Education + Advocacy = Change

 

Click a topic below for an index of articles:

New-Material

Home

Alternative-Treatments

Financial or Socio-Economic Issues

Forum

Health Insurance

Hepatitis

HIV/AIDS

Institutional Issues

International Reports

Legal Concerns

Math Models or Methods to Predict Trends

Medical Issues

Our Sponsors

Occupational Concerns

Our Board

Religion and infectious diseases

State Governments

Stigma or Discrimination Issues

 

If you would like to submit an article to this website, email us at info@heart-intl.net for a review of this paper

any words all words
Results per page:

“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”

    

PLAGUES AND DISEASES

BUBONIC PLAGUE

http://idcs0100.lib.iup.edu/westcivi/the8.htm

 

In the early 1330s an outbreak of deadly bubonic plague occurred in China. Plague mainly affects rodents, but fleas can transmit the disease to people. Once people are infected, they infect others very rapidly. Plague causes fever and a painful swelling of the lymph glands called buboes, which is how it gets its name. The disease also causes spots on the skin that are red at first and then turn black.

Since China was one of the busiest of the world's trading nations, it was only a matter of time before the outbreak of plague in China spread to western Asia and Europe. In October of 1347, several Italian merchant ships returned from a trip to the Black Sea, one of the key links in trade with China. When the ships docked in Sicily, many of those on board were already dying of plague. Within days the disease spread to the city and the surrounding countryside. An eyewitness tells what happened:

"Realizing what a deadly disaster had come to them, the people quickly drove the Italians from their city. But the disease remained, and soon death was everywhere. Fathers abandoned their sick sons. Lawyers refused to come and make out wills for the dying. Friars and nuns were left to care for the sick, and monasteries and convents were soon deserted, as they were stricken, too. Bodies were left in empty houses, and there was no one to give them a Christian burial."

The disease struck and killed people with terrible speed. The Italian writer Boccaccio said its victims often

"ate lunch with their friends and dinner with their ancestors in paradise."

By the following August, the plague had spread as far north as England, where people called it "The Black Death" because of the black spots it produced on the skin. A terrible killer was loose across Europe, and Medieval medicine had nothing to combat it.

In winter the disease seemed to disappear, but only because fleas--which were now helping to carry it from person to person--are dormant then. Each spring, the plague attacked again, killing new victims. After five years 25 million people were dead--one-third of Europe's people.

Even when the worst was over, smaller outbreaks continued, not just for years, but for centuries. The survivors lived in constant fear of the plague's return, and the disease did not disappear until the 1600s.

Medieval society never recovered from the results of the plague. So many people had died that there were serious labor shortages all over Europe. This led workers to demand higher wages, but landlords refused those demands. By the end of the 1300s peasant revolts broke out in England, France, Belgium and Italy.

The disease took its toll on the church as well. People throughout Christendom had prayed devoutly for deliverance from the plague. Why hadn't those prayers been answered? A new period of political turmoil and philosophical questioning lay ahead.

 

DISASTER STRIKES

Estimated population of Europe from 1000 to 1352.

bullet

1000 38 million

bullet

1100 48 million

bullet

1200 59 million

bullet

1300 70 million

bullet

1347 75 million

bullet

1352 50 million

25 million people died in just under five years between 1347 and 1352.

The plague bacillus was first isolated in 1894 by Andre Yersin, a French bacteriologist. Although he originally named it Pasteurella pestis after his teacher, the name giving its discoverer credit, Yersinia pestis, is the one that stuck

No other bacteria, perhaps organism, had so much of an effect on human history as Yersinia pestis, the bacteria that causes plague. Many outbreaks of plague have caused death and population reduction throughout history. The most famous, however, was the notorious Black Death of medeival times that killed one third of the population of 14th century Europe. People watched their family and friends die with sickly buboes (swollen lymph nodes) on their necks and a color near black all over their bodies, caused by respiratory failure. People who contracted the disease and were unable to fight it off died within three to five days.

In Medieval England, the Black Death was to kill 1.5 million people out of an estimated total of 4 million people between 1348 and 1350. No medical knowledge existed in Medieval England to cope with the disease. After 1350, it was to strike England another six times by the end of the century. Understandably, peasants were terrified at the news that the Black Death might be approaching their village or town.

The Black Death is the name given to a disease called the bubonic plague which was rampant during the Fourteenth Century. In fact, the bubonic plague affected England more than once in that century but its impact on English society from 1348 to 1350 was terrible. No amount of medical knowledge could help England when the bubonic plague struck. It was also to have a major impact on England’s social structure which lead to the Peasants Revolt of 1381.

The Black Death was caused by fleas carried by rats that were very common in towns and cities. The fleas bit into their victims literally injecting them with the disease. Death could be very quick for the weaker victims.

It symptoms were described in 1348 by a man called Boccaccio who lived in Florence, Italy:

"The first signs of the plague were lumps in the groin or armpits. After this, livid black spots appeared on the arms and thighs and other parts of the body. Few recovered. Almost all died within three days, usually without any fever."

Written evidence from the time indicates that nearly all the victims died within three days though a small number did last for four days.

Why did the bubonic plague spread so quickly?

In towns and cities people lived very close together and they knew nothing about contagious diseases. Also the disposal of bodies was very crude and helped to spread the disease still further as those who handled the dead bodies did not protect themselves in any way.

The filth that littered streets gave rats the perfect environment to breed and increase their number. It is commonly thought that it was the rats that caused the disease. This is not true – the fleas did this. However, it was the rats that enabled the disease to spread very quickly and the filth in the streets of our towns and cities did not help to stop the spread of the disease.

Lack of medical knowledge meant that people tried anything to help them escape the disease. One of the more extreme was the flagellants. These people wanted to show their love of God by whipping themselves, hoping that God would forgive them their sins and that they would be spared the Black Death.

Flagellants hoping to escape the Black Death

The Black Death had a huge impact on society. Fields went unploughed as the men who usually did this were victims of the disease. Harvests would not have been brought in as the manpower did not exist. Animals would have been lost as the people in a village would not have been around to tend them.

Therefore whole villages would have faced starvation. Towns and cities would have faced food shortages as the villages that surrounded them could not provide them with enough food. Those lords who lost their manpower to the disease, turned to sheep farming as this required less people to work on the land. Grain farming became less popular – this, again, kept towns and cities short of such basics as bread. One consequence of the Black Death was inflation – the price of food went up creating more hardship for the poor. In some parts of England, food prices went up by four times.

How did peasants respond?

Those who survived the Black Death believed that there was something special about them – almost as if God had protected them. Therefore, they took the opportunity offered by the disease to improve their lifestyle.

Feudal law stated that peasants could only leave their village if they had their lord’s permission. Now many lords were short of desperately needed labour for the land that they owned. After the Black Death, lords actively encouraged peasants to leave the village where they lived to come to work for them. When peasants did this, the lord refused to return them to their original village.

Peasants could demand higher wages as they knew that a lord was desperate to get in his harvest.

So the government faced the prospect of peasants leaving their villages to find a better ‘deal’ from a lord thus upsetting the whole idea of the Feudal System which had been introduced to tie peasants to the land. Ironically, this movement by the peasants was encouraged by the lords who were meant to benefit from the Feudal System.

To curb peasants roaming around the countryside looking for better pay, the government introduced the Statute of Labourers in 1351 that stated:

bullet

No peasants could be paid more than the wages paid in 1346.

bullet

No lord or master should offer more wages than paid in 1346.

bullet

No peasants could leave the village they belonged to.

