The Black Death

It was quickly realized that there was no need to touch a sick man to be infected. Most people believed that the disease passed by breath but other theories existed. Looks, according to a physician from Montpellier, could kill.^{31} ‘Instantaneous death occurs when the aerial spirit escaping from the eyes of the sick man strikes the eyes of a healthy person standing near and looking at the sick, especially when the latter are in agony; for then the poisonous nature of that member passes from one to the other, killing the other.’ But swift and terrible though the infection might be, it was also evident that it varied in its dreadfulness from place to place and time to time. On one occasion a whole community would be obliterated, on another there would only be one or two victims and the rest would survive unscathed; here a family would die within twenty-four hours, there the father would die one day, a child three weeks later, another child after a month and then there would be no further victim. In general this was accepted apathetically as yet another of those inexplicable phenomena of which the Black Death was composed. A few doctors noted that the infection seemed more virulent where there was spitting of blood. Only Gui de Chauliac went on to deduce that, of the two forms of the disease which were apparent, one was notably more infectious than the other.

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Enjoying as we do the immense superiority of a generation which has devised means of mass destruction more effective even than those inflicted by nature on our ancestors, it is easy and tempting to deride their inability to understand the calamity which had overtaken them. It would, perhaps, be more fitting to wonder at the courage and wisdom of men like Gui de Chauliac who saw their civilization apparently doomed by a hideous and inexplicable calamity and could still observe its development with scientific objectivity, draw reasonable deductions about its habits and likely course and do their best to curb its ravages. It is also sobering to reflect that only within the last century have we learned enough to detect the origins and plot the course of the epidemics and that, even today, quick and expensive action is necessary if they are to be checked before they do great damage. It is much less than a hundred years since the sophisticated and immensely learned Dr Creighton concluded positively that the source of the Black Death lay in the mounds of dead left unburied by the successive disasters which had overtaken China. He invoked cadaveric poisoning as the reason for the high death rate among priests and monks: priests tended to live near the village churchyard while: ‘Within the monastery walls were buried not only generations of monks, but often the bodies of princes, of notables of the surrounding country, and of great ecclesiastics.’^{32}

Today we smile politely at Dr Creighton’s blunders; it is reasonable to wonder whether a hundred years from now the theories of today may not seem equally ridiculous. On the whole it is unlikely that they will. Undoubtedly further discoveries will be made, dark corners illuminated, concepts amended or refined. But the techniques of scientific investigation are now sufficiently evolved to have established as a fact the main elements of the Black Death and to explain authoritatively the cycle of its activity.^{33}

That the Black Death, in its original form, was bubonic plague has been commonly accepted for many years. Bubonic plague is endemic to certain remote areas of the world; those which have been identified with reasonable certainty are Uganda, Western Arabia, Kurdistan, Northern India and the Gobi Desert. From time to time it erupts there in the form of minor, localized epidemics. Far more rarely it breaks its bounds and surges forth as one of the great pandemics. Unlike influenza, bubonic plague in such a mood moves slowly, taking ten years or more to run its course across the world. When it comes, it comes to stay. The high mortality of its initial impact is followed by a long period in which it lies endemic, a period interspersed with occasional epidemics which gradually die away in frequency and violence. Finally, perhaps several hundred years after the original outbreak, the plague vanishes.