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  • The Black Plague

    Black Death


    This article concerns the worldwide pandemic starting in the mid-14th century, with a focus on material available from European records and accounts. For detailed information on the most widely accepted cause of the disease, see bubonic plague.


    The Black Death, also known as the Black Plague, was a devastating pandemic that first struck Europe in the mid-late-14th century (1347?51), killing up to between a third and two thirds of Europe's population, this is around 25 million people. Almost simultaneous epidemics occurred across large portions of Asia and the Middle East during the same period, indicating that the European outbreak was actually part of a multi-regional pandemic. Including Middle Eastern lands, India, and China, the Black Death killed at least 75 million people. The same disease is thought to have returned to Europe every generation with varying degrees of intensity and fatality until the 1700s.Notable later outbreaks include the Italian Plague of 1629-1631, the Great Plague of London (1665?66), the Great Plague of Vienna (1679), the Great Plague of Marseille in 1720-1722 and the 1771 plague in Moscow. The disease was completely eradicated in Europe only at the beginning of the 19th century, but survives in other parts of the world (Central and Oriental Africa, Madagascar, Asia, Americas ? including the United States).

    In addition to its drastic effect on Europe's population, the Black Death irrevocably changed Europe's social structure, was a serious blow to Europe's predominant religious institution (the Roman Catholic Church), resulted in widespread persecution of minorities such as Jews and lepers, and created a general mood of morbidity that influenced people who were uncertain of their daily survival to live for the moment, illustrated by Giovanni Boccaccio in The Decameron (1353).The initial fourteenth-century European event was called the "Great Mortality" by contemporary writers and, with later outbreaks, became known as the "Black Death". It has been popularly thought that the name came from a striking symptom of the disease, called acral necrosis, in which sufferers' skin would blacken due to subdermal haemorrhages. However, the term refers in fact to the figurative sense of "black" (glum, lugubrious or dreadful) Stéphane Barry and Norbert Gualde, "The Biggest Epidemics of History" (La plus grande épidémie de l'histoire, in L'Histoire n°310, June 2006, pp.38 (article from pp.38 to 49, the whole issue is dedicated to the Black Plague, pp.38-60) . Historical records have convinced most scientists that the Black Death was an outbreak of bubonic plague, caused by the bacterium Yersinia pestis and spread by fleas with the help of animals like the black rat (Rattus rattus), but there are some scientists who question this.

    Pattern of the pandemic

    The plague disease, caused by Yersinia pestis, is endemic in populations of ground rodents in central Asia, but it is not entirely clear where the fourteenth-century pandemic started. The most popular theory places the first cases in the steppes of central Asia, though some speculate that it originated around northern India. From there, supposedly, it was carried east and west by traders and Mongol armies along the Silk Road, and was first exposed to Europe at trading ports in Sicily.

    Whether or not this theory is accurate, it is clear that several pre-existing conditions such as war, famine, and weather contributed to the severity of the Black Death. A devastating civil war in China between the established Chinese population and the Mongol hordes raged between 1205 and 1353. This war disrupted farming and trading patterns, and led to episodes of widespread famine. A so-called "Little Ice Age" had begun at the end of the thirteenth century. The disastrous weather reached a peak in the first half of the fourteenth century with severe results worldwide.

    In the years 1315 to 1322 a catastrophic famine, known as the Great Famine, struck all of Northern Europe. Food shortages and sky-rocketing prices were a fact of life for as much as a century before the plague. Wheat, oats, hay and consequently livestock were all in short supply; and their scarcity resulted in hunger and malnutrition. The result was a mounting human vulnerability to disease due to weakened immune systems. The European economy entered a vicious circle in which hunger and chronic, low-level debilitating disease reduced the productivity of labourers, and so the grain output suffered, causing the grain prices to increase. The famine was self-perpetuating, impacting life in places like Flanders and Burgundy as much as the Black Death was later to impact all of Europe.

    A typhoid epidemic was to be a predictor of the coming disaster. Many thousands died in populated urban centres, most significantly Ypres. In 1318 a pestilence of unknown origin, sometimes identified as anthrax, hit the animals of Europe. The disease targeted sheep and cattle, further reducing the food supply and income of the peasantry and putting another strain on the economy. The increasingly international nature of the European economies meant that the depression was felt across Europe. Due to pestilence, the failure of England's wool exports led to the destruction of the Flemish weaving industry. Unemployment bred crime and poverty.

    Asian outbreak


    The Central Asian scenario agrees with the first reports of outbreaks in China in the early 1330s. The plague struck the Chinese province of Hubei in 1334. During 1353?54, more widespread disaster occurred. Chinese accounts of this wave of the disease record a spread to eight distinct areas: Hubei, Jiangxi, Shanxi, Hunan, Guangdong, Guangxi, Henan and Suiyuan (a historical Chinese province that now forms part of Hebei and Inner Mongolia), throughout the Mongol and Chinese empires. Historian William McNeill noted that voluminous Chinese records on disease and social disruption survive from this period, but no one has studied these sources in depth.

    It is probable that the Mongols and merchant caravans inadvertently brought the plague from central Asia to the Middle East and Europe. The plague was reported in the trading cities of Constantinople and Trebizond in 1347. In that same year, the Genoese possession of Caffa, a great trade emporium on the Crimean peninsula, came under siege by an army of Mongol warriors under the command of Janibeg, backed by Venetian forces. After a protracted siege during which the Mongol army was reportedly withering from the disease, they might have decided to use the infected corpses as a biological weapon. The corpses were catapulted over the city walls, infecting the inhabitants.
    Svat Soucek. A History of Inner Asia. Cambridge University Press, 2000. ISBN 0521657040. P. 116.
    The Genoese traders fled, transferring the plague via their ships into the south of Europe, from whence it rapidly spread. According to accounts, so many died in Caffa that the survivors had little time to bury them and bodies were stacked like cords of firewood against the city walls.

    European outbreak


    The Black Death rapidly spread along the major European sea and land trade routes.

    In October 1347, a fleet of Genovese trading ships fleeing Caffa reached the port of Messina. By the time the fleet reached Messina, all the crew members were either infected or dead. It is presumed that the ships also carried infected rats and/or fleas. Some ships were found grounded on shorelines, with no one aboard remaining alive. Looting of these lost ships also helped spread the disease. From there, the plague spread to Genoa and Venice by the turn of 1347/1348.

    From Italy the disease spread northwest across Europe, striking France, Spain, Portugal and England by June 1348, then turned and spread east through Germany and Scandinavia from 1348 to 1350, and finally to north-western Russia in 1351. However, the plague largely spared some parts of Europe, including the Kingdom of Poland and parts of Belgium and the Netherlands.

    Middle Eastern outbreak


    The plague struck various countries in the Middle East during the pandemic, leading to serious depopulation and permanent change in both economic and social structures. The disease first entered the region from southern Russia. By autumn 1347, the plague reached Alexandria in Egypt, probably through the port's trade with Constantinople and ports on the Black Sea. During 1348, the disease travelled eastward to Gaza, and north along the eastern coast to cities in Lebanon, Syria and Palestine, including Asqalan, Acre, Jerusalem, Sidon, Damascus, Homs, and Aleppo. In 1348?49, the disease reached Antioch. The city's residents fled to the north, most of them dying during the journey, but the infection had been spread to the people of Asia Minor.

    Mecca became infected in 1349. The people of Mecca blamed the disease on non-believers entering the city, but it is more likely to have arrived with Muslim pilgrims from surrounding infected areas. During the same year, records show the city of Mawsil (Mosul) suffered a massive epidemic, and the city of Baghdad experienced a second round of the disease. In 1351, Yemen experienced an outbreak of the plague. This coincided with the return of King Mujahid of Yemen from imprisonment in Cairo. His party may have brought the disease with them from Egypt.

    Recurrence


    The plague repeatedly returned to haunt Europe and the Mediterranean throughout the fourteenth to seventeenth centuries, and although the bubonic plague still exists with isolated cases today, the Great Plague of London in 1665-1666 is generally recognized as one of the last major outbreaks. The Great Fire of London in 1666 may have killed off any remaining plague bearing rats and fleas, which led to a decline in the plague. The destruction of black rats in the Great Fire may also have contributed to the ascendancy of brown rats in England. According to the bubonic plague theory, one possible explanation for the disappearance of plague from Europe may be that the black rat (Rattus rattus) infection reservoir and its disease vector was subsequently displaced and succeeded by the bigger Norwegian, or brown, rat (Rattus norvegicus), which is not as prone to transmit the germ-bearing fleas to humans in large rat die-offs (see Appleby and Slack references below).

    Late outbreaks in central Europe include the Italian Plague of 1629-1631, which is associated with troop movements during the Thirty Years' War, and the Great Plague of Vienna in 1679, which may have been due to a reintroduction of the plague from eastern trading ports.

    Causes


    Bubonic plague theory


    Bubonic and septicaemic plague are transmitted by direct contact with fleas. The bacteria multiply inside a flea, blocking its stomach and causing it to become very hungry. The flea then voraciously bites a host and continues to feed because it is unable to satisfy its hunger. During the feeding process, infected blood carrying the plague bacteria flows into the wound. The plague bacteria then has a new host, and the flea eventually dies from starvation.

    The human pneumonic plague has a different form of transmission. It is transmitted through bacteria in droplets of saliva coughed up by persons with bloodstream infection (sepsis) or pneumonia, which may have started as the bubonic form of disease. The airborne bacteria may be inhaled by a nearby susceptible person, and a new infection starts directly in the lungs or throat of the other, bypassing the bubonic form of disease.

    The ecology of Yersinia pestis in soil, rodent and (possibly & importantly) human ectoparasites are reviewed and summarized by Michel Drancourt in a model of sporadic, limited and large plague outbreaks [1]. Modelling of epizootic plague observed in prairie dogs suggests that occasional reservoirs of infection such as an infectious carcass, rather than 'blocked fleas' are a better explanation for the observed epizootic behaviour of the disease in nature [2].

    An interesting hypothesis about the appearance, spread and especially disappearance of plague from Europe is that the flea-bearing rodent reservoir of disease was eventually succeeded by another species. The black rat (Rattus rattus) was originally introduced from Asia to Europe by trade, but was subsequently displaced and succeeded throughout Europe by the bigger Norwegian or brown rat (Rattus norvegicus). The brown rat was not as prone to transmit the germ-bearing fleas to humans in large die-offs due to a different rat ecology (see Appleby and Slack, secondary references below). The dynamic complexities of rat ecology, herd immunity in that reservoir, interaction with human ecology, secondary transmission routes between humans with or without fleas, human herd immunity and changes in each might explain the eruption, dissemination, and re-eruptions of plague that continued for centuries until its (even more) unexplained disappearance.

    Signs and symptoms


    The three forms of plague brought an array of signs and symptoms to those infected. Bubonic plague refers to the painful lymph node swellings called buboes. The septicaemic plague is a form of blood poisoning, and pneumonic plague is an airborne plague that forms a first attack on the lungs. The classic sign of bubonic plague was the appearance of buboes in the groin and armpits, which ooze pus and blood. Victims underwent damage to the skin and underlying tissue until they were covered in dark blotches. This symptom is called acral necrosis. Most victims died within four to seven days after infection. When the plague reached Europe, it first struck port cities and then followed the trade routes, both by sea and land.

    The bubonic plague was the most commonly seen form during the Black Death, with a mortality rate of thirty to seventy-five percent and symptoms including fever of 38 - 41 °C (101-105 °F), headaches, aching joints, nausea and vomiting, and a general feeling of malaise. The pneumonic plague was the second most commonly seen form during the Black Death, with a mortality rate of ninety to ninety-five percent. Symptoms included slimy sputum tinted with blood. As the disease progressed, sputum became free flowing and bright red. Septicaemic plague was the most rare of the three forms, with mortality close to one hundred percent. Symptoms were high fevers and skin turning deep shades of purple due to DIC (Disseminated intravascular coagulation).

    Alternative explanations


    Recent scientific and historical investigations have led some researchers to doubt the long-held belief that the Black Death was an epidemic of bubonic plague. For example, in 2000, Gunnar Karlsson (Iceland's 1100 Years: The History of a Marginal Society) pointed out that the Black Death killed between half and two-thirds of the population of Iceland, although there were no rats in Iceland at this time. Rats were accidentally introduced in the nineteenth century, and have never spread beyond a small number of urban areas attached to seaports. In the fourteenth century there were no urban settlements in Iceland. Iceland was unaffected by the later plagues which are known to have been spread by rats.

    In addition, it was previously argued that tooth pulp tissue from a fourteenth-century plague cemetery in Montpellier tested positive for molecules associated with Y. pestis. However, such a finding was never confirmed in any other cemetery, nor were any DNA samples recovered. In September 2003, a team of researchers from Oxford University tested 121 teeth from sixty-six skeletons found in fourteenth-century mass graves. The remains showed no genetic trace of Y. pestis, and the researchers suspect that the Montpellier study was flawed.

