Death Defined

Black Death Causes and Symptoms

Plague-Infected Flea
A flea infected with plague. Public Domain; Courtesy National Institute of Allergies and Infectious Diseases

Please note: this document contains graphic descriptions of plague symptoms, causes, and results.

Plague Symptoms

What was it like for a victim of the plague?

It started with a headache. Then chills and fever, which left him exhausted and prostrate. Maybe he experienced nausea, vomiting, back pain, soreness in his arms and legs. Perhaps bright light was too bright to stand.

Within a day or two, the swellings appeared.

They were hard, painful, burning lumps on his neck, under his arms, on his inner thighs. Soon they turned black, split open, and began to ooze pus and blood. They may have grown to the size of an orange.

Maybe he recovered. It was possible to recover. But more than likely, death would come quickly. Yet... perhaps not quickly enough. Because after the lumps appeared he would start to bleed internally. There would be blood in his urine, blood in his stool, and blood puddling under his skin, resulting in black boils and spots all over his body. Everything that came out of his body smelled utterly revolting. He would suffer great pain before he breathed his last. And he would die barely a week after he first contracted the disease.

Types of Plague

The swellings, called buboes, were the victim's lymph nodes, and they gave the Bubonic Plague its name. But the bubonic form of the disease was only one manifestation of the horrible pandemic that swept Europe in the 1340s.

Another form was Pneumonic Plague. The victims of Pneumonic Plague had no buboes, but they suffered severe chest pains, sweated heavily, and coughed up blood. Virtually no one survived the pneumonic form.

The third manifestation was Septicemic Plague. This sickness would befall when the contagion poisoned the victim's bloodstream.

Victims of Septicemic Plague died the most swiftly, often before any notable symptoms had a chance to develop. Another form, Enteric Plague, attacked the victim's digestive system, but it too killed the patient too swiftly for diagnosis of any kind.

Medieval Europeans had no way of knowing any of this. The causes of plague were not discovered until the late nineteenth century.

The Transmission of Plague

Plague is carried by rodents like rats and squirrels, but it is transmitted to humans by the fleas who live on them. A flea, having ingested plague-infected blood from its host, can live for as much as a month away from that host before he needs to find another warm body to live on. When a blood-engorged flea attempts to draw blood from another victim, it invariably injects into that victim some of the blood already within it. If the injected blood contains the bacterium yersinia pestis, the result is Bubonic Plague. Fleas were, alas, such a part of everyday life that no one noticed them much. In this invisible manner, the plague spread from rat to human and to cat and dog, as well.

Pneumonic plague is airborne. It is contracted by breathing the infected water droplets breathed (or coughed) out by a victim of the disease.

The pneumonic form was much more virulent and spread much more quickly and just as invisibly.

Plague is occasionally transmitted by direct contact with a carrier through open sores or cuts, directly into the bloodstream. This could result in any form of the plague except pneumonia, although it is likely that such incidents most often resulted in the septicemic variety. The septicemic and enteric forms of the plague killed most quickly of all, and probably accounted for the stories of individuals going to bed apparently healthy and never waking up.

People died so swiftly and in such high numbers that burial pits were dug, filled to overflowing and abandoned; bodies (sometimes still living) were shut up in houses which were then burned to the ground; and corpses were left where they died in the streets.

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