are challenging to estimate, but there is no doubt that the Black Death and its recurrences were devastating for the Egyptian countryside. As another example of how Egypt’s geography made it vulnerable, the yearly flooding of the Nile River likely forced rats indoors, exposing many villages to the plague.[36] Heightened mortality rates in Egyptian villages left behind a chain of adverse side effects. Firstly, if not enough people were left to maintain the local baladi canals, traditional agriculture would become impossible in the area. This was likely one cause for the increasing cultivation of sorghum, which was correlated with irrigation decay.[37] If a community could not shift its production, the villagers would have had few options but to leave. As iqṭā profits primarily came from agricultural production, this decline of the countryside severely affected Mamluk wealth.[38] This period also saw high turnover rates for iqṭās, which would have made the financial situation of many Mamluks more precarious.[39] The Mamluk elite extracted even more money from rural Egypt to maintain their previous profits by increasing rent prices, demanding unpaid labor, and diverting taxes away from irrigation and towards themselves.[40] The result of this was an irrigation system that was in disrepair, causing both floods and droughts, decimating rural production.[41] With the decline of the countryside, the Mamluks searched for new ways to increase revenue.
Even though the Mamluks redoubled their efforts to extract revenue from the Egyptian countryside, the regime could no longer support itself on its traditional agrarian profits. The decline of the land tax can be used to help quantify the loss of resources the elite experienced. While Egypt’s land tax raised nine million dinars in 1215, that number dropped to only two million dinars by 1517.[42] However, the Mamluk elite did not suffer this loss passively. Instead, their attention shifted towards Egypt’s urban centers. One result of this was that the imposition of new taxes became commonplace. These would typically take the form of weekly or monthly taxes for merchants, or levies on specific products.[43] This taxation was often met with some resistance, as it affected urban populations directly and negatively. Another method the government used was the attempted taxation and seizure of awqaf assets. Awqaf, or pious endowments, were charitable funds put towards various services carried out by religious institutions, such as feeding and providing medical care to the poor.[44] As many Mamluks began to use awqaf as a wayto pass wealth on to their children illegally, the government made attempts to tax and seize funds from awqaf, with some success.[45] However, much like how taxation was met with resistance from urban residents, these efforts were met with resistance from religious officials. While these attempts successfully generated revenue for the government, they also escalated tensions between the elites and various other parts of society.
Unsurprisingly, the Mamluks themselves were not immune to the plague. Their mortality rates were high, especially at the beginning of the Black Death. Factionalism within the Mamluks and the fear of losing iqṭās kept many from fleeing to safety from 1348-1349, leading many to die.[46] This constant death of Mamluks was one reason for the aforementioned high turnover rate of iqṭās. There are multiple reports of this, including one from Ibn Taghrī Birdī, who claimed that a single iqṭā was transferred to nine people in the span of a few days, with each new owner dying.[47] As time went on, the iqṭā system continued destabilizing as military officers began leasing their iqṭās to those who could afford it, including commoners.[48] Plague and corruption also directly affected the military capabilities of the Mamluk government. Death in the military had become so rampant that roles were being transferred to people of other professions, such as artisans.[49] At the same time, experienced military officers were being given administrative positions, such as market inspector, far from the battlefield as a reward for factional loyalty.[50] With a severely weakened military, the Mamluks began to lose control of the countryside. This can be seen in the growing incursions of Bedouins onto Egyptian agricultural land.[51] As time went on, civil wars between Mamluk factions and growing Bedouin unrest destroyed even more farmland, further weakening the military capabilities of the Mamluks.[52] While the countryside was devastated and dissatisfaction with the ruling elite grew in urban centers, factionalism within the ranks of the Mamluks had made their position increasingly precarious.
