FEODOSIYA SITS ON THE EASTERN COAST OF THE CRIMEA, A RECTANGULAR spit of land where the Eurasian steppe stops to dip its toe into the Black Sea. Today the city is a rusty wasteland of post-Soviet decay. But in the Middle Ages, when Feodosiya was called Caffa and a Genoese proconsul sat in a white palace above the harbor, the city was one of the fastest-growing ports in the medieval world. In 1266, when the Genoese first arrived in southern Russia, Caffa was a primitive fishing village tucked away far from the eyes of God and man on the dark side of the Crimea—a collection of windswept lean-tos set between an empty sea and a ring of low-rising hills. Eighty years later, seventy thousand to eighty thousand people coursed through Caffa’s narrow streets, and a dozen different tongues echoed through its noisy markets. Thrusting church spires and towers crowded the busy skyline, while across the bustling town docks flowed Merdacaxi silks from Central Asia, sturgeon from the Don, slaves from the Ukraine, and timber and furs from the great Russian forests to the north. Surveying Caffa in 1340, a Muslim visitor declared it a handsome town of “beautiful markets with a worthy port in which I saw two hundred ships big and small.”
It would be an exaggeration to say that the Genoese willed Caffa into existence, but not a large exaggeration. No city-state bestrode the age of city-states with a more operatic sense of destiny—none possessed a more fervent desire to cut abella figurain the world—than Genoa. The city’s galleys could be found in every port from London to the Black Sea, its merchants in every trading center from Aleppo (Syria) to Peking. The invincible courage and extraordinary seamanship of the Genoese mariner was legendary. Long before Christopher Columbus, there were the Vivaldi brothers, Ugolino and Vadino, who fell off the face of the earth laughing at death as they searched for a sea route to India. Venice, Genoa’s great rival, might carp that she was “a city of sea without fish, . . . men without faith, and women without shame,” but Genoese grandeur was impervious to such insults. In Caffa, Genoa built a monument to itself. The port’s sunlit piazzas and fine stone houses, the lovely women who walked along its quays with the brocades of Persia on their backs and the perfumes of Arabia gracing their skin, were monuments to Genoese wealth, virtue, piety, and imperial glory.
As an Italian poet of the time noted,
And so many are the Genoese
And so spread . . . throughout the world
That wherever one goes and stays
He makes another Genoa there.
Caffa’s meteoric rise to international prominence also owed something to geography and economics. Between 1250 and 1350 the medieval world experienced an early burst of globalization, and Caffa, located at the southeastern edge of European Russia, was perfectly situated to exploit the new global economy. To the north, through a belt of dense forest, lay the most magnificent land route in the medieval world, the Eurasian steppe, a great green ribbon of rolling prairie, swaying high grass, and big sky that could deliver a traveler from the Crimea to China in eight to twelve months. To the west lay the teeming port of Constantinople, wealthiest city in Christendom, and beyond Constantinople, the slave markets of the Levant, where big-boned, blond Ukrainians fetched a handsome price at auction. Farther west lay Europe, where the tangy spices of Ceylon and Java and the sparkling diamonds of Golconda were in great demand. And between these great poles of the medieval world lay Caffa, with its “worthy port” and phalanx of mighty Russian rivers: the Volga and Don immediately to the east, the Dnieper to the west. In the first eight decades of Genoese rule the former fishing village doubled, tripled, and quadrupled in size. Then the population quadrupled a second, third, and fourth time; new neighborhoods and churches sprang up; six thousand new houses rose inside the city, and then an additional eleven thousand in the muddy flats beyond the town walls. Every year more ships arrived, and more fish and slaves and timber flowed across Caffa’s wharves. On a fine spring evening in 1340, one can imagine the Genoese proconsul standing on his balcony, surveying the tall-masted ships bobbing on a twilight tide in the harbor, and thinking that Caffa would go on growing forever, that nothing would ever change, except that the city would grow ever bigger and wealthier. That dream, of course, was as fantastic a fairy tale in the fourteenth century as it is today. Explosive growth—and human hubris—always come with a price.
Before the arrival of the Genoese, Caffa’s vulnerability to ecological disaster extended no farther than the few thousand meters of the Black Sea its fishermen fished and the half moon of sullen, windswept hills behind the city. By 1340 trade routes linked the port to places half a world away—places even the Genoese knew little about—and in some of the places strange and terrible things were happening. In the 1330s there were reports of tremendous environmental upheaval in China. Canton and Houkouang were said to have been lashed by cycles of torrential rain and parching drought, and in Honan mile-long swarms of locusts were reported to have blacked out the sun. Legend also has it that in this period, the earth under China gave way and whole villages disappeared into fissures and cracks in the ground. An earthquake is reported to have swallowed part of a city, Kingsai, then a mountain, Tsincheou, and in the mountains of Ki-ming-chan, to have torn open a hole large enough to create a new “lake a hundred leagues long.” In Tche, it was said that 5 million people were killed in the upheavals. On the coast of the South China Sea, the ominous rumble of “subterranean thunder” was heard. As word of the disasters spread, the Chinese began to whisper that the emperor had lost the Mandate of Heaven.
In the West, news of the catastrophes evoked horror and dread. Gabriel de’ Mussis, a notary from Piacenza, wrote that “in the Orient at Cathay, where the world’s head is . . . , dreadful signs and portents have appeared.” A musician named Louis Heyligen, who lived in Avignon, passed on an even more alarming tale to friends in Flanders. “Hard by greater India, in a certain province, horrors and unheard of tempests overwhelmed the whole province for the space of three days,” Heyligen wrote. “On the first day, there was a rain of frogs, serpents, lizards, scorpions, and many venomous beasts of that sort. On the second, thunder was heard, and lightning and sheets of fire fell upon the earth, mingling with hail stones of marvelous size. . . . On the third day, there fell fire from heaven and stinking smoke which slew all that were left of man and beasts and burned up all the cities and towns in those parts.”
