Thanks to the miasma theory of disease, which claimed that diseases were spread upon foul-smelling air vapors, 14th-century people seized on the idea that if foul smells spread illness then undoubtedly pleasant smells must prevent them. With the lack of any ability to identify the real source of the disease and thousands dying around you, why not try every possible route to avoid sickness?
The macabre, birdlike appearance of plague doctors has been immortalized in steampunk fantasy, horror games, and more. While it may seem like a grotesque reference to death, the masks had a very functional design. The long, beak-like masks were stuffed with a wealth of flowers to keep the foul miasmas from reaching the noses of the physicians. If they couldn’t smell the diseased vapors, they believed they wouldn’t be able to catch the plague.
Body collectors had far less wealth and couldn’t purchase the fanciful-looking physician’s masks, but they too attempted to use flowers to prevent disease. While it may seem absurd to us now, the miasma theory of disease transmission was the dominant belief in society from ancient times up until the late 19th century when germ theory finally, and correctly, become the prevailing view of public health and medicine.
At the height of the Black Death pandemic, hundreds were dying every day throughout Europe. Giovanni Boccaccio, who lived through the worst of the 14th Century outbreak in Florence, said the city itself turned into a graveyard due to the countless dead bodies laying throughout the city. He wrote, “Many died daily or nightly in the public streets.” For thousands who died in their homes, “the departure was hardly observed by their neighbors until the stench of their putrefying bodies carried the tidings.”
In addition to the staggering rate of death, many who were employed as gravediggers died themselves leaving few to carry out the necessary work. The bodies of plague victims are infectious, so gravediggers were especially hard hit by the pandemic alongside doctors and priests who had contact with live victims. Gravedigging was exhausting manual labor at the time, so anyone weakened by a near-death bout of the plague would also have been unable to assist in the work.
The popular imagery of carts full of bodies and chants of “bring out your dead” arises from this era. Bodies did, in fact, have to be carted out of cities for mass burials in outlying areas. The stench of numerous dead bodies would have led to panic, as the contemporary belief was that foul smells, or “miasmas,” caused diseases themselves.
4. A Florentine Writer Compared Mass Graves to Making Lasagna
Once the bodies were collected by the ill-fated and flower-wearing body collectors, they would be transported to mass grave sites. There was neither space nor the manpower to dig individual graves for the thousands of plague victims, especially those from the lower social classes. While many of the deceased were buried in churchyards, they still used pits of mass burials.
Florence, one of the worst-hit cities, was the site of many such mass graves. A Florentine writer described the process of mass burials, saying, “At every church, they dug deep pits . . . those who were poor who died during the night were bundled up quickly and thrown into the pit.” He went even further, comparing the layer of the body to a famous pasta dish, “Others were placed on top of them and then another layer of earth, just as one makes lasagne with layers of pasta and cheese.”
“Plague pits” as the mass graves came to be called in Great Britain, have actually been discovered and excavated. One such pit was found at the site of the medieval Thornton Abbey in Immingham in Lincolnshire. The 48 skeletons, 27 of which were children, were carbon-dated to the 14th century and their teeth contained evidence of the presence of Yersinia pestis. Interestingly, the skeletons were found laid out respectfully in straight rows, not dumped in roughly as some medieval art would indicate.
Not every town had the ability or space to dig the multitude of mass graves required to accommodate the many victims of the plague. With no tools available beyond shovels, digging any size grave to an adequate depth was a hugely laborious undertaking. With many experienced grave diggers dying in the first waves of the plague, and even more citizens weakened by grief or their own bouts of illness, some cities turned to labor-cutting methods.
The chronicler Agnolo di Tura of Siena, Italy wrote that “in many places in Siena great pits were dug and piled deep with the multitude of dead.” However, many were not dug deep enough or were filled too close to the top and he wrote with horror that “There were also those who were so sparsely covered with earth that the dogs dragged them forth and devoured many bodies throughout the city.”
In Avignon, France, they literally ran out of space for bodies and were not able to dig any more mass graves. In a real act of desperation, Pope Clement VI consecrated the entire Rhône river so that it would be fit for the burial of Christian bodies. This decision led to countless bodies being dumped into the river, which was doubtless also a source of drinking and bathing water for many people along the path of the river.
One of the hallmark symptoms of the Bubonic Plague is the buboes from which it takes its name. Buboes are fluid-filled swellings of the lymph nodes, typically found in the armpit and groin. The buboes could be as large as an apple and extremely painful. While we now know not to drain them, at the time a chicken feather was often used to lance and drain the buboes. The fluid within was highly infectious and could often spread the disease to the doctor lancing the buboes.
