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The Black Death (also known as the Pestilence, the Great Mortality or the Plague) was a
bubonic plague Bubonic plague is one of three types of plague caused by the plague bacterium Bacteria (; common noun bacteria, singular bacterium) are a type of biological cell The cell (from Latin ''cella'', meaning "small room") is the basic ...
pandemic occurring in
Afro-Eurasia Afro-Eurasia (or Afroeurasia, Field, Henry.The University of California African Expedition: I, Egypt, ''American Anthropologist,'' New Series Vol. 50, No. 3, Part 1 (Jul. - Sep., 1948), pp. 479-493. or Eurafrasia), nicknamed the World Island, ...

Afro-Eurasia
from 1346 to 1353. It is the most fatal pandemic recorded in human history, causing the death of people in
Eurasia Eurasia () is the largest continent A continent is any of several large landmasses. Generally identified by convention (norm), convention rather than any strict criteria, up to seven geographical regions are commonly regarded as cont ...

Eurasia
and
North Africa North Africa or Northern Africa is a region encompassing the northern portion of the African continent. There is no singularly accepted scope for the region, and it is sometimes defined as stretching from the Atlantic shores of Mauritania in th ...

North Africa
, peaking in
Europe Europe is a continent A continent is any of several large landmasses. Generally identified by convention (norm), convention rather than any strict criteria, up to seven geographical regions are commonly regarded as continents. Ordered ...

Europe
from 1347 to 1351. Bubonic plague is caused by the
bacterium Bacteria (; common noun bacteria, singular bacterium) are a type of biological cell The cell (from Latin ''cella'', meaning "small room") is the basic structural, functional, and biological unit of all known organisms. Cells are the sma ...

bacterium
''
Yersinia pestis ''Yersinia pestis'' (''Y. pestis'') (formerly ''Pasteurella __NOTOC__ ''Pasteurella'' is a genus Genus (plural genera) is a taxonomic rank Taxonomy (general) is the practice and science of classification of things or concepts, including the ...

Yersinia pestis
'', but it may also cause septicaemic or
pneumonic plague Pneumonic plague is a severe lung infection caused by the bacterium Bacteria (; common noun bacteria, singular bacterium) are a type of Cell (biology), biological cell. They constitute a large domain (biology), domain of prokaryotic micr ...

pneumonic plague
s. The Black Death was the beginning of the
second plague pandemic The second plague pandemic was a major series of epidemics of plague that started with the Black Death The Black Death (also known as the Pestilence, the Great Mortality or the Plague) was a bubonic plague pandemic occurring in Afro-Eurasia ...
. The plague created religious, social and economic upheavals, with profound effects on the course of European history. Today, a vaccine exists and bubonic plague is easily cured with antibiotics. The origin of the Black Death is disputed. The pandemic originated either in
Central Asia Central Asia is a region in Asia Asia () is 's largest and most populous , located primarily in the and . It shares the continental of with the continent of and the continental landmass of with both Europe and . Asia covers an area ...

Central Asia
or
East Asia East Asia is the eastern region of Asia, which is defined in both Geography, geographical and culture, ethno-cultural terms. The modern State (polity), states of East Asia include China, Japan, Mongolia, North Korea, South Korea, and Taiwan. ...

East Asia
but its first definitive appearance was in
Crimea Crimea; crh, Къырым, translit=Kirim/Qırım; grc, Κιμμερία/Ταυρική, translit=Kimmería/Taurikḗ is a peninsula A peninsula ( la, paeninsula from ' "almost" and ' "island") is a landform surrounded by water on mos ...

Crimea
in 1347. From Crimea, it was most likely carried by
fleas Flea, the common name for the order Order or ORDER or Orders may refer to: * Orderliness Orderliness is associated with other qualities such as cleanliness Cleanliness is both the abstract state of being clean and free from germs, dirt, tra ...
living on the
black rat The black rat (''Rattus rattus''), also known as the roof rat, ship rat, or house rat, is a common long-tailed rodent Rodents (from Latin , 'to gnaw') are mammals of the Order (biology), order Rodentia (), which are characterized by a si ...
s that travelled on
Genoese Genoese may refer to: * a person from Genoa * Genoese dialect, a dialect of the Ligurian language * Republic of Genoa (–1805), a former state in Liguria See also

* Genovese, a surname * Genovesi, a surname * * * * * Genova (disambiguati ...
slave ships, spreading through the Mediterranean Basin and reaching Africa,
Western Asia Western Asia, West Asia, or Southwest Asia, is the westernmost subregion A subregion is a part of a larger region In geography, regions are areas that are broadly divided by physical characteristics ( physical geography), human impact character ...

Western Asia
and the rest of Europe via
Constantinople la, Constantinopolis ota, قسطنطينيه , alternate_name = Byzantion (earlier Greek name), Nova Roma ("New Rome"), Miklagard/Miklagarth (), Tsargrad (), Qustantiniya (), Basileuousa ("Queen of Cities"), Megalopolis ("the Great City"), Πό ...

Constantinople
,
Sicily (man) it, Siciliana (woman) , population_note = , population_blank1_title = , population_blank1 = , demographics_type1 = Ethnicity , demographics1_footnotes = , demographi ...

Sicily
and the
Italian Peninsula The Italian Peninsula (Italian Italian may refer to: * Anything of, from, or related to the country and nation of Italy ** Italians, an ethnic group or simply a citizen of the Italian Republic ** Italian language, a Romance language *** Regi ...
. There is evidence that once it came ashore, the Black Death was in large part spread by
human flea Humans (''Homo sapiens'') are the most abundant and widespread species In biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structure, Biochemistry, chemical processes, ...
s – which cause pneumonic plague – and the person-to-person contact via aerosols which pneumonic plague enables, thus explaining the very fast inland spread of the epidemic, which was faster than would be expected if the primary vector was
rat flea Rats are various medium-sized, long-tailed rodents. Species of rats are found throughout the order Rodentia, but stereotypical rats are found in the genus ''Rattus''. Other rat genera include ''Neotoma'' (pack rats), ''Bandicota'' (bandicoot ra ...
s causing bubonic plague. The Black Death was the second disaster affecting Europe during the
Late Middle Ages The Late Middle Ages or Late Medieval Period was the period Period may refer to: Common uses * Era, a length or span of time * Full stop (or period), a punctuation mark Arts, entertainment, and media * Period (music), a concept in musical comp ...
(the first one being the
Great Famine of 1315–1317 The Great Famine of 1315–1317 (occasionally dated 1315–1322) was the first of a series of large-scale crises that struck Europe Europe is a continent A continent is one of several large landmasses. Generally identified by conve ...
) and is estimated to have killed 30 per cent to 60 per cent of the European population. The plague may have reduced the
world population In demographics Demography (from prefix ''demo-'' from Ancient Greek Ancient Greek includes the forms of the Greek language used in ancient Greece and the classical antiquity, ancient world from around 1500 BC to 300 BC. It is oft ...

world population
from to 350–375 million in the 14th century. There were further outbreaks throughout the Late Middle Ages and with other contributing factors the
Crisis of the Late Middle Ages The Crisis of the Late Middle Ages was a series of events in the fourteenth and fifteenth centuries that ended centuries of Europe Europe is a continent A continent is one of several large landmasses. Generally identified by convent ...
caused the recovery of the European population to the level of 1300 to take until 1500. Outbreaks of the plague recurred around the world until the early 19th century.


