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Black Death

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Lisa Wolfe
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« on: June 24, 2012, 05:55:26 pm »

Black Death

The Black Death was one of the most devastating pandemics in human history, peaking in Europe between 1348 and 1350. Although there were several competing theories as to the etiology of the Black Death, it has been conclusively proven via analysis of ancient DNA from plague victims in northern and southern Europe that the pathogen responsible is the Yersinia pestis bacterium.[1] Thought to have started in China or central Asia,[2] it travelled along the Silk Road and reached the Crimea by 1346.

From there it was probably carried by Oriental rat fleas living on the black rats that were regular passengers on merchant ships. It spread throughout the Mediterranean and Europe. The Black Death is estimated to have killed 3060 percent of Europe's population,[3] reducing world population from an estimated 450 million to between 350 and 375 million in the 14th century. The aftermath of the plague created a series of religious, social and economic upheavals, which had profound effects on the course of European history. It took 150 years for Europe's population to recover. The plague occasionally reoccurred in Europe until the 19th century.
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« Reply #1 on: June 24, 2012, 05:56:32 pm »



Miniatur aus der Toggenburg-Bibel (Schweiz) von 1411. ( Die Krankheit wird allgemein für Pest gehalten. Die Lage der Beulen oder Blasen deuten aber eher auf Pocken hin. ) Translation: Miniature out of the Toggenburg Bible (Switzerland) of 1411th (the illness is considered generally to be the plague. The situation of the bump or bubbles point however sooner at pock there.) The disease is widely believed to be the plague. The location of bumps or blisters, however, is more consistent with smallpox (as the bubonic plague normally causes them only in the groin and in the armpits). This image is generally interpreted as a depiction of the plague - "the Black Death".
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« Reply #2 on: June 24, 2012, 05:57:21 pm »



This image is the Dance of Death in the German printed edition, folio CCLXI recto from Hartman Schedel's Chronicle of the World (Nuremberg, 1493) thought to be created by Michael Wolgemut (b. 1434, Nürnberg, d. 1519, Nürnberg). There was also a Latin printed edition of the same year. It seems not to be by Hans Holbein the Younger, as often stated. He was not alive at the time of its publication in 1493.
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« Reply #3 on: June 24, 2012, 05:57:46 pm »

There have been three major outbreaks of plague. The Plague of Justinian in the 6th and 7th centuries is the first known attack on record, and marks the first firmly recorded pattern of bubonic plague. From historical descriptions, as much as 40 percent of the population of Constantinople died from the plague. Modern estimates suggest half of Europe's population was wiped out before the plague disappeared in the 700s.[4] After 750, major epidemic diseases did not appear again in Europe until the Black Death of the 14th century.[5] The Third Pandemic hit China in the 1890s and devastated India but was confined to limited outbreaks in the west.[6]

The Black Death originated in or near China and spread by way of the Silk Road or by ship.[6] It may have reduced world population from an estimated 450 million to between 350 and 375 million in 1400.[7]
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« Reply #4 on: June 24, 2012, 05:58:06 pm »

The plague is thought to have returned at intervals with varying virulence and mortality until the 18th century.[8] On its return in 1603, for example, the plague killed 38,000 Londoners.[9] Other notable 17th-century outbreaks were the Italian Plague (1629–1631), the Great Plague of Seville (1647–1652), the Great Plague of London (1665–1666),[10] and the Great Plague of Vienna (1679). There is some controversy over the identity of the disease, but in its virulent form, after the Great Plague of Marseille in 1720–1722,[11] the Great Plague of 1738 (which hit Eastern Europe), and the Russian plague of 1770-1772, it seems to have gradually disappeared from Europe. By the early 19th century, the threat of plague had diminished, but it was quickly replaced by a new disease. The Asiatic cholera was the first of several cholera pandemics to sweep through Asia and Europe during the 19th and 20th centuries.[12]

