Black Death

The Black Death, also known as the Great Plague or the Plague, or less commonly the Black Plague, was one of the most devastating pandemics in human history, resulting in the deaths of an estimated 75 to 200 million people in Eurasia and peaking in Europe from 1347 to 1351.[1][2][3] The bacterium Yersinia pestis, which results in several forms of plague, is believed to have been the cause.[4] The Black Death was the first major European outbreak of plague, and the second plague pandemic.[5] The plague created a number of religious, social and economic upheavals which had profound effects on the course of European history.

The Black Death is thought to have originated in the dry plains of Central Asia, where it travelled along the Silk Road, reaching Crimea by 1343.[6] From there, it was most likely carried by fleas living on the black rats that traveled on all merchant ships, spreading throughout the Mediterranean Basin and Europe.

The Black Death is estimated to have killed 30% to 60% of Europe's population.[7] In total, the plague may have reduced the world population from an estimated 450 million to 350–375 million in the 14th century.[8] It took 200 years for the world population to recover to its previous level.[9][10] The plague recurred as outbreaks in Europe until the 19th century.

1346-1353 spread of the Black Death in Europe map
Spread of the Black Death in Europe and the Near East (1346–1353)


Origins of the disease

The plague disease, caused by 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 and Uganda.[11] Due to climate change in Asia, rodents began to flee the dried out grasslands to more populated areas, spreading the disease.[12] Nestorian graves dating to 1338–1339 near Issyk-Kul in Kyrgyzstan have inscriptions referring to plague and are thought by many epidemiologists to mark the outbreak of the epidemic, from which it could easily have spread to China and India.[13] In October 2010, medical geneticists suggested that all three of the great waves of the plague originated in China.[14]

The 13th-century Mongol conquest of China caused a decline in farming and trading. However, economic recovery had been observed at the beginning of the fourteenth century. In the 1330s, a large number of natural disasters and plagues led to widespread famine, starting in 1331, with a deadly plague arriving soon after.[15] Epidemics that may have included plague killed an estimated 25 million Chinese and other Asians during the fifteen years before it reached Constantinople in 1347.[16][17]

The disease may have travelled along the Silk Road with Mongol armies and traders or it could have come via ship.[18] By the end of 1346, reports of plague had reached the seaports of Europe: "India was depopulated, Tartary, Mesopotamia, Syria, Armenia were covered with dead bodies".[19]

Plague was reportedly first introduced to Europe via Genoese traders from the port city of Kaffa in the Crimea in 1347.[20][21] During a protracted siege of the city by the Mongol army under Jani Beg, whose army was suffering from the disease, the army catapulted infected corpses over the city walls of Kaffa to infect the inhabitants. The Genoese traders fled, taking the plague by ship into Sicily and the south of Europe, whence it spread north.[22] Whether or not this hypothesis is accurate, it is clear that several existing conditions such as war, famine, and weather contributed to the severity of the Black Death.

European outbreak

There appears to have been several introductions into Europe. The plague reached Sicily in October 1347, carried by twelve Genoese galleys,[23] and rapidly spread 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 Marseille.[24]

From Italy, the disease spread northwest across Europe, striking France, Spain, Portugal and England by June 1348, then turned and spread east and north through Germany, Scotland and Scandinavia from 1348 to 1350. It was introduced in Norway in 1349 when a ship landed at Askøy, then spread to Bjørgvin (modern Bergen) and Iceland.[25] Finally it spread to northwestern Russia in 1351. The plague was somewhat less common in parts of Europe that had smaller trade relations with their neighbours, including the majority of the Basque Country, isolated parts of Belgium and the Netherlands, and isolated alpine villages throughout the continent.[26][27]

Modern researchers do not think that the 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.[28][29]

Middle Eastern outbreak

The plague struck various regions in the Middle East during the pandemic, leading to serious depopulation and permanent change in both economic and social structures. It spread from China with the Mongols to a trading post in Crimea, called Kaffa, controlled by the Republic of Genoa. As infected rodents infected new rodents, the disease spread across the region, entering also from southern Russia. By autumn 1347, the plague reached Alexandria in Egypt, through the port's trade with Constantinople, and ports on the Black Sea. During 1347, the disease travelled eastward to Gaza, and north along the eastern coast to cities in Lebanon, Syria and Palestine, including Ashkelon, Acre, Jerusalem, Sidon, Damascus, Homs, and Aleppo. 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.[30]

Mecca became infected in 1349. During the same year, records show the city of Mawsil (Mosul) suffered a massive epidemic, and the city of Baghdad experienced a second round of the disease.

Signs and symptoms

Acral gangrene due to plague
A hand showing how acral gangrene of the fingers due to bubonic plague causes the skin and flesh to die and turn black
Plague bubo
An inguinal bubo on the upper thigh of a person infected with bubonic plague. Swollen lymph glands (buboes) often occur in the neck, armpit and groin (inguinal) regions of plague victims.

Contemporary accounts of the plague are often varied or imprecise. The most commonly noted symptom was the appearance of buboes (or gavocciolos) in the groin, the neck and armpits, which oozed pus and bled when opened.[31] 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.[32]

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.[33]

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,[34] which could have been caused by flea-bites, were identified as another potential sign of the plague.

Some accounts, like that of Lodewijk Heyligen, whose master the Cardinal Colonna died of the plague in 1348, noted a distinct form of the disease that infected the lungs and led to respiratory problems[31] and is identified with pneumonic plague.

