The Bubonic Plague Pandemic, AKA the Black Death

The Bubonic Plague, better known as the Black Death, was one of the worst catastrophes in recorded history.  From 1347 to 1351, it ravaged kingdoms across Europe, eradicating one- third of Europe’s inhabitants. It destroyed a higher proportion of the population than any other single known event since. At that time in the Middle Ages, no one was sure what caused the plague.  The living were barely able enough to bury the dead.  Over the next four years, the Black Death rampaged through Europe, killing more than 20 million.

The Bubonic Plague arrived in Europe in October 1347, when 12 trading ships from the Black Sea docked at the Sicilian port of Messina. Sicilians were horrified to discover most sailors onboard were dead, and those still alive were covered in putrid black boils that oozed blood and pus.  Sicily hastily ordered the fleet of “Death Ships” out of the harbor … but it was too late.

Europeans had heard disturbing rumors of a “Great Pestilence” spreading across the trade routes to the Far East. In the early 1340s, the disease had already struck China, India, and Persia.  It may have originated in the Qinghai Plateau of Central Asia.  After landing in Sicily, the Black Death creeped northwest into Italy, Spain, France and England.  The plague then spread northeast into the Germanic states, then on to Scandinavia and even Russia. It’s thought the Black Death spread at a rate of about eight miles a day, the rate an average horse-drawn wagon could travel in a single day.

Medieval physicians noted it took as little as 5 days to cause death. 

And these were 5 very bad days.  European doctors were ill equipped to deal with the Black Death. Swellings in the groin and armpits grew from the size of an egg to an apple, becoming infected plague-boils, called buboes.  The disease attacks the body’s lymphatic system, causing swelling in the lymph nodes clustered there.  Blood and pus rush out of the swollen boils when they burst, followed by a host of unpleasant symptoms—fever, vomiting, diarrhea, terrible pain—and in short order, death. The infection spreads quickly to the lungs causing pneumonia, and in some cases sepsis.

Medieval folk, both kings and peasants, believed the Black Death was a curse from God.  There was no known remedy, but people wanted something – anything.  Physicians relied on crude treatments like bloodletting and boil-lancing. Doctors wore long-beaked plague masks, filled with dried flower petals to mask the bad air surrounding the patients.  The superstitious looked to gypsy practices like burning herbs and bathing in rosewater.

Meanwhile, panicked, healthy people ran from the sick. Some doctors refused to see them; priests refused to administer last rites; and shopkeepers shut their doors. The only true remedy for the plague was to run away from it.  Many fled cities for the countryside.  Some, so desperate to save themselves, even abandoned their sick loved ones on their death beds.  But even in the countryside, they could not escape the Black Death, as it affected livestock as well.

The Bubonic Plague was a quick, indiscriminate contagion, merely touching the clothes of the sick appeared to pass the disease.  It was also terrifyingly efficient. People who were perfectly healthy one day could be dead the next.  The elderly and the children, male and female, royalty and peasants  – ALL were affected.  No one had immunity.  Many wealthy convents and monasteries lost more than half of their members, with some closing down. There were shortages of people to till the farms and tend cattle and sheep.

This pandemic was caused not by a virus, like COVID-19, but rather a bacteria, Yersinia pestis. 

The plague bacteria was identified in the 1890s, connecting it to animal fleas.   It was transmitted by, of all things, the bite of the fleas of rats. And there was no shortage of rats in the Middle Ages, especially on trading ships.  Its lethality arose from the onslaught of two phases: first bubonic, transmitted by rat fleas, and then pneumonic (transmitted airborne, person to person).  It’s worth noting that modern antibiotics can easily combat the plague.

50 million people may have died over the course of its 4 year run. It killed from 30-60% of the population in both rural and urban areas. Some communities were wiped out; others abandoned.  The term ‘quarantine’ originated in Venice, based on a 40-day Biblical period of isolation.  Sailors were kept on board their ships and not allowed to leave.  Cities that managed to keep the plague at bay were those that implemented strict quarantines, city gate & dock controls, health passports, and spy networks to signal when plague erupted in other cities.

Survivors decried the abandonment of the sick, and labelled clergymen and doctors who escaped the plague as cowards. They praised those who stayed on to nurse the afflicted, often losing their lives in so doing.  Looking for a scapegoat, some municipal governments, bishops, and kings accused Jews of spreading the Black Death by poisoning food and water.

They massacred entire communities of Jews for the supposed crime of causing the plague.

Because they didn’t understand the biology, many people believed the Black Death was divine punishment—retribution for sins against God such as greed, blasphemy, heresy, and even fornication.  By this logic, the only way to beat the plague was to win God’s forgiveness for their community.  How to do this? They purged their communities of ‘heretics’ and other troublemakers—like the aforementioned Jews.

Some wealthy men joined processions of Flagellants, traveling from town to town, engaging in public displays of penance and self-punishment. They would beat themselves bare chested with leather straps, studded with metal, while the townspeople watched. For a month, the flagellants repeated this ritual 3 times a day. They would then move on to the next town and begin the process all over again.

The plague never really ended and returned in smaller outbreaks decades later. There have actually been 3 Bubonic Plague Pandemics. The first was a international epidemic in the sixth century AD, the Plague of Justinian.  Second, starting with the Black Death, then breaking out every 20 or so years, until it disappeared after the Great Plague of London in 1665. Third, the disease broke out once more in Asia in the 1890s, where it’s still found in animals today.

One can surely expect that our current public health situation has improved to such an extent as to eradicate medieval bubonic plague, especially through our sanitary regulations and modern vaccines.  Right?  While antibiotics are available to treat the Black Death, according to the World Health Organization (WHO), there are still up to 1,000 cases of plague globally every year.  An outbreak in the city of Surat in western India in 1994 caused mass panic in the country.  700 were infected and 52 people died. With limited antibiotics available, 300,000 residents fled the city in just 2 days.

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