Flight From Plague and Social Instability
In this context, in the fifteenth century, Ibn Hajar felt the need to settle an old debate on conduct regarding plague-stricken regions. Derived from the Prophet Muhammad’s teachings, it was believed that “plague was a mercy and a martyrdom from God for the faithful Muslim” and that “a Muslim should neither enter nor flee a plague-stricken land.”[53] The latter point became relevant early in the Rashidun period, when Caliph ‘Umar pulled his army out of Syria during the plague of ‘Amwas. In Ibn Hajar’s telling of the story, ‘Umar “was traveling on the road to Syria, [and] turned around when he heard that the plague had struck there.”[54] This perspective shows ‘Umar abiding by the teaching to avoid plagued lands, reinforcing its value. However, this leaves out the more controversial details of the story. According to Dols, ‘Umar only traveled to Syria after a failed attempt to ask his commander Abu ‘Ubaydah to flee plague-stricken ‘Amwas.[55] The omission of this detail was likely intentional, as it would have undermined Ibn Hajar’s argument. The fact that he brought this controversy up about 800 years later and dedicated an entire chapter of his book to condemning flight piques interest. Due to the impact of plague on early Islamic history, the many traditions that emerged regarding it, such as its ability to provide martyrdom and the prohibition on flight, were interpreted differently by each jurist.[56] Since his conclusion emphasized that fleeing to escape the plague was disallowed, the section’s inclusion reinforces the idea that flight was likely a problem in Mamluk Egypt. Dols claimed that “we have no evidence of any formal government action to control the mobility of the peasantry at the time of the Black Death, which would be comparable to European legislation.”[57] Considering the devastation to Mamluk finances caused by rural depopulation, if the government could have prevented flight, it likely would have attempted to.
This context is helpful for speculation on Ibn Hajar’s intent when publishing the Merits of the Plague. The depopulation of the Egyptian countryside had dealt a significant blow to the finances of the elite, and the government seemed unable to stem the flow of rural migration. Because of this, Ibn Hajar’s goal was likely to discourage internal migration when the government could not control it. While his words could have reached as far down as some tradesmen and craftsmen, due to the expansion of elementary schooling raising literacy rates, it is doubtful that he could directly influence the peasants fleeing from the plague.[58] Instead, his intended audience was most likely fellow jurists. Since jurists had no consensus on the prohibition of flight, Ibn Hajar may have attempted to sway them to his side to spur change within administrative and legal circles. In this way, there was an attempt to shift religious doctrine to address a societal problem caused by the plague.
Part of this societal problem can be seen in the section where Ibn Hajar discussed non-religious arguments for remaining during a plague. He claimed that there was wisdom in refusing to flee, because those who do leave behind the sick and the dead, thus denying them care and burial.[59] In addition to this, flight would be emotionally draining for those who remained. He likened this to warriors fleeing the battlefield, whose “fleeing fills those who remain in the battle with fear, alarm, and defeat.”[60] These points paint migration as an abandonment of responsibility, explaining how a migrant’s community would suffer in their absence.
As the Shafi‘i chief judge in Egypt and Syria, who was also in the Sultan’s inner circle, it seems likely that Ibn Hajar was using his religious and legal authority to target migration due to fear of social disorder.[61] One likely cause of this fear was the sheer number of deaths amongst migrants. To see the numbers involved, Stuart Borsch created a model that estimates migrant deaths using disparities between inheritance records and oratories.[62] The results suggest both mass migration and high mortality rates for migrants. For example, in the 1430 outbreak, approximately 43,000 rural migrants died, accounting for about 48% of the deaths in Cairo.[63] This shows the staggering number of migrants present and their vulnerability. One explanation given for these high mortality rates is that migrants were often fleeing due to famine and lacked even basic hygiene as a result of traveling.[64] This would have weakened their immune systems and brought them into more contact with disease. This result, increased rates of plague for those fleeing the countryside, as well as a contemporary explanation of what caused it, can be seen in Ibn Hajar’s summarization of Ibn Abi Jamra’s work:
And among other reasons not to flee are what one of the physicians has asserted: that in the country in which a pestilence occurs, the humors of the people adapt to the air of those places and absorb it into their own temperaments, and thereby it becomes like what is healthy air for others. But if they move to places with healthy air, it does not suit them. Rather, when they [breathe] in the healthy air, it ushers to the heart the malicious vapors to which the body had adapted. When it reaches the heart, the very illness that they were fleeing from strikes them. So the Prophet prohibited their flight on these grounds.[65]
By including this, Ibn Hajar strengthened his non-religious arguments against flight. With this understanding, not only would fleeing ignore one’s responsibilities for attending to the sick and dead, but it would also increase the risk of contracting plague. In conjunction with his religious justifications, it is clear that Ibn Hajar was interested in making the strongest case he could against plague-induced migration. While he was ultimately unable to change government policy, as seen earlier by the lack of evidence for migration controls, it would be hasty to claim that he was ineffective. Ibn Hajar’s arguments held weight in scholarly circles, and his writings are commonly sold in Islamic bookstores to this day.[66] Though he may have been unable to decrease migration rates, Ibn Hajar’s attempt to do so had a long-lasting impact on religious and legal studies.