Names

European writers contemporary with the plague described the disease in Latin as or ; ; . In English prior to the 18th century, the event was called the "pestilence" or "great pestilence", "the plague" or the "great death". Subsequent to the pandemic "the ''furste moreyn''" (first
murrain Murrain (also known as distemper) is an antiquated term for various infectious diseases affecting cattle and sheep. The word originates from Middle English ''moreine'' or ''moryne'', as a derivative of Latin ''mori'' "to die". The word 'murrain ...
) or "first pestilence" was applied, to distinguish the mid-14th century phenomenon from other infectious diseases and epidemics of plague. The 1347 pandemic plague was not referred to specifically as "black" in the 14th or 15th centuries in any European language, though the expression "black death" had occasionally been applied to fatal disease beforehand. "Black death" was not used to describe the plague pandemic in English until the 1750s; the term is first attested in 1755, where it translated . This expression as a proper name for the pandemic had been popularised by Swedish and Danish chroniclers in the 15th and early 16th centuries, and in the 16th and 17th centuries was transferred to other languages as a
calque In linguistics Linguistics is the scientific study of language, meaning that it is a comprehensive, systematic, objective, and precise study of language. Linguistics encompasses the analysis of every aspect of language, as well as the me ...

calque
: , , and . Previously, most European languages had named the pandemic a variant or calque of the . The phrase 'black death' – describing
Death Death is the permanent, irreversible cessation of all biological functions that sustain a living Living or The Living may refer to: Common meanings *Life, a condition that distinguishes organisms from inorganic objects and dead organi ...

Death
as black – is very old.
Homer Homer (; grc, Ὅμηρος , ''Hómēros'') was an ancient Greek Ancient Greek includes the forms of the Greek language Greek ( el, label=Modern Greek Modern Greek (, , or , ''Kiní Neoellinikí Glóssa''), generally re ...

Homer
used it in the
Odyssey The ''Odyssey'' (; grc, Ὀδύσσεια, Odýsseia, ) is one of two major ancient Greek Ancient Greek includes the forms of the used in and the from around 1500 BC to 300 BC. It is often roughly divided into the following pe ...
to describe the monstrous
Scylla tail and dog heads sprouting from her body. Detail from a red-figure bell-crater in the Louvre, 450–425 B.C. This form of Scylla was prevalent in ancient depictions, though very different from the description in Homer, where she is land-based an ...
, with her mouths "full of black Death" ().
Seneca the Younger Lucius Annaeus Seneca the Younger (; AD65), usually known as Seneca, was a Roman Roman or Romans most often refers to: *, the capital city of Italy *, Roman civilization from 8th century BC to 5th century AD *, the people of ancient Rome *', ...
may have been the first to describe an epidemic as 'black death', () but only in reference to the acute lethality and dark
prognosis Prognosis (Greek#REDIRECT Greek Greek may refer to: Greece Anything of, from, or related to Greece Greece ( el, Ελλάδα, , ), officially the Hellenic Republic, is a country located in Southeast Europe. Its population is approximately ...
of disease. The 12th–13th century French physician
Gilles de CorbeilGilles de Corbeil (Latin: ''Egidius de Corbolio'' or ''Egidius Corboliensis''; also ''Aegidius'') was a French royal physician, teacher, and poet. He was born in approximately 1140 in Corbeil-Essonnes, Corbeil and died in the first quarter of the 13 ...
had already used ' to refer to a "pestilential fever" () in his work ''On the Signs and Symptoms of Diseases'' (). The phrase , was used in 1350 by Simon de Covino (or Couvin), a Belgian astronomer, in his poem "On the Judgement of the Sun at a Feast of Saturn" (), which attributes the plague to an astrological
conjunction Conjunction may refer to: * Conjunction (astronomy), in which two astronomical bodies appear close together in the sky * Conjunction (astrology), astrological aspect in horoscopic astrology * Conjunction (grammar), a part of speech * Logical conjun ...
of Jupiter and Saturn. His use of the phrase is not connected unambiguously with the plague pandemic of 1347 and appears to refer to the fatal outcome of disease. The historian Cardinal
Francis Aidan Gasquet Francis Aidan Gasquet (born Francis Neil Gasquet, 5 October 1846 – 5 April 1929) was an English Benedictine monk and historical scholar. He was created Cardinal (Catholicism), Cardinal in 1914. Life Gasquet was the third of six children of Ray ...
wrote about the Great Pestilence in 1893 and suggested that it had been "some form of the ordinary Eastern or bubonic plague". In 1908, Gasquet claimed that use of the name ' for the 14th-century epidemic first appeared in a 1631 book on Danish history by J. I. Pontanus: "Commonly and from its effects, they called it the black death" (').


Previous plague epidemics

Recent research has suggested plague first infected humans in Europe and Asia in the Late Neolithic-Early Bronze Age. Research in 2018 found evidence of ''
Yersinia pestis ''Yersinia pestis'' (''Y. pestis'') (formerly ''Pasteurella __NOTOC__ ''Pasteurella'' is a genus Genus (plural genera) is a taxonomic rank Taxonomy (general) is the practice and science of classification of things or concepts, including the ...

Yersinia pestis
'' in an ancient Swedish tomb, which may have been associated with the " Neolithic decline" around 3000 BCE, in which European populations fell significantly. This ''Y. pestis'' may have been different from more modern types, with bubonic plague transmissible by fleas first known from Bronze Age remains near
Samara Samara ( rus, Сама́ра, p=sɐˈmarə), known from 1935 to 1991 as Kuybyshev (; ), is the largest city and administrative centre of Samara Oblast. The city is located at the confluence of the Volga and the Samara (Volga), Samara rivers, with ...

Samara
. The symptoms of bubonic plague are first attested in a fragment of Rufus of Ephesus preserved by
Oribasius Oribasius or Oreibasius ( el, Ὀρειβάσιος; c. 320 – 403) was a Greek medical writer and the personal physician of the Roman emperor Julian the Apostate Julian ( la, Flavius Claudius Julianus; grc-gre, Ἰουλιανός; 331 – ...
; these ancient medical authorities suggest bubonic plague had appeared in the
Roman Empire The Roman Empire ( la, Imperium Rōmānum ; grc-gre, Βασιλεία τῶν Ῥωμαίων, Basileía tôn Rhōmaíōn) was the post-Republican Republican can refer to: Political ideology * An advocate of a republic, a type of governme ...

Roman Empire
before the reign of
Trajan Trajan ( ; la, Caesar Nerva Trajanus; 18 September 539/11 August 117) was Roman emperor The Roman emperor was the ruler of the Roman Empire during the History of the Roman Empire, imperial period (starting in 27 BC). The emperors use ...

Trajan
, six centuries before arriving at
Pelusium Pelusium ( ar, الفرما; cop, Ⲡⲉⲣⲉⲙⲟⲩⲛ and Ⲡⲉⲣⲉⲙⲟⲩⲏ or Ⲥⲓⲛ; Tell el-Farama) was an important city in the eastern extremes of Egypt Egypt ( ; ar, مِصر ), officially the Arab Republic of Egyp ...
in the reign of
Justinian I Justinian I (; la, Flavius Petrus Sabbatius Iustinianus; grc-gre, Ἰουστινιανός ; 48214 November 565), also known as Justinian the Great, was the Byzantine emperor This is a list of the Byzantine emperors from the foundation o ...
. In 2013, researchers confirmed earlier speculation that the cause of the
Plague of Justinian The plague of Justinian or Justinianic plague (541–549 AD) was the first major outbreak In epidemiology, an outbreak is a sudden increase in occurrences of a disease in a particular time and place. It may affect a small and localized group or ...
(541–542 CE, with recurrences until 750) was ''Y''. ''pestis''. This is known as the
First plague pandemic The First Plague Pandemic was the first Old World The "Old World" is a retronym A retronym is a newer name for an existing thing that differentiates the original form/version from a more recent one. It is thus a word or phrase created to a ...
.


