Q: Was an epidemic like the plague inevitable during the medieval period?

Ole Jørgen Benedictow: No, it was not inevitable, but the requirements for its arrival and devastating long-time presence in Europe increased with rising population density and local and regional trade.


The development of long-distance trade by galleys and cogs from the late 1200s was crucial to plague’s spread, because it linked Europe together and with distant trading stations and commercial hubs near plague focal points in north Africa, the near east, the Middle East, and in southern Russia. In the early 1300s, the probability that plague would arrive in Europe was rapidly increasing; the commercial and demographic requirements for its dissemination were all in place.

Mark Ormrod: Some people have a deterministic view of population history, believing that, in pre-industrial societies, population generally tended to grow at a faster rate than the economy and that some external factor – be it famine, disease or war – would then intervene to re-establish the balance. There is plenty of evidence that parts of Europe were becoming ‘calamity-sensitive’ around 1300 and that the plague acted to restore equilibrium. But this is a long way from saying the plague, in its form and timing, was a historical inevitability.

Carole Rawcliffe: Famine-related epidemics were a fact of life for people who lacked the benefits of modern medicine and whose levels of resistance were often compromised by poor diet and unhygienic living conditions, as well as by endemic diseases such as tuberculosis and malaria. Several serious outbreaks of infectious disease are recorded across Europe in the decades before the Black Death, and although none rivalled it in severity, there can be little doubt that conditions favoured the spread of a major pandemic.

Q: Do we know how many people actually died from the Black Death in the 14th century?

MO: It is agonisingly difficult to get good population data for medieval Europe: even for England, where the information is especially rich. No one took death tolls so we have to develop models of mortality from sources like clergy lists, manor court rolls and tax records. The conventional view is that around a third of the population of Europe died in the first outbreak of the plague between 1347 and 1350. But it returned on a regular basis and became endemic for the following 300 years.

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The second outbreak of the Black Death, in the early 1360s, became known as the children’s plague because of the high mortality among the generation born since the first visitation. By the end of the 14th century the population of some parts of Europe may have been only half what it had stood at two generations earlier.

CR: Local studies prove instructive when ascertaining the death toll. In cities like Norwich, where we have a reasonably good idea of population levels before and after the first two national epidemics (about 25,000 in 1330 and around 8,000 in the early 1370s), mortality seems to have been sufficiently high to justify at least some of the claims made by contemporary chroniclers. Florence, which is better documented, lost about two-thirds of its inhabitants in 1348 alone, but staged an effective demographic recovery. By contrast, many German cities escaped untouched.

OJB: My research indicates that very few mortality rates were as low as one third, and many were as high as 60 per cent or more. For example, studies of 7,655 householders in Provence exhibit a mortality rate of 52 per cent, while 79 studies of customary tenantry on manors across England show an average mortality rate of about 55 per cent. If we take into account the very high death rate among the poor, women and children, a general mortality rate of over 60 per cent is indicated.

Q: What would the disease have been like for those who contracted it?

CR: Even allowing for the exaggeration often found in medieval chronicles, first-hand descriptions of the Black Death make for grim reading. One account by a Franciscan friar from the Isles of Scilly describes the initial appearance of small pustules or buboes, accompanied by a feeling of cold and stiffness, which would “so weaken and torment” the victim that he or she could no longer remain standing. Chill then gave way to a burning fever and searing pain as the buboes grew in size and the lungs became infected. By this stage, the victim would be coughing up blood and vomiting incessantly until death intervened approximately four days after the first signs of infection.

Q: How were the afflicted treated by their families and communities?

MO: Responses were many and various, with panic, flight and the mass burial of abandoned corpses all common. One consequence was the growth of religious guilds, which aimed to provide some level of security for people worried they would have no kin to attend to them in illness or remember them after death.

Tom James: Some were abandoned. In Winchester in 1349, for example, townspeople attacked a monk conducting a burial service. The townspeople also took over parts of the burial ground around the cathedral priory so that plague burials could not take place there.

Evidence from London suggests that at first the dead were buried in coffins. As the disease got worse the bodies were placed in pits. However, the excavations show that the bodies were laid out in orderly rows with respect. A pit in Hereford, by contrast, is suggestive that the bodies were thrown in more higgledy-piggledy. Elsewhere, contemporary evidence from Rochester relates that the pits were left open and the weeping parents brought their children to the open pits and laid their bodies there.

CR: Levels of care varied dramatically from callous disregard to selfless devotion, although fear that the disease might be communicated through the gaze, breath or even the clothes of victims made most people understandably wary about close contact. In continental Europe (but not England), towns and cities engaged the services of surgeons and physicians whose duty was to care for the sick, but who sometimes took flight at the first sign of infection. In Italy, religious guilds undertook to provide support for the sick poor and the many destitute widows and orphans who were left behind after each epidemic.

Q: What was life like for the survivors of the Black Death?

TJ: Medieval people knew what to do in time of plague and other disasters. Disposal of bodies in pits is well attested from earlier disasters, for example a volcanic eruption in the tropics in 1258 that led to widespread famine in Europe. More than 10,500 skeletons have been recovered from the Spitalfields market area of London alone since the 1990s, probably a proportion of a higher number dating to that disaster.

