The Human Story – Black Death & Disease

We left this series off last time by laying a large portion of blame for the Black Death at the doorstep of the Mongol Empire and their opening of trade routes. It only seems natural to have a look at disease and how it has impacted the human story.

Fortunately for us, we live in the 21st century, a time when communicable disease does not play such a massive role on society, unless you are speaking about cases of SARS and its various offshoots, including the coronavirus, HIV/Aids, bird flu, swine flu or any other recent anti-biotic resistant bacteria.

Traditionally, the study of history has not focused much on disease, partly because they are mysterious and terrifying and partly because they do not fit in with our narrative that history has been made as the result of some people doing good things, or some people doing bad things, or at the very least some people doing some kind of things. However, the reality is that history often happens due to factors that are out with human control such as lots of people contracting smallpox or bubonic plague. Also, very often diseases are seen as a result of some divine judgement. Perhaps the most likely reason that people tend to not focus so much on disease as being a major contributor to the human story is down to the fact that people did not understand or know very much about them. If they did not understand it, they were less likely to write about it and when they did, which some chroniclers did, they would often write rather vaguely about them.

A New Dawn for Bacterial Evolution

Given that, we are going to have to engage in a little speculation here. So, diseases have been with humans for as long as there have been humans, this much we do know. Humans, you will recall from the first article of this series, first appeared in the tropical regions of Africa, in which live a wide and varying range of micro parasitic bacteria so it is probably a safe bet that these parasites played some role in keeping the human population extremely low for a very long time. It is only after we see the migration out of Africa and into regions that are less agreeable to diseases, around 64,000 years or so ago, that we really start to see the growth of human populations necessary to create what we would call civilisations.

Humans migrated into these river valleys that over time became the cradles of civilisation with their agriculture and surpluses. This allowed these early migrants to escape the population limiting tropical diseases, but it created all kinds of new disease problems. The communities that sprang up in these river valleys had more people which led to population density that, in turn, allowed for epidemics. One of the great things about hunting and gathering is that diseases cannot wipe out cities if there are no cities to wipe out.


Also, river valleys can often be breeding grounds for diseases, especially in the valleys where cultures developed irrigation which often relied on slow moving or standing water. Still water is the perfect incubator for disease carrying and nasty micro-organisms that are often associated with disease. For example, schistosomiasis, the symptoms of which include abdominal pain, diarrhoea, bloody stool and blood in the urine, was recorded as early as 1200 BCE in ancient Egypt. Additionally, lots of diseases originate in domestic animals who were living in close proximity to these new agriculturists; but you cannot have ham and bacon without having a little swine flu.

From a macro historical point of view, it is not like these diseases always came only with downsides. It is a matter of historical fact that certain diseases have helped certain populations throughout history shield themselves against would-be conquerors. For example, large swathes of Africa were protected as late as the nineteenth century; early modern-era European attempts to colonise the continent were thwarted by diseases such as malaria which sickened the humans and nagana which the European’s horses contracted.

We like to say that one of the hallmarks of civilisation is the written word and surely pandemics were exactly the type of events that people would tend to write about in early civilisation because they were such a big deal. Pestilence appears in the Sumerian Epic of Gilgamesh and early Chinese historians recorded an alarming decrease in populations as diseases and their migrant hosts spread from the northern Yellow River region down to the more tropical Yangtze River basin.

Ancient Greece was relatively disease free thanks to its climate and the isolationist nature of city-states. However, as these city-states began to trade more with one another they became more susceptible to endemics. The most well-known example of this was the plague that struck the city of Athens in 430-429 BCE during the Peloponnesian War with Sparta and her allies. This conveniently leads us to a very important point: there is a decent correlation between war and disease. Armies tended to carry disease along with them and this combined with food shortages and displacement meant that civilian populations were more likely to get sick. This is still very much the case.

However, nothing spreads disease quite like trade.

Trade is so good for economies and yet so bad for keeping individual people healthy and alive. Ancient Rome’s integration into the transcontinental trade routes, like the Silk Road, may explain why the Roman historian, Titus Livius, more commonly known today as Livy, recorded as many as eleven separate pestilential disasters and it is very likely that these diseases and the accompanying decline in Rome’s population contributed to the fall of the Roman Empire.

Black Death

Of course, we cannot talk about disease throughout history without touching upon the most infamous pandemic of them all: The Black Death which ravaged Europe from 1347 to 1353.

In October 1347, twelve Genoese ships dropped anchor at the Sicilian port of Messina. Those that eagerly approached the vessels were met with a grisly sight. Almost all onboard the vessels were either dead or dying, their skin erupting with blackened boils that oozed pus and blood. The Sicilian authorities quickly moved these cargo ships on, but the damage had already been done.

Europe may have been hit hard by the plague, but it was not hit first. Those Genoese ships were travelling from somewhere, after all and the reason that they were quickly moved away from the port was because the rumours about the disease spread westward before the disease itself. There were stories of a terrifying and mysterious sickness devastating the populations of first China, then India, Egypt, Persia and Syria, getting ever closer to Europe.


The death rate of this plague was incredibly high. It is estimated that anywhere from 30% to 60% of the population of people living in Europe died from the Black Death.

We are not 100% sure that the disease that caused the Black Death was the bubonic plague as its virulence in some regions suggest that it may have been pneumonic, but we do have descriptions of it that match bubonic plague symptoms. The Florentine chronicler Matteo Villani said:

“It was a plague which touched people of every condition, age and sex. They began to spit blood and then they died – some immediately, some in two or three days, and some in a longer time… most had swellings in the groin, and many had them in the left and right armpits and in other places, one could almost always find an unusual swelling somewhere on the victim’s body.”