14th-century plague


Causes


Early theory

The most authoritative contemporary account is found in a report from the medical faculty in Paris to
Philip VI of France Philip VI (french: Philippe; 17 November 1293 – 22 August 1350), called the Fortunate (french: le Fortuné, link=no) and of Valois, was the first King of France from the House of Valois, reigning from 1328 until his death. Philip's reign was ...

Philip VI of France
. It blamed the heavens, in the form of a
conjunction Conjunction may refer to: * Conjunction (astronomy), in which two astronomical bodies appear close together in the sky * Conjunction (astrology), astrological aspect in horoscopic astrology * Conjunction (grammar), a part of speech * Logical conjun ...

conjunction
of three planets in 1345 that caused a "great pestilence in the air" (
miasma theory upright=1.1, An 1831 color lithograph by Robert Seymour (illustrator), Robert Seymour depicts cholera as a robed, skeletal creature emanating a deadly black cloud. The miasma theory (also called the miasmatic theory) is an Superseded scientific ...
). Muslim religious scholars taught that the pandemic was a “martyrdom and mercy” from God, assuring the believer's place in paradise. For non-believers, it was a punishment. Some Muslim doctors cautioned against trying to prevent or treat a disease sent by God. Others adopted preventive measures and treatments for plague used by Europeans. These Muslim doctors also depended on the writings of the ancient Greeks.


Predominant modern theory

Due to climate change in Asia, rodents began to flee the dried-out grasslands to more populated areas, spreading the disease. The plague disease, caused by the bacterium ''
Yersinia pestis ''Yersinia pestis'' (''Y. pestis'') (formerly ''Pasteurella __NOTOC__ ''Pasteurella'' is a genus Genus (plural genera) is a taxonomic rank Taxonomy (general) is the practice and science of classification of things or concepts, including the ...

Yersinia pestis
'', is
enzootic Enzootic is the non-human equivalent of endemic Endemism is the state of a species In biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structure, Biochemistry, chemical ...
(commonly present) in populations of fleas carried by ground
rodent Rodents (from Latin Latin (, or , ) is a classical language belonging to the Italic branch of the Indo-European languages. Latin was originally spoken in the area around Rome, known as Latium. Through the power of the Roman Republi ...

rodent
s, including
marmot Marmots are relatively large ground squirrels in the genus ''Marmota'', with 15 species living in Asia, Europe, and North America. These herbivores are active during the summer when often found in groups, but are not seen during the winter when ...

marmot
s, in various areas, including
Central Asia Central Asia is a region in Asia Asia () is 's largest and most populous , located primarily in the and . It shares the continental of with the continent of and the continental landmass of with both Europe and . Asia covers an area ...

Central Asia
,
Kurdistan Kurdistan ( ku, کوردستان ,Kurdistan ; lit. "land of the Kurds") or Greater Kurdistan is a roughly defined geo-cultural territory in Western Asia Western Asia, also West Asia, is the westernmost subregion of Asia. It is entirely a pa ...

Kurdistan
,
Western Asia Western Asia, West Asia, or Southwest Asia, is the westernmost subregion A subregion is a part of a larger region In geography, regions are areas that are broadly divided by physical characteristics ( physical geography), human impact character ...

Western Asia
,
North India North India is a loosely defined region consisting of the northern part of India India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the List of countries and dependencies by area, seventh-largest count ...

North India
,
Uganda Uganda (Ugandan Languages: Yuganda), officially the Republic of Uganda ( sw, Jamhuri ya Uganda), is a landlocked A landlocked country is a country that does not have territory connected to an ocean or whose coastlines lie on endorheic bas ...

Uganda
and the western United States. ''Y. pestis'' was discovered by
Alexandre Yersin Alexandre Emile Jean Yersin (22 September 1863 – 1 March 1943) was a Swiss Swiss may refer to: * the adjectival form of Switzerland *Swiss people Places *Swiss, Missouri *Swiss, North Carolina *Swiss, West Virginia *Swiss, Wisconsin Other u ...
, a pupil of
Louis Pasteur Louis Pasteur (, ; 27 December 1822 – 28 September 1895) was a French chemist A chemist (from Greek ''chēm(ía)'' alchemy; replacing ''chymist'' from Medieval Latin ''alchemist'') is a scientist A scientist is a person who conducts S ...

Louis Pasteur
, during an epidemic of bubonic plague in Hong Kong in 1894; Yersin also proved this
bacillus ''Bacillus'' (Latin "stick") is a genus Genus (plural genera) is a taxonomic rank Taxonomy (general) is the practice and science of classification of things or concepts, including the principles that underlie such classification. The term ma ...
was present in rodents and suggested the rat was the main vehicle of transmission. The mechanism by which ''Y. pestis'' is usually transmitted was established in 1898 by
Paul-Louis Simond Paul-Louis Simond (30 July 1858 – 3 March 1947) was a French physician, chief medical officer and biologist whose major contribution to science was his demonstration that the intermediates in the transmission of bubonic plague from rats to h ...
and was found to involve the bites of fleas whose
midgut The midgut is the portion of the embryo An embryo is the early stage of development of a multicellular organism. In general, in organisms that Sexual reproduction, reproduce sexually, embryonic development is the part of the life cycle that beg ...
s had become obstructed by replicating ''Y. pestis'' several days after feeding on an infected host. This blockage starves the fleas and drives them to aggressive feeding behaviour and attempts to clear the blockage by , 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, which act as
hosts A host is a person responsible for guests at an event or for providing hospitality during it. Host may also refer to: Places *Host, Pennsylvania, a village in Berks County People *Jim Host (born 1937), American businessman *Michel Host (1 ...
, keeping the disease
endemic Endemism is the state of a species In biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structure, Biochemistry, chemical processes, Molecular biology, molecular interact ...
, and a second that lack resistance. When the second population dies, the fleas move on to other hosts, including people, thus creating a human
epidemic An epidemic (from Greek#REDIRECT Greek Greek may refer to: Greece Anything of, from, or related to Greece Greece ( el, Ελλάδα, , ), officially the Hellenic Republic, is a country located in Southeast Europe. Its population is approx ...
.


DNA evidence

Definitive confirmation of the role of ''Y. pestis'' arrived in 2010 with a publication in ''
PLOS Pathogens ''PLOS Pathogens'' is a peer-reviewed open-access medical journal. All content in ''PLOS Pathogens'' is published under the Creative Commons Creative Commons (CC) is an American non-profit organization and international network devoted to educ ...
'' by Haensch et al. They assessed the presence of
DNA Deoxyribonucleic acid (; DNA) is a molecule File:Pentacene on Ni(111) STM.jpg, A scanning tunneling microscopy image of pentacene molecules, which consist of linear chains of five carbon rings. A molecule is an electrically neutral gro ...

DNA
/
RNA Ribonucleic acid (RNA) is a polymer A polymer (; Greek ''wikt:poly-, poly-'', "many" + ''wikt:-mer, -mer'', "part") is a Chemical substance, substance or material consisting of very large molecules, or macromolecules, composed of many Re ...

