Black Death

Black Death

Overview
The Black Death was one of the most devastating pandemic
Pandemic
A pandemic is an epidemic of infectious disease that is spreading through human populations across a large region; for instance multiple continents, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic...

s in human history
History of the world
The history of the world or human history is the history of humanity from the earliest times to the present, in all places on Earth, beginning with the Paleolithic Era. It excludes non-human natural history and geological history, except insofar as the natural world substantially affects human lives...

, peaking in Europe between 1348 and 1350. Of several competing theories, the dominant explanation for the Black Death is the plague theory, which attributes the outbreak to the bacterium Yersinia pestis
Yersinia pestis
Yersinia pestis is a Gram-negative rod-shaped bacterium. It is a facultative anaerobe that can infect humans and other animals....

. Thought to have started in China, it travelled along the Silk Road
Silk Road
The Silk Road or Silk Route refers to a historical network of interlinking trade routes across the Afro-Eurasian landmass that connected East, South, and Western Asia with the Mediterranean and European world, as well as parts of North and East Africa...

 and reached the Crimea
Crimea
Crimea , or the Autonomous Republic of Crimea , is a sub-national unit, an autonomous republic, of Ukraine. It is located on the northern coast of the Black Sea, occupying a peninsula of the same name...

 by 1346. From there, probably carried by Oriental rat fleas living on the black rat
Black Rat
The black rat is a common long-tailed rodent of the genus Rattus in the subfamily Murinae . The species originated in tropical Asia and spread through the Near East in Roman times before reaching Europe by the 1st century and spreading with Europeans across the world.-Taxonomy:The black rat was...

s that were regular passengers on merchant ships
Cargo ship
A cargo ship or freighter is any sort of ship or vessel that carries cargo, goods, and materials from one port to another. Thousands of cargo carriers ply the world's seas and oceans each year; they handle the bulk of international trade...

, it spread throughout the Mediterranean
Mediterranean Basin
In biogeography, the Mediterranean Basin refers to the lands around the Mediterranean Sea that have a Mediterranean climate, with mild, rainy winters and hot, dry summers, which supports characteristic Mediterranean forests, woodlands, and scrub vegetation...

 and Europe.

The Black Death is estimated to have killed 30–60 percent of Europe's population, reducing the world's population
World population
The world population is the total number of living humans on the planet Earth. As of today, it is estimated to be  billion by the United States Census Bureau...

 from an estimated 450 million to between 350 and 375 million in the 14th century.
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Encyclopedia
The Black Death was one of the most devastating pandemic
Pandemic
A pandemic is an epidemic of infectious disease that is spreading through human populations across a large region; for instance multiple continents, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic...

s in human history
History of the world
The history of the world or human history is the history of humanity from the earliest times to the present, in all places on Earth, beginning with the Paleolithic Era. It excludes non-human natural history and geological history, except insofar as the natural world substantially affects human lives...

, peaking in Europe between 1348 and 1350. Of several competing theories, the dominant explanation for the Black Death is the plague theory, which attributes the outbreak to the bacterium Yersinia pestis
Yersinia pestis
Yersinia pestis is a Gram-negative rod-shaped bacterium. It is a facultative anaerobe that can infect humans and other animals....

. Thought to have started in China, it travelled along the Silk Road
Silk Road
The Silk Road or Silk Route refers to a historical network of interlinking trade routes across the Afro-Eurasian landmass that connected East, South, and Western Asia with the Mediterranean and European world, as well as parts of North and East Africa...

 and reached the Crimea
Crimea
Crimea , or the Autonomous Republic of Crimea , is a sub-national unit, an autonomous republic, of Ukraine. It is located on the northern coast of the Black Sea, occupying a peninsula of the same name...

 by 1346. From there, probably carried by Oriental rat fleas living on the black rat
Black Rat
The black rat is a common long-tailed rodent of the genus Rattus in the subfamily Murinae . The species originated in tropical Asia and spread through the Near East in Roman times before reaching Europe by the 1st century and spreading with Europeans across the world.-Taxonomy:The black rat was...

s that were regular passengers on merchant ships
Cargo ship
A cargo ship or freighter is any sort of ship or vessel that carries cargo, goods, and materials from one port to another. Thousands of cargo carriers ply the world's seas and oceans each year; they handle the bulk of international trade...

, it spread throughout the Mediterranean
Mediterranean Basin
In biogeography, the Mediterranean Basin refers to the lands around the Mediterranean Sea that have a Mediterranean climate, with mild, rainy winters and hot, dry summers, which supports characteristic Mediterranean forests, woodlands, and scrub vegetation...

 and Europe.

The Black Death is estimated to have killed 30–60 percent of Europe's population, reducing the world's population
World population
The world population is the total number of living humans on the planet Earth. As of today, it is estimated to be  billion by the United States Census Bureau...

 from an estimated 450 million to between 350 and 375 million in the 14th century. The aftermath of the plague created a series of religious, social and economic upheavals, which had profound effects on the course of European history. It took 150 years for Europe's population to recover. The plague returned at various times, killing more people, until it left Europe in the 19th century.

Overview



There have been three major outbreaks of plague. The Plague of Justinian
Plague of Justinian
The Plague of Justinian was a pandemic that afflicted the Eastern Roman Empire , including its capital Constantinople, in 541–542 AD. It was one of the greatest plagues in history. The most commonly accepted cause of the pandemic is bubonic plague, which later became infamous for either causing or...

 in the 6th and 7th centuries is the first known attack on record, and marks the first firmly recorded pattern of bubonic plague
Bubonic plague
Plague is a deadly infectious disease that is caused by the enterobacteria Yersinia pestis, named after the French-Swiss bacteriologist Alexandre Yersin. Primarily carried by rodents and spread to humans via fleas, the disease is notorious throughout history, due to the unrivaled scale of death...

. From historical descriptions, as much as 40 percent of the population of Constantinople
Constantinople
Constantinople was the capital of the Roman, Eastern Roman, Byzantine, Latin, and Ottoman Empires. Throughout most of the Middle Ages, Constantinople was Europe's largest and wealthiest city.-Names:...

 died from the plague. Modern estimates suggest half of Europe's population was wiped out before the plague disappeared in the 700s. After 750, major epidemic diseases did not appear again in Europe until the Black Death of the 14th century. The Third Pandemic hit China in the 1890s and devastated India but was confined to limited outbreaks in the west.

The Black Death originated in or near China and spread by way of the Silk Road
Silk Road
The Silk Road or Silk Route refers to a historical network of interlinking trade routes across the Afro-Eurasian landmass that connected East, South, and Western Asia with the Mediterranean and European world, as well as parts of North and East Africa...

 or by ship. It may have reduced the world's population
World population
The world population is the total number of living humans on the planet Earth. As of today, it is estimated to be  billion by the United States Census Bureau...

 from an estimated 450 million to between 350 and 375 million in 1400.

The plague is thought to have returned at intervals with varying virulence
Virulence
Virulence is by MeSH definition the degree of pathogenicity within a group or species of parasites as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. The pathogenicity of an organism - its ability to cause disease - is determined by its...

 and mortality until the 18th century. On its return in 1603, for example, the plague killed 38,000 Londoners. Other notable 17th-century outbreaks were the Italian Plague (1629–1631), the Great Plague of Seville
Great Plague of Seville
The Great Plague of Seville was a massive outbreak of disease in Spain that killed up to a quarter of Seville's population.Unlike the plague of 1596–1602 which claimed 600,000 to 700,000 lives, or a little under 8% of the population, and initially struck northern and central Spain and Andalusía in...

 (1647–1652), the Great Plague of London
Great Plague of London
The Great Plague was a massive outbreak of disease in the Kingdom of England that killed an estimated 100,000 people, 20% of London's population. The disease is identified as bubonic plague, an infection by the bacterium Yersinia pestis, transmitted through a flea vector...

 (1665–1666), and the Great Plague of Vienna
Great Plague of Vienna
The Great Plague of Vienna occurred in 1679 in Vienna, Austria, the imperial residence of the Austrian Habsburg rulers. From contemporary descriptions, the disease is believed to have been bubonic plague, which is caused by the bacterium Yersinia pestis, carried by fleas associated with the black...

