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the pandemic are varied and often imprecise e the most commonly noted symptom was the appearance of buboes or gavocciolos in the groin neck and armpits which oozed pus and bled when opened 77 boccaccio s description in men and women alike it first betrayed itself by the emergence of certain tumours in the groin or armpits some of which grew as large as a common apple others as an egg from the two said parts of the body this deadly gavocciolo soon began to propagate and spread itself in all directions indifferently after which the form of the malady began to change black spots or livid making their appearance in many cases on the arm or the thigh or elsewhere now few and large now minute and numerous as the gavocciolo had been and still was an infallible token of approaching death such also were these spots on whomsoever they showed themselves 122 123 f this was followed by acute fever and vomiting of blood most people died two to seven days after initial infection freckle like spots and rashes 125 which may have been caused by flea bites were identified as another potential sign of plague lodewijk heyligen whose master cardinal giovanni colonna died of plague in 1348 noted a distinct form of the disease pneumonic plague that infected the lungs and led to respiratory problems 77 symptoms include fever cough and blood tinged sputum as the disease progresses sputum becomes free flowing and bright red pneumonic plague has a mortality rate of 90 95 126 septicemic plague is the least common of the three forms with an untreated mortality rate near 100 symptoms are high fevers and purple skin patches purpura due to disseminated intravascular coagulation 126 in cases of pneumonic and particularly septicemic plague the progress of the disease is so rapid that there would often be no time for the development of the enlarged lymph nodes that were noted as buboes 126 consequences main article consequences of the black death deaths inspired by the black death the dance of death or danse macabre an allegory on the universality of death was a common painting motif in the late medieval period there are no exact figures for the death toll the rate varied widely by locality urban centers with higher populations suffered longer periods of abnormal mortality 127 some estimate that it may have killed between 75 000 000 and 200 000 000 people in eurasia 128 129 130 better source needed a study published in 2022 of pollen samples across europe from 1250 to 1450 was used to estimate changes in agricultural output before and after the black death the authors found great variability in different regions with evidence for high mortality in areas of scandinavia france western germany greece and central italy but uninterrupted agricultural growth in central and eastern europe iberia and ireland 131 the authors concluded that the pandemic was immensely destructive in some areas but in others it had a far lighter touch the study methodology invalidates histories of the black death that assume y pestis was uniformly prevalent or nearly so across europe and that the pandemic had a devastating demographic impact everywhere the black death killed by various estimations from 25 to 60 of europe s population robert gottfried writes that as early as 1351 agents for pope clement vi calculated the number of dead in christian europe at 23 840 000 with a preplague population of about 75 million clement s figure accounts for mortality of 31 a rate about midway between the 50 mortality estimated for east anglia tuscany and parts of scandinavia and the less than 15 morbidity for bohemia and galicia and it is unerringly close to froissart s claim that a third of the world died a measurement probably drawn from st john s figure of mortality from plague in the book of revelation a favorite medieval source of information 132 ole j benedictow proposes 60 mortality rate for europe as a whole based on available data with up to 80 based on poor nutritional conditions in the 14th century 133 134 g according to medieval historian philip daileader it is likely that over four years 45 50 of the european population died of plague 135 h the overwhelming number of deaths in europe sometimes made mass burials necessary and some sites had hundreds or thousands of bodies 136 the mass burial sites that have been excavated have allowed archaeologists to continue interpreting and defining the biological sociological historical and anthropological implications of the black death 136 the mortality rate of the black death in the 14th century was far greater than the worst 20th century outbreaks of y pestis plague which occurred in india and killed as much as 3 of the population of certain cities 137 in 1348 the disease spread so rapidly that nearly a third of the european population perished before any physicians or government authorities had time to reflect upon its origins in crowded cities it was not uncommon for as much as 50 of the population to die 59 half of paris s population of 100 000 people died in italy the population of florence was reduced from between 110 000 and 120 000 inhabitants in 1338 to 50 000 in 1351 at least 60 of the population of hamburg and bremen perished 138 and a similar percentage of londoners may have died from the disease as well 66 leaving a death toll of approximately 62 000 between 1346 and 1353 53 i florence s tax records suggest that 80 of the city s population died within four months in 1348 137 before 1350 there were about 170 000 settlements in germany and this was reduced by nearly 40 000 by 1450 140 the disease bypassed some areas with the most isolated areas being less vulnerable to contagion plague did not appear in flanders until the turn of the 15th century and the impact was less severe on the populations of hainaut finland northern germany and areas of poland 137 monks nuns and priests were especially hard hit since they cared for people ill with the plague 141 the level of mortality in the rest of eastern europe was likely similar to that of western europe in the first outbreak with descriptions suggesting a similar effect on russian towns and the cycles of plague in russia being roughly equivalent 104 citizens of tournai bury plague victims in 1382 the physician to the avignon papacy raimundo chalmel de vinario latin magister raimundus lit master raymond observed the decreasing mortality rate of successive outbreaks of plague in 1347 1348 1362 1371 and 1382 in his treatise on epidemics de epidemica 142 in the first outbreak two thirds of the population contracted the illness and most patients died in the next half the population became ill but only some died by the third a tenth were affected and many survived while by the fourth occurrence only one in twenty people were sickened and most of them survived 142 by the 1380s in europe the plague predominantly affected children 137 chalmel de vinario recognised that bloodletting was ineffective though he continued to prescribe bleeding for members of the roman curia whom he disliked and said that all true cases of plague were caused by astrological factors and were incurable he was never able to effect a cure 142 the populations of some italian cities notably florence did not regain their pre 14th century size until the 19th century 143 italian chronicler agnolo di tura recorded his experience from siena where plague arrived in may 1348 father abandoned child wife husband one brother another for this illness seemed to strike through