RNA
with
polymerase chain reaction Polymerase chain reaction (PCR) is a method widely used to rapidly make millions to billions of copies (complete copies or partial copies) of a specific DNA Deoxyribonucleic acid (; DNA) is a molecule File:Pentacene on Ni(111) STM. ...

polymerase chain reaction
(PCR) techniques for ''Y. pestis'' from the tooth sockets in human skeletons from 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 cause of the Black Death, and unambiguously demonstrates that ''Y. pestis'' was the
causative agent A disease causative agent is substance that causes disease. Examples include biological pathogens (such as a virus, bacteria, parasites, and fungus), toxins, tobacco, radiation, and asbestos. See also

* List of human diseases associated with i ...
of the epidemic plague that devastated Europe during the Middle Ages". In 2011, these results were further confirmed with genetic evidence derived from Black Death victims in the
East Smithfield East Smithfield is a road in the London Borough of Tower Hamlets The London Borough of Tower Hamlets is a London boroughs, London borough located in East London; it covers much of the traditional East End of London, East End. It was formed ...
burial site in England. Schuenemann et al. concluded in 2011 "that the Black Death in medieval Europe was caused by a variant of ''Y. pestis'' that may no longer exist". Later in 2011,
Bos ''Bos'' (from Latin '':wikt:bōs, bōs'': cow, ox, bull) is the genus of wild and domestication, domestic cattle. ''Bos'' can be divided into four subgenera: ''Bos'', ''Bibos'', ''Novibos'', and ''Poephagus'', but including these last three div ...
et al. reported in ''
Nature Nature, in the broadest sense, is the natural, physical, material world or universe The universe ( la, universus) is all of space and time and their contents, including planets, stars, galaxy, galaxies, and all other forms of matter an ...
'' the first draft genome of ''Y. pestis'' from plague victims from the same East Smithfield cemetery and indicated that the strain that caused the Black Death is ancestral to most modern strains of ''Y. pestis''. Since this time, further genomic papers have further confirmed the
phylogenetic In biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structure, Biochemistry, chemical processes, Molecular biology, molecular interactions, Physiology, physiological mechanism ...

phylogenetic
placement of the ''Y. pestis'' strain responsible for the Black Death as both the ancestor of later plague epidemics including the third plague pandemic and as the descendant of the strain responsible for the
Plague of Justinian The plague of Justinian or Justinianic plague (541–549 AD) was the first major outbreak In epidemiology, an outbreak is a sudden increase in occurrences of a disease in a particular time and place. It may affect a small and localized group or ...
. In addition, plague genomes from significantly earlier in prehistory have been recovered. DNA taken from 25 skeletons from 14th century London have shown plague is a strain of ''Y. pestis'' almost identical to that which hit Madagascar in 2013.


Alternative explanations

It is recognised that an
epidemiological Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants In mathematics, the determinant is a Scalar (mathematics), scalar value that is a function (mathematics), function of the entries of a s ...
account of 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 disease in England, and even estimates of overall population at the start vary by over 100% as no census was undertaken in England between the time of publication of the
Domesday Book Domesday Book () – the Middle English Middle English (abbreviated to ME) was a form of the English language spoken after the Norman conquest of England, Norman conquest (1066) until the late 15th century. The English language underwent ...
of 1086 and the
poll tax A poll tax, also known as head tax or capitation, is a tax levied as a fixed sum on every liable individual (typically every adult), without reference to income or resources. Head taxes were important sources of revenue for many governments fr ...

poll tax
of the year 1377. Estimates of plague victims are usually
extrapolated In mathematics, extrapolation is a type of estimation, beyond the original observation range, of the value of a variable on the basis of its relationship with another variable. It is similar to interpolation, which produces estimates between known ...

extrapolated
from figures for the clergy.
Mathematical modelling A mathematical model is a description of a system A system is a group of Interaction, interacting or interrelated elements that act according to a set of rules to form a unified whole. A system, surrounded and influenced by its environment, ...
is used to match the spreading patterns and the means of
transmission Transmission may refer to: Science and technology * Power transmissionPower transmission is the movement of energy from its place of generation to a location where it is applied to perform useful Mechanical work, work. Power (physics), Power is d ...
. A research in 2018 challenged the popular hypothesis that "infected rats died, their flea parasites could have jumped from the recently dead rat hosts to humans". It suggested an alternative model in which "the disease was spread from human fleas and body lice to other people". The second model claims to better fit the trends of death toll because the rat-flea-human hypothesis would have produced a delayed but very high spike in deaths, which contradict historical death data. 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. Similarly,
Green Green is the between and on the . It is evoked by light which has a of roughly 495570 . In systems, used in painting and color printing, it is created by a combination of yellow and ; in the , used on television and computer screens, ...
has argued that greater attention is needed to the range of (especially non-
commensal Commensalism is a long-term biological interaction In ecology Ecology (from el, οἶκος, "house" and el, -λογία, label=none, "study of") is the study of the relationships between living organisms, including humans, and their phy ...

commensal
) animals that might be involved in the transmission of plague. Archaeologist Barney Sloane has argued that there is insufficient evidence of the extinction of numerous rats in the archaeological record of the medieval waterfront in London and that the disease spread too quickly to support the thesis that ''Y. pestis'' was spread from fleas on rats; he argues that transmission must have been person to person. This theory is supported by research in 2018 which suggested transmission was more likely by body lice and human fleas during the
second plague pandemic The second plague pandemic was a major series of epidemics of plague that started with the Black Death The Black Death (also known as the Pestilence, the Great Mortality or the Plague) was a bubonic plague pandemic occurring in Afro-Eurasia ...
.


Summary

Although academic debate continues, no single alternative solution has achieved widespread acceptance. Many scholars arguing for ''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, also known as typhus fever, is a group of infectious diseases An infection is the invasion of an organism's body tissues by disease-causing agents, their multiplication, and the reaction of host tissues to the infectious agents ...
,
smallpox Smallpox was an infectious disease An infection is the invasion of an organism's body Tissue (biology), tissues by Pathogen, disease-causing agents, their multiplication, and the reaction of host (biology), host tissues to the infectious ...

smallpox
and respiratory infections. In addition to the bubonic infection, others point to additional septicaemic (a type of "blood poisoning") and pneumonic (an airborne plague that attacks the lungs before the rest of the body) forms of plague, which lengthen the duration of outbreaks throughout the seasons and help account for its high mortality rate and additional recorded symptoms. In 2014,
Public Health England Public Health England (PHE) was an executive agency of the Department of Health and Social Care in England which began operating on 1 April 2013 to protect and improve health and wellbeing and reduce health inequalities. Its formation came as a r ...
announced the results of an examination of 25 bodies exhumed in the Clerkenwell area of London, as well as of wills registered in London during the period, which supported the pneumonic hypothesis. Currently, while osteoarcheologists have conclusively verified the presence of ''Y. pestis'' bacteria in burial sites across northern Europe through examination of bones and dental pulp, no other epidemic pathogen has been discovered to bolster the alternative explanations. In the words of one researcher: "Finally, plague is plague."


Transmission

The importance of
hygiene Hygiene is a series of practices performed to preserve health Health, according to the World Health Organization, is "a state of complete physical, Mental health, mental and social well-being and not merely the absence of disease and infirmi ...

hygiene
was recognised only in the nineteenth century with the development of the
germ theory of disease The germ theory of disease is the currently accepted scientific theory A scientific theory is an explanation of an aspect of the natural world and universe that has been repeatedly tested and verified in accordance with the scientific method ...
; until then streets were commonly filthy, with live animals of all sorts around and human parasites abounding, facilitating the spread of transmissible disease.