    In 1984, Graham Twigg published The Black Death: A Biological Reappraisal, where he argued that the climate and ecology of Europe and particularly England made it nearly impossible for rats and fleas to have transmitted bubonic plague. Combining information on the biology of Rattus rattus, Rattus norvegicus, and the common fleas Xenopsylla cheopis and Pulex irritans with modern studies of plague epidemiology, particularly in India, where the R. rattus is a native species and conditions are nearly ideal for plague to be spread, Twigg concludes that it would have been nearly impossible for Y. pestis to have been the causative agent of the beginning of the plague, let alone its explosive spread across all of Europe. Twigg also shows that the common theory of entirely pneumonic spread does not hold up. He proposes, based on a re-examination of the evidence and symptoms, that the Black Death may actually have been an epidemic of pulmonary anthrax caused by Bacillus anthracis.

    In 2001, epidemiologists Susan Scott and Christopher Duncan from Liverpool University proposed the theory that the Black Death might have been caused by an Ebola-like virus, not a bacterium. Their rationale was that this plague spread much faster and the incubation period was much longer than other confirmed Yersinia pestis plagues. A longer period of incubation will allow carriers of the infection to travel farther and infect more people than a shorter one. When the primary vector is humans, as opposed to birds, this is of great importance. Studies of English church records indicate an unusually long incubation period in excess of thirty days, which could account for the rapid spread, topping at 5 km/day. The plague also appeared in areas of Europe where rats were uncommon like Iceland. Epidemiological studies suggest the disease was transferred between humans (which happens rarely with Yersinia pestis and very rarely for Bacillus anthracis), and some genes that determine immunity to Ebola-like viruses are much more widespread in Europe than in other parts of the world. Their research and findings are thoroughly documented in Return of the Black Death: The World's Greatest Serial Killer. More recently the researchers have published computer modeling (Journal of Medical Genetics: March 2005) demonstrating how the Black Death has made around 10% of Europeans resistant to HIV.

    In a similar vein, historian Norman F. Cantor, in his 2001 book In the Wake of the Plague, suggests the Black Death might have been a combination of pandemics including a form of anthrax, a cattle murrain. He cites many forms of evidence including: reported disease symptoms not in keeping with the known effects of either bubonic or pneumonic plague, the discovery of anthrax spores in a plague pit in Scotland, and the fact that meat from infected cattle was known to have been sold in many rural English areas prior to the onset of the plague. It is notable that the means of infection varied widely, from human-to-human contact as in Iceland (rare for plague and cutaneous Bacillus anthracis) to infection in the absence of living or recently-dead humans, as in Sicily (which speaks against most viruses). Also, diseases with similar symptoms were generally not distinguished between in that period (see murrain above), at least not in the Christian world; Chinese and Muslim medical records can be expected to yield better information which however only pertains to the specific disease(s) which affected these areas.
    See ISBN 0060014342

    Counter-arguments


    Still, the majority of historians support the theory that the bubonic plague caused the black death, so counterarguments have been developed.

    The uncharacteristically rapid spread of the plague could be due to respiratory droplet transmission, and low levels of immunity in that period's European population. Historical examples of pandemics of other diseases in populations without previous exposure, such as smallpox and tuberculosis transmitted by aerosol amongst Native Americans, show that the low levels of inherited adaptation to the disease cause the first epidemic to spread faster and to be far more virulent than later epidemics among the descendants of survivors. Also, the plague returned again and again and was regarded as the same disease through succeeding centuries into modern times when the Yersinia bacterium was identified.

    Consequences
    Depopulation



    Information about the death toll varies widely by area and from source to source. Approximately twenty five million deaths occurred in Europe alone , with many others occurring in northern Africa, the Middle East and Asia.
    Asia
    Estimates of the demographic impact of the plague in Asia are based on both population figures during this time and estimates of the disease's toll on population centres. The initial outbreak of plague in the Chinese province of Hubei in 1334 claimed up to ninety percent of the population, an estimated five million people. During 1353?54, outbreaks in eight distinct areas throughout the Mongol/Chinese empires may have caused the death of two-thirds of China's population, often yielding an estimate of twenty-five million deaths.

    Europe and Middle East


    It is estimated that between one-third and two-thirds of the European population died from the outbreak between 1348 and 1350. Contemporary observers estimated the toll to be one-third (e.g. Froissart), but modern estimates range from one-half to two-thirds of the population Stéphane Barry and Norbert Gualde, "The Biggest Epidemics of History" (La plus grande épidémie de l'histoire, in L'Histoire n°310, June 2006, pp.45-46 . As many as 25% of all villages were depopulated, mostly the smaller communities, as the few survivors fled to larger towns and cities . The Black Death hit the culture of towns and cities disproportionately hard, although rural areas (where 90% of the population lived ) were also significantly affected. A few rural areas, such as Eastern Poland and Lithuania, had such low populations and were so isolated that the plague made little progress. Parts of Hungary and, in modern Belgium, the Brabant region, Hainaut and Limbourg, as well as Santiago de Compostella, were unaffected for unknown reasons (some historians have assumed that the presence of sanguine groups in the local population helped them resist the disease, although these regions would be touched by the second plague burst in 1360-1363 and later during the numerous resurgences of the plague) . Other areas which escaped the plague were isolated mountainous regions (e.g. the Pyrenees). Larger cities were the worst off, as population densities and close living quarters made disease transmission easier. Cities were also strikingly filthy, infested with lice, fleas and rats, and subject to diseases related to malnutrition and poor hygiene. According to journalist John Kelly, "(w)oefully inadequate sanitation made medieval urban Europe so disease-ridden, no city of any size could maintain its population without a constant influx of immigrants from the countryside." (p. 68) The influx of new citizens facilitated the movement of the plague between communities, and contributed to the longevity of the plague within larger communities.

    In Italy, Florence's population passed from 110 000 or 120 000 inhabitants in 1338 to 50 000 in 1351. Between 60 to 70% of Hambourg or Bremen's population died. In Provence, Dauphiné or Normandy, historians observe a decrease of 60% of fiscal hearths. In some regions, two thirds of the population was annihilated. In the town of Givry, in the Bourgogne region in France, the friar, who used to note 28 to 29 funerals a year, recorded 649 deaths in 1348, half of them in September. About half of Perpignan's population died in several months (only two of the eight physicians survived the plague). England lost 70% of its population, which passed from 7 million to 2 million in 1400 .

    All social classes were affected, although the lower classes, living together in unhealthy places, were most vulnerable. Alfonso XI of Castile was the only royal victim of the plague, but Peter IV of Aragon lost his wife, his daughter and a niece in six months. The Byzantine Emperor lost his son, while in the kingdom of France, Joan of Navarre, daughter of Louis X le Hutin and of Margaret of Burgundy, was killed by the plague, as well as Bonne of Luxembourg, the wife of the future John II of France.

    Furthermore, resurgences of the plague in latter years must also be counted: in 1360-62 (the "little mortality"), in 1366-1369, 1374-1375, 1400, 1407, etc. The plague was not eradicated until the 19th century.

    The precise demographic impact of the disease in the Middle East is very difficult to calculate. Mortality was particularly high in rural areas, including significant areas of Palestine and Syria. Many surviving rural people fled, leaving their fields and crops, and entire rural provinces are recorded as being totally depopulated. Surviving records in some cities reveal a devastating number of deaths. The 1348 outbreak in Gaza left an estimated 10,000 people dead, while Aleppo recorded a death rate of 500 a day during the same year. In Damascus, at the disease's peak in September and October 1348, a thousand deaths were recorded every day, with overall mortality estimated at between twenty-five and thirty-eight percent. Syria lost a total of 400,000 people by the time the epidemic subsided in March 1349. In contrast to some higher mortality estimates in Asia and Europe, scholars believe the mortality rate in the Middle East was less than one-third of the total population, with higher rates in selected areas.

    Socio-economic effects


    The governments of Europe had no apparent response to the crisis because no one knew its cause or how it spread. Most monarchs instituted measures that prohibited exports of foodstuffs, condemned black market speculators, set price controls on grain, and outlawed large-scale fishing. At best, they proved mostly unenforceable, and at worst they contributed to a continent-wide downward spiral. The hardest hit lands, like England, were unable to buy grain abroad: from France because of the prohibition, and from most of the rest of the grain producers because of crop failures from shortage of labour. Any grain that could be shipped was eventually taken by pirates or looters to be sold on the black market. Meanwhile, many of the largest countries, most notably England and Scotland, had been at war, using up much of their treasury and exacerbating inflation. In 1337, on the eve of the first wave of the Black Death, England and France went to war in what would become known as the Hundred Years' War, further depleting their treasuries, population, and infrastructure. Malnutrition, poverty, disease and hunger, coupled with war, growing inflation and other economic concerns made Europe in the mid-fourteenth century ripe for tragedy.

    The plague did more than just devastate the medieval population; it caused a substantial change in economy and society in all areas of the world. Economic historians like Fernand Braudel have concluded that Black Death exacerbated a recession in the European economy that had been under way since the beginning of the century. As a consequence, social and economic change greatly accelerated during the fourteenth and fifteenth centuries. The church's power was weakened, and in some cases, the social roles it had played were replaced by secular ones. Also the plague led to peasant uprisings in many parts of Europe, such as France (the Jacquerie rebellion), Italy (the Ciompi rebellion, which swept the city of Florence), and in England (the English Peasant Revolt).

    Europe had been overpopulated before the plague, and a reduction of 30% to 50% of the population could have resulted in higher wages and more available land and food for peasants because of less competition for resources. However, for reasons that are still debated, population levels in fact continued to decline until around 1420 and did not begin to rise again until 1470, so the initial Black Death event on its own does not entirely provide a satisfactory explanation to this extended period of decline in prosperity. See Medieval demography for a more complete treatment of this issue and current theories on why improvements in living standards took longer to evolve.

    The great population loss brought economic changes based on increased social mobility, as depopulation further eroded the peasants' already weakened obligations to remain on their traditional holdings. In Western Europe, the sudden scarcity of cheap labour provided an incentive for landlords to compete for peasants with wages and freedoms, an innovation that, some argue, represents the roots of capitalism, and the resulting social upheaval caused the Renaissance and even Reformation. In many ways the Black Death improved the situation of surviving peasants. In Western Europe, because of the shortage of labour they were in more demand and had more power, and because of the reduced population, there was more fertile land available; however, the benefits would not be fully realized until 1470, nearly 120 years later, when overall population levels finally began to rise again.

    In Eastern Europe, by contrast, renewed stringency of laws tied the remaining peasant population more tightly to the land than ever before through serfdom. Sparsely populated Eastern Europe was less affected by the Black Death and so peasant revolts were less common in the fourteenth and fifteenth centuries, not occurring in the east until the sixteenth through nineteenth centuries. Since it is believed to have in part caused the social upheavals of fourteenth- and fifteenth-century Western Europe, some see the Black Death as a factor in the Renaissance and even the Reformation in Western Europe. Therefore, historians have cited the smaller impact of the plague as a contributing factor in Eastern Europe's failure to experience either of these movements on a similar scale. Extrapolating from this, the Black Death may be seen as partly responsible for Eastern Europe's considerable lag in scientific and philosophical advances as well as in the move to liberalise government by restricting the power of the monarch and aristocracy. A common example is that England is seen to have effectively ended serfdom by 1550 while moving towards more representative government; meanwhile, Russia did not abolish serfdom until an autocratic tsar decreed so in 1861.

    On top of all this, the plague's great population reduction brought cheaper land prices, more food for the average peasant, and a relatively large increase in per capita income among the peasantry, if not immediately, in the coming century. However, the upper class often attempted to stop these changes, initially in Western Europe, and more forcefully and successfully in Eastern Europe, by instituting laws which barred the peasantry from certain actions or material goods. A good example of this is the Sumptuary laws which were passed throughout Europe which regulated what people (particularly of the peasant class) could wear, so that nobles could ensure that peasants did not begin to dress and act as a higher class member with their increased wealth. Another tactic was to fix prices and wages so that peasants could not demand more with increasing value. This was met with varying success depending on the amount of rebellion it inspired; such a law was one of the causes of England's 1381 Peasants' Revolt.

    Persecutions


    As with other natural and man-made social disasters, renewed religious fervour and fanaticism bloomed in the wake of Black Death, targeting "various groups such as Jews, friars, foreigners, beggars, pilgrims and Muslims" David Nirenberg, Communities of Violence, op.cit. , as well as lepers.

    Because Jews had a religious obligation to be clean, they did not use water from public wells. Thus Jews were suspected of causing the plague by deliberately poisoning wells. Typically, comparatively fewer Jews died from the Black Death, in part due to rabbinical laws that called for a lifestyle that was, in general, cleaner than that of a typical medieval villager, and because of isolation in Jewish ghettos; this difference in mortality rate raised the suspicion of people who at that time had no concept of bacterial transmission. Jews were sometimes believed to have invoked the anger of God and it was believed that their sins were the main reason for the plague. Fierce pogroms frequently resulted in the death or banishment of most of the Jews in a town or city. By 1351, sixty major and 150 smaller Jewish communities had been exterminated, and more than 350 separate massacres had occurred. This persecution was often not merely out of religious hatred, but also as a way of attacking the kings or Church who protected the Jews (Jews were often called the King's property) as a way of lashing out at the institutions that had failed them. An important legacy of the Black Death was to cause the eastward movement of what was left of north European Jewry to Poland and Russia, where it remained until the twentieth century.

