Chapter 20

Facing God's Judgement: Dealing with the Black Death

In This Chapter

● Tracing the origins of the plague

● Assessing the plague’s impact on Europe

● Tackling the plague and its consequences

The dreadful pestilence penetrated the sea coast by Southampton and came to Bristol, and there almost the whole population of the town perished, as if it had been seized by sudden death; for few kept their beds more than two or three days, or even half a day. . . .

-Henry Knighton, historian, 1354

Between 1346-1353, Europe was utterly devastated by an appalling disease - the plague. Historians estimate that during this period the disease killed between 30 and 60 per cent of Europe’s population: that’s at least 75 million people and possibly as many as 200 million. At the lower end, that’s more people than live in the United Kingdom, and in the upper range, about two-thirds of the population of the United States. These numbers can be difficult to take in so perhaps the way to think of it is as follows: imagine if between a third and a half of the population where you live died within a short space of time. That’s how it would have been.

In this chapter I provide a sense of the massive impact that the plague had on Europe. I examine where the plague originated, how it spread and how people attempted to explain and deal with it. I also look at how Europe slowly tried to recover. Be warned, although fascinating, this chapter covers some gruesome stuff. If you haven’t got a strong stomach, look away now.

Journeying Far and Wide: Death Comes West

The great plague probably began in 1346. People today refer to this outbreak of disease as the ‘Black Death’, but the term is from the nineteenth century and wasn’t used at the time. People then would have referred to it as a ‘pestilence’. Throughout this chapter I refer to it as a ‘plague’.

One of the big ironies of history is that the plague’s effectiveness was due in part to the huge expansion in trade that took place during the thirteenth century (check out Chapter 18 for more details). The relatively new, speedier and more efficient trade routes that were established during this period allowed the deadly cargo to travel faster and farther than ever before.

Tracking down the plague’s origins

Most historians agree that the plague started among the Mongols, the descendants of Genghis Khan. Their capital in the thirteenth century was at Sarai, on the northwest shore of the Caspian Sea in modern-day Russia. Despite being thousands of miles from Western Europe, the plague managed to spread from Sarai incredibly quickly.

The most well-supported theory is that the disease began within the squirrel population around the Volga River, whose fur the Mongols traded with the merchants of Genoa, Italy. As Figure 20-1 shows, the Italian city of Genoa had a trading station at Tana, from which the disease was easily exported throughout the region.

Spreading across Europe

As soon as the plague hit the Mediterranean, it became unstoppable because the disease transferred extremely efficiently among rats. Actually, the disease was a bacteria carried in the lice and fleas that attached themselves to rodents. When a host rodent died, the fleas and bacteria simply moved on to another rodent - or several other rodents. These fleas eventually made their way on to human beings who then spread the disease to one another.

Travelling by sea

All Mediterranean ports were full of rats, many of which quickly travelled by ship to other ports hundreds of miles away.

Figure 20-1: The spread of the plague from 1346-1353

Port cities such as Alexandria, Venice and Genoa were some of the first places in Europe that the plague struck. Sicily was another, and Gabrielle de Mussi, a notary from the island, gave this account of its first contact:

Alas! our ships enter the port, but of a thousand sailors hardly ten are spared. We reach our homes; our kindred. . . come from all parts to visit us. Woe to us for we cast at them the darts of death!. . . Going back to their homes, they in turn soon infected their whole families, who in three days succumbed, and were buried in one common grave. Priests and doctors visiting . . . from their duties ill, and soon were . . . dead. O death! cruel, bitter, impious death! . . . Lamenting our misery, we feared to fly, yet we dared not remain.

Crossing land

After the disease arrived in mainland Europe, it moved incredibly fast. The spread was helped by the numbers of people who fled infected areas but were already infected themselves, thus taking the disease to new areas. Also many plague-infested cargoes were unloaded and moved overland, spreading the disease like wildfire.

From its beginnings deep in Russia in 1346, the plague was everywhere within two years. By 1348 it was virulent throughout Italy, France and Spain and had crossed the channel to Britain and Ireland. To the south, it was in Egypt, along the coast of Syria and Palestine (including the former Crusader Kingdom of Outremer) and had travelled as far as the Yemen.

