Ignorance and prejudice about the Black Death mowed down millions

2024 Author: Seth Attwood | [email protected]. Last modified: 2023-12-16 15:55

The plague has firmly entered the history and culture of mankind as a monstrous disease from which no one could escape - not even the doctors themselves. Pestilence infiltrated homes, exterminated families, cities filled with thousands of corpses. Now mankind knows the causes of the disease and how to treat it, but in the past, healers were powerless in the face of the Plague.

Neither knowledge of astrology, nor the study of ancient treatises written by ancient authorities helped. "Lenta.ru" talks about plague pandemics and how they made mankind think about the real nature of infections.

Plague is one of the most ancient diseases. Traces of its pathogen - Yersinia pestis - were found in the teeth of people who lived five thousand years ago, in the Bronze Age. This bacterium has caused two of the deadliest pandemics in human history, killing several hundred million people. The disease spread like a fire, destroying entire cities, and doctors could not oppose it - largely due to prejudice and low level of medical knowledge. Only the invention of antibiotics and vaccines allowed mankind to overcome the plague, although its outbreaks still occur in various parts of the world, even in developed countries.

Resourceful killer

The illness begins like a cold or flu: the temperature rises, weakness and headache occur. The person does not even suspect that the cause of his illness was an invisible bacteriological bomb - a flea, whose insides are stuffed with a plague stick. The insect is forced to regurgitate the absorbed blood back into the wound, and a whole army of deadly bacteria enters the body. If they penetrate the lymph nodes, then the patient develops a bubonic form of the disease. The nodes are very swollen. In the Middle Ages, they were burned and pierced - to the detriment of the patient himself and those who were nearby.

The septic form of plague occurs when the plague bacillus enters the bloodstream, causing it to coagulate intravascularly. Clots disrupt tissue nutrition, and non-clotted blood, penetrating the skin, causes a characteristic black rash. According to one version, it was precisely because of the blackening of the skin that the plague pandemic in the Middle Ages was called the Black Death. Septic plague is less common than other forms, but in the past, mortality from it reached almost one hundred percent - antibiotics were not yet known at that time.

Finally, the pneumonic form of the plague is what made the Black Death different. During the first pandemic, the Justinian plague, there was almost no mention of hemoptysis, but in the Middle Ages this symptom was as common as buboes. The bacteria entered the lungs and caused pneumonia, and the patient exhaled the plague bacillus, which entered the respiratory organs of other people. During the Black Death, the disease was transmitted from person to person and did not need fleas as vectors.

The ingestion of a pathogen in the lungs in the past almost always meant certain death - without adequate antibiotic treatment, a person died in two to three days. It is the pulmonary form that is responsible for the death of tens of millions of people in the XIV century.

Waves of Death

There are three known major plague pandemics. The Justinian Plague, which began in AD 541, killed about one hundred million people worldwide over two centuries and wiped out half of Europe's population. The Black Death, the second wave of the disease, raged for two decades and claimed the lives of an estimated one to two hundred million people, making it the deadliest non-viral pandemic in human history. The third pandemic, which began in China and lasted for about a century (from 1855 to 1960), killed more than ten million people.

The history of the plague began ten thousand years ago, when the relatively harmless soil bacteria Yersinia pseudotuberculosis, which causes only mild gastrointestinal upset, acquired several mutations that allowed it to colonize human lungs. Then changes in the Pla gene made the bacterium extremely toxic: it learned to break down proteins in the lungs and multiply throughout the body through the lymphatic system, forming buboes. These same mutations gave her the ability to be transmitted by airborne droplets. As in many cases, epidemics are caused by close contact between humans and wildlife.

About four thousand years ago, mutations occurred that made Yersinia pestis highly virulent, capable of being transmitted by fleas through rodents, humans and other mammals. The blood-sucking insects parasitizing on mammals traveled long distances with the travelers. Fleas were taken into luggage and merchant goods, so the development of trade became one of the causes of the pandemic. The Justinian plague originated in Central Asia, but first penetrated through trade channels into Africa, and from there reached Byzantine Constantinople - a densely populated city and world center of the first millennium AD. The bubonic and septic forms of the disease at the peak of the epidemic killed five thousand inhabitants a day.

The Black Death was caused by another strain of the plague bacillus, which is not a direct descendant of the causative agent of the Justinian plague. It is believed that one of the impulses of the pandemic was the Mongol conquest in the 13th century, which caused a decline in trade and agriculture, and then famine. Climatic changes also played a role, when prolonged droughts led to mass migration of rodents, including marmots, closer to human settlements. Due to the crowding of animals, an epizootic arose - an analogue of an epidemic in animals.

