Medical History: The Black Death

by Dr. Mary Williams, R.N. D.C.

In 1347, death knocked on Europe's door in the form of the bubonic plague. Over the next five years, nearly one third of the entire European population would join the death tally, with more than 20 million people falling victim to the "black death." The people at the time did not understand the disease and how it spread. They also had virtually no options for treatment once the symptoms began. Consequently, the mortality rate for bubonic plague victims during the Middle Ages was as high as 75 percent, depending on other factors such as age and physical location.

Black Death Defined

Black death is synonymous with the bubonic plague, which started out infecting rats. The pathogen that causes bubonic plague is called Yersinia pestis, named for the scientist who discovered it in 1894. In normal conditions, this pathogen lives in the blood stream of rats. A flea on an infected rat may consume the pathogen, which then interferes with the flea's digestive tract. With the resulting blockage in the flea's digestive tract, the flea begins to starve. As the infected flea continues to try to feed on rats, vomiting occurs, leading to the infection of more and more rats. Typically, this transference of the pathogen would remain between fleas and rats. However, during the 14th century, the fleas branched out from their typical diet of rat blood and began biting humans and infecting them. Symptoms of bubonic plague include fever, chills, aches, diarrhea, vomiting, and marked swelling of lymph nodes. Over time, the swelling forms buboes, which eventually turn dark purple or black in color.

• Black Death: Bubonic plague, or black death, involves skin swellings that would discolor. First, the skin would turn red, and then, it would turn a purple-black color.
• Man and Disease: The Black Death: With its concentrated population and the years of famine that had weakened it, Europe was ripe for a disease epidemic as the bubonic plague coursed through this continent during the Middle Ages.
• The Black Death: The black death holds the title of the most devastating pandemic that has occurred in human history. Learn about some of the results of the bubonic plague from the University of Houston's College of Engineering.
• Scientific Causes of the Plague: Explore a discussion of the scientific causes of bubonic plague presented by Brown University. Infected fleas were the cause of black death spreading to and through the human population.
• The Plague Today: Fact Sheet: Yersinia Pestis, or the plague, still exists today. In 2013, it caused 126 deaths worldwide.
• The Black Death: The Disease and its Spread: The spread of the bubonic plague through Europe resulted in horrific scenes as entire towns fell victim to the disease and people struggled to bury the dead in large pits.

History of Black Death

In 1347, ships began arriving in Italian ports from China with entire crews either dead or dying of bubonic plague. Authorities responded by turning the ships back to sea, but they did not act swiftly enough to prevent the black death from entering Italy and spreading throughout Europe. Expansive depopulation occurred as approximately one-third of the entire European population died over the next five years. People tried to avoid the disease by ending contact with others: Doctors refused to see patients, and priests would not perform last rites. Townspeople even tried fleeing to the countryside, but the black death found them there, too.

• The Middle Ages: The Black Death: Boise State University provides an overview of how the black death impacted the Middle Ages in Europe.
• The Black Death and the Jews, 1348-1349: Explore a related component to the black death, which involved allegations of conspiracy between Jews and Christians, as presented by Fordham University.
• Children During the Black Death: As the black death raged through Europe, the society unraveled. Families broke apart, and children were often abandoned as people attempted to flee the disease.
• Overpopulation: The Black Death: Learn how years of abundant agricultural production had bloated the population in England. In total, including all of the outbreaks, the bubonic plague cut England's population by 50 percent.
• The Black Death: Horseman of the Apocalypse in the Fourteenth Century: The bubonic plague originated in China during the 1320s. Eventually, well-traversed trade routes were the avenue by which the plague spread to Europe.
• The Black Death: This report explores the connection of the common children's song "Ring Around the Rosy" with the bubonic plague.

Survivors of the Black Death

The era after the black death was fundamentally different for European people. The influence of the church changed for survivors of the bubonic plague because they had watched the relentless progression of the disease without intervention or protection from God. On the other side of the plague, people were stronger physically, and they began living longer. Municipalities enacted new sanitary practices as a result of the black death to protect people. In the post-plague era, survivors had a new perspective, often showing a greater focus on time and work than people typically had before the plague.

• New Study Sheds Light on Survivors of the Black Death: This report published by the University of South Carolina details how black death survivors were stronger and healthier after the epidemic ended.
• The Black Death and Public Health: Explore the new sanitary practices and health rules that municipalities began following as a result of the black death.
• The Black Death Actually Improved Public Health: The Smithsonian reports that the bubonic plague was instrumental in improving public health because living conditions advanced and life spans lengthened.
• The Black Death in Western Europe: This report summarizes the black death, including the events that led up to it, the epidemic itself, and its aftermath.
• Was the Black Death an Economic Revolution? Explore the effects the black death had on Europe's economy in this report.