By 1340, medieval Europe was beset by a range of problems. Ploughing of the marginal land failed to produce enough food to feed the ever-growing population and as a result poverty, unemployment and vagrancy were all on the increase. Outbreaks of disease were by no means uncommon – illness was a fact of life - but all this was about to be eclipsed by the wholly unforeseen and devastating arrival of seemingly new disease: the Black Death.
Now it is widely believed that a series of natural disasters in the furthest reaches of the Orient in the first third of the fourteenth century heralded the outbreak of the epidemic, when a deadly plague arrived during a period of widespread famine. The disease may have then travelled along the Silk Road with Mongol armies and traders, or via ship, before reaching the shores of the eastern Mediterranean in 1347. However this deadly, indiscriminate disease arrived, within a few decades it had ripped through towns, villages and families and wiped out vast swathes of the population.
Between 1347 and 1350 it is estimated that up to one third of England’s population died, although we will probably never be able to estimate the Black Death’s toll with any precision. More than a thousand villages were deserted, most never to be repopulated, and in towns and cities the cemeteries were unable to provide space for all the dead. Violence and crime spiralled, travel became dangerous and the supply of food and goods was interrupted, adding hunger and deprivation to the problems of people already overwhelmed by the threat of a horrific death.
Nor was 1350 the end of it. After the Black Death’s first terrible onslaught in the 1340s, plague recurred, haunting Europe and the Mediterranean with further attacks throughout the fourteenth to seventeenth centuries. For over three hundred years, Europeans were stalked by death. Whole societies were disrupted; racial tensions built and the social and economic consequences were far reaching. As a direct result of the horrific pestilence, Jews were persecuted throughout the continent and in England the feudal system disintegrated, culminating in the Peasants’ Revolt of 1381.
Due to the extensive trading routes and increasing merchant shipping across Europe, the speed of the plague’s progress was phenomenal. Its supposed first landfall in England occurred in the Dorset port of Melcome Regis, now part of Weymouth, in 1348, although the merchants of Melcombe Regis chose to keep quiet about the deaths for fear of halting trade in the prosperous small town:
‘In this year 1348, in Melcombe, in the county of Dorset, a little before the Feast of St John the Baptist (24 June), two ships, one of them from Bristol, came alongside. One of the sailors had brought with him from Gascony the seeds of the terrible pestilence and, through him, the men of that town of Melcombe were the first in England to be infected.’ – Grey Friar’s Chronicle at Lynn
Rumours had been rumbling for a while about a terrible continental plague, and it is hardly surprising that seaports such as Melcombe and Bristol would be the first to be affected. Bristol, at that point, was the second largest city in Britain, a vibrant trading post and the principal port of entry for the West Country with close connections with the continent.
Living conditions in English towns and villages contributed to the rapid spread of the disease. A combination of overcrowding in cities and universal poor sanitation allowed the plague to flourish. In country houses, pigs, chickens and perhaps even ponies, cows and sheep would share common residence. In towns and cities, people had a tendency to empty their chamberpots out of their windows directly onto the street below and the disposal of offal and other refuse from street traders such as butchers and tanners was a serious problem. Furthermore, townsfolk drew their water from the river, which was polluted with waste and also being used for industrial purposes by local brewers. These filthy conditions were the perfect environment for the spread of infectious diseases and for rats to breed.
The plague presents itself in three distinct forms, named after their most obvious characteristic: bubonic (buboes or swellings are present), pneumonic (a virulent form which occurs when the infection moves into the lungs) and septicaemic (the bacteria enters and infects the bloodstream). Most experts believe that the Black Death was mostly caused by bubonic plague in the summer months of 1348, which mutated into the more contagious and deadly air-based pneumonic form with the onset of winter. Supporting this theory, evidence produced by archaeologists and forensic scientists in 2014 from human remains in the City of London suggests that fleas could not actually have been responsible for an infection that spread so fast – it had to be airborne. Once the disease reached the lungs of the malnourished, it was then spread to the wider population through sneezes and coughs. The morality rate of the bubonic plague was 50%, pneumonic plague 90%, and in the rarer septecaemic plague 100%. Most victims died three to ten days after initial infection, although in the case of pneumonic and septecaemic plague victims died quickly, within one or two days.
It is widely believed that the bubonic plague was carried by fleas living on rats and that black rats living on merchant ships brought the disease to Europe. The bacteria, the fleas which carried them and the rats which carried the fleas, flourished in the filthy conditions of medieval towns and villages. Bubonic plague was passed between rats by bites from the fleas they were carrying, but when a rat died the flea had to seek a new host to live on – it is thought that humans contracted the plague through the bite of fleas which had previously fed on an infected animal.
The Black Death took many forms, but the most common symptoms included:
In the case of bubonic plague, the buboes are red at first but later turn a dark purple, or black, which is what gave the ‘Black Death’ its name. Sometimes the buboes burst of their own accord and a foul-smelling black liquid oozed from the open boils, but this was a sign that the victim might recover.
While the poor had to make do with traditional herbal remedies, witchcraft and superstition to try and cure their ailments, the rich could afford to pay physicians. Not that there was much a doctor could do. The most common form of treatment was to lance the buboes, an approach adopted after it was noticed that those patients whose buboes burst often survived the disease. The traditional process of bleeding (where the veins leading to the heart are cut open) was also employed, but this usually only served to severely weaken the patient and speed up the death process. Other cures people tried included: