How the Black Death Spread Along the Silk Road

How the Black Death Spread Along the Silk Road

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The Silk Road, a network of land and sea trade routes that connected China and the Far East with Europe from 130 B.C. to 1453 A.D., became a vital source for everything from fabric and leather goods to spices and precious stones. It connected communities and allowed them to share innovations such as paper-making and printing technology, as well as language, culture and religious beliefs.

But the medieval superhighway also has a darker, lethal legacy: It enabled one of the first great pandemics—the plague known as the Black Death—to spread along its route and eventually reach the edge of Europe, where it killed more than 50 million people between 1346 and 1352.

“The Silk Road allowed, possibly for the first, the sustained transmission of diseases endemic to Central Asia to move out along the Road to Europe,” explains Mark Welford, a professor at the University of Northern Iowa and author of the 2018 book Geographies of Plague Pandemics.

READ MORE: The Black Death: A Timeline of the Gruesome Pandemic

The Silk Road Becomes a Network for Infection

As Welford explains, one reason the Silk Road was so effective in aiding spread of disease-causing microbes was that, despite its name, it wasn’t just a single route. The overland portion of the Silk Road was actually a set of paths that split and reconnected across the steppes of Central Asia, almost like the blood vessels of the human body or the veins in plant leaves.

Along that network there were various stops—villages, towns and outposts called cavaranserais—scattered about a day’s hike apart. Few travelers covered the Silk Road’s expanse, which stretched for thousands of miles from East Asia to Turkey. Instead, caravans of traders and camels traveled back and forth between the local nodes, trading their wares for other goods, gold or money, and then returned home. (Here’s a map of the basic route, from The Miami University Silk Road Project.)

In the process, the traders and their animals also passed along contagions, which spread slowly and gradually between points along the Silk Road. As bad luck would have it, the route also brought travelers in close proximity to what some researchers point to as a source for a particularly dangerous disease.

Contagious Fleas Leave Rodent Hosts for Humans

In a 2015 study, Norwegian and Swedish scientists proposed that fluctuations in the climate of the Central Asian steppes caused the region’s rodent population—probably gerbils and marmots in particular—to crash. That, in turn, may have forced fleas that carried the bacterium Yersinia pestis, which causes plague, to leave their rodent hosts and find new places to live, such as camels and their human owners. After several years of flea relocation, as the scientists’ theory goes, it took another decade for the caravans to gradually advance the plague westward, until it reached the edge of Europe.

Kaffa, a Crimean Black Sea port now known as Feodosia, “seems to be the jumping off point for the primary wave of the medieval Black Death from Asia to Europe in 1346-7,” Welford says. “Genoese or Venetians left Kaffa by boat, infected Constantinople and Athens as they made their way to Sicily and Venice and Genoa. But I suspect [Black Death] also made it to Constantinople via an overland route.”

One famous 14th-century account claimed that plague was introduced to Kaffa deliberately, through a Mongol biological warfare attack that involved hurling plague-infected corpses over the city’s walls.

Black Death Spreads East to West, And Then Back Again

WATCH: How the Black Death Spread So Widely

Whether that actually happened, the plague eventually became a disaster in the East as well as in the West. “It killed off many of the Mongol rulers and other elite, and weakened the army as well as the local economies,” explains Christopher I. Beckwith, a distinguished professor at Indiana University Bloomington, and author of the 2011 book Empires of the Silk Road. It’s estimated that the Black Death killed 25 million people in Asia and North Africa between 1347 and 1350, in addition to the carnage in Europe.

A 2019 study by German researchers genetically linked the Black Death to an outbreak that occurred in 1346 in Laishevo in Russia’s Volga region, raising the possibility that the disease may have spread from Asia by multiple routes.

In any case, when the Black Death reached Europe, it attacked a population that already was weakened and malnourished by the brutal nature of the feudal economy.

“I think a good argument can be made that [Black Death] hit at a time when the health of the poor was compromised by the stress of famines, poverty and the very nature of serfdom,” Welford says.

In The Decameron, written in 1352, Giovanni Boccaccio describes the Black Death, which reached Florence in 1348. Victims first developed a swelling in their groins and armpits, after which the disease “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, then minute and numerous.”

Between March and July of that awful year, Boccaccio noted that more than 100,000 of the city’s inhabitants died, their bodies piled outside doorways. Grand palaces and stately homes where the nobility and their servants had dwelled were left empty, so that the city was “well-nigh depopulated.”

READ MORE: Pandemics that Changed History

Newly Connected World Is Forced to Quarantine

Without modern scientific knowledge and antibiotics, Europeans struggled by trial and error to find ways to fight the bacterium’s wrath. “The waning of the Plague occurred because of the combined use of quarantine, lazarettos, plague hospitals and rudimentary use of masks by medics, the establish of health-cordons and the shutting of borders, and use of health spies to forewarn countries of impending plague surges,” Welford explains.

But the Black Death wasn’t completely over. Different strains of the same bacterium returned to ravage Europe and again and again until the 1700s. Additionally, as Science magazine reported in 2016, researchers found that a strain of the disease that developed in Europe eventually made its way eastward, and killed millions of people in China in the 1800s.

The spread of the Black Death coincided with the beginning of a smaller, more connected and integrated world, thanks in part to the Silk Road. Along its routes, microbes spread as readily as people, inventions and ideas.

See all pandemic coverage here.

The Spread of Disease along the Silk Roads: Smallpox

This article is the second in a series on the spread of disease along the Silk Roads which examines the ways in which people have historically responded to illness and explores how we might approach newly arising challenges today. It uses the Silk Roads as an instructive example of the benefits of an interconnected world built on collaboration and timely and reliable knowledge sharing. This article details the spread of smallpox along the Silk Roads and the transmission of novel public health measures to combat it, including variolation and, later, vaccines.

Wherever people, animals and goods have moved and brought enriching effects, undesirable phenomena such as disease have also been transmitted on a broad scale. Historically, trade and movement have inevitably played a major role in the spread of infectious disease. In addition to diseases caused by bacteria, such as Plague, many viruses have been transmitted via movement along the Silk Roads. One notable example of a viral disease which has been prevalent throughout much of human history is smallpox. However, just as the disease itself travelled the Silk Roads, so too did a number of public health measures designed to combat it, including an early precursor to vaccinations, a practice known as “variolation”. Indeed, the first ever vaccines produced were used to protect people from catching smallpox, which, due to large scale international vaccination programmes in the 20 th century, has since been successfully eradicated worldwide.

Smallpox is an infectious disease caused by the “Variola” virus characterised by the formation of small sores all over the body. The disease spreads via contact with an infected person or from a contaminated item such as clothing or bedding. Although the exact origins of smallpox are unknown, there is evidence of the disease having been present in Ancient Egypt from as early as the 3 rd century BCE. It appears that trade played an early role in spreading smallpox and there is speculation amongst historians that traders from Egypt might have transmitted the disease to the Indian Subcontinent sometime in the 1 st millennium BCE. Some of the earliest written descriptions of smallpox date from 4 th century CE China and, as trade along the Silk Roads increased in the 6 th century CE, the disease spread rapidly to Japan and the Korean Peninsula. Notably, smallpox broke out between 735 – 737 CE in Japan, where it is believed to have killed up to one-third of the population.

By the 7 th century CE, as trade and travel along the Silk Roads increased, smallpox became “endemic” (outbreaks regularly reoccurring within a given population) in the Indian Subcontinent. Muslim expansion during this time spread smallpox into Northern Africa, Spain and Portugal. In the 9 th century CE, the Persian physician Razi, an early proponent of experimental medicine and chief physician of Baghdad and Rey hospitals in the Abbasid Caliphate, produced one of the most definitive descriptions of smallpox and the first account differentiating it from other similar diseases such as measles and chickenpox. By the 10 th century smallpox had spread throughout Anatolia, with another wave of increased activity along the Silk Roads in the 13 th century CE causing the disease to become endemic in previously unaffected areas such as Central and Northern Europe. In the 15 th century, Portuguese expeditions to the West Coast of Africa and the establishment of new trade routes introduced the disease to further previously unaffected areas.

