Death strangling victim of Black Death, 1376. (Artist Werner Forman, image Alamy)
Q: What was the Black Death?
A: In the Middle Ages the Black Death, or ‘pestilencia’, as contemporaries called various epidemic diseases, was the worst catastrophe in recorded history. Some dubbed it ‘magna mortalitas’ (great mortality), emphasising the death rate.
It destroyed a higher proportion of the population than any other single known event. One observer noted ‘the living were scarcely sufficient to bury the dead.’ No one could be sure what caused it.
Q: When did the Black Death break out?
A: The disease arrived in western Europe in 1347 and in England in 1348. It faded away in the early 1350s.
Q: Where did it originate, and what areas did it affect?
A: Breaking out in ‘the east’, as medieval people put it, it came north and west after striking the eastern Mediterranean and Italy, Spain and France.
It then came to Britain, where it struck Dorset and Hampshire along the south coast of England simultaneously. It then spread north and east, then on to Scandinavia and Russia.
Q: How did it spread?
A: The disease spread from animal populations to humans through the agency of fleas from dying rats. Plague bacteria stifled the vital organs of those infected.
Its lethality arose from the onslaught of three types: bubonic, pneumonic and, occasionally, septicaemic plague.
Q: Who was affected?
A: Old and young, men and women: all of society – royalty, peasants, archbishops, monks, nuns and parish clergy.
Both artisan and artistic skills were lost or severely affected, from cathedral building in Italy to pottery production in England. Artists such as the Lorinzetti brothers of Siena were victims, and the English royal masons, the Ramseys, died.
There were shortages of people to till the land and tend cattle and sheep.
Q: What were the symptoms?
A: Symptoms included swellings – most commonly in the groin, armpits and neck; dark patches, and the coughing up of blood.
Medieval observers – and their modern counterparts in 19th-century China and 20th-century Vietnam, observing more recent outbreaks – noted that different strains of the disease took from five days to as little as half a day to cause death.
Q: How many people were killed?
A: In Europe in three or four years, 50 million people died. The population was reduced from some 80 million to 30 million. It killed at least 60 per cent of the population in rural and urban areas.
Some communities such as Quob in Hampshire were wiped out; many rural communities went into decline and were in time deserted. We know that some populations survived, but medieval people had no such knowledge – all they knew was that everyone would certainly die.
Q: Was it a one-off occurrence?
A: No. There have been three identified so-called ‘pandemics’. First, there was a significant international epidemic in the sixth century AD.
Second, starting with The Black Death – its deadliest attack - plague later returned to Britain in 1361 (when it affected especially younger and elderly people); 1374, and regularly until it disappeared shortly after the Great Plague of 1665.
Third, the disease broke out once more in Asia in the 1890s, and established new foci, where it is still found in animal populations today.
Q: What remedies were used?
A: Medieval people believed that the disease came from God, and so responded with prayers and processions. Some contemporaries realised that the only remedy for plague was to run away from it – Boccaccio’s Decameron is a series of tales told among a group of young people taking refuge from the Black Death outside Florence.
There was no known remedy, but people wanted medicines: Chaucer commented that the Doctor of Physic made much ‘gold’ out of the pestilence. The plague bacteria were identified in Asia in the 1890s, and the connection with animals and fleas established.
Modern antibiotics can combat plague, but these are under threat from mutating diseases and immunity to antibiotics’ effects.
Q: Will it return?
A: In fact, the disease has never gone away. An outbreak in Surat in India in the early 1990s caused panic across the world. The death of a herdsman in Kyrgyzstan in 2013 from bubonic plague was wildly exaggerated in the media.
With our better understanding of historic plague, other diseases among animals such as bird-flu and swine-flu are carefully monitored today in case they develop into person-to-person infections resulting in high mortality as witnessed in the Black Death.