 

How it was Transmitted

 

     How was the Black Death transmitted? The three forms of the Black Death were transmitted two ways. The septicemic and bubonic plague were transmitted with direct contact with a flea, while the pneumonic plague was transmitted through airborne droplets of saliva coughed up by bubonic or septicemic infected humans.

     The bubonic and septicemic plague were transmitted by the the bite of an infected flea. Fleas, humans, and rats served as hosts for the disease. The bacteria (Yersinia pestis) multiplied inside the flea blocking the flea's stomach causing it to be very hungry. The flea would then start voraciously biting a host. Since the feeding tube to the stomach was blocked , the flea was unable to satisfy its hunger. As a result, it continued to feed in a frenzy. During the feeding process, infected blood carrying the plague bacteria , flowed into the human's wound. The plague bacteria now had a new host. The flea soon starved to death.

     The pneumonic plague was transmitted differently than the other two forms . It was transmitted through droplets sprayed from the lungs and mouth of an infected person. In the droplets were the bacteria that caused the plague. The bacteria entered the lungs through the windpipe and started attacking the lungs and throat.

The Black Death

      The Black Death came in three forms, the bubonic, pneumonic, and septicemic. Each different form of plague killed people in a vicious way. All forms were caused by a bacterium called Yersinia pestis.



 

 

     The bubonic plague was the most commonly seen form of the Black Death. The mortality rate was 30-75%. The symptoms were enlarged and inflamed lymph nodes (around arm pits, neck and groin). The term 'bubonic' refers to the characteristic bubo or enlarged lymphatic gland. Victims were subject to headaches, nausea, aching joints, fever of 101-105 degrees, vomiting, and a general feeling of illness. Symptoms took from 1-7 days to appear.


 

      The pneumonic plague was the second most commonly seen form of the Black Death. The pneumonic and the septicemic plague were probably seen less then the bubonic plague because the victims often died before they could reach other places (this was caused by the inefficiency of transportation). The mortality rate for the pneumonic plague was 90-95% (if treated today the mortality rate would be 5-10%). The pneumonic plague infected the lungs. Symptoms included slimy sputum tinted with blood. Sputum is saliva mixed with mucus exerted from the respiratory system. As the disease progressed, the sputum became free flowing and bright red. Symptoms took 1-7 days to appear.


 

      The septicemic plague was the most rare form of all. The mortality was close to 100% (even today there is no treatment). Symptoms were a high fever and skin turning deep shades of purple due to DIC (disseminated intravascular coagulation). According to Dr. Matt Luther, Vanderbilt University Medical Center "The plague often caused DIC in severe forms, and DIC can be fatal. The picture above demonstrates what DIC can look like. In its most deadly form DIC can cause a victims skin to turn dark purple. The black death got its name from the deep purple, almost black discoloration." Victims usually died the same day symptoms appeared. In some cities, as many as 800 people died every day.

 

Black Death Spreads

 

Europe, 1348

Hundreds of thousands of people - men. women and children - are dying in every country in Europe, struck down by an epidemic of an apparently incurable plague which the healthy and afflicted alike call the Black Death".

Not since the sixth century has such an epidemic attacked Europe. Spreading from Asia. and carried by rat-fleas via the ports of the Black Sea. the plague takes two forms. Bubonic plague is seen in the swellings, or buboes. That inflate the lymph nodes at the neck, armpit or groin, while the pneumonic" plague affects the lungs. and vic tims choke on their own blood.

The plague has stunned Europe, and everywhere people are desperate for an explanation. Some blame invisible particles carried in the wind, others talk of poisoned wells. Many inevitably, blame the Jews. Immediate responses differ widely. Some choose to challenge the plague by bouts of riotous living, others seek protection by barring their doors and living as recluses. Neither method has halted the disease. Others have left home, seeking safety in the remote countryside, but often they too have fallen ill. Attempts to bar villages, towns, even whole cities, to sufferers have all failed. The plague moves on.

The outbreak has shattered communities. Families havebeen set against each other- the well rejecting the sick. Essential services have collapsed; law and order, with so many administrators struck down, barely exist in some areas. A sense of panic pervades Europe and everyone, it appears, is struggling only for his own survival. Properties stand empty, de serted by desperate owners; the sick die alone, for even the most de~oted doctors cannot save them: corpses are simply dumped in the street or buried in mass graves. Some depraved creatures, them selves already infected, break into houses and threaten to contaminate all within unless bribed to leave. Agriculture is at a standstill. Crops wither in the fields; cattle wander untended.

Doctors do what they can, but the plague seems irresistible. Even the most expert physicians can do little more than help strengthen people's resolve and build morale.

Some recommend the burning of aromatic woods and herbs; others suggest special diets, courses of bleeding, new postures for sleeping and many other remedies. The very rich are trying medicines made of gold and pearls. The terrible truth is that nothing seems to work. Flight is the best option, and if one cannot fly, then all that remains is resignation and prayer.

The Path



 

     If the plague had just stayed in one city, the containment might have spared Europe. Unfortunately, the plague spread when people fled to other cities.

It is believed the plague originated in Asia, and moved west with Mongol armies and traders.

     "According to a traditional story, the plague came to Europe from the town of Caffa, a Crimean port on the Black Sea where Italian merchants from Genoa maintained a thriving trade center. The Crimea was inhabited by Tartars, a people of the steppe, a dry, treeless region of central Asia. When the plague struck the area in 1346, tens of thousands of Tartars died. Perhaps superstition caused the Muslim Tartars to blame their misfortune on the Christian Genoese. Or perhaps a Christian and Muslim had become involved in a street brawl in Caffa, and the Tartars wanted revenge. In any case, the Tartars sent an army to attack Caffa, where the Genoese had fortified themselves. As the Tartars laid siege to Caffa, plague struck their army and many died. The Tartars decided to share their suffering with the Genoese. They used huge catapults to lob the infected corpses of plague victims over the walls of Caffa. As the Tartars had intended, the rotting corpses littered the streets, and the plague quickly spread throughout the besieged city. The Genoese decided they must flee; they boarded their galleys and set sail for Italy, carrying rats, fleas, and the Black Death with them."

(Corzine, 1997)      The plague traveled on trade routes and caravans. Its path of death was generally from south to north and east to west passing through Italy, France, England, Germany, Denmark,

Sweden, Poland, Finland, and eventually reaching Greenland.

 

The Plague: Will it Ever End?

Europe, 1349

Bands of hooded men, wearing white robes marked front and back with a red cross, are moving to and fro across Europe, attempting to atone for the ravages of the Black Death by whipping themselves in ritual public ceremonies.

The Flagellant Brahren, as they are known, believe that the plague is a punishment for human sin, and that by scourging themselves they can show mankind's repentance. They travel in parties of anything from 50 to 500 men, and are high ly organized. Led by a layman - the master - they move from town to town to perform their rituals. Singing hymns and sobbing, the men beat themselves with scourges studded with iron spikes. Blood gushes from their many wounds, and the spikes embed themselves in the torn flesh. The ritual is perform ed in public twice each day.

Such exhibitions are highly influential. The establishment may focus their attacks on church corruption and their promotion of a wave of savage anti-Semitism. but the masses worship the flagellants as living martyrs. Their deeds are to be admired and their commands to be carried out.