Black spots under the skin due to hemorrhage were a common sign of the septicemic variety of the plague. Even in the 14th century, it was understood that this presentation meant death was almost inevitable and imminent. Gangrene sometimes affected the extremities of victims, causing dead and blackened fingers or toes, and the flea bites that caused the disease could also become gangrenous.
In the pneumatic form of the disease, victims would often cough up a bloody froth in the hours before dying. Sufferers would have had chest pain and extreme difficulty breathing in the hours before death. For septicemic sufferers, they would have had unsightly bruising and hemorrhaging over their entire bodies before dying of fever, blood loss, or shock from the systemic infection.
Perhaps unsurprisingly, the men responsible for hauling loved ones away (at a high cost) after tragic deaths at the hands of the plague were not terribly popular. In Florence, body collectors were called becchini which literally translates to gravediggers and were widely reviled. One chronicler wrote, “gangs of shovel-wielding grave diggers known as the becchini stalked the streets.” […] stinking with the effluvia of death, . . . [and] earning more than they had ever done before.”
As happens with any necessary service, some body collectors abused their positions and demanded extortionate prices or even bribes to remove bodies from homes. There are reports that some also threatened the living with the promise of murdering them and passing them off as plague victims if they didn’t pay the high prices they were demanding.
A few body collectors were also accused of poor public behavior, with a chronicle stating some “showed off by laughing, drinking, and assaulting innocent people.” One can empathize with the frustrations of townspeople if they saw someone drinking and celebrating with the money he or she just paid to have a dear deceased love one carted away. However, one does wonder how many of the negative reports were driven by the prejudices towards the idea of the lower class earning money above their station.
Cleanliness is now mostly inseparable from ideas of health, but without germ theory, the people of the 14th Century had no reason to see any link between the two. With the strong religious ideals of the time, a popular theory of the plague’s origin was that God was angered by the sinfulness of the population, including the sin of vanity. The miasma theory also contributed to the avoidance of bathing, as physicians argued that opening the pores of the skin would make it easier for foul miasmas to enter the body.
Bathing was considered a luxury and a sign of vanity in the 14th century. With no indoor plumbing, drawing even a cold bath took a great deal of energy. A heated bath required even more time and energy. Thus, enjoying a bath with any frequency would have been viewed as wasteful and vain. Changing clothes in the 14th century, at a time when most people likely had one or two significant items of clothing, was also viewed as vanity and discouraged to remain pious and in God’s good graces.
The miasma theory reared its head to cause trouble again in the form of physicians encouraging people not to bathe. Physicians at the time were aware that exposure to hot water opened the pores of the skin, and they believed these “openings” into the body could allow foul air and water into the body, thereby transferring disease. The belief that opening the pores could allow an infection to enter the body persisted in Europe well into the 19th Century.
At its peak in the middle of the 14th Century, the body collectors would have handled around 25 million corpses. However, this period was far from the only time the Black Death visited Eurasia. England alone was hit by plague epidemics six more times in the 14th Century alone. Thousands more died during each of these flare-ups, and England was not the only country to see a resurgence of the plague throughout the years. The Black Death continued to periodically ravage England all the way into the 18th Century before finally ending its widespread scourge.
The Black Death wasn’t the only disease that struck with enough ferocity to necessitate body collectors. The mid-19th Century cholera outbreaks of London saw thousands of people dying very rapidly. Due to the extremely rapid onset of the disease and the short duration of the illness, before death sets in, bodies piled up in a manner that would have been eerily similar to scenes of the plague.
Before the advent of germ theory and the discovery of penicillin in the 19th and 20th Centuries, many diseases had the capability of ravaging populations in isolated or widespread outbreaks that could have required the services of body collectors. Conditions that have been either eradicated or significantly reduced today, like smallpox and measles, would have caused huge spikes in the death rate and called the body collectors back out to their macabre profession.
10. “Bring Out Your Dead” Came From London’s 1665 Outbreak
London suffered another terrible epidemic of the Black Death in 1665. By September of that year, thousands were dying every single week. The city could not keep up with the terrible tide of corpses, and body collectors were once again back in demand. However, the sight of so many corpses being significantly collected upset and terrified the people of London. The city eventually ordered the body collectors to only work under the cover of darkness to avoid further frightening the besieged city.
