Not every pandemic is the Black Death

Interesting times, no? We live in interesting times. Oh ho ho the times they are interesting. By that, of course, I mean that I am very bored, but at the same time so anxious I am giving myself headaches. Pandemics are not fun! Staying in your house is not fun! Worrying that people are going to die is not fun! Watching governments debate whether rich people’s wealth is more important than people dying is not fun!

This is not as bad as living through the Black Death, or the plague generally.

And … you know that. You fundamentally understand that this is true. But it is also true that it is coming up over and over again right now as we all struggle to connect to something historical in the midst of a difficult time.

Now some of you may be wondering why I have deliniated between the Black Death and the plague up there. Well, that’s because the Black Death was an outbreak of bubonic plague, but not all bubonic plagues are the Black Death.  (All squares are rectangles, not all rectangles are squares, etc etc etc.)

K, so TF does that mean? Wellllllll the Black Death was, of course, an outbreak of the bubonic plague, otherwise known as Yersinia pestis. The thing about the bubonic plague is that it is a real one and it has been around the joint for a long damn time. The first European incursion of Yersinia pestis can be linked, for example to the early medieval period, when historians refer to it as the Justinian Plague. This little episode lasted from 541-542 and it was primarily felt in the Eastern Roman Empire (AKA Byzantium for the anachronistic crowd), especially in the capital Constantinople. It also killed a lot of people over in the Sassanian Empire, which we now know as Iran. When all was said and done after several recurrences, some historians have estimated that the Justinian plague killed about 25 – 100 million people, or about half the population of Europe. We are currently reassessing this as some historians have pointed out that these estimated may be based on traumatised people being extra, given that we don’t have the physical evidence to back it up. Either way, it was some real shit. It was not, however the Black Death.

Similarly, the piece of plague memorabilia that likely springs to mind when you think “plague”, aka plague doctor masks, are also not about the Black Death. Instead, they are linked to an outbreak of Yersinia pestis from the seventeenth century. Which means – and I cannot stress this enough – THEY ARE EARLY MODERN, AND NOT MEDIEVAL.

More specifically, they are linked to physicians in what is now France and Italy. A French medical Doctor Charles de Lorme helped to conjure up the beaked mask, the beak of which was filled with aromatic herbs to protect against miasma – or ill smells that were thought to make people ill. It also involved spectacles to protect the eyes and waxed leather robes that were thought to act not unlike armour. Lorme described his mask as having a “nose half a foot long, shaped like a beak, filled with perfume with only two holes, one on each side near the nostrils, but that can suffice to breathe and to carry along with the air one breathes the impression of the drugs enclosed further along in the beak.”[1]

This get up would remain popular with doctors working against the plague up into the eighteenth century, as they fought what historians refer to as the “Great Plagues”: a series of out breaks of Yersinia pestis including the Great Plague of Seville, the Great Plague of London, the Great Plague of Vienna, and the Great Plague of Marseille. This is just to name some of the major great plague hits but – crucially – these were not the Black Death.

This is because the Black Death is – specifically – the occurrence of Yersinia pestis linked to the fourteenth century. For those of you who like specifics, it started in Central Asia, and more specifically in what is now Kyrgyzstan around 1332 or so. A TL/DR of how Yersinia pestis managed to make the great leap into humans was that it had been out on the steppes of central Asia hanging out in the guts of fleas. The fleas lived in marmot colonies. With increasing trade across the Silk Road (because the fourteenth century fucking ruled and people were getting their spices on after a period of instability after the Mongol conquests. Shout out to my crew.) these marmots came into contact with the animals who were also caravanning about the joint. I mean horses, camels, and also humans but yeah rats. (It is important to me that we acknowledge that the problem here was fleas and not rats. #RatsDidNothingWrong) The fleas bit people up and travelled in some style east into India and China and west into Europe and the Middle East. It made it to Europe by 1347 and had more or less petered out after 1351, though it never really went away again, as the seventeenth century plagues illustrate.

It was, and is a fucking terrible and gruesome disease. The poet Boccaccio wrote of it in the Decameron:

“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.”[2]

While Bocaccio isn’t entirely correct here, in that it was theoretically possible to maybe survive if your buboes discharged on their own, (good luck champ!) – yeah most people who got this died. All in all it took down a quarter of the world’s population at the time, but that is an overall estimate. In some places the death toll was worse. We estimate that the population of Paris fucking halved. In 1338 Florence had about 120,000 inhabitants. When the Black Death abated 50,000 were left. In Bremen about sixty percent of the population died. In quiet backwaters like England entire villages were lost as those who survived couldn’t keep them running and moved elsewhere.

My point is this was a catastrophe that we simply cannot comprehend. This is not only because the mortality that we are seeing with Covid 19, which is already horrifying and numbing, is much smaller – but also you know why it is happening. You understand germ theory. You know the name of the fucking virus. All the people who died of the plague – in the Black Death or not – knew it was a sickness, but that is all that they knew.

