Understanding the Mechanisms of the Black Death: How It Killed Its Victims

During the 14th century, the Black Death struck Europe, causing widespread devastation. Few who contracted the disease survived, and it was one of the deadliest pandemics in human history. Its three forms—bubonic, septicemic, and pneumonic plague—were all killers, with only a lucky few possessing natural immunity.

Bubonic Plague

The bubonic form of the plague is characterized by the sudden onset of a high fever, headache, chills, and weakness. Additionally, patients develop one or more swollen, tender, and painful lymph nodes called buboes. This form of the disease is usually contracted through the bite of an infected flea. The bacteria multiply in the lymph node closest to where the bacteria entered the human body.

Septicemic Plague

The septicemic form of the plague presents with fever, chills, extreme weakness, abdominal pain, shock, and possible bleeding into the skin and other organs. In some cases, the skin and other tissues may turn black and die, particularly on fingers, toes, and the nose. This form of the disease can occur as the initial symptoms or may develop from untreated bubonic plague. It results from the bite of an infected flea or from handling an infected animal.

First Symptoms of Septicemic Plague

The first signs of septicemic plague can include nausea, vomiting, diarrhea, and abdominal pain. A person can also develop severe bleeding problems, including sudden bleeding under the skin, scattered bruising, blood in the urine, and abnormal bleeding from the mouth, nose, and rectum.

Pneumonic Plague

Pneumonic plague is the most serious form of the disease and is the only form that can be spread from person to person through infectious droplets. Symptoms include fever, headache, weakness, and a rapidly developing pneumonia with shortness of breath, chest pain, cough, and sometimes bloody or watery mucous. Pneumonic plague can develop from inhaling infectious droplets or from untreated bubonic or septicemic plague that has spread to the lungs. The pneumonia can cause respiratory failure and shock.

How the Plague Brought About Death

Bubonic Plague

The bubonic form kills through high fever and the bacteria attacking other parts of the body. The patient often goes into septic shock, as the bacteria steal vital minerals from the blood, leading to multiple organ failure and death.

Sepiticemic Plague

Those suffering from septicemic plague die of blood loss, fever, and an inability to hold down food or liquids. The bacteria can cause severe bleeding problems and may lead to respiratory failure due to the spread of the infection to the lungs.

Pneumonic Plague

Victims of pneumonic plague often suffocate as their lungs fill with liquids, including blood. This form of the disease often claims lives within 24 hours.

Historical Context and Modern Cases

During the Black Death, autopsies were forbidden by the Church, and, consequently, few if any external signs of the pneumonic form existed. This made the diagnosis and treatment of the disease extremely challenging.

Modern cases of plague, such as septicemic plague, can still occur. However, with the availability of modern antibiotics, the mortality rate has dramatically decreased. In some instances, like the case of the poorly diagnosed bubonic plague that led to a bubo bursting, even with advanced medical care, the modern version of the disease can still be fatal.

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Treatments have advanced significantly since the 14th century, making the disease much less fatal in today's world. However, early recognition and timely treatment remain crucial.

In conclusion, the Black Death was a relentless killer, with each form of the plague bringing unique and often fatal symptoms. The understanding of its mechanisms and the advancements in medicine today have dramatically reduced its impact on humanity.