The bubonic plague was one of the first (and most feared) epidemics in western history. It affected society in unprecedented ways, leaving its mark in art and literature and establishing some of the first public health initiatives. Although the bubonic plague is often regarded as a medieval disease, there were in fact three distinctive pandemics that spanned the course of multiple centuries.
The first outbreak—known as the Plague of Justinian—lasted about two centuries beginning in 541 A.D., afflicting parts of Asia, Africa, and Europe. The second pandemic is by far the most well-known due to its influence on Renaissance history. It first erupted in Central Asia in the 1330s and arrived in Italy in 1347. The first few years of the epidemic in Europe became known as the Black Death, wiping out about a third of the continent’s population before subsiding in the 1350s. Thereafter, the plague broke out about once in a generation until the second pandemic was vanquished in 1743. The third and final plague largely spared the industrialized west and afflicted Asia for around a century starting in 1855. The most fatal outbreak occurred at the turn of the 20th century, taking the lives of more than 13 million people in India.
There were a few unifying characteristics that connected the three pandemics to a single disease. First of all, the bubonic plague was caused by the bacteria Yersinia pestis, which is transmitted by rodents and fleas. Because these hosts died and flourished with the change of the seasons, outbreaks tended to happen in the spring and summer when the weather was warm, and they faded away in the winter.
Once the victim was bitten, a black blister with red pock marks would appear at the site of the bite, then buboes (hence the name “bubonic”) would swell up all over the body, followed by the often fatal release of toxins into the bloodstream. Fever, nausea, delirium, and agonizing pain accompanied the dehumanizing appearance of the buboes, with around half of the cases resulting in death in a matter of days.
The plague affected the young and old, rich and poor alike, which led many to believe that the disease was a punishment hurled by a divine, angry God for earthly sins. This belief led to religious mass repentance, the scapegoating of foreigners and gypsies, and the rise of a cult of plague saints (Saint Sebastian and Saint Rocco being the most famous) who interceded on behalf of humanity. The Black Death also gave birth to the first organized public health measures. Boards of health were created, compulsory burials replaced funeral processions, and quarantines of the sick were enforced.
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