Territorial origins

According to a team of medical geneticists led by Mark Achtman that analysed the
genetic variation thumb File:Genetic Variation and Inheritance.svg, Parents have similar gene coding in this specific situation where they reproduce and variation in the offspring is seen. Offspring containing the variation also reproduce and passes down traits t ...

genetic variation
of the bacterium, ''Yersinia pestis'' "evolved in or near China", from which it spread around the world in multiple epidemics. Later research by a team led by Galina Eroshenko places the origins more specifically in the
Tian Shan mountains The Tian Shan,, dng, Тянсан, ; otk, 𐰴𐰣 𐱅𐰭𐰼𐰃, ; tr, Tanrı Dağı; mn, Тэнгэр уул, ; ug, تەڭرىتاغ, , ; kk, Тәңіртауы / Алатау, , ; ky, Теңир-Тоо / Ала-Тоо, , ; uz, Tyan-S ...

Tian Shan mountains
on the border between
Kyrgyzstan russian: Киргизская Республика, Kirgizskaya Respublika , image_flag = Flag of Kyrgyzstan.svg , image_coat = Emblem of Kyrgyzstan.svg , symbol_type = Emblem , motto = " ...

Kyrgyzstan
and China.
Nestorian Nestorianism is a polysemic Polysemy ( or ; from grc-gre, πολύ-, , "many" and , , "sign") is the capacity for a word or phrase to have multiple meanings, usually related by contiguity of meaning within a semantic field. Polysemy is thus ...

Nestorian
graves dating to 1338–1339 near
Issyk-Kul Issyk-Kul (also Ysyk Köl, Issyk-Kol, ky, Ысык-Көл, , , ; russian: Иссык-Куль, ) is an endorheic An endorheic basin (; also spelled endoreic basin or endorreic basin) is a drainage basin that normally retains water and allows ...
in
Kyrgyzstan russian: Киргизская Республика, Kirgizskaya Respublika , image_flag = Flag of Kyrgyzstan.svg , image_coat = Emblem of Kyrgyzstan.svg , symbol_type = Emblem , motto = " ...

Kyrgyzstan
have inscriptions referring to plague, which has led some historians and
epidemiologists Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in defined population In biology, a population is a number of all the organisms of the same group ...
to think they mark the outbreak of the
epidemic An epidemic (from Greek#REDIRECT Greek Greek may refer to: Greece Anything of, from, or related to Greece Greece ( el, Ελλάδα, , ), officially the Hellenic Republic, is a country located in Southeast Europe. Its population is approx ...
. Others favour an origin in China. According to this theory, the disease may have travelled along the
Silk Road The Silk Road () was and is a network of trade routes connecting the Eastern world, East and Western culture, West, from the 2nd century BCE to the 18th century CE. It was central to the economic, cultural, political, and religious interactions ...

Silk Road
with
Mongol The Mongols ( mn, Монголчууд, , ''Mongolchuud'', ; russian: Монголы, ) are an East Asian East Asia is the eastern region In geography Geography (from Greek: , ''geographia'', literally "earth description") ...

Mongol
armies and traders, or it could have arrived via ship. Epidemics killed an estimated 25 million across Asia during the fifteen years before the Black Death reached
Constantinople la, Constantinopolis ota, قسطنطينيه , alternate_name = Byzantion (earlier Greek name), Nova Roma ("New Rome"), Miklagard/Miklagarth (), Tsargrad (), Qustantiniya (), Basileuousa ("Queen of Cities"), Megalopolis ("the Great City"), Πό ...

Constantinople
in 1347. Research on the
Delhi Sultanate The Delhi Sultanate was an Islam Islam (; ar, اَلْإِسْلَامُ, al-’Islām, "submission o God Oh God may refer to: * An exclamation; similar to "oh no", "oh yes", "oh my", "aw goodness", "ah gosh", "ah gawd"; see int ...
and the
Yuan Dynasty The Yuan dynasty (), officially the Great Yuan (; xng, , , literally "Great Yuan State"), was a successor state Successor is someone who, or something which succeeds or comes after (see success and succession) Film and TV * ''The Succ ...
shows no evidence of any serious epidemic in fourteenth-century India and no specific evidence of plague in fourteenth-century China, suggesting that the Black Death may not have reached these regions. Ole Benedictow argues that since the first clear reports of the Black Death come from Kaffa, the Black Death most likely originated in the nearby plague focus on the northwestern shore of the
Caspian Sea The Caspian Sea (also known as Mazandaran Sea, Hyrcanian Ocean, or Khazar Sea), tk, Hazar deňzi, az, Xəzər Dənizi, russian: Каспийское море, script=Latn, fa, دریای مازندران، دریای خزر, script=Latn, tly, ...

Caspian Sea
.


European outbreak

Plague was reportedly first introduced to Europe via
Genoese Genoese may refer to: * a person from Genoa * Genoese dialect, a dialect of the Ligurian language * Republic of Genoa (–1805), a former state in Liguria See also

* Genovese, a surname * Genovesi, a surname * * * * * Genova (disambiguati ...
traders from their port city of Kaffa in the
Crimea Crimea; crh, Къырым, translit=Kirim/Qırım; grc, Κιμμερία/Ταυρική, translit=Kimmería/Taurikḗ is a peninsula A peninsula ( la, paeninsula from ' "almost" and ' "island") is a landform surrounded by water on mos ...

Crimea
in 1347. During a protracted siege of the city, in 1345–1346 the Mongol
Golden Horde The Golden Horde, self-designated as Ulug Ulus, 'Great State' in Turkic, was originally a Mongol The Mongols ( mn, Монголчууд, , ''Mongolchuud'', ; russian: Монголы, ) are an ethnic group to the , and the of Russia. ...
army of Jani Beg, whose mainly
Tatar The Tatars (; tt, , , , crh, tatarlar; otk, 𐱃𐱃𐰺, Tatar) is an umbrella term for different Turkic peoples, Turkic ethnic groups bearing the name "Tatar." Initially, the ethnonym ''Tatar'' possibly referred to the Tatar confederation ...
troops were suffering from the disease, catapulted infected corpses over the city walls of Kaffa to infect the inhabitants, though it is more likely that infected rats travelled across the siege lines to spread the epidemic to the inhabitants. As the disease took hold, Genoese traders fled across the
Black Sea , with the skyline of Batumi Batumi (; ka, ბათუმი ) is the second largest city of Georgia Georgia usually refers to: * Georgia (country) Georgia ( ka, საქართველო; ''Sakartvelo''; ) is a country locat ...

Black Sea
to
Constantinople la, Constantinopolis ota, قسطنطينيه , alternate_name = Byzantion (earlier Greek name), Nova Roma ("New Rome"), Miklagard/Miklagarth (), Tsargrad (), Qustantiniya (), Basileuousa ("Queen of Cities"), Megalopolis ("the Great City"), Πό ...

Constantinople
, where the disease first arrived in Europe in summer 1347. The epidemic there killed the 13-year-old son of the
Byzantine emperor This is a list of the Byzantine emperors from the foundation of Constantinople la, Constantinopolis ota, قسطنطينيه , alternate_name = Byzantion (earlier Greek name), Nova Roma ("New Rome"), Miklagard/Miklagarth (Old Norse ...

