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was considered that the Black Plague pandemic was responsible for the disappearance of over 100 million people or, according to other estimates, from the world’s population (about 450 million people in the 14th century) the number was reduced to 350–375 million. Apparently, the Black Plague started in Central Asia and reached Europe in 1347 where it killed about 30–60% of its inhabitants (between 1348–1350).

Theories on the cause of the pandemic

Among the theories related to Black Plague (also known as the Black Death) are those of Graham Twigg as it was not about the plague, but about anthrax, produced by the bacteria Bacillus anthracis, a disease common to humans, cattle, and mammals of wild herbivores in the Middle Ages and the historian Norman Cantor who claimed that the phenomenon occurred due to a combination of several bacterial diseases.

The most well-known and accepted theory regarding the Black Plague was that the disease was caused by the bacterium ‘Yersinia pestis’ which was transmitted from the rats hiding through commercial vessels to humans, through the stings of fleas that feed on the blood of both species. The most common manifestation was in bubonic form, by the appearance on the body of swelling, in the area of ​​the neck, of the thighs and the lymph nodes were increased in volume as a result of the infection.

Other symptoms were very high fever, the appearance of black spots on the body and necrosis of the extremities, delirium, convulsions, vomiting with blood, and terrible pain throughout the body. Most of those affected by the disease died after about 4 days of suffering. However, there are records from plague doctors that different organisms manifested different symptoms depending on the severity or stage that the plague had reached.

The plague in Winterthur in 1328. Lithograph by A. Corrodi ( Source: Wikimedia Commons)

In addition to the bubonic form, there were two more forms of manifestation, the pneumonic and the septicemic form. Even though they were rarely encountered, the mortality rate was higher because they spread directly from person to person and through coughing or sneezing. In the more isolated areas, there were fewer cases compared to the crowded cities where almost half of the people died. The nobles and important people allowed themselves to leave the affected areas in other regions, and the rest of the people working in the cities were much more affected.

It is imperative to understand that we are talking about medieval times, most of the population was not aware of basic hygiene, which allowed a very easy spread of the Black Plague which lead to an immediate pandemic. It wasn’t only this but also the fact that people were not aware of how contagious such sicknesses were as well as not aware of how these diseases were transmitted.

The creation of plague doctors

Illustration showing how medieval doctors protected themselves to treat patients suffering from the plague. ( Source: Wikimedia Commons )

Due to such a horrific event that hadn’t been met before, there was a need for as many medics as possible, however, as they were humans too they had to protect themselves in order to take care of those who didn’t have the knowledge. At this point in time, the medical school wasn’t as advanced as some historians would argue, many medics still relied on ancient treatments and basic forms of disinfection such as onion juice and sugar.

You may be wondering why did the plague doctors look so sinister, well this wasn’t their choice, the leather robe which covered their whole body protected them from those that were infected by the Black Plague. Think of it as a medieval version of the modern hazmat suit. The mask they were wearing was for them to be distinguished from the crowds as well as (arguably) offer facial protection against those who were infected.

These doctors were also teachers of hygiene for the population, even if their understanding of the plague was not great they had good knowledge on hygiene and they knew that the only way to put a stop to the pandemic was to have everyone follow a hygienic code such as washing your hands as often as possible with soap or some sort of disinfectant (alcohol) and avoid interaction with others.

The cure to the Black Plague

According to Stephen J. Spignesi in the “100 Greatest Disasters of All Time”, the defeat of the Black Plague was largely due to improvements in hygiene, which prevented the fleas from transmitting the disease to survive. However, it took more than a century for Europe’s population to return to the pre-pandemic level. The disease had appeared a few times before but was not as destructive as the first time. It remained in history as the Great Plague of Vienna (1679) or the Great Plague of London (1665–1666), continuing to appear until the 19th century.

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