The Genoese, who were much closer to Asia than de’ Mussis and Heyligen, undoubtedly heard rumors about the disasters, but in the 1330s and early 1340s they faced so many immediate dangers in Caffa, they could not have had much time to worry about events in faraway India or China. The port of Caffa was held under a grant from the Mongols, rulers of the greatest empire in the medieval world—indeed, in the fourteenth century, rulers of the greatest empire the world had ever seen. For the Tartars, Caffa was only a small part of a vast domain that stretched from the Yellow River to the Danube, from Siberia to the Persian Gulf, but, like a pebble in a boot, it was an annoying part—or, rather, its colonial power was. To the Mongols, the Genoese seemed vainglorious, supercilious, and deeply duplicitous, the kind of people who would name their children after you—as the Dorias of Genoa had named three sons after three Mongol notables; Huegu, Abaka, and Ghazan—while picking your pocket. When the founder of the Mongol empire, Genghis Khan, railed against “eaters of sweet greasy food [who wear] garments of gold . . . [and] hold in their arms the loveliest of women,” he might have had the Genoese in mind. In 1343 decades of economic and religious tension between the two powers finally erupted in a major confrontation at Tana, a trading station at the mouth of the Don, famous as the starting point of the land route to China. “The road you take from Tana to Peking,” beginsLa Practica della Mercatura,Francesco Balducci di Pegolotti’s fourteenth-century travel guide for eastern-bound merchants.
According to notary de’ Mussis,* the brawl grew out of a confrontation between Italian merchants and local Muslims on a Tana street. Apparently insults were exchanged, fists waved, punches thrown. Market stalls tumbled, pigs squealed, a knife flashed, and a Muslim fell to the ground, dead. Shortly thereafter, a Mongol khan named Janibeg, a self-proclaimed defender of Islam, appeared outside Tana, and with him, a large Tartar force. An ultimatum was sent into the besieged town and, according to a Russian historian named A. A. Vasiliev, a response, insolent even by Genoese standards, was sent back. Enraged, Janibeg flung his Mongols into Tana. Amid plumes of black smoke and the thundering cries of sword-slashing Tartar horsemen, the Italians, outnumbered but stout, made a fighting retreat to the harbor; from there, a race westward to Caffa commenced, with the pursued Italians traveling by ship, the pursuing Mongols by horse.
“Oh God,” writes de’ Mussis of the Mongols’ arrival on the hills above Caffa. “See how the heathen Tartar races, pouring together from all sides, suddenly invest . . . Caffa [attacking] the trapped Christians . . . [who] hemmed in by an immense army, could hardly breathe.” To the Genoese caught inside the city, the siege seemed like the end of the world, but they were wrong. In 1343 the end of the world was still several thousand miles away, on the eastern steppe.
Medieval Europeans like de’ Mussis and musician Louis Heyligen were aware that plague as well as ecological upheaval raged in Asia. The new global economy had made the world a little smaller. In his account of the siege of Caffa, de’ Mussis writes: “In 1346, in the countries of the East, countless numbers . . . were struck down by a mysterious illness.” Heyligen, too, mentions the plague in his account of “unheard of calamities . . . hard by Greater India.” The musician says that “the terrible events” in India culminated in an outbreak of the pestilence that infected “all neighboring countries . . . by means of the stinking breath.” However, the best medieval guide to the Black Death’s early history in Asia is Ibn al-Wardi, an Arab scholar who lived in the Syrian town of Aleppo, an important international trading center and listening post in the Middle Ages.
Al-Wardi, who like de’ Mussis also got his information from merchants, says that the pestilence raged in the East for fifteen years before arriving in the West. This timeline fits the plague’s pace of dissemination, which is relatively slow for an epidemic disease. A 1330s starting date would also explain the references to a mysterious illness that begin to appear in Asian documents around the same time. Among them are the Chronicles of the Great Mongol Khanate of Mongolia and Northern China, which state that, in 1332, the twenty-eight-year-old Mongol Great Khan Jijaghatu Toq-Temur and his sons died suddenly of a mysterious illness. In 1331, the year before the Great Khan’s death, the Chinese records also make reference to a mysterious illness; this one, a treacherous epidemic, swept through Hopei province in the northeast region of the country and killed nine-tenths of the population.
Most modern historians believe that what we call the Black Death originated somewhere in inner Asia, then spread westward to the Middle East and Europe and eastward to China along the international trade routes. One frequently mentioned origin point is the Mongolian Plateau, in the region of the Gobi desert where Marco Polo says the night wind makes “a thousand fantasies throng to mind.” In an account of the pestilence, the medieval Arab historian al-Maqrizi seems to speak of Mongolia when he says that before the Black Death arrived in Egypt, it had raged “a six month ride from Tabriz [in Iran, where] . . . three hundred tribes perished without apparent reason in their summer and winter encampments . . . [and] sixteen princes died [along with] the Grand Khan and six of his children. Subsequently, China was depopulated while India was damaged to a lesser extent.”
Another often mentioned origin point is Lake Issyk Kul, where medieval travelers would come to pick up the fast road into China. Surrounded by dense forest and snow-capped mountains, in Kirgizia, near the northwest border of China, the lake region is located close to several major plague foci. (Foci are regions were plague occurs naturally.) More to the point, something terrible happened around the lake a few years before the pestilence arrived in Caffa. In the late nineteenth century a Russian archaeologist named D. A. Chwolson found that an unusually large number of headstones in local cemeteries bore the dates 1338 and 1339, and several of the stones contained a specific reference to plague. One reads:
In the year . . . of the hare 
This is the grave of Kutluk.
