Consider a world in which over the next three months, between 30-50% of the people around you have died of a horrible disease, full of fever and boils, often vomiting blood. What would that be like?
As regular readers will know, from time to time I take a historical topic which I may have heard of, but only have a superficial knowledge, research it and lay the results of my researches before readers of this blog – with our learned editor’s permission. I do not know why. Sometimes I do it for relaxation when I am a bit stressed. Sometimes Raccoon Readers provide their own and learned additional insights.
Last week I decided to investigate The Black Death. It was a disease which wrought havoc in Europe for more than 300 years. In its earliest and most vicious incarnation it killed up to 50% of the population of Europe in a couple of years, perhaps 20 or more million men, women and children. I knew, or I thought I knew, that it was spread by rats and their fleas. I assumed I could provide some salacious and morbidly interesting delicacies with which to titillate the reader. So I bought a couple of books, one being the excellent “The Black Death” by Philip Zieglar (History Press, first published in 1969), donned my notional “Indiana Jones” hat, and headed for the internet. What I did not expect was to discover that most of what I had been told about the disease was probably wrong, and a detective story which would lead to the cutting edge of genetics and the battle against AIDS.
Our editor cautions me about banging on for too long in one piece, so I will write this piece in two parts, beginning with setting out what broadly happened.
In the early 1300’s, possibly about 1320, something very, very nasty awoke on the central steppes of Asia, perhaps in the Gobi desert. Whether there was a draught, an earthquake which caused something to be uncovered which should have been left alone, or a random genetic mutation of a previously harmless bacillus is unknown, and perhaps unknowable. But something happened, something was born or mutated, and people began to die. The Mongol Empire had unified and organised much of the Asiatic word, and opened up trade routes. Following these, inexorably, the terrible disease began to spread through Asia, as well as west.
It must be remembered that this was not a merely European phenomenon. In China, for example, the population dropped from around 125 million to 90 million over the course of the 14th Century.
India was devastated. Mesopotamia, Syria, Armenia, Caramania were struck down. More millions died. Although communications with Asia were poor, rumours began to reach Europe of some strange and horrific catastrophe or nemesis. Tales of fiery rain and an evil noxious mist or cloud that was ravaging the East began to be reported back.
By 1345 the pestilence was on the lower Volga River. By 1346 it was in the Caucasus and in Constantinople. In the same year It hit Alexandria. A thousand people a day were dying there. In Cairo the count was seven times that.
The contemporary Italian writer Gabriel de Mussis records that the plague settled in the Tartar lands of Asia Minor in 1346.
Crimea was an important interface between the Asiatic East and the trading powers of Genoa and Venice, and other Italian city states. At some time in early 1347 in a trading outpost there was a street fight between some Genoese merchants and the local Tartar. This got out of hand, and the Tartars chased the merchants back to their fortified base at Caffa. There the Tartars gathered an army and besieged the Genoese merchants. But as the Tartars waited, they fell sick and began to die. A fearful sickness swept through their camp, decimating them so that the survivors were forced to flee. According to legend, before they left they gave the besieged Genoese a parting gift. The scooped up the rotting bodies of the dead and used their siege catapults to fire them in great numbers over the walls of the fortress, poisoning the air and the water supply in what may have been the world’s first act of calculated germ warfare.
It may be the story of flinging the dead over the walls is apocryphal. Be that as it may, the Genoese fled in their ships, heading for the “safety” of the Italian peninsular. What happened next is most assuredly not apocryphal. The ships headed for the port of Messina, on Sicily. When they arrived, the locals found them full of corpses and dying sailors. This is a contemporary account:
“At the beginning of October, in the year of the incarnation of the Son of God 1347, twelve Genoese galleys . . . entered the harbor of Messina. In their bones they bore so virulent a disease that anyone who only spoke to them was seized by a mortal illness and in no manner could evade death. The infection spread to everyone who had any contact with the diseased. Those infected felt themselves penetrated by a pain throughout their whole bodies and, so to say, undermined. Then there developed on the thighs or upper arms a boil about the size of a lentil which the people called “burn boil”. This infected the whole body, and penetrated it so that the patient violently vomited blood. This vomiting of blood continued without intermission for three days, there being no means of healing it, and then the patient expired.”
