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|The Black Death, or the Black Plague,
was one of the deadliest pandemics in human history, widely thought to have been caused by a bacterium named Yersinia pestis (Bubonic plague), but recently attributed by some to other diseases.
The pandemic is thought to have begun in Central Asia or India,and spread to Europe during the 1340s.  The total number of deaths worldwide is estimated at 75 million people, approximately 25–50 million of which occurred in Europe. The Black Death is estimated to have killed 30% to 60% of Europe's population. It may have reduced the world's population from an estimated 450 million to between 350 and 375 million in 1400.
Bubonic plague is thought to have returned every generation with varying virulence and mortalities until the 1700s. During this period, more than 100 plague epidemics swept across Europe. On its return in 1603, the plague killed 38,000 Londoners. Other notable 17th century outbreaks were the Italian Plague of 1629–1631, the Great Plague of Seville (1647–1652), the Great Plague of London (1665–1666), the Great Plague of Vienna (1679). There is some controversy over the identity of the disease, but in its virulent form, after the Great Plague of Marseille in 1720–1722, the Great Plague of 1738 (which hit eastern Europe), and the 1771 plague in Moscow, it seems to have disappeared from Europe in the 19th century.
The 14th century eruption of the Black Death had a drastic effect on Europe's population, irrevocably changing the social structure. It was a serious blow to the Roman Catholic Church, and resulted in widespread persecution of minorities such as Jews, foreigners, beggars, and lepers. The uncertainty of daily survival created a general mood of morbidity, influencing people to "live for the moment", as illustrated by Giovanni Boccaccio in The Decameron (1353).
The Great Plague
Medieval people called the 14th century catastrophe either the "Great Pestilence"' or the "Great Plague". Writers contemporary to the plague referred to the event as the "Great Mortality".
The term "Black Death" was introduced for the first time in 1833. It has been popularly thought that the name came from a striking late-stage sign of the disease, in which the sufferer's skin would blacken due to subepidermal hemorrhages (purpura), and the extremities would darken with gangrene (acral necrosis). However, the term is more likely to refer to black in the sense of glum, lugubrious or dreadful.
The Black Death was, according to chronicles, characterized by buboes (swellings in lymph nodes), like the late 19th century Asian Bubonic plague. Scientists and historians at the beginning of the 20th century assumed that the Black Death was an outbreak of the same disease, caused by the bacterium Yersinia pestis and spread by fleas with the help of animals like the black rat (Rattus rattus). However, this view has recently been questioned by some scientists and historians. New research suggests Black Death is lying dormant.
Plaque in Weymouth, England.
The plague disease, originally thought to be caused by Yersinia pestis, is enzootic (commonly present) in populations of ground rodents in central Asia, but it is not entirely clear where the 14th century pandemic started. The popular theory places the first cases in the steppes of Central Asia, although some speculate that it originated around northern India, and others, such as the historian Michael W. Dols, argue that the historical evidence concerning epidemics in the Mediterranean and specifically the Plague of Justinian point to a probability that the Black Death originated in Africa and spread to central Asia, where it then became entrenched among the rodent population. Nevertheless, from central Asia it was carried east and west along the Silk Road, by Mongol armies and traders making use of the opportunities of free passage within the Mongol Empire offered by the Pax Mongolica. It was reportedly first introduced to Europe at the trading city of Caffa in the Crimea in 1347. After a protracted siege, during which the Mongol army under Janibeg was suffering the disease, they catapulted the infected corpses over the city walls to infect the inhabitants. The Genoese traders fled, bringing the plague by ship into Sicily and the south of Europe, whence it spread. Whether or not this hypothesis is accurate, it is clear that several pre-existing conditions such as war, famine, and weather contributed to the severity of the Black Death. In China, the thirteenth century Mongol conquest disrupted farming and trading, and led to widespread famine. The population dropped from approximately 120 to 60 million. The 14th century plague is estimated to have killed 1/3 of the population of China..
In Europe, the Medieval warm period ended sometime towards the end of the thirteenth century, bringing harsher winters and reduced harvests. In the years 1315 to 1317 a catastrophic famine, known as the Great Famine, struck much of North Western Europe. The famine came about as the result of a large population growth in the previous centuries, with the result that, in the early fourteenth century the population began to exceed the number that could be sustained by productive capacity of the land and farmers.
In Northern Europe, new technological innovations such as the heavy plough and the three-field system were not as effective in clearing new fields for harvest as they were in the Mediterranean because the north had poor, clay-like, soil. Food shortages and skyrocketing prices were a fact of life for as much as a century before the plague. Wheat, oats, hay, and consequently livestock, were all in short supply, and their scarcity resulted in hunger and malnutrition. The result was a mounting human vulnerability to disease, due to weakened immune systems.