Creating the perfect breeding ground

The Medieval World was a dangerous place. Illness aside, you were quite likely to get bludgeoned by an axe or a cudgel, cleaved by a sword or pierced by an arrow. As nearly every chapter in this book attests, war was a constant in the Medieval World; you were as likely to get killed fighting as from contracting an illness.

In addition to the potential for violent deaths, the Middle Ages were incredibly unhealthy in general. Cleanliness - or the lack of it - was a major issue. General ideas of cleanliness and hygiene were very basic indeed. Bathing was a luxury available only to a few and was often regarded with suspicion. Rich people were clean, in appearance at least, because turning up at the Royal Court dirty just wouldn’t do. But medieval people didn’t know that germs and infections caused disease, and so consequently they didn’t guard against them. Ironically, bathing actually declined in popularity after the plague because people suspected that it may have been a way that the disease spread. So the greatest disease in medieval history actually encouraged people to wash less!

In addition to personal cleanliness, sanitation and food were major problems:

● Poor people spent a lot of their time in close proximity to their own and other people’s faeces. Proper drainage systems were incredibly scarce, and the most common method of dealing with human refuse was to dump it in the street in piles. Human waste was also often disposed of close to, or even in, the local water supply, meaning that most people would be drinking from water already infected with all sorts of bacteria.

● Rotting meat was a major issue. The most common way of storing meat was to use salt, but people often ate meat that was decayed. The scarcity and price of meat meant that many people grabbed whatever they could.

Given these conditions and the fact that people lived in very close proximity, diseases and infections spread like wildfire. Even communities such as monasteries with relatively good sanitation were prone to disease outbreaks, and due to the number of people living in a concentrated spot, abbeys were often riskier places to live or seek assistance.

Nothing humour-ous about this

Medieval medical thought was fairly straightforward. Based on the work of Ancient Greek and Roman physicians, people believed that the entire world was made up of four basic elements: fire, water, earth and air. These elements were represented in the human body by four corresponding humours: blood, phlegm, black bile and choler (also known as yellow bile, like regular vomit).

Medieval physicians believed that as long as these four humours were in order and balanced, a person was perfectly well. If somebody was ill, their humours were simply not balanced. A person's temperament was also able to create an imbalance. For example, people with melancholic personalities were believed to have too much black bile in their systems. This philosophy meant that doctors not only treated illnesses but also individuals's characters.

Doctors used the scent of a patient's blood, faeces, vomit or urine to establish a diagnosis, often without even seeing the patient. Most treatments involved trying to reduce the humour that existed in a patient in too great a quantity. Forced vomiting and bloodletting were popular techniques. Famously, leeches were used to drain the blood and eat away diseased or infected flesh around a wound. Purgatives were used to enforce expulsion. (These medicines weren't always taken orally either; rudimentary medieval enemas involved using a pig's bladder to squirt a foul mixture up the anus. Hard to believe that this didn't have the desired effect!)

In effect, physicians and rudimentary surgeons tried everything and anything. In the vast majority of cases, patients ended up dying. People accepted this outcome and saw visiting a physician as very much a last chance saloon. Most people stuck to praying instead.

Experiencing the symptoms

Several different types of plague seem to have developed during the midfourteenth century because the disease mutated, but the most common form was the bubonic plague.

Historians have a lot of accounts of the plague hitting towns and cities, and they are fairly consistent in their descriptions of what happened to people who caught the disease:

● The first stage of the disease was a high fever that forced up patients’s temperatures and caused them to spit blood. These symptoms frequently caused death within three days. Many people went to bed with a fever and never woke up again. They were probably the lucky ones.

● The second stage, if the disease developed that far, involved large black growths known as buboes which developed in the armpits, neck and groin - the locations of the lymph nodes, which typically fight disease. The growths were incredibly painful, and patients often lingered on for up to five days.

Treating the plague

So what did you do if you had the plague? Well, the simple answer is that you died swiftly and painfully. Medieval medicine wasn’t particularly advanced.