Descriptions of the Flagellants

Here are a couple of descriptions of the flagellants from contemporary chroniclers. The first is from Jean de Venette.

While the plague was still active and spreading from town to town, men in Germany, Flanders, Hainault and Lorraine uprose and began a new sect on their own authority. Stripped to the waist, they gathered in large groups and bands and marched in procession throught the crossroads and squares of cities and good towns. They formed circles and beat upon their backs with weighted scourges, rejoicing as they did so in loud voices and singing hymns suitable to their rite and newly composed for it. Thus, for 33 days they marched through many towns doing penance and affording a great spectacle to the wondering people. They flogged their shoulders and arms, scourged with iron points so zealously as to draw blood."

This second account is from the medieval historian Jean Froissart, from his history of the Hundred Years' War.

...the penitents went about, coming first out of Germany. They were men who did public penance and scourged themselves with whips of hard knotted leather with little iron spikes. Some made themselves bleed very badly between the shoulder blades and some foolish women had cloths ready to catch the blood and smear it on their eyes, saying it was miraculous blood. While they were doing penance, they sang very mournful songs about nativity and the passion of Our Lord. The object of this penance was to put a stop to the mortality, for in that time . . . at least a third of all the people in the world died.

 

I Saw the Death

"Then the grievous plague penetrated the seacoasts from Southampton, and came to Bristol, and there almost the whole strength of the town died, struck as it were by sudden death. There died at Leicester in the small parish of St. Leonard more than 380, in the parish of Holy Cross more than 400; in the parish of S. Margaret of Leicester more than 700; and so in each parish a great number. Then the bishop of Lincoln gave general power to all and every priest to hear confessions, and absolve with full and entire authority except in matters of debt, in which case the dying man, if he could, should pay the debt while he lived, or others should certainly fulfill that duty from his property after his death. In the same year there was a great plague of sheep everywhere in the realm so that in one place there died in one pasturage more than 5,000 sheep, and so rotted that neither beast nor bird would touch them. And there were small prices for everything on account of the fear of death. For there were very few who cared about riches or anything else.... Sheep and cattle went wandering over fields and through crops, and there was no one to go and drive or gather them for there was such a lack of servants that no one knew what he ought to do. Wherefore many crops perished in the fields for want of someone to gather them. The Scots, hearing of the cruel pestilence of the English, believed it had come to them from the avenging hand of God, and--as it was commonly reported in England--took their oath when they wanted to swear, "By the foul death of England."

Meanwhile the king sent proclamation that reapers and other laborers should not take more than they had been accustomed to take (in pay). But the labourers were so lifted up and obstinate that they would not listen to the king's command, but if anyone wished to have them he had to give them what they wanted, and either lose his fruit and crops, or satisfy the wishes of the workmen.

After the pestilence, many buildings, great and small, fell into ruins in every city for lack of inhabitants, likewise many villages and hamlets became desolate, not a house being left in them, all having died who dwelt there; and it was probable that many such villages would never be inhabited. In the winter following there was such a want of servants in work of all kinds, that one would scarcely believe that in times past there had been such a lack. And so all necessities became so much dearer."

History of England by Henry Knighton, in Source Book of English History, by E.K. Kendall.

Boccaccio: THE DECAMERON , "INTRODUCTION"

Thirteen hundred and forty-eight years had passed since the fruitful Incarnation of the Son of God, when there came into the noble city of Florence, the most beautiful of all Italian cities, a deadly pestilence, which, either because of the operations of the heavenly bodies, or because of the just wrath of God mandating punishment for our iniquitous ways, several years earlier had originated in the Orient, where it destroyed countless lives, scarcely resting in one place before it moved to the next, and turning westward its strength grew monstrously. No human wisdom or foresight had any value: enormous amounts of refuse and manure were removed from the city by appointed officials, the sick were barred from entering the city, and many instructions were given to preserve health; just as useless were the humble supplications to God given not one time but many times in appointed processions, and all the other ways devout people called on God; despite all this, at the beginning of the spring of that year, that horrible plague began with its dolorous effects in a most awe-inspiring manner, as I will tell you. And it did not behave as it did in the Orient, where if blood began to rush out the nose it was a manifest sign of inevitable death; but rather it began with swellings in the groin and armpit, in both men and women, some of which were as big as apples and some of which were shaped like eggs, some were small and others were large; the common people called these swellings gavoccioli. From these two parts of the body, the fatal gavaccioli would begin to spread and within a short while would appear over the entire body in various spots; the disease at this point began to take on the qualities of a deadly sickness, and the body would be covered with dark and livid spots, which would appear in great numbers on the arms, the thighs, and other parts of the body; some were large and widely spaced while some were small and bunched together. And just like the gavaciolli earlier, these were certain indications of coming death.

To cure these infirmities neither the advice of physicians nor the power of medicine appeared to have any value or profit; perhaps either the nature of the disease did not allow for any cure or the ignorance of the physicians (whose numbers, because men and women without any training in medicine invaded the profession, increased vastly) did not know how to cure it; as a consequence, very few were ever cured; all died three days after the appearance of the first outward signs, some lasted a little bit longer, some died a little bit more quickly, and some without fever or other symptoms. But what gave this pestilence particularly severe force was that whenever the diseased mixed with healthy people, like a fire through dry grass or oil it would rush upon the healthy. And this wasn't the worst of the evil: for not only did it infect healthy persons who conversed or mixed with the sick, but also touching bread or any other object which had been handled or worn by the sick would transport the sickness from the victim to the one touching the object. It is a wondrous tale that I have to tell: if I were not one of many people who saw it with their own eyes, I would scarcely have dared to believe it, let alone to write it down, even if I had heard it from a completely trustworthy person. I say that the pestilence I have been describing was so contagious, that not only did it visibly pass from one person to another, but also, whenever an animal other than a human being touched anything belonging to a person who had died from the disease, I say not only did it become contaminated by the sickness, but also died literally within the instant. Of all these things, as I have said before, my own eyes had experience many times: once, the rags of a poor man who had just died from the disease were thrown into the public street and were noticed by two pigs, who, following their custom, pressed their snouts into the rags, and afterwards picked them up with their teeth, and shook them against their cheeks: and within a short time, they both began to convulse, and they both, the two of them, fell dead on the ground next to the evil rags.