    Lepers were also singled out and persecuted, indeed exterminated throughout Europe. Anyone with a skin disease such as acne or psoriasis was thought to be a leper, and leprosy was believed to be an outward sign of an inner defect of the soul. In essence Jews and lepers were persecuted because they became scapegoats for the disasters of society.
    R.I. Moore, The Formation of a Persecuting Society, Oxford, 1987 ISBN 0631171452David Nirenberg, Communities of Violence, 1998, ISBN 069105889X
    Religion

    Flagellants practiced self-flogging (whipping of oneself) to atone for sins. The movement became popular after general disillusionment with the church's reaction to the Black Death.

    The Black Death led to cynicism toward religious officials who could not keep their promises of curing plague victims and banishing the disease. No one, the Church included, was able to cure or even explain the plague. In fact, most thought it spread somehow through air, calling it miasma. This increased doubt in the clergy's abilities. Extreme alienation with the church culminated in either support for different religious groups such as the flagellants, which grew tremendously during the opening years of the Black Death, or to an increase in interest for more secular alternatives to problems facing European society and an increase of secular politicians.

    The Black Death hit the monasteries very hard because of their close quarters and their kindness in helping the sick, so that there was a severe shortage of clergy after the epidemic cycle. This resulted in a mass influx of new clergy members, most of whom did not share the life-long convictions and experiences of the veterans they replaced. This resulted in abuses by the clergy in years afterwards and a further deterioration of the position of the Church in the eyes of the people.

    Other effects


    Inspired by Black Death, Danse Macabre is an allegory on the universality of death and a common painting motif in late-medieval periods.

    After 1350, European culture in general turned very morbid. The general mood was one of pessimism, and the art turned dark with representations of death. The Dies Irae was created in this period as was the popular poem La Danse Macabre and the instructive and popular Ars moriendi ("the art of dying"). See also The Decameron.

    The practice of alchemy as medicine, previously considered the norm for most doctors, slowly began to wane as the citizenry began to realize that it seldom affected the progress of the epidemic and that some of the potions and "cures" used by many alchemists only helped to worsen the condition of the sick. Liquor (distilled alcohol), originally made by alchemists, was commonly applied as a remedy for the Black Death, and, as a result, the consumption of liquor in Europe rose dramatically after the plague.

    In 2006 a scientific study by Dr Thomas van Hoof (Utrecht University) suggests the Black Death contributed to the Little Ice Age. Pollen and leaf data, collected from lake-bed sediments in the southeast Netherlands, supports the idea that millions of trees sprang up on abandoned farmland soaking up carbon dioxide from the atmosphere and thus cooling the planet. The line of research is new and there are questions and further research is needed, but it does pose an interesting theory that man-caused climate change is older than current theories suggest. [3]

    A theory put forth by Stephen O'Brien says the Black Death is likely responsible, through natural selection, for the high frequency of the CCR5-D32 genetic defect in people of European descent. The gene affects T cell function and provides protection against HIV, smallpox, and possibly plague [4], though for the latter, no explanation as to how it would do that exists.


  • #2
    Re: The Black Plague

    Thank you for posting this Jonesie. This part is particularly relevant today regarding the "blame game" that is starting against Indonesia.

    Let us not follow in the path of spiritual corruption and degradation of our values.

    Let us change the course of history. The path of compassion, understanding, kindness, humility, and charity will lead to the salvation of many from a pandemic or series of epidemics.




    Persecutions


    As with other natural and man-made social disasters, renewed religious fervour and fanaticism bloomed in the wake of Black Death, targeting "various groups such as Jews, friars, foreigners, beggars, pilgrims and Muslims" David Nirenberg, Communities of Violence, op.cit. , as well as lepers.

    Because Jews had a religious obligation to be clean, they did not use water from public wells. Thus Jews were suspected of causing the plague by deliberately poisoning wells. Typically, comparatively fewer Jews died from the Black Death, in part due to rabbinical laws that called for a lifestyle that was, in general, cleaner than that of a typical medieval villager, and because of isolation in Jewish ghettos; this difference in mortality rate raised the suspicion of people who at that time had no concept of bacterial transmission. Jews were sometimes believed to have invoked the anger of God and it was believed that their sins were the main reason for the plague. Fierce pogroms frequently resulted in the death or banishment of most of the Jews in a town or city. By 1351, sixty major and 150 smaller Jewish communities had been exterminated, and more than 350 separate massacres had occurred. This persecution was often not merely out of religious hatred, but also as a way of attacking the kings or Church who protected the Jews (Jews were often called the King's property) as a way of lashing out at the institutions that had failed them. An important legacy of the Black Death was to cause the eastward movement of what was left of north European Jewry to Poland and Russia, where it remained until the twentieth century.

    Lepers were also singled out and persecuted, indeed exterminated throughout Europe. Anyone with a skin disease such as acne or psoriasis was thought to be a leper, and leprosy was believed to be an outward sign of an inner defect of the soul. In essence Jews and lepers were persecuted because they became scapegoats for the disasters of society.
    R.I. Moore, The Formation of a Persecuting Society, Oxford, 1987 ISBN 0631171452David Nirenberg, Communities of Violence, 1998, ISBN 069105889X
    Religion
    Last edited by sharon sanders; March 15, 2007, 08:24 PM. Reason: typo

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    • #3
      Re: The Black Plague

      Well said Florida !

      Comment


      • #4
        THE FIRST 3 BUBONIC PLAGUE PANDEMICS

        The Pandemic of 541?750

        Life and Afterlife of the First Plague Pandemic

        Lester K. Little

        In the summer of 541 AD a deadly infectious disease broke out in the Egyptian port city of Pelusium, located on the eastern edge of the Nile delta. It quickly spread eastward along the coast to Gaza and westward to Alexandria. By the following spring it had found its way to Constantinople, capital of the Roman Empire. Syria, Anatolia, Greece, Italy, Gaul, Iberia, and North Africa: none of the lands bordering the Mediterranean escaped it. Here and there, it followed river valleys or overland routes and thus penetrated far into the interior, reaching, for example, as far east as Persia or as far north, after another sea-crossing, as the British Isles.

        The disease remained virulent in these lands for slighty more than two centuries, although it never settled anywhere for long. Instead, it came and went, and as is frequently the case with unwelcome visitors, its appearances were unannounced. Overall, there was not a decade in the course of those two centuries when it was not inflicting death somewhere in the Mediterranean region. In those places where it appeared several times, the intervals between recurrences ranged from about six to twenty years. And then, in the middle of the eighth century, it vanished with as little ceremony as when it first arrived.

        Thus did bubonic plague make its first appearance on the world historical scene. Diagnosis of historical illnesses on the basis of descriptions in ancient texts can rarely be made with compelling certainty because all infectious diseases involve fever and the other symptoms tend not to be exclusive to particular diseases. Plague, however, is a major exception because of the unmistakable appearance of buboes on most of its victims, those painful swellings of the lymph nodes that appear in the groin, in the armpit, or on the neck just below the ear. Taken together, the dozens of epidemics of this disease that broke out throughout the Mediterranean basin and its hinterlands between the mid-sixth and mid-eighth centuries constitute the first historically documented pandemic of plague, the first of three.


        THE THREE PANDEMICS


        What came before were lethal epidemics to be sure, but of diseases that still lack generally agreed-upon diagnoses. The most notable of these were the ?plague? at Athens in 430 BC described by Thucydides, in which Pericles died, the Antonine Plague in Galen?s time that stretched over much of the Roman Empire between 169 and 194, in which Marcus Aurelius died, and that of a century later, between 250 and 270, in which another emperor, Claudius Gothicus, died. Smallpox, typhus, and measles were most likely the diseases involved in those epidemics. Meanwhile Greek and Roman medical writers, who commented on and anthologized the works of Hippocrates, apparently knew of plague, if only as an endemic disease. [B]In the works compiled by such writers as Aretaeus of Cappadocia (mid-first century AD), Rufus of Ephesus (late first century AD), and Oribasius (late fourth century AD), plague appears not as a disease experienced or observed, but as one heard about from the far side of the Mediterranean. They made frequent reference to cases in Egypt and Libya, less often in Syria, in which the sick and deceased had malignant buboes. Thus the presence of endemic plague in the ancient Near East centuries before the outbreak at Pelusium appears reasonably well attested. Then, when the disease did appear in full view of literate observers beginning in 541, some of these individuals gave convincingly precise descriptions of plague symptoms. And as this debut took place during the reign of the Emperor Justinian, Byzantinists especially refer to this outbreak as the ?Plague of Justinian? or the ?Justinianic Plague.?


        The second pandemic, well known to all readers of history as the ?Black Death,? erupted in Central Asia in the 1330s, reached the Crimea by 1346, and then moved on the following year to Constantinople and thence to ports all around the Mediterranean. It spread more widely and moved further inland than it had eight hundred years before, for example, by reaching Scandinavia and also far into the Arabian peninsula for the first time. For more than a century and a half it continued to recur with notable regularity, but then became sporadic, though still deadly, vanishing from Europe in 1772, but lingering in the Near East until the 1830s.

        The third pandemic broke out in China in the second half of the nineteenth century. It reached massive proportions and gained world attention in 1894 when it struck Canton and Hong Kong. While Europe, which so suffered from the Black Death, has barely ever been touched by this third, nameless pandemic, the disease has found its way to much of the rest of the world, excluding the polar regions but including the United States. Where sailing ships of the Age of Exploration, which fell within the time period of the second pandemic, failed to export plague to the New World, the speedier steamship succeeded. Plague crossed the Pacific to Honolulu and from there to San Francisco in 1899, and a gigantic disease pool has since developed among the wild rodent and small ground-mammal populations of the western, especially the southwestern, states. Modern medicine has for the most part successfully isolated the occasional outbreaks of plague, and yet the disease shows no signs of going away.

        Besides reaching the Western Hemisphere, the third pandemic gave occasion for the identification of the pathogen. In the years preceding its outbreak, the new science of microbiology had taken hold, most famously in the rival French and German schools of Louis Pasteur in Paris and of Robert Koch in Berlin. When word of the outbreak of plague in 1894 at Hong Kong spread, Shibasaburo Kitasato of Tokyo, a student of Koch, rushed to the scene, as did Alexandre Yersin, a Pasteur student who was then working in French Indochina. An intensely competitive race ensued. Although Kitasato was the first to claim victory, the scientific community eventually awarded that claim to Yersin. The bacillus he isolated and described was duly named Yersinia pestis. Between 1894 and 1897 Yersin developed the first anti-plague serum for vaccinations, and by 1898 his colleague Paul-Louis Simond had unraveled the nexus of bacilli, fleas, and rats while doing research in Bombay. He found the chief vector of Yersinia to be a flea, Xenopsylla cheopis, whose preferred hosts in turn were rats, either Rattus rattus, the common stay-at-home black rat, or Rattus norvegicus, the sea-going brown wharf rat. Contrary to the long-held assumption that plague is a contagious disease, it is most commonly by the bite of a rat flea that the highly toxic substance gets injected into a human being and drains into a lymph node. Multiplying rapidly, it there forms the painful swelling known as a bubo. Once fatal to slightly more than half the people who contracted it, plague in recent decades has become routinely curable, if timely diagnosis and medical supplies permit, preferably by streptomycin, gentamycin, cloramphenicol, or tetracycline.

        Can we be certain that the same disease was at play in all three pandemics? Or, to be more precise, can we be certain that Y. pestis was the causal agent of either or both of the first two, pre-microbiology pandemics? This question rarely came up at all during most of the twentieth century. Medical experts in the years around 1900, starting with Yersin himself in the very paper of 1894 in which he announced his discovery, declared that both the Black Death and the earlier pandemic were caused by the same plague bacillus as the one they could see under their microscopes. To make such historical assertions, they had not scrambled to become historians overnight. Instead, they were merely drawing on their secondary-school learning in ancient and medieval history, which had included some of the major descriptions of those earlier pandemics. Thus the authority they gained from using the new science to identify the pathogen during the third pandemic carried over sufficiently to validate as well their readings of historical texts concerning the first two. Only in recent years have some historians criticized those judgments and their unquestioning perpetuation by other historians throughout the intervening century. Yet also very recently, a completely new approach to these issues has been developing. It is the work not of historians but, as in 1894, of microbiologists, the heirs of Yersin and Kitasato, who now, redefined as molecular biologists, are extending their use of DNA analysis from the present and immediate past to the very remote past. Paleopathology is becoming an increasingly viable tool of research, a point to which we shall return.