Byzantine emperor
,
John VI Kantakouzenos John VI Kantakouzenos, Cantacuzenus, or Cantacuzene ( el, , ''Iōánnēs Ángelos Palaiológos Kantakouzēnós''; la, Johannes Cantacuzenus;  – 15 June 1383) was a Greek#REDIRECT Greek Greek may refer to: Greece Anything of, from, o ...

John VI Kantakouzenos
, who wrote a description of the disease modelled on Thucydides's account of the 5th century BCE
Plague of Athens The Plague of Athens ( grc, Λοιμὸς τῶν Ἀθηνῶν}, ) was an epidemic An epidemic (from Greek#REDIRECT Greek Greek may refer to: Greece Anything of, from, or related to Greece Greece ( el, Ελλάδα, , ), officially th ...
, but noting the spread of the Black Death by ship between maritime cities.
Nicephorus GregorasNicephorus Gregoras (; Medieval Greek, Greek: , ''Nikephoros Gregoras''; c. 1295 – 1360) was a Byzantine Empire, Byzantine Byzantine astronomy, astronomer, Byzantine history, historian, and Byzantine theology, theologian. Life Gregoras was ...
also described in writing to
Demetrios Kydones Demetrios Kydones, Latinized as Demetrius Cydones or Demetrius Cydonius ( el, Δημήτριος Κυδώνης; 1324, Thessalonica Thessaloniki (; el, Θεσσαλονίκη, ), also known as Thessalonica (), Saloniki or Salonica (), is the Lis ...
the rising death toll, the futility of medicine, and the panic of the citizens. The first outbreak in Constantinople lasted a year, but the disease recurred ten times before 1400. Carried by twelve Genoese galleys, plague arrived by ship in
Sicily (man) it, Siciliana (woman) , population_note = , population_blank1_title = , population_blank1 = , demographics_type1 = Ethnicity , demographics1_footnotes = , demographi ...

Sicily
in October 1347; the disease spread rapidly all over the island. Galleys from Kaffa 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. Black Death in Italy, From Italy, the disease spread northwest across Europe, Black Death in France, striking France, Spain (which was hit due to the heat – the Black Death in Spain, epidemic raged in the early weeks of July), Portugal and England by June 1348, then spread east and north Black Death in Germany, through Germany, Scotland and Scandinavia from 1348 to 1350. It was introduced Black Death in Norway, into Norway in 1349 when a ship landed at Askøy, then spread to Bjørgvin (modern Bergen) and Iceland. Finally, it spread to northwestern Russia in 1351. Plague was somewhat more uncommon in parts of Europe with less developed trade with their neighbours, including the majority of the Basque Country (greater region), Basque Country, isolated parts of Belgium and the Netherlands, and isolated Alpine villages throughout the continent. According to some epidemiologists, periods of unfavourable weather decimated plague-infected rodent populations and forced their fleas onto alternative hosts, inducing plague outbreaks which often peaked in the hot summers of the Mediterranean, as well as during the cool autumn months of the southern Baltic states. Among many other culprits of plague contagiousness, malnutrition, even if distantly, also contributed to such an immense loss in European population, since it weakened immune systems.


Western Asian and North African outbreak

The disease struck various regions in the Middle East and North Africa during the pandemic, leading to serious depopulation and permanent change in both economic and social structures. As infected rodents infected new rodents, the disease spread across the region, entering also from southern Russia. By autumn 1347, plague had reached Alexandria in Egypt, transmitted by sea from
Constantinople la, Constantinopolis ota, قسطنطينيه , alternate_name = Byzantion (earlier Greek name), Nova Roma ("New Rome"), Miklagard/Miklagarth (), Tsargrad (), Qustantiniya (), Basileuousa ("Queen of Cities"), Megalopolis ("the Great City"), Πό ...

Constantinople
; according to a contemporary witness, from a single merchant ship carrying slaves. By late summer 1348 it reached Cairo, capital of the Mamluk Sultanate (Cairo), Mamluk Sultanate, cultural centre of the Muslim world, Islamic world, and the largest city in the Mediterranean Basin; the Bahri dynasty, Bahriyya child sultan an-Nasir Hasan fled and more than a third of the 600,000 residents died. The Nile was choked with corpses despite Cairo having a medieval hospital, the late 13th century bimaristan of the Qalawun complex. The historian al-Maqrizi described the abundant work for grave-diggers and practitioners of Islamic funeral, funeral rites, and plague recurred in Cairo more than fifty times over the following century and half. During 1347, the disease travelled eastward to Gaza City, Gaza by April; by July it had reached Damascus, and in October plague had broken out in Aleppo. That year, in Syria (region), the territory of modern Lebanon, Syria, Israel, and Palestinian territories, Palestine, the cities of Ashkelon, Acre, Israel, Acre, Jerusalem, Sidon, and Homs were all infected. In 1348–1349, the disease reached Antioch. The city's residents fled to the north, but most of them ended up dying during the journey. Within two years, the plague had spread throughout the Islamic world, from Arabia across North Africa. The pandemic spread westwards from Alexandria along the African coast, while in April 1348 Tunis was infected by ship from Sicily. Tunis was then under attack by an army from Morocco; this army dispersed in 1348 and brought the contagion with them to Morocco, whose epidemic may also have been seeded from the Islamic city of Almería in al-Andalus. Mecca became infected in 1348 by pilgrims performing the Hajj. In 1351 or 1352, the Rasulid dynasty, Rasulid sultan of the Yemen, al-Mujahid Ali, was released from Mamluk captivity in Egypt and carried plague with him on his return home. During 1348, records show the city of Mosul suffered a massive epidemic, and the city of Baghdad experienced a second round of the disease.


Signs and symptoms


Bubonic plague

Symptoms of the disease include fever of , headaches, Arthralgia, painful aching joints, nausea and vomiting, and a general feeling of malaise. Left untreated, of those that contract the bubonic plague, 80 percent die within eight days. Contemporary accounts of the pandemic are varied and often imprecise. The most commonly noted symptom was the appearance of buboes (or ''gavocciolos'') in the groin, neck, and armpits, which oozed pus and bled when opened. Giovanni Boccaccio, Boccaccio's description: This was followed by acute fever and Hematemesis, vomiting of blood. Most victims died two to seven days after initial infection. Freckle-like spots and rashes, which could have been caused by Pulicosis, flea-bites, were identified as another potential sign of plague.


Pneumonic plague

Lodewijk Heyligen, whose master the Giovanni Colonna (cardinal, 1295–1348), Cardinal Colonna died of plague in 1348, noted a distinct form of the disease,
pneumonic plague Pneumonic plague is a severe lung infection caused by the bacterium Bacteria (; common noun bacteria, singular bacterium) are a type of Cell (biology), biological cell. They constitute a large domain (biology), domain of prokaryotic micr ...

pneumonic plague
, that infected the lungs and led to respiratory problems. Symptoms include fever, cough, and Hemoptysis, blood-tinged sputum. As the disease progresses, sputum becomes free-flowing and bright red. Pneumonic plague has a mortality rate of 90 to 95 percent.


Septicaemic plague

Septicemic plague, Septicaemic plague is the least common of the three forms, with a mortality rate near 100%. Symptoms are high fevers and purple skin patches (purpura due to disseminated intravascular coagulation). In cases of pneumonic and particularly septicaemic 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.