It is said that the plague takes three forms. In the first people suffer an infection of the lungs, which leads to breathing difficulties. Whoever has this corruption or contamination to any extent cannot escape but will die within two days. Another form ... in which boils erupt under the armpits, ... a third form in which people of both sexes are attacked in the groin.[35]


Xenopsylla chepsis (oriental rat flea)
The Oriental rat flea (Xenopsylla cheopis) engorged with blood. This species of flea is the primary vector for the transmission of Yersinia pestis, the organism responsible for bubonic plague in most plague epidemics. Both male and female fleas feed on blood and can transmit the infection.
Flea infected with yersinia pestis
Oriental rat flea (Xenopsylla cheopis) infected with the Yersinia pestis bacterium which appears as a dark mass in the gut. The foregut (proventriculus) of this flea is blocked by a Y. pestis biofilm; when the flea attempts to feed on an uninfected host Y. pestis is regurgitated into the wound, causing infection.
Yersinia pestis fluorescent.jpeg
Yersinia pestis (200x magnification), the bacterium which causes bubonic plague[36]

Medical knowledge had stagnated during the Middle Ages. The most authoritative account at the time came from the medical faculty in Paris in a report to the king of France that blamed the heavens, in the form of a conjunction of three planets in 1345 that caused a "great pestilence in the air".[37] This report became the first and most widely circulated of a series of plague tracts that sought to give advice to sufferers. That the plague was caused by bad air became the most widely accepted theory. Today, this is known as the miasma theory. The word plague had no special significance at this time, and only the recurrence of outbreaks during the Middle Ages gave it the name that has become the medical term.

The importance of hygiene was recognised only in the nineteenth century; until then it was common that the streets were filthy, with live animals of all sorts around and human parasites abounding. A transmissible disease will spread easily in such conditions. One development as a result of the Black Death was the establishment of the idea of quarantine in Dubrovnik in 1377 after continuing outbreaks.[38]

The dominant explanation for the Black Death is the plague theory, which attributes the outbreak to Yersinia pestis, also responsible for an epidemic that began in southern China in 1865, eventually spreading to India. 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.[39] The mechanism by which Y. pestis was 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 results in starvation and aggressive feeding behaviour by the fleas, which repeatedly attempt to clear their 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.[39]

The historian Francis Aidan Gasquet wrote about the Great Pestilence in 1893[40] and suggested that "it would appear to be some form of the ordinary Eastern or bubonic plague". 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 Justinian plague that was prevalent in the Eastern Roman Empire from 541 to 700 CE.[39]

An estimate of the mortality rate for the modern bubonic plague, following the introduction of antibiotics, is 11%, although it may be higher in underdeveloped regions.[41] 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.[42] Pneumonic plague has a mortality rate of 90 to 95 percent. Symptoms include fever, cough, and blood-tinged sputum. As the disease progresses, sputum becomes free-flowing and bright red. Septicemic 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 septicemic 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.[43]

A number of alternative theories – implicating other diseases in the Black Death pandemic – have also been proposed by some modern scientists (see below – "Alternative Explanations").

DNA evidence

Bubonic plague victims-mass grave in Martigues, France 1720-1721
Skeletons in a mass grave from 1720–1721 in Martigues, France, yielded molecular evidence of the orientalis strain of Yersinia pestis, the organism responsible for bubonic plague. The second pandemic of bubonic plague was active in Europe from 1347, the beginning of the Black Death, until 1750.

In October 2010, the open-access scientific journal PLoS Pathogens published a paper by a multinational team who undertook a new investigation into the role of Yersinia pestis in the Black Death following the disputed identification by Drancourt and Raoult in 1998. 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,[44] "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".[45]

The study also found that there were two previously unknown but related clades (genetic branches) of the Y. pestis genome associated with medieval mass graves. These clades (which are thought to be extinct) were found to be ancestral to modern isolates of the modern Y. pestis strains Y. p. orientalis and Y. p. medievalis, suggesting the plague may have entered Europe in two waves. Surveys of plague pit remains in France and England indicate the first variant entered Europe through the port of Marseille around November 1347 and spread through France over the next two years, eventually reaching England in the spring of 1349, where it spread through the country in three epidemics. Surveys of plague pit remains from the Dutch town of Bergen op Zoom showed the Y. pestis genotype responsible for the pandemic that spread through the Low Countries from 1350 differed from that found in Britain and France, implying Bergen op Zoom (and possibly other parts of the southern Netherlands) was not directly infected from England or France in 1349 and suggesting a second wave of plague, different from those in Britain and France, may have been carried to the Low Countries from Norway, the Hanseatic cities or another site.[45]

The results of the Haensch study have since been confirmed and amended. Based on 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."[46] A study published in Nature in October 2011 sequenced the genome of Y. pestis from plague victims and indicated that the strain that caused the Black Death is ancestral to most modern strains of the disease.[47]

DNA taken from 25 skeletons from the 14th century found in London have shown the plague is a strain of Y. pestis that is almost identical to that which hit Madagascar in 2013.[48][49]

Alternative explanations

The plague theory was first significantly challenged by the work of British bacteriologist J. F. D. Shrewsbury in 1970, who noted that the reported rates of mortality in rural areas during the 14th-century pandemic were inconsistent with the modern bubonic plague, leading him to conclude that contemporary accounts were exaggerations.[39] In 1984, zoologist Graham Twigg produced the first major work to challenge the bubonic plague theory directly, and his doubts about the identity of the Black Death have been taken up by a number of authors, including Samuel K. Cohn, Jr. (2002 and 2013), David Herlihy (1997), and Susan Scott and Christopher Duncan (2001).[39]

It is recognised that an epidemiological account of the 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 plague in England, and even estimates of overall population at the start vary by over 100% as no census was undertaken between the time of publication of the Domesday Book and the year 1377.[50] Estimates of plague victims are usually extrapolated from figures from the clergy.

