The Black Death of 1347-1352 CE is the most infamous plague outbreak of the medieval world, unprecedented and unequaled until the 1918-1919 CE flu pandemic in the modern age. The cause of the plague was unknown and, in accordance with the general understanding of the Middle Ages, was attributed to supernatural forces and, primarily, the will or wrath of God.
Accordingly, people reacted with hopeful cures and responses based on religious belief, folklore and superstition, and medical knowledge, all of which were informed by Catholic Christianity in the West and Islam in the Near East. These responses took many forms but, overall, did nothing to stop the spread of the disease or save those who had been infected. The recorded responses to the outbreak come from Christian and Muslim writers primarily since many works by European Jews – and many of the people themselves – were burned by Christians who blamed them for the plague and among these works, may have been treatises on the plague.
The perceived failure of God to answer prayers contributed to the decline of the Church's power & the eventual splintering of a unified Christian worldview.
No matter how many Jews, or others, were killed, however, the plague raged on and God seemed deaf to the prayers and supplications of believers. In Europe, the perceived failure of God to answer these prayers contributed to the decline of the medieval Church's power and the eventual splintering of a unified Christian worldview during the Protestant Reformation (1517-1648 CE). In the East, Islam remained intact, more or less, owing to its insistence on the plague as a gift which bestowed martyrdom on the victims and transported them instantly to paradise as well as the view of the disease as simply another trial to endure such as famine or flood.
Although many of the religious ideas concerning the plague in West and East were similar, this one difference was significant in maintaining Islamic cohesion, even though it most likely led to a higher death toll than official records maintain. After the plague had run its course, religious response in both East and West was generally credited with appeasing God who lifted the pestilence but Europe would be radically changed while the Near East was not.
The Black Death Origin & Spread
The plague originated in Central Asia and spread via the Silk Road and troop movements throughout the Near East. The first recorded outbreak of bubonic plague is the Plague of Justinian (541-542 CE) which struck Constantinople in 541 CE and killed an estimated 50 million people. This outbreak, however, was simply the furthest westerly occurrence of a disease that had been stalking the people of the Near East for years before. The historian John of Ephesus (l. c. 507 - c. 588 CE), an eyewitness to the plague, notes that the people of Constantinople were aware of the plague for two years before it came to the city but made no provision against it, believing it was not their problem.
After Constantinople, the plague died down in the East only to appear again with the Djazirah Outbreak of 562 CE which killed 30,000 people in the city of Amida and even more when it returned in 599-600 CE. The disease maintained this pattern in the East, seeming to disappear only to rise again, until it picked up momentum beginning in 1218 CE, further in 1322 CE, and was raging by 1346 CE.
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It was around this time that the Mongol Khan Djanibek (r. 1342-1357 CE) was laying siege to the port city of Caffa (modern-day Feodosia in Crimea) which was held by the Italians of Genoa. As his troops died of plague, Djanibek ordered their corpses catapulted over Caffa's walls, thereby spreading the disease to the defenders. The Genoese fled the city by ship and so brought the plague to Europe. From ports such as Marseilles and Valencia, it spread from city to city with every person who had had contact with anyone from the ships and there seemed no way to stop it.
Christian vs. Muslim View of Plague
Responses to the plague were informed by the dominant religions of West and East as well as the traditions and superstitions of the regions and presented as a narrative which explained the disease. Scholar Norman F. Cantor comments:
The scientific method had not yet been invented. When faced with a problem, people in the Middle Ages found the solution through diachronic (as opposed to synchronic) analysis. The diachronic is the historical narrative, horizontally developing through time: “Tell me a story”. With their fervent historical imagination, medieval people were very good at giving diachronic explanations for the outbreak of bubonic plague. (17)
Reactions, then, were based on the religious narratives created to explain the disease and fall, generally, into three beliefs about the plague held, respectively, by medieval Christianity and Islam. Even empirical observation was informed by religious belief, as in the case of whether the plague was contagious.
- The plague was a punishment from God for humanity's sins but could also be caused by “bad air”, witchcraft and sorcery, and individual life choices including one's piety or lack of it.
- Christians – especially in the early period of the outbreak – could leave a plague-stricken region for one with better air which was not infected.
- The plague was contagious and could be passed between people but one could protect oneself through prayer, penitence, charms, and amulets.
- The plague was a merciful gift from God which provided martyrdom for the faithful whose souls were instantly transported to paradise.
- Muslims should not enter nor should they flee from plague-stricken regions but should remain in place.
- The plague was not contagious because it came directly from God to specific individuals according to God's will.
Again, these are general views held by the majority and not every cleric of Europe or the Near East agreed with them nor did every layperson. These beliefs, however, carried enough weight with believers to encourage responses which – again, generally – fall into five main reactions.
- Penitential processions, attending mass, fasting, prayer, use of amulets and charms
- The Flagellant Movement
- Supposed cures and fumigation of “bad air”
- Flight from infected areas
- Persecution of marginalized communities, especially the Jews
- Prayer and supplication at mosques, processions, mass funerals, orations, fasting
- Increased belief in supernatural visions, signs, and wonders
- Magic, amulets, and charms used as cures
- Flight from infected areas
- No persecution of marginalized communities, respect for Jewish physicians
Christian Response in Detail
Since the plague was thought to have been sent by God as a punishment, the only way to end it was admission of one's personal sin and guilt, repentance of sin, and renewed dedication to God. To this end, processions would wind their way through cities from a given point – say the town square or a certain gate – to the church or a shrine, usually dedicated to the Virgin Mary. Participants would fast, pray, and purchase amulets or charms to keep them safe. Even after European Christians understood that the plague was contagious, these processions and gatherings continued because there seemed no other way to appease God's wrath.
The flagellants were a group of zealous Christians, who roamed from town to city to countryside whipping themselves for their sins & the sins of humanity.
As the plague raged and traditional religious responses failed, however, the Flagellant Movement emerged in 1348 CE in Austria (possibly Hungary also) and spread to Germany and Flanders by 1349 CE. The flagellants were a group of zealous Christians, led by a Master, who roamed from town to city to countryside whipping themselves for their sins and the sins of humanity, falling to the ground in penitential frenzy, and leading communities in the persecution and slaughter of Jews, gypsies, and other minority groups until they were banned by Pope Clement VI (l. 1291-1352 CE) as ineffectual, disruptive, and upsetting.
Cures were also often based on religious understanding, such as killing and chopping up a snake (associated with Satan) and rubbing the pieces on one's body in the belief that the “evil” of the disease would be drawn to the “evil” of the dead serpent. Drinking a potion made of unicorn horn was also considered effective as the unicorn was associated with Christ and purity.
Bad air, which was thought to be the result of planetary alignment or supernatural forces (usually demonic) was driven out of homes by incense or burning thatch and by carrying flowers or sweet-smelling herbs on one's person (a practice referenced in the children's rhyme “Ring Around the Rosie”). One could also fumigate one's self by sitting near a hot fire or a pond, pool, or pit used for dumping sewage as it was thought the “bad air” in one's body would be drawn to the bad air of the sewage.
People in the cities, almost always the wealthy upper class, fled to their villas in the countryside while poorer people and farmers often left their lands in rural areas for the city where they hoped to find better medical care and available food. Even after the plague was understood to be contagious, people still left quarantined cities or regions and spread the disease further.
Persecutions of Jews by the Christian community did not start with the Black Death or end there but certainly increased in Europe between 1347-1352 CE. Scholar Samuel Cohn, jr. notes:
That the blind fury of mobs comprised of workers, artisans, and peasants was responsible for the Black Death annihilation of Jews derives from modern historians' musings, not the medieval sources. (5)
Even so, he concedes, “the Black Death unleashed hatred, blame, and violence on a more horrific scale than by any pandemic or epidemic in world history” (6). Although his claim regarding modern historians' interpretation of pogroms against Jews has some validity, it does not seem to fully take into consideration the long-standing animosity felt toward Jews by Christian communities. Jews were routinely suspected of poisoning wells, murdering Christian children in secret rites, and practicing various forms of magic in order to injure or kill Christians. Scholar Joshua Trachtenberg cites one example:
[The townspeople], petitioning for the expulsion of the Jews, affirmed that their danger to the community extended far beyond an occasional child murder, for they dry the blood they thus secure, grind it to a powder, and scatter it in the fields early in the morning when there is a heavy dew on the ground; then in three or four weeks a plague descends on men and cattle, within a radius of half a mile, so that Christians suffer severely while the sly Jews remain safely indoors. (144)
In 1348 CE, Jews in Languedoc and Catalonia were massacred and, in Savoy, were arrested on charges of poisoning the wells. In 1349 CE, Jews were burned en masse in Germany and France, but also elsewhere in spite of papal bulls issued by Pope Clement VI expressly forbidding these types of actions.
Muslim Response in Detail
Muslims also gathered in large groups at mosques for prayer, but these were prayers of supplication, requesting God lift the plague, not penitential prayers for the forgiveness of sins. Scholar Michael W. Dols notes that “there is no doctrine of original sin and man's insuperable guilt in Islamic theology” (10) and so religious responses to the plague took the same form as supplications for a good harvest, a healthy birth, or success in business. Dols writes:
An important part of [Muslim] urban activity in response to the Black Death was the communal prayers for the lifting of the disease. During the greatest severity of the pandemic, orders were given in Cairo to assemble in the mosques and to recite the recommended prayers in common. Fasting and processions took place in the cities during the Black Death and later plague epidemics; the supplicatory processions followed the traditional form of prayer for rain. (12)
Mass funerals were conducted along the lines of traditional burial rites with the addition of an orator who would request the plague be lifted but, again, there was no mention of the sins of the deceased nor any reason given why they died and another lived; these things happened according to the will of Allah.
