Forty Days And Forty Nights – Part Seventeen


The Black Death – 1347 to 1350

The outbreak in 1347 was the first manifestation of the second great plague pandemic that occurred between the 14th and 18th centuries CE. The plague was brought to the Crimea from Asia Minor by the Tartar armies of Khan Janiberg. As a farewell present to the citizens of Kaffa who had successfully resisted their siege the Tartars catapulted corpses of those who had died from the disease over the walls. The Genoese traders who were there fled “with the sickness clinging to their bones”to Constantinople and then on to Messina where the great European pandemic started. By 1348 it had reached southern and northern France and Germany and a year later was affecting England, Spain and Norway and by 1350 was ravaging eastern Europe. Meanwhile the Tartars took their disease with them to Russia and India.

Between 1347 and 1350 it is estimated that the Black Death killed over 25 million in Europe or around a quarter of the population with a further 25 million succumbing in Asia and Africa. Death rates were even higher in major conurbations where the disease could spread more easily with cities such as Florence, Venice and Paris losing upwards of half of their citizenry. A second recurrence in 1361, the pestis secunds, accounted for another 10 to 20% of Europe’s population. It was not util the 16th century that Europe’s population reached its pre-pandemic level of 1290.

Giovanni Boccaccio in his book Decameron – a collection of tales told by Florentines who have gone into hiding to escape the ravages of the plague – gives us a first-hand description of the disease. “in men and women alike it first betrayed itself by the emergence of certain tumours in the groin or armpits. Some of which grew as large as a common apple, others as an egg, some more, some less, which the common folk call gavocciolo. From the two said parts of the body this deadly gavocciolo soon began to propagate and spread itself in all directions indifferently; after which the form of the malady began to change, black spots or livid making their appearance in many cases on the arm or the thigh or elsewhere…

The disease at the time was known prosaically as pestilentia or the pestilence. It was only much later that the pandemic acquired its more lurid nomenclature, possibly in reference to the haemorrhagic purpura and ischaemic gangrene of the limbs which often followed septicaemia. Italians called it mortalega grande, the great mortality.

So many victims died so quickly that the authorities were unable to bury the bodies individually and so corpses were often thrown into large communal pits or lay putrefying where they had died. For the superstitious the prospect of missing a burial and condemning their soul to eternal damnation was a more horrifying prospect than death itself. There being no obvious explanation for the plague gave the peccatogenesists a field day. The plague was punishment from God for their sins and immoral behaviour. Processions of flagellants were a common sight, whipping themselves with nail embedded scourges and chanting prayers and hymns as they moved from village to village, doubtless spreading the plague with them.

Medical knowledge was scanty at the time and so there were very few effective remedies – at least the inhalation of vapours from flowers and herbs could keep the disease at bay – and so there was a golden opportunity for quacks to peddle useless cures or magical amulets to the desperate.

Some good did come from the plague. Labour was so scarce that labourers were able to demand much higher wages from the aristocratic landlords and so contributed to breaking do the erstwhile rigid divisions between the upper and lower classes, allowing a new middle class to emerge.


Forty Days And Forty Nights – Part One


From a purely Malthusian perspective – in 1798 the Reverend Thomas Robert Malthus published his seminal work, An Essay on the Principle of Population, in which he observed that whilst population growth was exponential growth in food supply was arithmetical. Without checks populations would grow to a level where food supplies couldn’t sustain them. In the Malthusian view of the world there are two forms of check to the irresistible growth in humanity – preventive checks such as customs and moral restraints and positive checks such as disease, starvation and war – the spectre of plague that the current epidemic of Ebola generates can be seen as a corrective against the inexorable rise of human population.

Of course, the particular – the threat of and an actual outbreak of the disease in your vicinity – raises the age-old question of what to do about it. Our ancestors, heavily influenced by the writings and thinking of such legendary medical sages such as Hippocrates and Galen – thought that disease was caused and transmitted by miasmas. A miasma was a poisonous vapour or mist filled with particles of decomposed matter which caused illness. It was contaminated water, foul air and poor hygiene that caused disease. It was the proximity of humans to these miasmas that caused the epidemic, not the interaction between one infected individual with another.

That said, the idea of isolating the victim is an ancient one – Leviticus, the third book of the Pentateuch , recommends the practice for dealing with lepers. But it took a significant and cataclysmic medical emergency – the Black Death whose mortality rates put the World War carnage and the Spanish Flu epidemic into a cocked hat – before an organised and systematic approach to isolating victims was developed.

The city of Dubrovnik has the dubious privilege of introducing what is now known as quarantine. The city’s archives contain a letter dated 1377 in which it states that newcomers had to wait outside the city limits for a period of thirty days to see whether symptoms of the Black Death appeared. The period of isolation was extended to forty days, a practice that gave rise to the modern English appellation derived from the Italian quaranta giorni.

The city of Venice took the lead in introducing measures to stem the advance of the Black Death, appointing three guardians of public health in 1348 and the first lazaret or quarantine station for maritime travellers was opened in 1403 on a small island off its coast.

Quite why forty days was chosen as the appropriate period for isolation is not exactly clear. Of course, forty has biblical associations – Jesus, for example, was in the wilderness for forty days and forty nights. It may have owed its origins to a specific Hippocratic theory or it may have had a connection with the Pythagorean theory of numbers where four had a particular significance.

Anyway, whatever the reason the period was spent subjecting the poor travellers to a series of processes involving isolation, fumigation and disinfection. This was considered ample enough time to ensure the satisfactory and safe dispersal of the harmful miasmas in the air.

Next time we will look in more detail at the practice of quarantine in action.