        THE EVIDENCE


        Notwithstanding these promising laboratory developments, written sources remain the preeminent tool of historians. The principal sources available for studying the Plague of Justinian are written in four languages: Syriac, Arabic, Greek, and Latin. The lengthiest account in any language, found in the Ecclesiastical History of John of Ephesus, was written in Syriac. By an astonishing set of circumstances, he was completing a mission from Constantinople to Alexandria at the time the plague arrived in Egypt. Upon his return trip overland through Palestine, Syria, and Asia Minor, he found himself keeping abreast of the parallel movement of the disease as he traveled. In Palestine he saw entire town populations wiped out. ?During the tumult and intensity of the pestilence,? he wrote, ?we journeyed from Syria to the capital. Day after day we, too, used to knock at the door of the grave along with everyone else. We used to think that if there would be evening, death would come upon us suddenly in the night. Although the next morning would come, we used to face the grave during the whole day as we looked at the devastated and moaning villages in these regions, and at corpses lying on the ground with no one to gather them.? According to John, some people carried corpses all day, while others spent the day digging graves. Houses and farms were abandoned. Animals forgot their domestication. ?Crops of wheat in fertile fields located in all the regions through which we passed from Syria up through Thrace, were white and standing but there was no one to reap them and store the wheat. Vineyards, whose picking season came and went, shed their leaves, since winter was severe, but kept their fruits hanging on their vines, and there was no one to pick them or press them.? In his Lives of the Eastern Saints, John reported on one monastery that buried eighty-four of its members who had died of the plague. Other Syriac writings contain details of later outbreaks in Iraq, Egypt, Syria, and Palestine, including the Chronicle of Zuqnīn, whose monastic author, in recounting the epidemic of 743?745, specified that the victims had swellings in the groin, the armpit, or the neck.

        The situation with Arabic sources is altogether different. To begin with, written Arabic was still very rare in the sixth century. Moreover, the Arabian Peninsula itself seems to have escaped this plague pandemic. But already in the sixth year of the Islamic era, corresponding to 627? 628 AD, Arabic sources do contain a number of references to an outbreak of plague that devastated Sasanian Iraq; they call it the Plague of Sharawaygh for the Sasanian ruler it killed along with many inhabitants of Ctesiphon, the capital city. Then, after the death of Mohammed in 632 and the consolidation of power within Arabia under the first caliph, the Arabs went on the offensive in Syria, Palestine, and Iraq. With the conquest of Syria virtually complete by 638, the Arabs were beset for the first time with a major epidemic, this one named the Plague of Anwas (for a village where they first encountered it).

        These earliest Arabic testimonies concerning plague have not come to us directly from the seventh century. Later scholars, especially some located in Basra, refashioned them and incorporated them into larger, more systematic works, including plague chronologies and consolation treatises. The first of these included al-Asmai (died 862), a lexicographer who compiled a list of plague epidemics with their dates and their assigned names. Another was the historian al-Madaini (died 840), who worked independently of al-Asmai, although probably with common sources, and who provided considerable detail on the effects of the epidemics that struck Basra. And to mention just one more Basran scholar, al-Mubarrad (died in 899 or 900) wrote one of the earliest books of consolation, a type of work that told of the terrible encounters of Muslims with past epidemics, whether victims or survivors, to bolster the courage of present-day and future believers in confronting this dreadful scourge. But in the case of this writer and his book, we encounter another level of the complexity in untangling the Arabic sources dealing with the first plague pandemic, for this work is mainly known from those portions of it incorporated into the plague treatises that began to appear in the 1360s in the wake of the Black Death. Thus the earliest extant writings on the plague in Arabic, whether lists of epidemics or treatises, date from the ninth and later centuries, while of course referring back to works ? now lost ? of the seventh and eighth centuries.

        The principal Greek source is the work of the historian Procopius of Caesarea, who was present at the court of Justinian in Constantinople in the early 540s. In his Persian War, Procopius says with reference to this time, ?there was a pestilence by which the whole human race came near to being annihilated...It started among the Egyptians. Then it moved to Palestine and from there spread over the whole world...In the second year it reached Byzantium in the middle of the spring.? He says that for the majority of those stricken the onset of fever was the first sign, and then there developed after a few days a bubonic swelling, either in the groin, in the armpit, or beside the ears. He reports that the mortality rose alarmingly, eventually reaching more than ten thousand each day. Procopius also mentions that the emperor himself was taken ill, but only in his Secret History did he go on to reveal that there were rumors at court that Justinian had died and that speculation about the succession flourished. Justinian, however, recovered and reigned for two more decades.

        The lawyer Agathias undertook to continue the history of Procopius. He says that after 544 when plague ceased in Constantinople, it had never really stopped but simply moved on from place to place, until it returned to the city almost as though it had been cheated on the first occasion into a needlessly hasty departure. This was the spring of 558, when ?a second outbreak of plague swept the capital, destroying a vast number of people.? The form the epidemic took was not unlike that of the earlier outbreak. A swelling in the glands in the groin was accompanied by a high fever that raged night and day with unabated intensity and never left its victim until the moment of death.

        Another testimony in Greek came from the Antiochene lawyer Evagrius ?Scholasticus.? Plague broke out in 594 while he was at work on his Ecclesiastical History, and in a passage of that book he notes that this was the fourth episode of the plague in his experience, going back to 542 when the disease first arrived in Antioch and he himself, then six years old, suffered from its fevers and swellings. In each of the later outbreaks he lost servants and family members, including most recently a daughter and a grandson. We need emphasize that all three of these leading Greek sources, Procopius, Agathias, and Evagrius, were knowledgeable about earlier epidemics, yet clearly stressed the dreadful newness of the epidemics that started in 542.

        Of the Latin writers on this pandemic, Gregory of Tours (539?594) had the most to say. A native of Clermont and descendant of a Gallo-Roman family proud of its senatorial rank, he served as bishop of Tours from 573 to 594. In his History of the Franks and also in his Lives of the Fathers, he gives testimony to the first appearance of the plague in Gaul, which took place in the Rhone Valley in 543. The context was his telling of the saintly life of his uncle, Bishop Gallus of Clermont, in whose time, he says, ?that illness called inguinal raged in many regions and most notably it depopulated the province of Arles.? Gallus prayed that his diocese be spared and the Angel of the Lord came to him in a vision to assure him that his prayers would protect his people. Thus assured, Gallus led his people in various forms of devotion and indeed not a single one of them at Clermont died of the plague.

        Things went differently at Clermont in 571 under Bishop Cautinus, who scurried from one place to another to avoid the plague. ?So many people were killed off in the whole region and the dead bodies were so numerous that it was not even possible to count them. There was such a shortage of coffins and tombstones that ten or more bodies were buried in the same grave. In St. Peter?s church alone on a single Sunday three hundred dead bodies were counted.? Gregory describes the sore ?like a snake?s bite? that appeared in a victim?s groin or armpit, leading to death a few days later. He finishes off the paragraph by saying that Bishop Cautinus came back to Clermont, got the infection, and died on Good Friday, ?on the same day and at the same hour as his cousin Tetradus. Lyons, Bourges, Chalon-sur-Sa?ne, and Dijon were decimated by this plague.?

        Gregory?s references to plague in northern Gaul extend to Reims, which was protected miraculously by a relic of St. R?mi, and Trier, which was protected by the saintliness of Bishop Nicetius, but no further, while in the South these extend to Narbonne and Albi. His reference to the bishop of Nantes contracting plague suggests that the disease reached westward to the mouth of the Loire where it flows into the Atlantic. This in turn suggests that the probable route for the plague between Gaul and both Cornwall and Ireland was through Nantes, the port used in some instances by Irish monks in their travels to and from the Continent in the years around 600.

        http://www.cambridge.org/catalogue/c...1846394&ss=exc

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        • #5
          Re: The Black Plague

          do survivors gain immunity to Yersinia Pestis ?

          mortality of bubonic plague was 30-75% , I read.
          YP is about 700nm*700nm*2100nm , 1000times larger than flu in volume,
          5million nucleotides, recently sequenced,400times more than flu.
          It's probably not only submitted by flee-bites but also by other
          still unknown ways.

          are there examples of towns and strategies how to escape the plague ?
          Would these strategies/quarantines apply to flu-pandemics ?
          I'm interested in expert panflu damage estimates
          my current links: http://bit.ly/hFI7H ILI-charts: http://bit.ly/CcRgT

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          • #6
            Re: The Black Plague

            gs good questions. Are you able to find those strategies?

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            • #7
              Re: The Black Plague

              maybe..
              I could do some search on the web.
              But I don't want to do all search alone...
              I'm interested in expert panflu damage estimates
              my current links: http://bit.ly/hFI7H ILI-charts: http://bit.ly/CcRgT

              Comment


              • #8
                1348 REPORT: University of Paris Medical Faculty

                Week 2. Commerce


                excerpt from
                Report on the Cause of the Plague
                by the University of Paris Medical Faculty
                October 1348


                Seeing things which cannot be explained, even by the most gifted intellects, initially stirs the human mind to amazement; but after marvelling, the prudent soul next yields to its desire for understanding and, anxious for its own perfection, strives with all its might to discover the causes of the amazing events. For there is within the human mind an innate desire to seize on goodness and truth....

                To attain this end we have listened to the opinions of many modern experts on astrology and medicine about the causes of the epidemic which has prevailed since 1345....

                We, the masters of the faculty of medicine at Paris ... have decided to compile, with God's help, a brief compendium of the distant and immediate causes of the present universal epidemic ... and of wholesome remedies; drawing on the opinions of the most brilliant ancient philosophers and modern experts, astronomers as well as doctors of medicine....

                We say that the distant and first cause of this pestilence was and is the configuration of the heavens. In 1345, at one hour after noon on 20 March, there was a major conjunction of three planets in Aquarius. This conjunction, along with other earlier conjunctions and eclipses, by causing a deadly corruption of the air around us, signifies mortality and famine....

                Aristotle testifies that this is the case in his book Concerning the causes of the properties of the elements, in which he says that mortality of races and the depopulation of kingdoms occur at the conjunction of Saturn and Jupiter, for great events then arise, their nature depending on the trigon in which the conjunction occurs....

                Conjunctions of Saturn and Jupiter (1300-1490)
                depicted graphically

                Albertus Magnus ... says that the conjunction of Mars and Jupiter causes a great pestilence in the air, especially when they come together in a hot, wet sign, as was the case in 1345. For Jupiter, being wet and hot, draws up evil vapors from the earth and Mars, because it is immoderately hot and dry, then ignites the vapors, and as a result there were lightnings, sparks, noxious vapors and fires throughout the air.

                These effects were intensified because Mars--a malevolent planet, breeding anger and wars--was in the sign of Leo from 6 October 1347 until the end of May this year, along with the head of the dragon, and because all these things are hot they attracted many vapors; which is why the winter was not as cold as it should have been. And Mars was also retrograde and therefore attracted many vapors from the earth and sea which, when mixed with the air, corrupted its substance.

                The path of Mars (October 1994-August 1995) showing its retrograde motion in the constellation Leo from January 4 to March 25 1995.

                Mars was also looking upon Jupiter with a hostile aspect, that is to say quartile, and that caused an evil disposition or quality in the air, harmful and hateful to our nature. This state of affairs generated strong winds ... which gave rise to excess heat and moisture on the earth; although in fact it was the dampness which was most marked in our part of the world. And this is enough about the distant or universal cause for the moment.

                Although major pestilential illnesses can be caused by the corruption of water or food, as happens at times of famine and infertility, yet we still regard illnesses proceeding from the corruption of the air as much more dangerous. This is because bad air is more noxious than food or drink in that it can penetrate quickly to the heart and lungs to do its damage. We believe that the present epidemic or plague has arisen from air corrupt in its substance and not changed in its attributes. By which we wish it be understood that air, being pure and clear by nature, can only become putrid or corrupt by being mixed with something else, that is to say, with evil vapors.

                What happened was that the many vapors which had been corrupted at the time of the conjunction were drawn up from the earth and water, and were then mixed with the air and spread abroad by frequent gusts of wind in the wild southerly gales, and because of these alien vapors which they carried, the winds corrupted the air in its substance, and are still doing so. And this corrupted air, when breathed in, necessarily penetrates to the heart and corrupts the substance of the spirit there and rots the surrounding moisture, and the heat thus caused destroys the life force, and this is the immediate cause of the present epidemic.

                And moreover these winds, which have become so common here, have carried among us ... bad, rotten and poisonous vapors from elsewhere: from swamps, lakes and chasms, for instance, and also (which is even more dangerous) from unburied or unburnt corpses--which might well have been a cause of the epidemic. Another possible cause of corruption, which needs to be borne in mind, is the escape of the rottenness trapped in the center of the earth as a result of earthquakes--something which has indeed recently occurred. But the conjunctions could have been the universal and distant cause of all these harmful things, by which air and water have been corrupted....

                We must ... emphasize that although, because everyone has to breathe, everyone will be at risk from the corrupted air, not everyone will be made ill by it but only those, who will no doubt be numerous, who have a susceptibility to it; and very few indeed of those who do succumb will escape.

                The bodies most likely to take the stamp of this pestilence are those which are hot and moist, for they are the most susceptible to putrefaction. The following are also more at risk: Bodies bunged up with evil humors, because the unconsumed waste matter is not being expelled as it should; those following a bad life style, with too much exercise, sex and bathing; the thin and weak, and persistent worriers; babies, women and young people; and corpulent people with a ruddy complexion. However those with dry bodies, purged of waste matter, who adopt a sensible and suitable regimen, will succumb to the pestilence more slowly.