The European economy entered a vicious circle in which hunger and chronic, low-level debilitating disease reduced the productivity of labourers, and so the grain output was reduced, causing grain prices to increase. This situation was worsened when landowners and monarchs like Edward III of England (r. 1327–1377) and Philip VI of France (r. 1328–1350), out of a fear that their comparatively high standard of living would decline, raised the fines and rents of their tenants. Standards of living then fell drastically, diets grew more limited, and Europeans as a whole experienced more health problems.
In autumn of 1314, heavy rains began to fall, which led to several years of cold and wet winters. The already weak harvests of the north suffered and the seven-year famine ensued. The Great Famine was the worst in European history, reducing the population by at least ten percent. Records recreated from dendrochronological studies show a hiatus in building construction during the period, as well as a deterioration in climate.
This was the economic and social situation in which the predictor of the coming disaster, a typhoid (Infected Water) epidemic, emerged. Many thousands died in populated urban centres, most significantly Ypres. In 1318 a pestilence of unknown origin, sometimes identified as anthrax, targeted the animals of Europe, notably sheep and cattle, further reducing the food supply and income of the peasantry.
The scenario that would place the first outbreak in central Asia agrees with the first reports of outbreaks in China in the early 1330s. The plague struck the Chinese province of Hubei in 1334. On the heels of the European epidemic, a more widespread disaster occurred in China during 1353–1354. Chinese accounts of this wave of the disease record a spread to eight distinct areas: Hubei, Jiangxi, Shanxi, Hunan, Guangdong, Guangxi, Henan and Suiyuan, throughout the Mongol and Chinese empires. Historian William McNeill noted that voluminous Chinese records on disease and social disruption survive from this period, but no one has studied these sources in depth.
It is probable that the Mongols and merchant caravans inadvertently brought the plague from central Asia to the Middle East and Europe. The plague was reported in the trading cities of Constantinople and Trebizond in 1347.
The Black Death rapidly spread along the major European sea and land trade routes.
In October 1347, a fleet of Genoese trading ships fleeing Caffa reached the port of Messina in Sicily. By the time the fleet reached Messina, all the crew members were either infected or dead. It is presumed that the ships also carried infected rats and/or fleas. Some ships were found grounded on shorelines, with no one aboard remaining alive.
Looting of these lost ships also helped spread the disease. From there, the plague spread to Genoa and Venice by the turn of 1347–1348.
From Italy the disease spread northwest across Europe, striking France, Spain, Portugal and England by June 1348, then turned and spread east through Germany and Scandinavia from 1348 to 1350. It was introduced in Norway in 1349 when a ship landed at Askøy, then proceeded to spread to Bjørgvin (modern Bergen). Finally it spread to north-western Russia in 1351; however, the plague largely spared some parts of Europe, including the Kingdom of Poland and isolated parts of Belgium and The Netherlands.
At Siena, Agnolo di Tura wrote:
"They died by the hundreds, both day and night, and all were thrown in … ditches and covered with earth. And as soon as those ditches were filled, more were dug. And I, Agnolo di Tura … buried my five children with my own hands … And so many died that all believed it was the end of the world."
Middle Eastern outbreak
The plague struck various countries in the Middle East during the pandemic, leading to serious depopulation and permanent change in both economic and social structures. As it spread to western Europe, the disease also entered the region from southern Russia. By autumn 1347, the plague reached Alexandria in Egypt, probably through the port's trade with Constantinople, and ports on the Black Sea. During 1348, the disease traveled eastward to Gaza, and north along the eastern coast to cities in Lebanon, Syria and Palestine, including Ashkelon, Acre, Jerusalem, Sidon, Damascus, Homs, and Aleppo. In 1348–49, the disease reached Antioch. The city's residents fled to the north, most of them dying during the journey, but the infection had been spread to the people of Asia Minor.
Mecca became infected in 1349. During the same year, records show the city of Mawsil (Mosul) suffered a massive epidemic, and the city of Baghdad experienced a second round of the disease. In 1351, Yemen experienced an outbreak of the plague. This coincided with the return of King Mujahid of Yemen from imprisonment in Cairo. His party may have brought the disease with them from Egypt.