 (1679). There is some controversy over the identity of the disease, but in its virulent form, after the Great Plague of Marseille
Great Plague of Marseille
The Great Plague of Marseille was the last of the significant European outbreaks of bubonic plague. Arriving in Marseille, France in 1720, the disease killed 100,000 people in the city and the surrounding provinces. However, Marseille recovered quickly from the plague outbreak. Economic activity...

 in 1720–1722, the Great Plague of 1738
Great Plague of 1738
The Great Plague of 1738 was an outbreak of the bubonic plague between 1738-1740 that affected areas in the modern nations of Romania, Hungary, Ukraine, Serbia, Croatia, and Austria...

 (which hit Eastern Europe), and the Russian plague of 1770-1772
Russian plague of 1770-1772
The Russian plague epidemic of 1770—1772, also known as the Plague of 1771, was the last massive outbreak of plague in central Russia, claiming between 52 and 100 thousand lives in Moscow alone...

, it seems to have gradually disappeared from Europe. By the early 19th century, the threat of plague had diminished, but it was quickly replaced by a new disease. The Asiatic cholera
First cholera pandemic
The first cholera pandemic, also known as the first Asiatic cholera pandemic or Asiatic cholera, lasted from 1817 to 1824. While cholera had spread across India many times previously, this outbreak went further; it reached as far as China and the Caspian Sea before receding...

 was the first of several cholera
Cholera
Cholera is an infection of the small intestine that is caused by the bacterium Vibrio cholerae. The main symptoms are profuse watery diarrhea and vomiting. Transmission occurs primarily by drinking or eating water or food that has been contaminated by the diarrhea of an infected person or the feces...

 pandemics to sweep through Asia and Europe during the 19th and 20th centuries.

The 14th century eruption of the Black Death had a drastic effect on Europe's population, irrevocably changing the social structure. It was, arguably, a serious blow to the Catholic Church, and resulted in widespread persecution of minorities such as Jews, foreigners, beggars, and lepers
Leprosy
Leprosy or Hansen's disease is a chronic disease caused by the bacteria Mycobacterium leprae and Mycobacterium lepromatosis. Named after physician Gerhard Armauer Hansen, leprosy is primarily a granulomatous disease of the peripheral nerves and mucosa of the upper respiratory tract; skin lesions...

. The uncertainty of daily survival has been seen as creating a general mood of morbidity, influencing people to "live for the moment", as illustrated by Giovanni Boccaccio
Giovanni Boccaccio
Giovanni Boccaccio was an Italian author and poet, a friend, student, and correspondent of Petrarch, an important Renaissance humanist and the author of a number of notable works including the Decameron, On Famous Women, and his poetry in the Italian vernacular...

 in The Decameron
The Decameron
The Decameron, also called Prince Galehaut is a 14th-century medieval allegory by Giovanni Boccaccio, told as a frame story encompassing 100 tales by ten young people....

(1353).

Naming


Medieval
Middle Ages
The Middle Ages is a periodization of European history from the 5th century to the 15th century. The Middle Ages follows the fall of the Western Roman Empire in 476 and precedes the Early Modern Era. It is the middle period of a three-period division of Western history: Classic, Medieval and Modern...

 people called the catastrophe of the 14th century either the "Great Pestilence"' or the "Great Plague". Writers contemporary to the plague referred to the event as the "Great Mortality". Swedish and Danish chronicles of the 16th century described the events as "black" for the first time, not to describe the late-stage sign of the disease, in which the sufferer's skin would blacken due to subepidermal hemorrhages
Purpura
Purpura is the appearance of red or purple discolorations on the skin that do not blanch on applying pressure. They are caused by bleeding underneath the skin...

 and the extremities would darken with gangrene
Acral necrosis
Acral necrosis is a symptom common in bubonic plague. The striking black discoloration of skin and tissue, primarily on the extremities , is commonly thought to have given rise to the name "Black Death," associated both with the disease and the pandemic which occurred in the 14th century...

, but more likely to refer to black in the sense of glum or dreadful and to denote the terribleness and gloom of the events. The German physician and medical writer Justus Hecker
Justus Hecker
Justus Friedrich Karl Hecker was a German physician and medical writer, whose works appear in medical encyclopaedias and journals of the time...

 suggested that a mistranslation of the Latin atra mors (terrible, or black, death) had occurred in Scandinavia when he described the catastrophe in 1832 in his publication "Der schwarze Tod im vierzehnten Jahrhundert". The work was translated into English the following year, and with the cholera
Cholera
Cholera is an infection of the small intestine that is caused by the bacterium Vibrio cholerae. The main symptoms are profuse watery diarrhea and vomiting. Transmission occurs primarily by drinking or eating water or food that has been contaminated by the diarrhea of an infected person or the feces...

 epidemic happening at that time, "The Black Death in the 14th century" gained widespread attention and the terms Schwarzer Tod and Black Death became more widely used in the German and English speaking worlds, respectively.

Populations in crisis


In Europe, the Medieval Warm Period
Medieval Warm Period
The Medieval Warm Period , Medieval Climate Optimum, or Medieval Climatic Anomaly was a time of warm climate in the North Atlantic region, that may also have been related to other climate events around the world during that time, including in China, New Zealand, and other countries lasting from...

 ended sometime towards the end of the 13th century, bringing the "Little Ice Age
Little Ice Age
The Little Ice Age was a period of cooling that occurred after the Medieval Warm Period . While not a true ice age, the term was introduced into the scientific literature by François E. Matthes in 1939...

" and harsher winters with reduced harvests. In Northern Europe, new technological innovations such as the heavy plough
Plough
The plough or plow is a tool used in farming for initial cultivation of soil in preparation for sowing seed or planting. It has been a basic instrument for most of recorded history, and represents one of the major advances in agriculture...

 and the three-field system
Crop rotation
Crop rotation is the practice of growing a series of dissimilar types of crops in the same area in sequential seasons.Crop rotation confers various benefits to the soil. A traditional element of crop rotation is the replenishment of nitrogen through the use of green manure in sequence with cereals...

 were not as effective in clearing new fields for harvest as they were in the Mediterranean
Mediterranean Basin
In biogeography, the Mediterranean Basin refers to the lands around the Mediterranean Sea that have a Mediterranean climate, with mild, rainy winters and hot, dry summers, which supports characteristic Mediterranean forests, woodlands, and scrub vegetation...

 because the north had poor, clay-like soil. Food shortages and rapidly inflating prices were a fact of life for as much as a century before the plague. Wheat, oats, hay and consequently livestock, were all in short supply. Their scarcity resulted in malnutrition
Malnutrition
Malnutrition is the condition that results from taking an unbalanced diet in which certain nutrients are lacking, in excess , or in the wrong proportions....

, which increases susceptibility to infections due to weakened immunity. Consistently high fertility rates, at 5 children/woman or more throughout Europe, resulted in high population growth rates and contributed to food shortages. In the autumn of 1314, heavy rains began to fall, which were the start of several years of cold and wet winters. The already weak harvests of the north suffered and the seven-year famine ensued. In the years 1315 to 1317 a catastrophic famine, known as the Great Famine
Great Famine of 1315–1317
The Great Famine of 1315–1317 was the first of a series of large scale crises that struck Northern Europe early in the fourteenth century...

, struck much of North West Europe
North-West Europe
North-West Europe is a term that refers to a northern area of Western Europe, although the exact area or countries it comprises varies.-Geographic definition:...

. It was arguably the worst in European history, perhaps reducing the population by more than 10 percent.

Infection and migration



The plague disease, generally thought to be caused by Yersinia pestis
Yersinia pestis
Yersinia pestis is a Gram-negative rod-shaped bacterium. It is a facultative anaerobe that can infect humans and other animals....

, is enzootic
Enzootic
Enzootic is the non-human equivalent of endemic and means, in a broad sense, "belonging to" or "native to", "characteristic of", or "prevalent in" a particular geography, race, field, area, or environment; native to an area or scope....