Belief in supernatural visions and signs markedly increased. Dols cites the example of a man from Asia Minor who came to Damascus to inform a cleric of a vision he had been granted of the prophet Muhammad. In the vision, the prophet told the man to have the people recite the surah of Noah from the Quran 3,363 times while asking God to relieve them of the plague. The cleric announced the vision to the city and the people “assembled in the mosques to carry out these instructions. For a week the [people] performed this ritual, praying and slaughtering great numbers of cattle and sheep whose meat was distributed among the poor” (Dols, 11). Another man who received a vision from Muhammad claimed the prophet had given him a prayer to recite which would lift the plague; this prayer was copied and distributed to people with the instruction to recite it daily.
While the majority of Muslims believed that the plague had been sent by God, there were many who attributed it to the supernatural power of evil djinn (genies). Ancient Persian religion – pre- and post-Zoroaster (c. 1500-1000 BCE) – attributed various events and illnesses to the work of the malevolent deity Ahriman (also known as Angra Mainyu) or to spirits who sometimes advanced his agenda, such as djinn. This belief gave rise to an increase in folk magic and the use of amulets and charms to ward off evil spirits. The charm or amulet would be inscribed with one of the divine names or epithets of God and prayers and incantations would be recited to imbue the artifact with magical protective powers.
For the faithful Muslim, the plague was a merciful release from the world of multiplicity & change to the eternal, unchanging paradise of the afterlife.
As in Europe, those who could afford to do so left infected cities for the countryside and people from rural communities came to the cities for the same reasons as their European counterparts. Since the plague was not believed to be contagious, there was no reason for one to remain in one place or another except for a proscription attributed to Muhammad who forbade people going to or fleeing from plague-stricken regions. The reason for this proscription is unknown and it seems people ignored it because, whether the plague came from Allah or a djinn, it was not within an individual's power to escape the fate God had decreed. For the faithful Muslim, the plague was a merciful release from the world of multiplicity and change to the eternal, unchanging paradise of the afterlife; it seems only to have been considered a punishment for infidels outside the faith.
Even so, there is no evidence that minority populations – whether Christians, Jews, or any other – were persecuted in the Near East during the years of the plague. Jewish physicians, in fact, were highly regarded even though they could do no more for plague victims than any others.
As the plague raged on, people in Europe and the Near East continued their religious devotions which, after it had passed, were credited with finally working to influence God to lift the plague and restore a sense of normalcy to the world. Even so, the seeming ineffectuality of the Christian response to the people of the time caused many to question the vision and message of the Church and seek a different understanding of the Christian message and walk of faith. This impetus would eventually contribute to the Protestant Reformation and the change in philosophical paradigm which epitomizes the Renaissance.
Scholar Anna Louise DesOrmeaux notes that a significant aspect of the change in the religious model was the Christian belief that God had caused the plague to punish people for their sins and so there was nothing one could do but “turn humbly to God, who never denies His aid” (14). And yet, to the people of the time, it seemed as though God had denied his aid and this led people to question the authority of the Church.
No such dramatic change occurred in the Near East, however, and Islam continued on after the plague with little difference in understanding and observance than before. Dols comments:
The comparison of Christian and Muslim societies during the Black Death points to the significant disparity in their general communal responses…the Arabic sources do not attest to the “striking manifestations of abnormal collective psychology, of dissociation of the group mind,” which occurred in Christian Europe. Fear and trepidation of the Black Death in Europe activated what Professor Trevor-Roper has called, in a different context, a European “stereotype of fear”…Why are the corresponding phenomena not found in the Muslim reaction to the Black Death? The stereotypes did not exist. There is no evidence for the appearance of messianic movements in Muslim society at this time which might have associated the Black Death with an apocalypse. (20)
A number of Christian European writers of the time, and afterwards, refer to the Black Death as “the end of the world” while Muslim scribes tend to focus on the death toll in emphasizing the magnitude of the pestilence; they do so, however, in the same way they write about deaths from floods or other natural disasters. In the aftermath of the Black Death, Europe would be radically transformed in social, political, religious, philosophical, medical, and many other areas while the Near East would not; because of a different interpretation of exactly the same phenomenon.
The Black Death: How Different Were The Christian And Muslim Responses?
This paper discusses the responses of the Christians and Muslims during the Black Death. According to research Muslims tended to stay more calm and relaxed. While Christians started getting upset, this led to pointing fingers. In particular, this paper states exactly how the Muslims reacted versus the way the Christians reacted towards the cruel Black Death.
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The Black Death: How Different Were the Christian and Muslim Responses?
In 1346 European traders began to hear reports about earthquakes, floods, locusts, famine, and plague in faraway China. They knew very little then that the plague they were hearing about would follow the same trade routes to the Middle East, North Africa, and Europe that they themselves used. In five short years, the plague killed between 25 and 45% of the populations it encountered. So how different were the Christian and Muslim responses? In 1348 Christianity and Islam came face to face with the Black Death. In truth, Muslims and Christians responded in many different ways. Their ideas for what caused the Black Death were somewhat different from each other also. Even the way they thought they could cure the disease was almost entirely different. With evidence and accounts of people that exist from the Bubonic Plague, one may come to a conclusion that Christians were actually much more out of control than Muslims were during this time of need.
Responses that Christians made were much different from Muslims during the Bubonic Plague. William Dene described Christians as being in such chaos that “The laborers and skilled workmen were imbued with such a spirit of rebellion that neither king, law nor justice would curb them.” What Dene is basically describing is that because of the Black Death Christians were in such moral disarray that they were starting to become completely out of control. Dene also stated in is writing that “The people for the greater part ever became more depraved, more prone to every vice and more inclined than before to evil and wickedness, not thinking of death nor of the past plague nor of their own salvation.” Christians were throwing away their religion and were slipping into a life of wickedness and evil.
The Essay on Black Plague Death People Europe
Much of history is a record of the disasters men bring upon themselves. But some of the worst misfortunes of mankind-floods, earthquakes, famines, and plagues-seem to be inherent in the natural scheme of things or acts of God. The most terrible of these of which we have knowledge of was the Black Plague, which ravaged Europe in the fourteenth century (Cohen 106). The Bubonic Plague, which is a .
According to the charts, the death rates of the plague in the Europe as a whole was 31%, in England it was 33%, in Egypt it was 25 to 33%, and in Syria it was 33%. Also, the death rate of parish priest was 45%, people think the death rate was so high because priest came into contact with more people which made them more prone to receiving the plague. The priest might have also been older which could have also meant that they had a weaker immune system which would make them an easy target to sickness.
When the cities of Siena, Italy and Damascus, Syria were struck by the fierce hit of The Black Death their reactions were very different. In Damascus the people really didn’t have much time to react because within fifty hours of seeing a tumor that appear from the plague and after coughing up blood they died. But however, the people of Siena thought that it was all over now. The Italians thought I was going to be the end of the world.
According to both de Mussi and al-Manbiji God was delivering the plague to the people. According to de Mussi he thought the plague was being delivered because it was a punishment for the people’s sins. On the other hand, al-Manbiji thought the plague was a blessing from God and that He was getting rid of all the bad and unworthy people. As you can see al-Manbiji looked at things with a brighter perspective.
Even though the Christians and Muslims reacted to the plague differently they also had some similarities. They both believed that miasma, which is polluted unhealthy air, was carried by warm southern winds and was caused by the stench of the Mongol bodies from Crimea. They also believed that if you would build fires that it would fumigate the area and get rid of the miasma.
The Essay on The Black Death Plague People Europe
virulence that the course of human history changed forever (Wark). In its second pandemic, the bubonic plague, mostly referred to as the Black Death, wiped out almost a third of Europe s population. The Black Death was a horrible tragedy that was responsible for many deaths and caused many changes in the 14 th through 17 th century. The bubonic plague could not have spread on it s own: it needed .
William Dene believed that the English people behaved differently during the plague. He believed that they became more depraved and began to pick up bad habits, which made them prone to evil and wickedness. The priest even began to behave differently, they began to leave their own churches and to “chase the money”, and they would go to different churches to get larger stipends than in their own benefices.
While the Muslims cried and prayed together, the Christians were out pointing fingers, they began to blame or accuse the Jews. In the town of Strasbourg Christians kidnapped and burned the innocent Jews in a lieu. The city of Strasbourg wasn’t the only city destroyed they also destroyed 60 major and 150 smaller Jewish communities. They also participated and/or hose to destroy over 350 separate massacres.
The Pope even thought it wasn’t the Jews fault. He believes that everybody is dying, including Jews, so why would begin to kill their own people so brutally. So that’s him the Pope doesn’t think that the Jews committed such a mean and cruel crime.
In the end, there tends to be no tension between the Muslims, Christians, and Jews they all came together to pray to God and ask of him a favor to stop the plague and to sop killing all of these innocent, God-fearing, and God-loving creatures.
Michael Dols, The Black Death in the Middle East, Princeton University Press, 1997.
Robert S. Gottfried, The Black Death, New York: Macmillan Publishing, 1983.
Phillip Ziegler, The Black Death, London: Collins Press, 1969.
Michael Dols, The Black Death in the Middle East, Princeton Press, 1977.
Chronicler Agriolo di Tura (The Fat), Cronaca senese, Italy, 1348. In Robert Gottfried, The Black Death, New York: The Free Press, 1983
al-Maqrizi, circa 1400 in Michael Dols, The Black Death in the Middle East, Princeton University Press, 1997.
Pope Clement VI, July 5, 1348
Ibn Battuta, Travels in Asia and Africa 1325-1354.