However, this still leaves some questions: how exactly did social instability manifest, and in what ways did plague cause it? The outbreak in 1430 was deadly, but death alone does not threaten the social order; the actions of the living do. To see the myriad ways in which plague could cause disasters that created unrest, the best case study is the famine of 1402-04. The famine of 1402-04 is interesting because there were many points of failure, the first being monetary. In the years leading up to the famine, Mamluk Egypt had been experiencing a wave of inflation. According to al-Maqrizi:
On that date [20 June 1399], in Cairo, one irdabb of wheat sold for less than thirty dirhams. The next day its price reached forty dirhams. Prices continued to rise until one irdabb [of wheat] sold for more than seventy dirhams in the year 802/1399-1400. Wheat prices remained at this level until the Nile failed to reach its plentitude in 806/1403-4. This led to a calamity: prices soared so high that the price of one irdabb of wheat exceeded four hundred dirhams [of account].[67]
If food prices were already unreasonable, scarcity had made it prohibitively expensive. The cause of this deadly inflation can largely be attributed to the Mamluk currency reform. Beginning sometime in the 1380s/90s, copper coins were being minted en masse, while silver coins had stopped being minted altogether.[68] This resulted in rapid inflation of the currency that most of the lower classes used. The reason for this coinage reform can be traced back to the plague-induced economic crisis that the Mamluk government experienced, as established earlier. As traditional sources of revenue dried up, a devalued copper coinage made it easier for the government to meet its existing financial obligations.[69] This is a perfect example of the far-reaching effects of plague.
Another cause for the famine of 1402-04 was agricultural failure. In this case, the risks associated with poor irrigation maintenance, droughts, and floods became a reality. This began in 1403, when the Nile only reached the bare minimum height of sixteen dhira’ and one isba’.[70] 1404 would then see the Nile rise too high, making it impossible to sow crops in many areas.[71] In the middle of all this, an outbreak of pneumonic plague in the countryside created a labor shortage, making it even harder for crops to be sown.[72] In this case, plague not only led to the irrigation decay that made this famine more likely, but it also served to exacerbate the problem.
With the foundations of a crisis now laid out, it is important to understand the resulting signs of social unrest. In the case of famine, one main goal of the poor was to create social pressure for the rich to open up their large grain stores. This involved acts that could get the attention of authorities, ranging from peaceful petitioning to violent public disturbances.[73] One of the more common forms of violent attention-seeking was the stoning of the market inspector, as that was a message that was sure to make its way to the Sultan.[74] If the people’s needs were still unmet, they would often take matters into their own hands. This came in the form of grain riots, where bakeries and shops would be looted, though typically without bloodshed.[75] In general, these manifestations of unrest were loud but somewhat reserved. However, what has been described so far was typical social unrest in urban environments. While contemporary sources discussing rural life in Egypt are rare, al-Maqrizi briefly touched on rural unrest. He described the years preceding the famine of 1402-04 as “marked by rebellion among the rural population and the spread of swindlers and brigands. Roads became unsafe and travel within the country was impossible except at great risk.”[76] These descriptions of urban and rural unrest help understand what social instability Ibn Hajar was concerned about. These fears were indeed grounded in a world of recurring plague.