 (commonly present) in populations of fleas carried by ground rodent
Rodent
Rodentia is an order of mammals also known as rodents, characterised by two continuously growing incisors in the upper and lower jaws which must be kept short by gnawing....

s, including marmot
Marmot
The marmots are a genus, Marmota, of squirrels. There are 14 species in this genus.Marmots are generally large ground squirrels. Those most often referred to as marmots tend to live in mountainous areas such as the Alps, northern Apennines, Eurasian steppes, Carpathians, Tatras, and Pyrenees in...

s, in various areas including Central Asia
Central Asia
Central Asia is a core region of the Asian continent from the Caspian Sea in the west, China in the east, Afghanistan in the south, and Russia in the north...

, Kurdistan, Western Asia, Northern India and Uganda. Nestorian graves dating to 1338-9 near Lake Issyk Kul in Kyrgizstan have inscriptions referring to plague and recent investigations by the Russian archeologist Chwolson show a high incidence rate and are thought by many epidemiologists to mark the outbreak of the epidemic, from which they could easily have spread to China and India. In October 2010, medical geneticists confirmed that the plague originated in Yunnan, province
Yunnan
Yunnan is a province of the People's Republic of China, located in the far southwest of the country spanning approximately and with a population of 45.7 million . The capital of the province is Kunming. The province borders Burma, Laos, and Vietnam.Yunnan is situated in a mountainous area, with...

 in Southwest China
Southwest China
Southwest China is a region of the People's Republic of China defined by governmental bureaus that includes the municipality of Chongqing, the provinces of Sichuan, Yunnan and Guizhou, and the Tibet Autonomous Region.-Provinces:-Municipalities:...

. In China, the 13th century Mongol conquest
Mongol invasion of China
The Mongol invasion of China lasted over 6 decades and particularly involved the defeat of the Jin Dynasty, Western Xia, the Dali Kingdom, and the Southern Song, which finally fell in year 1276. The Mongols under Kublai Khan established the Yuan Dynasty in China and crushed the last Song resistance...

 caused a decline in farming and trading. However, economic recovery had been observed in the beginning of the 14th century. In 1330s high frequency of natural disaster and plague led to widespread famine starting in 1331 with deadly plague arriving soon after. The population dropped from approximately 120 to 60 million. The 14th-century plague killed an estimated 25 million Chinese and other Asians during the 15 years before it entered Constantinople in 1347.

The disease may have travelled along the Silk Road with Mongol
Mongols
Mongols ) are a Central-East Asian ethnic group that lives mainly in the countries of Mongolia, China, and Russia. In China, ethnic Mongols can be found mainly in the central north region of China such as Inner Mongolia...

 armies and traders or it could have come via ship. By the end of 1346 reports of plague had reached the seaports of Europe: "India was depopulated, Tartary, Mesopotamia, Syria, Armenia were covered with dead bodies".

Plague was reportedly first introduced to Europe at the trading city of Caffa in the Crimea
Crimea
Crimea , or the Autonomous Republic of Crimea , is a sub-national unit, an autonomous republic, of Ukraine. It is located on the northern coast of the Black Sea, occupying a peninsula of the same name...

 in 1347. After a protracted siege, during which the Mongol army under Jani Beg
Jani Beg
Jani Beg was a khan of the Golden Horde from 1342 to 1357, succeeding his father Uzbeg Khan.After putting two of his brothers to death, Jani Beg crowned himself in Saray-Jük. He is known to have actively interfered in the affairs of Russian principalities and of Lithuania...

 was suffering the disease, they catapulted the infected corpses over the city walls
Defensive wall
A defensive wall is a fortification used to protect a city or settlement from potential aggressors. In ancient to modern times, they were used to enclose settlements...

 to infect the inhabitants. The Genoese
Republic of Genoa
The Most Serene Republic of Genoa |Ligurian]]: Repúbrica de Zêna) was an independent state from 1005 to 1797 in Liguria on the northwestern Italian coast, as well as Corsica from 1347 to 1768, and numerous other territories throughout the Mediterranean....

 traders fled, taking the plague by ship into Sicily
Sicily
Sicily is a region of Italy, and is the largest island in the Mediterranean Sea. Along with the surrounding minor islands, it constitutes an autonomous region of Italy, the Regione Autonoma Siciliana Sicily has a rich and unique culture, especially with regard to the arts, music, literature,...

 and the south of Europe, whence it spread north. Whether or not this hypothesis is accurate, it is clear that several existing conditions such as war, famine, and weather contributed to the severity of the Black Death.

European outbreak


There appear to have been several introductions into Europe. It reached Sicily in October 1347 carried by twelve Genoese galleys, where it rapidly spread all over the island. Galleys from Caffa reached Genoa and Venice in January 1348 but it was the outbreak in Pisa a few weeks later that was the entry point to northern Italy. Towards the end of January one of the galleys expelled from Italy arrived in Marseilles.

From Italy the disease spread northwest across Europe, striking France, Spain, Portugal and England by June 1348, then turned and spread east through Germany and Scandinavia from 1348 to 1350. It was introduced in Norway in 1349 when a ship landed at Askøy
Askøy
Askøy is a municipality in the county of Hordaland, Norway. Since the opening of the Askøy Bridge leading to the mainland in Bergen in 1992, the population has increased rapidly. Its population growth is as of 2008 among the highest in Norway...

, then proceeded to spread to Bjørgvin (modern Bergen
Bergen
Bergen is the second largest city in Norway with a population of as of , . Bergen is the administrative centre of Hordaland county. Greater Bergen or Bergen Metropolitan Area as defined by Statistics Norway, has a population of as of , ....

) but never reached Iceland. Finally it spread to north-western Russia in 1351. The plague spared some parts of Europe, including the Kingdom of Poland and isolated parts of Belgium and the Netherlands.

Middle Eastern outbreak


The plague struck various countries in the Middle East during the pandemic
Pandemic
A pandemic is an epidemic of infectious disease that is spreading through human populations across a large region; for instance multiple continents, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic...

, leading to serious depopulation and permanent change in both economic and social structures. As it spread to western Europe, the disease also entered the region from southern Russia. By autumn 1347, the plague reached Alexandria
Alexandria
Alexandria is the second-largest city of Egypt, with a population of 4.1 million, extending about along the coast of the Mediterranean Sea in the north central part of the country; it is also the largest city lying directly on the Mediterranean coast. It is Egypt's largest seaport, serving...

 in Egypt
Egypt
Egypt , officially the Arab Republic of Egypt, Arabic: , is a country mainly in North Africa, with the Sinai Peninsula forming a land bridge in Southwest Asia. Egypt is thus a transcontinental country, and a major power in Africa, the Mediterranean Basin, the Middle East and the Muslim world...

, probably through the port's trade with Constantinople
Constantinople
Constantinople was the capital of the Roman, Eastern Roman, Byzantine, Latin, and Ottoman Empires. Throughout most of the Middle Ages, Constantinople was Europe's largest and wealthiest city.-Names:...

, and ports on the Black Sea
Black Sea
The Black Sea is bounded by Europe, Anatolia and the Caucasus and is ultimately connected to the Atlantic Ocean via the Mediterranean and the Aegean seas and various straits. The Bosphorus strait connects it to the Sea of Marmara, and the strait of the Dardanelles connects that sea to the Aegean...

. During 1347, the disease travelled eastward to Gaza
Gaza
Gaza , also referred to as Gaza City, is a Palestinian city in the Gaza Strip, with a population of about 450,000, making it the largest city in the Palestinian territories.Inhabited since at least the 15th century BC,...

, and north along the eastern coast to cities in Lebanon
Lebanon
Lebanon , officially the Republic of LebanonRepublic of Lebanon is the most common term used by Lebanese government agencies. The term Lebanese Republic, a literal translation of the official Arabic and French names that is not used in today's world. Arabic is the most common language spoken among...

, Syria
Syria
Syria , officially the Syrian Arab Republic , is a country in Western Asia, bordering Lebanon and the Mediterranean Sea to the West, Turkey to the north, Iraq to the east, Jordan to the south, and Israel to the southwest....

 and Palestine
Palestine
Palestine is a conventional name, among others, used to describe the geographic region between the Mediterranean Sea and the Jordan River, and various adjoining lands....

, including Ashkelon
Ashkelon
Ashkelon is a coastal city in the South District of Israel on the Mediterranean coast, south of Tel Aviv, and north of the border with the Gaza Strip. The ancient seaport of Ashkelon dates back to the Neolithic Age...

