The bubonic plague killed 60 million people. Moreover, in some regions the death toll reached two-thirds of the population. Due to the unpredictability of the disease, as well as the impossibility of curing it at that time, religious ideas began to flourish among people. Belief in a higher power has become commonplace. At the same time, persecution began of the so-called “poisoners”, “witches”, “sorcerers”, who, according to religious fanatics, sent the epidemic to people.

This period remained in history as a time of impatient people who were overcome by fear, hatred, mistrust and numerous superstitions. In fact, of course, there is a scientific explanation for the outbreak of bubonic plague.

The Myth of the Bubonic Plague

When historians were looking for ways the disease could penetrate Europe, they settled on the opinion that the plague appeared in Tatarstan. More precisely, it was brought by the Tatars.

In 1348, the Crimean Tatars, led by Khan Dzhanybek, during the siege of the Genoese fortress of Kafa (Feodosia), threw there the corpses of people who had previously died from the plague. After liberation, Europeans began to leave the city, spreading the disease throughout Europe.

But the so-called “plague in Tatarstan” turned out to be nothing more than a speculation of people who do not know how to explain the sudden and deadly outbreak of the “Black Death”.

The theory was defeated as it became known that the pandemic was not transmitted between people. It could be contracted from small rodents or insects.

This “general” theory existed for quite a long time and contained many mysteries. In fact, the plague epidemic of the 14th century, as it turned out later, began for several reasons.

Natural causes of the pandemic

In addition to dramatic climate change in Eurasia, the outbreak of bubonic plague was preceded by several other environmental factors. Among them:

• global drought in China followed by widespread famine;
• in Henan province there is a massive locust invasion;
• Rain and hurricanes prevailed in Beijing for a long time.

Like the Plague of Justinian, as the first pandemic in history was called, the Black Death struck people after massive natural disasters. She even followed the same path as her predecessor.

The decrease in people's immunity, provoked by environmental factors, has led to mass morbidity. The disaster reached such proportions that church leaders had to open rooms for the sick population.

The plague in the Middle Ages also had socio-economic prerequisites.

Socio-economic causes of bubonic plague

Natural factors could not provoke such a serious outbreak of the epidemic on their own. They were supported by the following socio-economic prerequisites:

• military operations in France, Spain, Italy;
• the dominance of the Mongol-Tatar yoke over part of Eastern Europe;
• increased trade;
• soaring poverty;
• too high population density.

Another important factor that provoked the invasion of the plague was a belief that implied that healthy believers should wash as little as possible. According to the saints of that time, contemplation of one’s own naked body leads a person into temptation. Some followers of the church were so imbued with this opinion that they never immersed themselves in water in their entire adult lives.

Europe in the 14th century was not considered a pure power. The population did not monitor waste disposal. Waste was thrown directly from the windows, slops and the contents of chamber pots were poured onto the road, and the blood of livestock flowed into it. This all later ended up in the river, from which people took water for cooking and even for drinking.

Like the Plague of Justinian, the Black Death was caused by large numbers of rodents that lived in close contact with humans. In the literature of that time you can find many notes on what to do in case of an animal bite. As you know, rats and marmots are carriers of the disease, so people were terrified of even one of their species. In an effort to overcome rodents, many forgot about everything, including their family.

How it all began

The origin of the disease was the Gobi Desert. The location of the immediate outbreak is unknown. It is assumed that the Tatars who lived nearby declared a hunt for marmots, which are carriers of the plague. The meat and fur of these animals were highly valued. Under such conditions, infection was inevitable.

Due to drought and other negative weather conditions, many rodents left their shelters and moved closer to people, where more food could be found.

Hebei province in China was the first to be affected. At least 90% of the population died there. This is another reason that gave rise to the opinion that the outbreak of the plague was provoked by the Tatars. They could lead the disease along the famous Silk Road.

Then the plague reached India, after which it moved to Europe. Surprisingly, only one source from that time mentions the true nature of the disease. It is believed that people were affected by the bubonic form of plague.

In countries that were not affected by the pandemic, real panic arose in the Middle Ages. The heads of the powers sent messengers for information about the disease and forced specialists to invent a cure for it. The population of some states, remaining ignorant, willingly believed rumors that snakes were raining on the contaminated lands, a fiery wind was blowing and acid balls were falling from the sky.

Modern characteristics of the bubonic plague

Low temperatures, a long stay outside the host's body, and thawing cannot destroy the causative agent of the Black Death. But sun exposure and drying are effective against it.

Symptoms of plague in humans

Bubonic plague begins to develop from the moment of being bitten by an infected flea. Bacteria enter the lymph nodes and begin their life activity. Suddenly, a person is overcome by chills, his body temperature rises, the headache becomes unbearable, and his facial features become unrecognizable, black spots appear under his eyes. On the second day after infection, the bubo itself appears. This is what is called an enlarged lymph node.

A person infected with the plague can be identified immediately. “Black Death” is a disease that changes the face and body beyond recognition. Blisters become noticeable already on the second day, and the patient’s general condition cannot be called adequate.

The symptoms of plague in a medieval person are surprisingly different from those of a modern patient.

Clinical picture of the bubonic plague of the Middle Ages

“Black Death” is a disease that in the Middle Ages was identified by the following signs:

• high fever, chills;
• aggressiveness;
• continuous feeling of fear;
• severe pain in the chest;
• dyspnea;
• cough with bloody discharge;
• blood and waste products turned black;
• a dark coating could be seen on the tongue;
• ulcers and buboes appearing on the body emitted an unpleasant odor;
• clouding of consciousness.

These symptoms were considered a sign of imminent and imminent death. If a person received such a sentence, he already knew that he had very little time left. No one tried to fight such symptoms; they were considered the will of God and the church.

Treatment of bubonic plague in the Middle Ages

Medieval medicine was far from ideal. The doctor who came to examine the patient paid more attention to talking about whether he had confessed than to directly treating him. This was due to the religious insanity of the population. Saving the soul was considered a much more important task than healing the body. Accordingly, surgical intervention was practically not practiced.

Treatment methods for plague were as follows:

• cutting tumors and cauterizing them with a hot iron;
• use of antidotes;
• applying reptile skin to the buboes;
• pulling out disease using magnets.

However, medieval medicine was not hopeless. Some doctors of that time advised patients to stick to a good diet and wait for the body to cope with the plague on its own. This is the most adequate theory of treatment. Of course, under the conditions of that time, cases of recovery were isolated, but they still took place.

Only mediocre doctors or young people who wanted to gain fame in an extremely risky way took on the treatment of the disease. They wore a mask that looked like a bird's head with a pronounced beak. However, such protection did not save everyone, so many doctors died after their patients.

Government authorities advised people to adhere to the following methods of combating the epidemic:

• Long distance escape. At the same time, it was necessary to cover as many kilometers as possible very quickly. It was necessary to remain at a safe distance from the disease for as long as possible.
• Drive herds of horses through contaminated areas. It was believed that the breath of these animals purifies the air. For the same purpose, it was advised to allow various insects into houses. A saucer of milk was placed in a room where a person had recently died of the plague, as it was believed to absorb the disease. Methods such as breeding spiders in the house and burning large numbers of fires near the living space were also popular.
• Do whatever is necessary to kill the smell of the plague. It was believed that if a person does not feel the stench emanating from infected people, he is sufficiently protected. That is why many carried bouquets of flowers with them.

Doctors also advised not to sleep after dawn, not to have intimate relations and not to think about the epidemic and death. Nowadays this approach seems crazy, but in the Middle Ages people found solace in it.

Of course, religion was an important factor influencing life during the epidemic.