In addition to arguing that the rat population was insufficient to account for a bubonic plague pandemic, sceptics of the bubonic plague theory point out that the symptoms of the Black Death are not unique (and arguably in some accounts may differ from bubonic plague); that transference via fleas in goods was likely to be of marginal significance; and that the DNA results may be flawed and might not have been repeated elsewhere or were not replicable at all, despite extensive samples from other mass graves.[39] Other arguments include the lack of accounts of the death of rats before outbreaks of plague between the 14th and 17th centuries; temperatures that are too cold in northern Europe for the survival of fleas; that, despite primitive transport systems, the spread of the Black Death was much faster than that of modern bubonic plague; that mortality rates of the Black Death appear to be very high; that, while modern bubonic plague is largely endemic as a rural disease, the Black Death indiscriminately struck urban and rural areas; and that the pattern of the Black Death, with major outbreaks in the same areas separated by 5 to 15 years, differs from modern bubonic plague—which often becomes endemic for decades with annual flare-ups.[39]

McCormick has suggested that earlier archaeologists were simply not interested in the "laborious" processes needed to discover rat remains.[51] 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.[52] Similarly, 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.[53]

Anthrax PHIL 2033
Anthrax skin lesion

A variety of alternatives to Y. pestis have been put forward. Twigg suggested that the cause was a form of anthrax, and Norman Cantor thought it may have been a combination of anthrax and other pandemics. Scott and Duncan have argued that the pandemic was a form of infectious disease that they characterise as hemorrhagic plague similar to Ebola. Archaeologist Barney Sloane has argued that there is insufficient evidence of the extinction of a large number of rats in the archaeological record of the medieval waterfront in London and that the plague 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.[54][55] This theory is supported by research in 2018 which suggested transmission was more likely by body lice and human fleas during the second plague pandemic.[56]

However, no single alternative solution has achieved widespread acceptance.[39] 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 septicemic (a type of "blood poisoning") and pneumonic (an airborne plague that attacks the lungs before the rest of the body) forms of the plague, which lengthen the duration of outbreaks throughout the seasons and help account for its high mortality rate and additional recorded symptoms.[31] 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.[48]


Death toll

Citizens of Tournai bury plague victims

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.[57] It killed some 75 to 200 million people in Eurasia.[1][58][3] According to medieval historian Philip Daileader in 2007:

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%.[59]

A death rate as high as 60% in Europe has been suggested by Norwegian historian Ole Benedictow:

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 per cent of Europe's population. It is generally assumed that the size of Europe's population at the time was around 80 million. This implies that around 50 million people died in the Black Death.[60]

The most widely accepted estimate for the Middle East, including Iraq, Iran and Syria, during this time, is for a death rate of about a third.[61] The Black Death killed about 40% of Egypt's population.[62] Half of Paris's population of 100,000 people died. In Italy, the population of Florence was reduced from 110,000–120,000 inhabitants in 1338 down to 50,000 in 1351. At least 60% of the population of Hamburg and Bremen perished,[63] and a similar percentage of Londoners may have died from the disease as well.[48] In London approximately 62,000 people died between 1346 and 1353.[12] While contemporary reports account of mass burial pits being created in response to the large numbers of dead, recent scientific investigations of a burial pit in Central London found well-preserved individuals to be buried in isolated, evenly spaced graves, suggesting at least some pre-planning and Christian burials at this time.[64] Before 1350, there were about 170,000 settlements in Germany, and this was reduced by nearly 40,000 by 1450.[65] In 1348, the plague 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.[39] The disease bypassed some areas, and the most isolated areas were less vulnerable to contagion. Monks and priests were especially hard-hit since they cared for victims of the Black Death.[66]


Nuremberg chronicles - Dance of Death (CCLXIIIIv)
Inspired by the Black Death, The Dance of Death, or Danse Macabre, an allegory on the universality of death, was a common painting motif in the late medieval period.

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",[67] lepers,[67][68] and Romani, thinking that they were to blame for the crisis. Lepers, and other individuals with skin diseases such as acne or psoriasis, were singled out and exterminated throughout Europe.

Because 14th-century healers were at a loss to explain the cause, Europeans turned to astrological forces, earthquakes, and the poisoning of wells by Jews as possible reasons for the plague's emergence.[69] The governments of Europe had no apparent response to the crisis because no one knew its cause or how it spread. The mechanism of infection and transmission of diseases was little understood in the 14th century; many people believed the epidemic was a punishment by God for their sins. This belief led to the idea that the cure to the disease was to win God's forgiveness.[70]

There were many attacks against Jewish communities.[71] In February 1349, the citizens of Strasbourg murdered 2,000 Jews.[71] In August 1349, the Jewish communities in Mainz and Cologne were annihilated. By 1351, 60 major and 150 smaller Jewish communities had been destroyed.[72] These massacres eventually died out in Western Europe, only to continue on in Eastern Europe. During this period many Jews relocated to Poland, where they received a warm welcome from King Casimir the Great.[73]


Great plague of london-1665
The Great Plague of London, in 1665, killed up to 100,000 people.

The plague repeatedly returned to haunt Europe and the Mediterranean throughout the 14th to 17th centuries.[74] According to Biraben, the plague was present somewhere in Europe in every year between 1346 and 1671.[75] The Second Pandemic was particularly widespread in the following years: 1360–1363; 1374; 1400; 1438–1439; 1456–1457; 1464–1466; 1481–1485; 1500–1503; 1518–1531; 1544–1548; 1563–1566; 1573–1588; 1596–1599; 1602–1611; 1623–1640; 1644–1654; and 1664–1667. Subsequent outbreaks, though severe, marked the retreat from most of Europe (18th century) and northern Africa (19th century).[76] According to Geoffrey Parker, "France alone lost almost a million people to the plague in the epidemic of 1628–31."[77]

In England, in the absence of census figures, historians propose a range of pre-incident population figures from as high as 7 million to as low as 4 million in 1300,[78] and a post-incident population figure as low as 2 million.[79] By the end of 1350, the Black Death subsided, but it never really died out in England. Over the next few hundred years, further outbreaks occurred in 1361–1362, 1369, 1379–1383, 1389–1393, and throughout the first half of the 15th century.[80] An outbreak in 1471 took as much as 10–15% of the population, while the death rate of the plague of 1479–1480 could have been as high as 20%.[81] The most general outbreaks in Tudor and Stuart England seem to have begun in 1498, 1535, 1543, 1563, 1589, 1603, 1625, and 1636, and ended with the Great Plague of London in 1665.[82]

Plague Riot in Moscow in 1771: during the course of the city's plague, between 50,000 and 100,000 people died, 17–33% of its population.