, Acre
Acre, Israel
Acre , is a city in the Western Galilee region of northern Israel at the northern extremity of Haifa Bay. Acre is one of the oldest continuously inhabited sites in the country....

, Jerusalem, Sidon
Sidon
Sidon or Saïda is the third-largest city in Lebanon. It is located in the South Governorate of Lebanon, on the Mediterranean coast, about 40 km north of Tyre and 40 km south of the capital Beirut. In Genesis, Sidon is the son of Canaan the grandson of Noah...

, Damascus
Damascus
Damascus , commonly known in Syria as Al Sham , and as the City of Jasmine , is the capital and the second largest city of Syria after Aleppo, both are part of the country's 14 governorates. In addition to being one of the oldest continuously inhabited cities in the world, Damascus is a major...

, Homs
Homs
Homs , previously known as Emesa , is a city in western Syria and the capital of the Homs Governorate. It is above sea level and is located north of Damascus...

, and Aleppo
Aleppo
Aleppo is the largest city in Syria and the capital of Aleppo Governorate, the most populous Syrian governorate. With an official population of 2,301,570 , expanding to over 2.5 million in the metropolitan area, it is also one of the largest cities in the Levant...

. In 1348–49, the disease reached Antioch
Antioch
Antioch on the Orontes was an ancient city on the eastern side of the Orontes River. It is near the modern city of Antakya, Turkey.Founded near the end of the 4th century BC by Seleucus I Nicator, one of Alexander the Great's generals, Antioch eventually rivaled Alexandria as the chief city of the...

. The city's residents fled to the north, most of them dying during the journey, but the infection had been spread to the people of Asia Minor.

Mecca
Mecca
Mecca is a city in the Hijaz and the capital of Makkah province in Saudi Arabia. The city is located inland from Jeddah in a narrow valley at a height of above sea level...

 became infected in 1349. During the same year, records show the city of Mawsil (Mosul) suffered a massive epidemic, and the city of Baghdad experienced a second round of the disease. In 1351, Yemen
Yemen
The Republic of Yemen , commonly known as Yemen , is a country located in the Middle East, occupying the southwestern to southern end of the Arabian Peninsula. It is bordered by Saudi Arabia to the north, the Red Sea to the west, and Oman to the east....

 experienced an outbreak of the plague. This coincided with the return of King Mujahid of Yemen from imprisonment in Cairo
Cairo
Cairo , is the capital of Egypt and the largest city in the Arab world and Africa, and the 16th largest metropolitan area in the world. Nicknamed "The City of a Thousand Minarets" for its preponderance of Islamic architecture, Cairo has long been a centre of the region's political and cultural life...

. His party may have brought the disease with them from Egypt.

Symptoms


Contemporary accounts of the plague are often varied or imprecise. The most commonly noted symptom was the appearance of bubo
Bubo
Bubo may refer to:* A bubo, a rounded swelling on the skin of a person afflicted by the bubonic plague.* Bubo, the horned owl and eagle-owl genus.* Bubo, a mechanical owl in the 1981 film Clash of the Titans...

es (or gavocciolos) in the groin, the neck and armpits, which oozed pus and bled when opened. Boccaccio's description is graphic:
"In men and women alike it first betrayed itself by the emergence of certain tumours in the groin or armpits, some of which grew as large as a common apple, others as an egg...From the two said parts of the body this deadly gavocciolo soon began to propagate and spread itself in all directions indifferently; after which the form of the malady began to change, black spots or livid making their appearance in many cases on the arm or the thigh or elsewhere, now few and large, now minute and numerous. As the gavocciolo had been and still was an infallible token of approaching death, such also were these spots on whomsoever they showed themselves."

Ziegler comments that the only medical detail that is questionable is the infallibility of approaching death, as if the bubo discharges, recovery is possible.

This was followed by acute fever and vomiting of blood. Most victims died within two to seven days after infection. David Herlihy identifies another potential sign of the plague: freckle-like spots and rashes which could be the result of flea-bites.

Some accounts, like that of Louis Heyligen, a musician in Avignon
Avignon
Avignon is a French commune in southeastern France in the départment of the Vaucluse bordered by the left bank of the Rhône river. Of the 94,787 inhabitants of the city on 1 January 2010, 12 000 live in the ancient town centre surrounded by its medieval ramparts.Often referred to as the...

 who died of the plague in 1348, noted a distinct form of the disease which infected the lungs and led to respiratory problems and which is identified with pneumonic plague
Pneumonic plague
Pneumonic plague, a severe type of lung infection, is one of three main forms of plague, all of which are caused by the bacterium Yersinia pestis. It is more virulent and rare than bubonic plague...

.
"It is said that the plague takes three forms. In the first people suffer an infection of the lungs, which leads to breathing difficulties. Whoever has this corruption or contamination to any extent cannot escape but will die within two days. Another form...in which boils erupt under the armpits,...a third form in which people of both sexes are attacked in the groin."

Causes



Medical knowledge had stagnated during the Middle Ages and the most authoritative account at the time came from the Medical Faculty in Paris in a report to the King of France, which blamed the heavens—a conjunction of three planets in 1345, which caused a "great pestilence in the air". This report became the first and most widely circulated of a series of "plague tracts" which sought to give advice to sufferers. That the plague was caused by bad air became the most widely accepted theory. It is important to realise that the word plague had no special significance at this time. But the recurrence of outbreaks during the Middle Ages gave it a unique reputation and the name has become the medical term.

The importance of hygiene was only recognised in the nineteenth century and until then it was common that the streets were filthy, with live animals of all sorts around and human fleas and ticks abounding. Any transmissible disease will spread easily in such conditions. One development as a result of the Black Death was the establishment of the idea of quarantine
Quarantine
Quarantine is compulsory isolation, typically to contain the spread of something considered dangerous, often but not always disease. The word comes from the Italian quarantena, meaning forty-day period....

 in Dubrovnik
Dubrovnik
Dubrovnik is a Croatian city on the Adriatic Sea coast, positioned at the terminal end of the Isthmus of Dubrovnik. It is one of the most prominent tourist destinations on the Adriatic, a seaport and the centre of Dubrovnik-Neretva county. Its total population is 42,641...

 in 1377 after continuing outbreaks.

Plague


The dominant explanation for the Black Death is the plague theory, which attributes the outbreak to Yersinia pestis
Yersinia pestis
Yersinia pestis is a Gram-negative rod-shaped bacterium. It is a facultative anaerobe that can infect humans and other animals....

, also responsible for an epidemic that began in southern China in 1865, eventually spreading to India. The investigation of the pathogen that caused the 19th-century plague was begun by teams of scientists who visited Hong Kong in 1894, among whom was Alexandre Yersin
Alexandre Yersin
Alexandre Emile Jean Yersin was a Swiss and French physician and bacteriologist. He is remembered as the co-discoverer of the bacillus responsible for the bubonic plague or pest, which was later re-named in his honour .Yersin was born in 1863 in Aubonne, Canton of Vaud, Switzerland, to a family...

, after whom the pathogen was named Yersinia pestis. The mechanism by which Y. pestis was usually transmitted was established in 1898 by Paul-Louis Simond
Paul-Louis Simond
Paul-Louis Simond was a French physician and biologist who was born in Beaufort-sur-Gervanne, on July 30, 1858. His major contribution to science was his demonstration that the intermediates in the transmission of bubonic plague from rats to humans are the fleas Xenopsylla cheopis that dwell on...

 and was found to involve the bites of fleas whose midgut
Midgut
The midgut is the portion of the embryo from which most of the intestines develop. After it bends around the superior mesenteric artery, it is called the "midgut loop"...

s had become obstructed by replicating Y. pestis several days after feeding on an infected host. This blockage results in starvation and aggressive feeding behaviour by the fleas, which repeatedly attempt to clear their blockage by regurgitation
Vomiting
Vomiting is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose...

, resulting in thousands of plague bacteria being flushed into the feeding site, infecting the host. The bubonic plague mechanism was also dependent on two populations of rodents — one resistant to the disease, who act as hosts, keeping the disease endemic, and a second who lack resistance. When the second population dies, the fleas move on to other hosts, including people, thus creating a human epidemic.

