The Black Plague: The Least You Need
to Know
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construction!
Ring around the rosies
A pocketful of posies
Ashes, ashes,
We all fall down.
--children's rhyme
|
Many a lovely lady and their lover-knights
Swooned and died in sorrow of Death's blows. . . .
For God is deaf nowadays, and will not hear us,
And for our guilt he grinds good men to dust.
--William Langland, Piers
Plowman, circa 1370
Translated
Siegfried Wenzel |
Q: What
was it?
A: Most
scholars think the Black Plague was a bacterial strain
of Yersinia pestis. A growing minority of scholars
(e.g., Graham Twigg) think we have misdiagnosed
the disease, and that it was actually anthrax or some mutation of cattle
murrain. It's also possible the Black Plague might not
have been a single disease at
all, but rather a combination of several at once
or a series of different ones over
many decades.
Q: Does it
have other names?
A: Today,
it's best known as the Black Death or the bubonic plague.
Medieval people called it "the blue sickness," La
pest ("the Pestilence"),
and "the Great Mortality." The name bubonic comes from the
medieval Latin word bubo via Italian bilbo--meaning a pustule, growth,
or swelling. In
Mongolia, the first outbreaks were called ko-ta-wen (literally, "sore-sore,")
and in southern China, the term was ta-wun, from which we get the Arabic
term ta'un.
Q: Where did it come from?
A: The first historical record of bubonic plague is in Central
Asia in 1338/39. It reached China and India by 1346. It infected
the Black Sea port of
Kaffa by 1347. One (false) legend says that the Mongols infected
the city of Kaffa
by
shooting infected corpses over the walls with catapults. It is
more likely that rats carried infected fleas into the town.
Fleeing ships then carried
infected
rats to Constantinople, Italy, and Marseilles during the year 1347.
In 1348, the first outbreaks appeared in England. In July 1349,
it spread
to Scotland.
In 1350, it stalked Scandinavia. In 1351, it arrived in Kiev, Russia.
Q: How it is transmitted?
A: Fleabite transmits common plague bacteria. Normally, the fleas that bite
humans (Pullex irritans) are a separate species from the fleas
that live on rats (Xenopsylla
cheopis), and the bubonic bacteria can survive indefinitely in
its normal host, the European black rat (Rattus rattus). Occasionally,
however,
a desperate
flea would mistakenly bite a human host, and then the human contracts
the disease. Once a human is infected, the plague bacterium can
spread for a few weeks by
human fleas hopping from person to person and biting them.
Once the bacteria
have built up in the human body, there is a small but documented
chance of it evolving into
an airborne version
(the "pneumatic strain")
that infiltrates the blood vessels in the lungs. This version
not only can be spread by fleabite, but it can be transmitted
by airborne
water
particles
from
coughs and sneezes. This pneumatic strain is the one that's
truly lethal. In Florence, archeologists exhuming 15th-century
mass
graves found
a mutant version
of the bubonic plague. Examining the molecular structure of
that plague shows that the plague strains extant in the 1400s
had
twice as many
protein receptor
sites as any known modern strain. It must have been wickedly
contagious. The historian Edward Thompson noted in 1998 that,
when archeologists
exhumed bodies
from a 15th-century mass grave for plague victims southwest
of Edinburgh, they found spores for anthrax, so a mixture of
anthrax
and plague
might have been
running concurrently. That's even worse because anthrax can
be transmitted by bodily fluids (saliva, sweat, tears) and
by skin
contact generally.
Q: What are
the symptoms?
A: Fever,
trembling, weakness, and profuse sweating are initial symptoms
of the bubonic version. In the pneumatic
version, coughing
and parched
throats
are
additional symptoms. In advanced cases, the most distinctive
sign is the agonizing rise
of dark "buboes": sensitive black-blue swellings
under the armpit and near the groin--spots where dead blood
and pus
builds up
in the lymph
nodes. If the buboes are not lanced, the buildup of infected
blood will cause the
buboes
in the armpit and groin area to expand in size (typically
the swelling is about golf-ball sized, but sometimes as large
as
softballs). Untreated,
the patient
will die from the buildup of dead blood in these buboes.
