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The Black Death

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The Black Death

The Black Death, possibly the worst disaster ever to hit Europe, was a series of three different plagues that killed one-third to one-half of the population of the continent from 1347 to 1351 (Cohen, 1974). Plague was once the general term given any widespread disease that caused a large number of deaths; what was once called a plague is now called an epidemic. A pandemic is an epidemic that covers a vast area. The Black Death was a pandemic of the disease that medieval man called the Plague. The Plague was an infectious fever caused by the Pasteurella pestis bacilli (The Black Death: Was it caused by rats or viruses?, 2001). This disease, commonly referred to as the bubonic plague today, is primarily a disease of wild rodents, most commonly the black rat (Cohen, 1974).

The black rat's home was originally in China, but during the Christian era, it slowly began to spread throughout Europe. By the fifteenth and sixteenth centuries, the black rat was replaced in many areas by its larger and stronger relative, the brown or Norway rat. But in the fourteenth century the black rat had not yet disappeared. Cities, towns, and the countrysides of Europe were infested by these plague-bearing rodents. The plague killed rats more rapidly than it killed men. Reports of large numbers of deaths of rats had long been associated with historical plagues (Halliday, 1965).

However, the bacillus doesn't pass directly from rat to rat, or even from rat to man. Instead, there is an intermediary-the rat flea-that sucks the blood of infected rats and picks up the plague (Cohen, 1974). The flea then transmits some of the bacilli when it sucks the blood of a new host, such as a man (Chase, 2001). Unfortunately for men, while the rat flea prefers the blood of rats, it will suck the blood of other warm-blooded animals, including men, if no other rats are available. When plague breaks out among rats, large numbers of them die, and the rat flea must seek a new host. At this point, the plague becomes dangerous to men. It is particularly dangerous when men and rats live together in close proximity.

Three different forms of the disease-bubonic, septicemia, and pneumonic plague-may be caused by the bacilli, depending on where they collect in the body of the victim (Cohen, 1973). The bubonic plague is probably the most common of these varieties; its characteristics include extremely high fever, chills, and ultimately delirium and death. Bacilli collect in the lymph nodes, mostly those in the armpits and groin. The nodes will swell, sometimes to the size of an egg or orange, and become very painful (Cohen, 1974). These swellings are known as buboes; from this name we get the name bubonic plague. Victims usually die within a week from the bubonic plague (Advent of Diseases, 1999).

The septicemia plague is an infection in which an overwhelming number of the plague bacilli go directly into the bloodstream (Cohen, 1974). Septicemia comes from the Greek words meaning putrid blood. Death from this form of plague usually comes within three days (Ziegler, 1969). There are even stories of people going to bed feeling healthy but dying of the plague before the next morning. The victims might even die before the characteristic signs of the plague-the purplish or blackish spots on the skin-appear. These discolorations may account for the name Black Death that is sometimes used to describe the disease.

Pneumonic plague is the third form of the plague. It may appear as a complication of the bubonic plague, although it can also be the original infection. Death may come within a few days from this form of the plague (Cohen, 1974). Not everyone who contracted the plague died, but in the fourteenth century the chances of recovery were very slight. An estimated 90% of the untreated cases of the plague resulted in death (Furedi, 2001). All three forms of the plague were usually present during an epidemic.

In the septicemic plague, there is a high concentration of bacilli in the bloodstream, and it is believed that this form of the disease may be carried from one person to another by the Pulex irritans, a flea that uses man as its primary host (Orent, 2001). These fleas were very common pests in medieval Europe. The plague bacilli might enter a human's bloodstream through breaks in the skin such as a cut. However, this method of infection was very rare.

The only form of the plague that could be spread easily from one person to another was the pneumonic plague (Orent, 2001). The victim commonly coughed up blood and mucus. Plague bacilli are contained in these tiny droplets of mucus and are coughed or sneezed into the air (Chase, 2001). These bacilli are breathed in by other people, and once inside the lungs of a new victim, the bacilli will multiply and form a new case of the pneumonic plague.

In the fourteenth century, people knew nothing of the plague bacillus. Their conceptions of how the disease spread and what forms it took were very sketchy and incomplete. Because of this, there was no general agreement as to the exact causes of the Black Death. But most medical authorities believe that the rat and rat flea were the main factors in the spread of the disease and the pandemic was essentially the bubonic plague (The Black Death: Was it caused by rats or viruses?, 2001). Whatever the cause or causes of the Black Death, it was the worst and most fearful pandemic ever experienced by western man. Conditions were just right in Europe in the fourteenth century for the spread of plague. Most Europeans lived in wretched and squalid circumstances. The majority of people were serfs or poor peasants who lived in windowless thatched huts. They knew very little about sanitation and very often dumped their waste into nearby fields or into the river from which they got their drinking water (Halliday, 1965). People very rarely took baths or even washed their clothes. Fleas, lice, and other vermin were dealt with and considered a part of the everyday afflictions of life (Ziegler, 1969). Rats were so common that they went almost unnoticed until there was a population explosion among them that threatened to eat up the food supply. Sanitary conditions were not much better, possibly even worse, for the nobles who lived in grander houses or walled castles. Waste disposal was much more difficult inside the walls of a castle than in a village.

Early deaths and diseases were just something that people grew to expect. Most children died before the age of six years, and mothers often died during childbirth. For those who survived childhood, death usually came by the age of 35. A person who reached the age of 50 was considered a marvel of longevity (Cohen, 1974).

A deeply religious era, the medieval



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