This description may be very important in understanding what the disease was or was not, for reasons I will explain on another occasion. It continues:
“Not only all those who had speech with them died, but also those who had touched or used any of their things. When the inhabitants of Messina discovered that this sudden death emanated from the Genoese ships they hurriedly ordered them out of the harbor and town. But the evil remained and caused a fearful outbreak of death. Soon men hated each other so much that if a son was attacked by the disease his father would not tend him. If, in spite of all, he dared to approach him, he was immediately infected and was bound to die within three days. Nor was this all; all those dwelling in the same house with him, even the cats and other domestic animals, followed him in death. As the number of deaths increased in Messina many desired to confess their sins to the priests and to draw up their last will and testament. But ecclesiastics, lawyers and notaries refused to enter the houses of the diseased.”
Understandably, the terrified citizens of Messina fled the town and dispersed across Sicily. But they took the pestilence with them. Whole towns and villages were wiped out. By the new year the pestilence had reached the Italian mainland.
In Sienna, a local merchant, shoe maker and sometime public official called Agnolo di Tura kept a diary of what was going on. He recorded this:
“The mortality in Siena began in May. It was a cruel and horrible thing. . . . It seemed that almost everyone became stupefied seeing the pain. It is impossible for the human tongue to recount the awful truth. Indeed, one who did not see such horribleness can be called blessed. The victims died almost immediately. They would swell beneath the armpits and in the groin, and fall over while talking. Father abandoned child, wife husband, one brother another; for this illness seemed to strike through breath and sight. And so they died. 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. In many places in Siena great pits were dug and piled deep with the multitude of dead. And they died by the hundreds, both day and night, and all were thrown in those ditches and covered with earth. And as soon as those ditches were filled, more were dug. I, Agnolo di Tura . . . buried my five children with my own hands. . . . And so many died that all believed it was the end of the world.”
Again, there is something extraordinary interesting, as well as sad, about what Agnolo writes. It actually struck me when I first heard his account and before I did some more research. He buried all five of his children. But why did he survive unscathed? In fact, this has curious parallels with the events which were to take place in the sleepy Derbyshire village of Eyam, more than 200 years later. Elizabeth Hancock, beloved wife and mother, buried her six children and husband in the space of less than a month. And yet she remained unscathed. Again, how and why? Luck? Or something more much more significant?
But I digress. The pestilence now raged across Italy and into the rest of Europe. In Venice, 90,000 died. In Marseille, half the population within two or three months. In Avignon 11, 000 were buried in six weeks.
In Florence, 75% of the population died. One of the citizens of Florence was a writer and philosopher called Giovanni Boccaccio. He was to go on to write a book of morality tales based on the pestilence called “The Decamaron”. The book was widely circulated and contained what became one of the best known (though possibly misleading!) descriptions of the symptoms of the disease:
“The first signs of the plague were swelling in the groin or armpits. These bulges ranged between the size of an apple and an egg. They were called gavoccioli. Soon after contracting the plague the gavoccioli would spread over the whole body. The next stage of the disease was black or livid spots on the arms and thighs, spreading over the rest of the body in a short time. Nothing could be done, most died within three days, only a few were ever cured. The pestilence passed from the sick to the healthy, being around a sick person in any way including touching their clothing could make you sick. I (the narrator) saw it with my own eyes. Animals even died from the pestilence.”
The pestilence moved with incredible speed for a world without cars, trains or aeroplanes. In less than a year it had devoured and traversed Europe. By the summer of 1348 it had reached the coast of France.
There are quite a few places that claim the “honour” of being the first place in England to welcome the infection. Bristol is one candidate, but there are others. A Grey Friar wrote this:
“In this year 1348, in Melcombe, in the county of Dorset, a little before the Feast of St John the Baptist, two ships, one of them from Bristol, came along side. One of the sailors had brought with him from Gascony the seeds of terrible pestilence and, through him, the men of the town of Melcombe were the first to be infected”.
Such was the virulence of the pestilence, it does not matter where it landed first. It was inexorable.
By November it was in London, and the carnage was appalling. Death pits such as those that have been excavated at East Smithfield were filled with thousands of bodies. Between one third and one half of the population of died within six months. One skeleton now in the British museum is a sad and grisly indication of how great the chaos was. It is the upper portion of a woman. There is nothing below the rib cage, but no sign of violence. The reasonable hypothesis is that her corpse had rotted for so long that when she came to be picked up, the body literally fell apart. The authorities were struggling to cope with “King Death”.