The historian Francis Aidan Gasquet, who had written about the 'Great Pestilence' in 1893 and suggested that "it would appear to be some form of the ordinary Eastern or bubonic plague" was able to adopt the epidemiology of the bubonic plague for the Black Death for the second edition in 1908, implicating rats and fleas in the process, and his interpretation was widely accepted for other ancient and medieval epidemics, such as the Justinian plague that was prevalent in the Eastern Roman Empire from 541 to 700 AD.

The modern bubonic plague
Bubonic plague
Plague is a deadly infectious disease that is caused by the enterobacteria Yersinia pestis, named after the French-Swiss bacteriologist Alexandre Yersin. Primarily carried by rodents and spread to humans via fleas, the disease is notorious throughout history, due to the unrivaled scale of death...

 has a mortality rate
Mortality rate
Mortality rate is a measure of the number of deaths in a population, scaled to the size of that population, per unit time...

 of 30 to 75 percent and symptoms including fever
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...

 of 38–41 °C (101–105 °F), headache
Headache
A headache or cephalalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the...

s, painful aching joints, nausea
Nausea
Nausea , is a sensation of unease and discomfort in the upper stomach with an involuntary urge to vomit. It often, but not always, precedes vomiting...

 and vomiting
Vomiting
Vomiting is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose...

, and a general feeling of malaise
Malaise
Malaise is a feeling of general discomfort or uneasiness, of being "out of sorts", often the first indication of an infection or other disease. Malaise is often defined in medicinal research as a "general feeling of being unwell"...

. If untreated, of those that contract the bubonic plague, 80 percent die within eight days. Pneumonic plague
Pneumonic plague
Pneumonic plague, a severe type of lung infection, is one of three main forms of plague, all of which are caused by the bacterium Yersinia pestis. It is more virulent and rare than bubonic plague...

 has mortality rate of 90 to 95 percent. Symptoms include fever, cough, and blood-tinged sputum
Sputum
Sputum is mucus that is coughed up from the lower airways. It is usually used for microbiological investigations of respiratory infections....

. As the disease progresses, sputum becomes free flowing and bright red. Septicemic plague
Septicemic plague
Septicemic plague is a deadly blood infection, one of the three main forms of plague. It is caused by Yersinia pestis, a gram-negative bacterium....

 is the least common of the three forms, with a mortality rate close to 100 percent. Symptoms are high fevers and purple skin patches (purpura
Purpura
Purpura is the appearance of red or purple discolorations on the skin that do not blanch on applying pressure. They are caused by bleeding underneath the skin...

 due to disseminated intravascular coagulation
Disseminated intravascular coagulation
Disseminated intravascular coagulation , also known as disseminated intravascular coagulopathy or consumptive coagulopathy, is a pathological activation of coagulation mechanisms that happens in response to a variety of diseases. DIC leads to the formation of small blood clots inside the blood...

). In cases of pneumonic and particularly septicemic plague the progress of the disease is so rapid that there would often be no time for the development of the enlarged lymph nodes that were noted as buboes.

"Many modern scholars accept that the lethality of the Black Death stemmed from the combination of bubonic and pneumonic plague with other diseases and warn that every historical mention of 'pest' was not necessarily bubonic plague...In her study of 15thC outbreaks, Ann Carmichael states that worms, the pox, fevers and dysentery clearly accompanied bubonic plague."

Alternative explanations


This interpretation was first significantly challenged by the work of British bacteriologist J. F. D. Shrewsbury in 1970, who noted that the reported rates of mortality in rural areas during the 14th century pandemic were inconsistent with the modern bubonic plague, leading him to conclude that contemporary accounts were exaggerations. In 1984 zoologist Graham Twigg produced the first major work to directly challenge the bubonic plague theory, and his doubts about the identity of the Black Death have been taken up by a number of authors, including Samuel K. Cohn, Jr. (2002), David Herlihy
David Herlihy
David Herlihy was an American historian who wrote on medieval and renaissance life. Particular topics include domestic life, especially the roles of women, and the changing structure of the family...

 (1997), and Susan Scott and Christopher Duncan (2001).

It is recognised that an epidemiological account of the plague is as important as an identification of symptoms, but researchers are hampered by the lack of reliable statistics from this period. Most work has been done on the spread of the plague in England, and even estimates of overall population at the start vary by over 100% as no census was undertaken between the Domesday Book
Domesday Book
Domesday Book , now held at The National Archives, Kew, Richmond upon Thames in South West London, is the record of the great survey of much of England and parts of Wales completed in 1086...

 and 1377. Estimates of plague victims are usually extrapolated from figures for the clergy.

In addition to arguing that the rat population was insufficient to account for a bubonic plague pandemic, sceptics of the bubonic plague theory point out that the symptoms of the Black Death are not unique (and arguably in some accounts may differ from bubonic plague); that transference via fleas in goods was likely to be of marginal significance and that the DNA testing may be flawed and have not been repeated elsewhere, despite extensive samples from other mass graves. Other arguments include: the lack of accounts of the death of rats before outbreaks of plague between the 14th and 17th centuries; temperatures that are too cold in Northern Europe for the survival of fleas; that, despite primitive transport systems, the spread of the Black Death was much faster than modern Bubonic plague; that mortality rates of the Black Death appear to be very high; that, while modern bubonic plague is largely endemic as a rural disease, the Black Death indiscriminately struck urban and rural areas; that the pattern of the Black Death, with major outbreaks in the same areas separated by between 5 and 15 years, differs from modern Bubonic plague, which often becomes endemic for decades, flaring up on an annual basis.

Walløe complains that all of these authors "take it for granted that Simond's infection model, black rat → rat flea → human, which was developed to explain the spread of plague in India, is the only way an epidemic of Yersinia pestis infection could spread", whilst pointing to several other possibilities.


A variety of alternatives to the Y. pestis have been put forward. Twigg suggested that the cause was a form of anthrax
Anthrax
Anthrax is an acute disease caused by the bacterium Bacillus anthracis. Most forms of the disease are lethal, and it affects both humans and other animals...

 and N. F. Cantor
Norman Cantor
Norman Frank Cantor was a historian who specialized in the medieval period. Known for his accessible writing and engaging narrative style, Cantor's books were among the most widely-read treatments of medieval history in English...

 (2001) thought it may have been a combination of anthrax and other pandemics. Scott and Duncan have argued that the pandemic was a form of infectious disease that characterise as hemorrhagic plague similar to Ebola
Ebola
Ebola virus disease is the name for the human disease which may be caused by any of the four known ebolaviruses. These four viruses are: Bundibugyo virus , Ebola virus , Sudan virus , and Taï Forest virus...

. Archaeologist Barney Sloane has argued that there are insufficient evidence of the extinction of large number of rats in the archaeological record of the medieval waterfront in London and that the plague spread too quickly to support the thesis that the Y. pestis was spread from fleas on rats and argues that transmission must have been person to person. However, no single alternative solution has achieved widespread acceptance. Many scholars arguing for the Y. pestis as the major agent of the pandemic, suggest that its extent and symptoms can be explained by a combination of bubonic plague with other diseases, including typhus
Typhus
Epidemic typhus is a form of typhus so named because the disease often causes epidemics following wars and natural disasters...

, smallpox
Smallpox
Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...

 and respiratory infections. In addition to the bubonic infection, others point to additional septicemic (a type of "blood poisoning") and pneumonic (an airborne plague that attacks the lungs before the rest of the body) forms of the plague, which lengthen the duration of outbreaks throughout the seasons and help account for its high mortality rate and additional recorded symptoms.

DNA evidence


In October 2010 the open-access scientific journal PLoS Pathogens
PLoS Pathogens
PLoS Pathogens is an open-access scientific journal published by the Public Library of Science. It publishes research and reviews on the biology of pathogens and host-pathogen interactions. The 2010 impact factor is 9.079....

published a paper by a multinational team who undertook a new investigation into the role of Yersinia pestis
Yersinia pestis
Yersinia pestis is a Gram-negative rod-shaped bacterium. It is a facultative anaerobe that can infect humans and other animals....

in the Black Death following the disputed identification by Drancourt & Raoult in 1998. Their surveys tested for DNA and protein signatures specific for Y. pestis in human skeletons from widely distributed mass graves in northern, central and southern Europe that were associated archaeologically with the Black Death and subsequent resurgences. The authors concluded that this new research, together with prior analyses from the south of France and Germany
"...ends the debate about the etiology
Etiology
Etiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....

 of the Black Death, and unambiguously demonstrates that Y. pestis was the causative agent of the epidemic plague that devastated Europe during the Middle Ages."