Because of all these things, and many others that were similar or even worse, diverse fears and imaginings were born in those left alive, and all of them took recourse to the most cruel precaution: to avoid and run away from the sick and their things; by doing this, each person believed they could preserve their health. Others were of the opinion that they should live moderately and guard against all excess; by this means they would avoid infection. Having withdrawn, living separate from everybody else, they settled down and locked themselves in, where no sick person or any other living person could come, they ate small amounts of food and drank the most delicate wines and avoided all luxury, refraining from speech with outsiders, refusing news of the dead or the sick or anything else, and diverting themselves with music or whatever else was pleasant. Others, who disagreed with this, affirmed that drinking beer, enjoying oneself, and going around singing and ruckus-raising and satisfying all one's appetites whenever possible and laughing at the whole bloody thing was the best medicine; and these people put into practice what they heartily advised to others: day and night, going from tavern to tavern, drinking without moderation or measure, and many times going from house to house drinking up a storm and only listening to and talking about pleasing things. These parties were easy to find because everyone behaved as if they were going to die soon, so they cared nothing about themselves nor their belongings; as a result, most houses became common property, and any stranger passing by could enter and use the house as if he were its master. But for all their bestial living, these people always ran away from the sick. With so much affliction and misery, all reverence for the laws, both of God and of man, fell apart and dissolved, because the ministers and executors of the laws were either dead or ill like everyone else, or were left with so few officials that they were unable to do their duties; as a result, everyone was free to do whatever they pleased. Many other people steered a middle course between these two extremes, neither restricting their diet like the first group, nor indulging so liberally in drinking and other forms of dissolution like the second group, but simply not going beyond their needs or satisfying their appetite beyond the necessary, and, instead of locking themselves away, these people walked about freely, holding in their hands a posy of flowers, or fragrant herbs, or diverse exotic spices, which sometimes they pressed to their nostrils, believing it would comfort the brain with smells of that sort because the stink of corpses, sick bodies, and medicines polluted the air all about the city. Others held a more cruel opinion, one that in the end probably guaranteed their safety, saying that there was no better or more effective medicine against the disease than to run away from it; convinced by this argument, and caring for no-one but themselves, huge numbers of men and women abandoned their rightful city, their rightful homes, their relatives and their parents and their things, and sought out the countryside, as if the wrath of God would punish the iniquities of men with this plague based on where they happened to be, as if the wrath of God was aroused against only those who unfortunately found themselves within the city walls, or as if the whole of the population of the city would be exterminated in its final hour.

Of all these people with these various opinions, not all died, nor did they all survive; on the contrary, many from each camp fell ill in all places, and having, when they were healthy, set an example to all those who remained healthy, they languished in their illness completely alone, having been abandoned by everybody. One citizen avoided another, everybody neglected their neighbors and rarely or never visited their parents and relatives unless from a distance; the ordeal had so withered the hearts of men and women that brother abandoned brother, and the uncle abandoned his nephew and the sister her brother and many times, wives abandoned their husbands, and, what is even more incredible and cruel, mothers and fathers abandoned their children and would refuse to visit them. As a result, of that innumerable number of those, men and women, who fell ill, there remained no-one to care for them except for friends, which were very few, or avaricious servants, who, despite the high salaries and easy service, became very scarce. And there were some men and women of such vulgar mind, that most of them were not accustomed to service, and did nothing other than serve things whenever the sick person asked and watch while they died; and the wages of this service was often death. And some of the sick were totally abandoned by neighbors, relatives, and friends, and, on account of the scarcity of servants, turned to a custom no-one had ever heard of before: no sick woman, even if she were a svelte, beautiful, and gentle lady, would care if she were being served by a man, young or otherwise, and would have no shame exposing every part of her body to him as if he were another woman, if the necessity of her sickness required her to; and this is why the women who were cured were a little less chaste afterwards. Moreover, many people died by chance who would have survived had they been helped. And so, because of the shortage of people to care for the sick, and the violence of the disease, day and night such a multitude died that it would dumbfound any to hear of it who did not see it themselves. As a result, partly out of necessity, there arose customs among those surviving that were contrary to the original customs of the city.

There used to be a custom, which is today still followed, where the women relatives and neighbors of a dead person would gather in the house and there mourn; on the other hand, there would gather at the front of the dead man's house neighbors and other citizens as well, whose numbers followed from the quality of the deceased man, and along with these priests in their finery, and with all the funeral pomp and candles and singing, he would be carried by those closest to him to the church of his choice. When the ferocity of the pestilence began to mount, for the most part people ceased with this custom and replaced it with a far different one. For not only did many people die without women surrounding them, most passed away from this life without anyone there to witness it at all; there were very few who departed amid the pious wailing and beloved tears of those close to them, far from this, most took up the custom of laughing and partying while their loved ones died; this latter usage, the women, who formerly had been so merciful and concerned with the health of the deceased one's soul, especially mastered. Also, it became rare for the body to be born to the church accompanied by more than ten or twelve men, who were not noble and cherished citizens, but a kind of grave-digger fraternity made up of the least men of the city (they demanded to be called sextons, and demanded high wages) who would bear them away; and these would bear the body quickly away, not to the church the dead man had asked for, but to the nearest one they could find, with four to six priests, maybe with a candle but sometimes not, in front; and with the help of these sextons, without fatiguing themselves with any long ceremony or rite, in any old tomb that they found unoccupied they'd dump the corpse.

As for the lesser people, who were for the most part middle class, they presented the most miserable spectacle: for these, who had no hope or who were seized with poverty, had to remain in the area, and fell ill by the thousands every day, and since they had no servants or any other kind of help, almost without exception all of them died. And many would meet their end in the public streets both day and night, and many others, who met their ends in their own houses, would first come to the attention of their neighbors because of the stench of their rotting corpses more than anything else; and with these and others all dying, there were corpses everywhere. And the neighbors always followed a particular routine, more out of fear of being corrupted by the corpse than out of charity for the deceased. These, either by themselves or with the help of others when available, would carry the corpse of the recently deceased from the house and leave it lying in the street outside where, especially in the morning, a countless number of corpses could be seen lying about. Funeral biers would come, and if there was a shortage of funeral biers, some other flat table or something or other would be used to place the corpses on. Nor did it infrequently happen that a single funeral bier would carry two or three people at the same time, but rather one frequently saw on a single bier a husband and a wife, two or three brothers, a father and a son, or some other relatives. And an infinite number of times it happened that two priests bearing a cross would be going to bury someone when three or four other biers, being born by bearers, would follow behind them; the priests would believe themselves to be heading for a single burial, and would find, when they arrived at the churchyard, that they had six or eight more burials following behind them. Nor were there ever tears or candles or any company honoring the dead; things had reached such a point, that people cared no more for the death of other people than they did for the death of a goat: for this thing, death, which even the wise never accept with patience, even though it occur rarely and relatively unobtrusively, had appeared manifestly to even the smallest intellects, but the catastrophe was so unimaginably great that nobody really cared. There was such a multitude of corpses that arrived at all churches every day and every hour, that sacred burial ground ran out, which was especially a problem if each person wanted their own plot in accordance with ancient custom. When the cemeteries were for the most part full, they excavated great pits in which they'd place hundreds of newly arrived corpses, and each corpse would be covered with a thin layer of dirt until the pit was filled.

And beyond all the particulars we suffered in the city, I will tell you not only about the ill times passing through the city, but also mention that the countryside was not spared these circumstances. For here, in the fortified towns, similar things occurred but on a lesser scale than in the city, through the small villages and through the camps of the miserable and poor laborers and their families, without any care from physicians or help from servants, and in the highways and the fields and their houses, day and night at whatever hour, not like humans but more like animals they died; and because of this, they came to neglect their customs, as did the people in the city, and had no concern for their belongings. Beyond all this, they began to behave as if every day were the day of their certain death, and they did no work to provide for their future needs by caring for their fields or their animals, but rather consumed everything they owned. Because of this, it happened that oxen, asses, sheep, goats, pigs, chickens, and dogs, the most faithful human companions, were driven from the houses, and in the fields, where the crops had been abandoned, not even reaped let alone gathered, they would wander about at their pleasure; and many, as if they possessed human reason, after they had pastured all day long, would return satiated to their houses without any guidance from any shepherd.

Let us leave the countryside and return to the city.