He died of the plague with his wife Magnu-Kelka.*
After Issyk Kul, the Black Death remains a shadowy presence for the next several years; there is no reliable information on its movements, except that it always seems to be glimpsed moving westward through the steppe high grass. The year after Kutluk and his wife, Magnu-Kelka, died, one account puts the disease in Belasagun, a rest stop to the west of Issyk Kul where riders of the Yam, the Mongol pony express, changed mounts and Marco Polo’s father, Niccolo, and uncle Maffeo stopped on their way into China. A year or so later, the plague is spotted in Talas, to the west of Belasagun, and then to the west of Talas in Samarkand, a major Central Asian market town and crossroads where medieval travelers could pick up the road south to India or continue onward toward the Crimea. But only in 1346 do the first reliable accounts become available. That year one Russian chronicle speaks of the plague arriving on the western shore of the Caspian Sea and attacking several nearby cities and towns, including Sarai, capital of the Mongol Principality of the Golden Horde and home to the busiest slave market on the steppe. A year later, while Sarai buried its dead, the pestilence lurched the final few hundred miles westward across the Don and Volga to the Crimea, came up behind the Tartar army in the hills above Caffa, and bit it in the back of the neck.
The Genoese, who imagined that God was born in Genoa, greeted the plague’s arrival with prayers of thanksgiving. The Almighty had dispatched a heavenly host of warrior angels to slay the infidel Mongols with golden arrows, they told one another. However, in de’ Mussis’s account of events, it is Khan Janibeg who commands the heavenly host at Caffa. “Stunned and stupefied” by the arrival of the plague, the notary says that the Tartars “ordered corpses to be placed in catapults and lobbed into the city in hopes that the intolerable stench would kill everyone inside. . . . Soon rotting corpses tainted the air . . . , poisoned the water supply, and the stench was so overwhelming that hardly one man in several thousand was in a position to flee the remains of the Tartar army.”
On the basis of de’ Mussis’s account, Janibeg has been proclaimed the father of biological warfare by several generations of historians, but the notary may have invented some of the more lurid details of his story to resolve an inconvenient theological dilemma. Self-evidently—to Christians, at least—the plague attacked the Tartars because they were pagans, but why did the disease then turn on the Italian defenders? Historian Ole Benedictow thinks de’ Mussis may have fabricated the catapults and flying Mongols to explain this more theologically sensitive part of the story—God did not abandon the gallant Genoese, they were smitten by a skyful of infected Tartar corpses, which, not coincidentally, was just the kind of devious trick good Christians would expect of a heathen people. Like most historians, Professor Benedictow believes the plague moved into the port the way the disease usually moves into human populations—through infected rats.* “What the besieged would not notice and could not prevent was that plague-infected rodents found their way through the crevices in the walls or between the gates and the gateways,” says the professor.
The siege of Caffa ended with both sides exhausted and decimated by war and disease. In April or May of 1347, as the hills above Caffa turned green under a soft spring sun, the dying Tartar army faded away, while inside the pestilential city, many of the Genoese defenders prepared to flee westward. There are no accounts of life in the besieged port that fateful spring, but we do have images of Berlin in 1945 and Saigon in 1975, enough information to suggest what Caffa’s final days may have looked like. As the death toll mounted, the streets would have filled with feral animals feeding on human remains, drunken soldiers looting and raping, old women dragging corpses through rubble, and burning buildings spewing jets of flame and smoke into the Crimean sky. There would have been swarms of rodents with staggering gaits and a strange bloody froth around their snouts, piles of bodies stacked like cordwood in public squares, and in every eye, a look of wild panic or dull resignation. The scenes in the harbor, the only means of escape in besieged Caffa, would have been especially horrific: surging crowds and sword-wielding guards, children wailing for lost or dead parents, shouting and cursing, everyone pushing toward teeming ships, and beyond the melee, on the departing galleys, prayerful passengers hugging one another under great white sheets of unfurling sail, ignorant that below deck, in dark, sultry holds, hundreds of plague-bearing rats were scratching themselves and sniffing at the cool sea air.
Caffa was almost certainly not the only eastern port the plague passed through en route to Europe, but for the generation who lived through the Black Death, it would forever be the place where the pestilence originated, and the Genoese, the people who brought the disease to Europe. The chronicler of Este spoke for his contemporaries when he wrote that Genoa’s “accursed galleys [spread the plague] to Constantinople, Messina, Sardinia, Genoa, Marseilles and many other places. . . . The Genoese wrought far more slaughter and cruelty . . . than even the Saracens.”
Plague is the most famous example of what the Pima Indians of the American Southwest calloimmeddam,wandering sickness; and an ancient Indian legend evokes the profound dreadoimmeddamproduced in premodern peoples.
“Where do you come from?” an Indian asks a tall, black-hatted stranger.
“I come from far way,” the stranger replies, “from . . . across the Eastern Ocean.”
“What do you bring?” the Indian asks.
“I bring death,” the stranger answers. “My breath causes children to wither and die like young plants in the spring snow. I bring destruction. No matter how beautiful a woman, once she has looked at me she becomes as ugly as death. And to men, I bring not death alone, but the destruction of their children and the blighting of their wives. . . . No people who looks upon me is ever the same.”
Plague is the most successful example ofoimmeddamin recorded history. Worldwide, the disease has killed an estimated 200 million people, and no outbreak of plague has claimed as many victims or caused as much anguish and sorrow as the Black Death. According to the Foster scale, a kind of Richter scale of human disaster, the medieval plague is the second greatest catastrophe in the human record. Only World War II produced more death, physical destruction, and emotional suffering, says Canadian geographer Harold D. Foster, the scale’s inventor. Harvard historian David Herbert Donald also ranks the Black Death high on a list of history’s worst catastrophes. However, the greatest—if most backhanded—tribute to the plague’s destructiveness comes from the United States Atomic Energy Commission, which used the medieval pestilence to model the consequences of all-out global nuclear war. According to the commission’sDisaster and Recovery,a Cold War–era study of thermonuclear conflict, of all recorded human events, the Black Death comes closest to mimicking “nuclear war in its geographical extent, abruptness of onset and scale of casualties.”
