Many of the afﬂictions described in medieval texts are still common today, but, in popular imagination, the most feared of all pestilential diseases, leprosy and bubonic plague, still color our perceptions of this era. Historians might argue that plague and leprosy should not be classi- ﬁed as ‘‘medieval diseases.’’ Epidemics of bubonic plague continued into the nineteenth century and both plague and leprosy remained as signiﬁ- cant public health threats in certain parts of the globe at the end of the twentieth century. On the other hand, it could also be argued that two of the most devastating pandemics the world has ever experienced—the Plague of Justinian and the Black Death—seem to provide an appropri- ate frame for the medical history of the Middle Ages.
When attempting to understand the impact of AIDS, the disease that emerged in the 1980s to become the great modern pandemic, histori- ans and physicians most often turned to bubonic plague and leprosy as the most signiﬁcant historical models of devastating epidemic diseases. If we can indeed look into the Middle Ages as a ‘‘distant mirror,’’ we may be able to think more clearly about the impact of catastrophic diseases on society and the human psyche. Plague and leprosy stand out among the myriad perils and adversities of the Middle Ages, much as AIDS emerged as the pestilence emblematic of the last decades of the twentieth century. Many aspects of the origin, impact, and present and future threat of AIDS are unclear, just as there are many uncertainties about the historical meaning of leprosy and plague. However, it is not unreasonable to hope that scientiﬁc knowledge concerning pathology and epidemiology, as well as historical research illuminating the social context in which particular diseases loomed so large, will eventually allow us to ask more meaningful questions about the ways in which people assess and respond to the threat of catastrophic disease.