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

The Black Death was caused by the bacterium Yersinia pestis, primarily transmitted to humans via the bites of infected fleas that lived on black rats.

This bacterium, even today, is a formidable enemy due to its rapid multiplication, resilience, and adaptability. 

The Black Death first arrived in Europe in October 1347, likely via trading ships from the East.

It spread with ruthless efficiency, travelling via trade and commerce routes, from the bustling ports of Italy to the furthest corners of the continent.

Within five years, it had decimated a large portion of Europe's population, with the death toll varying significantly from region to region.

The Black Death, which was a form of bubonic plague, was mainly spread through infected fleas.

These fleas were typically carried by black rats, which were common in European cities and towns in the 14th century.

The bacterium responsible for the plague, Yersinia pestis, resides in the gut of the flea.

When the flea bites a human, the bacteria can be transferred to the human host.

Once in the bloodstream, the bacteria travel to the lymph nodes, causing them to become swollen and painful – a condition known as 'buboes', which gave the bubonic plague its name.

In addition to bubonic plague, Yersinia pestis can also cause pneumonic and septicemic forms, which differ in transmission and symptoms.

The pneumonic form of the plague can spread from person to person through droplets in the air when someone with the infection coughs.

Septicemic plague, on the other hand, can spread through contact with body fluids or contaminated materials.

The initial signs of infection were insidious, beginning with flu-like symptoms such as fever, chills, fatigue, and body aches.

These early symptoms were soon followed by the characteristic and namesake 'buboes', painful swellings of the lymph nodes, often in the groin, armpit, or neck.

These buboes typically grow to the size of an egg or, in extreme cases, the size of an apple, causing excruciating pain and a visible sign of impending doom.

As the disease advanced, some victims experienced additional symptoms including severe nausea, vomiting, and diarrhea.

They also experienced extreme weakness and could barely eat or drink. There were neurological symptoms as well, such as confusion, seizures, and even coma in severe cases.

Perhaps most terrifying of all was the appearance of dark patches or blotches on the skin, a result of internal bleeding, which is one theory on how the plague got its name "The Black Death."

The sufferers often experienced acute pain and a high, continuous fever. By this stage of the disease, the chance of survival was exceedingly slim.

The time from the onset of initial symptoms to death was brutally short, often between two to seven days.

The rapid progression and high mortality rate of the disease added to the terror and confusion that swept through communities.

There was barely any time to process what was happening, let alone to respond or prepare.

Medical knowledge of the era was insufficient to combat the disease, and most treatments were based on theories of bodily humors and miasma, which were largely ineffective.

During the time of the Black Death, every facet of human life was irrevocably changed.

Individual experiences varied greatly, influenced by factors such as social status, location, personal health, and even luck.

However, certain themes persist across accounts, painting a poignant picture of life during the plague.

As the pandemic took hold, initial reactions often consisted of disbelief and fear.

As their neighbors and loved ones began to fall ill, people faced the horrifying reality of the plague.

First-hand accounts and diaries from this time speak of an overwhelming sense of doom and helplessness.

Boccaccio, in his work The Decameron, describes people "eating lunch with their friends and dinner with their ancestors in paradise."

Such descriptions underscore the swift and ruthless nature of the disease, and the abruptness with which it could snatch away loved ones.

Guy de Chauliac, a French physician who survived the plague in Avignon, described how people died so quickly that priests could not administer last rites, and bodies were left unburied.

Yet, alongside fear and grief, there was also resilience and determination.

Some people responded by caring for the sick, despite the risk to their own lives.

Others found solace and purpose in their faith, hoping for divine intervention or accepting the plague as God's will.

Some groups, such as the Flagellants, roamed across Europe whipping themselves in public as penance for the sins they believed had caused the plague.

However, many succumbed to despair, abandoning their duties and responsibilities to enjoy what little time they had left.

The plague also had profound social consequences. It instilled fear and suspicion, leading to the isolation of the sick and the stigmatization of certain groups, including Jews and beggars, groups unfairly blamed for the disease.

The Black Death triggered a broad range of emotional responses. Some people reacted with stoic acceptance or numb resignation, others with frantic panic or abject despair.

Others saw it as an opportunity for personal growth and transformation, a chance to reevaluate their priorities and values in the face of imminent death.

The Black Death fundamentally altered the societal, economic, and cultural environment of Europe, resulting in long-term changes.

Societally, the massive death toll disrupted established social hierarchies. With such a large portion of the population gone, labor shortages became common, leading to a newfound bargaining power for peasants and workers.

This shift in labor dynamics had far-reaching consequences, including the gradual breakdown of the feudal system, the rise of wages, and, in some instances, social uprisings like the Peasants' Revolt in England in 1381.

Economically, the plague caused an immediate contraction due to the high mortality rate and the disruption of trade.

However, in the long term, it led to substantial economic transformations. The drastic reduction in the population meant that the survivors had access to greater wealth and resources, leading to an increase in per capita income and improved living standards for many.

The labor shortage also spurred technological innovations and advancements, setting the stage for the economic growth of the Late Middle Ages and the Renaissance.

The Black Death had a profound impact culturally as well. It influenced art, literature, and music, fostering a deeper contemplation of mortality and the fleeting nature of life.

This cultural shift, characterized by the macabre, the morose, but also the hopeful, served as a cathartic outlet for the collective trauma and shaped the cultural expressions of the era.

In terms of religion, the plague tended to lead to either an extreme increased in piety or to religious skepticism depending on the individual.

While some turned towards the Church for solace and to look for ways to appease God to help end the plaque, others started questioning the church's authority and efficacy, leading to religious dissent which later paved the way for the Protestant Reformation.

The Black Death also had crucial implications for the field of medicine. The inability of traditional medical theories and practices to combat the plague spurred new interest in medical knowledge and practice, including early forms of public health measures and quarantine.

After the Black Death's devastating effects across Europe, it took nearly 200 years for the population to recover to pre-plague levels.