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Wednesday, January 26, 2022

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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  1. Thanks for this clear insight into a terrible diease, Ann, or, as you point out, 3 plagues in one. The devastation was terrible and haunted the survivors, although for some there were more life chances afterwars, with labour being so scarce.
    I find it chilling that Covid followed the same route - from the east, into Italy and then points north into Europe.

    1. Thanks, Lindsay. I also found the parallels with COVID unsettling.

  2. The Black Plague always intrigued me when I came across it in my reading. Although we're in a modern age now with medical miracles, in some ways we are just as mystified by Covid as people were with the Black Plague centuries ago--finding the cause and a cure. Sadly, we still have a long way to go with our current unresolved situation. Thank you for a very informative article, Ann. I always wondered about the purpose of that big beak but never took the time to research it.

  3. Thanks, Elizabeth. I'm thankful for all the scientists around the world who are working on preventing, treating and curing COVID. While there is still much to learn, we've come a long way in two years.

  4. A very apt time to post this, especially with all the various spins people put on it, and the way some people are treating Covid. The last house I lived in, in Scotland, was said to have been built by the man who brought the 1645 plague to Edinburgh. he was buried in the local Kirk yard.

    1. Thanks for your comment. What an interesting legacy for a house to carry! But then, when buildings have been around for so long, their history can hardly help but acquire some interesting details.

  5. Now this was one interesting post. I did not know the black plague originated in China. What's up with all the pandemics originating there?
    considering the costume worn by the physicians; well in some ways it's similar to isolation outfits in that the entire body is covered with a protective cover. I'll admit, we sometimes put Vick's Vapo Rub in our masks when we dealt with smelly situations like gangrene, so I get all the scented wax back during the plague.
    There are so many stories written about the black plague and how people would gather in a castle to isolate from the general public. The plague must have been a horrific and painful way to die. The methods of treatment were either useless, or counter-productive (as in the diarrhea inducement that only dehydrated the patient).
    All the best to you, Ann. This was a marvelous account of a horrible time in history.

    1. Thanks so much for your comment, Sarah. I had the same reaction to the doctor's costume. Even the N95 masks look a bit like short beaks.

  6. I remember being fascinated by the history around this 'plague' even while still young. There is a part of me that still finds the way people reacted of great interest.

    Thanks for the great overview of that trying time. Doris