The 14th century eruption of the Black Death had a drastic effect on Europe's population, irrevocably changing the social structure. It was, arguably, a serious blow to the Catholic Church, and resulted in widespread persecution of minorities such as Jews, foreigners, beggars, and lepers. The uncertainty of daily survival has been seen as creating a general mood of morbidity, influencing people to "live for the moment", as illustrated by Giovanni Boccaccio in The Decameron (1353).[13]
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« Reply #5 on: June 24, 2012, 05:58:52 pm »

Naming

Medieval people called the catastrophe of the 14th century either the "Great Pestilence"' or the "Great Plague".[14] Writers contemporary to the plague referred to the event as the "Great Mortality". Swedish and Danish chronicles of the 16th century described the events as "black" for the first time, not to describe the late-stage sign of the disease, in which the sufferer's skin would blacken due to subepidermal hemorrhages and the extremities would darken with a form of gangrene, acral necrosis, but more likely to refer to black in the sense of glum or dreadful and to denote the terror and gloom of the events.[15] The German physician and medical writer Justus Hecker suggested that a mistranslation of the Latin atra mors (terrible, or black, death) had occurred in Scandinavia when he described the catastrophe in 1832[14] in his publication "Der schwarze Tod im vierzehnten Jahrhundert". The work was translated into English the following year, and with the cholera epidemic happening at that time, "The Black Death in the 14th century" gained widespread attention and the terms Schwarzer Tod and Black Death became more widely used in the German and English speaking worlds, respectively
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« Reply #6 on: June 24, 2012, 05:59:28 pm »

Populations in crisis

In Europe, the Medieval Warm Period ended some time towards the end of the 13th century, bringing the "Little Ice Age"[16] and harsher winters with reduced harvests. In northern Europe, new technological innovations such as the heavy plough and the three-field system were not as effective in clearing new fields for harvest as they were in the Mediterranean because the north had poor clay soil,[14] and the potato, otherwise ideal for Northern Europe, was an American crop unknown in Europe at the time. Food shortages and rapidly inflating prices were a fact of life for as much as a century before the plague. Wheat, oats, hay and consequently livestock were all in short supply. Their scarcity resulted in malnutrition, which increases susceptibility to infections due to weakened immunity. Consistently high fertility rates, at five or more children per woman throughout Europe, resulted in high population growth rates and contributed to food shortages. In the autumn of 1314, heavy rains began to fall, followed by several years of cold and wet winters.[14] The already weak harvests of the north suffered and the seven-year famine ensued. In the years 1315 to 1317 a catastrophic famine, known as the Great Famine, struck much of northwest Europe. It was arguably the worst in European history, reducing the population by perhaps more than 10 percent.[14]
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« Reply #7 on: June 24, 2012, 06:00:23 pm »



Black Death strikes Europe: 1347-1353
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« Reply #8 on: June 24, 2012, 06:00:51 pm »

Infection and migration

The plague disease, generally thought to be caused by Yersinia pestis, is enzootic (commonly present) in populations of fleas carried by ground rodents, including marmots, in various areas including Central Asia, Kurdistan, Western Asia, Northern India and Uganda.[17] Nestorian graves dating to 1338–9 near Lake Issyk Kul in Kyrgizstan have inscriptions referring to plague and are thought by many epidemiologists to mark the outbreak of the epidemic, from which they could easily have spread to China and India.[18] In October 2010, medical geneticists confirmed that the plague originated in Yunnan, province in southwest China.[6] In China, the 13th century Mongol conquest caused a decline in farming and trading. However, economic recovery had been observed in the beginning of the 14th century. In the 1330s a high frequency of natural disasters and plagues led to widespread famine starting in 1331, with a deadly plague arriving soon after.[19] The 14th-century plague killed an estimated 25 million Chinese and other Asians during the 15 years before it entered Constantinople in 1347.[20] However, according to George Sussman, the first obvious medical description of plague in China dates to 1644.[21]

The disease may have travelled along the Silk Road with Mongol armies and traders or it could have come via ship.[22] By the end of 1346 reports of plague had reached the seaports of Europe: "India was depopulated, Tartary, Mesopotamia, Syria, Armenia were covered with dead bodies".[23]

