The Black Death

The Black Death, which arrived in England in 1348, was one of the deadliest pandemics in history, killing up to half of Europe’s population. Its arrival in England marked a turning point in medical history, with devastating social, economic, and cultural consequences.

What Was the Black Death?

The Black Death is believed to have been caused by two distinct but related diseases: the bubonic plague and the pneumonic plague.

Bubonic Plague: 

This form of the disease caused large, painful swellings known as buboes, which appeared primarily in the armpits, neck, and groin. It was spread by fleas that lived on rats, which were common in medieval towns. When infected rats travelled aboard ships from China to England, they brought the fleas with them, which then bit humans and transmitted the plague. The bubonic plague had a high mortality rate, but it was not as lethal as pneumonic plague.

Pneumonic Plague: 

This form of the disease attacked the lungs and was spread through coughs and sneezing. Pneumonic plague was far more deadly, with a near 100% mortality rate if untreated. The rapid spread of this variant made it especially deadly, as it could infect large numbers of people quickly.

Both forms of the Black Death spread rapidly across Europe, causing widespread panic and chaos. The disease eventually reached England, and its devastating impact resulted in millions of deaths, reshaping society for centuries to come.

Beliefs About the Causes of the Black Death

In medieval England, people had no understanding of germs or how diseases were transmitted. As a result, they came up with various theories about the causes of the Black Death:

• Miasma Theory: One of the most widely believed explanations was the idea of miasma, or "bad air." It was thought that disease could be spread through foul-smelling air, particularly from contaminated water, waste, or rotting food. People believed that breathing in this “poisonous air” caused the plague.
• Imbalance of the Four Humours: The theory of the four humours (blood, phlegm, yellow bile, and black bile) was a long-standing belief in medieval medicine. People thought that an imbalance in these bodily fluids caused disease. This idea, based on the work of the ancient physician Galen, influenced many treatments during the Black Death.
• Witchcraft and Supernatural Causes: In an age of deep religious belief, many people thought that the plague might be a form of divine punishment for sinful behaviour. Others believed in the power of witchcraft, thinking that the disease could have been caused by curses or spells cast by witches.
• Punishment from God: The most widely held belief in medieval Britain was that the Black Death was sent by God as a punishment for humanity’s sins. This idea led to widespread fear, as people believed they were being punished for their immoral actions, both individually and collectively.

Prevention and Cures

Medieval people tried many methods to prevent or cure the Black Death, despite having limited medical knowledge. These attempts were often based on religious or superstitious beliefs, rather than scientific understanding:

• Flagellants: A group of people known as the flagellants believed that by whipping themselves publicly, they could show God their repentance and seek forgiveness for their sins. They thought that this self-punishment would appease God and end the plague.
• Prayer and Religious Rituals: People prayed fervently, hoping that their faith would heal them or others. Religious leaders conducted special prayers and ceremonies, asking for divine mercy. Many believed that only divine intervention could save them from the disease.
• Bloodletting and the Four Humours: Following Galen’s theories, many doctors attempted to cure the disease by bloodletting. This treatment, which involved draining blood from the patient to restore balance to the humours, was commonly practised during the plague, although it often made patients weaker and more susceptible to death.
• Carrying Herbs or Flowers: Based on the miasma theory, people carried herbs or flower petals with them, believing that these strong scents could ward off the “bad air” and protect them from the disease. This practice was widespread in towns, where people tried to avoid the foul odours in the streets.
• Herbal Remedies: Physicians used a variety of herbal remedies in an attempt to treat the disease. These included mixtures made from plants such as sage, mint, and garlic, which were believed to have medicinal properties. However, these treatments had little success in combating the plague.

Consequences of the Black Death

The Black Death had devastating consequences for Europe, especially for England:

• Loss of Life: It is estimated that the plague wiped out between 30% to 60% of Europe’s population, with some areas losing almost half of their inhabitants. In England, the population dropped from around 4 million to 2 million within just a few years.
• Social and Economic Impact: The massive loss of life had a significant social and economic impact. With so many people dying, there were labour shortages, and the economy suffered. This resulted in a rise in wages for workers, as there were fewer people to do the work. The social structure also shifted, with some people questioning the power of the Church and the ruling classes, as they had been unable to protect the population from the plague.
• Changes in Religion and Society: The plague caused many people to turn to religion for comfort, while others became disillusioned, as they believed God had abandoned them. This led to increased devotion for some, but also led to growing resentment of the Church’s inability to stop the plague. The trauma of the Black Death contributed to social unrest and the eventual Peasants' Revolt in 1381.
• Recurring Plagues: After the initial outbreak of the Black Death, Europe continued to suffer from outbreaks of the plague. The disease returned in 1361 (known as the Children's Plague) and again in 1665, with similar methods of treatment and prevention being employed. This continued to highlight the lack of understanding of the true causes of disease, as medieval medicine failed to develop more effective treatments.

Long-Term Impact

While the Black Death left devastating physical and social scars, it also contributed to some long-term changes. The need for better healthcare became more apparent, and the plague led to changes in the way people viewed medicine. However, as the Black Death continued to resurface over the centuries, it would take until the later periods of medical advancement for a better understanding of disease transmission and prevention to emerge.

The Black Death demonstrated the limits of medieval knowledge and highlighted the need for further scientific exploration in understanding the nature of diseases, which would eventually lead to significant medical advancements in the centuries that followed. Despite the suffering, it also set the stage for the Renaissance, a period of cultural and intellectual rebirth that would pave the way for modern science and medicine.