                Comment


                • #9
                  THE BUBONIC PLAGUE

                  Bubonic plague
                  From Wikipedia, the free encyclopedia


                  Bubonic plague is the best-known variant of the deadly infectious disease plague, which is caused by the enterobacteria Yersinia pestis. The epidemiological use of the term plague is currently applied to bacterial infections that cause buboes, although historically the medical use of the term plague has been applied to pandemic infections generally.


                  Infection/transportation

                  Plague is primarily a disease of rodents. Infection most often occurs when a person is bitten by a rat or flea that has fed on an infected rodent. The bacteria multiply inside the flea, sticking together to form a plug that blocks its stomach and causes it to begin to starve. The flea then voraciously bites a host and continues to feed, even though it is unable to satisfy its hunger. During the feeding process, blood cannot flow into the blocked stomach, and consequently the flea vomits blood tainted with the bacteria back into the bite wound. The Bubonic plague bacterium then infects a new host, and the flea eventually dies from starvation. Any serious outbreak of plague is usually started by other disease outbreaks in rodents, or some other crash in the rodent population. During these outbreaks, infected fleas that have lost their normal hosts seek other sources of blood.

                  In 1894, two bacteriologists, the French Alexandre Yersin and the Japanese Shibasaburo Kitasato, independently isolated the bacterium in Hong Kong responsible for the Third Pandemic. Though both investigators reported their findings, a series of confusing and contradictory statements by Kitasato eventually led to the acceptance of Yersin as the primary discoverer of the organism. Yersin named it Pasteurella pestis in honour of the Pasteur Institute, where he worked, but in 1967 it was moved to a new genus, renamed Yersinia pestis in honour of Yersin. Yersin also noted that rats were affected by plague not only during plague epidemics but also often preceding such epidemics in humans, and that plague was regarded by many locals as a disease of rats: villagers in China and India asserted that, when large numbers of rats were found dead, plague outbreaks in people soon followed.

                  In 1898, the French scientist Paul-Louis Simond (who had also come to China to battle the Third Pandemic) established the rat-flea vector that drives the disease. He had noted that persons who became ill did not have to be in close contact with each other to acquire the disease. In Yunnan, China, inhabitants would flee from their homes as soon as they saw dead rats, and on the island of Formosa (Taiwan), residents considered handling dead rats a risk for developing plague. These observations led him to suspect that the flea might be an intermediary factor in the transmission of plague, since people acquired plague only if they were in contact with recently dead rats, but not affected if they touched rats that had been dead for more than 24 hours. In a now classic experiment, Simond demonstrated how a healthy rat died of plague after infected fleas had jumped to it from a plague-dead rat.


                  Clinical features

                  Bubonic plague becomes evident three to eight days after the infection. Initial symptoms are chills, fever, diarrhea, headaches, and the swelling of the infected lymph nodes, as the bacteria replicate there. If untreated, the rate of mortality for bubonic plague is 50-90%.

                  In septicemic plague, there is bleeding into the skin and other organs, which creates black patches on the skin. There are bite-like bumps on the skin, commonly red and sometimes white in the center. Untreated septicemic plague is universally fatal, but early treatment with antibiotics reduces the mortality rate to between 4 and 15 percent. People who die from this form of plague often die on the same day symptoms first appear.

                  The pneumonic plague infects the lungs, and with that infection comes the possibility of person-to-person transmission through respiratory droplets. The incubation period for pneumonic plague is usually between two and four days, but can be as little as a few hours. The initial symptoms, of headache, weakness, and coughing with hemoptysis, are indistinguishable from other respiratory illnesses. Without diagnosis and treatment, the infection can be fatal in one to six days; mortality in untreated cases may be as high as 95%.

                  Treatment

                  An Indian doctor of Russian-Jewish origin Vladimir Havkin was the first to invent and test a plague antibiotic.

                  The traditional treatments are:
                  Streptomycin 30 mg/kg IM twice daily for 7 days
                  Chloramphenicol 25?30 mg/kg single dose, followed by 12.5?15 mg/kg four times daily
                  Tetracycline 2 g single dose, followed by 500 mg four times daily for 7?10 days (not suitable for children)

                  More recently,
                  Gentamicin 2.5 mg/kg IV or IM twice daily for 7 days
                  Doxycycline 100 mg (adults) or 2.2 mg/kg (children) orally twice daily have also been shown to be effective.[5]

                  History

                  "Der Doktor Schnabel von Rom" (English: "Doctor Beak of Rome") engraving by Paul F?rst (after J Columbina). The beak is a primitive gas mask, stuffed with substances (such as spices and herbs) thought to ward off the plague.

                  The earliest (though unvalidated) account describing a possible plague epidemic is found in I Samuel 5:6 of the Hebrew Bible (Torah). In this account, the Philistines of Ashdod were stricken with a plague for the crime of stealing the Ark of the Covenant from the Children of Israel. These events have been dated to approximately the second half of the eleventh century B.C. The word "tumors" is used in most English translations to describe the sores that came upon the Philistines. The Hebrew, however, can be interpreted as "swelling in the secret parts". The account indicates that the Philistine city and its political territory were stricken with a "ravaging of mice" and a plague, bringing death to a large segment of the population.

                  In the second year of the Peloponnesian War (430 B.C.), Thucydides described an epidemic disease which was said to have begun in Ethiopia, pass through Egypt and Libya, then come to the Greek world. In the Plague of Athens, the city lost possibly one third of its population, including Pericles. Modern historians disagree on whether the plague was a critical factor in the loss of the war. This epidemic has long been considered an outbreak of plague, however, because of Thucydides' description, modern scholars dispute that it was indeed plague. Many modern scholars feel that typhus, smallpox or measles may better fit the descriptions. A recent study of the DNA found in the dental pulp of plague victims suggests that typhoid was actually responsible. Other scientists dispute these findings, citing serious methodologic flaws in the DNA study.

                  In the first century AD, Rufus of Ephesus, a Greek anatomist, refers to an outbreak of plague in Libya, Egypt, and Syria. He records that Alexandrian doctors named Dioscorides and Posidonius described symptoms including acute fever, pain, agitation, and delirium. Buboes?large, hard, and non-suppurating?developed behind the knees, around the elbows, and "in the usual places." The death toll of those infected was very high. Rufus also wrote that similar buboes were reported by a Dionysius Curtus, who may have practiced medicine in Alexandria in the third century B.C. If this is correct, the eastern Mediterranean world may have been familiar with bubonic plague at that early date. (ref. Simpson, W.J., Patrick, A.)


                  Plague of Justinian

                  The Plague of Justinian in A.D. 541?542 is the first known pandemic on record, and marks the first firmly recorded pattern of bubonic plague. This outbreak is thought to have originated in Ethiopia or Egypt. The huge city of Constantinople imported massive amounts of grain, mostly from Egypt, to feed its citizens. The grain ships may have been the source of contagion for the city, with massive public granaries nurturing the rat and flea population. At its peak the plague was killing 10,000 people in Constantinople every day and ultimately destroyed perhaps 40 percent of the city's inhabitants. It went on to destroy up to a quarter of the human population of the eastern Mediterranean.

                  In A.D. 588 a second major wave of plague spread through the Mediterranean into what is now France. A maximum of 25 million dead is considered a reasonable estimate. An outbreak of it in the A.D 560s was described in A.D. 790 as causing "swellings in the glands...in the manner of a nut or date" in the groin "and in other rather delicate places followed by an unbearable fever". While the swellings in this description have been identified by some as buboes, there is some contention as to whether the pandemic should be attributed to the bubonic plague, Yersinia pestis, known in modern times.

                  Black Death

                  Map showing the spread of bubonic plague in Europe

                  During the mid-14th century, from about 1347 to 1350, the Black Death, a massive and deadly pandemic, swept through Eurasia, killing approximately one third of the population (according to some estimates) and changing the course of Asian and European history.

                  It is estimated that anywhere from a quarter to two-thirds of Europe's population became victims to the plague, making the Black Death the largest death toll from any known non-viral epidemic. While accurate statistical data do not exist, it is estimated that 1/4 of England's population, totaling 4.2 million, died while a higher percentage of individuals likely died in Italy. Northeastern Germany, Bohemia, Poland and Hungary, on the other hand, are believed to have suffered less while there are no estimates for Russia or the Balkans at all.

                  In many European cities and countries, the presence of Jews was blamed for the arrival of the plague, and they were killed in pogroms or expelled.

                  The Black Death continued to strike parts of Europe throughout the 14th century, the 15th century and the 16th century with constantly falling intensity and fatality, strongly suggesting rising resistance due to genetic selection. Some have argued that changes in hygiene habits and strong efforts within public health and sanitation had a significant impact on the rate of infection. Also, medical practices of the time were based largely on spiritual and astrological factors, but towards the end of the plague doctors took a more scientific approach to helping patients.


                  Nature of the disease

                  In the early 20th century, following the identification by Yersin and Kitasato of the plague bacterium that caused the late 19th and early 20th century Asian bubonic plague (the Third Pandemic), most scientists and historians came to believe that the Black Death was an incidence of this plague, with a strong presence of the more contagious pneumonic and septicemic varieties increasing the pace of infection, spreading the disease deep into inland areas of the continents. It was claimed that the disease was spread mainly by black rats in Asia and that therefore there must have been black rats in north-west Europe at the time of the Black Death to spread it, although black rats are currently rare except near the Mediterranean. This led to the development of a theory that brown rats had invaded Europe, largely wiping out black rats, bringing the plagues to an end, although there is no evidence for the theory in historical records. The view that the Black Death was caused by Yersinia pestis has been incorporated into medical textbooks throughout the 20th century and has become part of popular culture, as illustrated by recent books, such as John Kelly's The Great Mortality.

                  Many modern researchers have argued that the disease was more likely to have been viral (that is, not bubonic plague), pointing to the absence of rats from some parts of Europe that were badly affected and to the conviction of people at the time that the disease was spread by direct human contact. According to the accounts of the time the black death was extremely virulent, unlike the 19th and early 20th century bubonic plague. The bubonic plague theory has been comprehensively rebutted by Samuel K. Cohn. In the Encyclopedia of Population, he points to five major weaknesses in this theory:

                  very different transmission speeds ? the Black Death was reported to have spread 385 km in 91 days in 664, compared to 12-15 km a year for the modern Bubonic Plague, with the assistance of trains and cars

                  difficulties with the attempt to explain the rapid spread of the Black Death by arguing that it was spread by the rare pneumonic form of the disease ? in fact this form killed less than 0.3% of the infected population in its worst outbreak (Manchuria in 1911)

                  different seasonality ? the modern plague can only be sustained at temperatures between 50 and 78 degrees F (10 and 26 degrees C) and requires high humidity, while the Black Death occurred even in Norway in the middle of the winter and in the Mediterranean in the middle of hot dry summers

                  very different death rates ? in several places (including Florence in 1348) over 75% of the population appears to have died; in contrast the highest mortality for the modern Bubonic Plague was 3% in Mumbai in 1903

                  the cycles and trends of infection were very different between the diseases ? humans did not develop resistance to the modern disease, but resistance to the Black Death rose sharply, so that eventually it became mainly a childhood disease

                  Cohn also points out that while the identification of the disease as having buboes relies on accounts of Boccaccio and others, they described buboes, abscesses, rashes and carbuncles occurring all over the body, mostly concentrated around the neck or behind the ears. In contrast, the modern disease rarely has more than one bubo, most commonly in the groin, and is not characterised by abscesses, rashes and carbuncles.


                  Third Pandemic

                  The Third Pandemic began in China in 1855, spreading plague to all inhabited continents and ultimately killing more than 12 million people in India and China alone. Casualty patterns indicate that waves of this pandemic may have come from two different sources. The first was primarily bubonic and was carried around the world through ocean-going trade, transporting infected persons, rats, and cargos harboring fleas. The second, more virulent strain was primarily pneumonic in character, with a strong person-to-person contagion. This strain was largely confined to Manchuria and Mongolia. Researchers during the "Third Pandemic" identified plague vectors and the plague bacterium (see above), leading in time to modern treatment methods.

                  The last significant European outbreak of plague occurred in Russia in A.D. 1877?1889 in rural areas near the Ural Mountains and the Caspian Sea. Efforts in hygiene and patient isolation reduced the spread of the disease, with approximately 420 deaths in the region. Significantly, the region of Vetlianka in this area is near a population of the bobak marmot, a small rodent considered a very dangerous plague reservoir.

                  The Bubonic Plague continued to circulate through different ports globally for the next 50 years. However, it was primarily found in Southeast Asia. An epidemic in Hong Kong in 1894 had particularly high death rates, greater than 75%. As late as 1897, medical authorities in the European powers organized a conference in Venice, seeking ways to keep the plague out of Europe. The disease reached the Republic of Hawaii in December of 1899, and in an unprecedented catastrophe, the Board of Health burned down all of Honolulu?s Chinatown on January 20, 1900. Plague finally reached the United States later that year in San Francisco.

                  Although the outbreak that began in China in 1855 is conventionally known as the Third Pandemic, (the First being the Plague of Justinian and the second being the Black Death), it is unclear whether there have been fewer, or more, than three major outbreaks of bubonic plague. Most modern outbreaks of bubonic plague amongst humans have been preceded by a striking, high mortality amongst rats, yet this phenomenon is absent from descriptions of some earlier plagues, especially the Black Death. The buboes, or swellings in the groin, that are especially characteristic of bubonic plague, are a feature of other diseases as well.


