Pandemic

 The Middle Ages was marked by two great outbreaks of the Black Death, also known as bubonic plague, also known by the scientific name of the bacteria that causes it, Yersinia pestis.  The second is well known, breaking out in 1346 in the eastern Mediterranean, becoming established in western Europe in 1347, and spreading and killing people for the next several years.  The first, much less well documented, had multiple outbreaks in western Europe in the second half of the sixth century.  That it was the same disease has been proven by the analysis of DNA from mass burial sites from the sixth century, where Y. pestis is clearly found.

The fourteenth-century plague killed at least a third of the medieval European population, maybe half in some areas.  Probably everybody caught at least a mild case.  It was spread by fleas, that would bite an infected rat, then bite a person, passing on the bacteria.  There was of course no vaccine.  The medieval population developed "herd immunity," that is with everybody infected and either dying or recovering with enough natural immunity to fight it off, the disease more or less disappeared after five or six years.

But it was not gone for good.  Over the next several centuries, it came back again (though never in such force) every generation or so, when a new generation had been born that had never been exposed.  The best known of these outbreaks was the Great Plague of 1666 in southern England.  In London it was stopped by the Great Fire, which by burning up a lot of rats and fleas slowed the disease way down.  The last major outbreak was in 1894 and affected people globally for close to twenty years.  As I have discussed earlier, the Black Death is still endemic in rodents (mostly ground squirrels) in the American southwest.  Fortunately it can now be cured with antibiotics if caught early.

Some people now advocate just letting everybody catch Covid-19 to develop "herd immunity" rather than striving for a vaccine.  Thinking about losing a third or more of the population in the process may change their minds.

It is not clear what proportion of the population of late antiquity was wiped out by the plague, but the records that do survive speak of a devastating impact.  Along with three or four outbreaks of the plague in fifty years or so, there was a smallpox epidemic.  Ah, good times.  It is however clear that the plague spread along trade routes and from the cities to the countryside as people fled from the urban centers where the infection rate was extremely high, not realizing they were spreading the disease in the process.

One indication of how devastating the sixth-century plague was is the evidence, from things like tree rings and pollen analysis, that the seventh and eighth centuries saw much smaller rural populations in Europe than in previous centuries.  And the cities shrank even more; in Arles for example the whole city moved into the old Roman amphitheater, building their houses on the rows of seats, and they all fit.

One might consider that the sixth-century plague really ended the Roman Empire (helped along by the seventh-century rise of Islam).  The fourteenth-century plague changed a lot of aspects of society as well as killing off people.  The basic optimism that had marked much of the Middle Ages was gone, and there was a new fixation on morbidity, taking the form in some cases of extreme piety, in other cases a careless "live for today" attitude.

What changes will come from the Covid-19 pandemic?  One assumes there will be more than an increased willingness of companies to have white-collar workers "work from home."

© C. Dale Brittain 2021

For more on disease and health and other aspects of life in the Middle Ages, see my ebook, Positively Medieval, available from Amazon.  Also available in paperback1

After the plague

As I have posted before, the Middle Ages certainly had epidemics, most notably the Black Death, usually known now as the bubonic plague (it also had a variant, the pneumonic plague, even more virulent).  I used to have trouble explaining to my students how serious the plague was in the fourteenth century and how much it disrupted what one might think of as normal.  Some would say, Is it like AIDS?  No, because AIDS is not particularly contagious, and people can live with it for years.  In the future it may be easier to explain the plague:  it's more like COVID-19.

Now the plague was far more deadly than our current epidemic.   Estimates are that maybe a third of Europe's population was wiped out within a year or two.  We are nowhere near that figure yet, but there's still time.

Part of Europe's problem in the fourteenth century was that it was impossible to practice "social distancing."  Houses were small and close together, so for most people "self-quarantining" away from everyone else was just not possible.  The same problem, that one cannot put distance between oneself and other people, is why the current disease has spread so rapidly in places like cruise ships, prisons, and Mediterranean countries where houses are still small and close together.  In the case of the plague, the disease could be spread by fleas, so staying 6 (or 12) feet apart was not going to be enough anyway.