Religion during the bubonic plague epidemic

"Black Death" is a disease that frightened people with its uncertainty. Therefore, against this background, various religious beliefs arose:

• The plague is a punishment for ordinary human sins, disobedience, bad attitude towards loved ones, the desire to succumb to temptation.
• The plague arose as a result of neglect of faith.
• The epidemic began because shoes with pointed toes came into fashion, which greatly angered God.

Priests who were obliged to listen to the confessions of dying people often became infected and died. Therefore, cities were often left without church ministers because they feared for their lives.

Against the background of the tense situation, various groups or sects appeared, each of which explained the cause of the epidemic in its own way. In addition, various superstitions were widespread among the population, which were considered the pure truth.

Superstitions during the bubonic plague epidemic

In any, even the most insignificant event, during the epidemic, people saw peculiar signs of fate. Some superstitions were quite surprising:

• If a completely naked woman plows the ground around the house, and the rest of the family members are indoors at this time, the plague will leave the surrounding areas.
• If you make an effigy symbolizing the plague and burn it, the disease will recede.
• To prevent the disease from attacking, you need to carry silver or mercury with you.

Many legends developed around the image of the plague. People really believed in them. They were afraid to open the door of their house again, so as not to let the plague spirit inside. Even relatives fought among themselves, everyone tried to save themselves and only themselves.

The situation in society

The oppressed and frightened people eventually came to the conclusion that the plague was being spread by so-called outcasts who wanted the death of the entire population. The pursuit of the suspects began. They were forcibly dragged to the infirmary. Many people who were identified as suspects committed suicide. An epidemic of suicide has hit Europe. The problem has reached such proportions that the authorities have threatened those who commit suicide by putting their corpses on public display.

Since many people were sure that they had very little time left to live, they went to great lengths: they became addicted to alcohol, looking for entertainment with women of easy virtue. This lifestyle further intensified the epidemic.

The pandemic reached such proportions that the corpses were taken out at night, dumped in special pits and buried.

Sometimes it happened that plague patients deliberately appeared in society, trying to infect as many enemies as possible. This was also due to the fact that it was believed that the plague would recede if it was passed on to someone else.

In the atmosphere of that time, any person who stood out from the crowd for any reason could be considered a poisoner.

Consequences of the Black Death

The Black Death had significant consequences in all areas of life. The most significant of them:

• The ratio of blood groups has changed significantly.
• Instability in the political sphere of life.
• Many villages were deserted.
• The beginning of feudal relations was laid. Many people in whose workshops their sons worked were forced to hire outside craftsmen.
• Since there were not enough male labor resources to work in the production sector, women began to master this type of activity.
• Medicine has moved to a new stage of development. All sorts of diseases began to be studied and cures for them were invented.
• Servants and the lower strata of the population, due to the lack of people, began to demand a better position for themselves. Many insolvent people turned out to be heirs of rich deceased relatives.
• Attempts were made to mechanize production.
• Housing and rental prices have dropped significantly.
• The self-awareness of the population, which did not want to blindly obey the government, grew at a tremendous pace. This resulted in various riots and revolutions.
• The influence of the church on the population has weakened significantly. People saw the helplessness of the priests in the fight against the plague and stopped trusting them. Rituals and beliefs that were previously prohibited by the church came into use again. The age of “witches” and “sorcerers” has begun. The number of priests has decreased significantly. People who were uneducated and inappropriate in age were often hired for such positions. Many did not understand why death takes not only criminals, but also good, kind people. In this regard, Europe doubted the power of God.
• After such a large-scale pandemic, the plague did not completely leave the population. Periodically, epidemics broke out in different cities, taking people’s lives with them.

Today, many researchers doubt that the second pandemic took place precisely in the form of the bubonic plague.

Opinions on the second pandemic

There are doubts that the “Black Death” is synonymous with the period of prosperity of the bubonic plague. There are explanations for this:

• Plague patients rarely experienced symptoms such as fever and sore throat. However, modern scholars note that there are many errors in the narratives of that time. Moreover, some works are fictional and contradict not only other stories, but also themselves.
• The third pandemic was able to kill only 3% of the population, while the Black Death wiped out at least a third of Europe. But there is an explanation for this too. During the second pandemic, there was terrible unsanitary conditions that caused more problems than illness.
• The buboes that arise when a person is affected are located under the armpits and in the neck area. It would be logical if they appeared on the legs, since that is where it is easiest for a flea to get into. However, this fact is not flawless. It turns out that, along with the rat flea, the human louse is the spreader of the plague. And there were many such insects in the Middle Ages.
• An epidemic is usually preceded by the mass death of rats. This phenomenon was not observed in the Middle Ages. This fact can also be disputed given the presence of human lice.
• The flea, which is the carrier of the disease, feels best in warm and humid climates. The pandemic flourished even in the coldest winters.
• The speed of the epidemic's spread was record-breaking.

As a result of the research, it was found that the genome of modern strains of plague is identical to the disease of the Middle Ages, which proves that it was the bubonic form of pathology that became the “Black Death” for the people of that time. Therefore, any other opinions are automatically moved to the incorrect category. But a more detailed study of the issue is still ongoing.

Plague is an infectious disease caused by the bacterium Yersinia Pestis. Depending on the presence of pulmonary infection or sanitary conditions, plague can be spread through the air, transmitted through direct contact, or very rarely through contaminated cooked food. Symptoms of plague depend on the concentrated areas of infection: bubonic plague appears in the lymph nodes, septicemic plague in the blood vessels, and pneumonic plague in the lungs. Plague is treatable if detected early. Plague is still a relatively common disease in some remote parts of the world. Until June 2007, plague was one of three epidemic diseases specifically reported to the World Health Organization (the other two being cholera and yellow fever). The bacterium is named after the French-Swiss bacteriologist Alexandre Yersin.

The massive plague pandemics that swept across Eurasia are believed to have been associated with very high mortality rates and major cultural changes. The largest of these was the Plague of Justinian of 541–542, the Black Death of 1340, which continued at intervals during a second plague pandemic, and a third pandemic that began in 1855 and has been considered inactive since 1959. The term "plague" is currently applied to any severe inflammation of a lymph node resulting from Y. pestis infection. Historically, the medical use of the term "plague" applied to pandemics of infection in general. The word "plague" is often associated with bubonic plague, but this type of plague is only one of its manifestations. Other names such as the Black Plague and the Black Death have been used to describe this disease; the latter term is now used primarily by scientists to describe the second, and most devastating, pandemic of the disease. The word "plague" is believed to come from the Latin plāga ("strike, wound") and plangere (to strike), cf. German Plage (“infestation”).

Cause

Transmission of Y. pestis to an uninfected individual is possible by any of the following methods.

Airborne transmission – coughing or sneezing on another person

Direct physical contact – touching an infected person, including sexual contact

Indirect contact – usually by touching contaminated soil or a contaminated surface

Airborne transmission – if the microorganism can remain in the air for a long time

Fecal-oral transmission - usually from contaminated food or water sources - is carried by insects or other animals.