How much more can be said of the cruelty of heaven, and possibly, in part, that of humanity, which between March and July of that year, because of the ferocity of the pestilence and the fact that many of the sick were poorly cared for or abandoned in their hour of need by people frightened for their health, killed off one hundred thousand human creatures for certain within the walls of the city of Florence Who, before this fatal calamity, would have thought there were so many within the city? Oh, how many grand palaces, how many beautiful homes, how many noble dwellings, filled with families, with lords and ladies, became completely emptied even of children! Oh, how many famous families, how many vast estates, how many renowned fortunes remained without any rightful successors! How many noble men, how many beautiful ladies, how many light-hearted youth, who were such that Galen, Hippocrates, or Asclepius would declare them the healthiest of all humans, had breakfast in the morning with their relatives, companions, or friends, and had dinner that evening in another world with their ancestors! As I think over these miseries, sorrow grows inside me . . .

Translated from the Italian by Richard Hooker ((c)1993) <H3ENDNOTES< H3>PosyA posy of flowers was thought to ward off the contagion; the children's song, "London Bridge is Falling Down" is a song about the plague: the "pocketful of posies" refers to the posies of flowers people would carry around during epidemics.
Sexton A sexton is a paid laborer who buries corpses; like most occupations in the Middle Ages, it was a profession and had its own guild (see our textbook). The fellows here, however, would be considered by Boccaccio's audience as "non-professional" opportunists.
Ancient Physicians These are the three great physicians of antiquity. Galen wrote several works on science including one on medicine; Hippocrates lived in Ancient Greece and a number of medical writings, mostly written by his followers, were collected under his name; Asclepius is a legendary figure who cured death and was punished by Apollo for going to far with his medical knowledge. The standard medical textbook in Boccaccio's time was Galen's.

 

Marchione di Coppo Stefani, The Florentine Chronicle: Concerning A Mortality In The City Of Florence In Which Many People Died (1348)

"Neither physicians nor medicines were effective. Whether because these illnesses were previously unknown or because physicians had not previously studied them, there seemed to be no cure. There was such a fear that no one seemed to know what to do. When it took hold in a house it often happened that no one remained who had not died. And it was not just that men and women died, but even sentient animals died. Dogs, cats, chickens, oxen, donkeys sheep showed the same symptoms and died of the same disease. And almost none, or very few, who showed these symptoms, were cured. The symptoms were the following: a bubo in the groin, where the thigh meets the trunk; or a small swelling under the armpit; sudden fever; spitting blood and saliva (and no one who spit blood survived it). It was such a frightful thing that when it got into a house, as was said, no one remained. Frightened people abandoned the house and fled to another."

-Marchione di Coppo Stefani

Marchione di Coppo Stefani, The Florentine Chronicle

Marchione di Coppo Stefani was born in Florence in 1336. He wrote his Florentine Chronicle in the late 1370s and early 1380s. Stefani, Marchione di Coppo. Cronaca fiorentina. Rerum Italicarum Scriptores, Vol. 30. , ed. Niccolo Rodolico. Citta di Castello: 1903-13.

 

    

Rubric 643: Concerning A Mortality In The City Of Florence In Which Many People Died.

In the year of the Lord 1348 there was a very great pestilence in the city and district of Florence. It was of such a fury and so tempestuous that in houses in which it took hold previously healthy servants who took care of the ill died of the same illness. Almost non of the ill survived past the fourth day. Neither physicians nor medicines were effective. Whether because these illnesses were previously unknown or because physicians had not previously studied them, there seemed to be no cure. There was such a fear that no one seemed to know what to do. When it took hold in a house it often happened that no one remained who had not died. And it was not just that men and women died, but even sentient animals died. Dogs, cats, chickens, oxen, donkeys sheep showed the same symptoms and died of the same disease. And almost none, or very few, who showed these symptoms, were cured. The symptoms were the following: a bubo in the groin, where the thigh meets the trunk; or a small swelling under the armpit; sudden fever; spitting blood and saliva (and no one who spit blood survived it). It was such a frightful thing that when it got into a house, as was said, no one remained. Frightened people abandoned the house and fled to another. Those in town fled to villages. Physicians could not be found because they had died like the others. And those who could be found wanted vast sums in hand before they entered the house. And when they did enter, they checked the pulse with face turned away. They inspected the urine from a distance and with something odoriferous under their nose. Child abandoned the father, husband the wife, wife the husband, one brother the other, one sister the other. In all the city there was nothing to do but to carry the dead to a burial. And those who died had neither confessor nor other sacraments. And many died with no one looking after them. And many died of hunger because when someone took to bed sick, another in the house, terrified, said to him: "I'm going for the doctor." Calmly walking out the door, the other left and did not return again. Abandoned by people, without food, but accompanied by fever, they weakened. There were many who pleaded with their relatives not to abandon them when night fell. But [the relatives] said to the sick person, "So that during the night you did not have to awaken those who serve you and who work hard day and night, take some sweetmeats, wine or water. They are here on the bedstead by your head; here are some blankets." And when the sick person had fallen asleep, they left and did not return. If it happened that he was strengthened by the food during the night he might be alive and strong enough to get to the window. If the street was not a major one, he might stand there a half hour before anyone came by. And if someone did pass by, and if he was strong enough that he could be heard when he called out to them, sometimes there might be a response and sometimes not, but there was no help. No one, or few, wished to enter a house where anyone was sick, nor did they even want to deal with those healthy people who came out of a sick person's house. And they said to them: "He is stupefied, do not speak to him!" saying further: "He has it because there is a bubo in his house." They call the swelling a bubo. Many died unseen. So they remained in their beds until they stank. And the neighbors, if there were any, having smelled the stench, placed them in a shroud and sent them for burial. The house remained open and yet there was no one daring enough to touch anything because it seemed that things remained poisoned and that whoever used them picked up the illness.

At every church, or at most of them, they dug deep trenches, down to the waterline, wide and deep, depending on how large the parish was. And those who were responsible for the dead carried them on their backs in the night in which they died and threw them into the ditch, or else they paid a high price to those who would do it for them. The next morning, if there were many [bodies] in the trench, they covered them over with dirt. And then more bodies were put on top of them, with a little more dirt over those; they put layer on layer just like one puts layers of cheese in a lasagna.