People tended to regard catching a disease as a judgement from God (flip to the later section ‘Posing theories and propagating persecutions’) and medical practices were fairly basic. Treatment from a doctor was expensive and not available for the majority of people. Physicians followed the teachings of Galen and Hippocrates, models from the Ancient World (see the sidebar ‘Nothing humour-ous about this’ for details).

Responding to the Plague

The plague was swift and terrible: from 1358 to 1360, between a quarter and a third of the population of Europe died. Physicians and medieval medicine were unable to stop it. Antibiotics and the World Health Organisation didn’t exist, and methods of communication across long distances were only rudimentary. Most people took the decision to travel a long way away and not come back for a while, but even this strategy rarely worked because the disease moved more quickly than people could travel.

Posing theories and propagating persecutions

Across Europe, people returned to attending church during the plague years to ask God for protection and to figure out whether this devastating illness was a judgement from God. One of the most popular ideas was that the plague was a miasma caused by something unpleasant in the air. Many people linked this idea with the plague having been a judgement from God on people’s corrupt and immoral lives, much like the story of Noah and the great flood.

Around Europe, all sorts of theories were hit upon as to why this epidemic had begun. Not unusually for the period, some of these theories inspired truly tragic and appalling deeds.

The following horrific and extreme reactions have to be understood in the context of the confusion and panic of the times. People had no understanding of bacterial infection and therefore were unable to work out why the disease had struck or what they needed to do to stop it.

Pointing fingers at the Jews

Jewish communities in Europe were among the first targets for persecution. Anti-Semitic acts were fairly common during the Middle Ages (see Chapters 14 and 15), but the plague persecutions were a new thing entirely.

A key element in people’s thinking arose from the fact that the Jewish religion required its adherents to wash on a daily basis, an unusual practice for non-Jews. Additionally, Jewish communities tended not to use water from public wells for their washing. As a result, rumours spread that the Jews had poisoned the public wells and started the disease.

Many accounts exist of such persecutions. Some of the most famous come from Strasbourg where Jews were tortured and forced to confess to the poisoning. Records of these confessions were sent around towns in Germany and as a result thousands of Jews were arrested and burnt alive.

The following chronicler is very insightful about the real reasons behind a 1350 purge:

On Saturday - that was St Valentine’s Day - they burnt the Jews on a wooden platform in their cemetery. There were about two thousand people of them. Those who wanted to baptize themselves were spared. [Some historians say that about 1,000 accepted baptism.] Many small children were taken out of the fire and baptized against the will of their fathers and mothers. And everything that was owed to the Jews was cancelled, and the Jews had to surrender all pledges and notes that they had taken for debts. The council, however, took the cash that the Jews possessed and divided it among the working-men proportionately. The money was indeed the thing that killed the Jews. If they had been poor and if the feudal lords had not been in debt to them, they would not have been burnt. After this wealth was divided among the artisans, some gave their share to the Cathedral or to the Church on the advice of their confessors.

Modern historians say that around 350 purges took place across Europe during 1351, wiping out more than 50 large communities. The only place that didn’t launch a Jewish persecution was England, but this fact wasn’t due to tolerance or understanding: Edward I had already expelled the entire Jewish population from the country in 1290.

Fearing differences

Jewish communities weren’t the only ones that suffered. Other groups who were different in some way became the victims of people’s anger and need for answers and vengeance:

● Leper communities across Europe were rooted out because people feared anybody with visible signs of disease. Even just sporting acne or any other common skin condition became dangerous.

● Anyone who travelled was under suspicion. Merchants and other foreigners were chased out of towns and killed. Particularly at risk were the Romany (traveller) communities of Europe who were constantly on the move and therefore suspected of being bringers of the disease.

● Travelling monks and friars became victims, although these individuals were most likely attempting to bring alms to the poor and sick.

Becoming whipping boys (and girls)

The plague encouraged a huge loss of faith in the clergy on mainland Europe as people asked what they’d done to stop the spread of the disease and began to look to themselves for answers.