William Dene, chronicler in Rochester, England, circa 1350, In Sir Arthur
Bryant, The Age of Chivalry: the Atlantic Saga, Garden City, NY: Doubleday, 1963
The Essay on Jew in a Christian society
Miss Daisy is a 72 year old widow living alone. She is a woman of strong will and values her independence. After having an accident backing out of her garage, her son, Boolie, insists on hiring a driver for her. Daisy resists this wish as she wants to be in control of her own life. Boolie is 40 years old and has taken over his father’s printing company. Boolie takes good care of his mother, but .
Michael Kleinlawl, as reported in the Strasbourg Chronicle (Alsace), 1348, in Johannes Nohl, The Black Death: A Chronicle of the Plague, New York: Harper and Row, 1969.
Black Death Plague Disease Europe
. of the plague, Jews were blamed for bringing the Black Death to Europe. The Jews were . the Christian Italian merchants and the Muslim citizens in the area. The Muslims asked . situation where a large number of people died suddenly and inexplicable in .
Black Death Plague Europe Began
. Black Death also affected the arts. In Giovanni Boccaccio's Decameron, a group of young people fleeing the plague . Christians assumed illness was a call to repentance. In response, some Christians, . thought to protect against plague, . tension, Jews were .
Black Death Plague People Disease
. plague, persecuted and massacred the Jews. While many people were looking for an explanation for the Black Death . to give them a Christian burial. The wealthy nobles . in the cities. In response of the need . treatment. It is thought that the people of the .
The Bubonic Plague or Black Plague
. people who actually brought the Black Death to Europe were either Genoese or Venetian sailors.As the plague . were alive during the plague thought a combination of things. . Human interventionThe Black Death caused many things. Jews, outsiders, and lepers .
Comparision Of Christians And Muslims In The Crusades
. they are merely glanced at. Both Christians and Muslims are devoted religious people who are willing to fight and . (16: 828). The Christians did not attack the Muslims like the Muslims attacked they Jews, the Christians simply stole the items .
Lessons from Medieval Responses to the Plague
In the late 1340s, the plague outbreak that we know as the Black Death descended upon Asia, Europe, and Africa, causing widespread disruption and death. Medieval responses to the pandemic varied. In many European cities, social chaos, fear, and mistrust were widespread. In Syria, by contrast, we find the example of a community that united in its response to the pandemic. Although medieval people lacked the medical knowledge to help them avoid infection and the plague was far more lethal than today’s COVID-19 virus, their reactions to the pandemic can still teach us today.
In his preface to The Decameron (1353), the Italian scholar Giovanni Boccaccio (d. 1375) detailed not only the physical symptoms of the Black Death as it arrived in Florence in 1348, but also its influence on Italian society. Boccaccio describes people who, whether through indifference, bravado, or fear of social isolation, continued to go out to bars and public events even when the evidence indicated that seclusion was the best option. He recounted how funeral rites in Italy were canceled and families cut themselves off from infected relatives and neighbors.
Similar to today, economic divides influenced the ability of people to respond to the plague, as wealthy Italians fled to countryside retreats while the poor tried to isolate themselves as best they could in crowded cities. Across Europe, foreigners and Jews were scapegoated, tortured, and killed, even as those very same communities fell victim to the illness. According to the chronicler Jacob Königshofen (d. 1420), for instance, Christians in Basel, Germany in 1349 accused Jews of poisoning their wells and compelled their town council to ban Jews from the city for 200 years. The news shows us similar responses taking place today, with nation-specific travel bans and Asian-Americans being subjected to discrimination and bullying on account of the coronavirus.
While some medieval communities succumbed to fear and distrust, others found ways to support one another. Examples of such behavior also can be found in The Decameron. Boccaccio explains that during the plague women served as physicians to men — something almost unheard-of in the 14th century — while those with specialized knowledge used their skills to help those who didn’t have other means of support. Municipal and local government officials did their best to keep public places clean, and many people made efforts to self-quarantine. Meanwhile, quarantined people entertained themselves by telling stories and singing songs to one another. In our own time, people are also singing from balconies to lift each other’s spirits.
One of the most striking examples of a community uniting under duress comes from another 14th-century writer, the Moroccan Berber adventurer Ibn Battuta (d. 1368/9), who chronicled his 29 years of traveling some 75,000 miles around the Middle East, Asia, and Africa in a book commonly known as the Rihla, or Journey. In this book, Ibn Battuta describes the arrival of the plague in Syria in 1348. During this time of tribulation, he writes, the citizens of Damascus did not abandon one another or persecute the minority Christian and Jewish populations living within the city. Instead, the Damascenes set aside their differences. Members of the city’s various faith groups — Muslims, Jews, and Christians alike, from children to political leaders — united in their efforts to protect their community.
Ibn Battuta explains how all the various people of the city came together and processed through the streets. The Muslims carried aloft copies of the Quran, Jews brought out the Torah, and Christians brandished the Bible in a united appeal to God to spare their city. The result, Ibn Battuta argued, is that Damascus had significantly fewer fatalities than other cities.
Today, of course, we know better than to hold large public gatherings during pandemics. Ibn Battuta did not know the modern scientific reasons for social distancing. Yet, he pointed to a communal ethos of overcoming differences in a time of trouble that probably helped Damascus’ response and still resonates today. In the face of a pandemic, the Syrians of Damascus demonstrated that the best response is to combine our resources, share our knowledge, and remember our common humanity.
Katie L. Hodges-Kluck is the program coordinator and research associate for the Marco Institute for Medieval and Renaissance Studies at the University of Tennessee, Knoxville, where she completed her PhD in medieval history in 2015. Her research focuses on the role of religion, myth, and memory in shaping medieval political ideologies and identities.
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Miniature by Pierart dou Tielt illustrating the Tractatus quartus bu Gilles li Muisit (Tournai, c. 1353). The people of Tournai bury victims of the Black Death. via Wikimedia Commons
When a Third of the World Died
In October 1347, when a Genoese trading ship fresh from the Crimea docked at a harbor in Sicily, dead and dying men lay at the oars. The sailors had black swellings the size of eggs in their armpits and groins, swellings that oozed blood and pus, and spreading boils and black blotches on the skin. The sick endured severe pain and died within five days of the first symptoms.
Other symptoms appeared in some of the next victims: continuous fever and spitting of blood. These victims coughed, sweated heavily, and died within three days or less&mdashsometimes in 24 hours. No matter the symptoms, everything about the victims smelled foul, and depression and despair fell over them when they contracted the disease.
The disease, bubonic plague, was so lethal some went to bed well and died before morning some doctors caught the illness at the patient&rsquos bedside and died before the patient.
Borne by ships traveling the coasts and rivers, by early 1348, the plague had penetrated Italy, North Africa, France, and crossed the English Channel. At the same time, it moved across the Alps into Switzerland and reached eastward to Hungary.
In a given area, the plague wreaked its havoc within four to six months and then faded, except in larger cities. There it slowed in winter only to reappear in spring to rage for another six months. In 1349, it hit Paris again and began spreading through England, Scotland, and Ireland as well as Norway, Sweden, Denmark, Prussia, and Iceland, sometimes in chilling fashion. Off the coast of Norway, a ship drifted aimlessly offshore, finally grounding itself in Bergen. On boarding the ship, people discovered a load of wool and a dead crew.
By mid-1350, the plague had passed through most of Europe. The mortality rate ranged from 20 percent in some places to 90 percent in others. In many rural villages, the last survivors moved away, and the village sank back into the wilderness, leaving only grass-covered mounds. Overall the estimate of one medieval observer matches that of modern demographers: &ldquoA third of the world died.&rdquo That would have meant about 20 million deaths.
In other words, from 1347 to about 1350, medieval Europe experienced perhaps the greatest calamity in human history. It shouldn&rsquot surprise us that this plague, or the Black Death as it is often called, left its mark on medieval Christianity. But in many cases, the mark it left looked as hideous as the symptoms of the Black Death itself.
Deserting Loved Ones
In the beginning, people were merely astonished, and awed witnesses tended to exaggerate their reports. In Avignon, France, chroniclers put the death toll at 62,000 (and some at 120,000), although the city&rsquos population was probably less than 50,000. Exaggeration or not, the plague devastated cities and grand projects came to a standstill: in Siena, Italy, as the Black Death took more than half the inhabitants, work was abandoned on the great cathedral, planned to be the largest in the world.
The primary concern at first was burying all the bodies. When graveyards filled up, bodies at Avignon were thrown into the Rhone river until mass burial pits were dug. In London, corpses piled up until they overflowed out of the pits. Corpses were left in front of doorways, and the light of each morning revealed new piles of bodies.
Rather than encourage mutual aid, the plague&rsquos deadliness drove people from one another. One Sicilian friar reported, &ldquoMagistrates and notaries refused to come and make the wills of the dying,&rdquo and worse, &ldquoeven the priests did not come to hear their confessions.&rdquo In one account called the Decameron, the author said, &ldquoOne man shunned another &hellip kinsfolk held aloof, brother was forsaken by brother, oftentimes husband by wife nay, what is more, and scarcely to be believed, fathers and mothers were found to abandon their own children to their fate, untended, unvisited as if they had been strangers.&rdquo
Yet there were also pockets of extraordinary Christian charity. According to one French chronicler, the nuns at one city hospital, &ldquohaving no fear of death, tended the sick with all sweetness and humility.&rdquo New nuns replaced those who died, until most had died: &ldquoMany times renewed by death [they] now rest in peace with Christ as we may piously believe.&rdquo
Appeasing God&rsquos Wrath
To most people there was but one explanation for the calamity: the wrath of God. A scourge so sweeping had to be divine punishment for sin. One writer compared the plague to the Flood.
Efforts to appease God&rsquos wrath took many forms, but the most common were processions authorized at first by the pope. Some lasted as long as three days, and some were attended by as many as 2,000 (which, of course, just help spread the plague). Penitents went barefoot and wore sackcloth they sprinkled themselves with ashes, wept, prayed, tore their hair, carried candles and relics. They wound through city streets, begging for mercy from Jesus, Mary, and the saints.