Consequences


Deaths

There are no exact figures for the death toll; the rate varied widely by locality. In urban centres, the greater the population before the outbreak, the longer the duration of the period of abnormal mortality. It killed some people in Eurasia. The mortality rate of the Black Death in the 14th century was far greater than the worst 20th-century outbreaks of ''Y. pestis'' plague, which occurred in India and killed as much as 3% of the population of certain cities. The overwhelming number of deceased bodies produced by the Black Death caused the necessity of mass burial sites in Europe, sometimes including up to several hundred or several thousand skeletons. The mass burial sites that have been excavated have allowed archaeologists to continue interpreting and defining the biological, sociological, historical, and anthropological implications of the Black Death. According to medieval historian Philip Daileader, it is likely that over four years, 45–50% of the European population died of plague. Norwegian historian Ole Jørgen Benedictow, Ole Benedictow suggests it could have been as much as 60% of the European population. In 1348, the disease 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% of the population to die. Half of Paris' population of 100,000 people died. In Italy, the population of Florence was reduced from between 110,000 and 120,000 inhabitants in 1338 down to 50,000 in 1351. At least 60% of the population of Hamburg and Bremen perished, and a similar percentage of Londoners may have died from the disease as well, with a death toll of approximately 62,000 between 1346 and 1353. Florence's tax records suggest that 80% of the city's population died within four months in 1348. Before 1350, there were about 170,000 settlements in Germany, and this was reduced by nearly 40,000 by 1450. The disease bypassed some areas, with the most isolated areas being less vulnerable to contagious disease, contagion. Plague did not appear in Douai in French Flanders, Flanders until the turn of the 15th century, and the impact was less severe on the populations of County of Hainaut, Hainaut, Medieval Finland, Finland, northern Germany, and areas of Poland. Monks, nuns, and priests were especially hard-hit since they cared for victims of the Black Death. The physician to the Avignon Papacy, Raimundo Chalmel de Vinario (), observed the decreasing mortality rate of successive outbreaks of plague in 1347–48, 1362, 1371, and 1382 in his 1382 treatise ''On Epidemics'' (). In the first outbreak, two thirds of the population contracted the illness and most patients died; in the next, half the population became ill but only some died; by the third, a tenth were affected and many survived; while by the fourth occurrence, only one in twenty people were sickened and most of them survived. By the 1380s in Europe, it predominantly affected children. Chalmel de Vinario recognized that bloodletting was ineffective (though he continued to prescribe bleeding for members of the Roman Curia, whom he disliked), and claimed that all true cases of plague were caused by astrological factors and were incurable; he himself was never able to effect a cure. The most widely accepted estimate for the Middle East, including Iraq, Iran, and Syria, during this time, is for a death toll of about a third of the population. The Black Death killed about 40% of Egypt's population. In Cairo, with a population numbering as many as 600,000, and possibly the largest city west of China, between one third and 40% of the inhabitants died inside of eight months. Italian chronicler Agnolo di Tura recorded his experience from Siena, where plague arrived in May 1348:


Economic

With such a large population decline from the pandemic, wages soared in response to a labour shortage. On the other hand, in the quarter century after the Black Death in England, it is clear many labourers, artisans, and craftsmen, those living from money-wages alone, did suffer a reduction in real incomes owing to rampant inflation. Landowners were also pushed to substitute monetary rents for labour services in an effort to keep tenants.


Environmental

Some historians believe the innumerable deaths brought on by the pandemic cooled the climate by freeing up land and triggering reforestation. This may have led to the Little Ice Age.


Persecutions

Renewed religious fervour and fanaticism bloomed in the wake of the Black Death. Some Europeans targeted "various groups such as Jews, friars, foreigners, beggars, pilgrims", lepers, and Romani people, Romani, blaming them for the crisis. Leprosy, Lepers, and others with skin diseases such as acne or psoriasis, were killed throughout Europe. Because 14th-century healers and governments were at a loss to explain or stop the disease, Europeans turned to astrology, astrological forces, earthquakes, and the poisoning of wells by Jews as possible reasons for outbreaks. Many believed the epidemic was a Divine retribution, punishment by God for their sins, and could be relieved by winning God's forgiveness. There were many attacks against Jewish communities.Black Death
, Jewishencyclopedia.com
In the Strasbourg massacre of February 1349, about 2,000 Jews were murdered. In August 1349, the Jewish communities in Mainz and Cologne were annihilated. By 1351, 60 major and 150 smaller Jewish communities had been destroyed. During this period many Jews relocated to Kingdom of Poland (1025–1385), Poland, where they received a warm welcome from King Casimir III the Great, Casimir the Great.


Social

One theory that has been advanced is that the devastation in Florence caused by the Black Death, which hit Europe between 1348 and 1350, resulted in a shift in the world view of people in 14th-century Italy and led to the Renaissance. Italy was particularly badly hit by the pandemic, and it has been speculated that the resulting familiarity with death caused thinkers to dwell more on their lives on Earth, rather than on spirituality and the afterlife. It has also been argued that the Black Death prompted a new wave of piety, manifested in the Patron#Arts, sponsorship of religious works of art. This does not fully explain why the Renaissance occurred in Italy in the 14th century. The Black Death was a pandemic that affected all of Europe in the ways described, not only Italy. The Renaissance's emergence in Italy was most likely the result of the complex interaction of the above factors, in combination with an Greek scholars in the Renaissance#Contribution of Greek scholars to the Italian Renaissance, influx of Greek scholars following the Fall of Constantinople#Impact on the Renaissance, fall of the Byzantine Empire. As a result of the drastic reduction in the populace the value of the working class increased, and commoners came to enjoy more freedom. To answer the increased need for labour, workers travelled in search of the most favorable position economically. Prior to the emergence of the Black Death, the workings of Europe were run by the Catholic Church and the continent was considered a feudalistic society, composed of fiefs and city-states. The pandemic completely restructured both religion and political forces; survivors began to turn to other forms of spirituality and the power dynamics of the fiefs and city-states crumbled. Cairo's population, partly owing to the numerous plague epidemics, was in the early 18th century half of what it was in 1347. The populations of some Italian cities, notably Florence, did not regain their pre-14th century size until the 19th century. The demographic decline due to the pandemic had economic consequences: the prices of food dropped and land values declined by 30–40% in most parts of Europe between 1350 and 1400. Landholders faced a great loss, but for ordinary men and women it was a windfall. The survivors of the pandemic found not only that the prices of food were lower but also that lands were more abundant, and many of them inherited property from their dead relatives, and this probably destabilized feudalism. The word "quarantine" has its roots in this period, though the concept of isolating people to prevent the spread of disease is older. In the city-state of Republic of Ragusa, Ragusa (modern Dubrovnik, Croatia), a thirty-day isolation period was implemented in 1377 for new arrivals to the city from plague-affected areas. The isolation period was later extended to forty days, and given the name "quarantino" from the Italian word for "forty".


