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The Black Death reached England on 1st August 1348. The first case was at the port of Melcombe Regis in August, 1348. From Dorset it spread west to Devon, Cornwall and Somerset. The port of Bristol, England second largest town, was very badly hit. It has been estimated that approximately 40% of the town's population died from the disease. It then started moving east. Hampshire, Sussex, Surrey and by the end of September it was in London.
The first symptoms of the Black Death included a high temperature, tiredness, shivering and pains all over the body. The next stage was the appearance of small red boils on the neck, in the armpit or groin. These lumps, called buboes, grew larger and darker in colour. Eyewitness accounts talk of these buboes growing to the size of apples. The final stage of the illness was the appearance of small, red spots on the stomach and other parts of the
body. This was caused by internal bleeding, and death followed soon after.
The Black Death is, in fact, not one but two related diseases. The most common form is bubonic plague. This disease is spread when infected fleas that normally live on black rats land on people and bite them. A person suffering from bubonic plague in the Middle Ages had a 60% chance of dying within two to five days of being infected.
In some cases bubonic plague becomes concentrated in the lungs and causes symptoms similar to pneumonia. This pneumonic version is even worse than bubonic plague. People with pneumonic plague usually die within a couple of hours of catching the disease. It is also highly infectious, as people can catch it by breathing in bacilli coughed out by the person suffering from the disease.
Doctors could do little to help those suffering from the Black Death. The most common form of medical treatment was to lance the buboes, expelling a foul smelling, blackish liquid. Other methods involved bleeding and washing the body with vinegar.
The sailors brought in their bones a disease so violent that whoever spoke a word to them was infected and could in no way save himself from death... Those to whom the disease was transmitted by infection of the breath were stricken with pains all over the body and felt a terrible lassitude. There then appeared, on a thigh or an arm, a pustule like a lentil. From this the infection penentrated the body and violent bloody vomiting began. It lasted for a period of three days and there was no way of preventing its ending in death.
If an ulcer appears... near the ear or the throat, take blood from the arm on that side, that is, from the vein between the thumb and the first finger... But if you have an ulcer in the groin, then open a vein in the foot between the big toe and its neighbour... At all events, bloodletting should be carried out when the plague first strikes.
The King of Tharsis, seeing so sudden and unheard of death among his subjects, set out with a large number of nobles towards the Pope... He proposed to be baptised a Christian, believing that God's vengeance had fallen upon his people by reason of their evil lack of faith. But, after twenty days' journey, hearing that the plague had created a great havoc among Christians... turned and went no farther on that way, but hastened home unto his own country.
It first betrayed itself by the emergence of certain tumours in the groin or the armpits, some of which grew as large as a common apple, others as an egg... merely by speech or association with the sick was the disease communicated to the healthy... any that touched the clothes of the sick... seemed to catch the disease... Many died daily or nightly in the public streets. Of many others, who died at home, the departure was hardly observed by their neighbours, until the stench of the bodies carried the news.
In the year 1350, there was, in the kingdom of Scotland, a great plague... nearly a third of mankind died... By God's will, this evil led to a strange kind of death, insomuch that the flesh of the sick was somehow puffed out and swollen... Now this attacked everywhere, especially the common people - seldom the magnates.
A medicine for the plague... Take an egg that is newly laid, and make a hole in either end, and blow out all that is within. And lay it to the fire and let it roast till it may be ground to powder, but do not burn it. Then take a quantity of good treacle, and mix it with chives and good ale. And then make the sick drink it for three evenings and three mornings.
In 1349 over six hundred men came to London from Flanders... Each wore a cap marked with a red cross in front and behind. Each had in his right hand a scourge with three nails. Each tail had a knot and through the middle of it there were sometimes sharp nails fixed. They marched naked in a file one behind the other and whipped themselves with these scourges on their naked bleeding bodies.
Some did not shut themselves in, but went about, some carrying flowers in their hands, some fragrant herbs... which they frequently smelled, thinking it good to comfort the brain with such odours.
The plague... has left many parish churches... without parson or priest to care for their parishioners... Therefore, to provide for the salvation of souls... you should at once publicly command and persuade all men that, if they are on the point of death and cannot secure the services of a priest, then they should make confession to each other... if no man is present, then even to a woman.
Questions for Students
Question 1: What were the symptoms of the Black Death?
Question 2: What were the main differences between bubonic plague and pneumonic plague?
Question 3: Describe the different methods that were used to either prevent or cure the plague. Comment on the effectiveness of these methods.
Question 4: Why did people come up with different ideas on how to deal with the Black Death?
Question 5: Sources 2, 3, 5, 6, 8, 9, 11, 12 and 14 who lived during the Middle Ages. How reliable are these sources in providing information on the cause of the Black Death?
A commentary on these questions can be found here.
The Shifting Explanations for the Black Death, the Most Devastating Plague in Human History
Mr. Kelly, who holds a graduate degree in European history, is the author most recently of The Great Mortality: An Intimate History of the Black Death, The Most Devastating Plague of All Time (HarperCollins), from which the following article is adapted.
FOR THE LAST TWENTY YEARS, A SMALL BUT VOCAL GROUP OF scholars has been challenging the traditional view of the Black Death as a plague pandemic. The &ldquoorigins&rdquo controversy, as it might be called, was ignited in 1984 when Graham Twigg, a respected British zoologist, published The Black Death: A Biological Reappraisal. Since then, works such as The Biology of Plagues, by Susan Scott, a British sociologist, and her colleague, biologist Christopher J. Duncan and The Black Death Transformed, by Samuel K. Cohn, a professor of medieval history at the University of Glasgow, have kept the controversy roiling. For lack of a better term, these authors&mdashand their supporters&mdashmight be called the Plague Deniers, since they believe that the Black Death was caused by a disease other than plague.
The Deniers&rsquo case against Y. pestis can be reduced to two basic points. The first and weaker part of their argument involves their pet theories about what else could have caused the medieval plague. Anthrax, zoologist Twigg&rsquos candidate, has never struck a human community in epidemic form and does not produce buboes (although anthrax victims do develop black boils). Professor Cohn&rsquos candidate is a mysterious Disease X, which he does not name, but believes has probably gone extinct. Scott and Duncan go furthest of all, arguing improbably that many of the worst epidemics in Western history, from the fifth century B.C. Plague of Athens to the Black Death, were caused by an by an Ebola-like illness they call hemorrhagic plague.
The second part of the Deniers&rsquo case against Y. pestis is far more substantial. Our modern understanding of plague is based on the comprehensive studies that were done during the Third Pandemic. In the hinge decades between the nineteenth and twentieth centuries, Alexandre Yersin identified the plague bacillus Paul-Louis Simond, a French scientist, the rat-flea mechanism that drives the disease and the Indian Plague Commission, a creation of the British Raj and one of the great achievements of Victorian medicine, compiled an unprecedentedly detailed profile of Y. pestis. Commission officials studied the role climate, sanitation, population density, and&mdashin a few commission reports&mdashnutritional status played in the spread of the plague bacillus and its vectors, the rat and rat flea. The commissioners also looked at which transportation facilities and goods were most often associated with the movement of the disease&mdashgrain unsurprisingly proved to be a big magnet for rats.
As the Plague Deniers are quick to point out, the disease that emerged from the commission&rsquos findings bears little resemblance to the disease described in the Black Death chronicles. A case in point already mentioned is the widely different dissemination rates of the two pandemics. While the Black Death virtually leaped across Europe, sometimes traveling two to two and a half miles a day, the plague of the Third Pandemic moved at a relatively sluggish ten to twenty miles per year. Another key difference is the astonishing variation in mortality rates. How could a disease that killed at least a third of the population in one appearance (the Black Death) kill under 3 percent of the population in a later outing? Some of the other discrepancies the Plague Deniers cite include:
&bull Differences in symptoms. Cardinal Francis Aidan Gasquet, the great Victorian scholar of the Black Death in England, was among the first experts to call attention to this difference. Writing at the time of the Third Pandemic, the cardinal noted that contemporary accounts of the &ldquoordinary eastern or bubonic plague&rdquo rarely mentioned four symptoms that Black Death chroniclers referred to frequently. The four were: a &ldquo(1) Gangrenous inflammation of the throat and lungs, (2) violent pains in the region of the chest, (3) vomiting and spitting of blood, and (4) the pestial odor coming from the bodies and breath of the sick.&rdquo
Add contagion to the cardinal&rsquos list of symptoms, and you have an almost perfect description of the disease Friar Michele da Piazza described tumbling off the Genoese galleys at Messina. &ldquoBreath spread the infection . . . , and it seemed as if victims were struck all at once by the affliction . . . and so to speak, shattered by it. . . . [They] violently coughed up blood and after three days of incessant vomiting for which there was no cure, they died.&rdquo
Louis Heyligen&rsquos description of the Black Death also contains the cardinal&rsquos symptom list. &ldquoThe disease is threefold in its infection,&rdquo Heyligen wrote,&rdquo . . . firstly men suffer in their lungs and breathing, and whoever have these corrupted or even slightly attacked cannot by any means escape nor live beyond two days. . . . Many dead bodies have been . . . dissected and it is found that all that die, thus . . . have had their lungs infected and spat blood. . . .&rdquo
Echoing Cardinal Gasquet, the Plague Deniers note that no description of the Third Pandemic, whether written by the Indian Plague Commission or by other Western scientists, contains a list of symptoms comparable to that of Friar Michele and Heyligen, and that includes the symptom of contagion, since until it goes pneumonic, modern plague is spread via rat and flea, not from person to person.