Changing Medical Practice
Medicine and religion cannot be separated in this context. Since everything in the physical world was thought to be downstream of God’s will, prayer was considered a legitimate treatment for disease. Refuting one of his contemporaries, Ibn Hajar claimed that the idea that it would be illegal to pray for plague to be lifted was ridiculous, because that “would require abandoning treatment for sickness even though authentic hadiths authorize and permit it, and even though there is no doubt that seeking treatment through prayer is more effective than seeking treatment through natural substances.”[77] This excerpt helps show that both prayer and physical medicine were considered acceptable treatments, though prayer was considered the better option. As a religious scholar, Ibn Hajar was likely biased in favor of prayer, but he still believed the intervention of a physician to be a valid form of treatment. Due to the immense mortality of the plague, people began searching for new preventions and treatments, drastically changing medical practice in the region.
As a treatment available to everyone, prayer was an important part of addressing the plague. When discussing legal responses to the plague, prayer was the first one brought up by Ibn Hajar.[78] According to him, praying for the plague to be lifted, either individually or in a group, was legally authorized due to its nature as a calamity.[79] By proving one’s piety, the goal was to have God protect them from the plague. Another acceptable way to do this was to listen to recitations of the Qur’an and hadiths.[80] However, there were also religious practices that were considered more controversial by legal scholars. The most notable was a congregational prayer modeled after a prayer for rain. This prayer, which was performed in Mamluk Damascus in 1348 and 1363, and in Cairo in 1430, consisted of a group walking into the desert, praying, and fasting for three days.[81] This was considered to be a “heretical practice” by Ibn Hajar, who claimed that it worsened outbreaks of plague.[82] Despite being discouraged by those in positions of authority, it was practiced multiple times. This suggests that the desperate conditions brought about by the plague were leading people towards treatments considered taboo by traditional authorities.
Rejection of authority can be seen in the many forms of mysticism practiced at this time. Ibn Hajar claimed that the plague served as a punishment for:
He [who] repels it with a variety of things that are said to do so: incantations, rings, incenses, amulets that are worn over one’s head, and writing on one’s doors. He gets involved in all manner of fortune-telling, which the religious law forbids, and avoids many foods and things like that. He assigns the disease’s cause to the wind and the water, without looking into its real cause and its true substance. He avoids funerals, even though it would soften his heart, draw his tears, humble him, and make him fear God. He also dallies in other corrupt things that would forbid him a heavenly reward and martyrdom similar to that which is attained through patience and self-reflection.[83]
Mysticism is another practice that Ibn Hajar feared would cause societal instability. His examples, such as wearing jewelry, burning incense, writing on doors, and avoiding funerals, would be visible signs that an area was in distress. In this description, Ibn Hajar also grouped overtly mystical practices like fortune-telling with concepts such as miasma theory. The primary similarity between these is that they both run contrary to Ibn Hajar’s understanding of plague, which is caused by pricks of the jinn and is best addressed through prayer.[84] This shows the practice of mysticism to be somewhat in defiance of religious authority, which could not be controlled.
Despite this disapproval, Dols found many references to magical treatments in various plague treatises from the Mamluk period. Many of these are precisely what Ibn Hajar had rallied against. For example, amulets and talismans would be engraved with specific Quranic verses known as the “curative verses.”[85] Similarly, the first verse of the Quran would be written in cups and bowls, and it was thought that water which had dissolved the text had special properties to combat the plague.[86] One could also engrave “the Eternal, the Creator” on their door to protect the household from plague.[87] Other ways to defend against the plague involved the magical properties of Arabic letters. Ibn Haydūr detailed ring engravings that used Arabic letters in geometric patterns to protect one from plague-induced fever.[88] Despite not being accepted by legal scholars like Ibn Hajar, these treatments had an underlying religious nature, holding the Quran and the Arabic language to be sacred. In conjunction with prayer and intervention by a physician, this magic was embraced to improve one’s chances of living.