The beccamorti [literally vultures] who provided their service, were paid such a high price that many were enriched by it. Many died from [carrying away the dead] , some rich, some after earning just a little, but high prices continued. Servants, or those who took care of the ill, charged from one to three florins per day and the cost of things grew. The things that the sick ate, sweetmeats and sugar, seemed priceless. Sugar cost from three to eight florins per pound. And other confections cost similarly. Capons and other poultry were very expensive and eggs cost between twelve and twenty-four pence each; and he was blessed who could find three per day even if he searched the entire city. Finding wax was miraculous. A pound of wax would have gone up more than a florin if there had not been a stop put [by the communal government] to the vain ostentation that the Florentines always make [over funerals]. Thus it was ordered that no more than two large candles could be carried[in any funeral]. Churches had no more than a single bier which usually was not sufficient. Spice dealers and beccamorti sold biers, burial palls, and cushions at very high prices. Dressing in expensive woolen cloth as is customary in [mourning] the dead, that is in a long cloak, with mantle and veil that used to cost women three florins climbed in price to thirty florins and would have climbed to 100 florins had the custom of dressing in expensive cloth not been changed. The rich dressed in modest woolens, those not rich sewed [clothes] in linen. Benches on which the dead were placed cost like the heavens and still the benches were only a hundredth of those needed. Priests were not able to ring bells as they would have liked. Concerning that [the government] issued ordinances discouraging the sounding of bells, sale of burial benches, and limiting expenses. They could not sound bells, sell benches, nor cry out announcements because the sick hated to hear of this and it discouraged the healthy as well. Priests and friars went [to serve] the rich in great multitudes and they were paid such high prices that they all got rich. And therefore [the authorities] ordered that one could not have more than a prescribed number [of clerics] of the local parish church. And the prescribed number of friars was six. All fruits with a nut at the center, like unripe plums and unhusked almonds, fresh broadbeans, figs and every useless and unhealthy fruit, were forbidden entrance into the city. Many processions, including those with relics and the painted tablet of Santa Maria Inpruneta, went through the city crying our "Mercy" and praying and then they came to a stop in the piazza of the Priors. There they made peace concerning important controversies, injuries and deaths. This [pestilence] was a matter of such great discouragement and fear that men gathered together in order to take some comfort in dining together. And each evening one of them provided dinner to ten companions and the next evening they planned to eat with one of the others. And sometimes if they planned to eat with a certain one he had no meal prepared because he was sick. Or if the host had made dinner for the ten, two or three were missing. Some fled to villas, others to villages in order to get a change of air. Where there had been no [pestilence], there they carried it; if it was already there, they caused it to increase. None of the guilds in Florence was working. All the shops were shut, taverns closed; only the apothecaries and the churches remained open. If you went outside, you found almost no one. And many good and rich men were carried from home to church on a pall by four beccamorti and one tonsured clerk who carried the cross. Each of them wanted a florin. This mortality enriched apothecaries, doctors, poultry vendors, beccamorti, and greengrocers who sold of poultices of mallow, nettles, mercury and other herbs necessary to draw off the infirmity. And it was those who made these poultices who made alot of money. Woolworkers and vendors of remnants of cloth who found themselves in possession of cloths [after the death of the entrepreneur for whom they were working] sold it to whoever asked for it. When the mortality ended, those who found themselves with cloth of any kind or with raw materials for making cloth was enriched. But many found [who actually owned cloths being processed by workers] found it to be moth-eaten, ruined or lost by the weavers. Large quantities of raw and processed wool were lost throughout the city and countryside.

This pestilence began in March, as was said, and ended in September 1348. And people began to return to look after their houses and possessions. And there were so many houses full of goods without a master that it was stupefying. Then those who would inherit these goods began to appear. And such it was that those who had nothing found themselves rich with what did not seem to be theirs and they were unseemly because of it. Women and men began to dress ostentatiously.

Rubric 635
How Many Of The Dead Died Because Of The Mortality Of The Year Of Christ 1348

Now it was ordered by the bishop and the Lords [of the city government]that they should formally inquire as to how many died in Florence. When it was seen at the beginning of October that no more persons were dying of the pestilence, they found that among males, females, children and adults, 96,000 died between March and October.

 

Rubric 636
How They Passed Ordinances Concerning Many Things In Florence

In the said year, when the mortality stopped, women and men in Florence were unmindful of [traditional modesty concerning] their dress. And ordinances were passed concerning this giving authority to the Judge of the Grascia to enforce these ordinances. The tailors made such boundless demands for payment that they could not be satisfied. Authority was granted [to the judge] that he should handle all matters himself. Servants were so unhappy about the very high prices [they paid] that it was necessary to make great efforts to restrain [the price rises]. The workers on the land in the countryside wanted rent contracts such that you could say that all they harvested would be theirs. And they learned to demand oxen from the landlord but at the landlord's risk [and liability for any harm done to the animal]. And then they helped others for pay by the job or by the day. And they also learned to deny [liability for] loans and [rental] payments. Concerning this serious ordinances were instituted; and [hiring] laborers became much more expensive. You could say that the farms were theirs; and they wanted the oxen, seed, loans quickly and on good terms. It was necessary to put a brake on weddings as well because when they gathered for the betrothal each party brought too many people in order to increase the pomp. And thus the wedding was made up of so many trappings. How many days were necessary and how many women took part in a woman's wedding. And they passed many other ordinances concerning [these issues].

 

 

Pistoia, "Ordinances for Sanitation in a Time of Morality"f (1348)

PISTOIA, "ORDINANCES FOR SANITATION IN A TIME OF MORTALITY"

Pistoia was a provincial city of about 11,000 in the early fourteenth century located in the region of Tuscany, less than thirty kilometers northwest of Florence. Its government was in the hands of a small executive council made up of the Anziani or Elders of the People and the Standardbearer of Justice. The chief administrative officers were the Captain of the People and the Podesta who served six-month terms. They could not be Pistoian or even Tuscan. They were allowed limited social contact with Pistoians and their behavior was audited, or "syndicated" at the end of their terms of office. This allowed anyone who felt wronged by their actions to bring charges. The eight Anziani and the Standardbearer of Justice were citizens of the city selected by lot to serve two-month terms from among the citizens of the city who met age, professional and property qualifications. This small council debated all issues and made recommendations to a general city council, the Council of the People which was required either to approve or reject proposals without amendment. As will be clear from the ordinances, there were virtually no issues which affected life in the city which the government could not debate. The context of the Ordinances was the arrival of the Plague early in the Spring of 1348. Plague probably cost the city and surrounding countryside about one fourth of the total population. The statutes themselves reflect both the scientific knowledge and the practical issues which this crisis brought to a head.

In the name of Christ Amen. Herein are written certain ordinances and provisions made and agreed upon by certain wise men of the People of the city of Pistoia elected and commissioned by the lords Anziani and the Standardbearer of Justice of the said city concerning the preserving, strengthening and protecting the health of humans from various and diverse pestilences which otherwise can befall the human body. And written by me Simone Buonacorsi notary. . . in the year from the Nativity of the Lord MCCCXLVIII, the first Indiction.

First. So that no contaminated matter which presently persists in the areas surrounding the city of Pistoia can enter into the bodies of the citizens of Pistoia, these wise men provided and ordered that no citizen of Pistoia or dweller in the district or the county of Pistoia . . . shall in any way dare or presume to go to Pisa or Lucca or to the county or district of either. And that no one can or ought to come from either of them or their districts ... to the said city of Pistoia or its district or county on penalty of £ 50 ... And that gatekeeper of the city of Pistoia guarding the gates of the said city shall not permit those coming or returning to the said city of Pistoia from the said cities of Pisa or Lucca, their districts or counties to enter the said gates on penalty of £ 10 ... It is licit, however, for citizens now living in Pistoia to go to Pisa and Lucca, their districts and counties and then return if they have first obtained a license from the Council of the People ....

II. Item. The foresaid wise men provided and ordered that no person whether citizen, inhabitant of the district or county of the city of Pistoia or foreigner shall dare or presume in any way to bring ... to the city of Pistoia, its district or county, any used cloth, either linen or woolen, for use as clothing for men or women or for bedclothes on penalty of £ 200. ... Citizens of Pistoia, its district and county returning to the city, district or county will be allowed to bring with them the linen or woolen cloths they are wearing and those for personal use carried in luggage or a small bundle weighing 30 pounds or less. ... And if any quantity of cloth of the said type or quality has been carried into the said city, county or district, the carrier shall be held to and must remove and export it from the said city, county and district within three days of the adoption of the present ordinance under the foresaid penalty for each carrier or carriers and for each violation.