When the plague refused to abate, the processions moved from ceremonies of remorse to self-flagellation. The flagellants believed they were society&rsquos redeemers they re-enacted Christ&rsquos scourging on their own bodies to atone for human sin.
Stripped to the waists, beating themselves with leather whips tipped with iron spikes until the blood flowed, groups of 200 to 300 (and sometimes up to 1,000), marched from city to city. They begged Christ and Mary for pity, and townspeople sobbed and groaned in sympathy. They performed three times a day, twice publicly in the church square and once in private.
They were organized under a lay Master for usually 33 1/2 days&mdashto represent Christ&rsquos years on earth. They pledged self-support and obedience to the Master. They were not allowed to bathe, shave, change clothes, sleep in beds, talk or have intercourse with women without the Master&rsquos permission.
The movement quickly spread from Germany through the Low Countries to France. Hundreds of bands roamed the land, exciting already overwrought emotions in city after city. Inhabitants greeted them with the ringing of church bells and offered them hospitality. Children were brought to them to be healed. People dipped cloths in the flagellants&rsquo blood and pressed the cloths to their eyes and preserved them as relics.
The flagellants quickly grew arrogant and began overtly attacking the church. Masters began hearing confessions, granting absolution, and imposing penance. Priests who tried to stop them were stoned opponents were denounced as Antichrists. The flagellants took over churches, disrupted services, ridiculed the Eucharist, looted altars, and claimed the power to cast out demons and raise the dead.
Then the self-torturers and other Christians turned their anxiety upon another group: the Jews. Jews were suspected of poisoning city wells, intending &ldquoto kill and destroy the whole of Christendom and have lordship over all the world.&rdquo Lynchings began in the spring of 1348 following the first plague deaths. In France, Jews were dragged from their houses and thrown into bonfires.
Pope Clement VI tried to stop the hysteria. He said Christians who imputed the pestilence to the Jews had been &ldquoseduced by that liar, the Devil,&rdquo and that the charge of well-poisoning and the massacres were a &ldquohorrible thing.&rdquo He urged priests to take Jews under their protection as he himself offered to do, but his voice was hardly heard in the rush to find a scapegoat.
In one town, an entire community of several hundred Jews was burned in a wooden house especially constructed for the purpose. The 2,000 Jews of Strasbourg, France, were taken to the cemetery, where those who didn&rsquot convert were burned in rows of stakes.
Eventually church and state got the upper hand. When Clement VI called for their arrest, the flagellants disbanded and fled, &ldquovanishing as suddenly as they had come,&rdquo wrote one witness, &ldquolike night phantoms or mocking ghosts.&rdquo
The plague broke out about once a decade over the next sixty years in various places. Yet for all the excess of sorrow and death, there were few profound lasting effects on society.
Some noted the sad effect on morals, &ldquolowering virtue throughout the world.&rdquo There was an orgy of greed with the glut of merchandise available in the aftermath. Peasants took unclaimed tools and livestock. The poor moved into deserted houses, slept on beds, and ate off silver. Lawsuits to gain deserted lands proliferated.
Others noted an improvement: many people living together got married, and swearing and gambling had so diminished that manufacturers of dice were turning their product into beads for saying prayers.
Higher education benefited. Emperor Charles IV felt deeply the cause of &ldquoprecious knowledge which the mad rage of pestilential death has stifled throughout the wide realms of the world.&rdquo He founded the University of Prague in the plague year of 1348. By 1353, three new colleges were founded at Cambridge, one of them funded by the income derived from masses for the dead.
The church was also enriched, first by the offerings of pilgrims who, in 1350, flocked to Rome seeking absolution from their sins. Also, a flood of bequests were made to religious institutions. In October 1348, the Council of Siena temporarily suspended its annual taxes for religious charities because these were so &ldquoimmensely enriched and indeed fattened&rdquo by bequests.
But the church also garnered much criticism. Most clergy turned out to be as frightened and self-serving as the populace, some gouging people for their services during the crisis. This was severely condemned by Pope Clement VI and violently resented by the people. In Worcester, England, for example, citizens broke down the gates of a priory, attacked the monks, and tried to set fire to the buildings.
Wrote one contemporary, &ldquoWhen those who have the title of shepherd play the part of wolves, heresy grows in the garden of the church.&rdquo Most people plodded on as before, but dissatisfaction with the church&rsquos behavior at a critical moment accelerated reform movements, which were to break out uncontrolled a century and a half later.
Mark Galli is editor of CHRISTIAN HISTORY.
Copyright © 1996 by the author or Christianity Today/Christian History magazine.
Click here for reprint information on Christian History.
Religious Responses to the Black Death - History
When facing death, medieval society in 1348 looked to the Church, just as they did to medics, for rituals of comfort. Fearing contagion, burials became hasty affairs. By law, no one other than immediate family could accompany the body to the cemetery and many city governments forbid the ringing of parish church bells, believing it would discourage the sick and dying multitudes.
In past centuries, death was embraced as a sister and friend, a welcome bridge to eternal rest. A priest would administer the Sacrament of Extreme unction to help prepare the traveler for his journey. Those left behind held ornate funeral procession and saw their loved ones buried in consecrated ground.
Some eyewitnesses were disillusioned with the clergy. Priests and friars went to see the rich in great multitudes and were paid such high prices that they all got rich. Reports the Florentine Chronicler. Some priests even refused to set foot inside the houses of the sick, neglecting the cries of their flock. However, several accounts show that many friars, priests and nuns gave their lives in faithful ecclesiastical service. Some perished administering the sacrament in the same room as their patients.
Overall, the 1348 plague revealed the Churchs human side and left such a traumatic impression on minds of the people that it influenced Martin Luthers Reformation movement in the 1500s.
Now, death was a ravishing monster, an enemy to be feared. How the disease tortured and humiliated the human body was no secret. How to escape the plague remained unknown.
Healing was an alluring promise of many saints venerated during the plague epidemics. As a result, saints became part of the iconography of the plague.
St. Sebastian, who died around 300 AD, became a Roman soldier under Emperor Diecletian, who was unaware of Sebastians beliefs. Sebastian was known for spreading the Gospel message throughout Rome and helping keep his fellow soldiers strong in the Christian faith. Discovering Sebastian was a Christian, the Emperor had him tied, pierced with arrows, and left for dead.
As legend holds, a widow nursed Sebastian back to health. He lived only long enough to confront Emperor Diecletian about his cruelty to Christians. Because of his outspoken act, the ruler had him beaten to death. Sebastian began to be venerated around 1400 in Milan, and he is considered patron saint of archers, athletes, soldiers, as well as a protector from the plague. The flying arrows have since become a symbol of the plague. Sebastians wounds resemble plague boils.
Saint Rocco (Rouque in Spanish) gained his fame during a pilgrimage to Rome in the 1300s while plague ravaged Italy. Devoting himself to caring for the plague victims, he became ill himself at Piacenza but he recovered and was said to have performed miraculous healings. A hundred years after his death, Rocco was reported to have interceded in miracles. He is usually pictured pointing to a plague boil on his inner thigh and often with a dog, a symbol of fidelity.
Saint Lorenzo was a deacon of a church in Rome who was killed for his faith in no ordinary manner. He was burned alive in a gridiron for his faith. Like with saint Bartolomeo, plague victims could identify with the pain Saint Lorenzo experienced.
In 1427, the legend of Saint Bartolomeo gained popularity. An apostle who was flogged and crucified, he, like Lorenzo, experienced dreadful suffering and was called upon to alleviate the plague. Interestingly, many scholars associate with a disturbing detail in Michelangelo's Sistine Chapel: the figure that holds his own skin is thought to be a reference to Bartolomeo and to the plague, since it was most manifested in buboes on the skin.
Pogroms against Jews
Pogrom gegen Juden im Jahre 1349 – Darstellung einer jüdischen Chronik
Pogroms against Jews
The divine and secular powers lost their authority because of them being helpless faced with the epidemic. This affected mostly those people who belonged to a cultural Minority in the medieval society. So there were many pogroms against the Jewish, which couldn’t be suppressed by the divine and secular powers and which led to the result that after 1353 only a few Jews lived in Germany and the Netherlands anymore.
The pogroms started after there were rumours about the Jews being the cause of the disease and the confession of Jews, who told under torture that they were to blame. Following you can read the confession of a tortured Jew:
The Confession of Agimet of Geneva, Châtel, October 20, 1348
The year of our Lord 1348.
On Friday, the 10th of the month of October, at Châtel, in the castle thereof, there occurred the judicial inquiry which was made by order of the court of the illustrious Prince, our lord, Amadeus, Count of Savoy, and his subjects against the Jews of both sexes who were there imprisoned, each one separately. [Jews were sometimes imprisoned separately to prevent suicide.] This was done after public rumor had become current and a strong clamor had arisen because of the poison put by them into the wells, springs, and other things which the Christians use-demanding that they die, that they are able to be found guilty and, therefore, that they should be punished. Hence this their confession made in the presence of a great many trustworthy persons.
Agimet the Jew, who lived at Geneva and was arrested at Châtel, was there put to the torture a little and then he was released from it. And after a long time, having been subjected again to torture a little, he confessed in the presence of a great many trustworthy persons, who are later mentioned. To begin with it is clear that at the Lent just passed Pultus Clesis de Ranz had sent this very Jew to Venice to buy silks and other things for him. When this came to the notice of Rabbi Peyret, a Jew of Chamb6ry who was a teacher of their law, he sent for this Agimet, for whom he had searched, and when he had come before him he said: “We have been informed that you are going to Venice to buy silk and other wares. Here I am giving you a little package of half a span in size which contains some prepared poison and venom in a thin, sewed leather-bag. Distribute it among the wells, cisterns, and springs about Venice and the other places to which you go, in order to poison the people who use the water of the aforesaid wells that will have been poisoned by you, namely, the wells in which the poison will have been placed.”
