Diseases

The plague - history, causes and signs


Black Death

In earlier centuries it was pest one of the most feared epidemics worldwide, today large epidemics are unlikely. However, people still get the plague every year - even in modern industrialized nations such as the USA. The triggering bacteria have by no means disappeared.

In 541 AD, a plague broke out in the ancient Egyptian city of Pelusium, which was clearly the plague - with black spots, painful bumps, blood spills and sudden death. It devastated Alexandria, spread to Antioch and Syria, and reached 542 Constantinople. Since Emperor Justinian ruled there, the epidemic is called "Justinian Pest". They spread to seafarers in the Mediterranean: to Illyria, Tunisia, Spain and Italy. From Arles, she left a dead trail to the Rhine; 300,000 people fell victim to it in Constantinople alone. 544 the wave subsided for the time being, but in 557 the plague raged again in Antioch, then again in Constantinople, and now also in Ravenna, Istria and Liguria. 570 people died in the Rhone Valley.

Until the end of the 8th century, a plague epidemic broke out approximately every twelve years, spreading for two to three years in the western Mediterranean, Rhenish Germania and parts of Gaul, in the east in Syria, Asia Minor and Mesopotamia, and then it disappeared again. The disease literally depopulated countries of the Roman Empire, especially on the coasts of the Mediterranean and along the river valleys, i.e. the richest areas of the Occident.

The hour came for the neighboring peoples who had been spared the plague: 544 the Berbers invaded Tunisia; the Avars and Lombards conquered 542 Illyria; Persia and Greece invaded the Arabs in 630. But the new masters also became infected: when Caliph Omar took Damascus, he kept his troops in the desert until the plague had decimated the inhabitants and had subsided; only then did he invade 637. A few years later, the plague also took the Arabs in Palestine away.

The great death

In the Middle Ages, the visitation from Europe disappeared - why we do not know. But it came back in the 14th century and was worse than ever. The historians Sournia and Ruffié write: "Given today's conditions, one would have to compare their rage with a global nuclear war."

In 1347, Tartars besieged a Genoese trade fortress in the Black Sea port of Kaffa. However, they had to withdraw because more and more soldiers died of a plague. The besiegers left a fatal farewell to the Italians: they catapulted the deceased over the walls; So many Genoese died within a few days that the survivors panicked and fled home. Her galleys arrived in Messina, Sicily, a little later.

A Franciscan friar reported that "the seafarers carried in their bones an illness that affected anyone who only spoke to them, so that they could in no way escape death." Black death had come and it should be Europe for decades to go to hell.

First it hit Pisa, then Genoa, then Siena. Florence, then one of the largest and richest cities on the continent, became a cemetery. Giovanni Boccaccio wrote: “Since the consecrated earth of the cemeteries was not sufficient for the large number of corpses that were brought to all churches every day, almost every hour, large pits were made and hundreds of new ones were put in them; there, like merchandise in ships, they were laid on top of each other in layers and covered with little earth until the pit was full to the brim. ”

The word comes from the Latin pestis and means epidemic. First the lymph nodes, the groins, the armpits and the neck glands swell. This bubonic plague can develop into a lung plague due to the bacteria in the blood. The bubonic plague could survive if the suppurated lymph nodes were cut open early. The lung plague, on the other hand, always led to death.

People faced the horror helplessly. Superstition mixed with medicine and rumors. Fischer-Fabian writes: “In the most distant China, the earth has opened, blood has rained from the sky, snakes, toads, rats in huge numbers have driven people out of their homes. (...) The wind blows the fog of pestilence over to the countries of Europe, carried by the revenge angels. Because God had given the plague as punishment for the sins of men. "

But praying didn't help. Fischer-Fabian continues: “After every supplication service, more people died than before. Most of the victims were those who participated; they were infected and infected others again. "

Streets, villages and monasteries were deserted; few survivors gathered wealth; the administration broke up; vacant houses were taken over by migrants; Europe experienced the largest new mix of ethnicities since the Migration Period. In Tuscany the Medici rose and took the place of the wiped out elites.

Jews, lepers, Roma and Sinti as well as supposed "warlocks" were blamed for the plague: they should have poisoned the wells and spread the disease. A rioted mob destroyed their homes and burned them at the stake.