Descriptions of the bubo do appear in accounts of both the Third Pandemic and the Black Death. But as Professor Cohn, a leading Plague Denier, notes, medieval and modern accounts of the plague describe the bubo differently. In modern plague, 55 to 75 percent of the time, the bubo develops in the groin, 10 to 20 percent of the time in the neck. Since the ankle is the most flea-accessible part of the body, this pattern makes sense. However, it is not the pattern described by many Black Death chroniclers. Fourteenth-century accounts usually locate the bubo higher up on the body, behind the ears, for instance, or on the throat, regions difficult for an insect to reach, even one that can jump one hundred times its height.
&bull Rat die-offs. Since the rat flea, X. cheopis, does not jump to humans until the local rat population is nearly obliterated, in theory an outbreak of human plague should be preceded by a large rat die-off. And during the Third Pandemic, practice usually followed theory. Preplague rat die-offs were common. However, references to them are exceedingly rare in the literature of the Black Death. Some scholars have tried to explain away the omission by claiming that dead rats were so common on the medieval street, chroniclers thought them unworthy of mention. To put it charitably, that theory seems improbable in the extreme. If an epidemic on the scale of the Black Death was caused by a rat-borne plague, the streets would have been knee-deep in dead rats and people would have noticed and written about that.
&bull Incidence of pneumonic plague. The disease described by Friar Michele, Louis Heyligen, and other medieval chroniclers sounds like a variant of pneumonic plague, and, judging from the frequent references to blood spitting and hypercontagiousness in early accounts of the plague, the pneumonic disease seems to have been very common in the first six to twelve months of the Black Death, even in regions where the climate should have been hostile to it, like the Mediterranean south. In contrast, in modern outbreaks of the disease, pneumonic plague is uncommon. Some scholars claim that as many as 15 to 25 percent of modern plague cases &ldquogo pneumonic.&rdquo But in Vietnam only 2 percent of the reported cases did.
&bull Climate. The whole issue of climate and plague is perplexing. Plague outbreaks during the Third Pandemic usually reflected the sensitivities of the rat and flea vectors. Outbreaks were rare during the Indian hot season, when the weather was very hot and dry, but common on either side of the hot season, when humidity increased and temperatures moderated&mdashcreating conditions favorable to X. cheopis. By contrast, the Black Death seemed to be largely immune to climatic effects. While outbreaks were slightly more common in warm weather, as Plague Deniers Scott and Duncan note, in some regions of Europe the mortality reached its peak in December and January. Indeed, Y. pestis killed almost as many people in frigid Greenland as it did in temperate Siena.
Before turning to the rejoinders of what might be called the Plague Defenders, a group that includes the majority of historians and almost all microbiologists, mention should be made of two recent discoveries by a team of French scientists. Diagnosing a disease from a list of symptoms in a medieval chronicle or medical tract&mdasha favorite strategy of the Plague Deniers&mdashis fraught with difficulties and imprecisions. One doctor&rsquos carbuncle can be another&rsquos plague boil. More fundamentally, written evidence ignores the fact that diseases, like people, often change over time. Measles and syphilis look and behave a lot differently today than they did when they first burst into the European population.
DNA is a far more trustworthy diagnostic tool. With that thought in mind, in the late 1990s a group of French paleomicrobiologists removed dental pulp from corpses buried in two plague pits in southern France and tested it. One pit dated from the Black Death, the other from a later recurrence of the plague. In a series of papers published in the Proceedings of the National Academy of Sciences, the French investigators reported finding DNA from Y. pestis in both samples. The French work has yet to be confirmed by researchers in other laboratories&mdashthe final step in scientific acceptance&mdashbut Didier Raoult, the lead investigator in the DNA study, is confident of his team&rsquos findings. The &ldquomedieval Black Death was the plague,&rdquo he says without equivocation.
Adopting the Russian view and describing the Black Death as an outbreak of marmot plague would help to explain many of the discrepancies that trouble the Plague Deniers. For example, marmot plague&rsquos tropism for the lungs would account for the seemingly high incidence of pneumonic disease&mdasheven in warm climates, where the weather would not have favored its transmission. Moreover, marmot plague is the only form of rodent plague that is contagious marmots spread the disease the way humans do, via a marmot version of the cough.
Of course, marmot plague is still marmot plague. But if Dr. Wendy Orent is correct, and at some point the marmot disease evolved into a distinctly human form, given its genetic heritage, such a &ldquohumanized&rdquo plague might well produce symptoms like chest pain, blood spitting, and, as the lungs and throat became gangrenous and corrupted, a fetid body and breath odor. A humanized version of Y. pestis would also explain the absence of rat die-offs. Such an ailment would spread the way Friar Michele and Louis Heyligen describe the Black Death spreading, directly from person to person by way of the breath, though very likely other modes of transmission would have also developed. Thus, Dr. Orent thinks that P. irritans, the human flea, would have played an important role in the spread of a &ldquohumanized&rdquo plague.
Like their Russian counterparts, many American microbiologists reject the arguments of the Plague Deniers, but for different reasons. Most American scientists do not accept the Russian theory of &ldquohost&rdquo plague strains&mdashthat is, that the lethality of a particular strain of Y. pestis is shaped by its evolutionary history with particular rodent species. The plague bacillus is only fifteen thousand to twenty thousand years old, says Professor Robert Brubaker, dean of American plague researchers. In evolutionary terms, Dr. Brubaker thinks that is not enough time for the bacillus to have evolved very far away from its original form.
In Dr. Brubaker&rsquos view and that of most of his colleagues, the Black Death and the Third Pandemic were classic examples of rat-borne plague. In the American view, differences between the two outbreaks can be explained largely in terms of external factors. One of the most important of these externals is the very different levels of knowledge available to physicians of the fourteenth and late nineteenth centuries. From firsthand observation, medieval Europeans sensed that plague was affected by factors like sanitation, nutrition, and the movement of goods and people, but this practical knowledge was attached to beliefs about the importance of astrology, miasmas, and bodily humors.
&ldquoBy the late nineteenth century,&rdquo says Dr. Brubaker, &ldquophysicians and scientists understood the principles of contagion . . . [and] had a good working knowledge of how infectious disease spreads and the measures needed to be taken to safeguard public health.&rdquo One by-product of this new understanding was that seven-hundred-year-old insights could now be transformed into effective public health strategies. The municipal health board of Black Death Florence may have had little success with its sanitary measures, but &ldquothe Indian Plague Commissioners believed that they were able to prevent catastrophe [by] imposing aggressive controls on public and hospital sanitation,&rdquo says historian and physician Ann Carmichael of the University of Indiana.
Effective sanitary measures also played an important role in controlling plague outbreaks in Hong Kong and Canton in the mid-1890s. However, in those localities, physicians cited two other measures with Black Death echoes as also important&mdashadequate nutrition and decent nursing care.
It is noteworthy that when measures like stringent sanitation collapsed, as happened in Bombay during a disease outbreak in 1897, the plague of the Third Pandemic quickly began to behave like the plague of the Black Death. In a Bombay hospital a plague commissioner characterized as rife with &ldquofatigue, destitution, filth, poverty and overcrowding,&rdquo the death rate reached 64.5 percent in the spring of 1897. Professor Cohn may be correct in saying that no outbreak of the Third Pandemic produced mortalities on the scale of the Black Death, but in the terrible months between August 1896 and February 1897, Bombay lost nineteen thousand people to the disease.
A modern understanding of another aspect of sanitation&mdashpersonal hygiene&mdashmay also help explain why, if the Black Death was an outbreak of rat plague, there were so few rat die-offs. Given the unhygienic state of the medieval body, it is highly likely that P. irritans, which preys on people, not rodents, played a major role in spreading the plague from person to person.
The Plague Deniers have long argued that P. irritans&rsquos bite, unlike X. cheopis&rsquos, transmits too few plague bacilli to make it a very efficient disease vector. However, that weakness may not have mattered during the Black Death. Whatever its form, the medieval plague was extraordinarily virulent the very high concentrations of bacilli in human blood may have turned even normally weak insect vectors into efficient plague carriers. Furthermore, it is not at all clear that the human flea is that weak a disease vector. Observers as diverse as General Ishii (inventor of the Japanese plague bomb), United States Army Intelligence, and Giovanni Boccaccio have all offered testimonials to P. irritans&rsquos efficiency as a disease carrier. The two pigs Boccaccio describes as dropping dead after mauling a blanket almost certainly were killed by the bite of P. irritans, which is a pig as well as human flea.
Perhaps the most compelling testimony about the effectiveness of the human flea as a plague vector comes from Dr. Kenneth Gage, chief of the Plague Division at the Centers for Disease Control. From his personal experience fighting the disease in modern Africa, Asia, and South America, Dr. Gage has become convinced that the human flea plays an important but underappreciated role in the spread of plague.
The weakest part of the Black-Death-as-a-purely-rat-borne-plague theory involves the apparently very high incidence of the pneumonic form of the disease. Secondary pneumonic infections occur in bubonic plague, but, at least in modern experience, only infrequently. French scholar Jean-Noël Biraben hypothesizes that the unusually cold weather of the fourteenth century may have been especially &ldquopneumonic-friendly.&rdquo The problem with the Biraben theory is that, south of the Alps, the weather was still warm when the Black Death arrived.
One possible explanation for the high rate of &ldquopneumonic&rdquo Black Death is that two disease strains were at work in 1348 and l349. The Manchurian outbreak of pneumonic plague in 1911 arose from marmots. Yet the epidemic occurred in the midst of the rat-based bubonic plague of the Third Pandemic. Perhaps something similar occurred during the Black Death? Another possibility is that over the course of the middle years of the fourteenth century, Y. pestis underwent a fundamental evolutionary change, as Dr. Orent suggests.