The plague bacillus circulates in the body of animal carriers of the infection, especially in rodents, in natural foci of infection located on all continents except Australia. Natural foci of plague are located in a wide belt of tropical and subtropical latitudes and warm areas of temperate latitudes throughout the globe, between the parallels of 55 degrees north latitude and 40 degrees south latitude. Contrary to popular belief, rats were not directly involved in the beginning of the spread of bubonic plague. The disease was mainly transmitted through fleas (Xenopsylla cheopis) to rats, making rats themselves the first victims of the plague. In humans, infection occurs when a person is bitten by a flea that was infected by biting a rodent that was itself infected by the bite of a flea carrying the disease. The bacteria multiply inside the flea and clump together to form a plug that blocks the flea's stomach and causes it to starve. The flea then bites the host and continues to feed, even being unable to suppress its hunger, and consequently vomiting bacteria-infested blood back into the bite wound. The bubonic plague bacterium infects a new victim, and the flea eventually starves to death. Serious outbreaks of plague are usually triggered by other outbreaks of disease in rodents, or by an increase in the rodent population. In 1894, two bacteriologists, Alexandre Yersin of France and Kitasato Shibasaburo of Japan, independently isolated the bacterium in Hong Kong responsible for the third pandemic. Although both researchers reported their results, a series of confusing and contradictory statements by Shibasaburo ultimately led to Yersin being accepted as the primary discoverer of the organism. Yersin named the bacterium Pasteurella pestis after the Pasteur Institute, where he worked, but in 1967 the bacterium was transferred to a new genus and renamed Yersinia pestis, in Yersin's honor. Yersin also noted that rat plague was observed not only during plague epidemics, but also often preceded such epidemics in humans, and that many local residents believed that plague was a disease of rats: villagers in China and India claimed that the death of large numbers of rats entailed an outbreak of plague. In 1898, French scientist Paul-Louis Simon (who also came to China to fight the third pandemic) established the rat-flea vector that controls the disease. He noted that sick people should not be in close contact with each other so as not to acquire the disease. In Yunnan Province, China, residents fled their homes as soon as they saw dead rats, and on the island of Formosa (Taiwan), residents believed that contact with dead rats was associated with an increased risk of developing plague. These observations led the scientist to suspect that the flea may be an intermediate factor in the transmission of plague, since humans only acquired plague when they were in contact with recently deceased rats that had died less than 24 hours earlier. In a classic experiment, Simon demonstrated how a healthy rat died of plague after infected fleas jumped onto it from rats that had recently died of plague.

Pathology

Bubonic plague

When a flea bites a person and contaminates the wound with blood, plague-transmitting bacteria are transferred to the tissue. Y. pestis can reproduce inside a cell, so even if the cells are phagocytosed, they can still survive. Once in the body, the bacteria can enter the lymphatic system, which pumps out interstitial fluid. Plague bacteria produce several toxins, one of which is known to cause life-threatening beta-adrenergic blockade. Y. pestis spreads through the lymphatic system of an infected person until it reaches the lymph node, where it stimulates severe hemorrhagic inflammation that causes the lymph nodes to become enlarged. Enlargement of the lymph nodes is the cause of the characteristic "bubo" associated with this disease. If the lymph node is congested, the infection can spread to the blood, causing secondary septicemic plague, and if the lungs are seeded, it can cause secondary pneumonic plague.

Septicemic plague

The lymphatic system eventually drains into the blood, so plague bacteria can enter the bloodstream and end up in almost any part of the body. In the case of septicemic plague, bacterial endotoxins cause disseminated intravascular coagulation (DIC), resulting in the formation of small blood clots throughout the body and possibly ischemic necrosis (tissue death due to lack of circulation/perfusion to that tissue) of the clots. DIC depletes the body's clotting resources and the body can no longer control bleeding. Consequently, bleeding occurs into the skin and other organs, which can cause a red and/or black spotty rash and hemoptysis/hematemesis (coughing/vomiting blood). There are bumps on the skin that look like several insect bites; they are usually red, and sometimes white in the center. If left untreated, septicemic plague is usually fatal. Early treatment with antibiotics reduces mortality rates by between 4 and 15 percent. People who die from this form of plague often die the same day symptoms first appear.

Pneumonic plague

The pneumonic form of plague occurs from an infection of the lungs. It causes coughing and sneezing, and thus produces airborne droplets that contain bacterial cells that can infect someone if they are inhaled. The incubation period for pneumonic plague is short, typically lasting two to four days, but sometimes lasting only a few hours. Initial symptoms are indistinguishable from several other respiratory diseases; these include headache, weakness, and coughing up blood or hematemesis (spitting or vomiting blood). The course of the disease is rapid; if the diagnosis is not made and treatment is not carried out quickly enough, usually within a few hours, the patient dies within one to six days; in untreated cases, the mortality rate is almost 100%.

Pharyngeal plague

Meningeal plague

This form of plague occurs when bacteria cross the blood-brain barrier, resulting in infectious meningitis.

Other clinical forms

There are several other rare manifestations of plague, including asymptomatic plague and abortive plague. Cellulocutaneous plague sometimes leads to infections of the skin and soft tissue, often around the site of the flea bite.

Treatment

The first person to invent and test a vaccine against bubonic plague in 1897 was Vladimir Khavkin, a physician who worked in Bombay, India. When diagnosed early, various forms of plague are usually very responsive to antibiotic therapy. Commonly used antibiotics include streptomycin, chloramphenicol, and tetracycline. Among the newer generation of antibiotics, gentamicin and doxycycline have proven effective in the monotherapy treatment of plague. The plague bacterium may develop drug resistance and once again become a serious health threat. One case of a drug-resistant form of the bacterium was discovered in Madagascar in 1995. Another outbreak in Madagascar was reported in November 2014.

Vaccine against plague

Because human plague is rare in most parts of the world, routine vaccination is only needed for people at particularly high risk of infection or for people living in areas with enzootic plague occurring on a regular basis at predictable rates in populations and specific areas, such as the western United States States. Vaccinations are not even offered to most travelers to countries with known recent cases of the disease, especially if their travel is limited to urban areas with modern hotels. The Centers for Disease Control therefore recommends vaccination only for: (1) all laboratory and field personnel who work with antimicrobial-resistant Y. pestis organisms; (2) people participating in aerosol experiments with Y. pestis; and (3) people engaged in field operations in areas with enzootic plague when preventing exposure is not possible (eg, in some disaster areas). A systematic review by the Cochrane Collaboration found no studies of high enough quality to make any statement about the vaccine's effectiveness.

Epidemiology

Epidemic in Surat, India, 1994

In 1994, pneumonic plague broke out in Surat, India, killing 52 people and causing a major internal migration of some 300,000 residents who fled for fear of quarantine. The combination of heavy monsoon rains and clogged sewers led to widespread flooding due to unsanitary conditions and animal carcasses littering the streets. This situation is believed to have accelerated the epidemic. There was widespread fear that a sudden exodus of people from this area could have spread the epidemic to other parts of India and the world, but this scenario was averted, probably as a result of the effective response of Indian public health authorities. Some countries, especially in the neighboring Gulf region, have taken the step of canceling some flights and imposing a short-term ban on shipments from India. Much like the Black Death that spread across medieval Europe, some questions about the 1994 Surat epidemic still remain unanswered. Early questions about whether it was a plague epidemic arose because Indian health authorities were unable to culture the plague bacillus, but this may be due to poor quality laboratory procedures. However, there are several lines of evidence suggesting that this was a plague epidemic: blood tests for Yersinia were positive, the number of individuals showing antibodies against Yersinia, and the clinical symptoms displayed by patients were compatible with plague.