In 1466, perhaps 40,000 people died of the plague in Paris.[83] During the 16th and 17th centuries, the plague was present in Paris around 30 per cent of the time.[84] The Black Death ravaged Europe for three years before it continued on into Russia, where the disease was present somewhere in the country 25 times between 1350 and 1490.[85] Plague epidemics ravaged London in 1563, 1593, 1603, 1625, 1636, and 1665,[86] reducing its population by 10 to 30% during those years.[87] Over 10% of Amsterdam's population died in 1623–1625, and again in 1635–1636, 1655, and 1664.[88] Plague occurred in Venice 22 times between 1361 and 1528.[89] The plague of 1576–1577 killed 50,000 in Venice, almost a third of the population.[90] Late outbreaks in central Europe included the Italian Plague of 1629–1631, which is associated with troop movements during the Thirty Years' War, and the Great Plague of Vienna in 1679. Over 60% of Norway's population died in 1348–1350.[91] The last plague outbreak ravaged Oslo in 1654.[92]

In the first half of the 17th century, a plague claimed some 1.7 million victims in Italy, or about 14% of the population.[93] In 1656, the plague killed about half of Naples' 300,000 inhabitants.[94] More than 1.25 million deaths resulted from the extreme incidence of plague in 17th-century Spain.[95] The plague of 1649 probably reduced the population of Seville by half.[96] In 1709–1713, a plague epidemic that followed the Great Northern War (1700–1721, Sweden v. Russia and allies)[97] killed about 100,000 in Sweden,[98] and 300,000 in Prussia.[96] The plague killed two-thirds of the inhabitants of Helsinki,[99] and claimed a third of Stockholm's population.[100] Europe's last major epidemic occurred in 1720 in Marseille.[91]

World distribution of plague 1998
Worldwide distribution of plague-infected animals, 1998

The Black Death ravaged much of the Islamic world.[101] Plague was present in at least one location in the Islamic world virtually every year between 1500 and 1850.[102] Plague repeatedly struck the cities of North Africa. Algiers lost 30,000–50,000 inhabitants to it in 1620–1621, and again in 1654–1657, 1665, 1691, and 1740–1742.[103] 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.[104] Baghdad has suffered severely from visitations of the plague, and sometimes two-thirds of its population has been wiped out.[105]

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.[106] 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.[107]

The first North American plague epidemic was the San Francisco plague of 1900–1904, followed by another outbreak in 1907–1908.[108][109][110]

Modern treatment methods include insecticides, the use of antibiotics, and a plague vaccine. 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.[111] A further outbreak in Madagascar was reported in November 2014.[112] In October 2017 the deadliest outbreak of the plague in modern times hit Madagascar, killing 170 people and infecting thousands.[113]


The phrase "black death" (mors nigra) was used in 1350 by Simon de Covino or Couvin, a Belgian astronomer, who wrote the poem "On the Judgment of the Sun at a Feast of Saturn" (De judicio Solis in convivio Saturni), which attributes the plague to a conjunction of Jupiter and Saturn.[114] 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 vocatibant).[115] The name spread through Scandinavia and then Germany, gradually becoming attached to the mid 14th-century epidemic as a proper name.[116] However, atra mors is used to refer to a pestilential fever (febris pestilentialis) already in the 12th-century On the Signs and Symptoms of Diseases (Latin: De signis et sinthomatibus egritudinum) by French physician Gilles de Corbeil.[117] In English, the term was first used in 1755.[118] Writers contemporary with the plague described the event as "great plague"[69] or "great pestilence".[119]