However, the extent to which magical practices were employed requires some speculation. Dols mentions that most written works on magic can be traced back to the writings of al-Buni, so tracking the popularity of his work can be useful as an indicator for the popularity of magic.[89] Of the surviving Egyptian copies of al-Buni’s work, the fourteenth century is the only period where more copies of ʿAlam al-hudá, one of his works on mysticism, survived than any of his other works.[90] This correlates with the arrival of plague in 1347, supporting the idea that this period saw a rise in mystical practice. These copies are also notable for other reasons. Interestingly, they are relatively plain in presentation, and the text is sometimes modified to make reading and recitation easier.[91] This suggests that the owners were not elites; instead, they were likely well-off Sufis. Modifying some copies to aid recitation indicates that these ideas could have been disseminated to the lower classes through oration. By the fifteenth century, some of al-Buni’s other works, on letterist practices, cryptograms, and talismanic instructions, started growing in popularity.[92] This is also the period in which the greatest number of elite-owned copies of al-Buni’s works survive.[93] With the onset of the plague, interest in al-Buni’s mysticism grew among the non-elite. Then, as plague continued to recur into the fifteenth century, his work had somewhat become normalized. Elites grew increasingly interested in al-Buni, and his more explicitly magical practices saw newfound popularity.
Finally, traditional practices were subject to change as physicians attempted to deal with the plague. In medieval Egypt, medical practice was primarily based upon Ibn Sina’s writings. On the subject of plague, he recommended bloodletting, believing that the removal of five pounds of blood would relieve the patient’s fever.[94] However, it seems that medical practitioners held diverging opinions on this topic. On one hand, Ibn Khatimah wrote that he had heard of physicians removing as much as eight pounds of blood, which he then tried himself and recommended.[95] On the other hand, Ibn Hajar noted that “the physicians of our time and the preceding generation have neglected this regimen [of bloodletting]. The current consensus has forsaken this practice of treating the plague-afflicted patient with bloodletting, such that the absence of this practice has become so widespread that most physicians believe that treating plague patients through bloodletting is forbidden.”[96] While both are anecdotes brought to us from their respective authors, they suggest some diversity in medical approaches. This is to be expected, considering the scale of the pandemic. With plague being a regular occurrence, the many lives at stake would have given physicians ample cause to refine their practices and enough patients to do so. Some physicians chose to modify the teachings of Ibn Sina, while others outright rejected them, both in an attempt to address the plague.
With these changing medical practices, questions on their geographic distribution naturally arise. The sources used thus far have all been urban, with little mention of the countryside. While medical practice in rural regions was almost certainly different from that in cities, there is a lack of solid evidence as to how. This general problem was described succinctly by Adam Sabra, who said that “If very little has been said about the Egyptian countryside … this gap is not merely the result of a research strategy, but the consequence of an absence of detailed source material.”[97] In a society where the elite almost exclusively resided in cities, there is a strong bias for surviving documents to originate from urban areas. However, some general speculations can be made about rural medical practice. Traditional prayers for health and plague prevention were likely practiced, as that was the most accessible form of medicine. It is also possible, though unlikely, that some magic practices made their way to the countryside, though there is no evidence of this. The most that can confidently be said is that al-Buni’s work was accessible in smaller Egyptian cities, such as Dimyāṭ. [98] As for physicians, there were likely few, if any, in rural areas. In the Mamluk period, the hospitals where physicians worked were huge, expensive buildings that only Sultans could afford to commission.[99] To put it into perspective, Paris had sixty hospitals in the early fourteenth century, while Cairo had only two to three serving a similar population.[100] As hospitals were large, prestigious buildings, it is doubtful that any could be found outside urban centers. Without hospitals to train and employ physicians, the countryside would have had to cope in their absence. While these points are far from comprehensive, they are the most that can be assumed without further evidence.
Conclusion
This paper sought to make the case that plague and the Mamluk government’s response to it caused a crisis that allowed for a diversification of medical thought. The struggle that the Mamluk Sultanate faced was closely tied to the agricultural disruptions caused by the plague. Declining iqṭā revenue prompted action from the Mamluk elite, who were accustomed to wealth and the quality of life that came with it. Instead of aiding the countryside, they introduced new taxes and cuts to canal maintenance. This provided short-term revenue for the Mamluks, but made life in much of rural Egypt untenable. The government ultimately stabilized its finances by taking more from its urban centers, but this came at the expense of heightened tensions with residents. Factionalism, alongside the high plague mortality experienced by Mamluks, sowed the seeds for more crises. After Bedouin incursions and civil war, the Mamluk Sultanate ultimately fell to the powerful Ottoman Empire in 1517.