In England, in the absence of census figures, historians propose a range of pre-incident population figures from as high as 7 million to as low as 4 million in 1300, and a post-incident population figure as low as 2 million. By the end of 1350 the Black Death had subsided, but it never really died out in England over the next few hundred years: there were further outbreaks in 1361–62, 1369, 1379–83, 1389–93, and throughout the first half of the 15th century. Plague often killed 10% of a community in less than a year - in the worst epidemics, such as at Norwich in 1579 and Newcastle in 1636, as many as 30 or 40%. The most general outbreaks in Tudor and Stuart England, all coinciding with years of plague in Germany and the Low Countries, seem to have begun in 1498, 1535, 1543, 1563, 1589, 1603, 1625 and 1636.
The plague repeatedly returned to haunt Europe and the Mediterranean throughout the fourteenth to seventeenth centuries, and although bubonic plague still occurs in isolated cases today, the Great Plague of London in 1665–1666 is generally recognized as one of the last major outbreaks.
The plague of 1575–77 claimed some 50,000 victims in Venice. In 1634, an outbreak of plague killed 15,000 Munich residents. Late outbreaks in central Europe include the Italian Plague of 1629-1631, which is associated with troop movements during the Thirty Years' War, and the Great Plague of Vienna in 1679. About 200,000 people in Moscow died of the disease from 1654 to 1656. The last plague outbreak ravaged Oslo in 1654. In 1656 the plague killed about half of Naples's 300,000 inhabitants. Amsterdam was ravaged in 1663–1664, with a mortality given as 50,000.
A plague epidemic that followed the Great Northern War (1700–1721, Sweden v. Russia and allies) wiped out almost 1/3 of the population in the region. An estimated one-third of East Prussia's population died in the plague of 1709–1711. The plague of 1710 killed two-thirds of the inhabitants of Helsinki. An outbreak of plague between 1710 and 1711 claimed a third of Stockholm’s population.
During the Great Plague of 1738, the epidemic struck again, this time in Eastern Europe, spreading from Ukraine to the Adriatic Sea, then onwards by ship to infect some in Tunisia. The destruction in several cities in what is now Romania (such as Timişoara) was formidable, claiming tens of thousands of lives.
Causes of bubonic infection
Bubonic plague theory
Plague and the ecology of Yersinia pestis in soil, and in rodent and (possibly and importantly) human ectoparasites are reviewed and summarized by Michel Drancourt in modeling sporadic, limited and large plague outbreaks. Modelling of epizootic plague observed in prairie dogs suggests that occasional reservoirs of infection such as an infectious carcass, rather than "blocked fleas" are a better explanation for the observed epizootic behaviour of the disease in nature.
An interesting hypothesis about the epidemiology—the appearance, spread and especially disappearance—of plague from Europe is that the flea-bearing rodent reservoir of disease was eventually succeeded by another species. The black rat (Rattus rattus) was originally introduced from Asia to Europe by trade, but was subsequently displaced and succeeded throughout Europe by the bigger brown rat (Rattus norvegicus). The brown rat was not as prone to transmit the germ-bearing fleas to humans in large die-offs due to a different rat ecology. The dynamic complexities of rat ecology, herd immunity in that reservoir, interaction with human ecology, secondary transmission routes between humans with or without fleas, human herd immunity and changes in each might explain the eruption, dissemination, and re-eruptions of plague that continued for centuries until its (even more) unexplained disappearance.
Signs and symptoms
The three forms of plague brought an array of signs and symptoms to those infected. The septicaemic plague is a form of "blood poisoning," and pneumonic plague is an airborne plague that attacks the lungs before the rest of the body. The classic sign of bubonic plague was the appearance of buboes in the groin, the neck and armpits, which oozed pus and bled. Most victims died within four to seven days after infection. When the plague reached Europe, it first struck port cities and then followed the trade routes, both by sea and land.
The bubonic plague was the most commonly seen form during the Black Death, with a mortality rate of thirty to seventy-five percent and symptoms including fever of 38–41 °C (101–105 °F), headaches, painful aching joints, nausea and vomiting, and a general feeling of malaise. Of those who contracted the bubonic plague, 4 out of 5 died within eight days. Pneumonic plague was the second most commonly seen form during the Black Death, with a mortality rate of ninety to ninety-five percent. Symptoms included fever, cough and blood-tinged sputum. As the disease progressed, sputum became free flowing and bright red. Septicemic plague was the least common of the three forms, with a mortality rate close to one hundred percent. Symptoms were high fevers and purple skin patches (purpura due to DIC (Disseminated intravascular coagulation)).
David Herlihy identifies another potential sign of the plague: freckle-like spots and rashes. Sources from Viterbo, Italy refer to "the signs which are vulgarly called lenticulae", a word which bears resemblance to the Italian word for freckles, lentiggini. These are not the swellings of buboes, but rather "darkish points or pustules which covered large areas of the body".
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