Other modern cases

On August 31, 1984, the Centers for Disease Control and Prevention (CDC) reported a case of pneumonic plague in Claremont, California. The CDC believes the patient, a veterinarian, contracted the distemper from a stray cat. Since the cat was not available for necropsy, this cannot be confirmed. From 1995 to 1998, annual outbreaks of plague were observed in Mahajanga, Madagascar. The plague was confirmed in the United States from 9 western states during 1995. Currently, between 5 and 15 people in the United States are estimated to contract plague each year, usually in western states. Mice are considered to be the reservoir of the disease. In the US, about half of all plague deaths since 1970 have occurred in New Mexico. There were 2 plague deaths in the state in 2006, the first fatalities in 12 years. In February 2002, a small outbreak of pneumonic plague occurred in the Shimla district of Himachal Pradesh in northern India. In the fall of 2002, a couple in New Mexico became infected shortly before visiting New York. Both men were treated with antibiotics, but the man required both legs to be amputated to make a full recovery due to the lack of blood flow to his legs cut off by bacteria. On April 19, 2006, CNN News and other news outlets reported a case of plague in Los Angeles, California involving Nirvana laboratory technician Kowlessar, the first case in that city since 1984. In May 2006, KSL Newsradio reported a case of distemper in dead field mice and chipmunks at Natural Bridges National Wildlife Refuge, located about 40 miles (64 km) west of Blanding in San Juan County, Utah. In May 2006, Arizona media reported a case of distemper in a cat. One hundred deaths due to pneumonic plague were reported in the Ituri region in eastern Democratic Republic of Congo in June 2006. Control of the plague proved difficult due to the ongoing conflict. In September 2006, it was reported that three mice infected with distemper had apparently disappeared from a laboratory belonging to a public health research institute located on the campus of the University of Medicine and Dentistry of New Jersey, which conducts research on combating bioterrorism. for the US government. On May 16, 2007, an 8-year-old capuchin monkey died of bubonic plague at the Denver Zoo. Five squirrels and a rabbit were also found dead at the zoo and tested positive for the disease. On June 5, 2007, in Torrance County, New Mexico, a 58-year-old woman developed bubonic plague, which evolved into pneumonic plague. On November 2, 2007, Eric York, a 37-year-old wildlife biologist with the Mountain Lion National Park Conservation Program and the Felid Conservation Foundation, was found dead at his home in Grand Canyon National Park. On October 27, York performed a necropsy on a mountain lion that had apparently succumbed to illness and three days later, York reported flu-like symptoms and took time off work due to illness. He was treated at a local clinic but was not diagnosed with any serious illness. His death caused a minor panic, with officials saying he likely died from the plague or exposure to hantaviruses, and 49 people who had come into contact with York were given aggressive antibiotic treatment. None of them got sick. Autopsy results released on November 9 confirmed the presence of Y. pestis in his body, confirming plague as the likely cause of his death. In January 2008, at least 18 people died from bubonic plague in Madagascar. On June 16, 2009, Libyan authorities reported an outbreak of bubonic plague in Tobruk, Libya. There were 16-18 cases reported, including one death. On August 2, 2009, Chinese authorities quarantined the village of Ziketan, in Xinghai County, Hainan Tibet Autonomous Prefecture, Qinghai Province of China (Northwest China), following an outbreak of pneumonic plague. On September 13, 2009, Dr. Malcolm Casadaban died after accidental laboratory exposure to a weakened strain of the plague bacterium. This was due to his undiagnosed hereditary hemochromatosis (iron overload). He was an assistant professor of molecular genetics and cell biology and microbiology at the University of Chicago. On July 1, 2010, eight human cases of bubonic plague were reported in the Chicama region of Peru. One 32-year-old man was injured, as well as three boys and four girls aged 8 to 14 years. 425 houses were fumigated and 1,210 guinea pigs, 232 dogs, 128 cats and 73 rabbits were treated against fleas in an attempt to stop the epidemic. On May 3, 2012, a ground squirrel trapped at a popular campground on Mount Palomar in San Diego, California, tested positive for distemper bacteria during routine testing. On June 2, 2012, a man in Crook County, Oregon, was bitten and contracted septicemic plague while trying to save a cat that had choked on a mouse. On July 16, 2013, a squirrel captured at a campground in the Angeles National Forest tested positive for plague, prompting the closure of the campground while researchers tested other squirrels and took action against plague fleas. On August 26, 2013, Temir Isakunov, a teenager, died of bubonic plague in northern Kyrgyzstan. In December 2013, an epidemic of pneumonic plague was reported in 5 of Madagascar's 112 districts, believed to be caused by large bush fires forcing rats to flee to cities. On July 13, 2014, a Colorado man was diagnosed with pneumonic plague. On July 22, 2014, the city of Yumen, China, went into lockdown and 151 people were quarantined after one man died of bubonic plague. On 21 November 2014, the World Health Organization reported 40 deaths and 80 other infections on the island of Madagascar, with the first known case in the outbreak believed to have occurred in late August 2014.

Story

Antiquity

Y. pestis plasmids have been found in archaeological dental samples from seven Bronze Age individuals dating back 5,000 years ago (3000 BC), the Afanasyevskaya culture at Afanasyevo in Siberia, the Battle Ax culture in Estonia, the Sintashta culture in Russia, the Unetitsa culture in Poland and Andronovo culture in Siberia. Y. pestis existed in Eurasia during the Bronze Age. The common ancestor of all Y. pestis is estimated to be 5,783 years before the present. Yersinia mouse toxin (YMT) allows the bacteria to infect fleas, which can then transmit bubonic plague. Early versions of Y. pestis do not have the YMT gene, which was only found in 951 calibrated specimens dating back to BC. The Amarna Archive and Mursili II's plague prayers describe an outbreak among the Hittites, although some modern sources claim it may have been tularemia. The first book of Kings describes a possible outbreak of plague in Philistia, and the Septuagint version says it was caused by "the devastation of mice." In the second year of the Peloponnesian War (430 BC), Thucydides described an epidemic that was said to have started in Ethiopia, passed through Egypt and Libya, and then came to the Greek world. During the Plague of Athens, the city lost perhaps a third of its population, including Pericles. Modern historians disagree on whether the plague was a critical factor in population loss during the war. Although this epidemic has long been considered an outbreak of plague, many modern scientists believe that the descriptions made by the survivors are more likely to be typhus, smallpox, or measles. A recent study of DNA found in the tooth pulp of plague victims suggests that typhus was actually involved. In the first century AD, Rufus Ephesus, a Greek anatomist, described an outbreak of plague in Libya, Egypt and Syria. He notes that the Alexandrian physicians Dioscorides and Posidonius described symptoms including acute fever, pain, agitation, and delirium. Under the knees, around the elbows, and “in the usual places” the patients developed buboes - large, hard and not suppurating. The death toll among those infected was very high. Rufus also wrote that similar buboes were described by Dionysius Curtus, who may have practiced medicine in Alexandria in the third century BC. If this is correct, the eastern Mediterranean world may have been familiar with the bubonic plague at such an early stage. In the second century, the Antonine Plague, named after the surname of Marcus Aurelius Antoninus, swept across the world. The disease is also known as the Plague of Galen, who knew about it first hand. There is speculation that the disease may actually have been smallpox. Galen was in Rome when in 166 AD. this epidemic began. Galen was also present in the winter of 168-69. during an outbreak of disease among troops stationed in Aquileia; he had experience with the epidemic, calling it "very long" and describing the symptoms of the disease and his methods of treating it. Unfortunately, his notes are very brief and scattered across several sources. According to Barthold Georg Niebuhr, “this infection raged with incredible force, taking with it countless victims. The ancient world never recovered from the blow dealt by the plague during the reign of M. Aurelius.” The mortality rate from the plague was 7-10 percent; outbreak in 165(6)-168. killed between 3.5 and 5 million people. Otto Sieck believes that more than half the empire's population died. J. F. Gilliam believes that the Antonine plague probably caused more deaths than any other epidemic from imperial times to the mid-3rd century.

Medieval and post-medieval pandemics

Local outbreaks of plague are grouped into three plague pandemics, with the result that the respective start and end dates of some pandemic outbreaks are still a matter of debate. According to Joseph P. Byrne of Belmont University, these pandemics were: The first plague pandemic from 541 to ~750, spreading from Egypt to the Mediterranean (starting with the Plague of Justinian) and northwestern Europe. Second plague pandemic from ~1345 to ~1840, spreading from Central Asia to the Mediterranean and Europe (starting with the Black Death), and probably also entering China. Third plague pandemic from 1866 to the 1960s, spreading from China throughout the world, particularly in India and the West Coast of the United States. However, the Black Death of the late Middle Ages is sometimes seen not as the beginning of the second, but as the end of the first pandemic - in this case, the beginning of the second pandemic would be in 1361; Also, the end dates of the second pandemic in this literature are not constant, for example, ~1890 instead of ~1840.