Despite the fact that the movement of people and goods across vast distances has undoubtedly aided the spread of disease, the medical sciences have been one of the direct beneficiaries of the resulting intercultural exchanges. An excellent example of this is the development and transmission of “variolation”, a practice which was an early precursor to smallpox vaccination. There are early accounts of priests from the Indian Subcontinent travelling the Silk Roads popularising the practice of what they called “tika”, an early effort at inoculation (the introduction of a disease-causing agent in order to produce immunity to a specific disease). This involved taking matter from a smallpox patient’s sores and applying it to a small wound on an uninfected person, the idea being that the uninfected person would develop only a very mild case of the disease and, on recovery, become immune to catching a severe case in the future.

This practice may have developed independently in the Indian Subcontinent or, alternatively, practitioners might have learned it from Muslim physicians, who themselves came into contact with the practice via travel and trade with China. As early as the 1400s, medical healers in China had realized that those who survived smallpox did not catch the illness again and inferred that exposure to the illness protected a person from future instances of it. This observation gave rise to a second important public heath measure which was that those who had contracted the disease and survived were able to treat and care for new patients as they had incurred a natural immunity and were unlikely to become ill a second time. In order to transfer this immunity to new patients, Chinese doctors would grind smallpox scabs into a powder and insert it into a person’s nose with a long silver pipe. If only a very small amount of the virus was ingested that person would have a mild experience of the disease and be immunized for life. Similar practices, of “variolation”, were also documented in Africa in accounts from what is today Sudan. By the 16 th century, this practice was a widespread public health measure enacted across many regions of the Silk Roads reaching as far west as Anatolia, having been introduced via descriptions from travellers and merchants.

Throughout history, as we have developed better knowledge of how diseases are transmitted, how they can be treated, and the relevant public health measures that prevent their spread, a major trend for many endemic diseases has been the gradual reduction in their impact over time. In the case of a number of viral diseases, these measures have included the development of vaccinations, which, as in the practice of variolation, have an historic precedent in medicine transmitted along the Silk Roads. In the 18 th century, the English physician Edward Jenner built on the idea of variolation and made a major contribution to the development of the modern smallpox vaccine. He observed that those who had contracted cowpox, a similar but milder viral infection, rarely went on to catch smallpox later in life. It is from the disease cowpox, known in Latin as variola vaccina, that we derive the term “vaccine”. Coordinated international vaccination programmes throughout the 20 th century led to the eradication of smallpox in 1980, and today outbreaks of the disease no longer occur anywhere in the world. The eradication of smallpox is a testament to the development of the medical sciences over a long period of time, building on and sharing pre-existing medical knowledge and coordinating public health initiatives. A natural precursor to this vaccination dates back many hundreds of years with its origins in the many exchanges in the medical sciences taking place along the Silk Roads.

What were the countries along the Silk Road?

The UNESCO Silk Roads Programme lists 54 countries along the “historic land and maritime Silk Roads”. However, many of these countries were only connected via sea routes or extended road networks.

The map below shows where the original Silk Road was located. The primary route is marked in red.

These are the 54 countries along the Silk Road according to the UNESCO Silk Roads Programme.

Every effort has been made to verify this information using reliable and trustworthy sources. However, if you find an error or have any questions, please contact us.

Black Death

The Black Death was a plague pandemic which devastated medieval Europe from 1347 to 1352 CE, killing an estimated 25-30 million people. The disease originated in central Asia and was taken to the Crimea by Mongol warriors and traders. The plague then entered Europe via Italy, carried by rats on Genoese trading ships sailing from the Black Sea.

The disease was caused by a bacillus bacteria and carried by fleas on rodents. It was known as the Black Death because it could turn the skin and sores black while other symptoms included fever and joint pains. With up to two-thirds of sufferers dying from the disease, it is estimated that between 30% and 50% of the population of those places affected died from the Black Death. The death toll was so high that it had significant consequences on European medieval society as a whole, with a shortage of farmers resulting in demands for an end to serfdom, a general questioning of authority and rebellions, and the entire abandonment of many towns and villages. The worst plague in human history, it would take 200 years for the population of Europe to recover to the level seen prior to the Black Death.


Cause & Symptoms

The plague is an infectious disease caused by a bacillus bacteria which is carried and spread by parasitic fleas on rodents, notably the brown rat. There are three types of plague, and all three were likely present in the Black Death pandemic: Bubonic plague, Pneumonic plague and Septicemic plague. Bubonic plague was the most common during the 14th-century CE outbreak, causes severe swelling in the groin and armpits (the lymph nodes) which take on a sickening black colour, hence the name the Black Death. The black sores which can cover the body in general, caused by internal haemorrhages, were known as buboes, from which bubonic plague takes its name. Other symptoms are raging fever and joint pains. If untreated, bubonic plague is fatal in between 30 and 75% of infections, often within 72 hours. The other two types of plague - pneumonic (or pulmonary) and septicaemic - are usually fatal in all cases.

The terrible symptoms of the disease were described by writers of the time, notably by the Italian writer Boccaccio in the preface to his 1358 CE Decameron. One writer, the Welsh poet Ieuan Gethin made perhaps the best attempt at describing the black sores which he saw first-hand in 1349 CE:


We see death coming into our midst like black smoke, a plague which cuts off the young, a rootless phantom which has no mercy for fair countenance. Woe is me of the shilling of the armpit…It is of the form of an apple, like the head of an onion, a small boil that spares no-one. Great is its seething, like a burning cinder, a grievous thing of ashy colour…They are similar to the seeds of the black peas, broken fragments of brittle sea-coal…cinders of the peelings of the cockle weed, a mixed multitude, a black plague like half pence, like berries…(Davies, 411).


The 14th century CE in Europe had already proven to be something of a disaster even before the Black Death arrived. An earlier plague had hit livestock, and there had been crop failures from overexploitation of the land, which led to two major Europe-wide famines in 1316 CE and 1317 CE. There was, too, the turbulence of wars, especially the Hundred Years War (1337-1453 CE) between England and France. Even the weather was getting worse as the unusually temperate cycle of 1000-1300 CE now gave way to the beginnings of a “little ice age” where winters were steadily colder and longer, reducing the growing season and, consequently, the harvest.

A devastating plague affecting humans was not a new phenomenon, with a serious outbreak having occurred in the mid-5th century CE which ravaged the Mediterranean area and Constantinople, in particular. The Black Death of 1347 CE entered Europe, probably via Sicily, when it was carried there by four Genoese rat-infested grain ships sailing from Caffa, on the Black Sea. The port city had been under siege by Tartar-Mongols who had catapulted infected corpses into the city, and it was there the Italians had picked up the plague. Another origin was Mongol traders using the Silk Road who had brought the disease from its source in central Asia, with China specifically being identified following genetic studies in 2011 CE (although South East Asia has been proposed as an alternative source and actual historical evidence of an epidemic caused by plague in China during the 14th century CE is weak). From Sicily, it was but a short step to the Italian mainland, although one of the ships from Caffa had reached Genoa, been refused entry, and docked in Marseilles, and then Valencia. Thus, by the end of 1349 CE, the disease had been carried along trade routes into Western Europe: France, Spain, Britain, and Ireland, which all witnessed its awful effects. Spreading like wildfire, there were plague outbreaks in Germany, Scandinavia, the Baltic states, and Russia through 1350-1352 CE.

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Medieval doctors had no idea about such microscopic organisms as bacteria, and so they were helpless in terms of treatment, and where they might have had the best chance of helping people, in prevention, they were hampered by the level of sanitation which was appalling compared to modern standards. Another helpful strategy would have been to quarantine areas but, as people fled in panic whenever a case of plague broke out, they unknowingly carried the disease with them and spread it even further afield the rats did the rest.

There were so many plague victims and so many bodies that the authorities did not know what to do with them, and carts piled high with corpses became a common sight across Europe. It seemed the only course of action was to stay put, avoid people, and pray. The disease finally ran its course by 1352 CE but would recur again, in less severe outbreaks, throughout the rest of the medieval period.