While quality of life varied over the nearly two centuries of recurring plague in Mamluk Egypt, the non-elite often lived in uncertainty. Plague outbreaks proved deadly, but also exacerbated other crises, as seen in the famine of 1402-04. A deadly intersection between plague, irrigation decay, currency debasement, and taxation further stressed the finances of the non-elite, and this famine serves as a prime example of how fragile life could be in this period. In the words of al-Maqrizi, “conditions became perilous, disaster was widespread and calamity universal, to the degree that more than one-half of the population of the land [of Egypt] died of hunger and cold.”[101] While this is undoubtedly an exaggeration, it also offers a grim perspective of how living through such an event felt.
In times of plague, lacking a government able to address the problem adequately, medical practice began to turn away from traditional authority. People were understandably afraid and willing to try new things in hopes of being spared from the fatal illness. Prayers once considered heretical were being performed. Mysticism thrived amidst widespread desperation to evade the plague. Physicians became divided on the subject of bloodletting. Egyptian medical practice became incredibly diverse in this period following the Black Death. It is also important to accept that these were all forms of medical practice. From a modern viewpoint, it is easy to write off prayer, talisman-crafting, and bloodletting as backwards practices that have no effect on the plague. This is missing the point. These changes to common practice are notable because they show that people were attempting to adapt to changing conditions. The shift from the fourteenth century, when al-Buni’s works on mysticism were read mainly by the non-elite, to the fifteenth century, where his writings increasingly found their way into elite households, is one sign that reactions to plague had facilitated a cultural change. That is only one example of the value in studying changing medical practices.
However, more research must be carried out to better understand the second pandemic in Egyptian history. Interdisciplinary work will be crucial in this effort. The sequencing of Yersinia Pestis genomes from burial sites in Egypt and the surrounding regions could lead to the discovery of plague foci similar to the one found in Germany. Such a discovery, or even the lack thereof, would help understand plague recurrences in the region. Archival and translation work on medieval texts will also be necessary. For example, this paper would not have been possible without the recent English translation of Ibn Hajar’s Merits of the Plague by Joel Blecher and Mairaj Syed, as well as the English translation of al-Maqrizi’s Ighathah by Adel Allouche. While it also remains a problem that surviving Mamluk-era texts emerge overwhelmingly from urban sources, the offhand remarks regarding the countryside found in some of them can still serve as a much-needed glimpse into rural history.
[1] Philip Karczmit is a graduate of the New Jersey Institute of Technology (2024) with a bachelor’s in History. He wrote “Diversity of Medical Practice in Mamluk Egypt During the Second Pandemic” as part of his coursework in his senior year.
[2] Nükhet Varlik, Plague and Empire in the Early Modern Mediterranean World: The Ottoman Experience 1347-1600,(Cambridge University Press, 2017), p. 1.
[3] Michael Dols, Black Death in the Middle East, (Princeton University Press, 2019), p. 72.
[4] Dols, Black Death in the Middle East, pp. 72-73.
[5] Dols, Black Death in the Middle East, p. 73.
[6] Dols, Black Death in the Middle East, pp. 40-42.
[7] Dols, Black Death in the Middle East, pp. 35-38.
[8]Galina Eroshenko et al., “Yersinia Pestis Strains of Ancient Phylogenetic Branch 0.ANT Are Widely Spread in the High-Mountain Plague Foci of Kyrgyzstan,” PLoS ONE 12:10 (2017), p. 5.
[9] Dols, Black Death in the Middle East, p. 49.
[10] Dols, Black Death in the Middle East, p. 57.
[11] Dols, Black Death in the Middle East, pp. 223-24.
[12] Cody Parker et al., “14th Century Yersinia Pestis Genomes Support Emergence of Pestis Secunda within Europe,” PLoS Pathogens 19 (2023), p. 10.
[13] Parker et al., “14th Century Yersinia Pestis Genomes,” pp. 8-10.
