The Black Death

 

The Triumph of Death by Pieter Bruegel the Elder, circa 1562

     The bubonic plague is responsible for the most fatal pandemic recorded in human history. Known as the Great Pestilence, Black Plague, Black Death and similar names, this pandemic caused the deaths of an estimated 75-200 million people in Europe, Asia, and North Africa. Unlike COVID, which is caused by a virus, bubonic plague is caused by the bacterium Yersinia pestis which is commonly found in fleas carried by ground rodents, especially rats. Humans bitten by the fleas can contract the disease.

Citizens of Tournai Belgium Bury Plague Victims by Pierart dou Tielt, circa 1353

     The Black Death originated in China and Inner Asia, and was spread by the army that besieged the port of Kaffa (now Feodosiya), Crimea in 1347. From there, ships carried the epidemic to Mediterranean ports. It spread inland, affecting North Africa, mainland Europe, Great Britain, and Scandinavia.

Copper engraving of Doctor Schnabel, a plague doctor in Rome, by Paul Fürst circa 1721

     In 17th-century Europe, the physicians who tended to plague victims usually wore an outfit credited to Charles de Lorme, a physician who tended to many European royals. The ensemble included a coat covered in scented wax, breeches connected to boots, a tucked-in shirt, and a hat and gloves made of goat leather. The head covering included spectacles and a mask with a nose, which de Lorme described as “half a foot long, shaped like a beak, filled with perfume with only two holes, one on each side near the nostrils, but that can suffice to breathe and carry along with the air one breathes the impression of the [herbs] enclosed further along in the beak.” The purpose of this beak was to remove bad smells, which were thought to be the principal cause of the disease.

With no understanding as to the actual cause of the Black Plague and little or no medical training, the doctors used a variety of measures to treat victims. Putting frogs on swollen lymph nodes to “re-balance the humors” or attaching leeches for bloodletting were common treatments. Poultices of floral compounds or onion and butter were applied to the inflamed areas. Even arsenic and coatings of mercury were used.  In attempts to drive out the demons invading the victims’ bodies, a variety of methods to induce diarrhea were tried. In the end, most patients died, and an important task of the doctor was to compile public records of plague deaths.

Bubonic plague causes the skin and flesh to die and turn black. CDC

     During the Great Pestilence, three forms of the plague were seen. Bubonic plague refers to the painful lymph node swellings called buboes which oozed pus and bled. Victims underwent damage to the skin and underlying tissue until they were covered in dark blotches, hence the name Black Plague or Black Death. This was the most common form during the pandemic, with a mortality rate of 30-75%, with four out of five victims dying within eight days of onset.

     The pneumonic plague was airborne and attacked the lungs before the rest of the body. Pneumonic plague was the second most common form seen during the Black Death, with a mortality rate of 90-95%.

     The third form was septicemic plague. The bite of an infected flea was the primary route for contracting this deadly form of blood poisoning that was almost always fatal, with a mortality rate of 99-100%. This was the rarest of the three plague varieties.   

Bubonic plague victims in a mass grave in Martigues, France, 1720-1721

     The Black Plague peaked in Europe from 1347-1351. Although the pandemic is generally listed as occurring between 1346 and 1358, isolated eruptions were subsequently documented in various European locations up through 1770, when a two-year outbreak occurred in the Balkans. The most recent global outbreak of bubonic plague started in China in 1860 and didn't officially end until 1959. In the United States, 1964 was our last plague-free year. Today, the bubonic plague can be treated and cured with antibiotics.  
 

 Ann Markim

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