Monday, March 16, 2020

Deadly Plague: How It Devastated One-Third of Europe’s Population

By Sarah Natale

Medieval medical knowledge was insufficient to halt the spread of the fatal disease called the Black Death, which ravaged Europe from 1347 to 1351 in three forms: bubonic, pneumonic, and septicemic.

bacterium Yersinia pestis: 200x magnification
Imagine your house has been boarded up, and now you are trapped inside with your sick and dying family. With no form of escape, you will contract the disease, too, and death will inevitably follow. This is a classic instance of sacrificing a few to save the many. Ethics aside, this very scenario was not uncommon during the outbreak of plague in 14th century Europe from 1347 to 1351. Twenty to 30 million people died over this four-year span due to the bacterium Yersinia pestis, making this one of the deadliest pandemics of plague to date.

“Danse Macabre,” or “Dance of Death,”
by Michael Wolgemut
 in Hartmann Schedel’s 1493 Chronicle of the World
(known today as the Nuremberg Chronicle)
This disease has been dubbed many terms throughout history. At the time of the outbreak, people called it the Great Mortality, the Great Pestilence, or simply the “plague.” But it wasn’t until modern day that it received its most popular term of endearment: the Black Death. In this article, I’ll discuss the three forms of the plague, detail its rampant spread through medieval Europe, and explain the treatment practices of the time leading to the overall outcome.

Types of Plague
First, I’ll dive into the three most common forms of plague, their modes of transmission, symptoms, and levels of contagion. These three types are, namely, bubonic, pneumonic, and septicemic. The bubonic strain mainly infected lymph nodes, causing swelling and buboes, hence the name “bubonic.” Transmission occurred through bites from fleas that traveled on the backs of rats. Symptoms were often flu-like. These included fever, headaches, chills, weakness, and most notably, swollen and tender lymph glands. A “fun” fact about the bubonic strain is that, though the most widely talked about, it was the least deadly.

The pneumonic strain mainly infected the lungs. Its mode of transmission was through the air, mainly through coughing, sneezing, and the breaths of infected victims. Symptoms included shortness of breath, chest pain, bloody cough, fever, headaches, and weakness. A “fun” fact about the pneumonic strain is that it was the most contagious.

Lastly, the septicemic strain infected the blood. It was transmitted the same way as the bubonic strain, which was through bites from fleas. Symptoms included fever, chills, weakness, abdominal pain, shock, and internal bleeding. A “fun” fact about the septicemic strain is that it was the least contagious, but the most deadly. So if a person did contract it, it was almost always fatal.

To sum up the three most common forms of plague, the bubonic strain was a lymph node infection and the least deadly, the pneumonic strain was a lung infection and the most contagious, and the septicemic strain was a blood infection—though the most deadly, also the least contagious.

Passage through Europe
The plague originated in East Asia, specifically central China, in 1333. Its entrance into Europe was marked by Genoese trading ships sailing into the harbor of Messina, Sicily (an island in Italy) from Caffa in 1347. By January 1348, the disease had spread to the mainland, specifically Genoa, Italy. By summer, it had entered England through the county of Dorset, killing 30 to 50% of the country’s population. The disease entered on June 24th through a port in a sea town known as Melcombe Regis, now called Weymouth. Today, a plaque exists in Weymouth, chronicling the sea town’s key role in the historical spread of the disease. 

Plaque in Weymouth, Dorset, England
On November 1st, the plague reached London. It continued on to France, Spain, Portugal, Ireland, and all across Europe over the next three years.

Medieval medical treatments mainly consisted of bloodletting, which was to intentionally make incisions near a major vein and let the victim bleed out what physicians believed were “toxins” of the disease. They also advocated avoiding eating meat and animal products. People rarely took baths because they believed bathing contributed to the spread of the disease. One thing they did do well involved cleansing victims and surfaces in vinegar to ward off the disease, which we know today has disinfectant properties. 

1411 drawing of illness widely believed to be the plague
(though location of bumps more accurately
depicts smallpox) from Swiss Toggenburg Bible
The threat of infection was so great that a man named Agnolo di Tura in Italy wrote in a 1348 chronicle: 

Father abandoned child, wife husband, one brother another. And I, Agnolo di Tura, buried my five children with my own hands. So many died that all believed that it was the end of the world.”

Plague Today
The disease known by many names throughout history served only one purpose: to kill one-third of Europe’s population, thereby devastating the 14th century world. The two types of plague spread by fleas on the backs of rats, coupled with an airborne version of the bacteria, created a virtually unstoppable, fast-moving disease that infected every country from Asia to Europe. Treatment practices were primitive and most were ineffective.

The plague is still around today, though outbreaks are rare. The good news is though there is no vaccine, treatment exists in the form of antibiotics. If someone were to contract the plague today, as still happens in less developed areas of the world, they can rest assured that they will receive effective treatment.

More importantly, one can take solace in the fact that there is no more fear of being trapped inside a deadly Plague House. * 

This article is an Editor's Choice and was originally published August 3, 2019. 

Sarah Natale launched her author career as a teen when a high school assignment, written at 17 years old, received a book deal from a publisher. She has always held a fascination for the tragedy that devastated one-third of Europe’s population and was excited to craft a story around the historical event in her senior creative writing class. That story, The Kiss of Death (Kellan Publishing, 2015), received a fine arts literary award prior to publication. Sarah is a recent Summa Cum Laude graduate of Drake University, where she studied Writing, Public Relations, and Graphic Design. A shameless word nerd, nearly 150 of her works (stories, poems, and articles) have appeared in various publications (books, magazines, and newspapers). She frequently speaks about the writing, editing, publishing, and promotion stages of book publishing. When she’s not presenting or writing, she works as a Book Publishing Professional for a publisher in the Chicago area.

* as protagonist Elizabeth Chauncey finds herself in Sarah’s debut The Kiss of Death. Infusing fact with fiction was one of Sarah’s favorite parts of writing her story! If you enjoyed this article, check out the plague in action in Sarah’s historical fiction book below.



  1. Ho ho... very timely in a sort of black comedic way, but no less interesting for that. Thanks for sharing, especially as I missed it the first time round. Wishing you well with your writing.

  2. Pray for the conversion of England and the English speaking world. Our lady of walsingham pray for us.

  3. I've linked this article to our studies of your book during "distance learning." I hope my students learn as much from you as I have. Thank you!

  4. My students will be reading this article while reading your book during "distance learning." I hope they learn as much from you as I have. Thanks.

  5. I have re-posted to all social media..


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