The Black Death

Overview

The pandemic of bubonic plague that swept across Europe between 1347 and 1353 is known today as the Black Death, though contemporaries called it the "Great Pestilence," and the disease itself was generally known as peste. During these years, plague affected the lives of all Europeans, and killed nearly half of them. Its impact was enormous, not only because of the tremendous loss of life, but because of the pessimism, fear, suspicion, and even persecution of Jews (who were blamed for the disease) that followed.

In the long term, the Black Death may have increased economic opportunities and promoted a higher standard of living for those who survived. Its rapid spread gave rise to the medical theory of contagion. This scientific observation, in fact, is one reason that the epidemic is often cited as a turning point from the medieval era to the Renaissance.

Background

Plague, caused by the bacterium Yersinia pestis, is usually a disease of rats, not of man. Named for Alexander Yersin, the nineteenth-century scientist who first isolated it, the bacillus is found naturally in rodent populations, among which a small number of cases at any given time is common. Occasionally, however, the disease becomes endemic, killing off large numbers of rats. When this happens, the rat flea, Xenopsylla cheopis, which normally feeds on rodent hosts, turns to people instead. Their bite transmits the plague from infected rat to man.

In medieval times, plague was most often carried by the common black rat, Rattus rattus, which lived among the populace, feeding on grain stores and other foodstuffs. Some historians argue that the human flea, Pulex irritans, may also have played a significant role in transmitting the disease, as it will feed on any available blood source, moving indiscriminately between rats and humans.

Symptoms of plague develop quickly after infection. In man, the disease takes one of three forms: bubonic (involving the lymphatic system), pneumonic (centered in the respiratory system), and septicemic (involving the blood-stream).

The best-known symptom of bubonic plague were buboes—hard, extremely painful, swollen lymph nodes—which filled with blood and pus, turned black, and often burst, giving the disease its common name. The buboes were accompanied by a high fever, headache, chills, body aches, and sensitivity to light. At least half the people who contracted this form of the plague died.

Those who suffered from pneumonic plague usually had no buboes, but their lungs filled with fluid and blood, and they too endured raging fevers, sweats, and pain. Almost no one survived infection with this form, and unlike bubonic plague, pneumonic plague could be transmitted directly from one person to another. The septicemic form of the disease, which occured when the bacillus invaded the blood-stream, often killed its victims so quickly that symptoms rarely even had time to develop.

When plague exploded in 1347, it was an unknown disease. According to contemporary accounts, it was brought to Europe aboard Genoese grain ships, which had been trading for grain in the Black Sea port of Kaffa when Mongols attacked the city. When the disease broke out among the attacking troops, they are reported to have catapulted the dead bodies of plague victims over the city walls in an effort to spread disease among the besieged. The tactic worked, and Genoese ships fleeing the city carried the disease back to Italy.

While these Genoese ships certainly helped disseminate the disease into the Mediterranean basin, they were not the sole cause of plague's spread. Modern scholars have established that plague was actually spreading beyond its natural reservoirs in central Asia before the Genoese arrived in Kaffa. Mongol conquests and new trade routes likely disrupted these reservoirs, allowing plague to spread. The disease seems to have moved through the Middle East into the Upper Nile River, then traveled to the islands of Cyprus and Rhodes in 1348. From there, it spread eastward, infecting Eastern Mediterranean coastal cities. At the same time, the pestilence reached across the Mediterranean to infect Sicily, spread outward to Mediterranean port cities and then moved rapidly northwards. Over the next few years, it raced across all of Europe, reaching Scandinavia by 1351 and traveling eastwards to Moscow by 1353.

Impact

The plague wreaked enormous and long-lasting consequences. After the initial pandemic, known as the Black Death, it remained an active health threat for over 500 years. (The last pandemic started in Asia in 1894; by the time it ended in 1908, over 6 million people had died.) In the centuries that followed, port cities were most often affected, but all areas faced at least some risk. Subsequent epidemics prompted many negative but predictable reactions, including fear, blame, suspicion, and isolation.

Firsthand accounts of the Black Death refer repeatedly to the social breakdown that occurred as people tried to protect themselves, neglecting traditional ties and obligations to friends, neighbors, and even children and family. Plague victims and their families were isolated, sometimes even walled up inside their houses and left to die. It is clear that contemporaries were profoundly fearful, not only of the disease itself, but of the changes it produced in morality, beliefs, and social relations.

The people of the time believed that one or more factors had caused the plague, particularly divine punishment for mankind's sin. Many communities prayed, made pilgrimages, and held ritual processions in attempts to appeal for God's mercy. Patron saints of plague victims emerged, the first being the ancient martyr Saint Sebastian; later Saint Roch, himself a victim of the disease, was canonized. An extreme religious group, the flagellants, roamed the cities and towns of Central Europe holding public confessions and performing displays of piety in which they used whips, known as flagella to scourge themselves.

The most extreme response to the terror of the plague was the scapegoating of Jews, who were rumored to have poisoned communal wells to spread disease. This produced a hysterical campaign of ferocious violence against Jewish communities, many of which were entirely destroyed in mass executions.

Not everyone succumbed to ignorance, however. Physicians wanted a scientific explanation for the plague, and although no one would know the truth for another 600 years, they at least sought physical causes. The Paris Consilium, a committee of 49 medical experts from the University of Paris appointed by Philip VI in 1348, issued a treatise saying that absolute knowledge of the plague's origin was impossible. It suggested, however, that the alignment of stars and planets had produced earthquakes and storms. These, in turn, spread putrefaction and noxious fumes ("miasmas") arising from swamps, rotting garbage, and unburied corpses. When these poisonous vapors were inhaled, they went to the heart, corrupting the entire body from within.