Working in the dark necessitated the development of calls to alert city dwellers that the dead-carts, as the body collector’s wagons came to be called, were nearby and accepted bodies. Thus the “bring out your dead” call, perhaps now best known for its use in a Monty Python skit, was put into use.
In the 200 years since the first devastating pandemic, advances were made to avoid as much contact with the infectious corpses of victims. Families would often use poles with hooks to lower the bodies to the waiting dead-carts on the street, reducing the amount of physical contact both the family and body collectors had to have with the deceased. A diarist at the time, Samuel Pepys, wrote that he stopped going outside at night due to these practices and his “great fear of meeting dead corpses.”
11. Body Collectors Persisted in a Society Literally Falling Apart
In a society primarily structured and run by religion, every idea you’ve held about an organization is failing. Priests are falling dead at an alarming rate and were often among the first victims of plague epidemics due to the practice of performing last rites. In some French monasteries, every single monk died. Bodies are piling up so fast they can’t be dealt with appropriately. It would likely have seemed like the end of the world to the people of the time.
Even worse, Boccaccio wrote that even family ties were not safe from the chaos and misery of the time. He wrote, “Brother was forsaken by brother, nephew by uncle, brother by sister… [and] what is more, and scarcely to be believed, fathers and mothers were found to abandon their own children, untended, unvisited, to their fate as if they had been strangers.” People, believing it to be the end times, only could not be bothered to hold to the norms of the time.
Despite the widespread panic and depression, body collectors kept faithfully at their work. While the world was quite possibly, in their eyes, collapsing into the apocalypse around them, their nightly calls of “bring out your dead” were still a constant in the afflicted cities. One cannot even imagine the bravery and resilience it must have taken to toil through such adversity and terror – especially in a society that frowned upon the very job they were doing.
While they certainly had no understanding of this at the time, we know now that the Black Death was transmitted by the bacteria Yersinia pestis which was carried by fleas. The pneumonic course of the disease could also cause transmission directly between people through aerosolized droplets. Despite not knowing the science at the time, people were able to clearly observe that the virus was spreading rapidly and sometimes appeared to spread among people.
Another concept they lacked at the time but were able to observe was that of fomites. Fomites are nonliving items that are capable of transmitting infections by carrying infectious material. In the case of the Black Death, fomites from the septicemic course of the plague could infect the living. This made the entire body of deceased plague victims possible vectors of disease. While highly exaggerated, a story from Boccaccio’s Decameron claiming that two pigs rooted around in a plague victim’s clothing and immediately fell dead illustrates the general principle of a fomite in disease transmission.
The gravediggers and body movers during the plague would have doubtless come in contact with soiled clothing that contained disease material as well as the diseased fluids of the corpses themselves. While they would like to have misattributed the dangers of their occupation to the foul smells, or miasmas, surrounding the bodies, they were likely aware of just how dangerous their jobs were.
13. Jews Were Blamed for the Plague With Deadly Consequences
One of the less known, but deeply tragic, consequences of the Black Death was the pogrom of Jewish communities throughout Europe. Jews in Europe were frequently blamed and targeted for ills that befell communities, but at no time until the Holocaust was this more prevalent and deadly than during the 14th Century outbreak of the plague. While Jews, Christians, and Muslims were all equally likely to be infected by and die of the epidemic, Christian communities took out their fear and hatred and on their Jewish neighbors in particular.
The deadliest pogrom occurred in Strasbourg in what is now France. Many Jews were captured and tortured by city officials until a confession was forced from them. The crime they were accused of: poisoning the city’s wells in order to cause the plague. Thanks to confessions obtained by torture, the city declared their guilt and burned hundreds of Jews alive in the middle of the town. The death toll of the tortures, pogroms and other attacks on Jews is estimated at around 2,000 people. The rest of the Jews remaining in Strasbourg were driven out or fled.
A particularly horrifying and tragic outcome of these pogroms was the fact that the European Jewish population concentrated in Poland during the period due to the welcoming protection of King Casimir III the Great. Not only did he specifically invite European Jews to flee to Poland, but he also offered legal protections that were either nonexistent or not enforced in other countries. However, six hundred years later this condensation of the population would lead to tragedy as Polish Jews were rounded up to begin the Holocaust under Nazi Germany.
Before the Black Death began to ravage Europe, most European cultures had elaborate funeral rites that often involved something comparable to modern pallbearing, where a group of the deceased’s peers bore them to the gravesite. Boccaccio wrote that a dead body, in a proper rite, should be “borne on the shoulders of his peers… to the church selected by him before his death.” However, these rites obviously couldn’t be maintained when hundreds were dying in a matter of days.