Without modern medical treatments and sanitizers, medieval people could try to flee (often taking the disease with them), but the overall response was by necessity something close to what is now described as "ride it out," keep on trying to act normal, and figure that after a while everyone who was going to die is dead, and the rest either are immune or have recovered.

Well, the problem with that approach then (as it would be now) is that an awful lot of people die, and whatever health care facilities you have are overwhelmed, so a lot of those who die might have had a chance to recover in better circumstances.

And what happens then?  Well, in spite of happy hopes one sometimes hears expressed, you can't just restart an economy devastated by a pandemic.  In fourteenth-century Europe, trade routes had been completely disrupted, cities (the centers of economic exchange) decimated, churches and law courts emptied, and any sense of optimism for the future dealt a pretty significant blow.  You can't just put an economy back together when a lot of the people on whom the economy depends are dead.

Europe's cities shrank and did not return to their pre-plague size for at least another century.  Italian merchants who survived stopped putting their money into commerce, which looked decidedly iffy, and started patronizing art instead, kick-starting the Italian Renaissance.  Religious expression became far more morbid, with "dance of death" a common artistic scene:  Death is portrayed dancing across the countryside, bringing everyone with him, rich and poor, young and old, men and women.

Many started creating what might be considered double-decker tombstones, two depictions of the deceased carved in stone, one above the other like bunk beds.  In one the deceased would be seen dressed and peacefully sleeping, as seen in elite tombs for generations.  In the other, the deceased would be depicted as partially decayed, complete with worms carved in stone.

The only ones to come out of the plague better off (besides the Italian artists) were the peasants, if one can put "better off" and "many friends and family members dead" in the same sentence.  Europe had been overpopulated, without enough land (using fourteenth-century techniques and crops) to adequately feed the population.  Losing a third to a half of the population certainly solved that pesky problem!  Peasant families could start farming more land, because a lot of their neighbors were gone.  Landlords who relied on peasant rents and labor had to lower rents or pay more for labor if they didn't want to have to grow their own food themselves, because there was competition for the surviving peasant workers.

In some places landlords fought back.  England for example passed laws trying to keep peasants from demanding higher wages or lower rents.  These were not nearly as successful as hoped.  The peasants in turn fought back, becoming aware, really for the first time, that they had common cause with peasants around the country, resulting in the great Peasants Revolt of 1381.  But that's a story for another time.

© C. Dale Brittain 2020

For more on medieval disease and other aspects of medieval history, see my book Positively Medieval, available on Amazon and other ebook  and on-line platforms.

Medieval epidemics

As (justifiable) panic over Covid-19 spreads around the globe. some may be wondering:  did they have epidemics in the Middle Ages?  And what did they do about them?

Of course they had epidemics.  Any time you have a contagious disease and people living close together an epidemic is possible, that is infection spreading faster through a population than the population can handle it, accompanied by fear and despair.

The worst medieval epidemics were the two big outbreaks of the Black Death, the first in the sixth century, the second in the fourteenth.  The Black Death, now known as bubonic plague, killed maybe a third (or more) of Europe's population both times, having horrible ramifications for both economy and society for those who survived.  It's a bacterial disease so it can (now) be treated with antibiotics, unknown until the mid-twentieth century, but there was no good treatment then.  Covid-19 (which is viral, not bacterial, antibiotics won't touch it) is not nearly as serious, even though it's definitely serious (maybe a 4% fatality rate not 35%, though still far above the fatality rate of seasonal flu, which is well below 1%).

Although medieval people did not know about viruses and bacteria, they certainly could recognize contagion.  People fled the cities where disease spread much more rapidly, not appreciating that they might already be infected and were thus spreading rather than escaping disease--the same is the case today.  Medieval people understood about quarantine, and those not infected would try to stay well away from those who were infected.  Boccaccio's Decameron, now considered the first work of Renaissance literature, is a story of ten people self-quarantining and telling each other tales to pass the time.