                  Comment


                  • #10
                    Re: The Black Plague

                    The Role of Trade in Transmitting the Black Death



                    CASE NUMBER: 414
                    CASE MNEMONIC: BUBONIC
                    CASE NAME: The Black Death


                    A. IDENTIFICATION
                    1. The Issue

                    Between 1339 and 1351 AD, a pandemic of plague traveled from China to Europe, known in Western history as The Black Death. Carried by rats and fleas along the Silk Road Caravan routes and Spice trading sea routes, the Black Death reached the Mediterranean Basin in 1347, and was rapidly carried throughout Europe from what was then the center of European trade. Eventually, even areas of European settlement as isolated as Viking settlements in Greenland would be ravaged by the plague. By the time these plagues had run their course in 1351, between 25 and 50% of the population of Europe was dead. An equally high toll was exacted from the populations of Arabia, North Africa, South Asia, and East Asia. This paper will examine the role of trade in the spread of the plague.

                    Note: Europe is a crucial focus to plague as a trade related issue for this reason. Since plague is not native to the European region, the relationship between Medieval trade and Medieval Europe's greatest ecological disaster become obvious.

                    2. Description

                    The Black Death was actually a combination of three different types of plague: bubonic, pneumonic, and septicaemic, with bubonic being the most common. The bacteria which causes the diseases lives in the digestive tract of fleas, most frequently rat fleas. Plague bacteria can continue to survive in places like rat burrows (dark, moist environments) even after the plague has killed off all the rats in an infected group. Thus, the plague can lay dormant for a lengthy period of time until a new group of rodents moves into an infected burrow. Rats were extremely important to spreading the plague, but they were not the only means of dissemination. Through the spread of fleas among rodent populations, plague outbreaks can strike both urban and rural areas. Furthermore, the plague-bearing fleas could be transmitted to virtually any type of household or farm animal .

                    Bubonic Plague has an incubation period, from infection to the first symptoms, of approximately six days. The initial symptom is a blackish pustule forming over the point of the bite, followed by swollen lymph nodes near that bite. This is followed by subcutaneous hemorrhaging, which produces bruise-like purple blotches, called buboes, on the victim's skin. It is from this word, buboe, that the bubonic plague takes its name. The hemorrhaging causes an intoxication of the nervous system, which produces neurological and psychological disorders, including insomnia, delirium, and stupor . These disorders, particularly delirium, might be behind the bizarre danse macabre performed by plague victims that is described in medieval chronicles. Bubonic Plague is the least toxic of the three types, but still kills 50 to 60% of its victims.

                    Septicaemic plague is, like the bubonic plague, carried by insects. Its distinguishing feature is its rapidity - death occurs within a day of infection, even before buboes have had time to form. This form of the plague is the rarest rare, but is almost always fatal.

                    Pneumonic plague differs from the other two forms in that it can be spread from person to person. After a two to three day incubation period, victims suffer a sharp drop in body temperature, which is followed by sever coughing and discharge of a bloody sputum. This sputum contains the plague bacteria, making for an airborne transmission. As in bubonic plague, neurological and psychological disorders follow. Pneumonic plague is rarer than bubonic, but is fatal in over 95% of its victims.

                    None of these plagues are native to Europe. Plague bacteria normally resides in Central Asia, Yunan China, Arabia, East Africa, and limited areas of Iran and Libya. One reason for this is climactic. The weather in Northern Europe is hostile to the plague bearing fleas to such an extent that regular outbreaks would not be possible even in the summers, let alone the winters of 14th Century Europe. Their spread to Europe from these areas has always been through global commerce - trade which carried with it plague- bearing rats and fleas.

                    The first instance of a plague outbreak in Europe was Justinian's Plague, which raged from 541 to 544 AD, with sporadic lesser outbreaks of the plague lasting until the end of the Eighth Century. Outbreaks of Justinian's Plague almost invariably followed the same pattern. It is believed to have been carried down the Nile, from East Africa into the Mediterranean Basin. It rapidly spread along the trading routes from Egypt's main port, Alexandria, to Central and South Asia, Arabia, North Africa, and much of Southern Europe. Justinian's Plague was quite terrible - between years 541 and 542 about 40% of Constantinople, the central trading port of the Mediterranean world then, died of the plague. By the end of 544, it is estimated that 20 to 25% of the population of Europe south of the Alps had been killed by the plague. The spread of the plague into Northern and Central Europe was limited, probably by the lack of a significant trade infrastructure to the North in what was the ensuing Dark Ages.

                    By the 14th Century, things had changed. Due to technological innovations in agriculture, such as the three-field planting system, the population of Europe had risen to a level that it had not seen in a millennia, during the Roman Empire. This is despite the "Little Ice Age," a period of climactic deterioration and generally colder weather, which would not end until the mid-16th Century. A well-developed trade network in expensive luxury goods existed, carrying products by three main routes. The first was entirely overland, running from Northern China, through Central Asia, and then to the Black Sea. This was the famous "Silk Road." Spice trading ran along a route from South Asia to the Persian Gulf, and thence overland by caravan to the Levant. A second spice route ran by sea from South Asia to the Red Sea and Egypt.

                    From the Black Sea, the Levant, and Alexandria (still Egypt's main port), goods were picked up most often by Italian middlemen, who plying routes along the Mediterranean Basin, which was the nexus of European trade, delivered goods to Italy, Catalonia, and Southern France. By the 14th Century, there were also developed routes through the Straits of Gibraltar to England and Holland. From England and Holland, trade by sea extended into the Baltic, reaching lands as far away as Muscovy.

                    The great pandemic of plague, known in Europe as the Black Death, is thought to have begun in China in the early 1330s. Reliable chronicles tell of an outbreak of the plague in China, beginning in 1331. Sources in Latin, Arabic, and Chinese tell of numerous natural disasters such as floods and earthquakes. These events might have destroyed the habitats of the plague-bearing rodents, forcing them into contact with other rodent populations and thus spreading their fleas. By the 1350s, two-thirds of China's population lay dead.

                    From China, the plague is known to have been carried along the Silk Road into Central Asia, where there are records of outbreaks in 1339. Slowly, plague reached Sarai, on the Volga River, and the Crimea in 1345. From there it spread rapidly. By the next year, 1346, plague epidemics broke out in Astrakhan, Azerbaijan, and throughout the Caucasus. The northern and eastern shores of the Black Sea were ridden with plague, where the plague carrying fleas and rats were picked up in merchant ships and carried south, hiding in bulky crates and scurrying about ship.

                    In 1347, the plague struck Constantinople, no longer the center of Mediterranean trade, but still an important port. It also reached other important ports that year - Alexandria, Genoa, and ports in Sicily and Cyprus. From there it spread rapidly throughout the Mediterranean. By 1348 there were outbreaks in Cairo, Antioch, and much of southern Italy and Europe. Plague could move into the hinterland with only slightly more difficulty than traveling by sea, as urban rodents would share their infected fleas with their rural cousins, and sometimes infected livestock would be driven from a town into the countryside. Italy, its many mercantile city- states now the center of Mediterranean trade, suffered most heavily. Conservative estimates place the toll of the plague at one third of the populace, but many think it may have been as high as even one-half. By 1350, the plague had run its course through the Mediterranean Basin, carrying away between 35 to 40% of the population in that region. Following the sea lanes and rivers, it moved north.

                    Often, when a merchant ship full of dying and dead men came into port, the port authorities would order it quarantined, but this proved to be of little use. The quarantine was meant to keep sick sailors and traders from entering the town, not the disease bearing rats and fleas that would scurry down the ropes tying the ship to port.

                    The plague entered France, the most populace Kingdom of the 14th Century, primarily down routes such as the Rhone valley. The Black Death arrived in Paris in 1348, a city at with perhaps as many as 200,000 people living there. By the peak of the plague, reached in the months of November and December, Paris was losing as many as 800 people a day; 30% of the population of Normandy perished.

                    In 1349 it had reached Bergen, in Norway. Bergen was a member of the Hanseatic League, a confederation of Baltic trading towns, and a major commercial center. It was carried on a wool ship from London, the entire crew dead upon arrival. Plague was particularly severe in Scandinavia, perhaps because the cold weather caused pulmonary complications, and thus facilitated the deadly pneumonic plague. Plague deaths reached to between 45 and 55% of the population in Scandinavia. Yet even more grim is the transmission from Scandinavia to the Nordic settlements in Greenland. Greenland imported many of it supplies. Plague moved along the trade routes to Iceland, where it killed 60% of the populace, and then onto Greenland, reaching there probably in the winter of 1350. It annihilated the small population there. Chronicles tell of traders arriving in Greenland only to find villages deserted, with only the cattle roaming wild in them.

                    The Black Death is best documented in Britain, where it is believed to have arrived on Gascon ships to the port of Melcombe Regis, in 1348. Other outbreaks followed across southwest England. It reached London in the September of that year. London was the largest town of an overwhelmingly rural country, with a population of 50,000. It also suffered from extraordinarily poor sanitation. The plague ravaged London until the spring of 1350, killing between 35 to 40% of the populace. The port of Bristol also suffered 35-45% morbidity. Winchester may have reached a morbidity rate of 50%; there were so many deaths that High Street, the main urban road, was consecrated and used as a burial ground.

                    Ireland was stricken in 1349. The Black Death came through the passes in the Alps in to Germany, and across the Rhine from France and Holland. Hamburg, the second most important port in the Hanseatic League, two-thirds of the population died of plague. Nuremberg, an important hub in trans-Alpine overland trade, the plague eliminated 10% of the populace, despite Nuremburg's excellent public health system. Mortality in Germany was, on the whole, lower than elsewhere. Yet morbidity rates in Baltic ports were often as high as could be found elsewhere in Europe.

                    Eastern Europe was struck by the plague, but not as virulently as elsewhere in Europe. By 1351, when the plague was moving in that direction, along the rivers and through the Baltic, the epidemic was two and a half years old. By then, it is possible that the plague bacteria had mutated into a less virulent form. Geography also probably played a role. Bohemia, for example, is ringed on all sides but the east by mountains, and was not a major trading locale. Fewer rats lived there, and fewer still could have been imported. Neighboring Hungary lay on a plain, and was thus the habitat for many varieties of rodents. It also lay astride the Danube, and was hit much harder by the plague. Unfortunately, there are not reliable records as to the extent of the plague's morbidity in Eastern Europe.

                    By 1350 or 1351, the plague had finally reached the same region by which it entered Europe: Russia. By an ironic coincidence of geography, the trading routes in use did not run North across the steppes. Instead, it was carried into the Duchy of Muscovy through the Baltic ports and through Poland. As in Poland or Hungary, records of the death rates in Russia are unreliable. Yet native chronicles all agree that the Black Death was the worst epidemic in history.

                    This opinion is not limited to Europe. It is known that the plague also struck across the Moslem world. Evidence suggests that by 1349 one-third of the total population, and 40 to 50% of the urban populace of the Moslem world lay dead of the plague. Cairo, for example, lost one-third to two-fifths of its populace. The Plague reached Mecca, via the pilgrimage traffic. The Black Death ranks simply as the greatest ecological disaster of Medieval times, devastating human and certain animal populations across Eurasia and North Africa.

                    In Europe and the Middle East, local plague outbreaks would recur every few years until the 16th Century, keeping human populations in check and resulting in a long-term depopulation. It was not for two Centuries that Europe would return to the population level of the mid-14th Century. Ironically, this ecological disaster had some positive environmental effects. The depopulation caused the abandonment of much farm land, resulting in its return to the pastures or forests. The severe depopulation was a major contributing factor to many socio-economic changes in Europe, such as the decline of manorial feudalism.

                    Plague outbreaks continue to this day, even in Western countries with advanced medical and public health techniques. Plague-bearing rats returned to Britain in the early 20th Century in much the same way the arrived in the mid-14th Century: carried by merchant ships between 1896 and 1910, bubonic plague appeared in limited and sporadic outbreaks across Britain, but with the earliest cases being in ports Cardiff, Liverpool, Bristol, Hull, and London. Suffolk was struck by the pneumonic plague between 1910 and 1918. These outbreaks resulted in very little loss of life.

                    Other diseases are often geographically transmitted by trade and/or travel. The transmission of the global influenza epidemic during and after World War One is one example, carried by soldiers returning home from the unsanitary trenches of the Western Front. Filoviruses, such as Marburg and Ebola, are known to be transmitted out of Africa by the trade in medical research monkeys. HIV is thought to have spread throughout Central Africa by truck drivers sleeping with infected prostitutes along highway stops. Trade continues to have a strong connection with the spread of deadly diseases.



                    4. Draft Author: Richard Thomas, May, 1997


                    B. LEGAL FILTERS
                    5. Discourse and Status: Disagreement and Complete (Historical)

                    There are no historical indications of any international effort to deal with the Black Death in the 14th Century. Given the state of international relations at the time, this should not be surprising. Europe was still in deep in the feudal era during the 14th Century, with the focus of political power being the local Lord and the Manor. There were exceptions, particularly in the Mediterranean, but political perceptions of the time were strictly localized. It is doubtful that any 14th Century leaders even considered mounting an international effort to stop the progress of the plague, and even more doubtful that such an effort would have met any success, given the woeful state of medical knowledge at that time.

