The Black Death And Its Impact On The World Of Medicine

When one in modern times thinks about the term “epidemic”, many images may flash through their mind. Whether it be the Ebola crisis in Africa or the Swine Flu epidemic in the late 2000’s, people often feel that so long they attempt to be healthy, they’ll be safe. But what if there was a situation in which mass complications due to disease are unavoidable? This was a harsh reality for the people of Western Europe through 1347 to 1353 when the Black Plague struck. However unfortunate, this event created a lasting impact on the world of medicine and how illnesses are treated for years to come.

The Black Death, then known as “The Pestilence” or “The Plague” is a case of bubonic plague, which is caused by the bacteria Yersinia Pestis. This bacterium is common amongst packs of black rats, and often takes as little as ten to fourteen days to exterminate most of a rat colony. The issue in this case was not so much about the rats themselves, but the fleas that fed off the rats and found new hosts once their old hosts have died. These new hosts could be anything alive, from other rats to humans. This is what happened when infected rats were introduced to the shores of Italy in 1347. While it was once thought that the Black Death came from Asia, recent research shows that it began in southern Russia (Benedictow, 2005). Once these infected rats made their way on land, the illness spread quickly amongst the populace of Western Europe. Due to the unsanitary conditions in cities and towns, these rats were attracted to them and as such brought the infected fleas along into densely populated areas. All it took was one bite from an infected flea to become infected (McGill, 2017).

Once bitten, symptoms began showing slowly. Symptoms would begin to show as marks on the skin known as ‘tokens.’ These would be small, penny-sized marks, and the color of these markings often ranged from red, to orange, black, and purple. Many who were infected often did not know that they were until they found these ‘tokens’ on themselves. ‘Tokens’ were known as evidence of internal bleeding, and thus a sign of certain death. Another symptom, also how this illness got its name, is buboes. Buboes are swollen and painful lymph nodes that often appeared on the victim’s neck, armpits, and groin. Though this was a characteristic symptom, not all those who became infected experienced this. The common symptoms, however, are as follows: bleeding from the nose, continual vomiting, and fever. Some who were infected often did not know that they were until it was too late. On average, it took the symptoms of the plague 4-5 days to kill a person, with a range of 2-11 days.

These symptoms made the very principle of the Black Death a frightening thing to behold, but what is even more perturbing about this disease is the way that it spread. While it is described as an insect-borne illness, the plague got around in many ways. While the main transmitter of the illness were the fleas that fed off of infected rats, recent research suggests that rat fleas were certainly not the only way the plague spread amongst populations. The Black Death could be spread in three main ways: coming into contact with rat fleas, coming into contact with an infected person and attracting their lice and fleas, and being coughed on by an infected person. A large part in the spread of the Black Death was the unsanitary conditions in cities in Western Europe at the time which attracted rats, fleas, and lice. Modern doctors are using this information from the past to try to predict and prevent another massive outbreak from beginning again, and have used the Black Death as a learning opportunity to better advance modern medicine.

Due to Europe’s dependence on trade at the time, trade routes also played a part in the way the Black Death spread across the continent. Rats liked to live on ships, and as such, so did the infected rats and their fleas. It was not uncommon for the crews of said ships to become infected by the time they docked at their next destination. As a consequence of this, the disease spread quickly to the rest of Western Europe via trade routes, infecting northern cities Bruges and London. From these cities, trade ships brought the plague to other regions of Europe, namely the Baltic and Nordic regions. This made the disease spread far and wide, not only due to infected rats being introduced to other regions, but infected people as well. People began contracting the disease and dying very quickly, and with little to no effective treatment, one third of Europe’s entire population had died out.

As a consequence of the lack of preparation for the plague, public health measures were not effective once most of the population became infected. Some Italian cities began turning away trade ships once citizens became infected and tried to regulate trade routes to avoid a potentially bigger issue. While this would be a viable strategy for protecting the country, most of the time it was much too late for taking this measure. However ineffective, there were many unconventional practices thought to cure the plague. Some believed that strapping living chickens onto their buboes would help. Others drank potions, some containing dangerous chemicals such as arsenic and mercury. Most of these treatments were issued by doctors, who at the time carried flowers in their pockets to ‘purify the air’. Some physicians wore masks with long, bird-like beaks which were stuffed with flowers and herbs. These were thought to have been used as respirators of sorts, and used in order to protect them from breathing in ‘infected air’. Despite this, many physicians contracted the illness themselves (Espinoza, 2016).