The sheer scope of the medieval plague was extraordinary. In a handful of decades in the early and mid-fourteenth century, the plague bacillus,Yersinia pestis,swallowed Eurasia the way a snake swallows a rabbit—whole, virtually in a single sitting. From China in the east to Greenland in the west, from Siberia in the north to India in the south, the plague blighted lives everywhere, including in the ancient societies of the Middle East: Syria, Egypt, Iran, and Iraq. How many people perished in the Black Death is unknown; for Europe, the most widely accepted mortality figure is 33 percent.* In raw numbers that means that between 1347, when the plague arrived in Sicily, and 1352, when it appeared in the plains in front of Moscow, the continent lost twenty-five million of its seventy-five million inhabitants. But in parts of urban Italy, eastern England, and rural France, the loss of human life was far greater, ranging from 40 to 60 percent. The Black Death was particularly cruel to children and to women, who died in greater numbers than men, probably because they spent more time indoors, where the risk of infection was greater, and cruelest of all to pregnant women, who invariably gave birth before dying.
Contemporaries were stunned by the scale of death; almost overnight, it seemed, one out of every three faces vanished from the human community, and on the broad shires of England, the little villages along the Seine, and the cypress-lined roads of Italy—where the afternoon light resembles “time thinking about itself”—one out of two faces may have disappeared. “Where are our dear friends now?” wrote the poet Francesco Petrarch. “What lightning bolt devoured them? What earthquake toppled them? What tempest drowned them. . . . There was a crowd of us, now we are almost alone.”
In the Islamic Middle East and North Africa, mortality rates also were in the one-third range. To the Muslim historian Ibn Khaldun, it seemed “as if the voice of existence in the world had called out for oblivion.” In China the presence of chronic war makes it difficult to assess plague mortalities, but between 1200 and 1393 the population of the country fell 50 percent, from about 123 million to 65 million. Today a demographic disaster on the scale of the Black Death would claim 1.9 billion lives.
The Black Death would be an extraordinary accomplishment for any wandering sickness, but it is an especially extraordinary one for a sickness not even native to humans. Plague is a disease of rodents. People are simply collateral damage, wastage in a titanic global struggle between the plague bacillusYersinia pestisand the world’s rodent population.*Y. pestis’s natural prey are turbots, marmots, rats, squirrels, gerbils, prairie dogs, and roughly two hundred other rodent species. For the pathogen to ignite a major outbreak of human disease on the scale of the Black Death, a number of extraordinary things had to have happened. And while we will never know what all of them were, from about 1250 onward, social, economic, and perhaps ecological changes were making large parts of Eurasia an increasingly unhealthy place to live.
One new risk factor was increased mobility. Along with facilitating international trade, the Mongol unification of the steppe brought merchants, Tartar officials, and armies into proximity with some of the most virulent, and heretofore isolated, plague foci in the world. Rodents (and more to the point, their fleas) that once would have died a lonely, harmless death on a Gobi sand dune or Siberian prairie now could be transported to faraway places by caravans, marching soldiers, and riders of the Mongol express, who could travel up to a hundred miles a day on the featureless, windswept prairies of the northern steppe.
Environmental upheaval may also have played a role in the origin of the plague. Like a vain old matinee idol,Y. pestisis fond of ecological drum rolls. In the mid-sixth century, during the pestilence’s first (documented) visit to Europe, the Plague of Justinian, there were reports of blood-colored rain in Gaul, of a yellow substance “running across the ground like a shower of rain” in Wales, and of a dimming of the sun everywhere throughout Europe and the Middle East. “We marvel to see no shadow on our bodies at noon, to feel the mighty vigor of the sun’s heat wasted into feebleness,” wrote the Roman historian Flavius Cassiodorus.
Similar, if less flamboyant, accounts of environmental instability appeared in the decades prior to the Black Death. In the West as well as the East, there were reports of volcanic eruptions (Italy), earthquakes (Italy and Austria), major floods (Germany and France), a tidal wave (Cyprus), and swarms of locusts “three German miles” long (Poland). However, since the medieval world viewed natural disasters as portents and expressions of Divine Wrath, these accounts have to be read with caution. Undoubtedly, many of the calamities described by European—and Chinese—chroniclers were invented or exaggerated beyond recognition after the fact to provide the Black Death with a suitably apocalyptic overture.
That said, tree ring data indicates that the early fourteenth century was one of the most severe periods of environmental stress in the last two thousand years—perhaps due to unusual seismic activity in the world’s oceans. And modern experience shows that ecological upheaval in the form of droughts, floods, and earthquakes can play a role in igniting plague, usually because such events dislodge remote wild rodent communities, the natural home ofY. pestis,from their habitats and drive them toward human settlements in search of food and shelter.
Social and demographic conditions are also risk factors in plague. Like other infectious illnesses, the disease requires a minimum population base of four hundred thousand people to sustain itself. When human numbers fall below that base—or people are dispersed too widely—the chain of infection begins to break down. Sanitary conditions are important, too. A principal vector in human plague, the black rat—Rattus rattus—feeds on human refuse and garbage, so the filthier a society’s streets and homes and farms, the larger its plague risk. Since the flea is an even more critical disease vector, personal sanitation matters as well; people who wash rarely are more attractive to an infected flea than those who wash regularly. Humans who live with farm animals are also at greater risk because they are exposed to more rats and fleas; and if a population lives in homes with permeable roofs and walls, the risk is even greater.
The role of malnutrition in human plague is controversial, though perhaps unjustifiably so. It is true that bacteria, which require many of the same nutrients as humans, have more difficulty reproducing in malnourished hosts. But experience with plague in early-twentieth-century China and India suggests that nutritional status, like sanitation, is a risk factor in the disease, and emerging research suggests that nutrition may also affect susceptibility in another, more subtle way. Recent studies have found that exposure to malnutrition in utero damages the developing immune system, creating a lifelong vulnerability to illness in general.