See also


  1. ^ a b ABC/Reuters (29 January 2008). "Black death 'discriminated' between victims (ABC News in Science)". Australian Broadcasting Corporation. Retrieved 3 November 2008.
  2. ^ "Health: De-coding the Black Death". BBC. 3 October 2001. Retrieved 3 November 2008.
  3. ^ a b "Black Death's Gene Code Cracked". Wired. 3 October 2001. Retrieved 12 February 2015.
  4. ^ "Plague". World Health Organization. October 2017. Retrieved 8 November 2017.
  5. ^ The History of Plague – Part 1. The Three Great Pandemics
  6. ^ "Black Death". BBC – History. 17 February 2011.
  7. ^ Austin Alchon, Suzanne (2003). A pest in the land: new world epidemics in a global perspective. University of New Mexico Press. p. 21. ISBN 978-0-8263-2871-7.
  8. ^ "Historical Estimates of World Population". Retrieved 12 November 2016.
  9. ^ Wheeler, Dr. L. Kip. "The Black Plague: The Least You Need to Know". Dr. Wheeler's website. Dr. L. Kip Wheeler. Retrieved 9 August 2015.
  10. ^ Jay, Peter (17 July 2000). "A Distant Mirror". TIME Europe. 156 (3). Archived from the original on 25 July 2008. Retrieved 25 January 2018.
  11. ^ Ziegler 1998, p. 25.
  12. ^ a b Tignor, Adelman, Brown, Elman, Liu, Pittman, Shaw, Robert, Jeremy, Peter, Benjamin, Xinru, Holly, Brent (2014). Worlds Together, Worlds Apart, Volume 1: Beginnings to the 15th Century. New York, London: W.W Norton & Company. p. 407. ISBN 978-0-393-92208-0.CS1 maint: Multiple names: authors list (link)
  13. ^ Raoult; Drancourt (2008). "Paleomicrobiology: Past Human Infections". Springer: 152.
  14. ^ Nicholas Wade (31 October 2010). "Europe's Plagues Came From China, Study Finds". The New York Times. Retrieved 1 November 2010.
  15. ^ The Cambridge History of China: Alien regimes and border states, 907–1368, p. 585.
  16. ^ Kohn, George C. (2008). Encyclopedia of plague and pestilence: from ancient times to the present. Infobase Publishing. p. 31. ISBN 978-0-8160-6935-4.
  17. ^ Sussman GD (2011). "Was the black death in India and China?". Bulletin of the History of Medicine. 85 (3): 319–55. doi:10.1353/bhm.2011.0054. PMID 22080795.
  18. ^ Moore, Malcolm (1 November 2010). "Black Death may have originated in China". The Daily Telegraph.
  19. ^ Hecker 1859, p. 21 cited by Ziegler, p. 15.
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  21. ^ Barras, Vincent; Greub, Gilbert (June 2014). "History of biological warfare and bioterrorism". Clinical Microbiology and Infection. 20 (6): 498. doi:10.1111/1469-0691.12706. PMID 24894605. In the Middle Ages, a famous although controversial example is offered by the siege of Caffa (now Feodossia in Ukraine/Crimea), a Genovese outpost on the Black Sea coast, by the Mongols. In 1346, the attacking army experienced an epidemic of bubonic plague. The Italian chronicler Gabriele de’ Mussi, in his Istoria de Morbo sive Mortalitate quae fuit Anno Domini 1348, describes quite plausibly how the plague was transmitted by the Mongols by throwing diseased cadavers with catapults into the besieged city, and how ships transporting Genovese soldiers, fleas and rats fleeing from there brought it to the Mediterranean ports. Given the highly complex epidemiology of plague, this interpretation of the Black Death (which might have killed > 25 million people in the following years throughout Europe) as stemming from a specific and localized origin of the Black Death remains controversial. Similarly, it remains doubtful whether the effect of throwing infected cadavers could have been the sole cause of the outburst of an epidemic in the besieged city.
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  114. ^
    • On page 22 of the manuscript in Gallica, Simon mentions the phrase "mors nigra" (Black Death): "Cum rex finisset oracula judiciorum / Mors nigra surrexit, et gentes reddidit illi;" (When the king ended the oracles of judgment / Black Death arose, and the nations surrendered to him;).
    • A more legible copy of the poem appears in: Emile Littré (1841) "Opuscule relatif à la peste de 1348, composé par un contemporain" (Work concerning the plague of 1348, composed by a contemporary), Bibliothèque de l'école des chartes, 2 (2) : 201–243; see especially p. 228.
    • See also: Joseph Patrick Byrne, The Black Death (Westport, Connecticut: Greenwood Press, 2004), p. 1.
  115. ^ Francis Aidan Gasquet, The Black Death of 1348 and 1349, 2nd ed. (London, England: George Bell and Sons, 1908), p. 7. Johan Isaksson Pontanus, Rerum Danicarum Historia ... (Amsterdam (Netherlands): Johann Jansson, 1631), p. 476.
  116. ^ The German physician Justus Hecker (1795–1850) cited the phrase in Icelandic (Svarti Dauði), Danish (den sorte Dod), etc. See: J. F. C. Hecker, Der schwarze Tod im vierzehnten Jahrhundert [The Black Death in the Fourteenth Century] (Berlin, (Germany): Friedr. Aug. Herbig, 1832), page 3.
  117. ^ See: Stephen d'Irsay (May 1926) "Notes to the origin of the expression: atra mors," Isis, 8 (2): 328–332.
  118. ^ Oxford English Dictionary, 3rd edition, s.v.
  119. ^ John of Fordun's Scotichronicon ("there was a great pestilence and mortality of men") Horrox, Rosemary (1994). Black Death. ISBN 978-0-7190-3498-5.

Further reading

  • Armstrong, Dorsey (2016). The Black Death: The World's Most Devastating Plague. The Great Courses. ASIN B01FWOO2G6.
  • Benedictow, Ole Jørgen (2004). Black Death 1346–1353: The Complete History. ISBN 978-1-84383-214-0.
  • Byrne, J. P. (2004). The Black Death. London: Greenwood Publishing Group. ISBN 978-0-313-32492-5.
  • Cantor, Norman F. (2001). In the Wake of the Plague: The Black Death and the World It Made, New York, Free Press.
  • Cohn, Samuel K. Jr., (2002). The Black Death Transformed: Disease and Culture in Early Renaissance Europe, London: Arnold.
  • Gasquet, Francis Aidan (1893). The Great Pestilence AD 1348 to 1349: Now Commonly Known As the Black Death. ISBN 978-1-4179-7113-8.
  • Hecker, J.F.C. (1859). B.G. Babington (trans) (ed.). Epidemics of the Middle Ages. London: Trübner.
  • Herlihy, D., (1997). The Black Death and the Transformation of the West, Cambridge, Massachusetts: Harvard University Press.
  • McNeill, William H. (1976). Plagues and Peoples. Anchor/Doubleday. ISBN 978-0-385-11256-7.
  • Scott, S., and Duncan, C. J., (2001). Biology of Plagues: Evidence from Historical Populations, Cambridge: Cambridge University Press.
  • Shrewsbury, J. F. D., (1970). A History of Bubonic Plague in the British Isles, London: Cambridge University Press.
  • Twigg, G., (1984). The Black Death: A Biological Reappraisal, London: Batsford.
  • Ziegler, Philip (1998). The Black Death. Penguin Books. ISBN 978-0-14-027524-7. 1st editions 1969.

External links

Black Death Award

The Black Death Award is an individual honor awarded to college football players at the United States Military Academy (better known as 'West Point') who distinguish themselves during a game. It is presented to players only in the case of "exceptional, near perfect play."The award was first instituted by Army coach Jim Young in 1988. In 2007, Stan Brock, as the new head coach, reinstated the award. The award itself consists of a plaque featuring an Army Ranger-style knife and engraved with the honoree's name. According to Brock, it is given to players who go "above and beyond" and play "a near perfect game and have something to do with the outcome of the game for a victory."

Black Death Jewish persecutions

The Black Death persecutions and massacres were a series of violent attacks on Jewish communities blamed for an outbreak of the Black Death in Europe from 1348 to 1351.

Black Death in England

The Black Death was a bubonic plague pandemic, which reached England in June 1348. It was the first and most severe manifestation of the Second Pandemic, caused by Yersinia pestis bacteria. The term "Black Death" was not used until the late 17th century.

Originating in China, it spread west along the trade routes across Europe and arrived on the British Isles from the English province of Gascony. The plague seems to have been spread by flea-infected rats, as well as individuals who had been infected on the continent. Rats were the reservoir hosts of the Y. pestis bacteria and the Oriental rat flea was the primary vector.