Recurrences


Second plague pandemic

The plague repeatedly returned to haunt Europe and the Mediterranean throughout the 14th to 17th centuries. According to Jean-Noël Biraben, the plague was present somewhere in Europe in every year between 1346 and 1671. (Note that some researchers have cautions about the uncritical use of Biraben's data.) The second plague pandemic, second pandemic was particularly widespread in the following years: 1360–63; 1374; 1400; 1438–39; 1456–57; 1464–66; 1481–85; 1500–03; 1518–31; 1544–48; 1563–66; 1573–88; 1596–99; 1602–11; 1623–40; 1644–54; and 1664–67. Subsequent outbreaks, though severe, marked the retreat from most of Europe (18th century) and northern Africa (19th century). The historian George Sussman argued that the plague had not occurred in East Africa until the 1900s. However, other sources suggest that the Second pandemic did indeed reach Sub-Saharan Africa. According to historian Geoffrey Parker (historian), Geoffrey Parker, "France alone lost almost a million people to the plague in the epidemic of 1628–31." In the first half of the 17th century, a plague claimed some 1.7 million victims in Italy. More than 1.25 million deaths resulted from the extreme incidence of plague in 17th-century Habsburg Spain, Spain. The Black Death ravaged much of the Muslim world, 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 lost 30,000–50,000 inhabitants to it in 1620–21, and again in 1654–57, 1665, 1691, and 1740–42. Cairo suffered more than fifty plague epidemics within 150 years from the plague's first appearance, with the final outbreak of the second pandemic there in the 1840s. Plague remained a major event in Ottoman Empire, Ottoman society until the second quarter of the 19th century. Between 1701 and 1750, thirty-seven larger and smaller epidemics were recorded in
Constantinople la, Constantinopolis ota, قسطنطينيه , alternate_name = Byzantion (earlier Greek name), Nova Roma ("New Rome"), Miklagard/Miklagarth (), Tsargrad (), Qustantiniya (), Basileuousa ("Queen of Cities"), Megalopolis ("the Great City"), Πό ...

Constantinople
, and an additional thirty-one between 1751 and 1800. Baghdad has suffered severely from visitations of the plague, and sometimes two-thirds of its population has been wiped out.


Third plague pandemic

The third plague pandemic (1855–1859) started in China in the mid-19th century, spreading to all inhabited continents and killing 10 million people in India alone. 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 the French-Swiss bacteriologist
Alexandre Yersin Alexandre Emile Jean Yersin (22 September 1863 – 1 March 1943) was a Swiss Swiss may refer to: * the adjectival form of Switzerland *Swiss people Places *Swiss, Missouri *Swiss, North Carolina *Swiss, West Virginia *Swiss, Wisconsin Other u ...
, after whom the pathogen was named. Twelve plague outbreaks in Australia between 1900 and 1925 resulted in well over 1,000 deaths, chiefly in Sydney. This led to the establishment of a Public Health Department there which undertook some leading-edge research on plague transmission from rat fleas to humans via the bacillus ''Yersinia pestis''. The first North American plague epidemic was the San Francisco plague of 1900–1904, followed by another outbreak in 1907–1908.


Modern-day

Modern treatment methods include insecticides, the use of antibiotics, and a Waldemar Haffkine#Anti-plague vaccine, plague vaccine. It is feared that the plague bacterium could develop drug resistance and again become a major health threat. One case of a drug-resistant form of the bacterium was found in Madagascar in 1995. A further outbreak in Madagascar was reported in November 2014. In October 2017 the 21st century Madagascar plague outbreaks, deadliest outbreak of the plague in modern times hit Madagascar, killing 170 people and infecting thousands. An estimate of the case fatality rate for the modern
bubonic plague Bubonic plague is one of three types of plague caused by the plague bacterium Bacteria (; common noun bacteria, singular bacterium) are a type of biological cell The cell (from Latin ''cella'', meaning "small room") is the basic ...
, following the introduction of antibiotics, is 11%, although it may be higher in underdeveloped regions.


In popular culture

* ''A Journal of the Plague Year'' – 1722 book by Daniel Defoe describing the Great Plague of London of 1665–1666 * Black Death (film), ''Black Death'' – a 2010 action horror film set in medieval England in 1348 * The Betrothed (Manzoni novel), ''I promessi sposi'' ("The Betrothed") – a plague novel by Alessandro Manzoni, set in Milan, and published in 1827; turned into an opera by Amilcare Ponchielli in 1856, and adapted for film in 1908, The Betrothed (1941 film), 1941, 1990, and 2004 * ''Cronaca fiorentina di Marchionne di Coppo Stefani, Cronaca fiorentina'' ("Chronicle of Florence") – a literary history of the plague, and of Florence up to 1386, by Baldassarre Bonaiuti * ''Danse Macabre'' ("Dance of Death") – an artistic genre of allegory of the Late Middle Ages on the universality of death * ''The Decameron'' – by Giovanni Boccaccio, finished in 1353. Tales told by a group of people sheltering from the Black Death in Florence. Numerous adaptations to other media have been made * Doomsday Book (novel), ''Doomsday Book'' – a 1992 science fiction novel by Connie Willis * ''A Feast in Time of Plague'' – a verse play by Aleksandr Pushkin (1830), made into A Feast in Time of Plague (opera), an opera by César Cui in 1900 * Four thieves vinegar – a popular French legend supposed to provide immunity to the plague * Geisslerlieder – Medieval "flagellant songs" * "A Litany in Time of Plague" – a sonnet by Thomas Nashe which was part of his play ''Summer's Last Will and Testament'' (1592) * ''The Plague'' – a 1947 novel by Albert Camus, often read as an allegory about Fascism * ''The Seventh Seal'' – a 1957 film written and directed by Ingmar Bergman * ''World Without End (Follett novel), World Without End'' – a 2007 novel by Ken Follett, turned into World Without End (miniseries), a miniseries of the same name in 2012 * ''The Years of Rice and Salt'' – an alternative history novel by Kim Stanley Robinson set in a world in which the plague killed virtually all Europeans


See also

* Second plague pandemic * Black Death in medieval culture * Black Death in England *
Crisis of the Late Middle Ages The Crisis of the Late Middle Ages was a series of events in the fourteenth and fifteenth centuries that ended centuries of Europe Europe is a continent A continent is one of several large landmasses. Generally identified by convent ...
* Flagellant * Globalization and disease * List of epidemics * Timeline of plague


References


Notes


Citations


Bibliography

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Herlihy, D., (1997). ''The Black Death and the Transformation of the West'', Cambridge, Massachusetts: Harvard University Press. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 1st editions 1969. *


Further reading

* Alfano, Vincenzo, and Manuela Sgobbi. "A fame, peste et bello libera nos Domine: An Analysis of the Black Death in Chioggia in 1630." ''Journal of Family History'' (2021): 03631990211000615. * * Bailey, Mark. ''After the Black Death: Economy, society, and the law in fourteenth-century England'' (Oxford University Press, 2021). * Barker, Hannah. "Laying the Corpses to Rest: Grain, Embargoes, and Yersinia pestis in the Black Sea, 1346–48." ''Speculum'' 96.1 (2021): 97-126. * 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. * * Dols, Michael Walters. ''The black death in the Middle East'' (Princeton UP, 2019). * Dols, Michael W. "The comparative communal responses to the Black Death in Muslim and Christian societies." ''Viator'' 5 (1974): 269-288. * Dols, Michael W., and John Norris. "Geographical Origin of the Black Death." ''Bulletin of the History of Medicine'' 52.1 (1978): 112+. * Duncan, Christopher John, and Susan Scott. "What caused the black death?." ''Postgraduate medical journal'' 81.955 (2005): 315-320
online
* Green, Monica H. "The Four Black Deaths" ''American Historical Review'' (Dec 2020) 125#5 pp 1601–1631
abstract
* * Pamuk, Şevket. "The Black Death and the origins of the ‘Great Divergence’across Europe, 1300–1600." ''European Review of Economic History'' 11.3 (2007): 289-317
online
* 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.


External links

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Black Death
at BBC {{Authority control Black Death, Plague pandemics 14th-century health disasters 1340s in Asia 1340s in Europe Eurasian history History of medieval medicine History of the Middle East Medieval health disasters Second plague pandemic 1350s in Europe Causes of death 1350s in Asia ja:ペスト#14世紀の大流行