The study also found that there were two previously unknown but related clade
Clade
A clade is a group consisting of a species and all its descendants. In the terms of biological systematics, a clade is a single "branch" on the "tree of life". The idea that such a "natural group" of organisms should be grouped together and given a taxonomic name is central to biological...

s (genetic branches) of the Y. pestis genome
Genome
In modern molecular biology and genetics, the genome is the entirety of an organism's hereditary information. It is encoded either in DNA or, for many types of virus, in RNA. The genome includes both the genes and the non-coding sequences of the DNA/RNA....

 associated with medieval mass graves. These clades (which are thought to be extinct) were found to be ancestral to modern isolates of the modern Y. pestis strains Orientalis and Medievalis, suggesting that the plague may have entered Europe in two waves. Surveys of plague pit
Plague pit
A plague pit is the informal term used to refer to mass graves in which victims of the Black Death were buried. The term is most often used to describe pits located in Great Britain, but can be applied to any place where Bubonic plague victims were buried....

 remains in France and England indicate that the first variant entered Europe through the port of Marseille
Marseille
Marseille , known in antiquity as Massalia , is the second largest city in France, after Paris, with a population of 852,395 within its administrative limits on a land area of . The urban area of Marseille extends beyond the city limits with a population of over 1,420,000 on an area of...

 around November 1347 and spread through France over the next two years, eventually reaching England in the spring of 1349, where it spread through the country in three epidemics. Surveys of plague pit remains from the Dutch
Netherlands
The Netherlands is a constituent country of the Kingdom of the Netherlands, located mainly in North-West Europe and with several islands in the Caribbean. Mainland Netherlands borders the North Sea to the north and west, Belgium to the south, and Germany to the east, and shares maritime borders...

 town of Bergen op Zoom
Bergen op Zoom
Bergen op Zoom is a municipality and a city located in the south of the Netherlands.-History:Bergen op Zoom was granted city status probably in 1266. In 1287 the city and its surroundings became a lordship as it was separated from the lordship of Breda. The lordship was elevated to a margraviate...

 showed that the Y. pestis genotype responsible for the pandemic that spread through the Low Countries from 1350 differed from that found in Britain and France, implying that Bergen op Zoom (and possibly other parts of the southern Netherlands) was not directly infected from England or France in 1349 and suggesting that a second wave of plague, different from those in Britain and France, may have been carried to the Low Countries from Norway, the Hanseatic
Hanseatic League
The Hanseatic League was an economic alliance of trading cities and their merchant guilds that dominated trade along the coast of Northern Europe...

 cities or another site.

The results of the Haensch study have since been confirmed and amended. Based on genetic evidence derived from Black Death victims in the East Smithfield
East Smithfield
East Smithfield is the name of a road in the London Borough of Tower Hamlets in east London, part of the A1203 road. It was historically an alternative name for the liberty and parish of St Botolph without Aldgate....

 burial site in England, Schuenemann et al. in 2011 further conclude "that the Black Death in medieval Europe was caused by a variant of Y. pestis that may no longer exist." A study published in Nature
Nature (journal)
Nature, first published on 4 November 1869, is ranked the world's most cited interdisciplinary scientific journal by the Science Edition of the 2010 Journal Citation Reports...

in October 2011 sequenced the genome of Y. pestis from plague victims and indicated that the strain which caused the Black Death is ancestral to most modern strains of the disease.

Consequences



Figures for the death toll vary widely by area and from source to source as new research and discoveries come to light. It killed an estimated 75 million–200 million people in the 14th century. According to medieval historian Philip Daileader
Philip Daileader
Philip Daileader is an Associate Professor of History at The College of William and Mary in Virginia. He received his B.A. in history from Johns Hopkins University and earned his M.A. and Ph.D. in history from Harvard University...

 in 2007:


The trend of recent research is pointing to a figure more like 45 percent to 50 percent of the European population dying during a four-year period. There is a fair amount of geographic variation. In Mediterranean Europe, areas such as Italy, the south of France and Spain, where plague ran for about four years consecutively, it was probably closer to 75 percent to 80 percent of the population. In Germany and England ... it was probably closer to 20 percent.


The most widely accepted estimate for the Middle East, including Iraq
Iraq
Iraq ; officially the Republic of Iraq is a country in Western Asia spanning most of the northwestern end of the Zagros mountain range, the eastern part of the Syrian Desert and the northern part of the Arabian Desert....

, Iran
Iran
Iran , officially the Islamic Republic of Iran , is a country in Southern and Western Asia. The name "Iran" has been in use natively since the Sassanian era and came into use internationally in 1935, before which the country was known to the Western world as Persia...

 and Syria
Syria
Syria , officially the Syrian Arab Republic , is a country in Western Asia, bordering Lebanon and the Mediterranean Sea to the West, Turkey to the north, Iraq to the east, Jordan to the south, and Israel to the southwest....

, during this time, is for a death rate of about a third. The Black Death killed about 40% of Egypt's population. Half of Paris's population of 100,000 people died. In Italy, Florence
Florence
Florence is the capital city of the Italian region of Tuscany and of the province of Florence. It is the most populous city in Tuscany, with approximately 370,000 inhabitants, expanding to over 1.5 million in the metropolitan area....

's population was reduced from 110,000 or 120,000 inhabitants in 1338 to 50,000 in 1351. At least 60 percent of Hamburg
Hamburg
-History:The first historic name for the city was, according to Claudius Ptolemy's reports, Treva.But the city takes its modern name, Hamburg, from the first permanent building on the site, a castle whose construction was ordered by the Emperor Charlemagne in AD 808...

's and Bremen
Bremen
The City Municipality of Bremen is a Hanseatic city in northwestern Germany. A commercial and industrial city with a major port on the river Weser, Bremen is part of the Bremen-Oldenburg metropolitan area . Bremen is the second most populous city in North Germany and tenth in Germany.Bremen is...

's population perished. Before 1350, there were about 170,000 settlements in Germany, and this was reduced by nearly 40,000 by 1450. In 1348, the plague spread so rapidly that before any physicians or government authorities had time to reflect upon its origins, about a third of the European population had already perished. In crowded cities, it was not uncommon for as much as 50 percent of the population to die. Europeans living in isolated areas suffered less, whereas monks and priests were especially hard hit since they cared for the Black Death's victims.


Because 14th century healers were at a loss to explain the cause, Europeans turned to astrological forces, earthquake
Earthquake
An earthquake is the result of a sudden release of energy in the Earth's crust that creates seismic waves. The seismicity, seismism or seismic activity of an area refers to the frequency, type and size of earthquakes experienced over a period of time...

s, and the poisoning of wells by Jews as possible reasons for the plague's emergence. The government
Government
Government refers to the legislators, administrators, and arbitrators in the administrative bureaucracy who control a state at a given time, and to the system of government by which they are organized...

s of Europe had no apparent response to the crisis because no one knew its cause or how it spread. The mechanism of infection and transmission of diseases was little understood in the 14th century; many people believed only God's anger could produce such horrific displays. There were many attacks against Jewish
Jews in the Middle Ages
The history of Jews in the Middle Ages spans the timeframe of approximately 500 CE to 1750 CE. This article covers the medieval history of Jews in the Christian-dominated European region...

 communities. In August 1349, the Jewish communities of Mainz
Mainz
Mainz under the Holy Roman Empire, and previously was a Roman fort city which commanded the west bank of the Rhine and formed part of the northernmost frontier of the Roman Empire...

 and Cologne
Cologne
Cologne is Germany's fourth-largest city , and is the largest city both in the Germany Federal State of North Rhine-Westphalia and within the Rhine-Ruhr Metropolitan Area, one of the major European metropolitan areas with more than ten million inhabitants.Cologne is located on both sides of the...

 were exterminated. In February of that same year, the citizens of Strasbourg murdered 2,000 Jews. By 1351, 60 major and 150 smaller Jewish communities were destroyed. The Brotherhood of the Flagellant
Flagellant
Flagellants are practitioners of an extreme form of mortification of their own flesh by whipping it with various instruments.- History :Flagellantism was a 13th and 14th centuries movement, consisting of radicals in the Catholic Church. It began as a militant pilgrimage and was later condemned by...

s, a movement said to number up to 800,000, reached its peak of popularity.