Well, that sounds utterly horrifying!

People fleeing the cities for the countryside were no safer there either as plague infected and killed livestock too. Countless pigs, chickens, goats, sheep and cows fell to the disease that was caused by Yersinia Pestis. This was such a problem that it led to shortage of wool throughout Europe. The disease was so bad in Florence that an estimated 90% of the city’s population lost their lives. The European death toll is generally estimated to be between 50 and 75 million, whilst the worldwide death toll is placed between 155 and 200 million. To put into perspective just how devastatingly high this number is the world population at the time was approximately 500 million.

The plague obviously affected a lot of individual’s lives but it also affected world history. For example, the plague probably contributed massively to the fall of the Mongol Yuan Dynasty in China. The Yuan Dynasty’s collapse did not follow the typical dynastic loops that historians have observed throughout the history of China. There were virtually no records of serious corruptions, power struggles, internal conflicts within the royal court, external invasions or even large-scale famines during most of the Yuan’s reign. Yet the Dynasty fell so quickly and inevitably that many believe the Black Death may have been the underlying reason, in a roundabout way. The first wave of the plague struck China in 1344, three years before Europe and the epicentre appears to have been in the Huai River Basin, hometown of the later Hongwu Emperor of the Ming Dynasty. The story goes that he became homeless as all of his family had perished in the plague and as a result, he was forced to flee the disease by begging as a travelling monk, during which time he fell into the company of a resistance army against the Mongol Yuan. He quickly rose through the ranks and became a leading figure of the rebellion group and eventually captured the entire country, founding the Ming Dynasty.

Aside from being beneficial to the fortunes of the Ming Dynasty, there is substantial debate as to whether the Black Death kick-started Europe’s economy and ended the Middle Ages, propelling Western Europe onto a trajectory that would lead to the gunpowder empires and the modern era. Undoubtedly, the shortage of skilled workers did create opportunities, for example, Guilds being forced to admit new members in order to replace the many workers who had died and persistent European inflation until the end of the fourteenth century suggests both a shortage of products and higher wages. Again, we can look to Matteo Villani to provide some evidence to the effect of the plague on Italy’s economy:

“Nurses and minor artisans working with their hands want three times or nearly the usual pay, and labourers on the land all want oxen and all seed, and want to work the best lands, and to abandon all others.”

So, the Black Death may have been good for the standard of living for the workers who survived the pestilence.

Another probable impact that the plague had on world history is that it changed Europe’s views on Christianity. When people were faced with seemingly random and widespread deaths, it was inevitable that some people would completely abandon piety for decadence and debauchery and the ineffectiveness of the priesthood in dealing with the crisis may have led to an increase in anti-clericalism which later transpired into a greater and more readily acceptance of the Protestant Reformation when it came around.

Attempts to combat the pestilence sweeping across the land, which left thousands of European villages without one single living soul, changed the way that the people lived. For example, construction techniques changed, and people began building out of brick rather than wood and many places saw the mass introduction of tiled roofing which replaced thatched rooftops which were a haven for rats. These new shelters created more barriers between humans and the disease carrying, flea infested rodents.

The Fightback: Medicine – Leading the Charge

So, the Black Death looms larger in our Eurocentric imaging of history, but in terms of devastation and human suffering it pales in comparison to the Great Dying that accompanied the Columbian Exchange (which we will look at later). It is estimated that somewhere between 80% and 95% of Native Americans died within the first 150 years of Christopher Columbus setting foot on the New World. That truly is an astonishing and horrifying number, and much of it was down to the Old World diseases that the European invaders brought with them that the Americans had little or no immunity to.

Thankfully, the world has not seen anything remotely like the devastation brought by the Columbian Exchange since. Some of this is down to our shared immunological profiles, but much of the credit is due to massive improvements in science and medicine.


The most significant medical advance in the battle against infectious disease and viral epidemics like smallpox was the invention of inoculation. The first recordings of this form of fighting disease come from tenth century China but it came under widespread use in England in the eighteenth century and was soon followed by the rest of Europe. The development of antibiotics in the twentieth century proved to be extremely effective against bacterial diseases, like bubonic plague and tuberculosis. Some of these advances have had a tremendous results: smallpox was officially declared as the first disease to be completely eradicated from the human population in 1980 by the World Health Organisation.

However, infectious diseases continue to be a leading killer of human beings and we still see deadly outbreaks of diseases like Ebola and cholera around the world. And even though antibiotics have only been in wide use for less than a century, we are already beginning to see the emergence of drug-resistant bacteria and diseases such as tuberculosis making a bit of a comeback in recent years. Then there are the more modern diseases like HIV/Aids and the prospect of lurking epidemics like the various flus that we often hear about.

All of this demonstrates that diseases are still shaping the human story. Just look at the current flu pandemic that is sweeping its way across the earth, COVID-19, or better known by its virial name, the coronavirus, which has investors running for the hills and entire countries on lockdown.

The Rest will be History

The Rest is History

  1. The Wise Man’s Journey
  2. The Agricultural Revolution
  3. Early Settlement
  4. The Indus Valley Civilisation
  5. Mesopotamia
  6. Ancient Egypt
  7. West Vs East
  8. Hinduism, Buddhism & Ashoka the Great
  9. Ancient China
  10. Alexander…the Great?
  11. The Silk Road & Ancient Trade
  12. The Roman Republic. Or was it Empire?
  13. The Covenant & the Messiah
  14. Fall of the Roman Empire… Rise of the Byzantine Empire
  15. The Rise of Islam
  16. The Dark Ages
  17. The Cross and the Crescent – The Crusades
  18. Medieval Africa and Islam
  19. The Mongols

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s