Remi Chiu states the focus of his book at the very outset with such clarity that it warrants a full quotation here: “This book is about music and music-making as one of those resourceful strategies for surviving the plague. It treats music as an urgent and active curative with material consequences for the health and well-being of those assailed by the horrible disease. It shows that the production of music was animated by the changing experiences and knowledge of pestilence. . . . It makes no great claims about aesthetic breaks in music on account of trauma; rather, it focuses on how traditional beliefs about music became embroiled in the new discourses about plague and how established musical styles, techniques and practices were marshaled up to combat the disease” (5). As summarized on the back cover, Chiu's work “uncovers the place of music—whether regarded as an indispensable medicine or a moral poison that exacerbated outbreaks—in the management of the disease.”

Chiu structures his work in five chapters, plus a short epilogue with his overall conclusions. In chapter 1, “Medicine for the Body and the Soul,” he surveys several plague treatises that annotate the medical value of music, pointing out that “many authors promoted music-making as a salubrious recreation, placing it on the pharmacy shelf alongside anti-pestilential foodstuffs and other medicines” (8). This chapter also examines the opposite idea: how some other authors cautioned against the use of music, especially in “religiously skewed [medical] treatises” (8). Chapter 2, “Sympathetic Resonance, Sympathetic Contagion,” investigates what the author terms “the esoteric side of premodern medicine and its relationship to music” (9)—i.e., the doctrines of sympathetic resonance in the theory of contagion, Galenic bodily humors, and the rhetorical use of music in order to affect the mind-body complex under these perspectives. This chapter also focuses on the breaking of harmony between friends, kin, and compatriots as a form of breaking the harmony of social relationships, akin to the disharmony of the four humors that cause disease in Galenic medicine. The latter part of this second chapter centers on “anxieties surrounding this social breakdown [in times of pestilence] and the role that music may play in restoring the body politic” (9).

The third chapter, “Devotions on the Street and in the Home,” explores the conflict between spiritual and medical-civic authorities, especially regarding public penitential processions, which understandably generated concerns regarding contagion and agglomeration of people. Chapter 4, “The Cult of St. Sebastian,” is a study in the cult of this saint, the main devotional protector against plague from the fourteenth century onward, and the important repertoire that sprang up around these devotions. The fifth and final chapter is a case study on Paolo Caracciolo's Il primo libro de Madigali a cinque voci, published in 1582, which includes several songs composed in the crisis of the major outbreak in Milan between 1576 and 1578. According to the author, “these songs bring up important questions about the value of patronage of pestilential arts and monuments, as well as the medical value of commemoration—the act of remembering tragedy that may have vital repercussions on health” (10).

As can be seen from the above précis, the author proposes a new category of “pestilential music”—i.e., repertoire that mentions plague or makes explicit references to Saint Sebastian or other Catholic saints purported to be “plague protectors” (6), such as Saint Roch, Saint Anthony, or Joseph and Mary. At the end of the book the author includes a list of forty-five “select ‘pestilential’ motets and madrigals, 1400–1600” (253), conveniently classified as “Motets to St. Sebastian,” “Motets to St. Roch,” “Motets to the Virgin and Other Saints,” as well as madrigals by several composers concerning the 1576–78 outbreak of the plague in Milan, and settings of Petrarch's Canzona 323. According to the author, these works “are not meant to be an exhaustive coverage of all ‘pestilential music’; rather, they were chosen to illustrate aspects of the culture of plague” (6). The author acknowledges that he has chosen repertoires and composers from Catholic Europe in order to present “a coherent, operative theological understanding of illness throughout the book” (6), so the reactions to plague through music in Protestant territories are not covered in his study.

Overall, the book is a very judicious and well-structured study on this otherwise underresearched topic of music in the medical regimens against plague, and covers a wide span of Renaissance music from the fifteenth to the seventeenth centuries.