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HLTB21H3 (177)
Chapter 4


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Health Studies
Caroline Barakat

CHAPTER 4 AN ACIENT PLAGUE, THE BLACK DEATH - Three great bubonic plague pandemics have occurred during the last 2,000 years. They resulted in social and economic upheavals that are unmatched by those caused by any armed conflict or any other infectious disease. 1. The first bubonic plague pandemic 542 to 543; in Constantinople, the capital of the Roman Empire Contributed to Justinians failure to restore imperial unity. Also called the Justinian Plague. 2. The second bubonic plague pandemic 1346 1352 By the time it dissipated in 1352, the population of Europe and the Middle East had reduced from 100 million to 80 million people. This plague was known as the Black Death, the Great Dying, or the Great Pestilence. It put an end to the rise in human population that had begun in 5000 B.C. Some believed that this catastrophic crash in population to be Malthuss prophecy come true, but others, such as historian David Herlihy believed that it allowed Europeans to restructure their society along very different paths. Many people believed that the cause of the plague was due to air. - Today, we know that the source of the second pandemic was microbes left over from the first pandemic. - The microbes had moved eastward and remained endemic for seven centuries in voles, marmots, and the highly susceptible black rate (Rattus rattus) of the arid plateau of central Asia (Turkestan today). - Plague-infected rats They moved westward along the caravan routes between Asia and the Mediterranean known collectively as the Silk Road; plague travelled from central Asia, around the Caspian Seas, to the Crimea. The rats boarded ships and moved from port to port and country to country, spreading plague to the human populations living in filthy, rat-infested cities. The story of the Pied Piper who came to get rid of the rats. The Black Death - Most associated with Florence, one of the great cities of Europe at the time. - It felt the full impact of the epidemic. - Sometimes called the Plague of Florence. - Symptoms as witnessed by Giovanni Boccaccio: Blood from the nose. The emergence of appleegg-shaped tumors in the groin or armpit that grew larger. It would then spread. Black spots begin to appear on arms and thighs, first few and large, and then minute and numerous. www.notesolution.com Almost all within 3 days of the spread of the black spots, came death. - The contagious nature of plague led to the belief that the only way security could be achieved was total isolation of the sick. The enemy was the sick. The knowledge of the microbes of the past was unknown. o This led to the institution of crude and generally ineffectual public health measures. In 1374, the Venetian Republic required that all ships, their crew, passengers, and cargo had to remain on board for 40 days while tied up at the dock; this gave rise to the term quarantine. - This attempt didnt work because the infected rats left the ships by using the docking lines. Cordon sanitaires restricted the movement of people and may have reduced the spread of plague, but often times the infected individuals were shut up in their homes with the uninfected members of the family and the flea-infested rats, leading to higher mortality. o More effective measures included the burning of clothing and bedding and the burying of the dead in shallow unmarked graves sprinkled with lye. - The Black Death led to societal and religious changes: Societal Changes: o Feudal structures began to break down. o The labouring class became more mobile. o Merchants and craftsmen became more powerful. o Guild Structures were strengthened. Religious Changes: Decline in papal authority. People lost faith in a Christian church that was powerless to stem the tide of death. - It was the most dramatic outbreak of bubonic plague ever visited upon Europe. - It did not disappear altogether Between 1347 and 1722, plague epidemics occurred in Europe at infrequent intervals, without the introduction of caravans from Asia. In England, the epidemics occurred at 2- to 5-year intervals between 1361 and 1480. Half of the population in Milan died in 1630. 60% of the population of Genoa died in 1656 to 1657. 30% of the population of Marseilles died in 1720. In the Great Plague of 1665, at least 70,000 Londoners died, out of a population of 450,000. 3. The third bubonic plague pandemic It began in the 1860s in the war-torn Yunnan region of China. www.notesolution.com
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