Recurrence


An epidemic of plague dies out after a few months because it has no host in which the bacteria can survive. However that does not mean that there is not somewhere some surviving infection, in a rodent or flea or warm place, that acts as a reservoir so that sooner or later it breaks out again.

The plague repeatedly returned to haunt Europe and the Mediterranean throughout the 14th to 17th centuries. According to Biraben, plague was present somewhere in Europe in every year between 1346 and 1671. The Second Pandemic was particularly widespread in the following years: 1360–1363; 1374; 1400; 1438–1439; 1456–1457; 1464–1466; 1481–1485; 1500–1503; 1518–1531; 1544–1548; 1563–1566; 1573–1588; 1596–1599; 1602–1611; 1623–1640; 1644–1654; and 1664–1667. According to Geoffrey Parker, "France
Early Modern France
Kingdom of France is the early modern period of French history from the end of the 15th century to the end of the 18th century...

 alone lost almost a million people to plague in the epidemic of 1628–31."

In England, in the absence of census figures, historians propose a range of pre-incident population figures from as high as 7 million to as low as 4 million in 1300, and a post-incident population figure as low as 2 million. By the end of 1350 the Black Death subsided, but it never really died out in England. Over the next few hundred years, there were further outbreaks in 1361–62, 1369, 1379–83, 1389–93, and throughout the first half of the 15th century. An outbreak in 1471 took as much as 10-15 percent of the population, while the death rate of the plague of 1479-80 could have been as high as 20 percent. The most general outbreaks in Tudor
Tudor dynasty
The Tudor dynasty or House of Tudor was a European royal house of Welsh origin that ruled the Kingdom of England and its realms, including the Lordship of Ireland, later the Kingdom of Ireland, from 1485 until 1603. Its first monarch was Henry Tudor, a descendant through his mother of a legitimised...

 and Stuart
House of Stuart
The House of Stuart is a European royal house. Founded by Robert II of Scotland, the Stewarts first became monarchs of the Kingdom of Scotland during the late 14th century, and subsequently held the position of the Kings of Great Britain and Ireland...

 England seem to have begun in 1498, 1535, 1543, 1563, 1589, 1603, 1625, and 1636, and ended with the Great Plague of London
Great Plague of London
The Great Plague was a massive outbreak of disease in the Kingdom of England that killed an estimated 100,000 people, 20% of London's population. The disease is identified as bubonic plague, an infection by the bacterium Yersinia pestis, transmitted through a flea vector...

 in 1665.
In 1466, perhaps 40,000 people died of plague in Paris. During the 16th and 17th centuries, plague visited Paris for almost one year out of three. The Black Death ravaged Europe for three years before it continued on into Russia, where the disease hit somewhere once every five or six years from 1350 to 1490. Plague epidemics ravaged London in 1563, 1593, 1603, 1625, 1636, and 1665, reducing its population by 10 to 30% during those years. Over 10% of Amsterdam
Amsterdam
Amsterdam is the largest city and the capital of the Netherlands. The current position of Amsterdam as capital city of the Kingdom of the Netherlands is governed by the constitution of August 24, 1815 and its successors. Amsterdam has a population of 783,364 within city limits, an urban population...

's population died in 1623–1625, and again in 1635–1636, 1655, and 1664. There were twenty-two outbreaks of plague in Venice
Venice
Venice is a city in northern Italy which is renowned for the beauty of its setting, its architecture and its artworks. It is the capital of the Veneto region...

 between 1361 and 1528. The plague of 1576-1577 killed 50,000 in Venice, almost a third of the population. Late outbreaks in central Europe included the Italian Plague of 1629–1631, which is associated with troop movements during the Thirty Years' War
Thirty Years' War
The Thirty Years' War was fought primarily in what is now Germany, and at various points involved most countries in Europe. It was one of the most destructive conflicts in European history....

, and the Great Plague of Vienna
Great Plague of Vienna
The Great Plague of Vienna occurred in 1679 in Vienna, Austria, the imperial residence of the Austrian Habsburg rulers. From contemporary descriptions, the disease is believed to have been bubonic plague, which is caused by the bacterium Yersinia pestis, carried by fleas associated with the black...

 in 1679. Over 60 percent of Norway's population died from 1348 to 1350. The last plague outbreak ravaged Oslo
Oslo
Oslo is a municipality, as well as the capital and most populous city in Norway. As a municipality , it was established on 1 January 1838. Founded around 1048 by King Harald III of Norway, the city was largely destroyed by fire in 1624. The city was moved under the reign of Denmark–Norway's King...

 in 1654.

In the first half of the 17th century a plague claimed some 1,730,000 victims in Italy, or about 14% of the population. In 1656 the plague killed about half of Naples
Naples
Naples is a city in Southern Italy, situated on the country's west coast by the Gulf of Naples. Lying between two notable volcanic regions, Mount Vesuvius and the Phlegraean Fields, it is the capital of the region of Campania and of the province of Naples...

' 300,000 inhabitants. More than 1,250,000 deaths resulted from the extreme incidence of plague in 17th century Spain
Habsburg Spain
Habsburg Spain refers to the history of Spain over the 16th and 17th centuries , when Spain was ruled by the major branch of the Habsburg dynasty...

. The plague of 1649
Great Plague of Seville
The Great Plague of Seville was a massive outbreak of disease in Spain that killed up to a quarter of Seville's population.Unlike the plague of 1596–1602 which claimed 600,000 to 700,000 lives, or a little under 8% of the population, and initially struck northern and central Spain and Andalusía in...

 probably reduced the population of Seville
Seville
Seville is the artistic, historic, cultural, and financial capital of southern Spain. It is the capital of the autonomous community of Andalusia and of the province of Seville. It is situated on the plain of the River Guadalquivir, with an average elevation of above sea level...

 by half. In 1709–1713, a plague epidemic
Plague of Sweden (1710-1713)
The Plague of Sweden between 1710-1713 was the most recent plague epidemic to ravage Sweden. The contagion was spread from Livonia and Finland by ship.-History:...

 that followed the Great Northern War
Great Northern War
The Great Northern War was a conflict in which a coalition led by the Tsardom of Russia successfully contested the supremacy of the Swedish Empire in northern Central Europe and Eastern Europe. The initial leaders of the anti-Swedish alliance were Peter I the Great of Russia, Frederick IV of...

 (1700–1721, Sweden
Swedish Empire
The Swedish Empire refers to the Kingdom of Sweden between 1561 and 1721 . During this time, Sweden was one of the great European powers. In Swedish, the period is called Stormaktstiden, literally meaning "the Great Power Era"...

 v. Russia and allies) killed about 100,000 in Sweden, and 300,000 in Prussia. The plague killed two-thirds of the inhabitants of Helsinki
Helsinki
Helsinki is the capital and largest city in Finland. It is in the region of Uusimaa, located in southern Finland, on the shore of the Gulf of Finland, an arm of the Baltic Sea. The population of the city of Helsinki is , making it by far the most populous municipality in Finland. Helsinki is...

, and claimed a third of Stockholm
Stockholm
Stockholm is the capital and the largest city of Sweden and constitutes the most populated urban area in Scandinavia. Stockholm is the most populous city in Sweden, with a population of 851,155 in the municipality , 1.37 million in the urban area , and around 2.1 million in the metropolitan area...

's population. Europe's last major epidemic occurred in 1720 in Marseilles
Great Plague of Marseille
The Great Plague of Marseille was the last of the significant European outbreaks of bubonic plague. Arriving in Marseille, France in 1720, the disease killed 100,000 people in the city and the surrounding provinces. However, Marseille recovered quickly from the plague outbreak. Economic activity...

.