The first known case in England was a seaman who arrived at Weymouth, Dorset, from Gascony in June 1348. By autumn, the plague had reached London, and by summer 1349 it covered the entire country, before dying down by December. Low estimates of mortality in the early twentieth century have been revised upwards due to re-examination of data and new information, and a figure of 40–60 percent of the population is widely accepted.

The English government handled the crisis well, and the country did not experience the extreme reactions that were seen elsewhere in Europe. The most immediate consequence was a halt to the campaigns of the Hundred Years' War. In the long term, the decrease in population caused a shortage of labour, with subsequent rise in wages, resisted by the landowners, which caused deep resentment among the lower classes. The Peasants' Revolt of 1381 was largely a result of this resentment, and even though the rebellion was suppressed, in the long term serfdom was ended in England. The Black Death also affected artistic and cultural efforts, and may have helped advance the use of the vernacular.

In 1361–62 the plague returned to England, this time causing the death of around 20 percent of the population. After this the plague continued to return intermittently throughout the 14th and 15th centuries, in local or national outbreaks. From this point on its effect became less severe, and one of the last outbreaks of the plague in England was the Great Plague of London in 1665–66.

Blackened death metal

Blackened death metal (also known as black death metal) is an extreme subgenre of heavy metal that fuses elements of black metal and death metal.The genre emerged in early 1990s when black metal bands began incorporating elements of death metal, and vice-versa. The genre typically employs death growls, tremolo picking, blast beats, and Satanic lyrics and imagery. Bands of the genre typically employ corpse paint, which was adapted from black metal.

Blue Sky Black Death

Blue Sky Black Death (abbreviated BSBD) is a production duo based in the San Francisco Bay Area. It consists of Ryan Maguire, better known by his stage name Kingston, and Ian Taggart, better known by his stage name Young God. They are known principally for their hip hop and instrumental music, made with a mixture of live instrumentation and sampling. Their name is "a skydiving phrase alluding to beauty and death."

Bubonic plague

Bubonic plague is one of three types of plague caused by bacterium Yersinia pestis. One to seven days after exposure to the bacteria, flu-like symptoms develop. These symptoms include fever, headaches, and vomiting. Swollen and painful lymph nodes occur in the area closest to where the bacteria entered the skin. Occasionally, the swollen lymph nodes may break open.The three types of plague are the result of the route of infection: bubonic plague, septicemic plague, and pneumonic plague. Bubonic plague is mainly spread by infected fleas from small animals. It may also result from exposure to the body fluids from a dead plague-infected animal. In the bubonic form of plague, the bacteria enter through the skin through a flea bite and travel via the lymphatic vessels to a lymph node, causing it to swell. Diagnosis is made by finding the bacteria in the blood, sputum, or fluid from lymph nodes.Prevention is through public health measures such as not handling dead animals in areas where plague is common. Vaccines have not been found to be very useful for plague prevention. Several antibiotics are effective for treatment, including streptomycin, gentamicin, and doxycycline. Without treatment, plague results in the death of 30% to 90% of those infected. Death, if it occurs, is typically within ten days. With treatment the risk of death is around 10%. Globally there are about 650 documented cases a year, which result in ~120 deaths. In the 21st century, the disease is most common in Africa.The plague is believed to be the cause of the Black Death that swept through Asia, Europe, and Africa in the 14th century and killed an estimated 50 million people. This was about 25% to 60% of the European population. Because the plague killed so many of the working population, wages rose due to the demand for labor. Some historians see this as a turning point in European economic development. The term bubonic is derived from the Greek word βουβών, meaning "groin". The term "buboes" is also used to refer to the swollen lymph nodes.

Consequences of the Black Death

The consequences of the Black Death are short and long-term effects of the Black Death on human populations across the world. They include a series of various biological, social, economic, political and religious upheavals which had profound effects on the course of world history, especially European history. Often referred to as simply "The Plague", the Black Death was one of the most devastating pandemics in human history, peaking in Europe between 1348 and 1350 with an estimated one-third of the continent's population ultimately succumbing to the disease. Historians estimate that it reduced the total world population from 450 million to between 350 and 375 million. In most parts of Europe, it took nearly 80 years for population sizes to recover, and in some areas more than 150 years.

From the perspective of many of the survivors, the effect of the plague may have been ultimately favorable, as the massive reduction of the workforce meant their labor was suddenly in higher demand. R. H. Hilton has argued that those English peasants who survived found their situation to be much improved. For many Europeans, the 15th century was a golden age of prosperity and new opportunities. The land was plentiful, wages high, and serfdom had all but disappeared. A century later, as population growth resumed, the lower classes again faced deprivation and famine.

Daniel Kaluuya

Daniel Kaluuya (born 24 February 1989) is an English actor and writer who achieved international recognition and acclaim for his leading role as Chris Washington in the horror film Get Out (2017), for which he was nominated for the Academy Award, Golden Globe Award, SAG Award and BAFTA Award for Best Actor. In 2018, he won the BAFTA Rising Star Award.

Kaluuya began his career as a teenager in improvisational theatre. He subsequently appeared in the first two seasons of the British television series Skins, in which he co-wrote some of the episodes. Playing the lead role in Sucker Punch at the Royal Court Theatre in London, Kaluuya won rave reviews for his performance and he won both the Evening Standard Award and Critics' Circle Theatre Award for Outstanding Newcomer.

He gained further acclaim for his performance as Bingham "Bing" Madsen in the Black Mirror episode "Fifteen Million Merits". He then played Michael "Tealeaf" Fry in the BBC dark comedy series Psychoville and Michael "Mac" Armstrong in the BBC Three horror drama series The Fades. Kaluuya appeared as Agent Colin Tucker in the 2011 film Johnny English Reborn and portrayed Black Death in the 2013 film Kick-Ass 2. In 2015, he had a supporting role in Denis Villeneuve's film Sicario. In 2018, he portrayed W'Kabi in the Marvel Studios blockbuster film Black Panther and also appeared in Steve McQueen's heist film Widows.