Medievalist and physician Ann Carmichael also has a theory about the medieval plague, one that addresses not only the high incidence of pneumonic disease but, more sweepingly, why, on many clinical and epidemiological indexes, it looks so different from the Third Pandemic. &ldquoThere may have been something fundamentally different about the nature of the premodern world,&rdquo says Dr. Carmichael, &ldquosomething we don&rsquot understand and which cannot be duplicated today even in Third World regions.&rdquo
However, about one thing we can be certain.
Microbiologist Didier Raoult is right the Black Death was an outbreak of plague.
European writers contemporary with the plague described the disease in Latin as pestis or pestilentia, 'pestilence' epidemia, 'epidemic' mortalitas, 'mortality'.  In English prior to the 18th century, the event was called the "pestilence" or "great pestilence", "the plague" or the "great death".    Subsequent to the pandemic "the furste moreyn" (first murrain) or "first pestilence" was applied, to distinguish the mid-14th century phenomenon from other infectious diseases and epidemics of plague.  The 1347 pandemic plague was not referred to specifically as "black" in the 14th or 15th centuries in any European language, though the expression "black death" had occasionally been applied to fatal disease beforehand. 
"Black death" was not used to describe the plague pandemic in English until the 1750s the term is first attested in 1755, where it translated Danish: den sorte død, lit. 'the black death'.   This expression as a proper name for the pandemic had been popularized by Swedish and Danish chroniclers in the 15th and early 16th centuries, and in the 16th and 17th centuries was transferred to other languages as a calque: Icelandic: svarti dauði, German: der schwarze Tod, and French: la mort noire.   Previously, most European languages had named the pandemic a variant or calque of the Latin: magna mortalitas, lit. 'Great Death'. 
The phrase 'black death' – describing Death as black – is very old. Homer used it in the Odyssey to describe the monstrous Scylla, with her mouths "full of black Death" (Ancient Greek: πλεῖοι μέλανος Θανάτοιο , romanized: pleîoi mélanos Thanátoio).   Seneca the Younger may have been the first to describe an epidemic as 'black death', (Latin: mors atra) but only in reference to the acute lethality and dark prognosis of disease.    The 12th–13th century French physician Gilles de Corbeil had already used atra mors to refer to a "pestilential fever" (febris pestilentialis) in his work On the Signs and Symptoms of Diseases (De signis et symptomatibus aegritudium).   The phrase mors nigra, 'black death', was used in 1350 by Simon de Covino (or Couvin), a Belgian astronomer, in his poem "On the Judgement of the Sun at a Feast of Saturn" (De judicio Solis in convivio Saturni), which attributes the plague to an astrological conjunction of Jupiter and Saturn.  His use of the phrase is not connected unambiguously with the plague pandemic of 1347 and appears to refer to the fatal outcome of disease. 
The historian Cardinal Francis Aidan Gasquet wrote about the Great Pestilence in 1893  and suggested that it had been "some form of the ordinary Eastern or bubonic plague".  [c] In 1908, Gasquet claimed that use of the name atra mors for the 14th-century epidemic first appeared in a 1631 book on Danish history by J. I. Pontanus: "Commonly and from its effects, they called it the black death" (Vulgo & ab effectu atram mortem vocitabant).  
Recent research has suggested plague first infected humans in Europe and Asia in the Late Neolithic-Early Bronze Age.  Research in 2018 found evidence of Yersinia pestis in an ancient Swedish tomb, which may have been associated with the "Neolithic decline" around 3000 BCE, in which European populations fell significantly.   This Y. pestis may have been different from more modern types, with bubonic plague transmissible by fleas first known from Bronze Age remains near Samara. 
The symptoms of bubonic plague are first attested in a fragment of Rufus of Ephesus preserved by Oribasius these ancient medical authorities suggest bubonic plague had appeared in the Roman Empire before the reign of Trajan, six centuries before arriving at Pelusium in the reign of Justinian I.  In 2013, researchers confirmed earlier speculation that the cause of the Plague of Justinian (541–542 CE, with recurrences until 750) was Y. pestis.   This is known as the First plague pandemic.
The most authoritative contemporary account is found in a report from the medical faculty in Paris to Philip VI of France. It blamed the heavens, in the form of a conjunction of three planets in 1345 that caused a "great pestilence in the air" (miasma theory).  Muslim religious scholars taught that the pandemic was a “martyrdom and mercy” from God, assuring the believer's place in paradise. For non-believers, it was a punishment.  Some Muslim doctors cautioned against trying to prevent or treat a disease sent by God. Others adopted preventive measures and treatments for plague used by Europeans. These Muslim doctors also depended on the writings of the ancient Greeks.  
Predominant modern theory
Due to climate change in Asia, rodents began to flee the dried-out grasslands to more populated areas, spreading the disease.  The plague disease, caused by the bacterium Yersinia pestis, is enzootic (commonly present) in populations of fleas carried by ground rodents, including marmots, in various areas, including Central Asia, Kurdistan, Western Asia, North India, Uganda and the western United States.  
Y. pestis was discovered by Alexandre Yersin, a pupil of Louis Pasteur, during an epidemic of bubonic plague in Hong Kong in 1894 Yersin also proved this bacillus was present in rodents and suggested the rat was the main vehicle of transmission.   The mechanism by which Y. pestis is usually transmitted was established in 1898 by Paul-Louis Simond and was found to involve the bites of fleas whose midguts had become obstructed by replicating Y. pestis several days after feeding on an infected host. This blockage starves the fleas and drives them to aggressive feeding behaviour and attempts to clear the blockage by regurgitation, resulting in thousands of plague bacteria being flushed into the feeding site, infecting the host. The bubonic plague mechanism was also dependent on two populations of rodents: one resistant to the disease, which act as hosts, keeping the disease endemic, and a second that lack resistance. When the second population dies, the fleas move on to other hosts, including people, thus creating a human epidemic. 
Definitive confirmation of the role of Y. pestis arrived in 2010 with a publication in PLOS Pathogens by Haensch et al.  [d] They assessed the presence of DNA/RNA with polymerase chain reaction (PCR) techniques for Y. pestis from the tooth sockets in human skeletons from mass graves in northern, central and southern Europe that were associated archaeologically with the Black Death and subsequent resurgences. The authors concluded that this new research, together with prior analyses from the south of France and Germany, "ends the debate about the cause of the Black Death, and unambiguously demonstrates that Y. pestis was the causative agent of the epidemic plague that devastated Europe during the Middle Ages".  In 2011, these results were further confirmed with genetic evidence derived from Black Death victims in the East Smithfield burial site in England. Schuenemann et al. concluded in 2011 "that the Black Death in medieval Europe was caused by a variant of Y. pestis that may no longer exist". 
Later in 2011, Bos et al. reported in Nature the first draft genome of Y. pestis from plague victims from the same East Smithfield cemetery and indicated that the strain that caused the Black Death is ancestral to most modern strains of Y. pestis. 
Since this time, further genomic papers have further confirmed the phylogenetic placement of the Y. pestis strain responsible for the Black Death as both the ancestor  of later plague epidemics including the third plague pandemic and as the descendant  of the strain responsible for the Plague of Justinian. In addition, plague genomes from significantly earlier in prehistory have been recovered. 
DNA taken from 25 skeletons from 14th century London have shown plague is a strain of Y. pestis almost identical to that which hit Madagascar in 2013.  
It is recognised that an epidemiological account of plague is as important as an identification of symptoms, but researchers are hampered by the lack of reliable statistics from this period. Most work has been done on the spread of the disease in England, and even estimates of overall population at the start vary by over 100% as no census was undertaken in England between the time of publication of the Domesday Book of 1086 and the poll tax of the year 1377.  Estimates of plague victims are usually extrapolated from figures for the clergy.
Mathematical modelling is used to match the spreading patterns and the means of transmission. A research in 2018 challenged the popular hypothesis that "infected rats died, their flea parasites could have jumped from the recently dead rat hosts to humans". It suggested an alternative model in which "the disease was spread from human fleas and body lice to other people". The second model claims to better fit the trends of death toll because the rat-flea-human hypothesis would have produced a delayed but very high spike in deaths, which contradict historical death data.  
Lars Walløe complains that all of these authors "take it for granted that Simond's infection model, black rat → rat flea → human, which was developed to explain the spread of plague in India, is the only way an epidemic of Yersinia pestis infection could spread", whilst pointing to several other possibilities.  Similarly, Monica Green has argued that greater attention is needed to the range of (especially non-commensal) animals that might be involved in the transmission of plague. 
Archaeologist Barney Sloane has argued that there is insufficient evidence of the extinction of numerous rats in the archaeological record of the medieval waterfront in London and that the disease spread too quickly to support the thesis that Y. pestis was spread from fleas on rats he argues that transmission must have been person to person.   This theory is supported by research in 2018 which suggested transmission was more likely by body lice and fleas during the second plague pandemic. 
Although academic debate continues, no single alternative solution has achieved widespread acceptance.  Many scholars arguing for Y. pestis as the major agent of the pandemic suggest that its extent and symptoms can be explained by a combination of bubonic plague with other diseases, including typhus, smallpox and respiratory infections. In addition to the bubonic infection, others point to additional septicaemic (a type of "blood poisoning") and pneumonic (an airborne plague that attacks the lungs before the rest of the body) forms of plague, which lengthen the duration of outbreaks throughout the seasons and help account for its high mortality rate and additional recorded symptoms.  In 2014, Public Health England announced the results of an examination of 25 bodies exhumed in the Clerkenwell area of London, as well as of wills registered in London during the period, which supported the pneumonic hypothesis.  Currently, while osteoarcheologists have conclusively verified the presence of Y. pestis bacteria in burial sites across northern Europe through examination of bones and dental pulp, no other epidemic pathogen has been discovered to bolster the alternative explanations. In the words of one researcher: "Finally, plague is plague." 