In place of their regular religious practices, many people took to more extreme versions of their faith. For example, the Flagellants appeared as a particularly popular, extreme Catholic sect during this time. Flagellants believed in the mortification of the flesh by continually striking themselves with whips and other items. Their popularity grew hugely during the fourteenth century, particularly in Germany where the ‘Brothers of the Cross’ were the most famous order, and thousands joined the movement. Unfortunately, Flagellants soon became suspected (by those who didn’t share their beliefs) of actually spreading the disease. The Flagellants encouraged vast numbers of people to move from place to place to try and spread the word of their faith and recruit other members and by 1352 towns were closing their gates to them. These measures didn’t kill the sect off though, and they experienced periodic revivals throughout the fourteenth and fifteenth centuries despite being banned by some rulers.

Regrouping after the plague: England

Medieval England offers a really good example of how the plague affected society, with England suffering as badly as anywhere else. The plague hit in 1348 and within four years more than a third of the population was dead. During this time King Edward III took some rather bizarre actions in response. Even his family wasn’t safe from the plague - his daughter Joan died of the disease in 1348.

Dealing with labour shortages

The vast majority of plague victims in England were from the peasant class who worked the land, and by 1349 too few people were available to work the fields. The labour problem was made worse by the numbers of people leaving their homes to escape the plague and being tempted to work for other landowners in towns free of the disease, with the promise of higher wages.

Edward III attempted to regain control of the labour market with the Ordinance of Labourers in 1349, which parliament reinforced in 1351 with a bill called the Statute of Labourers. This bill set a maximum wage for labourers that was fixed at wage levels before the plague. The bill also forced any able-bodied man or woman to work (unless they were from the nobility, of course).

These measures didn’t go down very well with the peasantry and caused a huge economic depression. Part of the problem was that England was already going through economic problems due to the Hundred Years’ War (which I discuss in Chapters 21 and 23), and wages were being put back down to those levels. Additionally, harsh enforcement of these measures was one of the factors behind the unrest that eventually culminated in the Peasants’ Revolt of 1381 (turn to Chapter 22 for more details).

Catting for priests

Another area of English employment that suffered during the plague was the Church. The huge numbers of people killed resulted in a scarcity of priests throughout the country. This shortage was ironic, because at this time of great suffering vast numbers of people in England - particularly the nobility - returned to regular worship.

The plague also had a potentially devastating impact in that thousands and thousands of people died without being able to give their confession to a priest. This situation led to some extraordinary measures, as Ralph of Shrewsbury (who was the Bishop of Bath and Wells) ordained that:

The continuous pestilence of the present day...has left many parish churches without parson or priest...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, even to a woman.

This highlights how serious the situation had become as missing out on the afterlife was probably the greatest fear to the medieval mind. It also gives us a fair idea of some clerics’ attitudes towards women.

The shortage of priests meant that the English Church had to put its own house in order and the effect of the plague on Europe meant that they did this without help from Rome. Many historians suggest that these developments weakened the hold of the papacy on the English Church. Rome appointed fewer priests and although more members of the English aristocracy began taking an active interest in Church affairs, some people suggest that this was the first step on the way towards the Protestant Reformation.

Assessing the Plague's Impact

Most of Western Europe had suffered the worst of the plague by 1350, but the disease continued to spread elsewhere. Central and Eastern Europe were next to suffer, with the plague hitting Poland in 1351 and western Russia in the following year. Moscow was the last major city to be contaminated before, ironically, the plague dwindled to a stop in some small towns on the Volga River, only a few miles from where it had first begun seven years before.

Europe must have breathed a sigh of relief by 1353, but the plague wasn’t over. A new outbreak occurred in Germany during 1357 and spread across much of Central Europe. Further outbreaks occurred sporadically over the next 100 years into the fifteenth century, including the Plague of Paris that killed 40,000 people in 1466. One of the most famous outbreaks took place in England in 1664, known as the ‘Great Plague of London’, it ravaged the city for over two years. The greatest pandemic since the Black Death took place in the nineteenth century in China and India, killing around 10 million people, and individual cases have been reported as recently as 1995.

Despite the devastations of the plague, many of the policies of rulers remained relatively similar to before, especially with regard to foreign policy. The best example is the fact that by 1355 the Hundred Years’ War (see Chapter 21) had resumed, and England and France were happily battering away at each other again.