With such a dangerous disease spreading rapidly, the citizens of all of Western Europe fell on hard times. The very trade-heavy economy at the time collapsed upon itself not only due to workers catching the plague, but also due to trade spreading the plague even further into Europe. Wages for farmers rose as landlords were in need of people to work, but because so many farmers died off due to the plague, famine came. The Black Death did not only impact trade, but also the work of artisans and merchants. Because they were out and among the public day in and day out, artisans and merchants easily contracted the plague and transmitted it to others who purchased their goods. Christian faith played a large role during this time, however, and flourished due to this. The Christian population felt that the plague was a punishment for their sins and felt that they needed to make up for what they’ve done and go to church, some even going so far as to will their homes to the Church if and when the plague kills them. Other groups of people took a ‘live for today’ approach, doing whatever they wanted in the short time they had left.

After 6 years of the Black Death devastating Europe, the illness eventually tapered off due to all the deaths that were caused. One Third of the population of Europe was dead, and famine was an even larger issue than before. There was a shortage of workers, and thus a shortage of food and other goods. Europe was in an even worse place before, but managed to recover after six years of death and illness (Espinoza, 2016). However, because of the lack of food and resources, the recovery was not an easy one. Standards of living improved, as well as quality of life and worker’s wages. More of the population was eating better, healthier foods than they had before the Black Death had struck. As safe food and well-paying work began to rise, the population gradually did, as well. It took an estimated 200 years for the population to recover entirely. Europe rebuilt itself after the Black Death, and is now just as vast and diverse as ever.

However gruesome, the Black Death had a lasting impact on society today. Scientists today still study the Black Death and the way that it affected the population to get a better look at who contracted the disease, and what steps could have been taken in order to prevent the epidemic. Some believe it as a natural example of natural selection, as the bones that have been found seemed to be that of frailer people. The frailty of those who died may have been caused by malnutrition, as the Black Death spread around the same time as a large famine. Laboring classes benefitted from the system of serfdom collapsing, and more people got hired and began working than ever before. This meant an increase in food, land, and money all around for people that were not of royal descent (Shipman, 2018).

The Black Death was also credited for making astronomical changes in the world of medicine, which slowly evolved into the world of medicine we are so familiar with today. With this came the development of surgery, hospitals, and deontology. Because of this, medicine was well-developed and complex by the early sixteenth century. The Black Death had a lasting impact on medicine and the way we use it today.

While the illness took many lives and caused great suffering, the Black Death had a larger impact on the modern world than most people know. If it was not for the devastating outbreak and those who study it in modern times, we would likely not have as many medical advancements as we do now. The world recovered from the Black Death and is better for it.

Works Cited

  • Benedictow, Ole J. “THE BLACK DEATH.” History Today, vol. 55, no. 3, Mar. 2005, pp. 42–49., doi:10.3897/bdj.4.e7720.figure2f.
  • Brookshire, Bethany. “Don't Blame the Rats for Spreading the Black Death: People — Not Rodents — May Have Spread the Most Famous Plague in History.” Science News for Students.
  • DeWitte, Sharon N. “Mortality Risk and Survival in the Aftermath of the Medieval Black Death.” PLOS ONE, Public Library of Science,
  • Espinoza, Angelica. “Crisis and Recovery: The Bubonic Plague.” StMU History Media - Featuring Historical Research, Writing, and Media at St. Mary's University, 10 Nov. 2016,
  • McGill, Sarah Ann. “The Black Plague.” 1 Aug. 2017, doi:10.3897/bdj.4.e7720.figure2f.
  • “Science Museum. Brought to Life: Exploring the History of Medicine.” The Black Death and Early Public Health Measures,
  • Scott, Susan, and Duncan, C.J. Biology of Plagues: Evidence From Historical Populations.
  • Shipman, Pat Lee. “The Bright Side of the Black Death.” American Scientist, 2 May 2018,
  • Vanneste, Sarah Frances. “The Black Death And The Future Of Medicine.” DigitalCommons@WayneState,
  • Woodville, Louisa. “The Black Death.” Khan Academy, Khan Academy,
10 Jun 2021
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