On the other hand, lancing the bilbo or popping it can still
kill
the
victim from
toxic shock,
and the spray
from the bubo is profoundly infectious to those who come
into contact with it.
Q: How long
did the outbreaks last?
A: The pandemic lasted until 1351, but smaller outbreaks
(epidemics) continued off-and-on for decades. For instance,
Paris and Rouen
had epidemics in 1421,
1432, 1433, and an especially bad outbreak in 1437-39. Between
1453-1504, outbreaks died down dramatically across Europe.
The last major outbreaks
were in the
late 17th and early 18th centuries, such as the London outbreaks
in 1665 and 1722.
After that, cholera, typhoid fever, and tuberculosis were
much more significant causes of death, but small outbreaks
in Egypt,
Syria, Turkey, and Greece
have been reported as late as 1845; in Russia as late as
1879; and in Indonesia
in 1959. The most recent case in America I am aware of took
place in Pensacola Florida
in 1922.
Q: How bad
was this infection? What happened if you caught it?
A: Very,
very, very bad. About two-thirds of the victims died within
three or four days
of developing symptoms.
Most of the
rest lingered
about two weeks
and
then died. Note that an infected person could be a carrier
of the disease for a few days before any symptoms manifested
at all, which made quarantine
difficult.
In the twentieth-century,
it became possible to treat the Black Plague with antibiotics.
Without antibiotics, the mortality rate for infected victims
is 72%. However, a small
number of people are naturally resistant to bubonic plague
due
to unusual protein structures. The
bacteria's
enzymes cannot interact
with these proteins
easily. This protein structure seems to be tied to
a specific gene. Before the 1340s, only about 0.2% of the
European
population appeared to have
had this gene
when we examine DNA from their remains. Now a much
larger
percentage of the Europeans have the gene that makes
them resistant to
Yersinia pestis. The 0.2%
of people
who were immune back in the 1300s survived the genetic
bottleneck and then passed on this immunity to a significant
number
of their modern
descendents.
Today,
if you are a Caucasian American, the odds are about
15% that you have inherited this gene.
Q: How many
people died in the pandemic of 1346-1351?
A: The absolute minimum number of European dead would have
been 20 million, as J. F. Heckler suggests. Most modern
scholars place the estimate of
European dead
somewhere between 50-70 million dead (about one-third
of Europe's population on average), with perhaps the worldwide
count at
155-220 million. Remember,
in the early fourteenth century, the world population
was
only about 500 million as a whole before the plague struck.
Some places
(like certain islands off the western coast of Scotland)
were completely unaffected. The cities
of Genoa
and Dublin are
more typical cases in which
35% of the population died. In Paris (which was already
suffering from an earlier famine), the population fell
by 42%. The
mortality was even
higher in other
regions,
such as 66% percent in Caux, Normandy, or 90% in Florence,
Italy. In the
worst cases, mortality was absolute (i.e., 100%). For
example, over 3,000 villages
in France were completely emptied, with the entire
population dead or fled. Similar numbers of "ghost
towns" were
left as shells in other parts of Europe and Britain.
In these places, every
single
person died,
and forests
grew over
the streets. De-populated Europe forgot they ever existed.
Many of them not rediscovered until the rise of aerial
photographic
surveys
in the
years after
World War I
ended in 1918. The world population as a whole did
not recover to pre-plague levels until the 17th century.
Q: What were the sociological and economic effects?
A: They were mixed. The Black Plague accelerated the
demise of the feudal system of government, and it might
actually
have improved the economic
lot of serfs
after 1370. The disease hit rural farm workers especially
hard, so labor became scarce. According to the laws
of economics, wages would then go
up. Landowners
had to offer their workers special incentives to stay
and work
the land, or they would up and run off to work for
another lord down the road.
Increasingly,
the
aristocracy would grant charters to communities, or
release peasants of traditional demands and taxes, or even
(gasp!)
pay them actual money
for their work. This
ultimately encouraged the rise of a prosperous middle
class. That was a long-term benefit to the survivor's
grandchildren,
however.
In the
short term, it was
economically devastating. To illustrate how trade
was affected, consider that about 1,360
ships set sail to trade Gascon wine to England on
average each year between 1320-1340. In the year and a
half
after the black
plague, only 141 trading
ships sailed,
a 93% drop in trade--far worse than the Great Depression
in America.