Plague was reportedly first introduced to Europe at the trading city of Caffa in the Crimea in 1347. After a protracted siege, during which the Mongol army under Jani Beg was suffering the disease, they catapulted the infected corpses over the city walls to infect the inhabitants. The Genoese traders fled, taking the plague by ship into Sicily and the south of Europe, whence it spread north.[24] Whether or not this hypothesis is accurate, it is clear that several existing conditions such as war, famine, and weather contributed to the severity of the Black Death.
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« Reply #9 on: June 24, 2012, 06:01:08 pm »

European outbreak
'The seventh year after it began, it came to England and first began in the towns and ports joining on the seacoasts, in Dorsetshire, where, as in other counties, it made the country quite void of inhabitants so that there were almost none left alive.

... 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.' (Geoffrey the Baker, Chronicon Angliae)

There appear to have been several introductions into Europe. It reached Sicily in October 1347 carried by twelve Genoese galleys,[25] where it rapidly spread all over the island. Galleys from Caffa reached Genoa and Venice in January 1348 but it was the outbreak in Pisa a few weeks later that was the entry point to northern Italy. Towards the end of January one of the galleys expelled from Italy arrived in Marseille.[26]

From Italy the disease spread northwest across Europe, striking France, Spain, Portugal and England by June 1348, then turned and spread east through Germany and Scandinavia from 1348 to 1350. It was introduced in Norway in 1349 when a ship landed at Askøy, then spread to Bjørgvin (modern Bergen) but never reached Iceland.[27] Finally it spread to northwestern Russia in 1351. The plague spared some parts of Europe, including the Kingdom of Poland and isolated parts of Belgium and the Netherlands.[citation needed]
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« Reply #10 on: June 24, 2012, 06:01:23 pm »

Middle Eastern outbreak

The plague struck various countries in the Middle East during the pandemic, leading to serious depopulation and permanent change in both economic and social structures. As it spread to western Europe, the disease also entered the region from southern Russia. By autumn 1347, the plague reached Alexandria in Egypt, probably through the port's trade with Constantinople, and ports on the Black Sea. During 1347, the disease travelled eastward to Gaza, and north along the eastern coast to cities in Lebanon, Syria and Palestine, including Ashkelon, Acre, Jerusalem, Sidon, Damascus, Homs, and Aleppo. In 1348–49, the disease reached Antioch. The city's residents fled to the north, most of them dying during the journey, but the infection had been spread to the people of Asia Minor.

Mecca became infected in 1349. During the same year, records show the city of Mawsil (Mosul) suffered a massive epidemic, and the city of Baghdad experienced a second round of the disease. In 1351, Yemen experienced an outbreak of the plague. This coincided with the return of King Mujahid of Yemen from imprisonment in Cairo. His party may have brought the disease with them from Egypt.
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« Reply #11 on: June 24, 2012, 06:01:56 pm »

Symptoms


Contemporary accounts of the plague are often varied or imprecise. The most commonly noted symptom was the appearance of buboes (or gavocciolos) in the groin, the neck and armpits, which oozed pus and bled when opened.[28] Boccaccio's description is graphic:

    "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."[29]

Ziegler comments that the only medical detail that is questionable is the infallibility of approaching death, as if the bubo discharges, recovery is possible.[30]

This was followed by acute fever and vomiting of blood. Most victims died within two to seven days after infection. David Herlihy identifies another potential sign of the plague: freckle-like spots and rashes[31] which could be the result of flea-bites.

Some accounts, like that of Louis Heyligen, a musician in Avignon who died of the plague in 1348, noted a distinct form of the disease which infected the lungs and led to respiratory problems[28] and which is identified with pneumonic plague.