First Pandemic: Early Middle Ages

Plague of Justinian in 541-542 AD. is the first known epidemic to be described. It marks the first recorded pattern of bubonic plague. This disease is believed to have originated in China. It then spread to Africa, where the huge city of Constantinople imported large quantities of grain, mainly from Egypt, to feed its citizens. Grain ships were a source of infection for the city, and the massive government granaries harbored populations of rats and fleas. At the peak of the epidemic, according to Procopius, it killed 10,000 people daily in Constantinople. The real number was more likely around 5,000 people per day. The plague ultimately may have killed 40% of the city's inhabitants. The plague killed up to a quarter of the population of the eastern Mediterranean. In 588 AD. a second major wave of plague spread across the Mediterranean into what is now France. The Plague of Justinian is estimated to have killed approximately 100 million people worldwide. This epidemic reduced the population of Europe by approximately half between 541 and 700 BC. In addition, the plague may have contributed to the success of the Arab conquests. An outbreak of plague in 560 AD was described in 790 AD. The source says that the plague caused "swelling of the glands ... in the form of a nut or a date" in the groin area "and in other rather delicate places, followed by an intolerable fever." While the swellings in this description are identified by some as buboes, there is some disagreement as to whether this pandemic should be classified as the bubonic plague, Yersinia pestis, as known in modern times.

Second pandemic: from the 14th century to the 19th century

From 1347 to 1351, the Black Death, a massive and deadly pandemic originating in China, spread along the Silk Road and swept through Asia, Europe and Africa. This epidemic may have reduced the world population from 450 million to 350-375 million. China lost about half of its population, from about 123 million to about 65 million; Europe lost about 1/3 of its population, from about 75 million to 50 million people; and Africa lost about 1/8 of its population, from about 80 million to 70 million (death rates tend to correlate with population density, so Africa, being less dense overall, had the lowest death rates). The Black Death was associated with the highest number of deaths of any known non-viral epidemic. Although there are no exact statistics, it is believed that 1.4 million people died in England (a third of the 4.2 million people living in England), while in Italy an even larger percentage of the population was probably killed. On the other hand, populations in northeastern Germany, the Czech Republic, Poland and Hungary were likely less affected, and there are no estimates of mortality in Russia or the Balkans. It is possible that Russia was not as affected due to its very cold climate and large size, which resulted in less close contact with the infection. The plague returned repeatedly to Europe and the Mediterranean from the 14th to the 17th centuries. According to Biraben, the plague was present in Europe every year between 1346 and 1671. A second pandemic spread in 1360-1363; 1374; 1400; 1438-1439; 1456-1457; 1464-1466; 1481-1485; 1500-1503; 1518-1531; 1544-1548; 1563-1566; 1573-1588; 1596-1599; 1602-1611; 1623-1640; 1644-1654; and 1664-1667; subsequent outbreaks, although severe, marked the waning of outbreaks across much of Europe (18th century) and North Africa (19th century). According to Geoffrey Parker, "France lost nearly a million people in the plague of 1628-31." In England, in the absence of a census, historians offer a range of pre-epidemic population estimates ranging from 4 to 7 million in 1300, and 2 million after the epidemic. By the end of 1350, the Black Death had subsided, but it never fully disappeared from England. Over the next few hundred years, further outbreaks occurred in 1361-62, 1369, 1379-83, 1389-93 and during the first half of the 15th century. An outbreak in 1471 killed 10-15% of the population, and mortality from the plague of 1479-80. could reach 20%. The most common outbreaks in Tudor and Stuart England began in 1498, 1535, 1543, 1563, 1589, 1603, 1625 and 1636 and ended with the Great Plague of London in 1665. In 1466, 40,000 people died from the plague in Paris. During the 16th and 17th centuries, plague swept through Paris almost every third year. The Black Death ravaged Europe for three years and then continued into Russia, where the disease struck about once every five or six years from 1350 to 1490. Plague epidemics devastated London in 1563, 1593, 1603, 1625, 1636 and 1665, reducing its population by 10-30% in these years. More than 10% of Amsterdam's population died in 1623-1625, and again in 1635-1636, 1655 and 1664. There were 22 outbreaks of plague in Venice between 1361 and 1528. The plague of 1576-1577 killed 50,000 people in Venice, almost a third of the population. Later outbreaks in central Europe included the Italian plague of 1629–1631, which was associated with troop movements during the Thirty Years' War, and the great plague of Vienna in 1679. More than 60% of the population in Norway died in 1348-1350. The last outbreak of plague devastated Oslo in 1654. In the first half of the 17th century, the Great Plague of Milan killed 1.7 million people in Italy, or about 14% of the population. In 1656, plague killed about half of the 300,000 inhabitants of Naples. More than 1.25 million deaths are attributed to the extreme spread of plague in 17th century Spain. The plague of 1649 probably halved the population of Seville. In 1709-1713, the plague epidemic following the Great Northern War (1700-1721, Sweden vs. Russia and allies) killed about 100,000 people in Sweden and 300,000 people in Prussia. The plague killed two-thirds of the inhabitants of Helsinki, and a third of the population of Stockholm. The last major epidemic in Western Europe occurred in 1720 in Marseilles, in Central Europe the last major outbreaks occurred during the Great Northern War, and in Eastern Europe during the Russian plague of 1770-72. The Black Death devastated much of the Islamic world. Plague was present in some region of the Islamic world almost every year between 1500 and 1850. The plague struck cities in North Africa several times. Algeria lost 30,000-50,000 men in 1620-21, and again in 1654-57, 1665, 1691 and 1740-42. Plague remained an important factor in Ottoman society until the second quarter of the 19th century. Between 1701 and 1750, 37 major and minor epidemics were recorded in Constantinople, and 31 epidemics between 1751 and 1800. Baghdad was hit hard by the plague and two-thirds of its population was destroyed.

Nature of the Black Death

In the early 20th century, following Yersin and Shibasaburo's identification of the plague bacterium that caused the Asian bubonic plague (Third Pandemic) in the late 19th and early 20th centuries, most scientists and historians became convinced that the Black Death was strongly linked to the presence of more contagious pneumonic and septic variants of the disease, which increased the growth of infection and spread the disease deep into the interior of the continents. Some modern researchers argue that the disease was more likely viral, pointing to the absence of rats in parts of Europe that were heavily affected by epidemics, and to the belief of people at the time that the disease was spread by direct contact with an infected person. According to stories of the time, the Black Death was highly contagious, unlike the bubonic plague of the 19th and early 20th centuries. Samuel K. Cohn made a comprehensive attempt to disprove the bubonic plague theory. The researchers proposed a mathematical model based on the changing demographics of Europe from 1000 to 1800, demonstrating how plague epidemics from 1347 to 1670 may have driven selection that raised mutation rates to levels seen today, which prevents HIV from entering macrophages and CD4+ T cells that carry the mutation (average frequency of this allele is 10% in European populations). It is believed that one original mutation appeared more than 2,500 years ago, and that persistent epidemics of hemorrhagic fever broke out during the early classical civilizations. However, there is evidence that two previously unknown clades (variant strains) of Y. pestis were responsible for the Black Death. A multinational team conducted new surveys that used both ancient DNA analyzes and protein-specific detection methods to search for DNA and protein specific to Y. pestis in human skeletons from widespread mass graves in northern, central and southern Europe that were archaeologically associated with the Black Death and subsequent outbreaks. The authors concluded that this study, together with previous analyzes from southern France and Germany, "... puts to rest the debate over the etiology of the Black Death, and demonstrates unequivocally that Y. pestis was the causative agent of the plague that devastated Europe in the Middle Ages." The study also identified two previously unknown but related strains of Y. pestis that were associated with various medieval mass graves. These have been recognized as the ancestors of modern isolates of Y. pestis strains "Orientalis" and "Medievalis", suggesting that these variant strains (now considered extinct) may have entered Europe in two waves. Surveys of the graves of plague victims remaining in France and England indicate that the first variant entered Europe through the port of Marseille around November 1347 and spread throughout France over the next two years, eventually reaching England in the spring of 1349, where it spread throughout the country in three consecutive epidemics. Surveys of plague graves remaining in the Dutch town of Bergen op Zoom revealed the presence of a second genotype of Y. pestis, which is different from the genotype in Great Britain and France, and this second strain was believed to be responsible for the pandemic that spread through Holland. Belgium and Luxembourg since 1350. This discovery means that Bergen-op-zoom (and perhaps other regions in the southern Netherlands) did not directly receive infection from England or France around 1349, and the researchers suggested a second wave of plague infection, distinct from the infection that occurred in England and France may have reached the Low Countries from Norway, the Hanseatic cities or other regions.