The reason that the seventeenth-century plague doctors wore them beaky masks was because they, like many medieval physicians before them, had a best guess for what was causing the plague – miasma. Miasma theory, more or less, was the idea that bad smells or noxious air could cause diseases. It was the prevailing medical theory (in conjunction with humoral theory, which we have talked about before) up until the second half of the nineteenth century.

Even if you were pretty sure you had it nailed on miasma theory causing plague though, that doesn’t necessarily explain where said miasma came from. There were some competing ideas on this one. Some argued that the noxious air had come out of the earth’s crust during a major earthquake in Friuli (in what is now Italy) in 1348. It was a 6.9 on the Richter scale and was so strong it was felt as far away as Bohemia and the German lands. Such medical luminaries as Avicenna had argued that earthquakes could release gases which would petrify men or turn them to pillars of salt.[3] Why not gases that caused plague?

The Paris medical faculty, meanwhile argued that the gases had been caused by a “major conjunction of three planets in aquarius…[where] Jupiter, being wet and hot, draws up evil vapours from the earth and Mars, because it is immoderately hot and dry, then ignites the vapours, and as a result there were lightnings, sparks, noxious vapours and fires throughout the air. … Mars was also looking upon Jupiter with a hostile aspect, that is to say quartile, and that caused an evil disposition or quality in the air, harmful and hateful to our nature.”[4]

Also they were pretty sure that a corruption of food made stuff gross as well, but the major thing was the air corruption caused by the planets.

Now you, standing on the shoulders of giants, and having been told what a germ is from your childhood may laugh at this. But you have not been taught astronomy from an early age and been taught that the planets really do influence what happens with life on earth.

Moreover, you can go ahead and find the explanations for how the miasma occurred weird, but the thing about miasma theory itself is that it kinda seemed realistic based on actual observation.

Wash people up so they smell better? Incidences of disease go down a bit. Improve sanitation? Same deal. That is how you find yourself walking around with a bird mask stuffed full of aromatic herbs to keep yourself safe from plague. If you can’t smell the bad air, then you might be safe.

Sadly though, you would not, in fact be safe with a mask. Not in the early modern period when they were worn. Not if you sent the masks back to the medieval period by time travel just to prove some sort of long-game point to me. (I see you haters. I see you.) Not at all. So you would die. And your loved ones would die. And so many people would die it would feel like the end of the world.

This brings me to another reason why I think we bring up the Black Death in times like these. Because we know, deep down, that it was one of the most horrible things that humanity ever went through. You probably knew the figures about death off the top of your head! The idea of plague doctors lives in our cultural imagination even if people are misidentifying a modern phenomenon as a medieval one. Our go-to cultural reference for pandemic is the Black Death because it was so so bad … but humanity made it through.

It is comforting at times when stuff is scary and our general way of life is breaking down around us to know that worse things happened before and yet society continued on. Our medieval ancestors might have thought it was the end of the line, but it wasn’t. And in our heart of hearts we know we are better off. When you are facing something really scary down, it can be helpful to reflect on when times were worse. I mean, sure, we might not have enough ventilators, and our doctors don’t have adequate PPE, but it’s not bird masks and sweet orange peel, you know?

I understand why people want to reflect on the plague right now. I really really do. But let’s take comfort in the fact that as scary as this is, it is not the Black Death, and it’s not even the subsequent plagues.

They didn’t know what caused their pandemic, we do. They didn’t have medical interventions, we do. Are we prepared? Um, no. But we have models of other countries who have beat this very infection and it is to be hoped that at some point our leaders will be forced to try that.

In the meantime, I grant you the small joy of correcting people about plague masks. We all need new hobbies.

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[1] Vidal, Pierre; Tibayrenc, Myrtille; Gonzalez, Jean-Paul (2007). “Chapter 40: Infectious disease and arts”. In Tibayrenc, Michel (ed.). Encyclopedia of Infectious Diseases: Modern Methodologies. John Wiley & Sons. p. 680. 
[2] Boccaccio, Decameron, trans. M. Rigg (London: David Campbell, 1921), Vol. 1, pp. 5-11.
[3] Konrad von Megenberg, Buch der Natur, 2, 33.
[4]“The Report of the Paris Medical Faculty, October 1348”, https://sites.uwm.edu/carlin/the-report-of-the-paris-medical-faculty-october-1348/.

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For more on medieval medicine and the Black Death, see:
On masculinity and disease
On collapsing time, or, not everyone will be taken into the future
Plague Police roundup, or, I am tired, and you people give me no peace
Chatting about plague for HistFest
On the plague, sex, and rebellion
On Medical Milestones, Being Racist, and Textbooks, Part I
On Medical Milestones, the Myth of Progress, and Textbooks, Part II
On medieval healthcare and American barbarism