The importance of hygiene was recognised only in the nineteenth century with the development of the germ theory of disease until then streets were commonly filthy, with live animals of all sorts around and human parasites abounding, facilitating the spread of transmissible disease. 
According to a team of medical geneticists led by Mark Achtman that analysed the genetic variation of the bacterium, Yersinia pestis "evolved in or near China",   from which it spread around the world in multiple epidemics. Later research by a team led by Galina Eroshenko places the origins more specifically in the Tian Shan mountains on the border between Kyrgyzstan and China. 
Nestorian graves dating to 1338–1339 near Issyk-Kul in Kyrgyzstan have inscriptions referring to plague, which has led some historians and epidemiologists to think they mark the outbreak of the epidemic. Others favour an origin in China.  According to this theory, the disease may have travelled along the Silk Road with Mongol armies and traders, or it could have arrived via ship.  Epidemics killed an estimated 25 million across Asia during the fifteen years before the Black Death reached Constantinople in 1347.  
Research on the Delhi Sultanate and the Yuan Dynasty shows no evidence of any serious epidemic in fourteenth-century India and no specific evidence of plague in fourteenth-century China, suggesting that the Black Death may not have reached these regions.    Ole Benedictow argues that since the first clear reports of the Black Death come from Kaffa, the Black Death most likely originated in the nearby plague focus on the northwestern shore of the Caspian Sea. 
. But at length it came to Gloucester, yea even to Oxford and to London, and finally it spread over all England and so wasted the people that scarce the tenth person of any sort was left alive.
Plague was reportedly first introduced to Europe via Genoese traders from their port city of Kaffa in the Crimea in 1347. During a protracted siege of the city, in 1345–1346 the Mongol Golden Horde army of Jani Beg, whose mainly Tatar troops were suffering from the disease, catapulted infected corpses over the city walls of Kaffa to infect the inhabitants,  though it is more likely that infected rats travelled across the siege lines to spread the epidemic to the inhabitants.   As the disease took hold, Genoese traders fled across the Black Sea to Constantinople, where the disease first arrived in Europe in summer 1347. 
The epidemic there killed the 13-year-old son of the Byzantine emperor, John VI Kantakouzenos, who wrote a description of the disease modelled on Thucydides's account of the 5th century BCE Plague of Athens, but noting the spread of the Black Death by ship between maritime cities.  Nicephorus Gregoras also described in writing to Demetrios Kydones the rising death toll, the futility of medicine, and the panic of the citizens.  The first outbreak in Constantinople lasted a year, but the disease recurred ten times before 1400. 
Carried by twelve Genoese galleys, plague arrived by ship in Sicily in October 1347  the disease spread rapidly all over the island. Galleys from Kaffa reached Genoa and Venice in January 1348, but it was the outbreak in Pisa a few weeks later that was the entry point to northern Italy. Towards the end of January, one of the galleys expelled from Italy arrived in Marseilles. 
From Italy, the disease spread northwest across Europe, striking France, Spain (the epidemic began to wreak havoc first on the Crown of Aragon in the spring of 1348),  Portugal and England by June 1348, then spread east and north through Germany, Scotland and Scandinavia from 1348 to 1350. It was introduced into Norway in 1349 when a ship landed at Askøy, then spread to Bjørgvin (modern Bergen) and Iceland.  Finally, it spread to northwestern Russia in 1351. Plague was somewhat more uncommon in parts of Europe with less developed trade with their neighbours, including the majority of the Basque Country, isolated parts of Belgium and the Netherlands, and isolated Alpine villages throughout the continent.   
According to some epidemiologists, periods of unfavourable weather decimated plague-infected rodent populations and forced their fleas onto alternative hosts,  inducing plague outbreaks which often peaked in the hot summers of the Mediterranean,  as well as during the cool autumn months of the southern Baltic states.  [e] Among many other culprits of plague contagiousness, malnutrition, even if distantly, also contributed to such an immense loss in European population, since it weakened immune systems. 
Western Asian and North African outbreak
The disease struck various regions in the Middle East and North Africa during the pandemic, leading to serious depopulation and permanent change in both economic and social structures.  As infected rodents infected new rodents, the disease spread across the region, entering also from southern Russia.
By autumn 1347, plague had reached Alexandria in Egypt, transmitted by sea from Constantinople according to a contemporary witness, from a single merchant ship carrying slaves.  By late summer 1348 it reached Cairo, capital of the Mamluk Sultanate, cultural centre of the Islamic world, and the largest city in the Mediterranean Basin the Bahriyya child sultan an-Nasir Hasan fled and more than a third of the 600,000 residents died.  The Nile was choked with corpses despite Cairo having a medieval hospital, the late 13th century bimaristan of the Qalawun complex.  The historian al-Maqrizi described the abundant work for grave-diggers and practitioners of funeral rites, and plague recurred in Cairo more than fifty times over the following century and half. 
During 1347, the disease travelled eastward to Gaza by April by July it had reached Damascus, and in October plague had broken out in Aleppo.  That year, in the territory of modern Lebanon, Syria, Israel, and Palestine, the cities of Ashkelon, Acre, Jerusalem, Sidon, and Homs were all infected. In 1348–1349, the disease reached Antioch. The city's residents fled to the north, but most of them ended up dying during the journey.  Within two years, the plague had spread throughout the Islamic world, from Arabia across North Africa.  [ page needed ] The pandemic spread westwards from Alexandria along the African coast, while in April 1348 Tunis was infected by ship from Sicily. Tunis was then under attack by an army from Morocco this army dispersed in 1348 and brought the contagion with them to Morocco, whose epidemic may also have been seeded from the Islamic city of Almería in al-Andalus. 
Mecca became infected in 1348 by pilgrims performing the Hajj.  In 1351 or 1352, the Rasulid sultan of the Yemen, al-Mujahid Ali, was released from Mamluk captivity in Egypt and carried plague with him on his return home.   During 1348, records show the city of Mosul suffered a massive epidemic, and the city of Baghdad experienced a second round of the disease. [ citation needed ]
Signs and symptoms
Symptoms of the disease include fever of 38–41 °C (100–106 °F), headaches, painful aching joints, nausea and vomiting, and a general feeling of malaise. Left untreated, of those that contract the bubonic plague, 80 percent die within eight days. 
Contemporary accounts of the pandemic are varied and often imprecise. The most commonly noted symptom was the appearance of buboes (or gavocciolos) in the groin, neck, and armpits, which oozed pus and bled when opened.  Boccaccio's description:
In men and women alike it first betrayed itself by the emergence of certain tumours in the groin or armpits, some of which grew as large as a common apple, others as an egg . From the two said parts of the body this deadly gavocciolo soon began to propagate and spread itself in all directions indifferently after which the form of the malady began to change, black spots or livid making their appearance in many cases on the arm or the thigh or elsewhere, now few and large, now minute and numerous. As the gavocciolo had been and still was an infallible token of approaching death, such also were these spots on whomsoever they showed themselves.   [f]
This was followed by acute fever and vomiting of blood. Most victims died two to seven days after initial infection. Freckle-like spots and rashes,  which could have been caused by flea-bites, were identified as another potential sign of plague.
Lodewijk Heyligen, whose master the Cardinal Colonna died of plague in 1348, noted a distinct form of the disease, pneumonic plague, that infected the lungs and led to respiratory problems.  Symptoms include fever, cough, and blood-tinged sputum. As the disease progresses, sputum becomes free-flowing and bright red. Pneumonic plague has a mortality rate of 90 to 95 percent. 
Septicaemic plague is the least common of the three forms, with a mortality rate near 100%. Symptoms are high fevers and purple skin patches (purpura due to disseminated intravascular coagulation).  In cases of pneumonic and particularly septicaemic plague, the progress of the disease is so rapid that there would often be no time for the development of the enlarged lymph nodes that were noted as buboes. 
There are no exact figures for the death toll the rate varied widely by locality. In urban centres, the greater the population before the outbreak, the longer the duration of the period of abnormal mortality.  It killed some 75 to 200 million people in Eurasia.    [ better source needed ] The mortality rate of the Black Death in the 14th century was far greater than the worst 20th-century outbreaks of Y. pestis plague, which occurred in India and killed as much as 3% of the population of certain cities.  The overwhelming number of deceased bodies produced by the Black Death caused the necessity of mass burial sites in Europe, sometimes including up to several hundred or several thousand skeletons.  The mass burial sites that have been excavated have allowed archaeologists to continue interpreting and defining the biological, sociological, historical, and anthropological implications of the Black Death. 
According to medieval historian Philip Daileader, it is likely that over four years, 45–50% of the European population died of plague.  [g] Norwegian historian Ole Benedictow suggests it could have been as much as 60% of the European population.  [h] In 1348, the disease spread so rapidly that before any physicians or government authorities had time to reflect upon its origins, about a third of the European population had already perished. In crowded cities, it was not uncommon for as much as 50% of the population to die.  Half of Paris' population of 100,000 people died. In Italy, the population of Florence was reduced from between 110,000 and 120,000 inhabitants in 1338 down to 50,000 in 1351. At least 60% of the population of Hamburg and Bremen perished,  and a similar percentage of Londoners may have died from the disease as well,  with a death toll of approximately 62,000 between 1346 and 1353.  [i] Florence's tax records suggest that 80% of the city's population died within four months in 1348.  Before 1350, there were about 170,000 settlements in Germany, and this was reduced by nearly 40,000 by 1450.  The disease bypassed some areas, with the most isolated areas being less vulnerable to contagion. Plague did not appear in Douai in Flanders until the turn of the 15th century, and the impact was less severe on the populations of Hainaut, Finland, northern Germany, and areas of Poland.  Monks, nuns, and priests were especially hard-hit since they cared for victims of the Black Death. 