III. Item. They provided and ordered that the bodies of the dead, after they had died, can not be nor ought to be removed from the place in which they are found unless first such a body has been placed in a wooden casket covered by a lid secured with nails, so that no stench can issue forth from it; nor can it be covered except by a canopy, blanket or drape under a penalty for £ 50 of pennies paid by the heirs of the dead person.... And also that likewise such dead bodies of the dead must be carried to the grave only in the said casket under the said penalty as has been said. And so that the foresaid shall be noted by the rectors and officials of the city of Pistoia, present and future rectors of the parishes of the city of Pistoia in whose parish there is any dead person are held to and must themselves announce the death and the district [of the city] in which the dead person lived to the podesta and captain or others of the government of the said city. And they must notify them of the name of the dead person and of the district in which the dead person had lived or pay the said penalty for each contravention. And the podesta and captain to whom such an announcement or notification has been made, immediately are held to and must send one of their officials to the same location to see and inquire if the contents of the present article and other statutes and ordinances concerning funerals are being observed and to punish anyone found culpable according to the said penalty.... And the foresaid shall not be enforced nor is it extended to poor and miserable persons who are declared to be poor and miserable according to the form of any statutes or ordinances of the said city.

IV. Item. In order to avoid the foul stench which the bodies of the dead give off they have provided and ordered that any ditch in which a dead body is to be buried must be dug under ground to a depth of 2 1/2 braccia by the measure of the city of Pistoia.

V. Item. They have provided and ordered that no person of whatever condition or status or authority shall dare or presume to return or to carry to the city of Pistoia any dead body in or out of a casket or in any manner on penalty of £ 25 of pennies paid by whoever carries, brings, or orders [a body] to be carried or brought for each occasion. And that the gatekeepers of the said city shall not permit such a body to be sent into the said city on penalty of the foresaid fine by each gatekeeper at the gate through which the said body was sent.

VI. Item. They have provided and ordered that any person who will have come for the burial or to bury any dead person can not and may not be in the presence of the body itself nor with the relatives of such a dead person except for the procession to the church where it will be buried. Nor shall such persons return to the house where the defunct person lived or enter into that house or any other house on the said occasion on penalty of £ 10

VII. Item. They have provided and ordered that when anyone has died no person should dare or presume to present or to send any gift before or after burial to the former dwelling place of such a dead person or any other place on the said occasion or to attend or to go to a meal in that house or place on the said occasion on penalty of £ 25.... Children, carnal brothers and sisters, nieces and nephews of such a dead person and their children, however, shall be expected [from this provision].

VIII. Item. They have provided and ordered that in order to avoid useless or fruitless expenses no person should dare or presume to dress in new clothing during the period of mourning for any dead person or during the eight days after that, on penalty of £ 25 of pennies for whoever contravenes [this] and for each time. Wives of such dead persons however, shall be exempted; they can be dressed in whatever new clothing they wish without penalty.

IX. Item. They have provided and ordered that no paid mourner... shall dare or presume to mourn publicly or privately or to invite other citizens of Pistoia to go to the funeral or to the dead person; nor may anyone engage the foresaid mourner, hornplayer, cryer or drummer.

X. Item. So that the sounds of bells might not depress the infirm nor fear arise in them [the Wise Men] have provided and ordered that the bellringers or custodians in charge of the belltower of the cathedral of Pistoia shall not permit any bell in the said campanile to be rung for the funeral of the dead nor shall any person dare or presume to ring any of these bells on the said occasion.... At the chapel or parish church of the said dead person or at the friary if the person is to be buried at a church of the friars, they can ring the bell of the chapel, parish church or the church of the friars so long as it is rung only one time and moderately, on the foresaid penalty in the foresaid manner [for each violation].

XI. Item. They have provided and ordered that no one shall dare or presume to gather or cause to gather any persons for the purpose of bringing any widow from the former habitation of a dead person, unless at the time she is being returned from the church or cemetery where such a dead person was buried. [Blood relatives] of such a widow, however, wishing to bring the widow from the house at times other than at the time of burial may send up to four women to accompany the said woman, who is to be brought from the foresaid house of the dead person....

XII. Item. They have provided and ordered that no person should dare or presume to raise or cause to be raised any wailing or clamor over any person or because of any person who has died outside the city, district or county of Pistoia; nor on the said occasion should any persons be brought together in any place except blood relatives and associates of such a dead person, nor on the said occasion should any bell be rung or caused to be wrung, nor announcements be made through the city of Pistoia by mourners, nor on the said occasion should any invitation [to join the mourners ] be made on a penalty of £ 25.... It must be understood, however, in any written ordinances speaking of the dead and of honoring the burial of the dead that the foresaid shall not have force in the burial of the body of any soldiers of the militia, doctors of laws, judges or physicians whose bodies, because of their dignity, may be honored licitly at burial in a manner pleasing to their heirs.

XIV. Item. They have provided and ordered that butchers and retail vendors of meat, individually and in common, can not, nor ought to hold or maintain near a tavern or other place where they sell meats, or near a shop or beside or behind a shop any stable, pen or any other thing which will give off a putrid smell; nor can they slaughter meat animals nor hang them after slaughter in any stable or other place in which there is any stench on a penalty of £ 10.

XXII. Item. So that stench and putrefaction shall not be harmful to men, henceforth tanning of hides can not and must not be done within the walls of the city of Pistoia on penalty of £ 25....

XXIII. Item. For the observance of each and every provision contained in the present articles and everything in the article speaking of funerals of the dead, of butchers and retail vendors of meats, they provided and ordered that the lord podestˆ and captain and their officials charged pro tem with the foresaid [duties] shall and must proceed against, investigate, and inquire. . . concerning acts contrary to the foresaid [ordinances], and cause whatever of the foresaid ordained to be reviewed as often as possible, and punish the guilty by the foresaid fines. . . . Also any person may accuse or denounce before either the said podestˆ or captain any persons acting against the foresaid or any of the foresaid or the content of the said statutes or ordinances. And such denunciations or accusers shall, can and may have one fourth of the fine after it is levied and paid, which fourth part the treasurer pro tem of the treasury of the said city shall be held to and have to pay and give to the said accuser and informer as soon as the fine and penalty have been paid. And sufficient proof shall be offered by one witness worthy of belief, or four persons of good reputation who have learned [of the contravention]. . . .

A Description of the Plague

This first account is from Messina, and it described the arrival and initial progress of the disease.

At the beginning of October, in the year of the incarnation of the Son of God 1347, twelve Genoese galleys . . . entered the harbor of Messina. In their bones they bore so virulent a disease that anyone who only spoke to them was seized by a mortal illness and in no manner could evade death. The infection spread to everyone who had any contact with the diseased. Those infected felt themselves penetrated by a pain throughout their whole bodies and, so to say, undermined. Then there developed on the thighs or upper arms a boil about the size of a lentil which the people called "burn boil". This infected the whole body, and penetrated it so that the patient violently vomited blood. This vomiting of blood continued without intermission for three days, there being no means of healing it, and then the patient expired.

Not only all those who had speech with them died, but also those who had touched or used any of their things. When the inhabitants of Messina discovered that this sudden death emanated from the Genoese ships they hurriedly ordered them out of the harbor and town. But the evil remained and caused a fearful outbreak of death. Soon men hated each other so much that if a son was attacked by the disease his father would not tend him. If, in spite of all, he dared to approach him, he was immediately infected and was bound to die within three days. Nor was this all; all those dwelling in the same house with him, even the cats and other domestic animals, followed him in death. As the number of deaths increased in Messina many desired to confess their sins to the priests and to draw up their last will and testament. But ecclesiastics, lawyers and notaries refused to enter the houses of the diseased.