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From Caffa to the jungles of Vietnam,* war has also been an important predisposing factor in human plague. War creates human remains and refuse, which attract rats; filthy bodies, which attract fleas; and stresses, which can lower immune system function. Marching soldiers and cavalry also help to make a pestilence more mobile.
The historical evidence suggests that the existence of only a few of these conditions is not enough to ignite a pandemic, or major outbreak of plague. The Victorian West, for example, was far more densely interconnected and populated than medieval Europe, but when a major wave of plague swept through China and India a century ago, relatively healthy populations, relatively good sanitation and public health standards, and a sturdy physical plant—wood and brick houses—prevented the plague from gaining a toehold in either America or Europe. The disease reached the West, but after causing a few hundred deaths in Oakland, San Francisco, Glasgow, Hamburg, and several other cities, it died out.
The era that was once called the Dark Ages and is now referred to (less judgmentally, if no more accurately) as the Early Middle Ages also had several conditions associated with plague, including widespread violence, disorder, malnutrition, and filth—if early medieval Europeans washed or changed their clothes more than once or twice a year, it was the best-kept secret in Christendom. However, foreign trade had virtually disappeared, and the rise of hostile new Muslim states in the Middle and Near East put the plague foci of Central Asia and Africa at a further remove from Europe. Also, the early Middle Ages was a period of profound depopulation. In the sixth and seventh centuries a crumbling Roman Europe lost as much as one-half to two-thirds of its population. From Scotland to Poland, the inheritors of a once great civilization lived huddled together like fugitives in forest clearings. Even if, by some fluke,Y. pestishad managed to travel to the early medieval West, it would have failed as miserably as it did in the streets of Victorian San Francisco.
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By contrast, the environment of the fourteenth century was well suited toY. pestis. By modern standards, the population of medieval Europe was relatively low: about 75 million, compared to today’s nearly 400 million. However, compared to the resources available to the population, the continent had become dangerously overcrowded. The years between 1000 and 1250 were a period of great economic and demographic growth in the medieval West, but when the economy began to stall out after 1250, Europe found itself trapped in what historian David Herlihy has called “Malthusian deadlock.” Medieval Europeans were still able to feed, clothe, and house themselves, but because the balance between people and resources had become very tight, just barely. A worsening climate made the margin between life and death even narrower for tens of millions of Europeans. Between 1315 and 1322 the continent was lashed by waves of torrential rain, and by the time the sun came out again in some places 10 to 15 percent of the population had died of starvation. In Italy especially, malnutrition remained widespread and chronic, right until the eve of the plague.
In the fourteenth century war was almost as much a constant as hunger. Italy, where the papacy and Holy Roman Empire were fighting for ascendancy, had descended into a Hobbesian state of all against all. There were large, small, and in-between-sized wars raging in the papal states around Orvieto, Naples, and Rome. At sea, Italy’s “two torches,” as Petrarch called Genoa and Venice, were locked in an interminable maritime conflict. And almost everywhere up and down the peninsula, roving bands ofcondottieri(mercenaries) were waging fierce little freelance wars. To the north and west, conflict was raging in Scotland, Brittany, Burgundy, Spain, and Germany, and in the ports and plains and cities of northern France the English and French were fighting the first battles of the Hundred Years’ War.
“The city makes men free,” medieval Germans told one another, but a combination of people, rats, flies, waste, and garbage concentrated inside a few square miles of town wall also made the medieval city a human cesspool. By the early fourteenth century so much filth had collected inside urban Europe that French and Italian cities were naming streets after human waste. In medieval Paris, several street names were inspired bymerde,the French word for “shit.” There were rue Merdeux, rue Merdelet, rue Merdusson, rue des Merdons, and rue Merdiere—as well as a rue du Pipi. Other Parisian streets took their names from the animals slaughtered on them. There was a Champs-Dolet—roughly translated as “field of suffering and cries”—and l’Echorcheire: “place of flailing.” Every town of any size in Europe had its equivalent of l’Echorcheire: an outdoor slaughterhouse, where butchers in bloodstained clothing cut and chopped and sawed amid discarded body parts and offal and the agonizing moans of dying animals. One irate Londoner complained that the runoff from the local slaughterhouse had made his garden “stinking and putrid,” while another charged that the blood from slain animals flooded nearby streets and lanes, “making a foul corruption and abominable sight to all dwelling near.” In much of medieval Europe, sanitation legislation consisted of an ordinance requiring homeowners to shout, “Look out below!” three times before dumping a full chamber pot into the street.
The medieval countryside, where 90 percent of the population lived, was an even more dangerous place than the medieval city. Thinly walled, peasant homes were highly permeable, and the rat-to-person ratio tended to be very high in rural areas. Urban rat colonies usually divided their attention among several homes on a street, but in the country, not uncommonly, a single peasant family would find itself the target of an entire rodent colony.
The medieval body was in as shocking a state as the medieval street. Edward III scandalized London when he bathed three times in as many months. Friar Albert, a monk in Boccaccio’sDecameron,displays a more typical medieval attitude toward personal hygiene. “I shall do something today that I have not done for a very long time,” the friar announces cheerfully. “I shall undress myself.” When the assassinated Thomas à Becket was stripped naked, an English chronicler reports that vermin “boiled over like water in a simmering cauldron” from his body.
Arguably, medieval Europe’s reigning religious and medical orthodoxies also created a vulnerability to plague by promoting a public health program based on clothing the wicked, inhaling fragrances, and prayer. The educated classes, influenced by the theories of a former sports physician and Roman celebrity doctor named Galen, believed that the pestilence arose from miasmas—dense clouds of infected air. “Corrupted air, when breathed in, necessarily penetrates to the heart and corrupts the substance of the spirit there,” warned the Paris medical faculty, the most eminent medical body of the day. The “prince of physicians,” the Italian Gentile da Foligno, recommended the inhalation of herbs as an antidote for “corrupt” air.