Darkthrone is a black metal band from Kolbotn, Norway. It formed in 1986 as a death metal band under the name Black Death. In 1991, the band embraced a black metal style influenced by Bathory and Celtic Frost and became one of the leading bands in the Norwegian black metal scene.

Their first three black metal albums—A Blaze in the Northern Sky, Under a Funeral Moon and Transilvanian Hunger (sometimes dubbed the "Unholy Trinity") — are considered the peak of the band's career and to be among the most influential albums in the genre. For most of this time, Darkthrone has been a duo of Fenriz and Nocturno Culto ever since the guitarist Zephyrous left the band in 1993. The band have sought to remain outside the music mainstream. Since 2006, their work has strayed from the traditional black metal style and incorporated more elements of traditional heavy metal and speed metal, being likened to Motörhead.

Death metal

Death metal is an extreme subgenre of heavy metal music. It typically employs heavily distorted and low-tuned guitars, played with techniques such as palm muting and tremolo picking, deep growling vocals, aggressive, powerful drumming featuring double kick and blast beat techniques, minor keys or atonality, abrupt tempo, key, and time signature changes, and chromatic chord progressions. The lyrical themes of death metal may invoke slasher film-stylized violence, religion (sometimes Satanism), occultism, Lovecraftian horror, nature, mysticism, mythology, philosophy, science fiction, and politics, and they may describe extreme acts, including mutilation, dissection, torture, rape, cannibalism, and necrophilia.

Building from the musical structure of thrash metal and early black metal, death metal emerged during the mid-1980s. Bands such as Venom, Celtic Frost, Slayer, and Kreator were important influences on the genre's creation. Possessed, Death, Necrophagia, Obituary, Autopsy, and Morbid Angel are often considered pioneers of the genre. In the late 1980s and early 1990s, death metal gained more media attention as popular genre. Niche record labels like Combat, Earache, and Roadrunner began to sign death metal bands at a rapid rate.Since then, death metal has diversified, spawning several subgenres. Melodic death metal combines death metal elements with those of the new wave of British heavy metal. Technical death metal is a complex style, with uncommon time signatures, atypical rhythms, and unusual harmonies and melodies. Death-doom combines the deep growled vocals and double-kick drumming of death metal with the slow tempos and melancholic atmosphere of doom metal. Deathgrind, goregrind, and pornogrind mix the complexity of death metal with the intensity, speed, and brevity of grindcore. Deathcore combines death metal with metalcore traits. Death 'n' roll combines death metal's growled vocals and highly distorted, detuned guitar riffs with elements of 1970s hard rock and heavy metal.

Disease in fiction

Diseases, both real and fictional, play a significant role in fiction, with certain diseases like Huntington's disease and tuberculosis appearing in many books and films. Pandemic plagues threatening all human life, such as The Andromeda Strain, are among the many fictional diseases described in literature and film.

Gravity (comics)

Gravity is a fictional character, a superhero appearing in American comic books published by Marvel Comics. The character was created by Sean McKeever and Mike Norton, who wanted to create their own character inspired by the college-aged Spider-Man from the 1980s they grew up with.

John II of France

John II (French: Jean II; 26 April 1319 – 8 April 1364), called John the Good (French: Jean le Bon), was King of France from 1350 until his death. He was the second monarch from the House of Valois.

When John II came to power, France was facing several disasters: the Black Death, which killed nearly half of its population; popular revolts known as Jacqueries; free companies (Grandes Compagnies) of routiers who plundered the country; and English aggression that resulted in disastrous military losses, including the Battle of Poitiers of 1356, in which John was captured.

While John was a prisoner in London, his son Charles became regent and faced several rebellions, which he overcame. To liberate his father, he concluded the Treaty of Brétigny (1360), by which France lost many territories and paid an enormous ransom. In an exchange of hostages, which included his second son Louis, Duke of Anjou, John was released from captivity to raise funds for his ransom. Upon his return to France, he created the franc to stabilize the currency and tried to get rid of the free companies by sending them to a crusade, but Pope Innocent VI died shortly before their meeting in Avignon. When John was informed that Louis had escaped from captivity, he voluntarily returned to England, where he died in 1364. He was succeeded by his son Charles V.

Late Middle Ages

The Late Middle Ages or Late Medieval Period was the period of European history lasting from 1250 to 1500 AD. The Late Middle Ages followed the High Middle Ages and preceded the onset of the early modern period (and in much of Europe, the Renaissance).Around 1300, centuries of prosperity and growth in Europe came to a halt. A series of famines and plagues, including the Great Famine of 1315–1317 and the Black Death, reduced the population to around half of what it was before the calamities. Along with depopulation came social unrest and endemic warfare. France and England experienced serious peasant uprisings, such as the Jacquerie and the Peasants' Revolt, as well as over a century of intermittent conflict, the Hundred Years' War. To add to the many problems of the period, the unity of the Catholic Church was temporarily shattered by the Western Schism. Collectively, those events are sometimes called the Crisis of the Late Middle Ages.Despite the crises, the 14th century was also a time of great progress in the arts and sciences. Following a renewed interest in ancient Greek and Roman texts that took root in the High Middle Ages, the Italian Renaissance began. The absorption of Latin texts had started before the Renaissance of the 12th century through contact with Arabs during the Crusades, but the availability of important Greek texts accelerated with the Capture of Constantinople by the Ottoman Turks, when many Byzantine scholars had to seek refuge in the West, particularly Italy.Combined with this influx of classical ideas was the invention of printing, which facilitated dissemination of the printed word and democratized learning. Those two things would later lead to the Protestant Reformation. Toward the end of the period, the Age of Discovery began. The expansion of the Ottoman Empire cut off trading possibilities with the East. Europeans were forced to seek new trading routes, leading to the Spanish expedition under Christopher Columbus to the Americas in 1492 and Vasco da Gama’s voyage to Africa and India in 1498. Their discoveries strengthened the economy and power of European nations.