                    Modern historians and medical science are in general agreement about the causes of the plague, and the main means of dissemination - rats and fleas carried from port to port by merchant ships. Some debate remains over the true extent of the plague's morbidity. This is likely more due to the general unreliability and/or lack of Medieval records than anything else. There is even more disagreement on what the historical effects of the Black Death on European civilization.

                    Given the clear connection between trade and the spread of the Plague, however, and the connections between travel, trade and the spread of other diseases in the modern era, it is clear that this issue is still very relevant. More study should be given to the link between trade and disease, and more attention of stricter quarantine measures.

                    6. Forum and Scope: Many and Many

                    The Black Death was a pandemic, global in its proportions. It struck populations from China to Greenland. Yet each stricken community generally dealt with plague as if it were exclusively a local problem, even if it were aware that the neighboring shire, or even country was also afflicted by the plague. This was natural given the prohibitive nature of travel for the commoner, or even the upper classes at that time. The world outside of their village or town was something that most of the global populace was only dimly aware of and not very concerned with.

                    7. Decision Breadth: Many

                    The entire Old World trading system was effecting by the spread of the plague along its routes. From trading areas, it could easily spread inland as urban rodents spread plague-carrying fleas to their rural cousins.


                    Today, the Black Death is a matter of history, and is pursued by two different professions. One are European historians, who are interested primarily with the effects of the Plague on Europe's social and economic development. The other are those in medical sciences like Epidemiology, for whom the Black Plague is an important case study on Plague issues such as transmission, morbidity, outbreak causation, and other related issues.

                    Last edited by Jonesie; April 9, 2007, 01:43 PM.

                    Comment


                    • #11
                      Re: The Black Plague

                      plague as a weapon ?



                      Sci­en­tists are wor­ried that a dis­ease as­so­ci­at­ed with dev­as­tat­ing me­di­e­val epi­demics may make a come­back as a weap­on.

                      Plague’s abil­i­ty to spread via droplets makes pos­si­ble aerosol-based weap­ons ca­pa­ble of caus­ing wide­spread pneu­mon­ic plague out­break, ac­cord­ing to Pren­tice and Ra­hal­i­son. Ex­ac­er­abat­ing the dan­ger, they added, is the bac­te­ri­um’s wide dis­tri­bu­tion, ease of cul­tur­ing, and availa­bil­i­ty of ex­pert ad­vice from form­er weap­ons sci­en­tists.

                      An­tibi­otics are ef­fec­tive, but a Y. pestis strain in Mad­a­gas­car shows dis­turb­ing signs of hav­ing evolved re­sist­ance to some of these
                      I'm interested in expert panflu damage estimates
                      my current links: http://bit.ly/hFI7H ILI-charts: http://bit.ly/CcRgT

                      Comment


                      • #12
                        Re: The Black Plague

                        Originally posted by gsgs View Post
                        plague as a weapon ?
                        Yes. Here is the treatment recommended by Merck. I am sure there may be other medications also. Just reference your favorite source.

                        Treatment

                        Immediate treatment reduces mortality to < 5%. In septicemic or pneumonic plague, treatment must begin within 24 h with streptomycin 7.5 mg/kg IM q 6 h for 7 to 10 days. Many physicians give higher initial dosages, up to 0.5 g IM q 3 h for 48 h.
                        Doxycycline 100 mg IV or po q 12 h is an alternative.
                        Some Trade Names
                        PERIOSTAT
                        VIBRAMYCIN


                        Gentamicin is probably also effective. For plague meningitis, chloramphenicol should be given in a loading dose of 25 mg/kg IV, followed by 12.5 mg/kg IV or po q 6 h.
                        Some Trade Names
                        GARAMYCIN


                        Routine isolation precautions are adequate for patients with bubonic plague. Those with primary or secondary pneumonic plague require strict respiratory isolation. All pneumonic plague contacts should be under medical surveillance. Temperature should be taken q 4 h for 6 days. If this is not possible, tetracycline 1 g once/day po for 6 days can be given, but this can produce drug-resistant strains.
                        Some Trade Names
                        ACHROMYCIN V
                        TETRACYN
                        TETREX


                        Rodents should be controlled and repellents used to minimize flea bites. Travelers should consider prophylaxis with doxycycline 100 mg po q 12 h during exposure periods.
                        Some Trade Names
                        PERIOSTAT
                        VIBRAMYCIN


                        Other Yersinia Infections

                        Yersinia enterocolitica and Y. pseudotuberculosis occur worldwide and cause human infection.

                        Y. enterocolitica is a common cause of diarrheal disease and mesenteric adenitis. Y. pseudotuberculosis more commonly causes mesenteric adenitis and has been suspected in cases of interstitial nephritis, hemolytic-uremic syndrome, and a scarlet fever?like illness. Both species can cause pharyngitis, septicemia, focal infections in multiple organs, and reactive arthritis. Mortality from septicemia may be as high as 50%, even with treatment.

                        The organisms can be identified in standard cultures from normally sterile sites. Selective culture methods are required for nonsterile specimens. Serologic assays are available but difficult and not standardized. Diagnosis, particularly of the reactive arthritis, requires a high index of suspicion and close communication with the clinical laboratory.

                        Treatment of diarrhea is supportive because the disease is self-limited. Septic complications require β-lactamase?resistant antibiotics guided by sensitivity testing. Prevention focuses on food-handling and preparation, household pets, and epidemiology of suspected outbreaks.

                        Plague and Other Yersinia Infections - Etiology, pathophysiology, symptoms, signs, diagnosis & prognosis from the Merck Manuals - Medical Professional Version.

                        Comment


                        • #13
                          Re: The Black Plague

                          The Plague


                          --------------------------------------------------------------------------------

                          Material on this page copyright by David W Tschanz

                          In October 1347, two months after the fall of Calais, Genoese trading ships put into the harbor of Messina in Sicily with dead and dying passengers and crew. The afflicted sailors showed black swellings about the size of an apple in their armpits and their groins. The swellings oozed blood and pus as they grew in size and burst. The sick suffered severe pain and died within five days. Several days would pass before the citizens of Messina realized the dying and ill sailors and their ships had brought an epidemic into their midst. Their actions came too late to save them and served only to involve others.


                          The Messinans drove the ships out of port to find 'safe harbor' elsewhere. One ship bearing its lethal cargo made it to Marseilles in November, the remainder put in at Corsica and Sardinia. Ships from Marseilles carried the pestilence to Barcelona and Valencia, from whence the disease spread to Spain and Portugal. England, safe for awhile, was reached in August by a ship from Calais that had put into the Dorset port of Melcombe. By the end of 1349, the epidemic had spread its tendrils of death throughout Europe.


                          It was not to be called the Black Death until a century later. At its height it was merely called the Pestilence or the Great Mortality. The best estimates of modern demographers are that one third to a half of Europeans living in the warm air of the summer of 1347 would die by the winter of 1349 from the plague. One third of Europe would have meant twenty four million dead, but in truth no one knows how many died in Europe. Nor is the death toll in China, India, the Middle East, or North Africa known.

                          The Plague seems to have had its origins in southeast Asia. It spread to China when the Mongol overlords of the Celestial Empire attempted to invade southeast Asia. The Mongols carried it into Central Asia and southern Russia. It was there, whilst putting in to a Crimean port invested by the Mongols, that the Genoese seem to have acquired the disease: The Mongols had thoughtfully tossed the bodies of several plague victims over the walls using siege engines.


                          The urban centers of Europe were ripe for epidemic and they were hardest hit. The death list mounted so fast in some places that the victims died unattended and the living could barely keep up with the grim task of burying the corpses. The pattern of the disease was similar for each city. When a city was stricken the disease usually remained active some four to six months, killed off a large section of the population and disorganized the entire life of the town. Then it would subside during the winter, only to return the following spring where it raged again for six months.

                          In Paris, 800 died a day, and the city would lose 50% of its population of over 100,0000. Florence, already weakened by a famine in 1347, lost 80% of is citizens; Venice, Hamburg, and Bremen two thirds; London one half. In Marseilles 16,000 deaths were recorded in a single month. Previously flourishing cities, like Carcassone, Montpellier, Rouen, Arras, Laon, and Reims, were dealt an irreversible blow and sank to mere shadows of their former prosperity, never to recover.


                          In crowded Avignon, a city of 50,000 and the seat of the Papacy, 400 died daily, 7,000 houses were emptied, and a single graveyard received 11,000 corpses in six weeks. Half the city's inhabitants reportedly died in the space of a few months, including nine cardinals and 70 lesser prelates. When the graveyards could hold no more, corpses were tossed into the Rhone River, which Pope Clement VI was forced to consecrate as a burial ground. Everywhere the Church was forced to resort to extraordinary ends to assure at least the semblance of the sacraments for the dying --no small matter in a population as tied to religion as Europe's was at that time. Bishops in England, faced with a loss of priests to minister the sacraments gave permission to laymen to make confession to each other as was done by the Apostles, "or if no man is present than even a woman". Pope Clement finally granted remission of sins to all who died of the plague.


                          The situation was almost as bad in the countryside. Peasants dropped dead on the roads, in the fields, and in their houses. Survivors, in growing helplessness, fell into apathy, leaving ripe wheat uncut and livestock untended. English sheep, bearers of the precious wool, caught the disease too, and died throughout the countryside, with reports of 5,000 dead in one field alone, the stench of their rotting carcasses filled the air for miles around.


                          The mortality in the countryside was erratic, in one place only 20% would die, in another entire villages would be wiped out. By the time the plague was over, 200,000 villages and hamlets would be abandoned across the face of Europe. Givry in Burgundy was typical of the experience of the smaller vilages. A thriving little town of 1,300 in the summer of 1345, she recorded 615 deaths in the summer of 1348 in a fourteen week period.


                          Unsurprisingly, monasteries, convents, prisons, and other closed communities were doomed when the plague was introduced to them. The Convents of Carcassone and Marseille lost everyone. At Montpeiler 133 Dominican Friars died out of 140. Petrarch's brother, Gherardo, member of a Carthusian monastery of 36, buried the prior and 34 fellow monks one by one, sometimes three a day, until he was left alone with his dog. Petrarch's beloved Laura was among those who succumbed to the Plague.


                          Ships were death traps. Along the shores of England it was not uncommon to see ships under full sail being driven by the winds of the Channel, or tossing about aimlessly, making it clear that all aboard had died.


                          As the Black Death continued unchecked a change in its methods of transmission took place. As the sick became more numerous, some survived long enough to develop the infection in their lungs. Now the disease was no longer limited to the rat-flea-man cycle with its 50-75% mortality rate, but appeared in th emore deadly pneumonic form as well (as in the breakout in the Indian city of Surat in 1994). Both forms were lethal, but the pneumonic form could strike with an abruptness that added to the terror the disease evoked. Numerous chronicles from all over Europe tell of persons going to bed in health and never wakening, of doctors catching the illness at the bedside and dying before the patient, and of persons in normal conversation who dropped dead in midsentence.


                          As the death toll mounted, even the expression of grief became a cause for concern by the authorities. Seeking to stem public panic, officials forbade the ringing of bells, the wearing of black except by widows, and restricted funerals, when they were actually held, to only two mourners.


                          The Black Death, with its great mortality and its seeming sentence of death for all whom came in contact with it caused a warping of the collective medieval mortality which brought with it both a sense of a vanishing future and a dementia of despair.


                          The plague was not the kind of calamity to inspire man to greater heights of altruism. Its loathsomeness and deadliness did not herd people together in an air of mutual distress, rather it prompted their desire to escape one another.


                          Angelo di Tura, a chronicler of Siena, described the atmosphere as one in which "Father abandoned child, wife husband, one brother another for this plague seemed to strike through breath and sight, so they died. And no one could be found to bury the dead for money or friendship." The scene he described would be echoed across all of Europe. Guy de Chauliac, the Papal physician and the "father of surgery" was more blunt in his assessment -- "A father did not visit his son, nor the son his father. Charity was dead."

                          Those who could, primarily the wealthy, sought safety in flight (as in Boccaccio's Decameron,) leaving the urban poor to die in their burrows. But though the death rate was higher among the poor, the rich and the powerful also perished. Although Alfonso XI of Castile was the only monarch to die, his neighbor Pedro of Aragon lost his wife, a daughter, and a niece in the space of six months. The Byzantine Emperor lost his son. Charles IV's wife Jeanne and her daughter in law, the wife of the Dauphin, also succumbed. Jeanne, the Queen of Navarre and daughter of Louis X was another victim. Edward III's second daughter, Joanna, died of Plague in Bordeaux while on her way to marry Pedro, the heir of Castile. In England the Archbishop of Canterbury, John Stratford died in August 1348, his successor died in May 1349, and the next appointee three months later. Curious sweeps of mortality affected some bodies of London merchants. All eight wardens of the Company of Cutters, all six wardens of the Hatters, and four wardens of the Goldsmiths died. Sir John Pulteney, master draper and four times Lord Mayor of London was a victim, as was Sir John Montgomery, Governor of Calais.