To the Church and common folk, the plague was seen as a form of divine retribution for human wickedness. Henry Knighton, an English monk who hovers over the Black Death like a cackling Shakespearean witch, exemplifies this school of thinking. Knighton believed that God smote a third or more of Europe because medieval England’s most glamorous young women were becoming tournament groupies. “Whenever and wherever tournaments were held,” Knighton wrote a few decades after the Black Death, “a troupe of ladies would turn up dressed in a variety of male clothing . . . and mounted on chargers. There were sometimes as many as forty or fifty of them, representing the showiest and most beautiful, though not most virtuous, women of the realm. . . . [They] wore thick belts studded with gold and silver slung across their hips, below the navel . . . and were deaf to the demands of modesty. But God, present in these things, as in everything, supplied a marvelous remedy”—plague.
Plague is among the slowest moving of wandering sicknesses. New strains of influenza can leap around the world in a year or two, butY. pestis,like the AIDS virus, is tied to a complicated chain of infection that can take decades to unfold. The principal vector in the disease is not the rodent, the animal most often associated with it, but the rodent flea. When an infected host dies, the flea leaps to a new host, transferring the plague bacillus,Y. pestis,to the host by way of a skin bite. Sometimes humans are infected directly by one of the many flea species that prey on wild rodents, such as squirrels, prairie dogs, and marmots; however, most often the agent of infection in human plague is the more familiar black rat flea,Xenopsylla cheopis.
In human plague, the chain of infection can take several forms. For example, an ecological disaster, which destroys the food supply, or a dramatic spike in the rodent population, which puts tremendous pressure on it, may drive a colony of infected animals toward a human settlement, where members of the colony exchange fleas with domestic rats. Another possible scenario that may have relevance to the Black Death is that a group of travelers stumble into a wild rodent community in the midst of a plague outbreak; infected rodents—or their fleas—infiltrate the travelers’ saddlebags and carts, and when the group arrives in the next town or village, the hitchhikers leap from their hiding place and spread the disease to the domestic rodent population. The next-to-last stage in the sequence is the involvement ofX. cheopis,the rat flea, which becomes a disease vector because, in one way or another, its rat hosts have become infected by wild rodent fleas.
The jump of plague into man is driven byX. cheopis’s desperation. It does not particularly like human blood, but as plague kills off the local domestic rat community, the flea’s only alternatives are starvation orHomo sapiens. Once embedded in a human population, the rat flea becomes a very efficient disease vector.X. cheopiscan survive up to six weeks without a host—long enough to travel hundreds of miles in grain or cloth shipments. It is also an extremely aggressive insect. It has been known to stick its mouth parts into the skin of a living caterpillar and suck out the caterpillar’s bodily fluids and innards. However,X. cheopis’s greatest attribute as a disease vector lies in the vagaries of its digestive system.
In an uninfected rat flea, blood from a skin bite flows directly to the stomach, satiating hunger. In an infected flea, plague bacilli build up in the foregut, producing a blockage; this enhances the insect’s ability to spread infection in two ways. First, because no nutrients are reaching the stomach,X. cheopis,chronically hungry, bites constantly; and second, as undigested blood builds up in the foregut, the flea becomes a living hypodermic needle. Every time it bites, it gags on the undigested blood, now tainted with plague bacilli, and vomits it into the new bite.
The way to get from the digestive problems of a minor insect to 25 million to 30 million dead in Europe, a third of the Middle East wiped out, and China “depopulated,” is by multiplying. Normally a rodent only carries a half dozen or so fleas, but in the midst of an epizootic, when hosts become rare, surviving rodents often become the equivalent of flea towns, carrying a hundred to two hundred insects—and sometimes flea cities. Researchers counted nine hundred infected fleas on one unfortunate ground squirrel in Colorado.
Three forms of plague prey on humans.Bubonicplague, the most common form, is transmitted by a flea bite and has a two- to six-day incubation period. “Behold, the swelling, the warning signs sent by the Lord,” wrote a contemporary, of the Black Death’s most characteristic symptom, the egg-shaped bubo. Medieval chroniclers frequently described the bubo as tumorlike, and the analogy is an apt one. Like malignant cancer cells, once inside the body, plague bacilli multiply with an aggressive wildness. Typically, the site of the flea bite determines the site of thegavocciolo,as contemporaries called the bubo. Bacilli from leg and ankle bites produce buboes in the abdominal region or thigh; upper-body bites, buboes under the arms or on the neck. Exquisitely sensitive to pressure,gavocciolooften create odd deformations in their victims. Thus, a neck bubo may produce a head permanently cocked in the opposite direction, a thigh bubo a hopping limp, an underarm bubo an outstretched or raised arm. Buboes are also oddly noisy creatures. Human plague speaks to its victims in the strange gurgling tongue of the bubo.
According to the chroniclers, three other symptoms were also quite common in the bubonic plague of the Black Death. One were petechiae. These bruiselike purplish splotches often appeared on the chest, back, or neck, and were also known as “God’s tokens” because their appearance meant the victim had a fatal case of plague. Legend has it that the “tokens” were the inspiration for a Black Death–era nursery rhyme still sung today:
Ring around the rosie, pocket full of posies
Ashes, ashes [the hemorrhages], we all fall down.*
Malodorousness was another frequent symptom of historic bubonic plague. Victims not only looked as if they were about to die, according to many Black Death chroniclers, they often smelled as if they were. After visiting a plague-stricken friend, one man wrote, “The stench [of] sweat, excrement, spittle, [and] breath [was] overpowering.” A number of contemporary accounts also suggest that the medieval plague disrupted the nervous system. There are reports of delirious, agitated victims shouting madly from open windows or walking around half-naked or falling into a stupor.