Third pandemic: 19th and 20th centuries

The Third Pandemic began in China's Yunnan province in 1855, spreading the plague to every inhabited continent and ultimately causing the death of more than 12 million people in India and China. The analysis shows that the waves of this pandemic may come from two different sources. The first source is mainly the bubonic plague, which spread throughout the world through ocean trade, transporting infected people, rats and cargo that harbored fleas. The second, more virulent strain was mainly pulmonary in nature, with strong person-to-person transmission. This strain was largely limited to Manchuria and Mongolia. Researchers during the "Third Pandemic" identified plague vectors and plague bacteria, which eventually led to modern treatments. The plague struck Russia in 1877-1889, and it happened in rural areas near the Ural Mountains and the Caspian Sea. Efforts at hygiene and patient isolation reduced the spread of the disease, and the disease claimed only 420 lives in the region. It is important to note that the Vetlyanka region is located near a population of the steppe marmot, a small rodent considered a very dangerous reservoir of plague. The last significant outbreak of plague in Russia occurred in Siberia in 1910, after a sudden increase in demand for marmot pelts (a sable substitute) increased the price of the pelts by 400 percent. Traditional hunters did not hunt sick marmots, and it was forbidden to eat the fat from under a marmot's shoulder (where the axillary lymph gland in which plague often developed is located), so outbreaks tended to be limited to individuals. The rising prices, however, attracted thousands of Chinese hunters from Manchuria, who not only caught the sick animals, but also ate their fat, which is considered a delicacy. The plague spread from the hunting grounds to the end of the Chinese Eastern Railway and along the highway beyond it for 2,700 km. The plague lasted 7 months and killed 60,000 people. Bubonic plague continued to circulate through various ports around the world for the next fifty years; however, the disease was primarily found in Southeast Asia. An epidemic in Hong Kong in 1894 was associated with a particularly high mortality rate, 90%. As early as 1897, the medical authorities of the European powers organized a conference in Venice in search of a way to contain the plague in Europe. In 1896, the Mumbai plague epidemic struck the city of Bombay (Mumbai). In December 1899, the disease reached Hawaii, and the Board of Health's decision to initiate controlled burns of selected buildings in Honolulu's Chinatown resulted in an out-of-control fire that inadvertently burned most of Chinatown on January 20, 1900. Shortly thereafter, the plague reached the continental United States, marking the beginning of the 1900-1904 plague. in San Francisco. The plague persisted in Hawaii on the outer islands of Maui and Hawaii (The Big Island) until it was finally eradicated in 1959. Although the outbreak that began in China in 1855, traditionally known as the Third Pandemic, remains unclear, it was Whether there are fewer or more major outbreaks of bubonic plague than three. Most modern outbreaks of bubonic plague in humans were preceded by a strikingly high mortality rate in rats, but descriptions of this phenomenon are missing from accounts of some earlier epidemics, especially the Black Death. Buboes, or swellings in the groin area, which are especially characteristic of bubonic plague, are also a characteristic feature of other diseases. Research carried out by a team of biologists from the Pasteur Institute in Paris and the Johannes Gutenberg University of Mainz in Germany, by analyzing DNA and proteins from plague graves, published in October 2010, reported that, without a doubt, all "three major epidemics" were caused by by at least two previously unknown strains of Yersinia Pestis and originated in China. A team of medical geneticists, led by Mark Achtman of University College Cork in Ireland, reconstructed the family tree of this bacterium and, in the online issue of Nature Genetics on October 31, 2010, scientists concluded that all three major waves of plague originated in China.

Plague as a biological weapon

The plague was used as a biological weapon. Historical evidence from ancient China and medieval Europe demonstrates the use of contaminated animal carcasses, such as cows or horses, and human corpses by the Huns, Mongols, Turks, and other peoples to contaminate enemy water supplies. General Huo Qibin of the Han Dynasty died from such pollution while participating in military operations against the Huns. Plague victims were also catapulted into cities under siege. In 1347, Genoese-held Kaffa, a large trading center on the Crimean Peninsula, came under siege by an army of Mongol warriors of the Golden Horde under the command of Janibek. After a long siege, during which the Mongol army was reported to have suffered from the disease, the Mongols decided to use the infected corpses as biological weapons. The corpses were catapulted beyond the city walls, infecting the inhabitants. Genoese traders fled, carrying the plague (Black Death) with the help of their ships to the south of Europe, from where it quickly spread throughout the world. During World War II, a plague broke out in the Japanese army due to large numbers of fleas. During the Japanese occupation of Manchuria, Unit 731 deliberately infected Chinese, Korean, and Manchu civilians and prisoners of war with the plague bacterium. These people, called "maruta" or "logs", were then studied by dissection, others by vivisection while they were still conscious. Bloc members such as Shiro Ishii were exonerated from the Tokyo Tribunal by Douglas MacArthur, but 12 of them were prosecuted in trials in the Khabarovsk Military Courts in 1949, during which some admitted to spreading bubonic plague within a 36-minute radius km around the city of Changde. Ishii bombs, containing live mice and fleas, with very small explosive loads to deliver the weaponized microbes, overcame the problem of killing infected animals and insects with an explosive device by using a ceramic, rather than metal, warhead housing. Although no records remain regarding the actual use of ceramic shells, prototypes exist and they are believed to have been used in experiments during World War II. After World War II, the United States and the Soviet Union developed remedies for the military use of pneumonic plague. Experiments included different delivery methods, vacuum drying, calibrating the bacteria, developing antibiotic-resistant strains, combining the bacteria with other diseases (such as diphtheria), and genetic engineering. Scientists who worked on biological weapons programs in the USSR stated that the Soviet Union carried out powerful efforts in this direction, and that large stocks of plague bacteria were produced. Information about many Soviet projects is largely missing. Aerosol pneumonic plague remains the most serious threat. The plague can be easily treated with antibiotics, which some countries, such as the United States, stockpile in case of such an attack.

Wheelis M. (2002). "Biological warfare at the 1346 siege of Caffa." Emerg Infect Dis (Center for Disease Control) 8(9):971–5. doi:10.3201/eid0809.010536. PMC 2732530. PMID 12194776

IN XI in Europe the population began to grow sharply. TO XIV century it was impossible to feed everyone enough. More or less cultivable land was used. Lean years occurred more and more often, as the climate of Europe began to change - there was great cold and frequent rain. Hunger did not leave the cities and villages, the population suffered. But that wasn't the worst thing. The weakened population often fell ill. IN 1347 year the most terrible epidemic began.