Death Toll

Although it spread unchecked, the Black Death hit some areas much more severely than others. This fact and the often exaggerated death tolls of medieval (and some modern) writers means that is extremely difficult to accurately assess the total death toll. Sometimes entire cities, for example, Milan, managed to avoid significant effects, while others, such as Florence, were devastated - the Italian city losing 50,000 of its 85,000 population (Boccaccio claimed the impossible figure of 100,000). Paris was said to have buried 800 dead each day at its peak, but other places somehow missed the carnage. On average 30% of the population of affected areas was killed, although some historians prefer a figure closer to 50%, and this was probably the case in the worst affected cities. Figures for the death toll thus range from 25 to 30 million in Europe between 1347 and 1352 CE. The population of Europe would not return to pre-1347 CE levels until around 1550 CE.

Social Consequences

The consequences of such a large number of deaths were severe, and in many places, the social structure of society broke down. Many smaller urban areas hit by the plague were abandoned by their residents who sought safety in the countryside. Traditional authority - both governmental and from the church - was questioned for how could such disasters befall a people? Were not governors and God in some way responsible? Where did this disaster come from and why was it so indiscriminate? At the same time, personal piety increased and charitable organisations flourished.

The Black Death, as its name suggests, was given a personification for people to help understand what was happening to them, usually being depicted in art as the Grim Reaper, a skeleton on horseback whose scythe indiscriminately cut down people in their prime. Many people were simply bewildered by the disaster. Some thought it a supernatural phenomenon, perhaps connected to the comet sighting of 1345 CE. Others blamed sinners, notably the Flagellants of the Rhineland who paraded through the streets whipping themselves and calling for sinners to repent so that God might lift this terrible punishment. Many thought it an unexplainable trick of the Devil. Still others blamed traditional enemies, and age-old prejudices were fed leading to attacks on, and even massacres of, specific groups, notably the Jews, thousands of whom fled to Poland.


Even when the crisis had passed, there were now practical problems to be faced. With not enough workers to meet needs, salaries and prices soared. The necessity of farming to feed people would prove a serious challenge, as would the huge fall in demand for manufactured goods as there were simply far fewer people to buy them. In agriculture specifically, those who could work were in a position to ask for wages, and the institution of serfdom where a labourer paid rent and homage to a landlord and never moved on was doomed. A more flexible, more mobile, and more independent workforce was born. Social unrest followed, and often outright rebellions broke out when the aristocracy tried to fight these new demands. Notable riots were those in Paris in 1358 CE, Florence in 1378 CE, and London in 1381 CE. The peasants did not get all they wanted by any means, and a call for lower taxes was a significant fail, but the old system of feudalism was gone.

After the major famines in 1358 and 1359 CE and the occasional resurgence, albeit less severe, of the plague in 1362-3 CE, and again in 1369, 1374 and 1390 CE, daily life for most people did gradually improve by the end of the 1300s CE. The general welfare and prosperity of the peasantry also progressed as a reduced population reduced the competition for land and resources. Land-owning aristocrats, too, were not slow to pick up the unclaimed lands of those who had perished, and even upwardly mobile peasants could consider increasing their landholdings. Women, in particular, gained some rights of property ownership they had not had before the plague. Laws varied depending on the region but, in some parts of England, for example, those women who had lost husbands were permitted to keep his land for a certain period until they remarried or, in other, more generous jurisdictions, if they did remarry then they did not lose their late husband's property, as had been the case previously. While none of these social changes can be directly linked to the Black Death itself, and indeed some were already underway even before the plague had arrived, the shock wave the Black Death dealt to European society was certainly a contributing and accelerating factor in the changes that occurred in society as the Middle Ages came to a close.

How Europe exported the Black Death

The medieval Silk Road brought a wealth of goods, spices, and new ideas from China and Central Asia to Europe. In 1346, the trade also likely carried the deadly bubonic plague that killed as many as half of all Europeans within 7 years, in what is known as the Black Death. Later outbreaks in Europe were thought to have arrived from the east via a similar route. Now, scientists have evidence that a virulent strain of the Black Death bacterium lurked for centuries in Europe while also working its way back to Asia, with terrifying consequences.

At the Society for American Archaeology meetings earlier this month in Orlando, Florida, researchers reported analyzing the remains of medieval victims in London Barcelona, Spain and Bolgar, a city along the Volga River in Russia. They determined that the victims all died of a highly similar strain of Yersinia pestis, the plague bacterium, which mutated in Europe and then traveled eastward in the decade following the Black Death. The findings “are like pearls on a chain” that begins in western Europe, said Johannes Krause at the Max Planck Institute for the Science of Human History in Jena, Germany, an author of a soon-to-be-published study. (The lead author is Maria Spyrou, also at Jena.)

That chain may have stretched far beyond Russia. Krause argues that a descendant of the 14th century plague bacterium was the source of most of the world’s major outbreaks, including those that raged across East Asia in the 19th and 20th centuries and one afflicting Madagascar today. Eric Klingelhofer, an emeritus archaeologist at Mercer University in Macon, Georgia, called Krause’s presentation “a good piece of research.” But molecular microbiologist Holger Scholz at Munich, Germany’s Bundeswehr Institute of Microbiology is skeptical. “I just think it’s not very likely that a strain from China came to Europe, survived there for a couple of hundred years, and moved back to China,” she said. “That sounds pretty adventurous.”

Advances in sequencing the DNA of pathogens found in ancient human skeletons are driving new research—and debate—on the spread of plague. Thanks to a series of recent findings, the notion that plague remained in Europe for centuries after the Black Death, rather than arriving in repeated waves from Asia as historians long assumed, is gaining ground.

A team led by Lisa Seifert at Munich’s Ludwig Maximilian University reported in January that the Black Death strain persisted in Europe for at least 3 centuries, based on DNA sequences from eight skeletons at two burial sites in Germany that spanned the 14th to the 17th centuries. The sequences were “highly similar” to those from earlier European victims, according to the study, which included Scholz. While not precluding continued waves of plague coming from Asia, the team concluded that there was “a long-time persistence of the pathogen in a not-yet-identified reservoir”—perhaps rats.

Also in January, a team led by Kirsten Bos at Jena’s Max Planck Institute reported further evidence that a descendant of the Black Death strain hung on in Europe, implicating it in the last major European plague outbreak, in Marseille, France. Using DNA from the teeth of five individuals who died in 1722, the group found that the Y. pestis strain in Marseille likely evolved from the Black Death. “Our results suggest that the disease was hiding somewhere in Europe for several hundred years,” said Bos, whose team included Krause.

Now, Krause has traced the Black Death’s eastward spread. His team studied skeletons from a cemetery near the Tower of London firmly dated to 1348–1350, in the wake of the Black Death, as well as from a Barcelona cemetery radiocarbon-dated to the mid-14th century. The Russian evidence comes from a site that included coins from 1360 the burial is estimated to have taken place between the early 1360s and 1400. DNA sequencing from all three places revealed the same strain of Y. pestis. This strain appears to be the ancestor of the one that killed millions in 19th century China, based on phylogenetic clues.

“If the plague in China was actually European in origin, it’s a cruel irony of history,” says Klingelhofer, who notes that this was the era when Western powers dominated China. Krause adds that the plague affecting Madagascar as recently as last year also seems genetically related to the variety that spread east from Europe in the 14th century.

Researchers are eager to create a plague family tree in order to understand the movements and impact of different varieties of Y. pestis across time and space. Krause argues that three of the four branches of plague seem to have evolved in Asia. But he says the branch related to the strain that developed in Europe immediately after the Black Death has proved the most mobile and devastating.

Krause admits that between 14th century London and 21st century Madagascar, there are “a lot of steps missing” to identify the precise movements of the deadly bacterium. But he says that understanding plague’s long journey could help researchers limit its future spread.

The Pax Mongolica

The Pax Mongolica ushered in an era of stability and commerce that successfully connected Europe and East Asia.