Oddly, these last three symptoms are uncommon in modern bubonic plague. Dr. Kenneth Gage, chief of the Plague Division at the U.S. Centers for Disease Control, has encountered “God’s tokens” in his fieldwork, but so infrequently that, when asked if he had ever seen a plague victim with hemorrhagic bruises, he had to stop and think for a moment. While the CDC official has encountered many cases of malodorousness, he describes the foul odor as a by-product of poor nursing care—the plague victim was not being changed or bathed regularly, or lived in a hovel. The smells described by Black Death chroniclers—or at least some of them—seemed to emanate from inside the victim, as if his insides were gangrenous. Dr. Gage, who has fought plague in Asia and North and South America, cannot recall ever encountering a case of central nervous system involvement in a plague victim.
Bubonic plague is the most survivable of the three forms of the disease. Untreated, it has a mortality rate of about 60 percent.
Pneumonicis the second type of plague, and—uniquely—it can spread directly from person to person. However, like other forms of the infection, it is borne in the rodent/insect connection. In some cases of bubonic plague, bacilli escape the lymph system and infect the lungs, causing secondary pneumonic plague. As the victim begins to cough and spit up blood—the principal symptoms of the “coughing” plague—the disease breaks free of the flea connection and spreads into the population like a cold or flu—through the air. Though summer outbreaks occur, pneumonic plague is more frequent in winter, when the colder temperatures favor the transmission of pulverized and frozen sputum and cough droplets.
As with bubonic plague, there are also some notable differences between the modern variant of the “coughing plague” and its Black Death counterpart. One is incidence. Relatively uncommon today, during the first year of the Black Death pneumonic plague seemed to be everywhere in Italy and southern France. The other notable difference involves contagiousness. Modern pneumonic plague is not a particularly “catchy” disease, nor should it be. Plague bacteria are larger than viruses and thus harder to transmit directly from person to person—the bigger bacilli require bigger air droplets, and if they do reach another person, tend to get “stuck” in the upper respiratory system before they can reach the lungs.
Even making allowance for the medieval propensity to exaggerate, one gets the impression that the pneumonic plague of the Black Death was not merely highly contagious but explosive in the manner of a nuclear chain reaction. “Breath,” wrote one horrified Sicilian chronicler, “spread the infection among those speaking together . . . and it seemed as if the victim[s] were struck all at once by the affliction and [were] shattered by it. . . . Victims violently coughed up blood, and after three days of incessant vomiting for which there was no remedy, they died, and with them died not only everyone who talked with them but also anyone who had acquired or touched or laid hands on their belongings.”
The “coughing plague” is extremely lethal. If it goes untreated, the mortality rate in its victims is between 95 and 100 percent.
No one survives untreatedsepticemic plague,the third form of the disease. The shocklike movement of massive amounts of plague bacilli directly into the blood system creates such enormous toxicity that even insects normally incapable of transmittingY. pestis,such as body lice, can become disease vectors. During one outbreak of septicemic plague in the early twentieth century, the average survival time from onset of symptoms to death was 14.5 hours.
There have been suggestions that the horrible disfigurement caused by septicemic plague—the extremities become as black and hard as coal—inspired the term Black Death, but septicemic disease is uncommon, and, in any event, the application of the terms “Black Death” to the medieval plague grew out of an old historical error. In 1631, a historian named Johannes Isaacus Pontanus, perhaps thinking of Seneca’s use of the Latin term for Black Death—Arta mors—to describe an outbreak of epidemic disease in Rome, claimed that the phrase had been current during the fourteenth-century mortality. The Swedes, who began using the expression around 1555 (swarta döden), the Danes, who adopted it fifty years later (den sorte Død), and the rest of Europe, which began using the expression “Black Death” in the eighteenth century, may have been laboring under the same misapprehension. The generation who lived through the medieval pestilence called itla moria grandissima, la mortalega grande, très grande mortalité, grosze Pestilentz, peligro grande,andhuge mortalyte: names that translate roughly as the “Great Mortality,” or, more colloquially, the “Big Death.”
One of the great mysteries of the medieval plague is how the fleeing Genoese survived the sixteen-hundred-mile sea journey from Caffa to Sicily, where the disease enters European history. Even if the escaping galleys stopped first in Constantinople and other ports en route to Italy as seems likely, getting caught on an open sea withY. pestiswould have been akin to getting caught in a revolving door with a rattlesnake. The only current explanation for the riddle is lucky genes. Recent research suggests that an allele,* CCR5-∆32, may confer protection against plague. Possibly some of the crew members had the requisite lucky allele.
Clearer is what happened once Caffa slipped below the horizon. On the second or third day at sea a mariner awakes feeling feverish; after he falls asleep again, a shipmate steals his flea-infested jacket; a few days later, the thief is ill. As word of the men’s illness spreads through the ship, panicky crew members gather in the horse stalls on the lower deck to share rumors and conspire. That night there is a splash off the aft side of the ship, then a second; no one raises an alarm as the bodies sink below the surface in a cone of rippling moonlight.
As the days lengthen and the disease takes hold, men begin to turn on one another, as they will later in Europe, when the plague arrives. There are beatings, murders, summary executions, mutinies; only the progress of the pestilence prevents complete anarchy. Men become too ill to kill, then too ill to work. A helmsman with a neck bubo is strapped to the helm; a ship’s carpenter with a bloody cough, to his bench. A rigger shaking with fever is lashed to the mast.
Gradually each escaping vessel becomes a menagerie of grotesques. Everywhere there are delirious men who talk to the wind and stain their pants with bloody anal leakages; and weeping men who cry out for absent mothers and wives and children; and cursing men who blaspheme God, wave their fists at an indifferent sky, and burble blood when they cough. There are men who ooze pus from facial and body sores and stink to high heaven; lethargic men who stare listlessly into the cruel, gray sea; mad men who laugh hysterically and dig filthy fingernails into purple, mottled flesh; and dead men, whose bloated bodies roll back and forth across pitching decks until they hit a rail or mast and burst open like piñatas.
