The Prairie Doc Perspective

The terrible Black Death

By Richard P. Holm MD

There is a powerful lesson from the medieval plague and the terrible Black Death?

An earlier and similar epidemic killed half of Europe, during the sixth and seventh century but then seemed to disappear for about 700 years, until the plague raised it’s ugly head again in China, beginning the greatest international public health disaster in recorded history. This scourge is thought to have killed 25 million people in China, while spreading down the Silk Road through Mongolia, India, and central Asia, eventually reaching Europe, and killing up to 200 million.

From the account of an Italian historian (1), the infection entered Europe from the established Italian trading port of Caffa, an ancient city near Yalta on the Black Sea. It was here the caravan routes of the Far East connected to the shipping trade of Europe, and it was here during a Mongol siege of that city the story turns ghastly.

In 1346, apparently the epidemic had reached the Mongol army waiting outside the walled city. As they were struck down by the mysterious and deadly illness, they began hurling, by catapult, infected corpses over the walls. It was said mountains of dead bodies piled up inside, and indeed, the illness quickly spread within. Soon tremendous havoc, death, and panic took over, and fleeing sailors in 12 galleys carried the pestilence out into the Black Sea, over into the Mediterranean, becoming death ships carrying it into Genoa, Italy.

Over the next three years the horror spread through Europe killing one third to one half of the European population.  As one chronicled, “…so wasted the people that scarce the tenth person of any sort was left.” People were horrifically laying everywhere unattended as they died.

The consequences of such traumatic social stress resulted in widespread persecution of minorities, Jews, foreigners, beggars, lepers, even people with psoriasis, strange rashes, or even bad acne. And if fear and paranoia were not enough, guilt went ballistic, with the Brotherhood of Flagellants and self whipping growing to 800,000 people at its peak.

Five hundred years later scientists Alex Yersin and PL Simond defined how the Plague bacteria (Yersinia pestis) infects fleas riding on the backs of rats. Infection within the flea causes a strange voracious feeding behavior and then vomiting. And when such an infected flea finds a human, there is aggressive biting with a blood meal, then regurgitated bacteria are flushed into the feeding site, and thus the infection is spread. Once infected, many people are dead in two days, and 80 percent are dead in eight.

Scientific discovery brought us to understand the cause of the Black Death. Knowledge is our best protector from future plagues. God bless science.

1Wheelis, M. Biological Warfare at the 1346 Siege of Caffa. Emerging Inf Dis. 2002;v8,n9: CDC/PubMed

Dr. Rick Holm wrote this Prairie Doc Perspective for “On Call®,” a weekly program where medical professionals discuss health concerns for the general public.  “On Call®” is produced by the Healing Words Foundation in association with the South Dakota State University Journalism Department. “On Call®” airs Thursdays on South Dakota Public Broadcasting-Television at 7 p.m. Central, 6 p.m. Mountain. Visit us at OnCallTelevision.com. 

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