The physician to the Avignon Papacy, Raimundo Chalmel de Vinario (Latin: Magister Raimundus, lit. 'Master Raymond'), observed the decreasing mortality rate of successive outbreaks of plague in 1347–48, 1362, 1371, and 1382 in his 1382 treatise On Epidemics (De epidemica).  In the first outbreak, two thirds of the population contracted the illness and most patients died in the next, half the population became ill but only some died by the third, a tenth were affected and many survived while by the fourth occurrence, only one in twenty people were sickened and most of them survived.  By the 1380s in Europe, it predominantly affected children.  Chalmel de Vinario recognized that bloodletting was ineffective (though he continued to prescribe bleeding for members of the Roman Curia, whom he disliked), and claimed that all true cases of plague were caused by astrological factors and were incurable he himself was never able to effect a cure. 
The most widely accepted estimate for the Middle East, including Iraq, Iran, and Syria, during this time, is for a death toll of about a third of the population.  The Black Death killed about 40% of Egypt's population.  In Cairo, with a population numbering as many as 600,000, and possibly the largest city west of China, between one third and 40% of the inhabitants died inside of eight months. 
Italian chronicler Agnolo di Tura recorded his experience from Siena, where plague arrived in May 1348:
Father abandoned child, wife husband, one brother another for this illness seemed to strike through the breath and sight. And so they died. And none could be found to bury the dead for money or friendship. Members of a household brought their dead to a ditch as best they could, without priest, without divine offices . great pits were dug and piled deep with the multitude of dead. And they died by the hundreds both day and night . And as soon as those ditches were filled more were dug . And I, Agnolo di Tura . buried my five children with my own hands. And there were also those who were so sparsely covered with earth that the dogs dragged them forth and devoured many bodies throughout the city. There was no one who wept for any death, for all awaited death. And so many died that all believed it was the end of the world. 
With such a large population decline from the pandemic, wages soared in response to a labour shortage.  On the other hand, in the quarter century after the Black Death in England, it is clear many labourers, artisans, and craftsmen, those living from money-wages alone, did suffer a reduction in real incomes owing to rampant inflation.  Landowners were also pushed to substitute monetary rents for labour services in an effort to keep tenants. 
Some historians believe the innumerable deaths brought on by the pandemic cooled the climate by freeing up land and triggering reforestation. This may have led to the Little Ice Age. 
Renewed religious fervour and fanaticism bloomed in the wake of the Black Death. Some Europeans targeted "various groups such as Jews, friars, foreigners, beggars, pilgrims", lepers,   and Romani, blaming them for the crisis. Lepers, and others with skin diseases such as acne or psoriasis, were killed throughout Europe.
Because 14th-century healers and governments were at a loss to explain or stop the disease, Europeans turned to astrological forces, earthquakes, and the poisoning of wells by Jews as possible reasons for outbreaks.  Many believed the epidemic was a punishment by God for their sins, and could be relieved by winning God's forgiveness. 
There were many attacks against Jewish communities.  In the Strasbourg massacre of February 1349, about 2,000 Jews were murdered.  In August 1349, the Jewish communities in Mainz and Cologne were annihilated. By 1351, 60 major and 150 smaller Jewish communities had been destroyed.  During this period many Jews relocated to Poland, where they received a warm welcome from King Casimir the Great. 
One theory that has been advanced is that the devastation in Florence caused by the Black Death, which hit Europe between 1348 and 1350, resulted in a shift in the world view of people in 14th-century Italy and led to the Renaissance. Italy was particularly badly hit by the pandemic, and it has been speculated that the resulting familiarity with death caused thinkers to dwell more on their lives on Earth, rather than on spirituality and the afterlife.  [j] It has also been argued that the Black Death prompted a new wave of piety, manifested in the sponsorship of religious works of art. 
This does not fully explain why the Renaissance occurred in Italy in the 14th century. The Black Death was a pandemic that affected all of Europe in the ways described, not only Italy. The Renaissance's emergence in Italy was most likely the result of the complex interaction of the above factors,  in combination with an influx of Greek scholars following the fall of the Byzantine Empire. [ citation needed ] As a result of the drastic reduction in the populace the value of the working class increased, and commoners came to enjoy more freedom. To answer the increased need for labour, workers travelled in search of the most favorable position economically.  [ better source needed ]
Prior to the emergence of the Black Death, the workings of Europe were run by the Catholic Church and the continent was considered a feudalistic society, composed of fiefs and city-states.  The pandemic completely restructured both religion and political forces survivors began to turn to other forms of spirituality and the power dynamics of the fiefs and city-states crumbled.  
Cairo's population, partly owing to the numerous plague epidemics, was in the early 18th century half of what it was in 1347.  The populations of some Italian cities, notably Florence, did not regain their pre-14th century size until the 19th century.  The demographic decline due to the pandemic had economic consequences: the prices of food dropped and land values declined by 30–40% in most parts of Europe between 1350 and 1400.  Landholders faced a great loss, but for ordinary men and women it was a windfall. The survivors of the pandemic found not only that the prices of food were lower but also that lands were more abundant, and many of them inherited property from their dead relatives, and this probably destabilized feudalism.  
The word "quarantine" has its roots in this period, though the concept of isolating people to prevent the spread of disease is older. In the city-state of Ragusa (modern Dubrovnik, Croatia), a thirty-day isolation period was implemented in 1377 for new arrivals to the city from plague-affected areas. The isolation period was later extended to forty days, and given the name "quarantino" from the Italian word for "forty". 
Second plague pandemic
The plague repeatedly returned to haunt Europe and the Mediterranean throughout the 14th to 17th centuries.  According to Jean-Noël Biraben, the plague was present somewhere in Europe in every year between 1346 and 1671.  (Note that some researchers have cautions about the uncritical use of Biraben's data.  ) The second pandemic was particularly widespread in the following years: 1360–63 1374 1400 1438–39 1456–57 1464–66 1481–85 1500–03 1518–31 1544–48 1563–66 1573–88 1596–99 1602–11 1623–40 1644–54 and 1664–67. Subsequent outbreaks, though severe, marked the retreat from most of Europe (18th century) and northern Africa (19th century).  The historian George Sussman argued that the plague had not occurred in East Africa until the 1900s.  However, other sources suggest that the Second pandemic did indeed reach Sub-Saharan Africa. 
According to historian Geoffrey Parker, "France alone lost almost a million people to the plague in the epidemic of 1628–31."  In the first half of the 17th century, a plague claimed some 1.7 million victims in Italy.  More than 1.25 million deaths resulted from the extreme incidence of plague in 17th-century Spain. 
The Black Death ravaged much of the Islamic world.  Plague was present in at least one location in the Islamic world virtually every year between 1500 and 1850.  Plague repeatedly struck the cities of North Africa. Algiers lost 30,000–50,000 inhabitants to it in 1620–21, and again in 1654–57, 1665, 1691, and 1740–42.  Cairo suffered more than fifty plague epidemics within 150 years from the plague's first appearance, with the final outbreak of the second pandemic there in the 1840s.  Plague remained a major event in Ottoman society until the second quarter of the 19th century. Between 1701 and 1750, thirty-seven larger and smaller epidemics were recorded in Constantinople, and an additional thirty-one between 1751 and 1800.  Baghdad has suffered severely from visitations of the plague, and sometimes two-thirds of its population has been wiped out. 
Third plague pandemic
The third plague pandemic (1855–1859) started in China in the mid-19th century, spreading to all inhabited continents and killing 10 million people in India alone.  The investigation of the pathogen that caused the 19th-century plague was begun by teams of scientists who visited Hong Kong in 1894, among whom was the French-Swiss bacteriologist Alexandre Yersin, after whom the pathogen was named. 
Twelve plague outbreaks in Australia between 1900 and 1925 resulted in well over 1,000 deaths, chiefly in Sydney. This led to the establishment of a Public Health Department there which undertook some leading-edge research on plague transmission from rat fleas to humans via the bacillus Yersinia pestis. 
The first North American plague epidemic was the San Francisco plague of 1900–1904, followed by another outbreak in 1907–1908.   
Modern treatment methods include insecticides, the use of antibiotics, and a plague vaccine. It is feared that the plague bacterium could develop drug resistance and again become a major health threat. One case of a drug-resistant form of the bacterium was found in Madagascar in 1995.  A further outbreak in Madagascar was reported in November 2014.  In October 2017 the deadliest outbreak of the plague in modern times hit Madagascar, killing 170 people and infecting thousands. 
An estimate of the case fatality rate for the modern bubonic plague, following the introduction of antibiotics, is 11%, although it may be higher in underdeveloped regions. 
