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The Black Plague of 1348. Any connection to SARS and Coronavirus?

Prior to 1347, there had been plague in Eur­ope, but its effects were geographically limited. Peasants worked for noble landlords in exchange for prot­ection and use of land i.e a feudalist sys­tem. Thus most peasants were impover­ish­ed serfs who never travelled.

Catholicism was all-powerful in Europe. Dying the good death was the ideal situation for any Christian; a prolonged sickness, or advancing old age, would give an individual time to consider his sins, confess and repent. But what if disease was sudden and unexp­ected? Clerics were the only Church-approved medical prac­tit­ion­ers, so many Catholics relied on the Church for healing.

Before the Crusades began in 1095, Europeans rarely travelled to the Near East. Then the trade increased, population grew, commun­ities urban­ised, living conditions became unsanitary and health care failed. Once Eastern commodities were rediscovered, an increased desire for new trade routes to Asia was ignited. Trade between con­t­inents became more common and then expanded again in the C13th, increasing urbanisation and dense living conditions.

Thus Europe’s population outpaced the development of its resour­ces. Infrast­ruc­t­ure like sewers crumbled, result­ing in people sharing water sources and in waste running through streets. People inter­act­ed with disease carriers like rats.

Gilles Li Muisis, 1272-1352. 
The burial of the victims of the Black Death,
Tournai Bibliothèque royale de Belgique

The Great European Famine of 1315-17 caused by the popul­ation increases and crop failures, led to the deaths of c10% of the pop­ulation. In the 1330s, central Asian kingdoms suffered terrible plagues while exp­loring new trade routes. In 1346 plague-ridden Tatar Mongols assailed trading centres on the Crimean peninsula, populated primarily by European traders; those traders in turn spread the plague when the victims fled back to Europe. The war­time conditions during the Hundred Years’ War of 1337­-1453 between Eng­land and France caused chaos; sold­iers caught the disease in battle and spread it on returning home.

In early 1347, the Black Death spread via land-based trade routes to eastern Europe and via sea-based trade routes to Medit­erranean nations. In late 1347, following its spread to Sicily, Greece and Cons­t­antinople, the plague spread to Scandin­avia. Trade declined and the social order collapsed.

In the decades after the pandemic, Europe experienced significant economic, social and religious changes. The first economic change was the shift in the value of land and goods. Many workers had died, creating difficulties for land owners; it was more difficult to produce goods and to obtain goods through trade. Both caused an inflation in prices for goods, just as land val­ues deflated.

When the labour supply plummeted, the peasants could demand slightly higher wages. How ironic that the pandemic inspired peasants’ ex­ploration of revolutionary ideas and the creation of Poor Laws. Peasant rebellions started in France in 1358 and in Italy in 1378. Wat Tyler's Rebellion in England took place in 1381.

Pieter Bruegel the Elder, c1562
The Triumph of Death, 117 x 162 cm
Prado Madrid

There was a growing mistrust of the weakened Catholic Church. The Church lost many clergy members during the pandemic and without their spiritual help, people needed medical support from diff­erent sources. People questioned why they were not saved from God’s punishment, even though they’d been good Catholics.

People quickly realised the inevitability of death. Art started to show death’s grim influence eg Triumph of Death by Piet­er Bruegel. Artists coped with the devast­at­ion by creating a new dark genre: the Dance of Death. The possibility of sudden, miserable death evoked a hysterical de­s­ire for human activity, while they could. The Dance of Death was like the mediaeval mystery plays, strongly advising people to always be prepared for death.

Death and his infected victims moved in groups, dancing as their bodies twitched with spasms. People who engaged in this activity were in a frenzied trance! In fact the people afflicted by this obsession could die of exhaustion or hunger. The survivors could fall into a state of permanent mental illness and tremors. More about a specific death dance in a later post.

Medical practice improved after the pandemic. While medical pract­ice was still outlawed from non-Church staff, more people turned to independent practitioners. Plus many European governments created efficient public health protocols. Early forms of quarant­ine were developed and infected ships had to wait in the harbour.

The physicians were unable to treat the plague, so the impact of the Black Death on the medical profession was largely after the plague ended. Having revealed the shortcomings of the existing medical system in Europe, the top medical pract­itioners had to focus on theories of causation and prevention of disease. Physicians had to both develop treatments for the plague and take measures to secure their status by pushing for the regulation of medical practices. The Black Death did not completely destroy the existing medical system. Education based on the works of Hippocrates and Galen survived in the univ­er­sities, however the teaching of surgery and anatomy were gradually included as well. Thus the Black Death helped shape medieval medicine's course of development.

The Orchestra of the Dead, 1493
woodcut by Michael Wolgemu

Europe’s population outpaced the development of its resour­ces in the C14th. Infrast­ruc­t­ure like sewers crumbled, result­ing in people sharing water sources and in waste running through streets. At least the peasants who survived the plague were able to get better wages & working conditions! So while the Black Death was a catastrophe, the shattered feudal system, winding down of serfdom, more sophist­icated medicine and a better economic system.. all cont­rib­uted to an improvement in European life in the long run.

But what can we learn from the Black Death about the transmission of plagues, quarantine and treatment of C20thinfections. SARS (2003 from China), MERS (2012 from Saudi Arabia) and Coronavirus (2020 from China) are viruses and not bacteria, as the Black Plague was. But the speed of aeroplanes these days makes world travel an even more critical issue. 

Tongji Hospital Wuhan, 2020  
inundated with people waiting for testing kits, and confirmed cases.


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