Came to Sicily and ships from eastern countries. In their holds they carried black rats, which became the main source of a deadly type of plague. A terrible disease began to instantly spread throughout Western Europe. Everywhere people started dying. Some patients died in long agony, while others died instantly. Places of mass gatherings – cities – suffered the most. Sometimes there were no people there to bury the dead. Over 3 years, the European population decreased by 3 times. Frightened people fled the cities faster and spread the plague even more. That period of history was called the time "Black Death".

The plague affected neither kings nor slaves. Europe was divided into borders, to somehow reduce the spread of the disease.

IN 1346 year The Genoese attacked modern Feodosia. For the first time in history it was used biological weapons. The Crimean Khan threw the corpses of plague victims behind the besieged walls. The Genoese were forced to return to Constantinople, carrying with them a terrible murder weapon. Almost half of the city's population died.

European merchants, in addition to expensive goods from Constantinople, brought plague. Rat fleas were the main carriers of the terrible disease. The port cities were the first to take the hit. Their numbers decreased sharply.

The sick were treated by monks, who, by the will of the service, were supposed to help the suffering. It was among the clergy and monks that the greatest number of deaths occurred. Believers began to panic: if God’s servants were dying from the plague, what should the common people do? People considered it a punishment from God.

The Black Death plague came in three forms:

Bubonic plague– tumors appeared on the neck, groin and armpit. Their size could reach a small apple. The buboes began to turn black and after 3-5 days the patient died. This was the first form of plague.

Pneumonic plague– the person’s respiratory system suffered. It was transmitted by airborne droplets. The patient died almost instantly - within two days.

Septicemic plague– the circulatory system was affected. The patient had no chance to survive. Bleeding began from the mouth and nasal cavity.

Doctors and ordinary people could not understand what was happening. Panic began from horror. No one understood how he became infected with the Black Disease. On the first couple of occasions, the dead were buried in the church and buried in an individual grave. Later the churches were closed and the graves became common. But they too were instantly filled with corpses. Dead people were simply thrown out into the street.

In these terrible times, the looters decided to profit. But they also became infected and died within a few days.

Residents of cities and villages were afraid of becoming infected and locked themselves in their houses. The number of people able to work decreased. They sown little and harvested even less. To compensate for losses, landowners began to inflate land rent. Food prices have risen sharply. Neighboring countries were afraid to trade with each other. A poor diet further favored the spread of the plague.

The peasants tried to work only for themselves or demanded more money for their work. The nobility was in dire need of labor. Historians believe that the plague revived the middle class in Europe. New technologies and working methods began to appear: an iron plow, a three-field sowing system. A new economic revolution began in Europe in conditions of famine, epidemics and food shortages. The top government began to look at the common people differently.

The mood of the population also changed. People became more withdrawn and avoided their neighbors. After all, anyone could get the plague. Cynicism is developing, and morals have changed to the opposite. There were no feasts or balls. Some lost heart and spent the rest of their lives in taverns.

Society was divided. Some in fear refused a large inheritance. Others considered the plague a finger of fate and began a righteous life. Still others became real recluses and did not communicate with anyone. The rest escaped with good drinks and fun.

The common people began to look for the culprits. They became Jews and foreigners. The mass extermination of Jewish and foreign families began.

But after 4 years The Black Death plague in Europe in the 14th century subsided. Periodically, she returned to Europe, but did not cause massive losses. Today man has completely defeated the plague!

Speaking about the plague in European history, we primarily mean the so-called “Black Death”, which swept across the continent in 1346-1353 and wiped out - according to various estimates - from 30% to 50% of the population (15-30 million people) . Some cities and regions lost half (for example, Provence) or even three-quarters of their inhabitants (Tuscany).

Europe has experienced similar shocks before. In the 6th century, a pandemic swept the continent, which went down in history as the “Plague of Justinian.” But since then everything was limited to individual outbreaks - until 1346.

Then a real catastrophe struck - a terrible epidemic, nicknamed by contemporaries the “Black Death”.

The plague came from the East, where it raged at the beginning of the decade, and Crimea was the first to be hit, followed by Constantinople. At that time, trade on the Mediterranean Sea was of great importance and was very active, so it did not take long for the disease to reach the major Italian ports and Marseilles on ships.

Rampant obscurantism and plague pogroms

Medieval people did not have as much knowledge about the world as you and I did, and found it difficult to rationally explain many phenomena - including terrible diseases. Yes, the epidemics themselves were not something out of the ordinary, but the speed with which the black death spread through cities and villages, and its “inexorability” very quickly caused a surge of obscurantism in society.

Many saw the plague as a punishment from above, looking for an explanation for what was happening in distorted retellings of biblical legends, and tried to stop the epidemic with the help of religious rituals. Mass processions with self-flagellation were organized, and low-level priests invented new rituals on the fly, such as stretching a thread along the city wall.

The highest church hierarchs did not dare to intervene in the situation, although real sects of many thousands were being formed before their eyes. The Vatican understood that prayers for illness do not help and people need at least some kind of outlet.

Just recently, the Catholic Church very methodically suppressed major heresies, for example, the Cathar movement, but now it has let go of the reins.

If primitive superstitions forced people to lock themselves in their houses or leave cities, then the inspirers of the movements of self-flagellation flagellants or bianchi walking around the cities in white robes did the opposite. Mass events are not the best idea during an epidemic, to be sure.

Others found more rational explanations: they say, such a terrible misfortune cannot arise on its own, and the Lord is not so cruel - this is the evil intent of either people or the devil himself. Of course, in search of the culprits, they also reached the imaginary sorcerers and the Jewish quarters.

It even got in leper colonies, although they, it would seem, had absolutely nothing to do with it: the difference between their illness and the plague was obvious even to a medieval person.

Here the church no longer stood aside and tried to prevent bloodshed - both with exhortations and direct prohibitions: for lynching they were threatened with excommunication. Alas, this did not always stop the crowd.

The Catholic Church at that time was the most powerful organization in Europe - the Vatican often dictated its will even to kings. But during the years of the Black Death, it turned out to be practically powerless: seeing the real state of affairs, people either rapidly lost faith, or, on the contrary, became uncontrollable fanatics.

Fortunately, in the current situation, there were still those who were ready to act decisively and effectively. Secular authorities came to the forefront of history.

Cold-blooded quarantines and the strengthening of secular power

The image of the plague doctor is well known to everyone, and there really was a point in creating such “sanitary units”.

Of course, they did not know how to truly treat the sick - except to open and cauterize their buboes. And the rats continued to freely spread plague fleas throughout the cities (no one could figure out how the infection actually spreads).

Nevertheless, the presence of people in the epicenters of the epidemic who were able to restore at least some order helped. However, not only plague doctors were thrown into the fight.

The Italian cities that initially suffered the most from the epidemic quickly responded to the terrible events by establishing special commissions designed to deal with this issue. There was no serious experience in dealing with such a terrible scourge, but the authorities, nevertheless, took a number of reasonable measures. First of all, teams were created to collect, remove and bury corpses in separate burial grounds.

Now this may seem like a simple and obvious solution, but in the 14th century it was not easy to organize even ordinary street cleaning, much less clear the city space of bodies lying here and there.

In addition, the authorities have developed a number of serious quarantine measures. Although the efficiency of management in the 14th century left much to be desired and, in order to implement such decisions, remarkable administrative talent was required - the quarantine regime was in force, and the epidemic was at least somewhat contained. The successful experience of the Italian authorities began to be quickly adopted throughout Europe.

Also, despite numerous protests, taverns and brothels were forced to close everywhere. The mayors understood that the population density in their estates was colossal and it would not be possible to completely solve the problem, but limiting contact between people as much as possible was a useful and necessary measure.