Agimet took this package full of poison and carried it with him to Venice, and when he came there he threw and scattered a portion of it into the well or cistern of fresh water which was there near the German House, in order to poison the people who use the water of that cistern. And he says that this is the only cistern of sweet water in the city. He also says that the mentioned Rabbi Peyret promised to give him whatever he wanted for his troubles in this business. Of his own accord Agimet confessed further that after this had been done he left at once in order that he should not be captured by the citizens or others, and that he went personally to Calabria and Apulia and threw the above mentioned poison into many wells. He confesses also that he put some of this same poison in the well of the streets of the city of Ballet.
He confesses further that he put some of this poison into the public fountain of the city of Toulouse and in the wells that are near the [Mediterranean] sea. Asked if at the time that he scattered the venom and poisoned the wells, above mentioned, any people had died, he said that he did not know inasmuch as he had left everyone of the above mentioned places in a hurry. Asked if any of the Jews of those places were guilty in the above mentioned matter, he answered that he did not know. And now by all that which is contained in the five books of Moses and the scroll of the Jews, he declared that this was true, and that he was in no wise lying, no matter what might happen to him.
The confessions led to many assaults in Germany and Switzerland – especially in Alsace and alongside the Rhine.
On 9 th January 1349 in Basel a part of the Jewish inhabitants were murdered – although the Basel city council had banned the worst baiters out of the city before, they had to annul this ban under pressure by the inhabitants of the city and instead ban the Jews. A part of the displaced persons were arrested and banned into a house on an Isle in the Rhine, just build for this purpose.
Also in Strasbourg the city council tried to secure the Jews living there, but they were displaced by the votes of the guilds. The new council brooked the following massacre, which killed in February 1349, when the Black Death hadn’t even reached the city almost half of the Jewish citizens.
In March of the same year 400 members of the Jewish community of Worms burned themselves to avoid forced baptisms four months later the community of Frankfort did the same. In May 1349 Jews defended themselves in Mainz by killing 200 attacking citizens. Even this community killed itself later on by burning their houses. It was the largest community in Europe.
These pogroms didn’t stop before the end of the year 1349. It is said for many cities that so called flagellants (castigators) agitated part of the inhabitants to kill the Jewish for poisoning the wells. But new research believes that this passing on of the blame was rather a convenient attempt of justification by the historiography of the 14 th century.
Besides the search for a scapegoat and a increased intolerance of the church for people of different faith, also cupidity was a big motive for the killings. Many people thought that this way they would get rid of their creditors. For example the mayor of Augsburg head a high owed them a lot and thus led the murders happen very readily.
A lot of persons tried to advert to the situation. Already in 1348 pope Clement VI living in Avignon called the accusations “ridiculous” , because on the one hand the Black Death spread also in regions where no Jews were living, on the other hand killed the disease even the Jewish themselves. He demanded that the clerics should protect the Jews, and forbid to kill Jewish without a court or to plunder them. But this only worked out in the area around Avignon and nowhere else.
Black Death Muslim and Christian Responses Essay Example
According to document five both religions were finding non-religious alternatives to prevent the Black Death. In some cases, the Christians would try to sleeping on their backs to prevent the plague, while the Muslims would even avoid going outside. In addition they both drank a solution of Armenian clay to cleanse the body and built fires hoping that this would purify the contaminated air. Based on document nine both the religions united together to pray and they went back to their religious ways.
These documents prove that each religion in some cases stepped out their religious backgrounds to try to prevent the Black Death. Religious views played a big part on the different ways the Christians and Muslims responded to the Black Death. The Christians basically thought the plague was their fault. They believe that they’re being punished for their sins they’ve imputed against God. On the other hand the Muslims are taking the plague lightly. They believe that “a Muslim should devoutly accept the divine act. The Muslims also believe that this occurrence is a blessing from God. In addition document two explains the Black Death Mortality by comparing each religions death rate.
The mortality estimate Phillip Ziegler calculated for the Muslims shows that about 33% of the Middle Eastern population have deceased. While the Christian population in Europe mortality rate was only 31%. This document proves that the Muslims population decreased greater than the Christians. During the era of the Black Plague, the Christian community held a lood-thirsty lead hand in the fact of the matter, while the Islam society didn’t blame the epidemic on others and or try to solve the rampant disease with violence.
According to document seven the Christians blamed the Jews for causing the Black Death they believe the Jews poisoned the wells. The Muslims didn’t blame anyone for the occurrence of the Black Death, based on document ten. This proves that the Muslims believed that the plague was meant to happen, like document four said, “the plague is a blessing from God. ”
The Black Death
This book explores the life, thought and political commitments of the free-thinker John Toland (1670–1722). Studying both his private archive and published works, it illustrates how he moved in both subversive and elite political circles in England and abroad. The book explores the connections between Toland's republican political thought and his irreligious belief about Christian doctrine, the ecclesiastical establishment and divine revelation, arguing that far from being a marginal and insignificant figure, he counted queens, princes and government ministers as his friends and political associates. In particular, Toland's intimate relationship with the Electress Sophia of Hanover saw him act as a court philosopher, but also as a powerful publicist for the Hanoverian succession. The book argues that he shaped the republican tradition after the Glorious Revolution into a practical and politically viable programme, focused not on destroying the monarchy but on reforming public religion and the Church of England. It also examines how Toland used his social intimacy with a wide circle of men and women (ranging from Prince Eugene of Savoy to Robert Harley) to distribute his ideas in private. The book explores the connections between his erudition and print culture, arguing that his intellectual project was aimed at compromising the authority of Christian ‘knowledge’ as much as the political power of the Church. Overall, it illustrates how Toland's ideas and influence impacted upon English political life between the 1690s and the 1720s.
And yet, as John Aberth reveals in this lively work, late medieval Europeans' cultural assumptions uniquely equipped them to face up postively to the huge problems that they faced.
Praise for the first edition: "Aberth wears his very considerable and up-to-date scholarship lightly and his study of a series of complex and somber calamites is made remarkably vivid." -- Barrie Dobson, Honorary Professor of History, University of York The later Middle Ages was a period of unparalleled chaos and misery -in the form of war, famine, plague, and death. At times it must have seemed like the end of the world was truly at hand. And yet, as John Aberth reveals in this lively work, late medieval Europeans' cultural assumptions uniquely equipped them to face up postively to the huge problems that they faced. Relying on rich literary, historical and material sources, the book brings this period and its beliefs and attitudes vividly to life. Taking his themes from the Four Horsemen of the Apocalypse, John Aberth describes how the lives of ordinary people were transformed by a series of crises, including the Great Famine, the Black Death and the Hundred Years War. Yet he also shows how prayers, chronicles, poetry, and especially commemorative art reveal an optimistic people, whose belief in the apocalypse somehow gave them the ability to transcend the woes they faced on this earth. This second edition is brought fully up to date with recent scholarship, and the scope of the book is broadened to include many more examples from mainland Europe. The new edition features fully revised sections on famine, war, and plague, as well as a new epitaph. The book draws some bold new conclusions and raises important questions, which will be fascinating reading for all students and general readers with an interest in medieval history.
European writers contemporary with the plague described the disease in Latin as pestis or pestilentia, 'pestilence' epidemia, 'epidemic' mortalitas, 'mortality'.  In English prior to the 18th century, the event was called the "pestilence" or "great pestilence", "the plague" or the "great death".    Subsequent to the pandemic "the furste moreyn" (first murrain) or "first pestilence" was applied, to distinguish the mid-14th century phenomenon from other infectious diseases and epidemics of plague.  The 1347 pandemic plague was not referred to specifically as "black" in the 14th or 15th centuries in any European language, though the expression "black death" had occasionally been applied to fatal disease beforehand. 
"Black death" was not used to describe the plague pandemic in English until the 1750s the term is first attested in 1755, where it translated Danish: den sorte død, lit. 'the black death'.   This expression as a proper name for the pandemic had been popularized by Swedish and Danish chroniclers in the 15th and early 16th centuries, and in the 16th and 17th centuries was transferred to other languages as a calque: Icelandic: svarti dauði, German: der schwarze Tod, and French: la mort noire.   Previously, most European languages had named the pandemic a variant or calque of the Latin: magna mortalitas, lit. 'Great Death'. 
The phrase 'black death' – describing Death as black – is very old. Homer used it in the Odyssey to describe the monstrous Scylla, with her mouths "full of black Death" (Ancient Greek: πλεῖοι μέλανος Θανάτοιο , romanized: pleîoi mélanos Thanátoio).   Seneca the Younger may have been the first to describe an epidemic as 'black death', (Latin: mors atra) but only in reference to the acute lethality and dark prognosis of disease.    The 12th–13th century French physician Gilles de Corbeil had already used atra mors to refer to a "pestilential fever" (febris pestilentialis) in his work On the Signs and Symptoms of Diseases (De signis et symptomatibus aegritudium).   The phrase mors nigra, 'black death', was used in 1350 by Simon de Covino (or Couvin), a Belgian astronomer, in his poem "On the Judgement of the Sun at a Feast of Saturn" (De judicio Solis in convivio Saturni), which attributes the plague to an astrological conjunction of Jupiter and Saturn.  His use of the phrase is not connected unambiguously with the plague pandemic of 1347 and appears to refer to the fatal outcome of disease. 