Calculating the death toll

The most obvious impact of the plague was the depopulation that followed it. As I mention at the beginning of the chapter, between a third and a half of the population of Europe died from the disease. The vast majority of those who died were from the lower classes. Very few members of the nobility were killed. Not a single monarch or ruler died from the plague except for Alfonso XI of Castile, who is famous only for that reason. Several sons and daughters of monarchs were killed, but the political map of Europe in 1353 looked remarkably similar to that of 1346. One reason for this was that the wealthy were more able to lock themselves away in isolation from the disease and restrict whom they came into contact with.

The areas most affected were the towns and cities of Europe - places that packed thousands of people in close proximity and had unsanitary conditions. Some of the figures are quite startling. For example, the population of Florence, Italy, was reduced from 110,000 to around 50,000. More than 50 per cent of people who lived in Florence died or fled in the course of just three years.

The Malthusian interpretation

The plague that we call the Black Death has produced some interesting and controversial theories over the years. Economic historian Thomas Mathus put forward one of the more interesting at the beginning of the nineteenth century.

Mathus claimed that the plague was an inevitable consequence of the tendency of human beings to over-reproduce. He suggested that on a generational basis, humans would reproduce beyond the available food supply and accordingly some catastrophe - such as an act of God or great reckoning - would take place to reduce the numbers to an acceptable level. He argued that by the middle of the fourteenth century, Europe was overpopulated and that the Black Death was just the latest in a series of reckonings.

Mathus's idea is thought-provoking, but modern historians argue that Medieval Europe was overpopulated a long time before the Black Death arrived. His ideas were very unpopular during his lifetime, and he was subject to huge personal criticism and abuse.

Many impacts of this depopulation were economic. Goods were scarce, the transport of them dangerous and people had less money to spend. High prices and low spending power tipped Europe into its first big recession. However, social mobility was greatly increased. Figures aren’t available, but huge demographic changes must have taken place as groups of people moved from one area to another. Also, the scarcity of labour meant that some people were possibly better off financially and may even have managed to raise their social status. Some people could have moved from being the lowliest kind of serf to enjoying a position of greater privilege in a different place.

Affecting culture

One of the more interesting aspects of the plague is the impact it had on cultural life. The disease and its effects became a very rich topic for writers and artists and profoundly affected the way people felt and lived their lives.

Many historians and commentators have written about the increase in morbidity following the plague, with writers and artists finding inspiration in subjects like death, dying and purgatory. Certainly, medieval art and literature from the middle of the fourteenth century show a much greater interest in death and other morbid subjects.

Doctors in disguise

One of the most obvious and unusual impacts of the Black Death was the bizarre outfit that doctors began to wear as a result. Even when the worst of the pandemic was over, physicians were still very much at risk of coming into contact with the disease. As a result, they adopted a strange new form of dress.

They wore long leather coats, coated with wax for further protection and tucked into leather breaches so that the skin wasn't exposed. On their head they wore wide-brimmed leather hats to shield them from infection and to identify them as doctors. They were probably very easy to recognise because they also wore primitive gas masks that stuck out in front of the face. Long and shaped like a bird's beak, the masks were filled with herbs and spices to protect against miasma, the bad air that many believed transported the plague (flip to the earlier section 'Posing theories and propagating persecutions'). Accordingly, they were known as 'Beak Doctors'. Their stunning outfit was topped off with a long cane with which they could examine, touch or ward off people without any bodily contact. If you bumped into a doctor in this garb in the street you were probably as likely to die of shock as the plague!

One of the most popular subjects to arise after the plague was La Danse Macabre (‘The Dance of Death’). This theme was popular in art, music and literature. The works allegorically focus on the common fate of every individual, whatever their status in life, and typically involve the figure of Death as a skeleton, leading a group of various individuals on the journey to the great beyond. Dramatic representations of this subject were also popular and commonly performed.

The plague and its impact was also irresistible to the great writers of the time (as well as modern-day authors). The Italian writers Petrarch and Boccaccio discussed the subject in some of their greatest works, and it also features in The Canterbury Tales by Geoffrey Chaucer. Plague eventually became an actual character, taking on a personification like a pagan god. Medieval folklore features lots of depictions of plague, mostly shown as a bent old woman wielding a broom who brought death to anyone caught in her sweeping: an effective and chilling analogy.

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