The experience of the Venetians, who approached the matter with a cool head, is especially impressive. Panic was suppressed not only by force, but also by personal example: while ordinary people were trying to leave the cities, officials were strictly forbidden to flee. A quarantine was imposed on nearby islands, where all arrivals were checked for symptoms of the disease.

The Black Death became the most serious test for European cities. And the secular authorities, in contrast to the spiritual ones who had faded away, passed it, albeit with varying degrees of success.

For the first time in several centuries, secular government showed itself to be better than the Catholic Church, and from then on its influence began to grow noticeably.

The new look of Europe

It is impossible to overestimate the significance of what happened for Europe. It is difficult to even list all the changes directly or indirectly related to the Black Death. Oddly enough, some of these deepest scars became a real decoration for the portrait of the era: a terrible disaster had a number of positive consequences.

Urban boom and women's emancipation

The value of labor, especially more or less skilled labor, has increased sharply. Many guilds (craft or trade communities), which had previously been relatively closed organizations, now had to actively accept everyone into their ranks.

Of course, after this, a huge number of people wanted to move to cities from villages, especially since the former suffered more from the plague. For example, about a third of property in London remains ownerless.

The incomes of skilled people increased sharply - so much so that in many countries, cities and possessions this quickly met with opposition from the authorities, who tried to reduce wages again. The British in 1349 and 1351 passed special laws limiting the growth of workers' incomes (in the second case it was directly forbidden to pay them more than in 1346).

However, these regulations did not work at all. Firstly, ordinary people felt their own strength: after all, the authorities cannot do without them - someone has to work, one way or another. Secondly, such an order obviously contradicted the basic laws of the market: if supply has sharply decreased (there are simply fewer people of working age), then prices cannot help but rise.

It even got to the point that everyone who tried to change jobs or move was required by law to be put in prison - but such drastic measures were completely impossible.

A more adequate response of the authorities to the changes that frightened them were some provisional decrees. This term is usually referred to as “luxury taxes,” but in this case we are talking about restricting consumption for the lower and middle classes of society. The assumption was that if people had nothing better to spend their money on, then they wouldn't want to earn it. But despite radical legislative initiatives, governments still failed to stop the changes that had begun.

The lower-ranking townspeople who survived the plague epidemic noticeably improved their well-being.

The lack of hands also affected the position of women - in such a situation there is no time for sexism. Girls' or mixed guilds existed in Europe even before the Black Death, but now women had a real opportunity, so to speak, to advance up the career ladder. This affected village residents to a lesser extent, but a lot has already changed in the rural way of life...

Liberation of the peasantry

Perhaps the peasants benefited most from the plague, so to speak. Serfdom in Western Europe, even before the epidemic, was gradually giving way to a new system of class relations, and a sharp decline in population strengthened this trend: the feudal lords had to enter into dialogue with the people working on the land.

As a result, in almost all of Western Europe, the rights of peasants soon expanded, and various types of taxes decreased. Of course, many feudal lords tried to counteract this, so soon the villagers again had reasons for uprisings. However, it has also become much more difficult for weakened states to suppress their speeches.

The plague undoubtedly played a significant role in the process of liberation of the peasants. A lot of free land was formed - left over from those who simply did not survive the Black Death. A holy place is never empty, and even more so a fertile place: these fields and, most importantly, pastures made it possible to improve the food situation in Europe.

Trade also received a new impetus: for example, England began regular deliveries to Scandinavia and the Netherlands, where conditions for agriculture were far from ideal.

By the way, they began to work in the villages somewhat differently: the role of livestock farming, which required much fewer workers than agriculture, increased noticeably. The plots themselves have fallen significantly in price, and labor on them has become more expensive. This could not compensate for the terrible loss of life, but it served as at least some consolation.

The above is true for Western Europe. In the East, where the population density was lower, mainly cities were seriously affected by the plague, and little changed in the situation of residents of rural areas, which were less affected by the epidemic. Serfdom in some regions persisted here until the 19th century.

Democratization of the Church

The real Reformation is still far away, but already at this time Protestantism was emerging: the previous balance in spiritual life, very stable, was disrupted.

If the bitter example of the Cathars who were cut to pieces discouraged many from any freethinking at the turn of the 13th–14th centuries, now Europeans have clearly seen: the Vatican is not so omnipotent.

Since even in Italy the church really couldn’t (or didn’t want) to do anything about the rampant sects of varying degrees of adequacy, then why shouldn’t people in their right minds, who also have justified claims and demands, come out against it?

The clergy also greatly thinned out during the epidemic, which, alas, was greatly facilitated by the care of the monks for the sick - sometimes monasteries simply died out from the plague. And it was much more difficult to fill personnel gaps here than in the ranks of peasants and workers: we are talking about rather highly qualified specialists.

Throughout the Middle Ages, the church was the best and, most importantly, constantly accessible social elevator. Theoretically, any commoner could begin his career as a servant in a temple or a novice in a monastery, and die as a Pope. This is one of the few areas of activity in the Middle Ages where everything depended on the efforts and talents of the person himself, and not on any external factors such as origin.

Now there are many more “jobs” in the church, which means that many people have a great chance to realize themselves. This even affected women: now they too could achieve more in the monastic service.

The Black Death also played a colossal role in the fate of religious minorities: Jews living throughout the continent and Muslims settled on the Iberian Peninsula. And again we must remember the proverb “if there was no happiness, but misfortune would help”: on the one hand, the people of other faiths suffered greatly from the pogroms, and even after the pandemic they continued to be blamed for all the troubles. The already complex relations between people of different faiths have become strained, as always happens in moments of crisis. But on the other hand, the rise of science and the increased need for well-trained specialists turned out to be a blessing for the same Jews. So the communities oppressed during the disease not only recovered, but in part even became stronger.

Development of medicine and unity of society

And of course, the disaster that befell Europe spurred the development of medicine. The prestige of this department in universities increased sharply, active research began: people wanted to understand what caused the Black Death and how to prevent its recurrence.

Of course, before the discoveries of Louis Pasteur, it was technically impossible to achieve great success in this field, but the positive effect for science is obvious. The same anatomical studies, which traditionally met with opposition from the church, began to be treated more loyally.

In the end, a huge number of noble and influential people, including kings and the highest hierarchs of the church, died from the plague. Among them are the Castilian monarch Alfonso XI, the Queen of Aragon, Eleanor of Portugal, and the Vladimir prince Simeon the Proud (the widespread belief that there was no plague in Rus' is a misconception).

Now everyone understood that illness was a common problem, and not just a problem of the lower strata. You cannot hide from the plague behind the walls of a castle or temple. To some extent, no matter how pathetic it may sound, the misfortune that happened united society, although the Middle Ages still remained the Middle Ages - an era of severe social stratification.

Some scientists even note the role of the Black Death in natural selection, or, if you like, the evolution of humanity. According to them, after the pandemic, genes have spread that have increased people’s resistance to dangerous diseases. But statements of this kind are still quite controversial, and these studies are not directly related to historical science.

After the Black Death

The plague misadventures of Europe did not end there. There will be many more major epidemics. Let's say, in 1664–1665 London will lose about 25% of its population, and in 1720–1722 the same Marseille, which was once the “gateway” for the Black Death, will suffer even more. Let us also remember the plague riot in Moscow - which, by the way, happened during not the largest epidemic that Russia has known.

But none of the subsequent outbreaks of plague or any other diseases became such a shock for European civilization. We can say that the Black Death hardened the Old World.

Despite the terrible damage that all European countries suffered, this tragedy also had positive consequences.

In medicine there is the concept of crisis - a turning point in the course of a disease. The plague became such a “crisis” for the entire region. Europe might not have been able to withstand this test and risked falling back into the “dark ages,” once again finding itself in the state in which it was in the first centuries after the fall of the Roman Empire. But the plague crisis was successfully overcome, and it was not long before the Renaissance.