As a solution to this issue, many individuals from the lowest peasant groups saw an opportunity to earn money in a manner that would have been far beneath the dignity of the upper and noble classes. Thus the body collectors were created. Non-disabled men of the lower levels began using their carts to collect bodies instead of agricultural products, earning money out of tragedy. Boccaccio noted the emergence of this profession, writing “a sort of corpse-carriers drawn from the baser ranks, [who] performed such offices for hire.”
The work of the body collectors would be mirrored in the 19th century in connection with another pandemic: cholera. The 19th century saw the expansion of night soil men, particularly in London. Human waste had high value in the creation of both fertilizer and industrial chemicals like saltpeter. Night soil men would travel around cities in the early morning hours collecting trash, and many charged extremely high rates – especially during the cholera epidemic.
15. The Black Death Did Not Spare Royalty and Nobility
While many historical outbreaks, like London’s cholera epidemic, are linked with poverty and squalor, no social strata were left untouched by the Black Death. While only one reigning monarch died during the Black Death’s own reign of terror, many members of noble families and noted scholars died as well. Daughters, mothers, brothers and other relations of kings were not spared, nor were the wealthiest and most powerful families.
Alfonso XI of Castile, the king of Castile, León, and Galicia, also known as el Justiciero or the Avenger, died from the Black Death in 1350. He was the only actively reigning monarch of Europe to fall to the plague. However, many members of royal families died. Anne of Bohemia, the first wife of England’s King Richard II and daughter of Holy Roman Emperor Charles IV died in 1394. Blanche of Lancaster, daughter of wealthy Plantagenet Duke, Henry of Grosmont, wife of John of Gaunt and mother of King Henry IV died in 1368.
Giovanni Boccaccio, author of The Decameron and noted chronicler of the plague, died fell to the disease himself in 1375. Francesco Petrarca, or Petrarch, perished from the Black Death in 1374. One can only imagine the amount of potential art and literature lost with the death of so much of Europe’s population. So many lives cut short cannot happen without a corresponding loss of culture and creation.
16. The Black Death Changed Music, Literature, Art and Religion
Unsurprisingly, art and culture were both massively changed by the social upheaval that attended the loss of more than a third of Europe’s population. There was a strong sense of fatalism and merely waiting for the end of times during the 14th Century pandemic. This notion is reflected in the somber, morose tone of music, art, and literature created during the period. The Catholic Church also saw a loss of power during the chaos of the era, and the seeds were planted for the Protestant Reformation.
Art is, naturally, the easiest way to observe the cultural effects of the Black Death on the culture of the era. Death is frequently seen in pieces of the period, as in the famous illustration of dancing skeletons. Death stalked Europeans every day during the period, so it is unsurprising to see representations of that constant presence in their art. The music shifted during the period as well, becoming more somber and focused on death and the hope for salvation.
Literature of the period also reflects the themes of death and fatalism. Many authors also served as chroniclers of the chaos and destruction of the pandemic. Writers like Boccaccio provided a window for future readers into daily life under the shadow of the Black Death. The intense religious thought of the period saw a weakening of the Catholic Church’s power, as it was unable to keep its faithful safe during the crisis. The perceived failures of the church during the period helped sow some of the unrest that would later erupt as the Protestant Reformation.
17. The Plague Still Exists in the United States Today
The last major pandemic of the plague occurred in England in 1665, with smaller yet still devastating outbreaks ending in France with Marseilles in 1740. Despite its seeming disappearance, Yersinia pestis is actually still alive and well. Yersinia pestis is a zoonotic bacteria, meaning that it uses animals as its host and vector for transmission. It is endemic, meaning naturally occurring, all over the world from China to the United States.
The plague still infects humans, with cases occurring every single year. Thanks to the advent of penicillin and other antibiotics in the 20th century, the epidemic is now mostly treatable although the septicemic course of the disease remains dangerous and difficult to successfully treat. However, over 80% of the cases identified in the United States follow the bubonic path of the disease.
In the United States, the bubonic plague chiefly occurs in two regions: the Southwest states and a pocket in northern Nevada, southern Oregon and eastern California. On average, seven cases of the plague are identified every year. Outdoor activity in these areas is the main risk factor, as it brings people into contact with the habitat of rodents bearing fleas infected with the bacteria. Cases regularly occur around the world as well, wherever people can come into contact with rodents carrying infected fleas.
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