The Black Death ravaged much of the Islamic world. Plague was present in at least one location in the Islamic world virtually every year between 1500 and 1850. Plague repeatedly struck the cities of North Africa. Algiers
Algiers
' is the capital and largest city of Algeria. According to the 1998 census, the population of the city proper was 1,519,570 and that of the urban agglomeration was 2,135,630. In 2009, the population was about 3,500,000...

 lost 30,000–50,000 to plague in 1620–21, and again in 1654–57, 1665, 1691, and 1740–42. Plague remained a major event in Ottoman
Ottoman Empire
The Ottoman EmpireIt was usually referred to as the "Ottoman Empire", the "Turkish Empire", the "Ottoman Caliphate" or more commonly "Turkey" by its contemporaries...

 society until the second quarter of the 19th century. Between 1701 and 1750, 37 larger and smaller plague epidemics were recorded in Constantinople
Constantinople
Constantinople was the capital of the Roman, Eastern Roman, Byzantine, Latin, and Ottoman Empires. Throughout most of the Middle Ages, Constantinople was Europe's largest and wealthiest city.-Names:...

, and 31 between 1751 and 1800. Baghdad
Baghdad
Baghdad is the capital of Iraq, as well as the coterminous Baghdad Governorate. The population of Baghdad in 2011 is approximately 7,216,040...

 has suffered severely from visitations of the plague, and sometimes two-thirds of its population has been wiped out.

The Third Pandemic
Third Pandemic
Third Pandemic is the designation of a major Bubonic plague pandemic that began in the Yunnan province in China in 1855. This episode of bubonic plague spread to all inhabited continents, and ultimately killed more than 12 million people in India and China alone...

 (1855–1959) started in China in the middle of the 19th century, spreading plague to all inhabited continents and killing 10 million people in India alone.

From 1944 through 1993, 362 cases of human plague were reported in the United States; approximately 90 percent of these occurred in four western states; Arizona, California, Colorado, and New Mexico. Plague was confirmed in the United States from nine western states during 1995.

The plague bacterium could develop drug-resistance and again become a major health threat. The ability to resist many of the antibiotics used against plague has been found so far in only a single case of the disease in Madagascar
Madagascar
The Republic of Madagascar is an island country located in the Indian Ocean off the southeastern coast of Africa...

, in 1995.

In culture




The Black Death had a profound impact on art and literature throughout the generation that experienced it. Much of the most useful manifestations of the Black Death in literature, to historians, comes from the accounts of its chroniclers. Some of these chroniclers were famous writers, philosophers and rulers such as Boccaccio
Giovanni Boccaccio
Giovanni Boccaccio was an Italian author and poet, a friend, student, and correspondent of Petrarch, an important Renaissance humanist and the author of a number of notable works including the Decameron, On Famous Women, and his poetry in the Italian vernacular...

 and Petrarch
Petrarch
Francesco Petrarca , known in English as Petrarch, was an Italian scholar, poet and one of the earliest humanists. Petrarch is often called the "Father of Humanism"...

. Their writings, however, did not reach the majority of the European population. Petrarch's work was read mainly by wealthy nobles and merchants of Italian city-state
City-state
A city-state is an independent or autonomous entity whose territory consists of a city which is not administered as a part of another local government.-Historical city-states:...

s. He wrote hundreds of letters and vernacular poetry, and passed on to later generations a revised interpretation of courtly love
Courtly love
Courtly love was a medieval European conception of nobly and chivalrously expressing love and admiration. Generally, courtly love was secret and between members of the nobility. It was also generally not practiced between husband and wife....

. There was one troubadour
Troubadour
A troubadour was a composer and performer of Old Occitan lyric poetry during the High Middle Ages . Since the word "troubadour" is etymologically masculine, a female troubadour is usually called a trobairitz....

, writing in the lyric style
Lyric poetry
Lyric poetry is a genre of poetry that expresses personal and emotional feelings. In the ancient world, lyric poems were those which were sung to the lyre. Lyric poems do not have to rhyme, and today do not need to be set to music or a beat...

 long out of fashion, who was active in 1348. Peire Lunel de Montech
Peire Lunel de Montech
Peire Lunel or Cavalier Lunel de Montech or Monteg was a lawyer, politician, and author of Toulouse. His name indicates he was a knight from Montech....

 composed the sorrowful sirventes
Sirventes
The sirventes or serventes is a genre of Occitan lyric poetry used by the troubadours. In early Catalan it became a sirventesch and was imported into that language in the fourteenth century, where it developed into a unique didactic/moralistic type...

"Meravilhar no·s devo pas las gens" during the height of the plague in Toulouse
Toulouse
Toulouse is a city in the Haute-Garonne department in southwestern FranceIt lies on the banks of the River Garonne, 590 km away from Paris and half-way between the Atlantic Ocean and the Mediterranean Sea...

.

See also

  • Beak doctor costume
    Beak doctor costume
    ]The plague doctor's costume was the clothing worn by a plague doctor to protect him from airborne diseases. The costume consisted of an ankle length overcoat and a bird-like beak mask often filled with sweet or strong smelling substances , along with gloves, boots, a brim hat and an outer...

  • Black Death in England
    Black Death in England
    The pandemic known to history as the Black Death entered England in 1348, and killed between a third and more than half of the nation's inhabitants. The Black Death was the first and most severe manifestation of the Second Pandemic, probably caused by the Yersinia pestis bacteria. Originating in...

  • CCR5
    CCR5
    C-C chemokine receptor type 5, also known as CCR5, is a protein that in humans is encoded by the CCR5 gene. CCR5 is a member of the beta chemokine receptors family of integral membrane proteins...

    , a human gene hypothesised to be associated with the plague
  • Crisis of the Late Middle Ages
    Crisis of the Late Middle Ages
    The Crisis of the Late Middle Ages refers to a series of events in the fourteenth and fifteenth centuries that brought centuries of European prosperity and growth to a halt...

  • Death (personification)
    Death (personification)
    The concept of death as a sentient entity has existed in many societies since the beginning of history. In English, Death is often given the name Grim Reaper and, from the 15th century onwards, came to be shown as a skeletal figure carrying a large scythe and clothed in a black cloak with a hood...

  • Global population
  • Globalization and disease
    Globalization and disease
    Globalization, the flow of information, goods, capital and people across political and geographic boundaries, has helped to spread some of the deadliest infectious diseases known to humans. The spread of diseases across wide geographic scales has increased through history...

  • Plague doctor
    Plague doctor
    A plague doctor , was a special medical physician who saw those who had the bubonic plague. They were specifically hired by towns that had many plague victims in times of plague epidemics. Since the city was paying their salary they treated everyone, the rich and the poor...

  • Ring a Ring o' Roses
  • Cronaca fiorentina, Chronicle of Florence 14th century Black Death by Baldassarre Bonaiuti
  • Black Death (film)
    Black Death (film)
    Black Death is a 2010 historical horror action film directed by Christopher Smith from an original screenplay by Dario Poloni. It stars Sean Bean, Eddie Redmayne and Carice van Houten.-Plot:The film takes place in 1348 in plague-ridden medieval England...

  • Danse Macabre
    Danse Macabre
    Dance of Death, also variously called Danse Macabre , Danza de la Muerte , Dansa de la Mort , Danza Macabra , Dança da Morte , Totentanz , Dodendans , is an artistic genre of late-medieval allegory on the universality of death: no matter one's...


Further reading

}}
  • Cantor, Norman F. (2001), In the Wake of the Plague: The Black Death and the World It Made, New York, Free Press.
  • Cohn, Samuel K. Jr., (2002), The Black Death Transformed: Disease and Culture in Early Renaissance Europe, London: Arnold.}}}}
  • Herlihy, D., (1997), The Black Death and the Transformation of the West, Cambridge, Massachusetts: Harvard University Press. }}
  • Scott, S., and Duncan, C. J., (2001), Biology of Plagues: Evidence from Historical Populations, Cambridge: Cambridge University Press.
  • Shrewsbury, J. F. D., (1970), A History of Bubonic Plague in the British Isles, London: Cambridge University Press
  • Twigg, G., (1984), The Black Death: A Biological Reappraisal, London: Batsford. }} 1st editions 1969.

External links


  • Black Death at BBC
    BBC
    The British Broadcasting Corporation is a British public service broadcaster. Its headquarters is at Broadcasting House in the City of Westminster, London. It is the largest broadcaster in the world, with about 23,000 staff...