[14] Dols, Black Death in the Middle East, p. 85.
[15] Dols, Black Death in the Middle East, pp. 88-89.
[16] Joel Blecher and Mairaj Syed, “Introduction by Joel Blecher and Mairaj Syed.” Introduction. In Merits of the Plague, (Penguin Books, 2023), p. xvi.
[17] Ibn Hajar al-Asqalani, Joel Blecher, and Mairaj Syed. Merits of the Plague (Penguin Books, 2023), p. 22.
[18] Ibn Hajar al-Asqalani, Merits of the Plague, p. 23.
[19] Justin Stearns, “New Directions in the Study of Religious Responses to the Black Death,” History Compass 7:5, (September 2009), pp. 3-4.
[20] Dols, Black Death in the Middle East, p. 110.
[21] Stearns, “New Directions in the Study of Religious Responses to the Black Death,” p. 4.
[22] Ibn Hajar al-Asqalani, Merits of the Plague, p. 179.
[23] Ibn Hajar al-Asqalani, Merits of the Plague, p. 92.
[24] Stuart Borsch, “Plague Depopulation and Irrigation Decay in Medieval Egypt,” (The Medieval Globe, 2014), p. 129.
[25] Stuart Borsch, “Subsisting or Succumbing? Falling Wages in the Era of Plague.” (Annemarie Schimmel Kolleg Working Papers, 13 May 2014), p. 17.
[26] Borsch, “Plague Depopulation and Irrigation Decay in Medieval Egypt,” p. 126.
[27] Dols, Black Death in the Middle East, p. 143.
[28] Dols, Black Death in the Middle East, p. 145.
[29] Dols, Black Death in the Middle East, p. 144.
[30] Dols, Black Death in the Middle East, p. 148.
[31] Dols, Black Death in the Middle East, p. 152.
[32] Borsch, “Plague Depopulation and Irrigation Decay in Medieval Egypt,” p. 137.
[33] Borsch, “Plague Depopulation and Irrigation Decay in Medieval Egypt,” p. 137.
[34] Borsch, “Plague Depopulation and Irrigation Decay in Medieval Egypt,” p. 137.
[35] Borsch, “Plague Depopulation and Irrigation Decay in Medieval Egypt,” p. 138.
[36] Borsch, “Plague Depopulation and Irrigation Decay in Medieval Egypt,” p. 135.
[37] Borsch, “Subsisting or Succumbing? Falling Wages in the Era of Plague,” p. 17.
[38] Dols, Black Death in the Middle East, p. 275.
[39] Stuart Borsch and Tarek Sabraa, “Refugees of the Black Death: Quantifying Rural Migration for Plague and Other Environmental Disasters,” Annales de démographie historique 134:2 (January 31, 2018), pp. 81-82.
[40] Borsch, “Plague Depopulation and Irrigation Decay in Medieval Egypt,” p. 141.
[41] Borsch, “Plague Depopulation and Irrigation Decay in Medieval Egypt,” pp. 145-147.
[42] Amina Elbendary, Crowds and Sultans: Urban Protest in Late Medieval Egypt and Syria, (The American University in Cairo Press, 2016), p. 24.
[43] Elbendary, Crowds and Sultans, p. 31.
[44] Adam Sabra, Poverty and Charity in Medieval Islam: Mamluk Egypt, 1250-1517 (Cambridge University Press, 2006), p. 5.
[45] Elbendary, Crowds and Sultans, pp. 35-6.
[46] Dols, Black Death in the Middle East, p. 190.
[47] Dols, Black Death in the Middle East, p. 189.
[48] Elbendary, Crowds and Sultans, pp. 37-8.
[49] Dols, Black Death in the Middle East, p. 191.
[50] Elbendary, Crowds and Sultans, p. 38.
[51] Borsch, “Subsisting or Succumbing? Falling Wages in the Era of Plague,” p. 13.
[52] Dols, Black Death in the Middle East, p. 281.
[53] Dols, Black Death in the Middle East, p. 23.
[54] Ibn Hajar al-Asqalani, Merits of the Plague, p. 106.
[55] Dols, Black Death in the Middle East, p. 22.