In the thousand days between the autumn of 1347—when the Genoese arrived in Sicily, so diseased “that if anyone so much as spoke with one of them, he was infected”—and the winter of 1351–52, when the plague crossed the icy Baltic back into Russia,Y. pestisdrew a hangman’s noose around Europe.
From Sicily, where it raged unceasingly for a dozen months, one strain of the pestilence swept westward along the Mediterranean coast to Marseille, where half the city may have perished in the bitter winter of 1347–48. Sweeping up the Rhône to Avignon, in April 1348 the plague ended one of the mythic love stories in Western literature, exposed the moral weakness of a pope, and inspired nightly marches to the local cemeteries by Avignon’s hungry pigs. Farther to the east, in the Adriatic port city of Ragusa, authorities celebrated spring’s arrival by ordering all citizens to make out a will. In June the plague visited Paris, where the municipal cemetery ran out of burial space and the renowned Paris medical faculty pronounced the cause of the disease to be “an unusual conjunction of Saturn, Mars, and Jupiter at one on the afternoon on March 20th, 1345.” Later that bleak summer the plague forked like a serpent’s tongue. One strain swept northward toward Tournai on the Flemish border, where church bells rang unceasingly for two days to announce its arrival; while a second strain, enticed by the scent of war and death around recently besieged Calais, rolled up the coast and peered westward across the channel toward England. On the other side, from Dover to Land’s End, anxious Englishmen scanned the summer seas as they would not scan them again until the Battle of Britain in the summer of 1940.
In JulyY. pestisslipped through the cordon of watchers and entered the little port of Melcombe; a month later the town was still, except for the pounding of rain on village rooftops and the crash of surf against the chalky Dorset cliffs to the south. In the terrible month of September, the pestilence pivoted and wheeled eastward through an incessant late summer downpour toward London, where a grieving king mourned a beloved child. “No fellow human being could be surprised if we were inwardly desolated by the sting of this bitter grief, for we are human, too,” wrote Edward III of his plague-dead daughter, fifteen-year-old Princess Joan. In the spring of 1349, as the green hills of Wales echoed with birdsong, a local poet wrote, “Death comes into our midst like black smoke.” In the merry month of MayY. pestisarrived in Derbyshire, where in three short months it killed peasant William de Wakebridge’s wife, father, sister, a sister-in-law, and an aunt. Across the Irish sea, in Dublin, where the living had surrendered the streets to the dead, Franciscan John Glynn wrote, “I . . . am waiting among the dead for death to come.”
Another strain of the plague entered Europe through Genoa, where several galleys laid anchor on the last day of 1347. As a raw winter wind whipped through the city’s nighttime streets, a candle glowed in the window of local notary Antonio de Benitio, who remained in the infected city to make out wills for clients unable to flee. Swinging inland across the narrow plains of central Italy, the plague swept into Florence on a cold March day and killed so many of its citizens, church bells were stilled to preserve public morale; “the sick hated to hear [them] and it discourages the heathy as well,” wrote a survivor. In June, when the plague arrived in Siena, a tax collector and former shoemaker named Agnolo di Tura declared, “This is the end of the world.” Nearby Pistoia greeted the pestilence more pragmatically. “Henceforth . . . ,” declared the town fathers, “each grave shall be dug two and a half arms’ lengths deep.” In August the pestilence reached Perugia, where Gentile da Foligno, one of Italy’s most celebrated physicians, cast his lot with the poor. As the wealthy and well-born of Perugia fled, wealthy, well-born da Foligno remained at his post, visiting the stinking hovels of the needy until, at last, the plague claimed him.
Descending from the Alpine passes into Austria in the fall of 1348,Y. pestiskilled with such fetid abundance, one observer reports that the wolves who preyed on local sheep “turned and fled back into the wilderness . . . as if alarmed by some infallible warning.” Arriving in Central Europe, the pestilence ignited an unparalleled burst of anti-Semitism. In September 1348, in Chillon, a town near Lake Geneva, a Jewish surgeon and a Jewish mother were accused of fomenting plague, forcing the surgeon to choose between himself and his community, and the mother between herself and her son.
In January 1349 Basel burned its Jews on an island in the Rhine, while hygiene-conscious Speyer, fearing pollution, put its dead Jews in wine barrels and rolled them into the river. In February, as a prophylactic measure, Strasbourg marched its Jews to a local cemetery and burned them. Entering the cemetery, several beautiful young Jewesses refused salvation at Christian hands and insisted on going to the stake. The plague struck Strasbourg anyway. In Worms the local Jewish community, faced with death at the hands of Christian neighbors, locked themselves in their homes and set themselves ablaze. In Constance, under a gray March sky, a group of Jews marched into a fire, singing and laughing.
As the plague made its way through the primeval forests of Germany, another demon bubbled up from the medieval Teutonic psyche: the Flagellants, who believed the curse of the mortality could be lifted through self-abuse of the flesh and slaying Jews. Twenty years later one spectator could still recall the hysteria the Flagellants aroused. The men, he wrote, “lashed themselves viciously on their naked bodies until the blood flowed, while crowds, now weeping now singing, shouted, ‘Save us!’”
In May 1349 an English wool ship brought the plague to Bergen, in Norway. Within days of arriving the passengers and crew were all dead. By the end of the short Scandinavian summer, the pestilence was moving in an easterly arc toward Sweden, where King Magnus II, believing the mortality to be the work of an angry God, ordered foodless Fridays and shoeless Sundays to appease His divine wrath. Approaching the east coast of Greenland,Y. pestisencountered towering ice cliffs rising out of a frigid, white-capped sea like the parapets of an Arctic Xanadu; undaunted, it persevered. Later an observer would write that, from that moment on, “no mortal has ever seen that [eastern] shore or its inhabitants.”
In the three and a half years it tookY. pestisto complete its circle of death, plague touched the life of every individual European: killing a third of them, leaving the other two-thirds grieving and weeping.
Here is the story of that epic tragedy.