The historian Cardinal Francis Aidan Gasquet wrote about the Great Pestilence in 1893  and suggested that it had been "some form of the ordinary Eastern or bubonic plague".  [c] In 1908, Gasquet claimed that use of the name atra mors for the 14th-century epidemic first appeared in a 1631 book on Danish history by J. I. Pontanus: "Commonly and from its effects, they called it the black death" (Vulgo & ab effectu atram mortem vocitabant).  
Recent research has suggested plague first infected humans in Europe and Asia in the Late Neolithic-Early Bronze Age.  Research in 2018 found evidence of Yersinia pestis in an ancient Swedish tomb, which may have been associated with the "Neolithic decline" around 3000 BCE, in which European populations fell significantly.   This Y. pestis may have been different from more modern types, with bubonic plague transmissible by fleas first known from Bronze Age remains near Samara. 
The symptoms of bubonic plague are first attested in a fragment of Rufus of Ephesus preserved by Oribasius these ancient medical authorities suggest bubonic plague had appeared in the Roman Empire before the reign of Trajan, six centuries before arriving at Pelusium in the reign of Justinian I.  In 2013, researchers confirmed earlier speculation that the cause of the Plague of Justinian (541–542 CE, with recurrences until 750) was Y. pestis.   This is known as the First plague pandemic.
The most authoritative contemporary account is found in a report from the medical faculty in Paris to Philip VI of France. It blamed the heavens, in the form of a conjunction of three planets in 1345 that caused a "great pestilence in the air" (miasma theory).  Muslim religious scholars taught that the pandemic was a “martyrdom and mercy” from God, assuring the believer's place in paradise. For non-believers, it was a punishment.  Some Muslim doctors cautioned against trying to prevent or treat a disease sent by God. Others adopted preventive measures and treatments for plague used by Europeans. These Muslim doctors also depended on the writings of the ancient Greeks.  
Predominant modern theory
Due to climate change in Asia, rodents began to flee the dried-out grasslands to more populated areas, spreading the disease.  The plague disease, caused by the bacterium Yersinia pestis, is enzootic (commonly present) in populations of fleas carried by ground rodents, including marmots, in various areas, including Central Asia, Kurdistan, Western Asia, North India, Uganda and the western United States.  
Y. pestis was discovered by Alexandre Yersin, a pupil of Louis Pasteur, during an epidemic of bubonic plague in Hong Kong in 1894 Yersin also proved this bacillus was present in rodents and suggested the rat was the main vehicle of transmission.   The mechanism by which Y. pestis is usually transmitted was established in 1898 by Paul-Louis Simond and was found to involve the bites of fleas whose midguts had become obstructed by replicating Y. pestis several days after feeding on an infected host. This blockage starves the fleas and drives them to aggressive feeding behaviour and attempts to clear the blockage by regurgitation, resulting in thousands of plague bacteria being flushed into the feeding site, infecting the host. The bubonic plague mechanism was also dependent on two populations of rodents: one resistant to the disease, which act as hosts, keeping the disease endemic, and a second that lack resistance. When the second population dies, the fleas move on to other hosts, including people, thus creating a human epidemic. 
Definitive confirmation of the role of Y. pestis arrived in 2010 with a publication in PLOS Pathogens by Haensch et al.  [d] They assessed the presence of DNA/RNA with polymerase chain reaction (PCR) techniques for Y. pestis from the tooth sockets in human skeletons from mass graves in northern, central and southern Europe that were associated archaeologically with the Black Death and subsequent resurgences. The authors concluded that this new research, together with prior analyses from the south of France and Germany, "ends the debate about the cause of the Black Death, and unambiguously demonstrates that Y. pestis was the causative agent of the epidemic plague that devastated Europe during the Middle Ages".  In 2011, these results were further confirmed with genetic evidence derived from Black Death victims in the East Smithfield burial site in England. Schuenemann et al. concluded in 2011 "that the Black Death in medieval Europe was caused by a variant of Y. pestis that may no longer exist". 
Later in 2011, Bos et al. reported in Nature the first draft genome of Y. pestis from plague victims from the same East Smithfield cemetery and indicated that the strain that caused the Black Death is ancestral to most modern strains of Y. pestis. 
Since this time, further genomic papers have further confirmed the phylogenetic placement of the Y. pestis strain responsible for the Black Death as both the ancestor  of later plague epidemics including the third plague pandemic and as the descendant  of the strain responsible for the Plague of Justinian. In addition, plague genomes from significantly earlier in prehistory have been recovered. 
DNA taken from 25 skeletons from 14th century London have shown plague is a strain of Y. pestis almost identical to that which hit Madagascar in 2013.  
It is recognised that an epidemiological account of plague is as important as an identification of symptoms, but researchers are hampered by the lack of reliable statistics from this period. Most work has been done on the spread of the disease in England, and even estimates of overall population at the start vary by over 100% as no census was undertaken in England between the time of publication of the Domesday Book of 1086 and the poll tax of the year 1377.  Estimates of plague victims are usually extrapolated from figures for the clergy.
Mathematical modelling is used to match the spreading patterns and the means of transmission. A research in 2018 challenged the popular hypothesis that "infected rats died, their flea parasites could have jumped from the recently dead rat hosts to humans". It suggested an alternative model in which "the disease was spread from human fleas and body lice to other people". The second model claims to better fit the trends of death toll because the rat-flea-human hypothesis would have produced a delayed but very high spike in deaths, which contradict historical death data.  
Lars Walløe complains that all of these authors "take it for granted that Simond's infection model, black rat → rat flea → human, which was developed to explain the spread of plague in India, is the only way an epidemic of Yersinia pestis infection could spread", whilst pointing to several other possibilities.  Similarly, Monica Green has argued that greater attention is needed to the range of (especially non-commensal) animals that might be involved in the transmission of plague. 
Archaeologist Barney Sloane has argued that there is insufficient evidence of the extinction of numerous rats in the archaeological record of the medieval waterfront in London and that the disease spread too quickly to support the thesis that Y. pestis was spread from fleas on rats he argues that transmission must have been person to person.   This theory is supported by research in 2018 which suggested transmission was more likely by body lice and fleas during the second plague pandemic. 
Although academic debate continues, no single alternative solution has achieved widespread acceptance.  Many scholars arguing for Y. pestis as the major agent of the pandemic suggest that its extent and symptoms can be explained by a combination of bubonic plague with other diseases, including typhus, smallpox and respiratory infections. In addition to the bubonic infection, others point to additional septicaemic (a type of "blood poisoning") and pneumonic (an airborne plague that attacks the lungs before the rest of the body) forms of plague, which lengthen the duration of outbreaks throughout the seasons and help account for its high mortality rate and additional recorded symptoms.  In 2014, Public Health England announced the results of an examination of 25 bodies exhumed in the Clerkenwell area of London, as well as of wills registered in London during the period, which supported the pneumonic hypothesis.  Currently, while osteoarcheologists have conclusively verified the presence of Y. pestis bacteria in burial sites across northern Europe through examination of bones and dental pulp, no other epidemic pathogen has been discovered to bolster the alternative explanations. In the words of one researcher: "Finally, plague is plague." 
The importance of hygiene was recognised only in the nineteenth century with the development of the germ theory of disease until then streets were commonly filthy, with live animals of all sorts around and human parasites abounding, facilitating the spread of transmissible disease. 
According to a team of medical geneticists led by Mark Achtman that analysed the genetic variation of the bacterium, Yersinia pestis "evolved in or near China",   from which it spread around the world in multiple epidemics. Later research by a team led by Galina Eroshenko places the origins more specifically in the Tian Shan mountains on the border between Kyrgyzstan and China. 
Nestorian graves dating to 1338–1339 near Issyk-Kul in Kyrgyzstan have inscriptions referring to plague, which has led some historians and epidemiologists to think they mark the outbreak of the epidemic. Others favour an origin in China.  According to this theory, the disease may have travelled along the Silk Road with Mongol armies and traders, or it could have arrived via ship.  Epidemics killed an estimated 25 million across Asia during the fifteen years before the Black Death reached Constantinople in 1347.  
Research on the Delhi Sultanate and the Yuan Dynasty shows no evidence of any serious epidemic in fourteenth-century India and no specific evidence of plague in fourteenth-century China, suggesting that the Black Death may not have reached these regions.    Ole Benedictow argues that since the first clear reports of the Black Death come from Kaffa, the Black Death most likely originated in the nearby plague focus on the northwestern shore of the Caspian Sea. 
. But at length it came to Gloucester, yea even to Oxford and to London, and finally it spread over all England and so wasted the people that scarce the tenth person of any sort was left alive.
Plague was reportedly first introduced to Europe via Genoese traders from their port city of Kaffa in the Crimea in 1347. During a protracted siege of the city, in 1345–1346 the Mongol Golden Horde army of Jani Beg, whose mainly Tatar troops were suffering from the disease, catapulted infected corpses over the city walls of Kaffa to infect the inhabitants,  though it is more likely that infected rats travelled across the siege lines to spread the epidemic to the inhabitants.   As the disease took hold, Genoese traders fled across the Black Sea to Constantinople, where the disease first arrived in Europe in summer 1347. 
The epidemic there killed the 13-year-old son of the Byzantine emperor, John VI Kantakouzenos, who wrote a description of the disease modelled on Thucydides's account of the 5th century BCE Plague of Athens, but noting the spread of the Black Death by ship between maritime cities.  Nicephorus Gregoras also described in writing to Demetrios Kydones the rising death toll, the futility of medicine, and the panic of the citizens.  The first outbreak in Constantinople lasted a year, but the disease recurred ten times before 1400. 
Carried by twelve Genoese galleys, plague arrived by ship in Sicily in October 1347  the disease spread rapidly all over the island. Galleys from Kaffa reached Genoa and Venice in January 1348, but it was the outbreak in Pisa a few weeks later that was the entry point to northern Italy. Towards the end of January, one of the galleys expelled from Italy arrived in Marseilles. 