Geography, Social Studies, World History

Genghis Khan

Genghis Khan is the most famous ruler in all of Mongolia's history. Khan's empire occupied a large piece of modern day Asia, including most of China.

The Pax Mongolica, Latin for &ldquoMongol peace,&rdquo describes a period of relative stability in Eurasia under the Mongol Empire during the 13th and 14th centuries. The Pax Mongolica brought a period of stability among the people who lived in the conquered territory.

After the death of the first Mongol emperor, Genghis Khan, in 1227, the resulting empire extended from the China&rsquos Pacific coast to Eastern Europe. This meant that the Silk Road network, which had been dangerous to travel due to the warring kingdoms along the route, fell completely under Mongol control.

The resulting stability brought by Mongol rule opened these ancient trade routes to a largely undisturbed exchange of goods between peoples from Europe to East Asia. Along the Silk Road, people traded goods such as horses, porcelain, jewels, silk, paper, and gun powder. European travelers, such as the Venetian merchant Marco Polo, were able to go all the way to China and back. Polo went on to describe his experience in distant lands in a chronicle that captivated the European audience.

Aside from facilitating trade, the Mongol influence also improved the communication along the Silk Road by establishing a postal relay system. The Mongols culturally enhanced the Silk Road by allowing people of different religions to coexist. The merging of peoples and cultures from conquered territories brought religious freedom throughout the empire. Across the vast steppes of Asia, a traveler might encounter Muslims and Christians living and working alongside Mongols, who continued to practice their traditional religion.

But some of the things that made the Pax Mongolica so efficient are what caused its decline and fall in the mid-1300s. The efficient trade routes led to the rapid and unchecked spread of the bubonic plague, also known as the Black Death. The plague originated in central Asia, making its way westward to Europe where it spread further. In addition to disease, the fragmented empire endured increasing turmoil from within. This prevented further expansion and hastened its inevitable decline.

Genghis Khan is the most famous ruler in all of Mongolia's history. Khan's empire occupied a large piece of modern day Asia, including most of China.


The Silk Road is the most renowned trade route in the world, connecting numerous countries from East Asia to Europe. While it empowers communities to trade products and share their knowledge, culture, beliefs, and innovations, it also allows diseases to spread across countries. In this case, the Black Death plague severely influenced people along the route from Asia to Europe, killing more than 50 million people in less than 10 years. The article explains that the Silk Road serves as a crucial contact network for the Black Death infection, and its content is significantly related to our class discussion regarding epidemics. While its name seems like a single route, Silk Road is composed of multiple paths linked to numerous villages and towns, with traders frequently traveling between them. As illustrated by the graph below that shows a proportion of the Silk Road, there are many nodes and they are all connected to one or more of the other nodes.

The transmission of the contagions among countries along the Silk Road can be manifested using the branching process. While the Black Death is said to originate in Central or East Asia, the exact city remains unconfirmed. In the illustration below, I would like to use Tashkent as the starting node where the first infected person appears.

When traders travel from East to West, they go from Fergana to Tashkent, and infected travelers thereby infect people in Tashkent. Traders not only travel through nodes along the route but also trade at and between nodes. Therefore, when a patient from Tashkent trades with someone from Nukus, Khiva, Bukhara, or Samarkand, the traders from these locations are exposed to the microbes. If these traders also get infected, they are capable of infecting people at more nodes when they trade. For instance, after the disease transmits from Tashkent to Bukhara and Samarkand, Shahrisabz is also at risk, since people there also trade with people in Bukhara and Samarkand. The transmission between nodes is very likely to happen because of many factors. Similar to all other epidemics, the spread of the Black Death is based on the production number p times k. On the one hand, as the plague happened in the 1300s, people do not possess the knowledge and technology to effectively decrease the probability of infection. Trades also occur in close physical proximity, which makes the transmission of microbes from a person to another extremely likely. As a result, the value of p is not controlled. On the other hand, there is more than one trader at a node, so there are multiple trade exchanges between each pair of nodes, making the value of k very high. Furthermore, as discussed earlier, nodes are interconnected and one node could link to more than one other node. Here, even if the disease does not spread from Tashkent to Khiva, Khiva is still at risk as long as the disease arrives in Nukus, as Nukus is also connected to Khiva. The interconnectivity of the network makes various locations even more exposed and vulnerable to potential infection.

Because p and k are high, it is very likely that the basic reproduction number is significantly greater than 1, so the plague persists and becomes more and more severe, reaching more and more locations. After the disease gets into a new location through a trader, all citizens are exposed to the risk of getting infected. Such a process is also comprehensible with the branch model.

Apart from p still being ineffectively managed, there are meanwhile several types of connections making k also remain high. After traders bring back products, they either sell the products by themselves or sell them to the vendors. They thus come in contact with citizens from all kinds of places in addition to their personal network. After the first wave, those who get infected with probability p initiate the second wave. The vendors interact with more customers, who then spread the disease among friends and families. More and more waves occur as, within each village and town close to the Silk Road route, each individual node is connected to many other nodes within that location. Consequently, after the Black Death successfully gets into all locations along the route through trades, millions of people then get infected through subsequent waves, eventually resulting in more than 50 million deaths.

What makes the pandemic even more devastating is the nature of the Silk Road – it is a two-way route. As traders travel from East to West, traders also travel back from West to East. As suggested by the article, the Black Death spreads East to West and then back again. This is related to the concept of a SIR model. After the plague initiates in Central or East Asia and starts to spread to the West, some people are left uninfected and Susceptible at the origins, and some people might recover from the disease and become Removed. If traders who have left the East do not travel back, those Susceptible and Removed citizens are free from the Black Death. However, when traders bring the plague back to the origins in the East again from the West, those who are Susceptible and Removed are again at risk. On the one hand, even assuming that there are no more Infected people at the origins, Susceptible people are now again in contact with Infected traders back from the West. On the other hand, the immunity for the Black Death might be temporary, meaning that these Removed individuals who have just recovered from the disease are again Susceptible. Consequently, while the Black Death devastates people in the West, it meanwhile also devastates people in the East.

I find this phenomenon regarding the Silk Road and Black Death very relevant to Cornell’s schedule and travel policies specific to the COVID-19 pandemic. As we all know, in order to minimize unnecessary traveling. not only was the fall break canceled this semester, but the instruction also became entirely online after the Thanksgiving break. After students returned to their homes for the Thanksgiving break, they resumed the classes online instead of traveling back to Ithaca. These practices designed by Cornell are very reasonable and effective for alleviating the pandemic. Students’ routes back home are very similar to the routes of the Silk Road.

Just like the Silk Road traveling from East Asia to Europe through many locations, students must pass several locations when they travel from Cornell to their home. For example, a student might need to take a flight at Syracuse Airport in order to fly back home. Therefore, the student must travel from Ithaca to Syracuse first before going home. At the same time, other passengers at the airport are from various other cities. This significantly increases the number of contacts k and thus increases the likelihood of getting infected, and this is just one student’s route. When thousands of students all travel back home at the same time, their routes outnumber the routes on the Silk Road by far. When the students arrive at their homes, they also interacted with their families and friends, just like how the traders do when they go back to their hometown after trading. If Cornell decided to continue in-person instruction after the Thanksgiving break, all students needed to travel through the same routes again, doubling the number of contacts and the risk of infection, similar to the concept of the Black Death spreading from East to West and spreading back again. By removing this other round of traveling with the transition to online instruction, Cornell effectively minimizes the chance of a COVID-19 outbreak, thereby protecting students from further infection. Meanwhile, students should also try their best to travel with the most direct route from Cornell to their home, as doing so can help them minimize interactions with people from other locations, which are similar to the villages and towns along the Silk Road. By doing so, students also protect their personal network at their homes from the microbes that they might have caught from other travelers.

By implementing effective policies to reduce k as well as prevention methods like wearing masks and washing hands that reduce p, Cornell has successfully prevented any unnecessary outbreak. Scientific research and knowledge on networks have substantially empowered people to keep epidemics under control in contemporary society, thus preventing devastating impacts of the Black Death along the Silk Road from happening again.

