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



The Bubonic Plague

(AKA "Black Death")



Throughout history, the world has endured huge death rates caused by plagues, and the most notorious was arguably the bubonic plague. Named the Black Death in Medieval Europe, it wiped out one-third of the population of Europe, with the majority of deaths occurring between 1348 and 1351.


The bubonic plague is present in today's world. Throughout recorded history, there have been many outbreaks and mini-outbreaks; however, the plague has largely been dormant, appearing only in isolated regions with limited effects on overall world populations.

The global epidemic, or "Black Death," that most associate with medieval Europe actually began in central Asia in the early 14th century, probably near China's Gobi Desert. It then spread through China, killing approximately 35 million people. For reasons unknown (perhaps global cooling allowed it to thrive), the plague began a massive outbreak in all directions that eventually affected most of the world. It spread along Chinese trade routes and reached Europe in October 1347 when a fleet of Genoese merchant ships from Caffa landed in Sicily.


Once the plague reached Sicily, the most remote corners of Europe were infected in less than three years. During that period, one-third of Europe's population perished, everyone lived in terror of becoming the Black Death's next victim and all knew someone who had succumbed to the plague. No one knew how to prevent or cure it.

After the plague first struck in Sicily in October 1347, the disease spread rapidly:

1348 Cities Infected

1348                                                     Cities Infected

January                   Genoa , Marseilles

March                      Florence                               

April                         Avignon

June                        Paris

August                     Dublin, York

December                London                                                                                                                     



January                     Vienna

February                   Strasbourg

May                           Norway



June                        Hamburg , Stockholm                                                                                                              

Infection Death

Fleas were the primary carriers of the bubonic plague and initially rats serves as their hosts. Rats. however, were as susceptible to the disease as humans - or any other animal. As rats began to die from the plague, fleas sought new hosts from which to feed. Eventually, fleas found new human hosts who were in turn infected by the plague.

picture of flea

Once infected, death was inevitable and occurred swiftly - within three or four days. The first signs of infection appeared within two days of exposure and included dark, almost black buboes, or boils, that appeared in the infected person's armpits and groin area. It was for these dark buboes that the Black Death was named. A sudden high fever and severe pain throughout the body, especially in the joints, accompanied the buboes. As symptoms progressed, victims were unable to sleep, went into convulsions and had severe headaches that led to delirium. Their eyes went bloodshot and tongues swelled horrifically, went dry and even grew fur! Many of those infected vomited blood virtually nonstop for what remained of their pathetic lives.

The diagram below shows the process of fleas passing the disease to humans:

Forms of the Plague

Three varieties of the plague have infected humankind throughout time: First (an most notorious) is the bubonic plague, followed by the septicaemic plague and thirdly, the pneumonic plague.

Bubonic Plague - This strain attacks the lymph nodes, found in the human neck, armpit and groin. When infected with the plague, these areas become very swollen and turn dark blue or nearly black in color. Discoloration in these areas led people to dub the disease the "Black Death." This is the least deadly of the three plagues because it cannot be transmitted between humans without a carrier (such as a flea).

Sample of "blackened" skin

Septicaemic Plague - This strain attacks the blood and brain, and is the most deadly form of the disease - with death often occurring within 24 hours.


Pneumonic Plague - This form attacks the lungs and can be transmitted easily via common air. Death usually occurs within 3-4 days. Today, a treatment of antibiotics, if taken early at the onset of the disease, can spare humans the terrible death that would have surely occurred had they lived in the Middle Ages. While there is a chance that a person infected with bubonic plague could survive, the septicaemic and pneumonic forms of the plague are almost always fatal without treatment. To account for the world's extremely high death rate during the 1300s, researchers believe the Black Death was probably a combination of bubonic and one of the plague's other forms. A combination of these diseases could account for the horrendous and swift deaths of the Middle Ages.

Death Rates

The 200-250 million people died, with a death rate of 33%, may seem staggering, actual death rates for certain cities were even greater. A 33% death rate was the average throughout Europe; because cities hold the greatest concentrations of people, they were hit hardest. The average death rate in European cities, estimated at 50%, meant that so many died, there were not enough people left alive to bury the dead.