The changes brought about by these developments have led many scholars to view this period as the end of the Middle Ages and the beginning of modern history and of early modern Europe. However, the division is somewhat artificial, since ancient learning was never entirely absent from European society. As a result, there was developmental continuity between the ancient age (via classical antiquity) and the modern age. Some historians, particularly in Italy, prefer not to speak of the Late Middle Ages at all but rather see the high period of the Middle Ages transitioning to the Renaissance and the modern era.


A pandemic (from Greek πᾶν pan "all" and δῆμος demos "people") is an epidemic of disease that has spread across a large region; for instance multiple continents, or even worldwide. This may include communicable and noncommunicable diseases.

A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic. Further, flu pandemics generally exclude recurrences of seasonal flu. Throughout history, there have been a number of pandemics, such as smallpox and tuberculosis. One of the most devastating pandemics was the Black Death, which killed over 75 million people in 1350. The most recent pandemics include the HIV pandemic as well as the 1918 and 2009 H1N1 pandemics.

Plague (disease)

Plague is an infectious disease caused by the bacterium Yersinia pestis. Symptoms include fever, weakness and headache. Usually this begins one to seven days after exposure. In the bubonic form there is also swelling of lymph nodes, while in the septicemic form tissues may turn black and die, and in the pneumonic form shortness of breath, cough and chest pain may occur.Bubonic and septicemic plague is generally spread by flea bites or handling an infected animal. The pneumonitic form is generally spread between people through the air via infectious droplets. Diagnosis is typically by finding the bacterium in fluid from a lymph node, blood or sputum.Those at high risk may be vaccinated. Those exposed to a case of pneumonic plague may be treated with preventative medication. If infected, treatment is with antibiotics and supportive care. Typically antibiotics include a combination of gentamicin and a fluoroquinolone. The risk of death with treatment is about 10% while without it is about 70%.Globally about 600 cases are reported a year. In 2017 the countries with the most cases include the Democratic Republic of the Congo, Madagascar and Peru. In the United States infections occasionally occur in rural areas and the bacteria is believed to circulate among rodents. It has historically occurred in large outbreaks, with the best known being the Black Death in the 14th century, which resulted in greater than 50 million dead.

Plague doctor

A plague doctor was a medical physician who treated victims of the bubonic plague. In times of epidemics, such physicians were specifically hired by towns where the plague had taken hold. Since the city was paying their salary, they treated everyone: both the wealthy and the poor. However, some plague doctors were known to charge patients and their families additional fees for special treatments or false cures. Typically they were not professionally trained nor experienced physicians or surgeons, but rather they were often either second-rate doctors unable to otherwise run a successful medical practice or young physicians seeking to establish themselves. These doctors rarely cured their patients; rather, they served to record a count of the number of people contaminated for demographic purposes.

Plague doctors by their covenant treated plague patients and were known as municipal or "community plague doctors", whereas "general practitioners" were separate doctors and both might be in the same European city or town at the same time. In France and the Netherlands, plague doctors often lacked medical training and were referred to as "empirics". In one case, a plague doctor had been a fruit salesman before his employment as a physician.In the 17th, 18th, and 19th centuries, some doctors wore a beak-like mask which was filled with aromatic items. The masks were designed to protect them from putrid air, which (according to the miasmatic theory of disease) was seen as the cause of infection. The design of these clothes has been attributed to Charles de Lorme, the chief physician to Louis XIII.

Western Europe

Western Europe is the region comprising the western part of Europe. Though the term Western Europe is commonly used, there is no commonly agreed-upon definition of the countries that it encompasses.

Significant historical events that have shaped the concept of Western Europe include the rise of Rome, the adoption of Greek culture during the Roman Republic, the adoption of Christianity by Roman Emperors, the division of the Latin West and Greek East, the Fall of the Western Roman Empire, the reign of Charlemagne, the Viking invasions, the East–West Schism, the Black Death, the Renaissance, the Age of Discovery, the Protestant Reformation as well as the Counter-Reformation of the Catholic Church, the Age of Enlightenment, the French Revolution, the Industrial Revolution, the two world wars, the Cold War, the formation of the North Atlantic Treaty Organization and the expansion of the European Union.

Yersinia pestis

Yersinia pestis (formerly Pasteurella pestis) is a gram-negative, nonmotile, rod-shaped coccobacillus bacteria, with no spores. It is a facultative anaerobic organism that can infect humans via the Oriental rat flea. It causes the disease plague, which takes three main forms: pneumonic, septicemic and bubonic plagues. All three forms were responsible for a number of high-mortality epidemics throughout human history, including: the sixth century's Plague of Justinian; the Black Death, which accounted for the death of at least one-third of the European population between 1347 and 1353; and the Third Pandemic, sometimes referred to as the Modern Plague, which began in the late nineteenth century in China and spread by rats on steamboats claiming close to 10,000,000 lives. These plagues likely originated in China and were transmitted west via trade routes. Recent research indicates that the pathogen may have been the cause of what is described as the Neolithic Decline, when European populations declined significantly. This would push the date to much earlier and might be indicative of an origin in Europe rather than Eurasia.

Y. pestis was discovered in 1894 by Alexandre Yersin, a Swiss/French physician and bacteriologist from the Pasteur Institute, during an epidemic of the plague in Hong Kong. Yersin was a member of the Pasteur school of thought. Kitasato Shibasaburō, a German-trained Japanese bacteriologist who practised Koch's methodology, was also engaged at the time in finding the causative agent of the plague. However, Yersin actually linked plague with Y. pestis. Named Pasteurella pestis in the past, the organism was renamed Yersinia pestis in 1944.

Every year, thousands of cases of the plague are still reported to the World Health Organization, although with proper treatment, the prognosis for victims is now much better. A five- to six-fold increase in cases occurred in Asia during the time of the Vietnam War, possibly due to the disruption of ecosystems and closer proximity between people and animals. The plague is now commonly found in sub-Saharan Africa and Madagascar, areas which now account for over 95% of reported cases. The plague also has a detrimental effect on nonhuman mammals. In the United States, mammals such as the black-tailed prairie dog and the endangered black-footed ferret are under threat.

Black Death

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