Black Death Spreads East to West, And Then Back Again

WATCH: How the Black Death Spread So Widely

Whether that actually happened, the plague eventually became a disaster in the East as well as in the West. “It killed off many of the Mongol rulers and other elite, and weakened the army as well as the local economies,” explains Christopher I. Beckwith, a distinguished professor at Indiana University Bloomington, and author of the 2011 book Empires of the Silk Road. It’s estimated that the Black Death killed 25 million people in Asia and North Africa between 1347 and 1350, in addition to the carnage in Europe.

A 2019 study by German researchers genetically linked the Black Death to an outbreak that occurred in 1346 in Laishevo in Russia’s Volga region, raising the possibility that the disease may have spread from Asia by multiple routes.

In any case, when the Black Death reached Europe, it attacked a population that already was weakened and malnourished by the brutal nature of the feudal economy.

“I think a good argument can be made that [Black Death] hit at a time when the health of the poor was compromised by the stress of famines, poverty and the very nature of serfdom,” Welford says.

In The Decameron, written in 1352, Giovanni Boccaccio describes …read more

The Seven Deadliest Plagues in History

The Black Death decimated the population across Europe, Asia and Africa in the 14 th century. Not only did the Black Death cause massive numbers of deaths, it also facilitated significant social change across Europe and elsewhere.

Like the Plague of Justinian, the Black Death was caused by Yersinia pestis. Yersinia pestis is carried and spread by rodent fleas, making transmission nearly inevitable. The Black Death likely originated in India or China, spreading along the Silk Road. As early as 1331, plagues began in China, perhaps killing as many as 25 million in China. In 1338 and 1339, graves in Kyrgyzstan record a plague, perhaps Yersinia pestis. Yersinia pestis can cause three different variants of plague bubonic, pneumonic, and septicemic. Bubonic plague is the least fatal, but still resulted in death in 30 to 75 percent of those that contracted it.

By the end of 1346, Europeans were aware that plague had already destroyed the populations of cities in India, Mesopotamia, Syria and Armenia. Plague likely entered Europe through the Genoese ships fleeing plague elsewhere. These 12 ships quickly spread plague throughout port cities in Europe, including Venice, Marseilles, and Pisa.

By 1348, the Black Death had spread through France, Spain, Portugal, Italy and England. It moved east into Germany and Scandinavia between 1348 and 1350, and entered Russia in 1351. Between 1347 and 1351, the Black Death also spread throughout the Middle East, also along common trade routes. Isolated regions were less likely to experience plague than more cosmopolitan areas.

Death rates varied depending on region, but in Europe, around 45 to 50 percent of the overall population died, with higher numbers in the south and lower ones in the east. In the Middle East, around 30 percent of the population perished. Research suggests that the death toll in Eurasia was between 75 and 200 million people.

The dramatically reduced population led to significant increases in quality of life for the lower classes. Many of the survivors had inherited wealth and land due to the deaths, but also, could now demand much higher wages for their labor.


European writers contemporary with the plague described the disease in Latin as pestis or pestilentia, 'pestilence' epidemia, 'epidemic' mortalitas, 'mortality'. [13] In English prior to the 18th century, the event was called the "pestilence" or "great pestilence", "the plague" or the "great death". [13] [14] [15] Subsequent to the pandemic "the furste moreyn" (first murrain) or "first pestilence" was applied, to distinguish the mid-14th century phenomenon from other infectious diseases and epidemics of plague. [13] The 1347 pandemic plague was not referred to specifically as "black" in the 14th or 15th centuries in any European language, though the expression "black death" had occasionally been applied to fatal disease beforehand. [13]

"Black death" was not used to describe the plague pandemic in English until the 1750s the term is first attested in 1755, where it translated Danish: den sorte død, lit. 'the black death'. [13] [16] This expression as a proper name for the pandemic had been popularized by Swedish and Danish chroniclers in the 15th and early 16th centuries, and in the 16th and 17th centuries was transferred to other languages as a calque: Icelandic: svarti dauði, German: der schwarze Tod, and French: la mort noire. [17] [18] Previously, most European languages had named the pandemic a variant or calque of the Latin: magna mortalitas, lit. 'Great Death'. [13]

The phrase 'black death' – describing Death as black – is very old. Homer used it in the Odyssey to describe the monstrous Scylla, with her mouths "full of black Death" (Ancient Greek: πλεῖοι μέλανος Θανάτοιο , romanized: pleîoi mélanos Thanátoio). [19] [17] Seneca the Younger may have been the first to describe an epidemic as 'black death', (Latin: mors atra) but only in reference to the acute lethality and dark prognosis of disease. [20] [17] [13] The 12th–13th century French physician Gilles de Corbeil had already used atra mors to refer to a "pestilential fever" (febris pestilentialis) in his work On the Signs and Symptoms of Diseases (De signis et symptomatibus aegritudium). [17] [21] The phrase mors nigra, 'black death', was used in 1350 by Simon de Covino (or Couvin), a Belgian astronomer, in his poem "On the Judgement of the Sun at a Feast of Saturn" (De judicio Solis in convivio Saturni), which attributes the plague to an astrological conjunction of Jupiter and Saturn. [22] His use of the phrase is not connected unambiguously with the plague pandemic of 1347 and appears to refer to the fatal outcome of disease. [13]

The historian Cardinal Francis Aidan Gasquet wrote about the Great Pestilence in 1893 [23] and suggested that it had been "some form of the ordinary Eastern or bubonic plague". [24] [c] In 1908, Gasquet claimed that use of the name atra mors for the 14th-century epidemic first appeared in a 1631 book on Danish history by J. I. Pontanus: "Commonly and from its effects, they called it the black death" (Vulgo & ab effectu atram mortem vocitabant). [25] [26]

Recent research has suggested plague first infected humans in Europe and Asia in the Late Neolithic-Early Bronze Age. [28] Research in 2018 found evidence of Yersinia pestis in an ancient Swedish tomb, which may have been associated with the "Neolithic decline" around 3000 BCE, in which European populations fell significantly. [29] [30] This Y. pestis may have been different from more modern types, with bubonic plague transmissible by fleas first known from Bronze Age remains near Samara. [31]

The symptoms of bubonic plague are first attested in a fragment of Rufus of Ephesus preserved by Oribasius these ancient medical authorities suggest bubonic plague had appeared in the Roman Empire before the reign of Trajan, six centuries before arriving at Pelusium in the reign of Justinian I. [32] In 2013, researchers confirmed earlier speculation that the cause of the Plague of Justinian (541–542 CE, with recurrences until 750) was Y. pestis. [33] [34] This is known as the First plague pandemic.


Early theory

The most authoritative contemporary account is found in a report from the medical faculty in Paris to Philip VI of France. It blamed the heavens, in the form of a conjunction of three planets in 1345 that caused a "great pestilence in the air" (miasma theory). [35] Muslim religious scholars taught that the pandemic was a “martyrdom and mercy” from God, assuring the believer's place in paradise. For non-believers, it was a punishment. [36] Some Muslim doctors cautioned against trying to prevent or treat a disease sent by God. Others adopted preventive measures and treatments for plague used by Europeans. These Muslim doctors also depended on the writings of the ancient Greeks. [37] [38]

Predominant modern theory

Due to climate change in Asia, rodents began to flee the dried-out grasslands to more populated areas, spreading the disease. [39] The plague disease, caused by the bacterium Yersinia pestis, is enzootic (commonly present) in populations of fleas carried by ground rodents, including marmots, in various areas, including Central Asia, Kurdistan, Western Asia, North India, Uganda and the western United States. [40] [41]

Y. pestis was discovered by Alexandre Yersin, a pupil of Louis Pasteur, during an epidemic of bubonic plague in Hong Kong in 1894 Yersin also proved this bacillus was present in rodents and suggested the rat was the main vehicle of transmission. [42] [43] The mechanism by which Y. pestis is usually transmitted was established in 1898 by Paul-Louis Simond and was found to involve the bites of fleas whose midguts had become obstructed by replicating Y. pestis several days after feeding on an infected host. This blockage starves the fleas and drives them to aggressive feeding behaviour and attempts to clear the blockage by regurgitation, resulting in thousands of plague bacteria being flushed into the feeding site, infecting the host. The bubonic plague mechanism was also dependent on two populations of rodents: one resistant to the disease, which act as hosts, keeping the disease endemic, and a second that lack resistance. When the second population dies, the fleas move on to other hosts, including people, thus creating a human epidemic. [24]

