Context: Michael is sent down from heaven by God to tell Adam what will happen in the world in the future. The garden would have been the capital of the world if Adam had not sinned and so lost it. As things are to be, other great cities will arise. Michael and Adam ascend a hill of paradise, from the top of which they can see much of the earth, as far as from Mexico and Peru to China. Michael shows Adam what will come, beginning with the murder of Abel by Cain. Adam thus witnesses the death that his own sinful act brought into the world. Adam is mightily impressed, but Michael tells him that this is only one form of death, and there are many other kinds, all dismal. Some men shall fall by violence, others by the intemperate use of food and drink, which shall produce dire diseases in man. He says that he will present to Adam's eyes a monstrous crew of them so that he will know what Eve's intemperance brought into an otherwise good world: A lazar-house is a hospital for pestilence victims. It was a medieval belief that insanity (lunacy) was caused by moonlight.
Immediately a placeBefore his eyes appeared, sad, noisome, dark,A lazar-house it seemed, wherein were laidNumbers of all diseased, all maladiesOf ghastly spasm, or racking torture, qualmsOf heart-sick agony, all feverous kinds,Convulsions, epilepsies, fierce catarrhs,Intestine stone and ulcer, colic pangs,Daemonic phrenzy, moping melancholyAnd moon-struck madness, pining atrophy,Marasmus, and wide-wasting pestilence,Dropsies, and asthmas, and joint-racking rheums.Dire was the tossing, deep the groans, despairTended the sick busiest from couch to couch;And over them triumphant death his dartShook, but delayed to strike, though oft invokedWith vows, as their chief good, and final hope.. . .