For Jews, the
result of the plague was increasing victimization. Because
the Jews were often isolated
in ghettos far away
from the wharves where
rats dwelled,
and because of their strict hygiene and dietary
laws, it is likely that Jewish communities were less hard-hit
by
the plague.
That roused the
suspicions of
their Christian neighbors in France and Germany,
who often accused Jews of poisoning
wells to kill Christians. Purges against Jews took
place in 1349 and nearly every other year of a
plague
outbreak.
Q: What were the religious effects?
A: After
an initial frantic outburst of short-term piety and revival,
the Black Plague caused long-term damage to
religious
institutions. During
the plague
outbreaks, many believed God was punishing humanity
for its sins. Strange penitential practices
returned like those of the flagellants (who
went from town to town publicly whipping themselves
until they bled).
Some infected people tried to bury
themselves alive
in holy ground when no priests were left to perform
last rites. The Pope declared a worldwide indulgence,
allowing
the laity
to perform funerals
and hear confessions
to ensure all the dying would have a chance to confess
before death. Good priests, who would stick around
to administer last rites, perform
funerals, and comfort
the dying, were especially likely to contract the disease
from their parishioners and thus die themselves. Bad
priests would
simply run off
and hide. The church
suffered from a serious shortage of quality priests
after the pandemic, and it lowered its standards of
theological
training
and literacy in
order to attract
fresh blood over the next twenty-five years. Likewise,
the
sheer number of deaths
diminished the importance of the Cult of the Saints,
leading to a new interest in medicine. Before the Black
Death,
many medieval authorities
had discouraged
herbal and medicinal treatments, thinking this smacked
of witchcraft instead of faith in God, and priests
might urge
their sick
parishioners to pray for
healing or to visit the shrines of saints. In the case
of the plague, the demonstrable ineffectiveness of
this medical
regimen
in the long
run caused ritual pilgrimage
and ceremonial veneration of the saints to diminish
in prestige. Others despaired, and wrote that God did
not
exist, or that
He had died, or
He was asleep, or
He
had given up on humanity. Europe did not regain a sense
of optimism and hope until the Renaissance of the late
1500s.
Q: What were
the psychological effects and the effects on art?
A: Paradoxically, it led to a strong, conservative desire
for social stability in general, even as it gnawed away
at the
stability of
the church and the
feudal network. It also often led to a despairing carpe
diem attitude in some members
of the public. The average age of marriage suddenly moved
from sixteen to twenty-two. Many people became more xenophobic
and
isolationist.
In art, the trauma of
the plague lead to the common motif of the dans macabre--images
of the dead interacting
with humans--especially in visual art and on tombstones.
In other places, ossaries (human bone depositories)
were turned
into grotesque
skeletal
decorations when
locals took the jumbled bones from thousands of plague
victims and stacked them in odd, symbolic sculptures.
An example
is the Cemetery
Church of
All Saints
at Sedlec in the Czech Republic. Medieval literature
had always been somewhat "other
worldly," focused on rejecting the physical world
and embracing the spiritual world. This trend continued
and increased for thirty
or fifty
years, with morality
plays emphasizing the coming of death. On the other
hand, an increasing rise in secular literature also
accompanied
the plague,
with ribald fabliaux, courtly
love songs, and other entertainment serving to distract
the public from the anxieties of the plague. Boccacio's
Decameron, for instance,
uses
the frame
narrative of
young noblemen fleeing from the plague to a country estate
as its backdrop.
Q: The most visible sign of the plague is the bubo under
the arm or on the thigh. What should I do if I see someone
with
such symptoms?
A: Modern clothing would conceal the most obvious markers
of the disease, so you are only likely to spot the visual
symptoms
at a swimming pool,
gymnasium,
or a changing room. Norman Cantor tells his students, if
they see somebody with plague symptoms in a dressing room,
they
should put on their clothes
and immediately
walk out of the building and notify the CDC. If they see
a rat in the same vicinity of the infected person, they
should forget about putting
on their
clothes and
simply run away while still naked. That's good advice for
you
too.
Q: Where can
I learn more?
A: Any good encyclopedia is a starting spot, but consider
these books as well.