DNA evidence

Definitive confirmation of the role of Y. pestis arrived in 2010 with a publication in PLOS Pathogens by Haensch et al. [3] [d] They assessed the presence of DNA/RNA with polymerase chain reaction (PCR) techniques for Y. pestis from the tooth sockets in human skeletons from mass graves in northern, central and southern Europe that were associated archaeologically with the Black Death and subsequent resurgences. The authors concluded that this new research, together with prior analyses from the south of France and Germany, "ends the debate about the cause of the Black Death, and unambiguously demonstrates that Y. pestis was the causative agent of the epidemic plague that devastated Europe during the Middle Ages". [3] In 2011, these results were further confirmed with genetic evidence derived from Black Death victims in the East Smithfield burial site in England. Schuenemann et al. concluded in 2011 "that the Black Death in medieval Europe was caused by a variant of Y. pestis that may no longer exist". [46]

Later in 2011, Bos et al. reported in Nature the first draft genome of Y. pestis from plague victims from the same East Smithfield cemetery and indicated that the strain that caused the Black Death is ancestral to most modern strains of Y. pestis. [46]

Since this time, further genomic papers have further confirmed the phylogenetic placement of the Y. pestis strain responsible for the Black Death as both the ancestor [47] of later plague epidemics including the third plague pandemic and as the descendant [48] of the strain responsible for the Plague of Justinian. In addition, plague genomes from significantly earlier in prehistory have been recovered. [49]

DNA taken from 25 skeletons from 14th century London have shown plague is a strain of Y. pestis almost identical to that which hit Madagascar in 2013. [50] [51]

Alternative explanations

It is recognised that an epidemiological account of plague is as important as an identification of symptoms, but researchers are hampered by the lack of reliable statistics from this period. Most work has been done on the spread of the disease in England, and even estimates of overall population at the start vary by over 100% as no census was undertaken in England between the time of publication of the Domesday Book of 1086 and the poll tax of the year 1377. [52] Estimates of plague victims are usually extrapolated from figures for the clergy.

Mathematical modelling is used to match the spreading patterns and the means of transmission. A research in 2018 challenged the popular hypothesis that "infected rats died, their flea parasites could have jumped from the recently dead rat hosts to humans". It suggested an alternative model in which "the disease was spread from human fleas and body lice to other people". The second model claims to better fit the trends of death toll because the rat-flea-human hypothesis would have produced a delayed but very high spike in deaths, which contradict historical death data. [53] [54]

Lars Walløe complains that all of these authors "take it for granted that Simond's infection model, black rat → rat flea → human, which was developed to explain the spread of plague in India, is the only way an epidemic of Yersinia pestis infection could spread", whilst pointing to several other possibilities. [55] Similarly, Monica Green has argued that greater attention is needed to the range of (especially non-commensal) animals that might be involved in the transmission of plague. [32]

Archaeologist Barney Sloane has argued that there is insufficient evidence of the extinction of numerous rats in the archaeological record of the medieval waterfront in London and that the disease spread too quickly to support the thesis that Y. pestis was spread from fleas on rats he argues that transmission must have been person to person. [56] [57] This theory is supported by research in 2018 which suggested transmission was more likely by body lice and fleas during the second plague pandemic. [58]


Although academic debate continues, no single alternative solution has achieved widespread acceptance. [24] Many scholars arguing for Y. pestis as the major agent of the pandemic suggest that its extent and symptoms can be explained by a combination of bubonic plague with other diseases, including typhus, smallpox and respiratory infections. In addition to the bubonic infection, others point to additional septicaemic (a type of "blood poisoning") and pneumonic (an airborne plague that attacks the lungs before the rest of the body) forms of plague, which lengthen the duration of outbreaks throughout the seasons and help account for its high mortality rate and additional recorded symptoms. [59] In 2014, Public Health England announced the results of an examination of 25 bodies exhumed in the Clerkenwell area of London, as well as of wills registered in London during the period, which supported the pneumonic hypothesis. [50] Currently, while osteoarcheologists have conclusively verified the presence of Y. pestis bacteria in burial sites across northern Europe through examination of bones and dental pulp, no other epidemic pathogen has been discovered to bolster the alternative explanations. In the words of one researcher: "Finally, plague is plague." [60]


The importance of hygiene was recognised only in the nineteenth century with the development of the germ theory of disease until then streets were commonly filthy, with live animals of all sorts around and human parasites abounding, facilitating the spread of transmissible disease. [61]

Territorial origins

According to a team of medical geneticists led by Mark Achtman that analysed the genetic variation of the bacterium, Yersinia pestis "evolved in or near China", [62] [63] from which it spread around the world in multiple epidemics. Later research by a team led by Galina Eroshenko places the origins more specifically in the Tian Shan mountains on the border between Kyrgyzstan and China. [64]

Nestorian graves dating to 1338–1339 near Issyk-Kul in Kyrgyzstan have inscriptions referring to plague, which has led some historians and epidemiologists to think they mark the outbreak of the epidemic. Others favour an origin in China. [65] According to this theory, the disease may have travelled along the Silk Road with Mongol armies and traders, or it could have arrived via ship. [66] Epidemics killed an estimated 25 million across Asia during the fifteen years before the Black Death reached Constantinople in 1347. [67] [68]

Research on the Delhi Sultanate and the Yuan Dynasty shows no evidence of any serious epidemic in fourteenth-century India and no specific evidence of plague in fourteenth-century China, suggesting that the Black Death may not have reached these regions. [69] [66] [70] Ole Benedictow argues that since the first clear reports of the Black Death come from Kaffa, the Black Death most likely originated in the nearby plague focus on the northwestern shore of the Caspian Sea. [71]

European outbreak

. But at length it came to Gloucester, yea even to Oxford and to London, and finally it spread over all England and so wasted the people that scarce the tenth person of any sort was left alive.

Plague was reportedly first introduced to Europe via Genoese traders from their port city of Kaffa in the Crimea in 1347. During a protracted siege of the city, in 1345–1346 the Mongol Golden Horde army of Jani Beg, whose mainly Tatar troops were suffering from the disease, catapulted infected corpses over the city walls of Kaffa to infect the inhabitants, [73] though it is more likely that infected rats travelled across the siege lines to spread the epidemic to the inhabitants. [74] [75] As the disease took hold, Genoese traders fled across the Black Sea to Constantinople, where the disease first arrived in Europe in summer 1347. [76]

The epidemic there killed the 13-year-old son of the Byzantine emperor, John VI Kantakouzenos, who wrote a description of the disease modelled on Thucydides's account of the 5th century BCE Plague of Athens, but noting the spread of the Black Death by ship between maritime cities. [76] Nicephorus Gregoras also described in writing to Demetrios Kydones the rising death toll, the futility of medicine, and the panic of the citizens. [76] The first outbreak in Constantinople lasted a year, but the disease recurred ten times before 1400. [76]

Carried by twelve Genoese galleys, plague arrived by ship in Sicily in October 1347 [77] the disease spread rapidly all over the island. Galleys from Kaffa reached Genoa and Venice in January 1348, but it was the outbreak in Pisa a few weeks later that was the entry point to northern Italy. Towards the end of January, one of the galleys expelled from Italy arrived in Marseilles. [78]

From Italy, the disease spread northwest across Europe, striking France, Spain (the epidemic began to wreak havoc first on the Crown of Aragon in the spring of 1348), [79] Portugal and England by June 1348, then spread east and north through Germany, Scotland and Scandinavia from 1348 to 1350. It was introduced into Norway in 1349 when a ship landed at Askøy, then spread to Bjørgvin (modern Bergen) and Iceland. [80] Finally, it spread to northwestern Russia in 1351. Plague was somewhat more uncommon in parts of Europe with less developed trade with their neighbours, including the majority of the Basque Country, isolated parts of Belgium and the Netherlands, and isolated Alpine villages throughout the continent. [81] [82] [83]

According to some epidemiologists, periods of unfavourable weather decimated plague-infected rodent populations and forced their fleas onto alternative hosts, [84] inducing plague outbreaks which often peaked in the hot summers of the Mediterranean, [85] as well as during the cool autumn months of the southern Baltic states. [86] [e] Among many other culprits of plague contagiousness, malnutrition, even if distantly, also contributed to such an immense loss in European population, since it weakened immune systems. [89]

Western Asian and North African outbreak

The disease struck various regions in the Middle East and North Africa during the pandemic, leading to serious depopulation and permanent change in both economic and social structures. [90] As infected rodents infected new rodents, the disease spread across the region, entering also from southern Russia.