- A Journal of the Plague Year – 1722 book by Daniel Defoe describing the Great Plague of London of 1665–1666 – a 2010 action horror film set in medieval England in 1348 ("The Betrothed") – a plague novel by Alessandro Manzoni, set in Milan, and published in 1827 turned into an opera by Amilcare Ponchielli in 1856, and adapted for film in 1908, 1941, 1990, and 2004
- Cronaca fiorentina ("Chronicle of Florence") – a literary history of the plague, and of Florence up to 1386, by Baldassarre Bonaiuti
- Danse Macabre ("Dance of Death") – an artistic genre of allegory of the Late Middle Ages on the universality of death
- The Decameron – by Giovanni Boccaccio, finished in 1353. Tales told by a group of people sheltering from the Black Death in Florence. Numerous adaptations to other media have been made – a 1992 science fiction novel by Connie Willis
- A Feast in Time of Plague – a verse play by Aleksandr Pushkin (1830), made into an opera by César Cui in 1900 – a popular French legend supposed to provide immunity to the plague – Medieval "flagellant songs"
- "A Litany in Time of Plague" – a sonnet by Thomas Nashe which was part of his play Summer's Last Will and Testament (1592)
- The Plague – a 1947 novel by Albert Camus, often read as an allegory about Fascism
- The Seventh Seal – a 1957 film written and directed by Ingmar Bergman
- World Without End – a 2007 novel by Ken Follett, turned into a miniseries of the same name in 2012
- The Years of Rice and Salt – an alternative history novel by Kim Stanley Robinson set in a world in which the plague killed virtually all Europeans
- ^ Other names include Great Mortality (Latin: magna mortalitas, lit.'Great Death', common in the 14th century), atra mors, 'black death', the Great Plague, the Great Bubonic Plague or the Black Plague.
- ^ Declining temperatures following the end of the Medieval Warm Period added to the crisis
- ^ He was able to adopt the epidemiology of the bubonic plague for the Black Death for the second edition in 1908, implicating rats and fleas in the process, and his interpretation was widely accepted for other ancient and medieval epidemics, such as the Plague of Justinian that was prevalent in the Eastern Roman Empire from 541 to 700 CE. 
- ^ In 1998, Drancourt et al. reported the detection of Y. pestis DNA in human dental pulp from a medieval grave.  Another team led by Tom Gilbert cast doubt on this identification  and the techniques employed, stating that this method "does not allow us to confirm the identification of Y. pestis as the aetiological agent of the Black Death and subsequent plagues. In addition, the utility of the published tooth-based ancient DNA technique used to diagnose fatal bacteraemias in historical epidemics still awaits independent corroboration".
- ^ However, other researchers do not think that plague ever became endemic in Europe or its rat population. The disease repeatedly wiped out the rodent carriers, so that the fleas died out until a new outbreak from Central Asia repeated the process. The outbreaks have been shown to occur roughly 15 years after a warmer and wetter period in areas where plague is endemic in other species, such as gerbils. 
- ^ The only medical detail that is questionable in Boccaccio's description is that the gavocciolo was an "infallible token of approaching death", as, if the bubo discharges, recovery is possible. 
- ^ According to medieval historian Philip Daileader,
The trend of recent research is pointing to a figure more like 45–50% of the European population dying during a four-year period. There is a fair amount of geographic variation. In Mediterranean Europe, areas such as Italy, the south of France and Spain, where plague ran for about four years consecutively, it was probably closer to 75–80% of the population. In Germany and England . it was probably closer to 20%. 
Detailed study of the mortality data available points to two conspicuous features in relation to the mortality caused by the Black Death: namely the extreme level of mortality caused by the Black Death, and the remarkable similarity or consistency of the level of mortality, from Spain in southern Europe to England in north-western Europe. The data is sufficiently widespread and numerous to make it likely that the Black Death swept away around 60% of Europe's population. The generally assumed population of Europe at the time is about 80 million, implying that around 50 million people died in the Black Death. 
A New Strain Enters Europe
The plague in Tournai, 1349.
Photo12/Universal Images Group/Getty Images
A different plague strain enters Europe through Genoa, brought by another Caffan ship that docks there. The Genoans attack the ship and drive it away, but they are still infected. Italy faces this second strain while already battling the previous one.
Y. pestisਊlso heads east from Sicily into the Persian Empire and through Greece, Bulgaria, Romania and Poland, and south to Egypt, as well as Cyprus, which is also hit with destruction from an earthquake and deadly tidal wave at the same time.
Venice faces its own outbreak by pioneering the first organized response, with committees ordering ship inspections and burning those with contagions, shutting down taverns, and restricting wine from unknown sources. The canals fill with gondolas shouting official instructions for disposing of dead bodies. Despite those efforts, the plague kills 60 percent of the Venetian population.
The plague awakes an anti-Semitic rage around Europe, causing repeated massacres of Jewish communities, with the first one taking place in Provence, where 40 Jews were murdered.
The plague enters England through the port of Melcombe Regis, in Dorset. As it spreads through the town, some escape by fleeing inland, inadvertently spreading it further.
How Did The Black Death Spread?
The Black Death was terrifyingly, indiscriminately contagious: “the mere touching of the clothes,” wrote Boccaccio, 𠇊ppeared to itself to communicate the malady to the toucher.” The disease was also terrifyingly efficient. People who were perfectly healthy when they went to bed at night could be dead by morning.
Did you know? Many scholars think that the nursery rhyme “Ring around the Rosy” was written about the symptoms of the Black Death.
Contemporary Accounts of the Black Death (Classroom Activity) - History
C oming out of the East, the Black Death reached the shores of Italy in the spring of 1348 unleashing a rampage of death across Europe unprecedented in recorded history. By the time the epidemic played itself out three years later, anywhere between 25% and 50% of Europe's population had fallen victim to the pestilence.
The plague presented itself in three interrelated forms. The bubonic variant (the most common) derives its name from the swellings or buboes that appeared on a victim's neck, armpits or groin. These tumors could range in size from that of an egg to that of an apple. Although some survived
|The Plague's Progress |
Having no defense and no understanding of the cause of the pestilence, the men, women and children caught in its onslaught were bewildered, panicked, and finally devastated.
The Italian writer Giovanni Boccaccio lived through the plague as it ravaged the city of Florence in 1348. The experience inspired him to write The Decameron, a story of seven men and three women who escape the disease by fleeing to a villa outside the city. In his introduction to the fictional portion of his book, Boccaccio gives a graphic description of the effects of the epidemic on his city.
The Signs of Impending Death
"The symptoms were not the same as in the East, where a gush of blood from the nose was the plain sign of inevitable death but it began both in men and women with certain swellings in the groin or under the armpit. They grew to the size of a small apple or an egg, more or less, and were vulgarly called tumours. In a short space of time these tumours spread from the two parts named all over the body. Soon after this the symptoms changed and black or purple spots appeared on the arms or thighs or any other part of the body, sometimes a few large ones, sometimes many little ones. These spots were a certain sign of death, just as the original tumour had been and still remained.
The violence of this disease was such that the sick communicated it to the healthy who came near them, just as a fire catches anything dry or oily near it. And it even went further. To speak to or go near the sick brought infection and a common death to the living and moreover, to touch the clothes or anything else the sick had touched or worn gave the disease to the person touching. "
Varying Reactions to Disaster
". Such fear and fanciful notions took possession of the living that almost all of them adopted the same cruel policy, which was entirely to avoid the sick and everything belonging to them. By so doing, each one thought he would secure his own safety.
Some thought that moderate living and the avoidance of all superfluity would preserve them from the epidemic. They formed small communities, living entirely separate from everybody else. They shut themselves up in houses where there were no sick, eating the finest food and drinking the best wine very temperately, avoiding all excess, allowing no news or discussion of death and sickness, and passing the time in music and suchlike pleasures. Others thought just the opposite. They thought the sure cure for the plague was to drink and be merry, to go about singing and amusing themselves, satisfying every appetite they could, laughing and jesting at what happened. They put their words into practice, spent day and night going from tavern to tavern, drinking immoderately, or went into other people's houses, doing only those things which pleased them. This they could easily do because everyone felt doomed and had abandoned his
|A plague victim reveals|
the telltale buboe on
his leg. From a
14th century illumination
In this suffering and misery of our city, the authority of human and divine laws almost disappeared, for, like other men, the ministers and the executors of the laws were all dead or sick or shut up with their families, so that no duties were carried out. Every man was therefore able to do as he pleased.
Many others adopted a course of life midway between the two just described. They did not restrict their victuals so much as the former, nor allow themselves to be drunken and dissolute like the latter, but satisfied their appetites moderately. They did not shut themselves up, but went about, carrying flowers or scented herbs or perfumes in their hands, in the belief that it was an excellent thing to comfort the brain with such odours for the whole air was infected with the smell of dead bodies, of sick persons and medicines.
Others again held a still more cruel opinion, which they thought would keep them safe. They said that the only medicine against the plague-stricken was to go right away from them. Men and women, convinced of this and caring about nothing but themselves, abandoned their own city, their own houses, their dwellings, their relatives, their property, and went abroad or at least to the country round Florence, as if God's wrath in punishing men's wickedness with this plague would not follow them but strike only those who remained within the walls of the city, or as if they thought nobody in the city would remain alive and that its last hour had come."
The Breakdown of Social Order
Thus, a multitude of sick men and women were left without any care, except from the charity of friends (but these were few), or the greed, of servants, though not many of these could be had even for high wages, Moreover, most of them were coarse-minded men and women, who did little more than bring the sick what they asked for or watch over them when they were dying. And very often these servants lost their lives and their earnings. Since the sick were thus abandoned by neighbours, relatives and friends, while servants were scarce, a habit sprang up which had never been heard of before. Beautiful and noble women, when they fell sick, did not scruple to take a young or old man-servant, whoever he might be, and with no sort of shame, expose every part of their bodies to these men as if they had been women, for they were compelled by the necessity of their sickness to do so. This, perhaps, was a cause of looser morals in those women who survived."
"The plight of the lower and most of the middle classes was even more pitiful to behold. Most of them remained in their houses, either through poverty or in hopes of safety, and fell sick by thousands. Since they received no care and attention, almost all of them died. Many ended their lives in the streets both at night and during the day and many others who died in their houses were only known to be dead because the neighbours smelled their decaying bodies. Dead bodies filled every corner. Most of them were treated in the same manner by the survivors, who were more
|Citizens of Tournai bury plague victims. These are|
fortunate to have coffins. Most victims
were interred in mass graves
Such was the multitude of corpses brought to the churches every day and almost every hour that there was not enough consecrated ground to give them burial, especially since they wanted to bury each person in the family grave, according to the old custom. Although the cemeteries were full they were forced to dig huge trenches, where they buried the bodies by hundreds. Here they stowed them away like bales in the hold of a ship and covered them with a little earth, until the whole trench was full."