the breath and sight and so they died and none could be found to bury the dead for money or friendship members of a household brought their dead to a ditch as best they could without priest without divine offices great pits were dug and piled deep with the multitude of dead and they died by the hundreds both day and night and as soon as those ditches were filled more were dug and i agnolo di tura buried my five children with my own hands and there were also those who were so sparsely covered with earth that the dogs dragged them forth and devoured many bodies throughout the city there was no one who wept for any death for all awaited death and so many died that all believed it was the end of the world 144 the black death killed about 40 of egypt s population 145 in cairo with a population numbering as many as 600 000 and possibly the largest city west of china between one third and 40 of the inhabitants died within eight months 116 by the 18th century the population of cairo was halved from its numbers in 1347 116 economic it has been suggested that the black death like other outbreaks through history disproportionately affected the poorest people and those already in worse physical condition than the wealthier citizens 146 but along with population decline from the pandemic wages soared in response to a subsequent labour shortage 147 in some places rents collapsed e g lettings used to bring in 5 and now but 1 121 158 however many labourers artisans and craftsmen those living from money wages alone suffered a reduction in real incomes owing to rampant inflation 148 landowners were also pushed to substitute monetary rents for labour services in an effort to keep tenants 149 taxes and tithes became difficult to collect with living poor refusing to cover the share of the rich deceased because many properties were empty and unfarmed and because tax collectors where they could be employed refused to go to plague spots 121 158 the trade disruptions in the mongol empire caused by the black death was one of the reasons for its collapse 150 environmental a study performed by thomas van hoof of the utrecht university suggests that the innumerable deaths brought on by the pandemic cooled the climate by freeing up land and triggering reforestation this may have led to the little ice age 151 persecutions see also persecution of jews during the black death jews being burned at the stake in 1349 miniature from a 14th century manuscript antiquitates flandriae by gilles li muisis renewed religious fervor and fanaticism increased in the wake of the black death some europeans targeted various groups such as jews friars foreigners beggars pilgrims lepers 152 153 and romani blaming them for the crisis lepers and others with skin diseases such as acne or psoriasis were killed throughout europe because 14th century healers and governments were at a loss to explain or stop the disease europeans turned to astrological forces earthquakes and the poisoning of wells by jews as possible reasons for outbreaks 12 many believed the epidemic was a punishment by god for their sins and could be relieved by winning god s forgiveness 154 there were many attacks against jewish communities 155 in the strasbourg massacre of february 1349 about 2 000 jews were murdered 155 in august 1349 the jewish communities in mainz and cologne were annihilated by 1351 60 major and 150 smaller jewish communities had been destroyed 156 during this period many jews relocated to poland where they received a welcome from king casimir the great 157 social see also black death in medieval culture pieter bruegel s the triumph of death reflects the social upheaval and terror that followed the plague which devastated medieval europe one theory that has been advanced is that the black death s devastation of florence between 1348 and 1350 resulted in a shift in the world view of people in 14th century italy that ultimately led to the renaissance italy was particularly badly hit by the pandemic and the resulting familiarity with death may have caused thinkers to dwell more on their lives on earth rather than on spirituality and the afterlife 158 j it has also been argued that the black death prompted a new wave of piety manifested in the sponsorship of religious works of art 160 this does not fully explain why the renaissance occurred in italy in the 14th century the renaissance s emergence was most likely the result of the complex interaction of the above factors 161 in combination with an influx of greek scholars after the fall of the byzantine empire 162 as a result of the drastic reduction in the populace the value of the working class increased and commoners came to enjoy more freedom to answer the increased need for labour workers travelled in search of the most favorable position economically 163 better source needed prior to the emergence of the black death the continent was considered a feudalistic society composed of fiefs and city states frequently managed by the catholic church 164 the pandemic completely restructured both religion and political forces survivors began to turn to other forms of spirituality and the power dynamics of the fiefs and city states crumbled 164 the survivors of the pandemic found not only that the prices of food were lower but also that lands were more abundant and many of them inherited property from their dead relatives and this probably contributed to the destabilization of feudalism 165 166 the word quarantine has its roots in this period though the practice of isolating people to prevent the spread of disease is older in the city state of ragusa modern dubrovnik croatia a thirty day isolation period was implemented in 1377 for new arrivals to the city from plague affected areas the isolation period was later extended to forty days and given the name quarantino from the italian word for forty 167 all institutions were affected smaller monasteries and convents became unviable and closed up to half parish churches lost their priest apart from the parishioners religious sensibilities changed 121 looking back into the past the history of the church during the middle ages in england appears one continuous and stately progress it is much nearer to the truth to say that in 1351 the whole ecclesiastical system was wholly disorganised or indeed more than half ruined and that everything had to be built up anew to secure the most necessary public ministrations of the rites of religion the most inadequately prepared subjects had to be accepted and even these could be obtained only in insufficient numbers the immediate effect on the people was a religious paralysis instead of turning men to god the scourge turned them to despair in time the religious sense and feeling revived but in many respects it took a new tone and its manifestations ran in new channels characterised by a devotional and more self reflective cast than previously the new religious spirit found outward expression in the multitude of guilds which sprang into existence at this time in the remarkable and almost as it may seem to some extravagant development of certain pious practices in the singular spread of a more personal devotion to the blessed sacrament to the blessed virgin to the five wounds to the holy name and other such manifestations of a more tender or more familiar piety at the close of the fourteenth century and during the course of the fifteenth the supply of ornaments furniture plate statues painted or in highly...
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