By autumn 1347, plague had reached Alexandria in Egypt, transmitted by sea from Constantinople according to a contemporary witness, from a single merchant ship carrying slaves. [91] By late summer 1348 it reached Cairo, capital of the Mamluk Sultanate, cultural centre of the Islamic world, and the largest city in the Mediterranean Basin the Bahriyya child sultan an-Nasir Hasan fled and more than a third of the 600,000 residents died. [92] The Nile was choked with corpses despite Cairo having a medieval hospital, the late 13th century bimaristan of the Qalawun complex. [92] The historian al-Maqrizi described the abundant work for grave-diggers and practitioners of funeral rites, and plague recurred in Cairo more than fifty times over the following century and half. [92]

During 1347, the disease travelled eastward to Gaza by April by July it had reached Damascus, and in October plague had broken out in Aleppo. [91] That year, in the territory of modern Lebanon, Syria, Israel, and Palestine, the cities of Ashkelon, Acre, Jerusalem, Sidon, and Homs were all infected. In 1348–1349, the disease reached Antioch. The city's residents fled to the north, but most of them ended up dying during the journey. [93] Within two years, the plague had spread throughout the Islamic world, from Arabia across North Africa. [36] [ page needed ] The pandemic spread westwards from Alexandria along the African coast, while in April 1348 Tunis was infected by ship from Sicily. Tunis was then under attack by an army from Morocco this army dispersed in 1348 and brought the contagion with them to Morocco, whose epidemic may also have been seeded from the Islamic city of Almería in al-Andalus. [91]

Mecca became infected in 1348 by pilgrims performing the Hajj. [91] In 1351 or 1352, the Rasulid sultan of the Yemen, al-Mujahid Ali, was released from Mamluk captivity in Egypt and carried plague with him on his return home. [91] [94] During 1348, records show the city of Mosul suffered a massive epidemic, and the city of Baghdad experienced a second round of the disease. [ citation needed ]

Signs and symptoms

Bubonic plague

Symptoms of the disease include fever of 38–41 °C (100–106 °F), headaches, painful aching joints, nausea and vomiting, and a general feeling of malaise. Left untreated, of those that contract the bubonic plague, 80 percent die within eight days. [95]

Contemporary accounts of the pandemic are varied and often imprecise. 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. [59] 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. [96] [97] [f]

This was followed by acute fever and vomiting of blood. Most victims died two to seven days after initial infection. Freckle-like spots and rashes, [99] which could have been caused by flea-bites, were identified as another potential sign of plague.

Pneumonic plague

Lodewijk Heyligen, whose master the Cardinal Colonna died of plague in 1348, noted a distinct form of the disease, pneumonic plague, that infected the lungs and led to respiratory problems. [59] 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 to 95 percent. [100]

Septicaemic plague

Septicaemic plague is the least common of the three forms, with a mortality rate near 100%. Symptoms are high fevers and purple skin patches (purpura due to disseminated intravascular coagulation). [100] In cases of pneumonic and particularly septicaemic 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. [100]



There are no exact figures for the death toll the rate varied widely by locality. In urban centres, the greater the population before the outbreak, the longer the duration of the period of abnormal mortality. [101] It killed some 75 to 200 million people in Eurasia. [102] [103] [104] [ better source needed ] 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. [105] The overwhelming number of deceased bodies produced by the Black Death caused the necessity of mass burial sites in Europe, sometimes including up to several hundred or several thousand skeletons. [106] 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. [106]

According to medieval historian Philip Daileader, it is likely that over four years, 45–50% of the European population died of plague. [107] [g] Norwegian historian Ole Benedictow suggests it could have been as much as 60% of the European population. [108] [h] In 1348, the disease spread so rapidly that before any physicians or government authorities had time to reflect upon its origins, about a third of the European population had already perished. In crowded cities, it was not uncommon for as much as 50% of the population to die. [24] Half of Paris' population of 100,000 people died. In Italy, the population of Florence was reduced from between 110,000 and 120,000 inhabitants in 1338 down to 50,000 in 1351. At least 60% of the population of Hamburg and Bremen perished, [109] and a similar percentage of Londoners may have died from the disease as well, [50] with a death toll of approximately 62,000 between 1346 and 1353. [39] [i] Florence's tax records suggest that 80% of the city's population died within four months in 1348. [105] Before 1350, there were about 170,000 settlements in Germany, and this was reduced by nearly 40,000 by 1450. [111] The disease bypassed some areas, with the most isolated areas being less vulnerable to contagion. Plague did not appear in Douai 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. [105] Monks, nuns, and priests were especially hard-hit since they cared for victims of the Black Death. [112]

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 1347–48, 1362, 1371, and 1382 in his 1382 treatise On Epidemics (De epidemica). [113] 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. [113] By the 1380s in Europe, it predominantly affected children. [105] Chalmel de Vinario recognized that bloodletting was ineffective (though he continued to prescribe bleeding for members of the Roman Curia, whom he disliked), and claimed that all true cases of plague were caused by astrological factors and were incurable he himself was never able to effect a cure. [113]

The most widely accepted estimate for the Middle East, including Iraq, Iran, and Syria, during this time, is for a death toll of about a third of the population. [114] The Black Death killed about 40% of Egypt's population. [115] 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 inside of eight months. [92]

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. [116]


With such a large population decline from the pandemic, wages soared in response to a labour shortage. [117] On the other hand, in the quarter century after the Black Death in England, it is clear many labourers, artisans, and craftsmen, those living from money-wages alone, did suffer a reduction in real incomes owing to rampant inflation. [118] Landowners were also pushed to substitute monetary rents for labour services in an effort to keep tenants. [119]


Some historians believe 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. [120]


Renewed religious fervour and fanaticism bloomed in the wake of the Black Death. Some Europeans targeted "various groups such as Jews, friars, foreigners, beggars, pilgrims", lepers, [121] [122] 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. [14] Many believed the epidemic was a punishment by God for their sins, and could be relieved by winning God's forgiveness. [123]

There were many attacks against Jewish communities. [124] In the Strasbourg massacre of February 1349, about 2,000 Jews were murdered. [124] In August 1349, the Jewish communities in Mainz and Cologne were annihilated. By 1351, 60 major and 150 smaller Jewish communities had been destroyed. [125] During this period many Jews relocated to Poland, where they received a warm welcome from King Casimir the Great. [126]


One theory that has been advanced is that the devastation in Florence caused by the Black Death, which hit Europe between 1348 and 1350, resulted in a shift in the world view of people in 14th-century Italy and led to the Renaissance. Italy was particularly badly hit by the pandemic, and it has been speculated that the resulting familiarity with death caused thinkers to dwell more on their lives on Earth, rather than on spirituality and the afterlife. [127] [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. [129]

This does not fully explain why the Renaissance occurred in Italy in the 14th century. The Black Death was a pandemic that affected all of Europe in the ways described, not only Italy. The Renaissance's emergence in Italy was most likely the result of the complex interaction of the above factors, [130] in combination with an influx of Greek scholars following the fall of the Byzantine Empire. [ citation needed ] 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. [131] [ better source needed ]