Europe lost more than a third of its population within three years. The catastrophe in the Far East was similarly apocalyptic: in 1353, 80 percent of the people in the Chinese province of Shansi died; only one in three survived in Hupeh province.

The origin

The origin of the great plague was probably in Central Asia, i.e. today's Afghanistan, Turkmenistan, Uzbekistan and Mongolia. The plague bacterium is found there in wild rodents, and the region has been repeatedly plagued by the plague when the rodents left their burrows.

William Bernstein explains that Genghis Khan's triumphal advance and the subsequent trade between Asia and Europe brought the plague bacteria to Europe. It is possible, writes Philipp Alcabes, that the wild rodents transmitted the plague to rats, the rats lived in the caravan centers and thus moved west on the Silk Road.

Plague medicine

The 14th century doctors were helpless. They dealt with Hippocrates' juices; afterwards infections were due to a lack of balance of blood, mucus, black and yellow bile. They knew nothing of contagion and therefore believed that bad winds had carried the plague from Asia to Europe; gases from the interior of the earth were also suspected.

Prevention was consequently helpless: people should avoid heavy work and not sleep during the day; they should only open the windows to the north, not to the east. You should avoid warm, humid air as well as stagnant water.

The “dirty pharmacy” should also help, ie the contemporary idea that nasty helps against nasty: ointments from toad spawning, spider eggs and chicken droppings should alleviate the plague as well as a healthy lifestyle and avoiding pork.

The doctors lit incense sticks as well as myrrh, incense and sandalwood. Sometimes they suspected a constellation of Jupiter, Saturn and Mars, then they joined the priests who recognized the signs of the doomsday. After all, according to the Bible, he announced himself with the appearance of the apocalyptic riders - and one of them was pestilence.

Few doctors proceeded more modern: they sneaked into the cemeteries and dissected the bodies, because they rightly suspected the origin of the evil in the body of the victims and not outside. Pope Clement himself allowed the body to be opened, which was strictly forbidden in the high Middle Ages. If it had been worms and other parasites, they would have been successful, but bacteria cannot be seen with the naked eye, and their existence was not known in the Middle Ages.

The plague in modern times

In England in 1667 the plague struck for the last time with 68,000 victims; she disappeared in Scandinavia in 1712 and in Austria in 1716. She continued to haunt the East and returned to Europe with Napoleon. The French troops conquered Egypt and faced countless plague-infected people in southern Syria. In 1816 she raged again in Marseille, in 1819 in Mallorca and in 1828 in Odessa. But since the middle of the 19th century, core Europe has remained largely free of the plague.

Not so Asia: in Astrakhan it claimed various lives in 1876, the plague continued to rage in India and China; It broke out in Mumbai in 1896 and reportedly 6 million Indians died. Even more: international trade spread the bacterium worldwide. In 1897 she met Suez, in 1899 South Africa, in 1900 San Francisco. In 1920 she frightened Paris and Marseille again, but no epidemics occurred.

Big Bang of Modernity?

Historians argue whether the plague promoted the development of modernity. The plague waves shook the medieval world view in the psyche of the people. An order wanted by God, in which both lord and servant, priests and beggars found their place, broke within a few years.

At least in medicine, the plague drove progress. The plague shook confidence in Hippocrates' teaching of juices. The people observed that people who had previously had contact with plague sufferers from the plague. The theory of congregation, according to which illnesses were caused by touch and not by bad winds, only became established around 1500.

Breeding ground for the plague

The plague from 1348 to 1352 claimed many more lives than the plague waves of the early Middle Ages. Nevertheless, parts of Europe were spared: They were neither geographically isolated, for example as lonely mountain valleys or islands, nor socially. The "islands" in the epidemic were rather Flanders, the Auvergne, parts of Franconia and southern Germany. Hamburgers, Bremeners and Cologneers, however, died in large numbers.

Evolutionary biologist Josef H. Reichholf shows how natural conditions changed in the late Middle Ages. The "little ice age" had begun. The climate had warmed in the High Middle Ages; the Mediterranean warmth spread north of the Alps. For example, figs ripened on the Rhine.