There were set prayers and Bible extracts designated for use in time of plague. A special Mass of St Sebastian was used, for example – Sebastian being one of the patron saints of plague, the arrow wounds of his martyrdom being a trope for the buboes of the plague which broke out on victims’ bodies.

MO: The first outbreak of plague must have been an incredibly terrifying moment in human history. But medieval society was much more inured to natural and human disasters than is the case in the west today, and there is every sign that people re-established their lives remarkably quickly.

It was generally assumed that the plague was a result of poor air quality arising from high humidity or poor sanitary conditions. Although it took a long time to understand that the key cause of infection was the presence of rats, the idea of moving into the cleaner environment of the countryside did, in effect, provide some protection against infection for those lucky enough to escape the overcrowded towns.

CR: In England, the crown, parliament and local authorities did their best to contain such dangerous behaviour as the pollution of water supplies. Advice literature, increasingly produced in the vernacular rather than Latin, helped individuals and communities to avoid unnecessary risks. Spiritual health remained paramount, however, and although people may have grown less fatalistic in the face of disease they still regarded prayer and penance as their first line of defence.

Q: How did the epidemic change medieval society?

MO: If we take the long view, we can say that for at least a proportion of the survivors of plague, there was a real improvement in the quality of life. By the 15th century we find that people who survived to maturity tended to live longer than earlier generations because they were better fed, clothed and housed.

The drop in the population resulted in a redistribution of wealth: workers could demand higher wages, and tenant farmers could demand lower rents. This gave the poor more expendable income.

CR: Such a dramatic and sustained fall in population levels brought distinct benefits for ordinary people. On the whole, English men and women ate more meat and dairy produce than before and, in a rental market that favoured tenants rather than landlords, they were able to afford better quality housing.

The sanitary reforms introduced by urban authorities also made towns and cities cleaner and more pleasant places to live – or at least aimed to do so.

Q: What was the Black Death’s impact on European history?

OJB: The historical impact of the Black Death and subsequent plague epidemics resulted in a temporary halt in the development of the early Renaissance, which was not resumed until about 1450. It oriented the mental focus and energy of the time towards death and salvation – ars moriendi, the way of achieving a good death, became of paramount importance. This found expression in the movement towards the Reformation, which broke down the authority of the Catholic church as a guarantor of salvation, and conferred to the individual the decisive task of achieving salvation through a pious and righteous life.

TJ: There’s no doubt the Black Death was devastating when it first struck Europe between 1347 and the early 1350s. However the impact of the plague was exacerbated because it returned in 1361, 1374, 1389 and then in 1665 with the Great Plague of London and elsewhere. At Eyam in Derbyshire, for example, it is reckoned that 260 out of a population of 350 died when they cut themselves off from the outside world.

Plague continued in France until around 1720 – prompting Daniel Defoe’s fake Journal of the Plague Year (1722). In that sense, the grim reaper of the plague stalked Europe for centuries, breaking out like earthquakes, unheralded and randomly.

MO: The Black Death had a very different impact on western and eastern Europe – largely due to the response of the respective elites. In the west, the scarcity of population and the resulting increase in the economic capacity of the peasants meant that feudal lords were unable to enforce their traditional rights and had to engage in an open labour market. As a result, serfdom – the idea that peasant families were tied to the manor and had to perform unpaid service to their lord – simply became irrelevant.

In eastern Europe, conversely, the elites responded by reinforcing serfdom. The divergence was to be evident for centuries to come and had huge consequences for the levels of commercialisation and industrialisation experienced across Europe between the 16th and the 19th centuries.

Q: What do you think about recent research suggesting that gerbils, not rats, spread the disease?

OJB: The theory that the Black Death and subsequent plague epidemics arose among gerbils in east Asia according to climatic cycles should not be taken seriously. It is based on a series of erroneous or false historical assertions, like many other plague theories, such as that it was carried by human fleas and/or lice, or that it was, in fact, a viral disease that spread much like influenza.

MO: The gerbil theory is a fascinating idea but at the moment it is just a hypothesis.It’s worth noting that the scientists involved are assuming the Black Death was indeed bubonic plague borne by fleas living on the backs of rodents: the only difference here is that the rodents may have been gerbils rather than rats.

Other researchers in the past have suggested that the disease could have been anything from influenza to anthrax. All of this is a reminder of the many uncertainties that remain around the nature and spread of the Black Death pandemic.

The panel:

Carole Rawcliffe is professor emerita of history at the University of East Anglia. She co-edited Society in an Age of Plague (Boydell Press, 2013) with Linda Clark

Tom James is professor emeritus in archaeology and history at the University of Winchester. His books include The Story of England (Tempus, 2003)

The late Mark Ormrod was professor of history at the University of York. He co-edited The Black Death in England, 1348–1500 (Paul Watkins Publishing, 1996) with Phillip Lindley

Ole Jørgen Benedictow is professor emeritus at the University of Oslo. He is author of The Black Death 1346–1353: The Complete History (Boydell Press, 2012)


This article was first published in the July 2015 issue of BBC History Magazine