Prior to the emergence of the Black Death, the workings of Europe were run by the Catholic Church and the continent was considered a feudalistic society, composed of fiefs and city-states. [132] 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. [132] [133]

Cairo's population, partly owing to the numerous plague epidemics, was in the early 18th century half of what it was in 1347. [92] The populations of some Italian cities, notably Florence, did not regain their pre-14th century size until the 19th century. [134] The demographic decline due to the pandemic had economic consequences: the prices of food dropped and land values declined by 30–40% in most parts of Europe between 1350 and 1400. [135] Landholders faced a great loss, but for ordinary men and women it was a windfall. 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 destabilized feudalism. [136] [137]

The word "quarantine" has its roots in this period, though the concept 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". [138]

Second plague pandemic

The plague repeatedly returned to haunt Europe and the Mediterranean throughout the 14th to 17th centuries. [139] According to Jean-Noël Biraben, the plague was present somewhere in Europe in every year between 1346 and 1671. [140] (Note that some researchers have cautions about the uncritical use of Biraben's data. [141] ) The second pandemic was particularly widespread in the following years: 1360–63 1374 1400 1438–39 1456–57 1464–66 1481–85 1500–03 1518–31 1544–48 1563–66 1573–88 1596–99 1602–11 1623–40 1644–54 and 1664–67. Subsequent outbreaks, though severe, marked the retreat from most of Europe (18th century) and northern Africa (19th century). [142] The historian George Sussman argued that the plague had not occurred in East Africa until the 1900s. [69] However, other sources suggest that the Second pandemic did indeed reach Sub-Saharan Africa. [90]

According to historian Geoffrey Parker, "France alone lost almost a million people to the plague in the epidemic of 1628–31." [143] In the first half of the 17th century, a plague claimed some 1.7 million victims in Italy. [144] More than 1.25 million deaths resulted from the extreme incidence of plague in 17th-century Spain. [145]

The Black Death ravaged much of the Islamic world. [146] Plague was present in at least one location in the Islamic world virtually every year between 1500 and 1850. [147] Plague repeatedly struck the cities of North Africa. Algiers lost 30,000–50,000 inhabitants to it in 1620–21, and again in 1654–57, 1665, 1691, and 1740–42. [148] Cairo suffered more than fifty plague epidemics within 150 years from the plague's first appearance, with the final outbreak of the second pandemic there in the 1840s. [92] Plague remained a major event in Ottoman society until the second quarter of the 19th century. Between 1701 and 1750, thirty-seven larger and smaller epidemics were recorded in Constantinople, and an additional thirty-one between 1751 and 1800. [149] Baghdad has suffered severely from visitations of the plague, and sometimes two-thirds of its population has been wiped out. [150]

Third plague pandemic

The third plague pandemic (1855–1859) started in China in the mid-19th century, spreading to all inhabited continents and killing 10 million people in India alone. [151] The investigation of the pathogen that caused the 19th-century plague was begun by teams of scientists who visited Hong Kong in 1894, among whom was the French-Swiss bacteriologist Alexandre Yersin, after whom the pathogen was named. [24]

Twelve plague outbreaks in Australia between 1900 and 1925 resulted in well over 1,000 deaths, chiefly in Sydney. This led to the establishment of a Public Health Department there which undertook some leading-edge research on plague transmission from rat fleas to humans via the bacillus Yersinia pestis. [152]

The first North American plague epidemic was the San Francisco plague of 1900–1904, followed by another outbreak in 1907–1908. [153] [154] [155]


Modern treatment methods include insecticides, the use of antibiotics, and a plague vaccine. It is feared that the plague bacterium could develop drug resistance and again become a major health threat. One case of a drug-resistant form of the bacterium was found in Madagascar in 1995. [156] A further outbreak in Madagascar was reported in November 2014. [157] In October 2017 the deadliest outbreak of the plague in modern times hit Madagascar, killing 170 people and infecting thousands. [158]

An estimate of the case fatality rate for the modern bubonic plague, following the introduction of antibiotics, is 11%, although it may be higher in underdeveloped regions. [159]

  • A Journal of the Plague Year – 1722 book by Daniel Defoe describing the Great Plague of London of 1665–1666 – a 2010 action horror film set in medieval England in 1348 ("The Betrothed") – a plague novel by Alessandro Manzoni, set in Milan, and published in 1827 turned into an opera by Amilcare Ponchielli in 1856, and adapted for film in 1908, 1941, 1990, and 2004
  • Cronaca fiorentina ("Chronicle of Florence") – a literary history of the plague, and of Florence up to 1386, by Baldassarre Bonaiuti
  • Danse Macabre ("Dance of Death") – an artistic genre of allegory of the Late Middle Ages on the universality of death
  • The Decameron – by Giovanni Boccaccio, finished in 1353. Tales told by a group of people sheltering from the Black Death in Florence. Numerous adaptations to other media have been made – a 1992 science fiction novel by Connie Willis
  • A Feast in Time of Plague – a verse play by Aleksandr Pushkin (1830), made into an opera by César Cui in 1900 – a popular French legend supposed to provide immunity to the plague – Medieval "flagellant songs"
  • "A Litany in Time of Plague" – a sonnet by Thomas Nashe which was part of his play Summer's Last Will and Testament (1592)
  • The Plague – a 1947 novel by Albert Camus, often read as an allegory about Fascism
  • The Seventh Seal – a 1957 film written and directed by Ingmar Bergman
  • World Without End – a 2007 novel by Ken Follett, turned into a miniseries of the same name in 2012
  • The Years of Rice and Salt – an alternative history novel by Kim Stanley Robinson set in a world in which the plague killed virtually all Europeans


  1. ^ Other names include Great Mortality (Latin: magna mortalitas, lit.'Great Death', common in the 14th century), atra mors, 'black death', the Great Plague, the Great Bubonic Plague or the Black Plague.
  2. ^ Declining temperatures following the end of the Medieval Warm Period added to the crisis
  3. ^ He was able to adopt the epidemiology of the bubonic plague for the Black Death for the second edition in 1908, implicating rats and fleas in the process, and his interpretation was widely accepted for other ancient and medieval epidemics, such as the Plague of Justinian that was prevalent in the Eastern Roman Empire from 541 to 700 CE. [24]
  4. ^ In 1998, Drancourt et al. reported the detection of Y. pestis DNA in human dental pulp from a medieval grave. [44] Another team led by Tom Gilbert cast doubt on this identification [45] and the techniques employed, stating that this method "does not allow us to confirm the identification of Y. pestis as the aetiological agent of the Black Death and subsequent plagues. In addition, the utility of the published tooth-based ancient DNA technique used to diagnose fatal bacteraemias in historical epidemics still awaits independent corroboration".
  5. ^ However, other researchers do not think that plague ever became endemic in Europe or its rat population. The disease repeatedly wiped out the rodent carriers, so that the fleas died out until a new outbreak from Central Asia repeated the process. The outbreaks have been shown to occur roughly 15 years after a warmer and wetter period in areas where plague is endemic in other species, such as gerbils. [87][88]
  6. ^ The only medical detail that is questionable in Boccaccio's description is that the gavocciolo was an "infallible token of approaching death", as, if the bubo discharges, recovery is possible. [98]
  7. ^ According to medieval historian Philip Daileader,

The trend of recent research is pointing to a figure more like 45–50% of the European population dying during a four-year period. There is a fair amount of geographic variation. In Mediterranean Europe, areas such as Italy, the south of France and Spain, where plague ran for about four years consecutively, it was probably closer to 75–80% of the population. In Germany and England . it was probably closer to 20%. [107]

Detailed study of the mortality data available points to two conspicuous features in relation to the mortality caused by the Black Death: namely the extreme level of mortality caused by the Black Death, and the remarkable similarity or consistency of the level of mortality, from Spain in southern Europe to England in north-western Europe. The data is sufficiently widespread and numerous to make it likely that the Black Death swept away around 60% of Europe's population. The generally assumed population of Europe at the time is about 80 million, implying that around 50 million people died in the Black Death. [108]

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