Today, an infected person is easily treated with antibiotics (if the infection is detected early). During the era of the Black Death, science had not sufficiently progressed to where doctors could understand the plague, its origins or how it spread. Consequently, people resorted to a variety of treatments and preventative measures. Because the stench of decaying bodies from those who had succumbed to the plague was so noxious, many thought that the plague was spread via the atmosphere and so used pungent scents hoping to keep it away. Scents such as pine, rosemary were burned like incense or processed into oils in which handkerchief were dipped and placed over the mouth and nose.Church bells were chimed in a futile bid to ward off the plague. Merchants sold charms and spells to ward off the plague. Rumors that claimed a person had done or worn something particular to survive led to the newest fad to prevent or cure the disease.Perhaps the most widespread belief of the plague's origins blamed an act of god, which showed his displeasure over humankind's transgressions. Kings built magnificent cathedrals and monuments dedicated to god's glory, hoping he would allow the plague to pass over their city.In central Europe, commoners who could not make such grand and expensive promises often did penance for their sins by beating themselves. Known as flagellants, they walked in succession through towns bare backed, whipping themselves and those who accompanied them. Leather whips featured knots or small metal spikes attached at the end that drew blood with virtually every strike as they viciously flogged themselves. As they marched, flagellants sang and prayed from mercy, believing that if they demonstrated to god that they were truly repentant, he would spare their lives.


The plague had a devastating effect on every aspect of life and it would take Europe's population over 150 years to return to the pre-plague levels. Besides a massive decline in population, economic, social, and cultural effects continued to disrupt and influence European life throughout the next century.

Economic - The immediate economic effect of the plague was that the huge death toll created a serious labor shortage that affected all aspects of the economy. In agriculture, if the plague struck a town in summer, there were not enough laborers to harvest crops in the fall. If it struck in the winter, there were not enough laborers to plant in the spring.

Eventually, small farming villages and towns disappeared from the map because there was no one left to farm the land. The few who survived moved to other lands.

As the plague spread throughout Europ0e, building projects were left incomplete. Many artisans died and their shops remained empty. Church parishes had no priests to conduct services, lords did not have enough servants to meet their needs, and many private homes were abandoned. So severe was the labor shortage and so afraid of the plague were Europeans that there remained no one to bury the dead.

The plague was the ruin of many landlords and credit lenders. Landlords often borrowed large sums of money and, when serfs died or demanded higher wages, landlords could not raise money to repay creditors. If the landlord succumbed to the plague, there was no way for creditors to recover lost money.

Widespread labor shortages led to a rise in labor prices. This occurred in all aspects of the economy but was especially evident in the agricultural sector. Serfs who for centuries had worked the land for little or not pay, suddenly began to demand higher wages and, increasingly, revolted against a nobility that sought to work them for lower wages of the past.

Social Effects - The greatest social impact of the plague was that the rigid feudal system, in place in Europe for a thousand years, was dismantled. Feudalism was based on the nobility controlling land and the peasants who worked it. With immense labor shortages, serfs were free to leave the lands of the lords to seek higher wages.

Additionally, land that had traditionally been the primary source of wealth was now worthless. Entire estates, abandoned as families fell to the plague or fled in a futile bid to escape its wrath, were there for the taking.

As economies evolved away from relying on land as a primary source of wealth and toward money economies, an emerging middle class claimed more and more wealth and prestige - as the nobility began to lose both. Another social effect of the plague on European society was anti-Semitism. In an attempt to explain the cause of the plague, ignorant Europeans in search of a scapegoat suspected and accused many different groups. Witches, lepers and Jews were all targets of accusations and aggression by scared Europeans. Throughout central Europe, the flagellants convincingly charged the Jews. In Strasbourg alone, over 8,000 Jews were killed - 200 in one day.

Political Effects - As was the case socially, the breakdown of the feudal system had a lasting impact in Europe. Many nobles and vassals were killed by the plague, opening the door for kings who claimed power and established strong, aristocratic nation-states that governed Europe through the Renaissance 

So great was the death toll and fear of the plague that many courts and legislative bodies, on both the local and provincial levels, were abandoned. Even the art of waging war was affected by the plague: In 1348, the Hundred Years' War was postponed due to the high plague-related death toll among soldiers.

Cultural Effects - The plague's awesome impact on the arts is evident in paintings, sculpture and architecture. The medieval artistic world began to focus on death. As mentioned earlier, kings and wealthy nobility commissioned monuments, sculptures and cathedrals in response to the plague. Many were built to thank god for passing over a city or region; others were built as a reminder of the plague's devastation.

Both sculptors and painters began to portray the dead and dying, as well as images of death and the grim reaper. The style Danse Macabre, or dance of death, frequently portrayed scenes from everyday life, complete with images of the dead and/or skeletons. Skeletons were often depicted dancing, leading the living to their deaths or participating in a scene as though still alive. In some instances, art took on such extreme realism that partially decomposed bodies were included.

The Plague Today

Although the plague is today easily treatable with antibiotics, it has not yet been fully eradicated - nearly impossible since countless fleas and rodents still carry the disease. The plague can be found throughout most of the world today, especially in the western United States, Africa and southern Asia. As many as 3,00 cases are reported to the World Health Organization annually.


The map below shows a recent illustration of the bubonic plague in the modern world.