From Italy, the disease spread northwest across Europe, striking France, Spain (the epidemic began to wreak havoc first on the Crown of Aragon in the spring of 1348),  Portugal and England by June 1348, then spread east and north through Germany, Scotland and Scandinavia from 1348 to 1350. It was introduced into Norway in 1349 when a ship landed at Askøy, then spread to Bjørgvin (modern Bergen) and Iceland.  Finally, it spread to northwestern Russia in 1351. Plague was somewhat more uncommon in parts of Europe with less developed trade with their neighbours, including the majority of the Basque Country, isolated parts of Belgium and the Netherlands, and isolated Alpine villages throughout the continent.   
According to some epidemiologists, periods of unfavourable weather decimated plague-infected rodent populations and forced their fleas onto alternative hosts,  inducing plague outbreaks which often peaked in the hot summers of the Mediterranean,  as well as during the cool autumn months of the southern Baltic states.  [e] Among many other culprits of plague contagiousness, malnutrition, even if distantly, also contributed to such an immense loss in European population, since it weakened immune systems. 
Western Asian and North African outbreak
The disease struck various regions in the Middle East and North Africa during the pandemic, leading to serious depopulation and permanent change in both economic and social structures.  As infected rodents infected new rodents, the disease spread across the region, entering also from southern Russia.
By autumn 1347, plague had reached Alexandria in Egypt, transmitted by sea from Constantinople according to a contemporary witness, from a single merchant ship carrying slaves.  By late summer 1348 it reached Cairo, capital of the Mamluk Sultanate, cultural centre of the Islamic world, and the largest city in the Mediterranean Basin the Bahriyya child sultan an-Nasir Hasan fled and more than a third of the 600,000 residents died.  The Nile was choked with corpses despite Cairo having a medieval hospital, the late 13th century bimaristan of the Qalawun complex.  The historian al-Maqrizi described the abundant work for grave-diggers and practitioners of funeral rites, and plague recurred in Cairo more than fifty times over the following century and half. 
During 1347, the disease travelled eastward to Gaza by April by July it had reached Damascus, and in October plague had broken out in Aleppo.  That year, in the territory of modern Lebanon, Syria, Israel, and Palestine, the cities of Ashkelon, Acre, Jerusalem, Sidon, and Homs were all infected. In 1348–1349, the disease reached Antioch. The city's residents fled to the north, but most of them ended up dying during the journey.  Within two years, the plague had spread throughout the Islamic world, from Arabia across North Africa.  [ page needed ] The pandemic spread westwards from Alexandria along the African coast, while in April 1348 Tunis was infected by ship from Sicily. Tunis was then under attack by an army from Morocco this army dispersed in 1348 and brought the contagion with them to Morocco, whose epidemic may also have been seeded from the Islamic city of Almería in al-Andalus. 
Mecca became infected in 1348 by pilgrims performing the Hajj.  In 1351 or 1352, the Rasulid sultan of the Yemen, al-Mujahid Ali, was released from Mamluk captivity in Egypt and carried plague with him on his return home.   During 1348, records show the city of Mosul suffered a massive epidemic, and the city of Baghdad experienced a second round of the disease. [ citation needed ]
Signs and symptoms
Symptoms of the disease include fever of 38–41 °C (100–106 °F), headaches, painful aching joints, nausea and vomiting, and a general feeling of malaise. Left untreated, of those that contract the bubonic plague, 80 percent die within eight days. 
Contemporary accounts of the pandemic are varied and often imprecise. The most commonly noted symptom was the appearance of buboes (or gavocciolos) in the groin, neck, and armpits, which oozed pus and bled when opened.  Boccaccio's description:
In men and women alike it first betrayed itself by the emergence of certain tumours in the groin or armpits, some of which grew as large as a common apple, others as an egg . From the two said parts of the body this deadly gavocciolo soon began to propagate and spread itself in all directions indifferently after which the form of the malady began to change, black spots or livid making their appearance in many cases on the arm or the thigh or elsewhere, now few and large, now minute and numerous. As the gavocciolo had been and still was an infallible token of approaching death, such also were these spots on whomsoever they showed themselves.   [f]
This was followed by acute fever and vomiting of blood. Most victims died two to seven days after initial infection. Freckle-like spots and rashes,  which could have been caused by flea-bites, were identified as another potential sign of plague.
Lodewijk Heyligen, whose master the Cardinal Colonna died of plague in 1348, noted a distinct form of the disease, pneumonic plague, that infected the lungs and led to respiratory problems.  Symptoms include fever, cough, and blood-tinged sputum. As the disease progresses, sputum becomes free-flowing and bright red. Pneumonic plague has a mortality rate of 90 to 95 percent. 
Septicaemic plague is the least common of the three forms, with a mortality rate near 100%. Symptoms are high fevers and purple skin patches (purpura due to disseminated intravascular coagulation).  In cases of pneumonic and particularly septicaemic plague, the progress of the disease is so rapid that there would often be no time for the development of the enlarged lymph nodes that were noted as buboes. 
There are no exact figures for the death toll the rate varied widely by locality. In urban centres, the greater the population before the outbreak, the longer the duration of the period of abnormal mortality.  It killed some 75 to 200 million people in Eurasia.    [ better source needed ] The mortality rate of the Black Death in the 14th century was far greater than the worst 20th-century outbreaks of Y. pestis plague, which occurred in India and killed as much as 3% of the population of certain cities.  The overwhelming number of deceased bodies produced by the Black Death caused the necessity of mass burial sites in Europe, sometimes including up to several hundred or several thousand skeletons.  The mass burial sites that have been excavated have allowed archaeologists to continue interpreting and defining the biological, sociological, historical, and anthropological implications of the Black Death. 
According to medieval historian Philip Daileader, it is likely that over four years, 45–50% of the European population died of plague.  [g] Norwegian historian Ole Benedictow suggests it could have been as much as 60% of the European population.  [h] In 1348, the disease spread so rapidly that before any physicians or government authorities had time to reflect upon its origins, about a third of the European population had already perished. In crowded cities, it was not uncommon for as much as 50% of the population to die.  Half of Paris' population of 100,000 people died. In Italy, the population of Florence was reduced from between 110,000 and 120,000 inhabitants in 1338 down to 50,000 in 1351. At least 60% of the population of Hamburg and Bremen perished,  and a similar percentage of Londoners may have died from the disease as well,  with a death toll of approximately 62,000 between 1346 and 1353.  [i] Florence's tax records suggest that 80% of the city's population died within four months in 1348.  Before 1350, there were about 170,000 settlements in Germany, and this was reduced by nearly 40,000 by 1450.  The disease bypassed some areas, with the most isolated areas being less vulnerable to contagion. Plague did not appear in Douai in Flanders until the turn of the 15th century, and the impact was less severe on the populations of Hainaut, Finland, northern Germany, and areas of Poland.  Monks, nuns, and priests were especially hard-hit since they cared for victims of the Black Death. 
The physician to the Avignon Papacy, Raimundo Chalmel de Vinario (Latin: Magister Raimundus, lit. 'Master Raymond'), observed the decreasing mortality rate of successive outbreaks of plague in 1347–48, 1362, 1371, and 1382 in his 1382 treatise On Epidemics (De epidemica).  In the first outbreak, two thirds of the population contracted the illness and most patients died in the next, half the population became ill but only some died by the third, a tenth were affected and many survived while by the fourth occurrence, only one in twenty people were sickened and most of them survived.  By the 1380s in Europe, it predominantly affected children.  Chalmel de Vinario recognized that bloodletting was ineffective (though he continued to prescribe bleeding for members of the Roman Curia, whom he disliked), and claimed that all true cases of plague were caused by astrological factors and were incurable he himself was never able to effect a cure. 
The most widely accepted estimate for the Middle East, including Iraq, Iran, and Syria, during this time, is for a death toll of about a third of the population.  The Black Death killed about 40% of Egypt's population.  In Cairo, with a population numbering as many as 600,000, and possibly the largest city west of China, between one third and 40% of the inhabitants died inside of eight months. 
Italian chronicler Agnolo di Tura recorded his experience from Siena, where plague arrived in May 1348:
Father abandoned child, wife husband, one brother another for this illness seemed to strike through the breath and sight. And so they died. And none could be found to bury the dead for money or friendship. Members of a household brought their dead to a ditch as best they could, without priest, without divine offices . great pits were dug and piled deep with the multitude of dead. And they died by the hundreds both day and night . And as soon as those ditches were filled more were dug . And I, Agnolo di Tura . buried my five children with my own hands. And there were also those who were so sparsely covered with earth that the dogs dragged them forth and devoured many bodies throughout the city. There was no one who wept for any death, for all awaited death. And so many died that all believed it was the end of the world. 
With such a large population decline from the pandemic, wages soared in response to a labour shortage.  On the other hand, in the quarter century after the Black Death in England, it is clear many labourers, artisans, and craftsmen, those living from money-wages alone, did suffer a reduction in real incomes owing to rampant inflation.  Landowners were also pushed to substitute monetary rents for labour services in an effort to keep tenants. 
Some historians believe the innumerable deaths brought on by the pandemic cooled the climate by freeing up land and triggering reforestation. This may have led to the Little Ice Age. 
Renewed religious fervour and fanaticism bloomed in the wake of the Black Death. Some Europeans targeted "various groups such as Jews, friars, foreigners, beggars, pilgrims", lepers,   and Romani, blaming them for the crisis. Lepers, and others with skin diseases such as acne or psoriasis, were killed throughout Europe.
Because 14th-century healers and governments were at a loss to explain or stop the disease, Europeans turned to astrological forces, earthquakes, and the poisoning of wells by Jews as possible reasons for outbreaks.  Many believed the epidemic was a punishment by God for their sins, and could be relieved by winning God's forgiveness. 