Boccaccio, Giovanni, The Decameron vol. I (translated by Richard Aldington illustrated by Jean de Bosschere) (1930) Gottfried, Robert, The Black Death (1983).
Bubonic Plague/Black Death activity? (Freshmen World History)
I'm teaching the Black Death in my Freshmen World History class. I feel like there are a bunch of creative ways to teach this, particularly with a game of some sort. Has anyone done this in the past? Any advice for a fun lesson?
Give them an interesting task to complete, but remove some of them from the task every five minutes proportional to the percentage of Europeans who died from the plague every month/year, etc.
See if they're able to complete the task at all.
Thanks, I like this a lot. I was really hoping to show how drastic the casualties were, especially by showing he ratio using the class. I'll try to think of some tasks.
There was a game online years ago that I can't find. I know the site 404ɽ years ago but I was hoping it popped up somewhere else. If I remember it went something like this.
You need a lot of marbles/skittles/m&ms. Marbles work best because kids are handling them. Create 8-15 cities (groups) and make 6-15 merchants/traders/pilgrims/travelers. I like to name each city after a medieval city. Each city has a container that they can't see into. Each merchant has a bag they can't see into. You need to have the marbles divided up by color. Use a single easy to identify color to represent plague.
At the beginning of the class, have one or two merchants have most of their marbles be the plague color. Then they take a turn. Have the merchants move from group to group (city to city). You can use this time as a way to use time to have the merchants teach about life in the middle ages. For example have the soldier tell the group about being on pilgrimage. Have a wandering Jew talk about what life is like for a Jew in the Middle Ages (Use the trope to explain how Jews were treated in the Middle Ages). and so on.
When each traveler gets to a new town, each towns takes a number of marbles from the merchant and puts it into their town collection and the traveler takes the same back. At the end of each turn, have each group member take a marble from the collection. When a person has 4 plague marbles they are eliminated and must puts two of their marbles randomly back into their town's collection. Try to kill off your class.It won't take long for people to get the idea of who has the plague. Let them try to deal with stopping the plague. Feel free to break the rules and start starving them because they can't trade for goods to eat.
Watch and learn how the kids try to circumvent the game. Use that to create an analogy to how people in the Middle Ages would have reacted to a plague. This works best on a block schedule. But if you can keep efficient records you can do it over several days.
I think this is how the game goes. Use it modify it. Do what you need to make it work.
Shining the Light of Truth: Teaching Black History All Year Long
The end of this past school year, and the events surrounding the death of George Floyd while in police custody, have left all of us reeling.
For those of us who teach U.S. history, there is so much advice, so many suggestions from so many well-meaning individuals and organizations, so much to read. And more to read. I have gotten more links to lists of books to read about racism in the last few weeks than I can count.
But may I suggest that, for history teachers, what Dr. King described as the “urgency of now” demands we read as much about the past as the present?
Whenever I get overwhelmed, I go back to what matters most to me as a teacher. And right now, that means rethinking my curriculum to include more Black history than I already do. I teach 8th grade U.S. history picking up from after Reconstruction. I can imagine that what my new students understand about Reconstruction will be shaky due to remote learning.
So I am considering starting off the year with a review of the Reconstruction Era and how it is an unfinished process in our country.
“The 1873 Colfax Massacre Crippled the Reconstruction Era” (Smithsonian Magazine)
We must remember that African American history is not all about slavery, but that slavery had a profound impact and reach that continues today. (See the end of this post for resources on that continuing impact via the 1619 Project.)
We must remember that when we do teach about historical slavery, we can’t wait to teach it until right before we get to the Civil War unit. We must teach students about the enormous impact of slavery on the story of America from its very beginnings.
And when we wrap up our units on the Civil War and Reconstruction, we can’t ignore Black history until Rosa Parks. None of us – no matter our race or the race of our students – can afford such a distorted view of history.
If we are intentional about doing the work that social justice advocates are talking about right now, we will be busy. We will struggle this summer as we get ready for fall. Lonnie G. Bunch, Secretary of the Smithsonian, concluded his recent statement on racial violence and division with the quotation below.
If there is no struggle there is no progress. Those who profess to favor freedom and yet deprecate agitation are men who want crops without plowing up the ground. – Frederick Douglass
Why Students Need Black History All Year
Editor’s note: The remainder of this article first appeared on 9/17/19, and some comments date from then.
In the month of February you will find countless articles about Black History Month. One of the many suggestions you see in those articles is that Black history should be taught all year, which is why you are reading this in September.
In my classroom, we are newly back to school, and we cannot wait until February. Carter Woodson, the founder of what started out as Black history week, hoped that one day the need for such a special designation would disappear – that one day the history and contributions of Black people would be fully embedded in our classes.
I don’t think we’re at that point yet. How could we be when we still read stories about misguided teachers holding slavery simulations in their classrooms or asking students to identify slavery’s positive aspects?
But in my classroom I am working hard to reach Carter Woodson’s goals. The district where I teach has been wrestling with issues of equity that center around race with a new urgency during the past few years. As a result, I have been to a number of workshops on this issue.
These workshops and my own reading and experience confirm for me, a white teacher, that at least part of the answer is to be found in our curriculum. I cannot single-handedly close the achievement gap or end racism, but I can focus on Black history.
Black History Is for Everyone
Among my own students, 55% are white and the next largest group is African American. But whatever the racial makeup in a school, ALL of our students need Black history.
Why? Let me suggest four reasons, with three caveats.
Reason 1: U.S. history makes no sense without African American history.
As W.E.B. Du Bois famously wrote, “the problem of the twentieth century is the problem of the color-line.” The twenty-first century, so far, does not appear to be much different.
The color line, beginning with slavery, has informed every aspect of our history. Slavery is THE fundamental contradiction in our country’s history. Our nation’s founding principle – a dedication to the proposition that all men are created equal and endowed with certain unalienable rights – is in direct conflict with slavery.
Our country was built with slave labor, we went to war over slavery, and we have not yet made good on the promissory note Martin Luther King spoke of in 1963. As Nikole Hannah-Jones recently asked, “What if America understood…that we [African Americans] have never been the problem but the solution?”
While our country espouses the ideals of democracy, liberty and equality, we haven’t lived up to them, and yet ironically, it is Black Americans who have been the “foremost freedom fighters” in our history. Understanding this contradiction is one of the keys towards understanding the history of the United States of America.
Reason 2: African American history intersects in every unit and period.
Even after your class gets past Reconstruction, African American history continues to play an important role. The Jim Crow era, during the Harlem Renaissance of the 1920s, and the Civil Rights movements are the obvious spots, but African American history fits EVERYWHERE.
As I have taught different grades, I have found myself at different points in the curriculum during February, which has led me to research and then teach different aspects of Black history. A few years ago, I found myself teaching about the Spanish American War and the annexation of the Philippines during February. At first, I didn’t see how I would find a connection there. But find it I did. African Americans fought in the war, many because they hoped it would prove they were loyal Americans.
This would be true of every war the U.S. has ever fought, beginning with the American Revolution and the death of Crispus Attucks during the Boston Massacre. Interestingly, some Black Americans pointed out the hypocrisy of fighting to acquire the Philippines against the will of the population and then working to “civilize them” when there was still so much discrimination against African Americans at home.
Using primary sources such as this declaration from the Colored Citizens of Boston protesting the Filippino War, or “The Black Man’s Burden,” a response to Rudyard Kipling’s famous poem, “White Man’s Burden,” help provide alternative perspectives. Furthermore, the anti-imperialist view of the Colored Citizens of Boston is echoed in all the subsequent wars of the 20th century. I use this YouTube clip (starting at minute 1:51) of Muhammed Ali’s stance on Vietnam to demonstrate the parallel.
So whatever units or periods of American history that you teach, do some research. (See resources below for places to start.) You will find something on the role Blacks played that can fuel discussion and illuminate greater truths about the period. Whether it is the opportunities of the workers in the Gilded Age, or the cowboys out west, or the suffragists fighting for women’s right to vote, or the impact of World War II – there are Black people involved.
Reason 3: Our nation’s present problems with race and intolerance make no sense if we don’t know the history behind it.
As I write this post, the New York Times has just published The 1619 Project which examines “the ways the legacy of slavery continues to shape our country.” The last several years have brought renewed attention to the impact of slavery on the world today. (See the excellent podcast, Seeing White, from Scene on Radio.)
Whether you are looking at today’s rise of white supremacy movements, contemporary efforts to take down Confederate monuments, or the advantages slavery had for Northern institutions, it is clear that slavery was the major plot line of American history in the past and continues to inform the present.
When we teach Black history in isolation – as a pause for Dr. Martin Luther King, Jr., or a few heroes in February, or worse, as a few days spent on slavery, its abolition in 1865 and then nothing until Brown v. Board in 1954 – we contribute to our nation’s amnesia about race.
Our students – even in all/mostly white communities – know that race is a major issue in our country. When we don’t acknowledge that, when we don’t teach about the roots of it, then the misunderstanding and the racism continue. As I mentioned in a recent post, Professor Steven Thurston Oliver speaks eloquently about this issue in a podcast for Teaching Tolerance’s Hard History: American Slavery.
Reason 4: Students like Black History
In my experience – no matter what the racial composition of a student is – they like African American history. They like it because it is about justice and injustice. And there is nothing like injustice to stir the passion of a 13-year-old.
