What did it feel like to have the plague? The gruesome symptoms of the Black Death

Across the mid-fourteenth century, Europe faced a terrifying health disaster.

Known as the Black Death, the disease arrived in 1347 and killed an estimated 30 to 60 percent of the European population within only a few years.

Most historians agree that the cause of the Black Death was the bacterium Yersinia pestis, which caused a severe form of bubonic plague.

Its impact upset daily life, including government operations, religious practices, food production, and traditional burial customs. 

Witnesses at the time, including Giovanni Boccaccio and the University of Paris medical faculty, described a disease that moved rapidly through towns and villages, which left corpses in the streets.

Entire communities disappeared. Trade collapsed. Panic spread. By the early 1350s, no part of Europe remained untouched.

The disease did not stop there. It reached as far as Central Asia, North Africa, and the Middle East, which cut through both cities and remote countryside with equal intensity. 

Infection often began with a flea bite. Fleas that fed on infected black rats would move to human hosts after the rats died.

Once a person had received the bite, the bacteria would spread through their bloodstream and lodge in the lymph nodes.

From there, the infection grew worse with alarming speed. People also contracted the disease through airborne droplets when the pneumonic form of the plague developed, which in turn allowed human-to-human transmission by coughing or sneezing. 

Markets, monasteries, and ships became deadly places where the disease passed quickly between people in close quarters.

Cities with large port facilities, such as Marseille, Genoa, and Venice, saw some of the earliest outbreaks in Europe.

As infected travellers moved inland, they brought the disease into towns and villages.

Hygiene was poor, medical understanding was limited, and most people lacked the knowledge to take effective precautions.

Attempts at quarantine came too late or failed entirely. 

Within days of infection, the body developed a painful swelling in the lymph nodes, known as a bubo.

These lumps, usually found in the groin, armpit, or neck, became red, swollen, and tender.

The pain could be so intense that it prevented walking or even basic movement.

Alongside the buboes came an uncontrollable fever, which produced shivering, followed by confusion and hallucinations.

Victims lost their appetite, vomited frequently, and sweated heavily. In severe cases, the hands, feet, and nose would begin to turn black as tissue died from lack of blood supply. 

Many victims described a burning sensation in their skin, as if their blood boiled beneath the surface.

The pain spread across the body, and the mental effects followed soon after.

Delirium and paranoia were often seen in the final stages, leading patients to lose awareness.

Some screamed in agony. Others fell into unconsciousness. Death often occurred within three to five days after the first signs appeared.

When the pneumonic or septicaemic forms of the plague struck, death could come within hours.

No part of the experience offered relief. 

As the symptoms developed, neighbours and family often kept their distance.

People who once cared for the sick became afraid to remain near anyone who coughed, sweated, or trembled.

In many towns, people abandoned their infected relatives, which left them to die alone in their homes. Doors were nailed shut.

Priests refused to enter houses to give the last rites. Gravediggers hesitated to remove the corpses, which sometimes rotted in the streets. 

In wealthier areas, those who could afford to flee the city escaped to rural estates in the hope that fresh air and distance would protect them.

Others turned to flagellant groups or religious devotion and interpreted the plague as divine punishment for sin.

Fear controlled public behaviour, especially when rumours spread about poisoned wells, foreign plots, or divine wrath.

In some regions, mobs attacked marginalised communities, believing them responsible for the disaster.

Rational thought gave way to panic and desperation. 

Recovery from the Black Death did occur, but it came with long-term effects.

Survivors often suffered permanent physical damage, including scars from burst buboes, damaged organs, or reduced strength.

Some could no longer walk properly. Many carried deep psychological trauma.

They had watched family members die, heard the cries of neighbours, and lived in near isolation during periods of mass death.

Some lost entire households, with no surviving relatives to help them rebuild their lives. 

Once the immediate wave of infection passed, survivors entered a society that had changed dramatically.

A shortage of workers meant that peasants and workers could demand higher wages.

The fields had been left fallow and even entire monasteries had disappeared. Laws changed to respond to the economic and social shifts caused by population collapse.

In many towns, new leaders took charge. The old order had crumbled, and nothing returned to the way it had been.

The people who lived through the Black Death stepped into a world scarred by death and uncertainty and were forced to adapt to a new reality that offered little comfort.