    "It is said that the plague takes three forms. In the first people suffer an infection of the lungs, which leads to breathing difficulties. Whoever has this corruption or contamination to any extent cannot escape but will die within two days. Another form...in which boils erupt under the armpits,...a third form in which people of both sexes are attacked in the groin."[32]
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« Reply #12 on: June 24, 2012, 06:02:30 pm »



Right hand of a plague patient displaying acral gangrene. Gangrene is one of the manifestations of plague.
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« Reply #13 on: June 24, 2012, 06:03:05 pm »



Swollen lymph nodes termed "buboes" caused by plague bacteria (bubonic plague).
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« Reply #14 on: June 24, 2012, 06:03:52 pm »

Causes

Medical knowledge had stagnated during the Middle Ages. The most authoritative account at the time came from the medical faculty in Paris in a report to the king of France that blamed the heavens, in the form of a conjunction of three planets in 1345 that caused a "great pestilence in the air".[34] This report became the first and most widely circulated of a series of "plague tracts" that sought to give advice to sufferers. That the plague was caused by bad air became the most widely accepted theory. The word plague had no special significance at this time, and only the recurrence of outbreaks during the Middle Ages gave it the name that has become the medical term.

The importance of hygiene was recognised only in the nineteenth century; until then it was common that the streets were filthy, with live animals of all sorts around and human parasites abounding. A transmissible disease will spread easily in such conditions. One development as a result of the Black Death was the establishment of the idea of quarantine in Dubrovnik in 1377 after continuing outbreaks.[35]

The dominant explanation for the Black Death is the plague theory, which attributes the outbreak to Yersinia pestis, also responsible for an epidemic that began in southern China in 1865, eventually spreading to India. The investigation of the pathogen that caused the 19th-century plague was begun by teams of scientists who visited Hong Kong in 1894, among whom was Alexandre Yersin, after whom the pathogen was named Yersinia pestis.[36] The mechanism by which Y. pestis was usually transmitted was established in 1898 by Paul-Louis Simond and was found to involve the bites of fleas whose midguts had become obstructed by replicating Y. pestis several days after feeding on an infected host. This blockage results in starvation and aggressive feeding behaviour by the fleas, which repeatedly attempt to clear their blockage by regurgitation, resulting in thousands of plague bacteria being flushed into the feeding site, infecting the host. The bubonic plague mechanism was also dependent on two populations of rodents: one resistant to the disease, which act as hosts, keeping the disease endemic, and a second that lack resistance. When the second population dies, the fleas move on to other hosts, including people, thus creating a human epidemic.[36]

The historian Francis Aidan Gasquet, who had written about the 'Great Pestilence' in 1893[37] and suggested that "it would appear to be some form of the ordinary Eastern or bubonic plague" was able to adopt the epidemiology of the bubonic plague for the Black Death for the second edition in 1908, implicating rats and fleas in the process, and his interpretation was widely accepted for other ancient and medieval epidemics, such as the Justinian plague that was prevalent in the Eastern Roman Empire from 541 to 700 AD.[36]

More recently other forms of plague have been implicated. The modern bubonic plague has a mortality rate of 30 to 75 percent and symptoms including fever of 38–41 °C (101–105 °F), headaches, painful, aching joints, nausea and vomiting, and a general feeling of malaise. If untreated, of those that contract the bubonic plague, 80 percent die within eight days.[38] Pneumonic plague has mortality rate of 90 to 95 percent. Symptoms include fever, cough, and blood-tinged sputum. As the disease progresses, sputum becomes free flowing and bright red. Septicemic plague is the least common of the three forms, with a mortality rate close to 100 percent. Symptoms are high fevers and purple skin patches (purpura due to disseminated intravascular coagulation). In cases of pneumonic and particularly septicemic plague the progress of the disease is so rapid that there would often be no time for the development of the enlarged lymph nodes that were noted as buboes.[39]

"Many modern scholars accept that the lethality of the Black Death stemmed from the combination of bubonic and pneumonic plague with other diseases and warn that every historical mention of 'pest' was not necessarily bubonic plague...In her study of 15th Century outbreaks, Ann Carmichael states that worms, the pox, fevers and dysentery clearly accompanied bubonic plague."[40]
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