However, it got cold in the first decades of the 14th century. The rat rats previously lived outdoors, in the trash piles of the city trenches. People stored food in cellars. The climate deteriorated so quickly that the Central Europeans had not developed adequate heating systems. They put on another layer of clothing, providing fleas with a perfect habitat. Life was going on much more in the houses now; before that, our ancestors were out as often as today in the Mediterranean.

Most contemporaries only had candles and pine shavings as light sources - that was not enough to hunt the nightly rats and fleas. The rat (Rattus norvegicus) brought the rat flea with it, which carried the pathogen Yersinia pestis. It displaced the smaller and heat-loving house rat (Rattus rattus). The house rat was pushed back into the warm attics, the rat occupied the cellars and vaults. The population had also quadrupled since 900; the cities were crowded. So there were favorable conditions for the plague.

Since the outbreak in Messina, incoming ships have had to be in quarantine for forty days before being allowed to enter the ports - a sensible measure against human infection. This did not prevent the rats from running ashore on the rope, and the horror took its course.

The plague today

A plague wave with a rapidly increasing number of victims as in the Middle Ages is unlikely in Europe today. Health and safety regulations in aviation and seafaring, rat extermination on ships, mandatory reporting of the plague and better hygiene make it difficult for the plague bacteria. The bacillus, rat and flea are fought in triplicate, and infection chains can be stopped. There are also effective medicines and antibiotics for the plague. Recognized early, the bubonic plague no longer means death.

However, it has not been eradicated in the western world. Colorado, New Mexico, Nevada, Arizona and California are breeding grounds for the bacterium, which lives here not in rats but in croissants. The plague only came to the new world in the 20th century and quickly spread from ship rats to wild rodents.

National park visitors feed the ground squirrels and thus become infected. An average of seven people die from the plague in the United States each year. The main concern of the local doctors is that the ground squirrels transfer the plague back to the rats that live in the cities; then individual cases could easily become an epidemic.

In 2015, 11 people became infected by September, and four of them died. Most became infected in Yosemite National Park. The last victim died in Utah in August; About 70 prairie dogs died of the plague were previously found in this state.

Plague cases occur again and again in China. A 38-year-old man died after feeding an infected marmot to his dog. Then he got a fever of over 40 degrees, headache and body aches, his lymph nodes on the groin became inflamed and formed black bumps. He was dead after a few days.

Diagnosis

Depending on the type of plague, there are differences in the earliest stage: in the case of bubonic plague, blisters form around the bite site of the flea, often a rash spreads; the lymph nodes in this region are very swollen, the bitten area hurts.

If suspected, the doctor stabs a swollen lymph node and sends the sample to a laboratory. The Max von Pettenkofer Institute for Medical Microbiology in Munich comes first here.

The lung plague shows up by coughing, bloody expectoration, high fever and nausea. The bacterium is detectable in saliva. The patient must be isolated immediately.

In plague sepsis, the bacterium is in the patient's blood. They are bedridden, their blood pressure is low and they have a high fever.

Pest - prevention and treatment

In plague areas in Central Asia, the southwestern United States, China, India and central Africa, travelers should take precautions: treat pets against fleas to prevent transmission, DEET-containing mosquito sprays prevent fleas from being transmitted to humans; avoid contact with sick and dead rodents.

Pest risk factors

Low living and hygiene standards such as in India
Direct contact with rodents such as in Indian temples, African slums and American national parks.

There is a vaccination against, but it only lasts for six months and its effectiveness has not been systematically proven. Antibiotics such as streptomycin, gentamycin, tetracycline, doxycycline and chloramphenicol help against the plague diseases. Untreated, about 50 percent of the sick die from bubonic plague, but the disease is treated early, only every fifth. (Dr. Utz Anhalt)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Swell:

  • Jacques Ruffié / Jean-Charles Sournia: The epidemics in human history. Munich 1992
  • Robert Koch Institute (RKI): Pest (Yersinia pestis) (access: August 27, 2019), rki.de
  • World Health Organization (WHO): Plague - Fact Sheet (accessed: August 27, 2019), who.int
  • Julia M. Riehm, Thomas Löscher: Plague and lung plague pathogenicity, epidemiology, clinic and therapy, Bundesgesundheitsblatt, July 2015, rki.de
  • Centers for Disease Control and Prevention (CDC): Plague (accessed: August 27, 2019), cdc.gov


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