Throughout 1349 the plague raged throughout the rest of England, and then carried on through Scotland and up to the Baltic. It was then to seemingly vanish, only to re appear a few years later and crop up sporadically for the next 300 years.
What was the cause of this pestilence? Does it still exist, or is there a modern counterpart? How did it spread? Why was it so virulent?
From about 1860 a plague began to spread across South East Asia. In 1894 it arrived in Hong Kong. The symptoms included raging fever, coughing, and the eruption of swollen lymph nodes in the groin, armpits and neck – so called “buboes” – delirium, and death within a few days.
A brilliant young Swiss scientist called Alexander Yersin was determined to identify the cause of the plague, even though the British authorities resented it and tried to stop him. Illegally, he obtained access to the dead and started dissecting the buboes on the still rotting bodies. He discovered that the cause of the infection was the so called “Yersinia Pestis” or “Y Pestis” bacterium. It plainly attacked the lymph nodes (which are the body’s control centre for fighting infection, causing the swelling or “buboes”). The cause of so called “Bubonic” Plague, if not the means of abating it, had been explained.
But the mechanism of infection still remained unexplained. By 1898 the Plague had reached India. No one could stem it because the mechanism of infection was unknown. In Karachi, one of Yersin’s students called Paul-Louise Simond noticed the numbers of rats dying in the street. He also noticed flea bites on the bodies of the afflicted. He sensed a connection, and discovered that the Y Pestis bacterium could be found in the stomach’s of the rat fleas. He then risked his own life by catching a plague infected rat and conducting an experiment which proved that infected rats spread the plague. When the rats died, the fleas sought a new home and something new to eat. If that had to be a human, so be it. In the rat flea, the bacterium multiplies in the flea’s stomach causing congestion. When the flea wants to feed it regurgitates the stomach contents into the host’s blood stream, and the bacillus is passed on with fatal results.
At the time the scientific press was quick to draw a correlation between Bubonic Plague and the Black Death, and ever since it has been assumed that the cause of the epidemic – and the Black Death – is explained in the form of Bubonic Plague. In fact, there are at least three forms of Plague.
Bubonic Plague itself. Due to its bite-based form of infection, the bubonic plague is often the first step of a progressive series of illnesses. Bubonic plague symptoms appear suddenly, usually 2–5 days after exposure to the bacteria. Symptoms include:
- • Acral gangrene: Gangrene of the extremities such as toes, fingers, lips and tip of the nose.
- • Chills
- • General ill feeling (malaise)
- • High fever (39 °Celsius; 102 °Fahrenheit)
- • Muscle Cramps
- • Seizures
- • Smooth, painful lymph gland swelling called a buboe, commonly found in the groin, but may occur in the armpits or neck, most often at the site of the initial infection (bite or scratch)
- • Pain may occur in the area before the swelling appears
- • Skin color changes to a pink hue in some very extreme cases
Another form is Pneumonic Plague, passed by coughing and a lung infection caused by the primary Bubonic form. The third manifestation is Septicemic Plague. This sickness would befall when the contagion poisoned the victim’s bloodstream. Victims of Septicemic Plague died the most swiftly, often before any notable symptoms had a chance to develop. Another form, Enteric Plague, attacked the victim’s digestive system.
Looking at these strains of Bubonic Plague and the symptoms desrcribed above, it would be easy to come to the conclusion that the Black Death was shorthand for all these strains, or perhaps as hybrid form of the Plague. In fact a combination of historical research, statistics, and understanding of how Bubonic Plague is spread now strongly suggests that the Black Death was not Bubonic Plague at all, or at least not as presently in existence, but something even more deadly, and that rats had nothing to do with it. Medieval man may have had very little scientific understanding, but just looking at the accounts I have set out above, it is quite striking how they stress personal contact as being a factor in transmission. And there is that puzzling feature I mentioned above. If the plague was so virulent, how can a man in 14th Century Italy and a woman in 17th Century England both be exposed, bury all their families and yet suffer no ill effects?
In another blog I shall try to explain why the commonly taught notions about what the Black Death was and how it was transmitted have now been overturned. And how the actions the actions of a 17th Century Derbyshire village throw light on the genetic history of Europe, and the fight against AIDS.
Gildas the Monk