While little could be done to change the heavens, attempts were made to purify air by publicly burning herbs such as rosemary, and by cleaning streets and removing garbage. Individuals tried to protect themselves by carrying handkerchiefs or posies (bouquets of flowers) that were thought to block out these poisonous fumes, and doctors devised elaborate protective costumes similarly meant to prevent breathing any corrupt air.

An important result of the Black Death was the development of a crude theory of contagion. Until the advent of germ theory in the nineteenth century, disease was believed to result from an imbalance of the four basic humors within the body (blood, phlegm, black bile, and yellow bile or choler). The humoral theory held that just as the world was composed of four basic elements (earth, air, fire, water), the human body was composed of four constituents, called humors, which were maintained in individual proportions in each body. Since disease was thought to result from humoral imbalance, there was little thought that one person could "give" disease to another.

When plague began to spread in the mid-fourteenth century, observation and experience seemed to point to a form of contagion. The disease spread quickly within households, often taking entire families. Those in closest contact to the sick, such as caretakers, clergy, and medical professionals were frequently the next to fall ill, seemingly because of their simple proximity to the disease. Thus, a belief in the transmissibility of plague developed long before a formal medical theory was proposed. It was not until 1546 that the Italian physician Girolamo Fracastoro (c. 1478-1553) argued that illness could be spread directly from person to person via "seeds" that could travel short distances or become embedded in textiles for longer trips.

This belief in contagion reinforced people's natural tendency to flee in the face of in impending epidemic, but it also gave weight to municipal responses that emphasized exclusion and isolation. By the late fourteenth century, the Italian town of Ragusa required arriving ships to wait at sea for a period of 40 days in order to confirm the health of the crew. Thus the quarantine (from the Italian quaranti giorni, or 40 days) was born. In subsequent decades, cities and towns began to restrict entry in times when plague threatened, often requiring health "passports" for admittance. Once plague broke out within cities, they employed a practice of isolation, building plague hospitals, called lazarettos, outside the city walls and placing those diagnosed with the disease in them, using force if necessary. While certainly a rational response to contagion, it did little to prevent the movement of rats and their fleas, which continued to roam the city freely.

If any good can be said to have come from the Black Death, it's that those who survived were able to improve their place in society afterward. The tremendous loss of population created much economic opportunity, and many scholars believe that it hastened the end of serfdom by making labor both scarce and valuable. The plague's most surprising result, however, was the intellectual and artistic flowering of the Renaissance, which followed quickly on its heels. The intellectuals who emerged as the first generation of Renaissance humanists, such as Frances Petrarch (1304-1377), were survivors of the Black Death; their successors continued to strive and achieve despite the constant threat of plague.

KRISTY WILSON BOWERS

Further Reading

Biraben, Jean-Noël. Les Hommes et la peste en France et dans les pays européens et méditerranéens, 2 volumes. Paris: Mouton, 1975.

Campbell, Anna Montgomery. The Black Death and Men of Learning. New York: AMS Press, 1969.

Carmichael, Ann G. "Contagion Theory and Contagion Practice in Fifteenth-Century Milan." Renaissance Quarterly (1991): 213-256.

Carmichael, Ann G. Plague and the Poor in Renaissance Florence. New York: Cambridge University Press, 1986.

Cipolla, Carlo. Fighting the Plague in Seventeenth-Century Italy. Madison, WS: University of Wisconsin Press, 1981.

Dols, Michael. The Black Death in the Middle East. Princeton: Princeton University Press, 1977.

Herlihy, David. The Black Death and the Transformation of the West. Cambridge, MA: Harvard University Press, 1997.

Shrewsbury, J.F.D. A History of Bubonic Plague in the British Isles. Cambridge: Cambridge University Press, 1970.

Slack, Paul. The Impact of Plague in Tudor and Stuart England. London: 1985.

Twigg, Graham. The Black Death: a Biological Reappraisal. London: Batsford Academic and Educational Press, 1984.

Williman, Daniel, ed. The Black Death: The Impact of the Fourteenth-century Plague. Binghamton, NY: Center for Medieval and Early Renaissance Studies, 1982.

Zeigler, Philip. The Black Death. New York: 1969.

BUILDING A BETTER RAT TRAP

Rats have bedeviled humans throughout recorded history. They eat food needed by the hungry, they can inflict serious bites and injury, and they can spread disease, including the bubonic plague that decimated Europe several times in the past millennium. Finding a way to catch and kill rats is one of the biggest challenges in public health, and has been for millennia. In general, rats are adaptable, intelligent, and breed quickly.

For centuries, there just weren't many ways to catch rats. The story of the Pied Piper aside, most rats were killed with shovels and hoes. Although cats can be efficient rat killers, in the Middle Ages cats were often thought to be associated with witches. Thus, rather than using cats to their advantage in the battle against rats, people tended to kill cats or drive them away. In the twelfth century rat traps finally began to find common use. These traps had many advantages over previous methods of rat-killing. One person could set many traps, and the traps were automatic, catching rats even when humans were asleep. Rat traps did not, of course, eliminate rats, and bubonic plague continued to pose a threat. But for the first time, people had a weapon to use. Rats continue to be a nuisance today, especially in urban areas.

P. ANDREW KARAM