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The Black Death, also known as the Plague, Great Bubonic Plague, or the Pestilence, was a pandemic that hit Eurasia in the mid-14th century, peaking in Europe between 1347 and 1351, and claiming 75 to 200 million lives. It is believed the Black Death killed between 30% and 60% of Europe’s population, making it the deadliest pandemic that ever existed. Although the Black Death abated, it never wholly disappeared, returning in subsequent but lesser outbreaks to ravage cities and kingdoms until finally vanishing in the 19th century.

What is the Black Death?

There are several theories trying to explain the nature of the pandemic, but the mainstream theory believes that it was a combination of virulent strains of bubonic, pneumonic, and septicemic plague. All still exist nowadays, and although much subdued, they still claimed hundreds of lives in Madagascar, in 2014 and 2017. This deadly trinity of plague is caused by a bacteria called Yersina pestis, which chooses fleas as its main host. At the same time, the infected fleas pick rats, rodents, and other mammals, as their hosts to feed off their blood. Out of rats, the fleas can even opt for domestic cattle and humans. Once the flea bites the skin of its host to feed, it regurgitates the Yersina pestis that has been multiplying on its stomach, thus infecting the victim.   

It has been proved that Y. Pestis and the fleas are able to survive months without a host, in the dark, moist environments of the rodents’ burrows, even after all these sewer-dwellers had been wiped off by the epidemic. This helps explaining the cyclic occurrence of the plague, when the fleas would have to wait for a new fresh badge of rodents to appear, then triggering a new outbreak.

Symptoms and types

The most common strain in 1347 was the bubonic one. After six days of incubation it spread through and attacked the lymphatic system, causing buboes under armpits, groin or neck, depending on the place of the flea bite. It caused subcutaneous haemorrhages, which in turn caused necrosis, purplish blotches and swelling of the lymphatic glands. Contemporary descriptions of the plague in 1347 matches the bubonic symptoms. Although less of a killer that its cousins, the bubonic plague still has 50 to 60% mortality rate.

The upper thigh of a person infected with bubonic plague. It shows the buboes
Buboes caused by bubonic plague

Unlike the bubonic type, which needs of fleas and rodents to spread, pneumonic plague can be transmitted from person to person. It affects the lungs after a two-to-three day incubation period, and causes a severe cough of blood sputum, which contains Yersina pestis, making airborne transmission likely. Here death chances skyrocket to an almost 100%.

Septicemic plague on the other hand, affects the blood stream, causing hundreds of small clots to form. These deplete the body’s clotting resources and stop it from controlling the bleeding. Subcutaneous and organ bleeding happen swiftly, followed by necrosis and ultimately, certain death.

Swelling and necrosis caused on the feet of a person infected with septicemic plague
Necrosis caused by septicemic plague

Origins and how it spread

It is believed that the Yersina pestis bout that caused the Black Death, originated in central Asia, quickly causing havoc there before moving to Mesopotamia, Syria, Armenia and Crimea, in 1346. There, the Genoese merchants had an outpost in the city of Kaffa (modern day Feodosia), which was then besieged by the Mongol Army. The siege was eventually lifted due their ranks being thinned by the pestilence, but before leaving the bitter Mongols catapulted their death inside Kaffa to infect the garrison.

The Genoese crews were thus forced to abandon their ravaged outposts and flee to Europe for refuge. They docked first in Sicily, in October 1347, where their diseased and dying crews were quarantined by local authorities, but it was too late. The true pathological bomb lay in the dark and humid bowels of their vessels, rats mounted by fleas gorged on Yersina pestis. Soon the scurry rodents and its blood-sucking guests made it to Genoa, Venice, Pisa, and even Marseille. Until 1351 they would spread to the whole of France, then the Christian and Muslim kingdoms of modern-day Spain, reaching the centre and north of Europe in 1349-50, and leaving a trail of corpses extending to the principalities of Rus’ (modern day Russia, Ukraine and Belarus).

Map of Europe and bits of Asia and Africa showing the advance of the plague from 1346 to 1347
Progress of the Black Death

Medieval beliefs about the Black Death

Faced with such a virulence that halved towns and cities’ inhabitants in a blink of an eye, the average medieval person became desperate. The most common assumption was that the sickness was caused by the heavenly bodies, or was fanned by God’s Wrath against impious sinners. Others opted the classic ‘blame the Jews’ strategy, readily accusing them of poisoning the wells, thus often resulting in violent pogroms against Europe’s Jewish communities.

A widely accepted belief was that of a poisonous cloud or miasma, which polluted the air and infected the victims. The pestilence, as it was known then, quickly ravaged a town and moved to the next, randomly depopulating some hamlets but leaving others relatively untouched. Faced with these unpredictable patterns, even the doctors of the time couldn’t come up with a better explanation. Moreover, in the cases of pneumonic and septicemic cases, deaths could occur from night to day, further reinforcing the mainstream belief in the wind-propelled miasma theory.

Notwithstanding this, folk also believed the infected to be highly contagious themselves, and as a result, a symptomatic citizen was as good as a dead one. Those suspected of having had contact with plague-ridden victims were ostracised, and refused any help for fear of contagion. At the time when towns struggled to get rid of the huge piles of corpses and the half-feral dogs which preyed upon them, some authorities resorted to forced confinement of the infected together with those whom they had had contact, regardless if they presented symptoms or not.  

Mortality rate and consequences

It is believed that the Black Death killed between 75 and 200 million people overall. At a time when the world population barely reached 500 million this was a catastrophic event. 30% to 60% of Europe’s total population died, with some areas experiencing a staggering 80% mortality rate, whereas others suffered less.

Miniature showing the citizens of Tournai carrying the coffins of the victims to bury them
Miniature by Pierart dou Tielt in 1353, depicting the citizens of Tournai, modern day Belgium, burying the plague victims

Large cities, with its cramped conditions and lack of hygienic which facilitated the breeding of rats and mice, were at high risk. Amongst the social classes, the nobility had the best chances to make it though. Their abundant resources allowed them to obtain more food (thus reinforcing their health) and the fact that they didn’t live in the congested conditions of a common peasant or a burgh citizen, gave them a better chance at isolation. The lower clergy was perhaps the most vulnerable, since their tasks included close-contact and high-risk duties like giving last rites and the tending of the sick. However and overall, the Black Death cared not for social boundaries, targeting royalty and peasantry alike.

The Pope, a king, a cardinal and nobility are represented next to skeletons, which seek to remind the viewer that death comes to all
The Danse Macabre was a popular allegory that accurately represented the fragility of life in the middle ages, by depicting the death in the shape of skeletons next to nobles, kings and even the Pope

The economy didn’t escape unscathed either, although not all the consequences were negative. Land became abundant, forcing landlords to pay higher wages to their remaining workers, and resulting in a surplus of resources. Large plots of unattended fields forced the owners to switch to cattle, thus increasing meat and dairy production. Although scarred and traumatised by the immense loss of friends and relatives, overall the survivors had an easier time henceforth, provided they weren’t struck by a new outbreak (which sadly happened very often), but never again would a disease match the unbelievable virulence of the Black Death. 

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