HEALTH & MEDICINE: The Black Death

Section Author: Adrianna Bakos, University of the Fraser Valley


Learning Objectives

  • Describe the symptoms, modes of transmission, and impact of the disease on Europe
  • Evaluate the varied individual and communal responses to the epidemic
  • Articulate some of the short- and long-term consequences of the Black Death
  • Summarize historiographical debates about the nature of the Black Death

The Black Death stalked Europe pitilessly between 1347 and 1353. The epidemic took a devastating toll; historians estimate that between 30 and 60 percent of the European population died in that six-year window. In some cases, whole communities were extinguished in a matter of months. Arguably the emotional toll was even greater than the demographic one. In the introduction to his Decameron, Florentine author Giovanni Boccaccio lamented, “for their terror was such, that a brother even fled from his brother, a wife from her husband, and (what is more uncommon) a parent from its own child.” The bonds of family and fellowship could not withstand the corrosive effect of the contagion. No wonder then that more than one observer expressed communal existential dread – would humanity survive this last, greatest punishment from a disappointed God?

The epidemic of the mid-14th century was not called the Black Death by contemporaries on account of the black, necrotizing flesh of the victims. Rather, this was a term later chroniclers applied to it to capture the depth of crisis and despair into which Europe had fallen at that time. People living through the trauma generally called it the Great Mortality or La peste. Part of the horror for contemporaries was not knowing where the disease came from or how it was transmitted.

A tomb full of human skeletons
Figure 4.1 A plague pit in Lyon, France containing numerous victims of the Black Death



Much modern scholarship has been devoted to the determination of which pathogen caused this devastating epidemic. It was during the course of the third (and last) significant outbreak of plague at the end of the 19th century, that French physician and bacteriologist Alexandre Yersin identified the specific pathogen which causes plague; in recognition of his discovery, the bacterium was later named Yersinia pestis. For many years there was no scholarly consensus that the bacterium Yersin discovered was, in fact, responsible for the epidemic in the 14th century. In large measure this was due to the fact that there is no contemporary evidence of rats and other small animals dying off in large numbers, which is assumed by historical epidemiologists to be a necessary precondition for the transfer of fleas (the primary disease vector) to human hosts. Over the years other diseases such as anthrax and ebola have been bruited as the possible cause, but advancements in DNA technology in the last two decades have allowed researchers to extract material from corpses dumped in plague pits across Europe, all of which points to a definitive determination that Yersinia pestis is the culprit. Recent research has demonstrated through computer modelling that human to human transmission, via human lice and fleas, was a more likely transmission route, explaining the lack of an accompanying rat die-off.[1]

There is general consensus that the disease originated in the Gobi desert region, where the plague bacterium is found enzootically[2] within resident rodent populations. Historians speculate that at some point early in the 14th century, a climatic shift or some other ecological event drove small animal populations out of the desert and into contact with rodents living in closer contact with humans. The disease then travelled in tandem with trading caravans on the Silk Road; some of the first evidence of mortality associated with the outbreak can be found on gravestones in Issyk Kul (in modern day Kyrgystan), dating from the 1330s. Sometime in 1346, the disease arrived in Caffa, a trading port on the shores of the Black Sea controlled by the Italian city-state of Genoa. At that time, the Genoese were engaged in conflict with the Golden Horde. Ever since, an apocryphal story has circulated that the disease entered the fortified city by means of corpses catapulted over the walls by the besieging and infected army.[3]By whatever means the infection entered Caffa, from thence it was carried by boat to a number of ports in the Mediterranean, including Marseilles, Venice and Split. Over the course of the next four years, the plague would travel in a roughly clockwise direction across Europe, generally following well-established trade routes. Very few communities were spared the devastating visitation, although a few fortunate towns such as Milan and Liège were inexplicably immune.

Listen to the Black Death from the BBC program “In Our Time,” for more information

Questions for Consideration

  1. Was the Black Death a “turning point” in European history? Is this the event which separates the medieval from the modern worlds?
  2. Have historians overemphasized the short- and long-term impact of the epidemic?
  3. What do the coping strategies of individuals and communities reveal about the mental world of Europeans in the 14th century?

Media Attributions

  1. Katharine R. Dean, Fabienne Krauer, Lars Walløe, Ole Christian Lingjærde, Barbara Bramanti, Nils Chr. Stenseth, Boris V. Schmid, “Human Ectoparasites and the Spread of Plague in Europe during the Second Pandemic,” Proceedings of the National Academy of Sciences 115, no. 6 (February 2018): 1304-09.
  2. The terms “enzootic” and “endemic” refer to diseases which regularly recur and/or exist in balanced state within animal and human populations, respectively. “Epizootic” and “epidemic” diseases are those which break out intermittently and with virulence.
  3. While many have dismissed the notion the Genoese in Caffa were infected via what has been characterized as the known example of biological warfare, in recent years, the story has been endorsed by the Centers for Disease Control. See Mark Wheelis, “Biological Warfare at the 1346 Siege of Caffa,” Historical Review 8, no. 9 (2002): 971-75.


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The Ancient and Medieval World Copyright © by Adrianna Bakos; Barrie Brill; Niall Christie; Jessica Hemming; Aleksandar Jovanović; and Tracey J. Kinney is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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