Yersinia pestis. Who would think that such a microscopic organism in the gut of an infected flea could create an upheaval in human society?
The most terrible pestilence humanity has witnessed, the Black Death of the 1340s killed an estimated 75–200 million people. To many, it seemed that the end of the world had come. In a sense, they were right. The “Great Mortality” ended one world and ushered in a new, better one. Despite the horrors of bubonic plague, Europe showed remarkable resilience in its survival.
The Black Death, tragic though it was, may have made the world a brighter place. The following improvements to society would no doubt have inevitably evolved gradually, but the Black Death was a catalyst. In spearheading change it allowed humanity to benefit from the new circumstances sooner than later.
10 Healthier People
Human populations evolve when confronted with disease. Gene variants help certain people fight infection better than those who do not have those variants. People with these beneficial genes tend to bear more children than those who don’t. This process, known as positive selection, results in favored genes persisting over time while inferior genes die out.
Recent studies have found that descendants of Europeans who survived the plague had their genes altered to make them more resistant to disease. It may explain why Europeans respond differently from other people to certain illnesses and autoimmune disorders. More specifically, a cluster of three immune system genes code proteins that latch onto harmful bacteria, triggering a defensive response. People living in places the Black Death did not ravage lack these toll-like receptor genes.
The Black Death may have been a gigantic laboratory for natural selection to weed out the weak and frail from the population. An analysis of skeletal remains in a London churchyard revealed that people after the plague had a much lower risk of dying at any age than those who lived before. Before the plague, only 10 percent of the population could expect to live past 70; post-plague, that figure had risen to 20 percent. This reshaping of human biology, coupled with the better diets available after the pestilence, allowed post-plague Europeans to be more resilient and thus live longer. As the adage goes, “What doesn’t kill you will make you stronger.”
9 The Perfume Industry
During the Black Death, doctors believed, among other things, that poisonous vapors caused the plague. They used aromatic herbs to purify the air. Before the pestilence, humans did have a long history of using perfume, but with the Black Death, use of personal fumigants truly became the rage.
One of the most popular was orange mixed with dry cloves. People also carried posies of aromatic flowers. Doctors wore nose bags filled with herbs and spices. Pomanders, or so-called “amber apples,” were balls of amber compounded with musk, aloes, camphor, and rosewater, worn around the neck. There was great demand for aromatic waters such as the concoction of rosemary, lavender, and alcohol known as Eau de la Reine de Hongrie (“the Queen of Hungary’s water”), said to be the forerunner of Eau de Cologne (“water from Cologne”), as well as simpler herbal scents for poorer folk. In the south of France, the area around Montpellier and Grasse became famous as growers of herbs and flowers and as manufacturers of scented waters.
People shunned bathing in the belief that it opened the pores of the body and allowed the foul air in. In the centuries that followed, dousing oneself with perfume to mask body odor took the place of taking a bath. What started as a protective measure against disease gradually evolved into a social custom among the upper classes.
8 Hospitals
Before the Black Death, hospitals were simply places where the sick were isolated so they would not infect others. A critically ill person entering a medieval hospital was a hopeless case. All that the hospital could do was dispose of whatever property the unfortunate wretch had and say a Mass for his soul. In fact, these hospitals took more care of one’s soul than one’s body, since disease and sickness were regarded as punishments for sin. Indeed, hospitals were religious institutions where the patient’s treatment regimen were confession and prayer. The Mass was the central aspect of hospital life.
Medieval hospitals had no professional doctors or nurses and were staffed by monks and nuns. Curing the sick physically, though practiced, was not high on the agenda and largely consisted of herbal concoctions. Hospitals also functioned as almshouses and pensionaries, taking in widows, orphans, guests, and travelers. The word “hospitality” shares the same Latin root as “hospital.”
The great pestilence jump-started the transformation of the hospital from a charity endeavor to a place where the sick go for treatment. With so many stricken by the disease, hospitals were forced to give up their multiple functions as way stations and hospices so that they could concentrate on the sick and dying.
Simultaneously, there were important changes in medical practice. The failure of traditional medicine to arrest the plague was analyzed and discussed, and new ideas were put forward. Medicine ceased to be theoretical and text-bound and became more observational and practical. Anatomy and surgery became parts of the medical program in universities. From being a quaint philosophy, medicine evolved into a practical physical science.
With professional doctors becoming more central to a hospital’s operations, medical services were specialized, and there arose hospitals or wards devoted to different categories of illnesses.