Since marmot meat was considered a delicacy, the spread of the disease among people was a matter of time.

The plague first struck Asia, the Middle East, Africa, and with merchant ships penetrated Europe, where it killed an estimated 34 million people.

The third pandemic began with an outbreak of the bubonic plague in China in 1855, after which the infection spread to all continents except Antarctica. The natural focus was in Yunnan province, which still carries an epidemiological threat. In the second half of the 19th century, the Chinese began to settle in the area in order to increase the extraction of minerals, for which there was a high demand. But this led to close contact of people with yellow-chested rats, which were inhabited by plague-infected fleas. The growth of the urban population and the emergence of congested transport routes opened the way for the bubonic plague. From Hong Kong, the plague spread to British India, where it claimed the lives of one million people, and over the next thirty years - 12.5 million.

Dangerous prejudices

As with other pandemics, the prevailing misconceptions about the nature of infectious diseases contributed to the spread of the plague. For medieval doctors, the authority of the ancient thinkers Hippocrates and Aristotle was undeniable, and a thorough study of their works was mandatory for all those who were going to connect their lives with medicine.

According to the principles of Hippocrates, illness occurs due to natural factors and a person's lifestyle. At one time, this thought was generally advanced, since before Hippocrates, diseases were usually considered the results of the intervention of supernatural forces. However, the ancient Greek doctor had scant knowledge of human anatomy and physiology, so he believed that in order for the patient to recover, it was necessary to properly care for him so that the body could cope with the disease itself.

University-educated medieval doctors were the least experienced in the treatment of disease, but had high status and authority. They did not know much about anatomy, and they considered surgery a dirty trade. Religious authorities opposed autopsies, so there were very few universities in Europe that paid attention to the structure of the human body. The fundamental medical principle was the humor theory, according to which human health depended on the balance of four fluids: blood, lymph, yellow bile and black bile.

Most medieval theoretical physicians believed in Aristotle's principle that the plague was caused by miasms - vapors that make the air "bad." Some believed that miasms were formed due to the unfavorable location of celestial bodies, others blamed earthquakes, wind from swamps, disgusting smells of manure and decaying corpses. One of the medical treatises of 1365 stated that the plague cannot be cured without knowledge of humoral theory and astrology, which are very important for the practicing physician.

All preventive measures to combat the plague were reduced to the elimination of the poisonous air that allegedly came from the south. Doctors recommended building houses with windows to the north. It was also necessary to avoid the sea coasts, because the fact that outbreaks of plague began in port cities did not escape the attention of medical authorities. Only they could not have imagined that the disease spread through trade routes, and did not hover in the sea air. In order not to get sick with the plague, supposedly you need to hold your breath, breathe through fabric, or burn aromatic herbs. Perfumes, precious stones and metals such as gold were used against the disease.

It was believed that buboes contain plague poison that must be removed. They pierced them, burned them, applied an ointment sucking out the poison, but at the same time bacteria were released that could infect others. Despite the fact that the doctors took, as they thought, all the necessary protective measures, many of them died. Others, realizing that their treatment was ineffective, followed their own advice and fled from the cities, although the plague overtook them at a distance from the centers. Despite the fact that the plague demonstrated the complete impotence of medieval medicine, doctors did not soon overcome their dependence on ancient authorities and moved on to their own observation and experience.

New era

Quarantine has proven to be one of the few effective methods (albeit with varying success), despite constant protests from freedom-loving citizens and merchants. In Venice, a delay was established for the entry of ships into the port, which lasted 40 days (the word "quarantine" comes from the Italian quaranta giorni - "forty days"). A similar measure was introduced for people who arrived from plague-infected territories. City councils began hiring doctors - plague doctors - specifically to treat the disease, after which they also went into quarantine.

With many leading theorists killed by the pandemic, the discipline was open to new ideas. University medicine failed, so people began to turn to medical practitioners more. With the development of surgery, more and more attention was paid to the direct study of the human body. Medical treatises began to be translated from Latin into languages accessible to a wide audience, which stimulated the revision and development of ideas.

Overall, the pandemic has contributed to the development of health systems

The true cause of the plague - Yersinia pestis - was discovered only a few centuries after the Black Death. This was helped by the dissemination among scientists of the advanced ideas of Louis Pasteur, who in the 19th century turned over the views on the causes of many diseases. The scientist, who became the founder of microbiology, was able to prove that infectious diseases are caused by microorganisms, and not by miasms and disturbances in the balance of the body, as contemporaries continued to think, including his teacher and colleague Claude Bernard. Pasteur developed methods of treatment against anthrax, cholera and rabies and founded the Pasteur Institute, which from now on became a center for the fight against dangerous infections.