[56] Stearns, “New Directions in the Study of Religious Responses to the Black Death,” pp. 4-5.
[57] Dols, Black Death in the Middle East, p. 163.
[58] Elbendary, Crowds and Sultans, p. 81.
[59] Ibn Hajar al-Asqalani, Merits of the Plague, p. 149.
[60] Ibn Hajar al-Asqalani, Merits of the Plague, p. 150.
[61] Blecher, “Introduction by Joel Blecher and Mairaj Syed,” p. xviii.
[62] Borsch, “Refugees of the Black Death,” p. 76.
[63] Borsch, “Refugees of the Black Death,” p. 80.
[64] Borsch, “Refugees of the Black Death,” p. 74.
[65] Ibn Hajar al-Asqalani, Merits of the Plague, p. 153.
[66] Blecher, “Introduction by Joel Blecher and Mairaj Syed,” p. xvi.
[67] Aḥmad ibn ʻAlī al-Maqrīzī and Adel Allouche, Mamluk Economics: A Study and Translation of Al-Maqrīzī’s Ighāthah (University of Utah Press, 1994), p. 51.
[68] Aḥmad ibn ʻAlī al-Maqrīzī, Mamluk Economics, p. 71.
[69] Sabra, Poverty and Charity in Medieval Islam, p. 151.
[70] Sabra, Poverty and Charity in Medieval Islam, p. 151.
[71] Sabra, Poverty and Charity in Medieval Islam, p. 152.
[72] Sabra, Poverty and Charity in Medieval Islam, p. 152.
[73] Sabra, Poverty and Charity in Medieval Islam, p. 166.
[74] Boaz Shoshan, “Grain Riots and the ‘Moral Economy’: Cairo, 1350-1517,” The Journal of Interdisciplinary History 10:3 (1980), p. 471.
[75] Shoshan, “Grain Riots and the ‘Moral Economy,’” p. 473.
[76] Aḥmad ibn ʻAlī al-Maqrīzī, Mamluk Economics, p. 53.
[77] Ibn Hajar al-Asqalani, Merits of the Plague, p. 160.
[78] Ibn Hajar al-Asqalani, Merits of the Plague, p. 157.
[79] Ibn Hajar al-Asqalani, Merits of the Plague, p. 158.
[80] Stearns, “New Directions in the Study of Religious Responses to the Black Death,” p. 5.
[81] Ibn Hajar al-Asqalani, Merits of the Plague, p. 169.
[82] Ibn Hajar al-Asqalani, Merits of the Plague, p. 169.
[83] Ibn Hajar al-Asqalani, Merits of the Plague, p. 92.
[84] Ibn Hajar al-Asqalani, Merits of the Plague, p. 22, p. 160.
[85] Dols, Black Death in the Middle East, p. 126.
[86] Dols, Black Death in the Middle East, p. 126.
[87] Dols, Black Death in the Middle East, p. 137.
[88] Dols, Black Death in the Middle East, p. 133.
[89] Dols, Black Death in the Middle East, p. 124.
[90] Noah Gardiner, “Esotericism in a manuscript culture: Aḥmad al-Būnī and his readers through the Mamlūk period,” (PhD dissertation: University of Michigan, 2014), p. 265.
[91] Gardiner, “Esotericism in a Manuscript Culture,” p. 265.
[92] Gardiner, “Esotericism in a Manuscript Culture,” pp. 266-7.
[93] Gardiner, “Esotericism in a Manuscript Culture,” p. 267.
[94] Dols, Black Death in the Middle East, p. 105.
[95] Dols, Black Death in the Middle East, p. 105.
[96] Ibn Hajar al-Asqalani, Merits of the Plague, p. 179.
[97] Sabra, Poverty and Charity in Medieval Islam, p. 169.
[98] Gardiner, “Esotericism in a Manuscript Culture,” p. 268.
[99] Sabra, Poverty and Charity in Medieval Islam, p. 73.
[100] Sabra, Poverty and Charity in Medieval Islam, p. 172.
[101] Aḥmad ibn ʻAlī al-Maqrīzī, Mamluk Economics, p. 51.