There were many attacks against Jewish communities.  In the Strasbourg massacre of February 1349, about 2,000 Jews were murdered.  In August 1349, the Jewish communities in Mainz and Cologne were annihilated. By 1351, 60 major and 150 smaller Jewish communities had been destroyed.  During this period many Jews relocated to Poland, where they received a warm welcome from King Casimir the Great. 
One theory that has been advanced is that the devastation in Florence caused by the Black Death, which hit Europe between 1348 and 1350, resulted in a shift in the world view of people in 14th-century Italy and led to the Renaissance. Italy was particularly badly hit by the pandemic, and it has been speculated that the resulting familiarity with death caused thinkers to dwell more on their lives on Earth, rather than on spirituality and the afterlife.  [j] It has also been argued that the Black Death prompted a new wave of piety, manifested in the sponsorship of religious works of art. 
This does not fully explain why the Renaissance occurred in Italy in the 14th century. The Black Death was a pandemic that affected all of Europe in the ways described, not only Italy. The Renaissance's emergence in Italy was most likely the result of the complex interaction of the above factors,  in combination with an influx of Greek scholars following the fall of the Byzantine Empire. [ citation needed ] As a result of the drastic reduction in the populace the value of the working class increased, and commoners came to enjoy more freedom. To answer the increased need for labour, workers travelled in search of the most favorable position economically.  [ better source needed ]
Prior to the emergence of the Black Death, the workings of Europe were run by the Catholic Church and the continent was considered a feudalistic society, composed of fiefs and city-states.  The pandemic completely restructured both religion and political forces survivors began to turn to other forms of spirituality and the power dynamics of the fiefs and city-states crumbled.  
Cairo's population, partly owing to the numerous plague epidemics, was in the early 18th century half of what it was in 1347.  The populations of some Italian cities, notably Florence, did not regain their pre-14th century size until the 19th century.  The demographic decline due to the pandemic had economic consequences: the prices of food dropped and land values declined by 30–40% in most parts of Europe between 1350 and 1400.  Landholders faced a great loss, but for ordinary men and women it was a windfall. The survivors of the pandemic found not only that the prices of food were lower but also that lands were more abundant, and many of them inherited property from their dead relatives, and this probably destabilized feudalism.  
The word "quarantine" has its roots in this period, though the concept of isolating people to prevent the spread of disease is older. In the city-state of Ragusa (modern Dubrovnik, Croatia), a thirty-day isolation period was implemented in 1377 for new arrivals to the city from plague-affected areas. The isolation period was later extended to forty days, and given the name "quarantino" from the Italian word for "forty". 
Second plague pandemic
The plague repeatedly returned to haunt Europe and the Mediterranean throughout the 14th to 17th centuries.  According to Jean-Noël Biraben, the plague was present somewhere in Europe in every year between 1346 and 1671.  (Note that some researchers have cautions about the uncritical use of Biraben's data.  ) The second pandemic was particularly widespread in the following years: 1360–63 1374 1400 1438–39 1456–57 1464–66 1481–85 1500–03 1518–31 1544–48 1563–66 1573–88 1596–99 1602–11 1623–40 1644–54 and 1664–67. Subsequent outbreaks, though severe, marked the retreat from most of Europe (18th century) and northern Africa (19th century).  The historian George Sussman argued that the plague had not occurred in East Africa until the 1900s.  However, other sources suggest that the Second pandemic did indeed reach Sub-Saharan Africa. 
According to historian Geoffrey Parker, "France alone lost almost a million people to the plague in the epidemic of 1628–31."  In the first half of the 17th century, a plague claimed some 1.7 million victims in Italy.  More than 1.25 million deaths resulted from the extreme incidence of plague in 17th-century Spain. 
The Black Death ravaged much of the Islamic world.  Plague was present in at least one location in the Islamic world virtually every year between 1500 and 1850.  Plague repeatedly struck the cities of North Africa. Algiers lost 30,000–50,000 inhabitants to it in 1620–21, and again in 1654–57, 1665, 1691, and 1740–42.  Cairo suffered more than fifty plague epidemics within 150 years from the plague's first appearance, with the final outbreak of the second pandemic there in the 1840s.  Plague remained a major event in Ottoman society until the second quarter of the 19th century. Between 1701 and 1750, thirty-seven larger and smaller epidemics were recorded in Constantinople, and an additional thirty-one between 1751 and 1800.  Baghdad has suffered severely from visitations of the plague, and sometimes two-thirds of its population has been wiped out. 
Third plague pandemic
The third plague pandemic (1855–1859) started in China in the mid-19th century, spreading to all inhabited continents and killing 10 million people in India alone.  The investigation of the pathogen that caused the 19th-century plague was begun by teams of scientists who visited Hong Kong in 1894, among whom was the French-Swiss bacteriologist Alexandre Yersin, after whom the pathogen was named. 
Twelve plague outbreaks in Australia between 1900 and 1925 resulted in well over 1,000 deaths, chiefly in Sydney. This led to the establishment of a Public Health Department there which undertook some leading-edge research on plague transmission from rat fleas to humans via the bacillus Yersinia pestis. 
The first North American plague epidemic was the San Francisco plague of 1900–1904, followed by another outbreak in 1907–1908.   
Modern treatment methods include insecticides, the use of antibiotics, and a plague vaccine. It is feared that the plague bacterium could develop drug resistance and again become a major health threat. One case of a drug-resistant form of the bacterium was found in Madagascar in 1995.  A further outbreak in Madagascar was reported in November 2014.  In October 2017 the deadliest outbreak of the plague in modern times hit Madagascar, killing 170 people and infecting thousands. 
An estimate of the case fatality rate for the modern bubonic plague, following the introduction of antibiotics, is 11%, although it may be higher in underdeveloped regions. 
- A Journal of the Plague Year – 1722 book by Daniel Defoe describing the Great Plague of London of 1665–1666 – a 2010 action horror film set in medieval England in 1348 ("The Betrothed") – a plague novel by Alessandro Manzoni, set in Milan, and published in 1827 turned into an opera by Amilcare Ponchielli in 1856, and adapted for film in 1908, 1941, 1990, and 2004
- Cronaca fiorentina ("Chronicle of Florence") – a literary history of the plague, and of Florence up to 1386, by Baldassarre Bonaiuti
- Danse Macabre ("Dance of Death") – an artistic genre of allegory of the Late Middle Ages on the universality of death
- The Decameron – by Giovanni Boccaccio, finished in 1353. Tales told by a group of people sheltering from the Black Death in Florence. Numerous adaptations to other media have been made – a 1992 science fiction novel by Connie Willis
- A Feast in Time of Plague – a verse play by Aleksandr Pushkin (1830), made into an opera by César Cui in 1900 – a popular French legend supposed to provide immunity to the plague – Medieval "flagellant songs"
- "A Litany in Time of Plague" – a sonnet by Thomas Nashe which was part of his play Summer's Last Will and Testament (1592)
- The Plague – a 1947 novel by Albert Camus, often read as an allegory about Fascism
- The Seventh Seal – a 1957 film written and directed by Ingmar Bergman
- World Without End – a 2007 novel by Ken Follett, turned into a miniseries of the same name in 2012
- The Years of Rice and Salt – an alternative history novel by Kim Stanley Robinson set in a world in which the plague killed virtually all Europeans
- ^ Other names include Great Mortality (Latin: magna mortalitas, lit.'Great Death', common in the 14th century), atra mors, 'black death', the Great Plague, the Great Bubonic Plague or the Black Plague.
- ^ Declining temperatures following the end of the Medieval Warm Period added to the crisis
- ^ He was able to adopt the epidemiology of the bubonic plague for the Black Death for the second edition in 1908, implicating rats and fleas in the process, and his interpretation was widely accepted for other ancient and medieval epidemics, such as the Plague of Justinian that was prevalent in the Eastern Roman Empire from 541 to 700 CE. 
- ^ In 1998, Drancourt et al. reported the detection of Y. pestis DNA in human dental pulp from a medieval grave.  Another team led by Tom Gilbert cast doubt on this identification  and the techniques employed, stating that this method "does not allow us to confirm the identification of Y. pestis as the aetiological agent of the Black Death and subsequent plagues. In addition, the utility of the published tooth-based ancient DNA technique used to diagnose fatal bacteraemias in historical epidemics still awaits independent corroboration".
- ^ However, other researchers do not think that plague ever became endemic in Europe or its rat population. The disease repeatedly wiped out the rodent carriers, so that the fleas died out until a new outbreak from Central Asia repeated the process. The outbreaks have been shown to occur roughly 15 years after a warmer and wetter period in areas where plague is endemic in other species, such as gerbils. 
- ^ The only medical detail that is questionable in Boccaccio's description is that the gavocciolo was an "infallible token of approaching death", as, if the bubo discharges, recovery is possible. 
- ^ According to medieval historian Philip Daileader,
The trend of recent research is pointing to a figure more like 45–50% of the European population dying during a four-year period. There is a fair amount of geographic variation. In Mediterranean Europe, areas such as Italy, the south of France and Spain, where plague ran for about four years consecutively, it was probably closer to 75–80% of the population. In Germany and England . it was probably closer to 20%. 
Detailed study of the mortality data available points to two conspicuous features in relation to the mortality caused by the Black Death: namely the extreme level of mortality caused by the Black Death, and the remarkable similarity or consistency of the level of mortality, from Spain in southern Europe to England in north-western Europe. The data is sufficiently widespread and numerous to make it likely that the Black Death swept away around 60% of Europe's population. The generally assumed population of Europe at the time is about 80 million, implying that around 50 million people died in the Black Death.