Although the Black Death was the most serious medieval epidemic, others, like smallpox, came through periodically.  So did measles.  Both of these, especially smallpox, would leave disfiguring marks on your skin but would not (necessarily) kill.  Both of these, however, became devastating epidemics in the New World in the sixteenth century, killing a great number of indigenous people before the Europeans even had a chance to kill them themselves.

Medieval Europe certainly had a health care system, hospitals where sick people would be kept warm and dry and fed in the hope that their immune system would kick in soon, and barber-surgeons who could cut off infected limbs, but obviously these were ineffective against epidemics.  The image below is the interior of a medieval hospital at Beaune.

Patients would each have a curtained bed, and nuns would bring them chicken soup and saint dust.  Hospitals like this were overwhelmed in epidemics.


© C. Dale Brittain 2020

For more on medieval health and disease, see my ebook, Positively Medieval:  Life and Society in the Middle Ages.

The Black Death

Everyone has heard of the Black Death, which sounds very scary, and so it should.  It's often associated  with the Middle Ages, but in fact there were only two medieval outbreaks, one in the sixth century and one in the fourteenth, that is at the beginning and end of the Middle Ages.

In both cases, the Black Death came out of central Asia (it also devastated China).  It's a bacterial disease, spread especially by fleas.  In both of its medieval manifestations, the bacteria seem to have mutated into a particularly virulent form, that then spread rapidly, especially in an urban environment where people lived close together, and where rats could serve as hosts for the fleas.  A city could be fine one day, and two weeks later three-quarters of the population would be dead.

In the sixth century, this disease broke down Roman urban culture, which did not recover until the eleventh and twelfth centuries (see my post on the medieval city).  In the fourteenth century, the Black Death marks the beginning of the Renaissance, a time when people turned to art because the economy had tanked.  (The first work of Renaissance art was a piece of literature, Boccaccio's Decameron, about people fleeing the plague.)

In both cases, the impact was devastating.  We know more about the fourteenth century than the sixth, and it's quite horrifying.  An infected ship from the Middle East came into Genoa harbor in 1346, with almost all the sailors dead, and from there one can map the spread of the disease like ripples on a pond.  Probably between a quarter and half of Europe's population died, especially in the cities.

People fled to try to escape, not realizing they were probably already infected and were carrying the disease with them.  Realizing that the disease was carried on fleas, people killed cats and dogs—whose fleas just jumped on humans.

Sometimes you'll see the Black Death compared to AIDS, but it's really not comparable.  It was easy to catch, whereas AIDS is quite hard to catch, and it killed you very quickly, whereas many people now live with AIDS for years.  In practice, probably everyone in the fourteenth century caught at least a mild form of the plague, so one could survive, but at least a third of the population did not.

The worst passed off in a few years, but it tended to keep coming back every generation or so, as children were born who had not been exposed and thus had not developed immunity.  There was a very serious outbreak in England in 1666 (well after the end of the Middle Ages), which ended only with the Great London Fire, which burned up the rats and fleas along with much of the city.

In reaction to the Black Death, some people in the fourteenth century became very pious, multiplying prayers and rituals.  Others however adopted a hedonistic, live-for-today mentality, pointing out that priests had fled from the plague just as fast as anyone else.  Art became much more morbid, and many an expensive tomb featured stone carvings on two levels (almost like bunk beds)—on one level the deceased lay clothed, looking peacefully asleep, whereas on the other the deceased was carved as naked and half decayed.

There has been some debate among scholars about whether the Black Death was the same as the bubonic plague that is still found in the American Southwest and the Sierras.  The current consensus is that it was.  Fortunately, because it's a bacterial disease (and not nearly as virulent as in the fourteenth century), it can be cured with antibiotics.

The chipmunks in the Sierras (actually golden-mantled ground squirrels, but they look like big chipmunks as you can see from the picture) carry the plague today.  No matter how cute they look, do not pat them.  And if you've been camping there and get home feeling funky, tell your doctor you have the plague (otherwise she'll probably test you for AIDS before thinking of the plague).

Click here for more on medieval views on death.

© C. Dale Brittain 2014

For more on medieval health and disease and other aspects of medieval history, see my ebook Positively Medieval, available on Amazon and other ebook platforms.