                          Naturally the death rate was highest among the clergy and the doctors whose professions brought them in close contact with the sick and dying. Out of 24 physicians in Venice, 20 lost their lives in the plague. Clerical motrality varied with rank. Prelates managed to sustain a higher survival rate than the lesser clergy. Among bishops, the death rate has been estimated at one out of six. Priests died at a rate closer to one out of two. The Pope may have owed his survival to a peculiar treatment which 'purified' the air about him: Three fires were kept buring about his person for days on end, the heat probably making things uncomfortable for the fleas, not to mention His Holiness.


                          Government officials found no special immunity and their loss contributed to the general chaos. In Siena, four of the nine members of the governing oligarchy died. In France one third of the royal notaries succumbed, while in Bristol 15 out of 52 members of the Town Council died.


                          To add to the terror of the seemingly unstoppable march of death was the unknown nature of its origin. The absence of an identifiable earthly cause gave the plague supernatural and sinister quality.


                          The role of rats and fleas as vectors in the transmission of the disese was never suspected. There were several reasons for this. Both were common in the period and had achieved a familiar anonymity (remember 'The Pied Piper of Hamlin"). There must have been great die offs of the rats, who would have been struck by the plague first, but if there were, no one saw it sufficiently unusual to comment on it. To confuse any attempt to associate these common medieval vermin with the disease striking Europe was the fact that the plague was also being spread by respiratory infection. And, finally and simply stated, the medieval mind was unable to make the connection. Besides there were other possible causes that better fit their preconceived notions of the way the universe was ordered.


                          An earthquake, which had a carved a path of wreckage from Naples to Venice in the summer of 1347, was blamed for releasing gases into the air which poisoned all on whom they fell. The scholars of the University of Paris stated that the Black Death resulted from "a triple conjunction of Saturn, Jupiter, and Mars in the 40th degree of Aquarius, occurring on the 20th of March 1345", but added that they did not know how.


                          No one really believed them anyway. To the common people there could only be one source of a thing as sweeping and as total as the Pest --the wrath of God punishing mankind for its sins. There was official support for this feeling. In a bull of 1348 Clement called the Plague, "a pestilence with which God is afflicting his Christian people." King Philip VI believed that God was punishing France for her sins and issued a unusual public health decree against blasphemy. For the first offense a man was to lose a lip, for the second the other lip and for the third, the tongue itself.


                          Others saw it as more than just an expression of divine displeasure and chastisement. The Italian chronicler Matteo Villani spoke for them when he said the plague was "Divine action with no goal less than the extermination of mankind." Villani himself succumbed to the disease, literally dying at his desk as he wrote of its terrors..

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                          • #14
                            Re: The Black Plague

                            Petrarch on the Plague

                            Petrarch endured the Black Death in Parma, and responded to it quite unlike Boccaccio. Petrarch addressed the effects of the plague in highly personal and emotional lamentations. One such lamentation discusses the death of Laura de Noves, whom Petrarch had met at Avignon in his youth. Laura died in Avignon, a victim of the plague that was raging there, and Petrarch learned of her death in a letter he received from a friend in May of 1348. Later he expressed the sadness he felt at her death in some lines he wrote on a manuscript of Virgil:

                            Laura, illustrious by her virtues, and long celebrated in my songs, first greeted my eyes in the days of my youth, the 6th of April, 1327, at Avignon; and in the same city, at the same hour of the same 6th of April, but in the year 1348, withdrew from life, while I was at Verona, unconscious of my loss.... Her chaste and lovely body was interred on the evening of the same day in the church of the Minorites: her soul, as I believe, returned to heaven, whence it came. To write these lines in bitter memory of this event, and in the place where they will most often meet my eyes, has in it something of a cruel sweetness, but I forget that nothing more ought in this life to please me.


                            As the plague raged in Parma, the poet wrote to his brother, who lived in a monastery in Monrieux. His brother was the only survivor out of thirty-five people there, and had remained, alone with his dog, to guard and tend the monastery. Petrarch's letter relies greatly on the classics, much as Boccaccio's account does on the influence of Thucydides. The genuine anguish of Petrarch's letter is as apparent as is the horror of Boccaccio's account:

                            My brother! My brother! My brother! A new beginning to a letter, though used by Marcus Tullius [Cicero] fourteen hundred years ago. Alas! my beloved brother, what shall I say? How shall I begin? Whither shall I turn? On all sides is sorrow; everywhere is fear. I would, my brother, that I had never been born, or, at least, had died before these times. How will posterity believe that there has been a time when without the lightnings of heaven or the fires of earth, without wars or other visible slaughter, not this or that part of the earth, but well-nigh the whole globe, has remained without inhabitants. When has any such thing been even heard or seen; in what annals has it ever been read that houses were left vacant, cities deserted, the country neglected, the fields too small for the dead and a fearful and universal solitude over the whole earth?... Oh happy people of the future, who have not known these miseries and perchance will class our testimony with the fables. We have, indeed, deserved these [punishments] and even greater; but our forefathers also have deserved them, and may our posterity not also merit the same...


                            (M.R., ed: D.S.) Adapted from: George Deaux, The Black Death 1347. New York: Weybright and Talley, 1969. Chapter IV, pp. 92-94.

                            http://www.brown.edu/Departments/Ita...petrarca.shtml


                            From a headstone in Ireland:
                            Death leaves a heartache no one can heal, love leaves a memory no one can steal.

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                            • #15
                              Re: The Black Plague

                              The Lasting Consequences of Plague in Siena

                              Ryan S. Davis

                              In the mid 14th century, Italy was not Italy as we know it today. The peninsula was broken into city-states, where independent oligarchies controlled by the wealthy made laws for each of their areas. Tuscany, in northern Italy, was the economic capital of the world. Florence, Siena, and Milan flourished both in prosperity through control of eastern trade to its northern neighbors, and broad taxation of its citizenry (Benedictow, 2004). Some postulate that this was the birthplace of the free-market economy. People could buy, sell, and trade in almost any manner that they preferred; the reigning government took their cut off of the top of each deal. Each was extremely urbanized for the time, which fueled the fire for plague transmission.

                              Tuscany, Florence in particular, developed into a cultural dynamo harboring artists and philosophers. Dante, Petrarch, and Boccaccio, all Tuscans, developed the humanistic tradition, which planted seeds for the Italian Renaissance 50 years later. A robust rivalry between cities pushed each to develop their own traditions, and to compete with each other in any realm possible. As part of the cultural rivalry, Siena planned to expand the Duomo di Siena to become an extremely large cathedral (Nardo, 1999). In 1348, the pestilence struck these highly populated urban areas without mercy; Siena lost 30-50% of its population (Benedictow, 2004). Florence and Milan would rebound, but Siena, a thriving metropolis in 1340, died and never recovered. She limped along; her cathedral never finished; her economy never reaching its past glory; her town never reemerging as would her neighbors. Siena suffered immensely more than other Tuscan cities from the Black Death, and lost out to Florence both culturally and economically.

                              Before the epidemic, the city depended on the considerable agricultural prosperity of the surrounding lands. Like many other city-states, Siena bankrolled the papacy gaining on interest returns as the loans were being paid off (Adams, 1992). The local wealthy government, called the ?IX?, was incredibly strong and surpassed ecclesiastical authority. Government decided taxes; government tried legal disputes; government made laws. The church was involved to an extent, but the secular government held most of the money and authority (Adams, 1992). The urbanized center, Siena itself, was economically based on the exchange of goods. These included crops from outside of the city, wool, and crafted wares (Caferro, 1994). Although the numbers vary, the population has been estimated to be from 25,000 to 47,500, as very few seem to be consistent (Bowsky, 1964). About the same number lived outside of the city in smaller towns that were governed by Siena, and had to pay taxes based on the size of their town (Bowsky, 1964).

                              Scholars have analyzed city records of Siena before 1348; these records indicate that Siena was experiencing economic growth at that time. Many new citizens of the city promised to build new houses within the city walls, and the walls had to be expanded in all four districts of the city to protect new inhabitants. Wars with small independent neighbors were fruitful, and the armies of Siena conquered those border regions to add territory to the state (Bowsky, 1964). These indicators of growth may have continued after the plague had it not been for Siena?s location.

                              However, Siena could not recover after the disease killed a large part of its urban population. It is far inland thus without a port; nor is it a major transport route from north to south (Adams, 1992). The city relied on well water, and had little surface water to exploit that could support a large population (Adams, 1992). Wars with their Florentine neighbors kept the government from accumulating an excess of wealth for civic projects. Areas that could provide an effective infrastructure for survival drew people away from Siena, and to more amenable cities. Efforts to repopulate the city after the plague failed, despite liberal laws embracing many types of individuals (Bowsky, 1964). Geographical restraints did not provide an incentive for promoting growth after the plague died down. The city did not return to pre-plague numbers until the 20th century (Bowsky, 1964). Conversely, other booming cities did not lack the resources to cope with rapid growth after the plague. Florence and Milan expanded their commerce as Europe began to recover, and conquered neighbor states like Siena to increase their assets, and tax base.

                              The economic changes related to taxation and labor became a major concern as the Black Death began to ravage the city. This was the foremost problem that had the furthest reaching effect throughout time. Although, Siena was thriving, the agricultural years of 1346 and 1347 were poor, and set the stage for calamity (Bowsky, 1964). In the summer 1348, labor was short as many poor, working class peasants died in their filthy neighborhoods that were infested with rats and fleas (Bowsky, 1964). Others fled, thinking they could outrun the disease?s steady progress. Industry, trade, and commerce were halted as even those in the IX postponed government, and took retreat in the country to avoid the disease (Bowsky, 1964). In this time period, from the end of May until the end of August, government, labor, and taxes ceased. This led to a complete absence of prosperity, and the city, like so many others of the era, suffered greatly without recovery. Eventually, the city would fall under the Medici?s of Florence, and from that time until the Italian Unification could not escape from being attached to Florence (Bowsky, 1964).

                              When the plague rescinded, after three months of infection on the city?s inhabitants, the social structure changed significantly. Many folks found themselves without family; others were without assets. Out of the rubble of human catastrophe, those who stole, or inherited assets became modestly wealthy. These nouveaux riches infiltrated society, and chipped away at the IX?s rule until they gained seats in public office. The artisans and literates who survived ignored the IX?s orders of wage limitations and demanded enormous sums to perform skilled labor and notary work. For the first few years after the plague, Siena saw a moderate amount of economic growth. The foundations of this growth were shaky, and a decade later the government did not have enough in the treasury to keep public support. The IX was overthrown in 1355; the change in the social structure as a result of the pestilence was simply too difficult to govern.

                              The Tuscan city-states were very competitive about the role of cultural achievement in art and architecture as the regions were progressively patriotic at the time. Within the competition, Siena began construction on the Duomo di Siena in 1249, and it has never been finished (Nardo, 1999). A wholesale expansion project began in the early 1300?s as a response to this competition, which would have made the cathedral enormous, was halted when the plague struck (Nardo, 1999). The lack of funds, labor, and craftsmen made it impossible to pick up the work immediately after the plague, and the town never found a reason to follow up on the original plan. The duomo, as it is, has inlays of black and white marble inside and out, and was built in the Italian gothic style. Busts of popes line the walls; the pulpit, baptistery, and fountain are considered masterpieces. Many important artists were commissioned to sculpt and paint to add to the interiors motif. The duomo could be taken as a cross section of art in the city throughout the middle ages, and contains works of Michelangelo, Donatello, and Pisano (Figs. 1-3).



                              After the Black Death, art around the world, and in Siena, was affected in ways that related to the state of the people, and the state of the artists. Doubting a loving God, the art began to contain images of an angry, or at least indifferent, deity that was punishing people for the sins of humanity (Pollefey, 1998). Also, without a doubt, artistic ingenuity was stunted in that many practicing artists and craftsmen did not survive (Bowsky, 1964). Commissions would have been harder to come by as the depression caused by the plague left the rich with less money to use after the epidemic. Entertainment and expression were minimized by the need for survival. Like Siena, Sienese art lost out in relevance and prestige to well renowned art in Florence. Alternate interpretations of the implications of Plague on the city have been put forth.

                              Adams (1992) suggested that Siena?s government and infrastructure kept it stable for the last 600 years. Hence, plague in the long term did not affect the city. This cannot be true as is it was conquered by Florence in the next century, and under their rule until Italian unification (Bowsky, 1964). After the Florentines took over, Siena?s government and influence was obsolete. It is more likely a direct loss to its Tuscan neighbors that suppressed growth for centuries. They had water, dynamic trade, and a dominating government, whereas, Siena was not large or rich enough to defend itself from being gobbled up by the much larger Florence.

                              The case of Siena is an example of how nature can direct the events of human history, and change the course of a government and society. Pestilence limited the city?s growth, cultural expression, and military defense. Siena was known throughout Europe in 1340. By 1450, it was part of Florence. Plague struck the medieval city, and devastated it. Today, Siena has modernized slowly, with grace, and its beauty rests in its inability to recover from the pestilence 650 years ago.

                              http://entomology.montana.edu/histor...says/Davis.htm

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