Sharecroppers evicted 1936, John Vachon
During my unit on the Great Depression, I use an engaging, 10 minute film clip from the History Channel. I watch students watch it (and they are mostly watching), but I always have a few who drift in and out. Until the part when noted actor Ossie Davis comes on and talks about FDR’s fireside chats.
Davis says, “…and me, a little Black boy down in Georgia…it wasn’t that [FDR] told it to Daddy…or told it to Mama. No, he was talking to little Ossie.” And when he says that, I kid you not, the entire class, including the white kids, perk up and refocus. I know, because I have watched all 5 of my classes for the past few years I have shown this, and it never fails. The same thing happens every time. There is something about that comment (and it’s not just Davis’s wonderful voice) that speaks to them.
This is how it is whenever I teach Black history. Middle school students are (please forgive my broad generalization here) idealistic, full of hatred against anything that isn’t fair. Too often they feel powerless. African American history is all about that and more.
3 Important Caveats
Remember that there is diversity of experience over time and place. Do not treat all African Americans alike. Not every Black person was a slave. Slavery was different in the North from the South. Consider urban vs. rural, small farm or large plantation. Consider the conditions of Black people in the colonial period vs. antebellum vs. 1920s.
The Great Migration fundamentally changed the demographics of our country and life was different for those who made the journey and those who didn’t, for those who followed family and for those who were the first to arrive. There is a beautiful expression of this by classroom teacher Jordan Lanfair in #15 of the Teaching Hard History: American Slavery podcasts at about minute 38:00.
Even African Americans who had the same experiences did not interpret them the same way. I love to use two opposing documents about women’s suffrage from Booker T. Washington and Du Bois to illuminate this. Students are surprised that a Black man would oppose women’s suffrage.
Be sure your entire focus is not slavery and oppression. It shouldn’t be, and not only for the sake of our Black students, who can be justifiably proud of the enormous impact Black culture continues to have on everything American. While slavery and oppression, of course, are a major part of the story, they don’t explain the cultural longevity and successes of African Americans, nor their unique contributions to the arts, to literature (including SF), to music, to sports, to business, to science and mathematics.
One source I especially like to use to address this is a brief video from a New York Times interactive collection featuring the voices of “hypenated” Americans. Michaela, a very light-skinned woman who identifies as Black, is so proud of her identity she pointedly asks, “Why would I want to be White?”
Another piece of cultural history is found in a chapter from Langston Hughes’s 1940 autobiography, The Big Sea, called “When the Negro Was in Vogue.” Students will see echoes of the role African American culture played in the 1920s in our society today.
And one last question you might have….
So if you do this all year, what do you do in February? I’m still wrestling with this question. It is probably wise at the start of the month to explain to students the story of how Black History Month came to be. History.com’s video does this well. I then remind them of other designated months.
You might consider a discussion of what African American history month is for. Is it a celebration of famous people and contributions? A time to focus our attention on the history of African Americans as a people? Is it a time to focus on the successes and the victories? Or the struggle? Or the work yet to be done?
To do all this well, you will need sources other than a textbook. A few of my favorites are linked below.
- Ta-Nehisi Coates’s “The Case for Reparations” is an important article that is really an overview of the impact of slavery. I also like the essay by Lonnie Bunch, the director of the National Museum of African American History and Culture, about the continuing importance of Black History Month. – from Teaching Tolerance – great lessons that need editing for middle schoolers. – from Facing History – part of New York public library – useful for pedagogical issues to consider when thinking about painful topics, like slavery, Jim Crow and lynching.
Lauren S. Brown (@USHistoryIdeas) has taught U.S. history, sociology and world geography in public middle and high schools in the Midwest. She currently teaches 8th grade U.S. history in suburban Chicago. Lauren has also supervised pre-service social studies teachers and taught social studies methods courses. Her degrees include an M.A. in History from the University of Illinois at Chicago. Her blog U.S. History Ideas for Teachers is insightful and packed with resources.
Thank you for this article. It articulates perfectly all the ideas I have about how to teach history in an inclusive way. Though I appreciate the purpose of Black History month, it does tend to allow teachers to avoid the importance of African Americans in ALL parts of our history.
Thank you. I think Black History month is still important and needed, but I agree–it can also lead to ignoring this history until then.
How sad that so many of the ideas here are so racially divisive – just after 2 successful elections of the first black president. What part of the American dream are citizens not allowed to partake? Yes, MLK lived at a time when Jim Crow was still highly active– and his speech was a catalyst for freedoms enjoyed now. Even then he said, “Let us not seek to satisfy our thirst for freedom by drinking from the cup of bitterness and hatred.” Yet, the recommended video of Muhammed Ali, refusing to fight when called by his country (many did this) has him yelling “you white people are my enemy!”
And “there’s nothing like injustice to stir a 13-year old!” It just seems your recommended curriculum seems to be grievance based. Which seems antithetical to MLK’s vision of a color blind world. Does it imply that “whites” have an idyllic world without problems? To actually be fair, we have to teach Hispanic history, Asian history, LGBT history, Filipino history, and so forth. As we break (and keep) individuals in their respective groups, we totally lose the idea of “American History.”
I can see why so many Americans hate the country and deny anything good about it. We need to see people as individuals – not divided into grievance/victim groups. Does your curriculum strengthen or weaken that?
I don’t see my suggestions as grievance-based I see them as U.S. history. Muhammed Ali was speaking at a time when there was significant racism impacting Black Americans. And, as I mentioned, I used the clip during a lesson on the war with the Filipinos. It illustrates a recurring theme in American history. It does not imply that other groups do not have problems.
The quotation you mention from MLK about not drinking from the cup of bitterness and hatred is a poignant one and speaks to the broad point you are making. We do, I agree, have to be careful to avoid presenting a view of American history that is so depressing our students lose hope. While I say that there is nothing like injustice to stir a 13-year old, the corollary is that they have tremendous hope and idealism, and we must do all we can to harness that.
That is why I think teaching about past injustices is so important many of these injustices have been addressed. But King’s “vision of a color blind world” is a vision that I do not think has yet been achieved. We are not in the “post-racial” world that many spoke about following Obama’s election. African Americans still fall behind Whites in so many areas– education, economics, health. The evidence is quite clear. Being “color conscious” in the classroom means being aware of and sensitive to the many different backgrounds and cultural roots of our students. That awareness is necessary to teach effectively. Color-blindness, in that context, would not be acceptable. Nor would color-blindness in teaching about the past.
I believe in E Pluribus Unum out of many, one. I do not think that telling the stories of different groups detracts from the story of our nation as a whole. It’s not all about grievances and victims. It is also about overcoming adversity and adding to the body politic. I just finished listening to the first podcast of the 1619 Project: https://www.nytimes.com/2019/08/23/podcasts/1619-slavery-anniversary.html There’s a lovely bit at the very end (about minute 36:00) where Nikole Hannah-Jones explains the role African Americans played in fulfilling the promises and ideals made by the Declaration of Independence and the 13th, 14th and 15th Amendments. It’s a beautiful thought about the ideals for which this country stands.
I would just like to say as an African American student, I’m glad that you took the time to actually try to teach and educate people as to why it’s important to teach African American history – which is in fact American history. Thank you so much for making an effort.
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The catastrophic plague known as the Black Death hit Europe in 1348 and swept through the continent rapidly. It would eventually kill between a third and half of the population. These huge death tolls sparked off a chain of events that would change the position of the peasant in England forever. Because so many had died, there were far fewer people to work the land: peasants were therefore able to demand better conditions and higher wages from their landlords. Many advanced to higher positions in society.
This chronicle, written at the cathedral priory of Rochester between 1314 and 1350, includes a firsthand account of the Black Death, describing the changes in the everyday lives of people across the social scale: ‘there was such a shortage of servants, craftsmen, and workmen, and of agricultural workers and labourers. [that] churchmen, knights and other worthies have been forced to thresh their corn, plough the land and perform every other unskilled task if they are to make their own bread.’
Shelfmark: Cotton Faustina B V
Extract in present day English:
A great mortality . destroyed more than a third of the men, women and children. As a result, there was such a shortage of servants, craftsmen, and workmen, and of agricultural workers and labourers, that a great many lords and people, although well-endowed with goods and possessions, were yet without service and attendance. Alas, this mortality devoured such a multitude of both sexes that no one could be found to carry the bodies of the dead to burial, but men and women carried the bodies of their own little ones to church on their shoulders and threw them into mass graves, from which arose such a stink that it was barely possible for anyone to go past a churchyard.
As remarked above, such a shortage of workers ensued that the humble turned up their noses at employment, and could scarcely be persuaded to serve the eminent unless for triple wages. Instead, because of the doles handed out at funerals, those who once had to work now began to have time for idleness, thieving and other outrages, and thus the poor and servile have been enriched and the rich impoverished. As a result, churchmen, knights and other worthies have been forced to thresh their corn, plough the land and perform every other unskilled task if they are to make their own bread.
Bentley, Jerry H., Ziegler, Herbert F., Streets, Heather E. (2008) Traditions and
Encounters: A Brief Global History, ch9,15,19, McGraw-Hill, Inc.
Bridbury, A. (1973). The Black Death. The Economic History Review, 26: 577 – 592.
Bryrne, J. (2011). Black Death. World Book Advanced. Web.
Carol, B. (1996). Bubonic Plague in the nineteenth-century China.
Robin, N. (2011). Apocalypse Then: A History of Plague. Special Report. World Book Advanced. Web.
The Black Death And Its Effects. (1935). Readings in English History Drawn from the Original Sources: Intended to Illustrate a Short History of England. Boston: Ginn.