Soon the corpses were lying forsaken in the houses. No ecclesiastic, no son, no father and no relation dared to enter, but they hired servants with high wages to bury the dead. The houses of the deceased remained open with all their valuables, gold and jewels. . . . When the catastrophe had reached its climax the Messinians resolved to emigrate. One portion of them settled in the vineyards and fields, but a larger portion sought refuge in the town of Catania. The disease clung to the fugitives and accompanied them everywhere where they turned in search of help. Many of the fleeing fell down by the roadside and dragged themselves into the fields and bushes to expire. Those who reached Catania breathed their last in the hospitals there. The terrified citizens would not permit the burying of fugitives from Messina within the town, and so they were all thrown into deep trenches outside the walls.

Thus the people of Messina dispersed over the whole island of Sicily and with them the disease, so that innumerable people died. The town of Catania lost all its inhabitants, and ultimately sank into complete oblivion. Here not only the "burn blisters" appeared, but there developed gland boils on the groin, the thighs, the arms, or on the neck. At first these were of the size of a hazel nut, and developed accompanied by violent shivering fits, which soon rendered those attacked so weak that they could not stand up, but were forced to lie in their beds consumed by violent fever. Soon the boils grew to the size of a walnut, then to that of a hen's egg or a goose's egg, and they were exceedingly painful, and irritated the body, causing the sufferer to vomit blood. The sickness lasted three days, and on the fourth, at the latest, the patient succumbed. As soon as anyone in Catania was seized with a headache and shivering, he knew that he was bound to pass away within the specified time. . . . When the plague had attained its height in Catania, the patriarch endowed all ecclesiastics, even the youngest, with all priestly powers for the absolution of sin which he himself possessed as bishop and patriarch. But the pestilence raged from October 1347 to April 1348. The patriarch himself was one of the last to be carried off. He died fulfilling his duty. At the same time, Duke Giovanni, who had carefully avoided every infected house and every patient, died.

 

Giovanni Sercambi: An Image of Plague (1348)

 

The Black Death of 1347-1351

 

During the next few years, the European economy slowly improved, and agricultural and manufacturing production eventually reached pre-famine levels. This return to normalcy was suddenly ended in the year 1347 by a disaster even worse than the Great Famine.

Since the failure of Justinian's attempt to reconquer the lands of the Western Empire in 540-565, Europe had been relatively isolated, its population sparse, and intercommunication among its villages slight. It was as if the continent were divided up into a number of quarantine districts. Although many diseases were endemic (that is, they were always present), contagious diseases did not spread rapidly or easily. So the last pandemic (an epidemic that strikes literally everywhere within a short time) to strike Europe had been the one brought to the West by Justinian's armies in 547. By the 14th century, however, the revival of commerce and trade and the growth of population had altered that situation. There was much more movement of people from place to place within Europe, and European merchants travelled far afield into many more regions from which they could bring home both profitable wares and contagious diseases. Moreover, the diet, housing, and clothing of the average men and women of Western Europe were relatively poor, and a shortage of wood for fuel had made hot water a luxury and personal hygiene substandard.

Contrary to popular belief, medieval people actually liked to wash. They particularly enjoyed soaking in hot tubs and, as late as the mid- thirteenth century, most towns and even villages had public bath houses not unlike the Japanese do today. The conversion of forest into arable land had reduced the supply of wood, however, and the bath houses began to shut down because of the expense of heating the water. They tried using coal, but decided that burning coal gave off unhealthy fumes (They were right, by the way) and abandoned the use of the stuff. By the mid-fourteenth century, only the rich could afford to bathe during the cold Winter months, and most of the population was dirty most of the time, even if they did not enjoy being so

The Black Death seems to have arisen somewhere in Asia and was brought to Europe from the Genoese trading station of Kaffa in the Crimea (in the Black Sea). The story goes that the Mongols were besieging Kaffa when a sickness broke out among their forces and compelled them to abandon the siege. As a parting shot, the Mongol commander loaded a few of the plague victims onto his catapults and hurled them into the town. Some of the merchants left Kaffa for Constantinople as soon as the Mongols had departed, and they carried the plague with them. It spread from Constantinople along the trade routes, causing tremendous mortality along the way.

[map of the spread of the black death through
europe]

The disease was transmitted primarily by fleas and rats. The stomachs of the fleas were infected with bacteria known as Y. Pestis. The bacteria would block the "throat" of an infected flea so that no blood could reach its stomach, and it grew ravenous since it was starving to death. It would attempt to suck up blood from its victim, only to disgorge it back into its prey's bloodstreams. The blood it injected back, however, was now mixed with Y. Pestis. Infected fleas infected rats in this fashion, and the other fleas infesting those rats were soon infected by their host's blood. They then spread the disease to other rats, from which other fleas were infected, and so on. As their rodent hosts died out, the fleas migrated to the bodies of humans and infected them in the same fashion as they had the rats, and so the plague spread

The disease appeared in three forms:
bubonic [infection of the lymph system -- 60% fatal]
pneumonic [respiratory infection -- about 100% fatal], and
septicaemic [infection of the blood and probably 100% fatal]

The plague lasted in each area only about a year, but a third of a district's population would die during that period. People tried to protect themselves by carrying little bags filled with crushed herbs and flowers over their noses, but to little effect. Those individuals infected with bubonic would experience great swellings ("bubos" in the Latin of the times) of their lymph glands and take to their beds. Those with septicaemic would die quickly, before any obvious symptoms had appeared. Those with respiratory also died quickly, but not before developing evident symptoms: a sudden fever that turned the face a dark rose color, a sudden attack of sneezing, followed by coughing, coughing up blood, and death.

It is a popular (although incorrect) belief that this latter sequence is recalled in a children's game-song that most people know and have both played and sung:

 

Ring around the rosie,
A pocketful of posie,
Ashes, ashes
All fall down!

 

According to this conception, the ring mentioned in the verse is a circular dance, and the plague was often portrayed as the danse macabre, in which a half-decomposed corpse was shown pulling an apparently healthy young man or woman into a ring of dancers that included man and women from all stations and dignities of life as well as corpses and skeletons. The rosie is believed to represent the victim with his or her face suffused with blood, and the posie is the supposedly prophylactic bag of herbs and flowers. Ashes, ashes is the sound of sneezing, and all fall down! is the signal to reenact the death which came so often in those times.

Partially due to the lack of children's skills to provide for themselves, the children suffered. A common nursery rhyme is proof.

          Ring a-round the rosy
          Pocket full of posies
          Ashes, ashes!
          We all fall down!

     Ring around the rosy: rosary beads give you God's help. A pocket full of posies: used to stop the odor of rotting bodies which was at one point thought to cause the plague, it was also used widely by doctors to protect them from the infected plague patients. Ashes, ashes: the church burned the dead when burying them became to laborious. We all fall down: dead. Not only were the children effected physically, but also mentally. Exposure to public nudity, craziness, and (obviously) abundant death was premature. The decease of family members left the children facing death and pain at an early age. Parents even abandoned their children, leaving them to the streets instead of risking the babies giving them the dr