The Black Death Plague in China in the 1300s

The cause of the black death was only recently hypothesized and proven to be the Yersinia pestis with scientific advancement made in the 18th and 19th centuries. The pandemic that wiped out the Chinese population from 120 to 60 million people is now recognized as the bubonic plague. In the 19th century, the epidemics that riddled Asia, the Middle East, and Europe were attributed to the Bubonic Plague between 1347 and 1670.[footnoteRef:1] The ancient medicine that was practiced in China, where the plague had a devastating impact on the population, was still rudimental and stemmed from the cultural practices and the advancements in medicine made by Aristotle and Hippocrates in the 4th century[footnoteRef:2]. The origins of the plague were traced to Siberia and Mongolia. This study will explore the pathology, spread, the socio-economic and political impact of the bubonic plague, including a review of the black death in China. [1: Duncan, "What Caused the Black Death?." 315.] [2: Legan, "The Medical Response to The Black Death," 25.]

Pathology

The black death was a result of a variety of bacteria that fall under the Yersinia pestis classification. The origin of the bacteria is not known to be the Mongolian Steppes around 1331. Between 1347 and 1350, the bacteria had spread across Asia, Europe, and North Africa.[footnoteRef:3] The bacteria typically live in the stomach of rat fleas and might also live in the stomach of the human flea. The bacteria block the digestion of the flea, and as the flea feeds, they regurgitate the bacteria from their stomachs into their victim[footnoteRef:4]. The bacteria, Y. pestis, point of entry into the human body is the skin breakage, but access into the human is limited if ones skin is healthy. Since rodents infested with fleas are the main carriers of the bacteria, such as marmots, tarbagons, and susliks in Asia, and were virtually in every household in the 14th to the 16th century, would attack human beings after they ran out of rodent hosts. Therefore, humans were victims of epizootic disease. [3: Jedwab and Koyama, Negative Shocks and Mass Persecutions: Evidence from The Black Death, 5.] [4: Legan, 6.]

The survival conditions in the absence of rodent hosts for a year are active between 59 and 68?F with humidity between 90% and 95%. Where humid drops below 70%, the rodent fleas (Xenopsylla cheopis) are unlikely to survive.[footnoteRef:5] This explains why the plague and the black death were experienced at lethal rates during late summer and early in the spring when the climatic conditions were suitable for the fleas. When the rodent population would increase due to food availability, the bubonic place would surface again.[footnoteRef:6] Once the population of rodents decreased, the bacteria, Y. pestis, would survive in the rodents burrows for prolong periods since they are dark and moist. Once a new population of rodents would move into these caves, they would be infected, leading to a new epidemic. As a result, the black death in China was not due to a cyclic occurrence of epidemics that made the disease more fatal than its virulence alone and explained the population catastrophe of the black death. [5: Legan, "The Medical Response to The Black Death, 6. Duncan, "What Caused the Black Death?" 315.Wheelis, "Biological Warfare at the 1346 Siege of Caffa."] [6: ]

Variants of the Plague

The bubonic plague had three main variants, septicaemic, pneumonic, and bubonic. The variants of the plague occurred in different regions across Europe, the Middle East, and Asia.[footnoteRef:7] The bubonic plague had been the most common and recurrent form of the plague. The bubonic plague had an incubation period of size days and would be followed by the appearance of a blackish gangrenous pustule on the site of the skin where the victim was bit by the flea. Another symptom that would follow was the swelling of lymph nodes in the neck, groin, and armpit region, depending on which location was the closest to the location of the bite.[footnoteRef:8] As the disease advanced, a subcutaneous hemorrhaging would begin, eventually causing the swelling and development of purple hinted or black blotches in the lymphatic nodes, thus, the name Black Death. The hemorrhaging would cause intoxication and neurosis of the nervous system resulting in psychological and neurological disorders.[footnoteRef:9] The bubonic variant victims would often have diarrhea, committing, and pneumonia. The bubonic plague had a 50% to 60% fatality rate among the infected. [7: ] [8: Legan, "The Medical Response to The Black Death," 7.Duncan, "What Caused the Black Death?" 317.Duncan, 317.] [9: Legan, 5.]

The Septicaemic variant of the plague was the rarest and most hazardous variant of the plague. Like the bubonic plague, this variant was transmitted by fleas, X. cheopis, rather than from person to person. This variant occurred when a victims bloodstream was saturated with the bacteria but only for several hours. Due to the high fatality rate of the bacteria, the victim would succumb to this variant before any of the symptoms identified in the bubonic variant of the plague emerged, such as imperfections in the lymphatic glands.[footnoteRef:10] Notably, the concentration of bacteria in the bloodstream of the victim was saturated. When a human flea bit an infected person, it would contract the bacteria and transmit to other people who would later be its host. In this form, the human flea, Cortophylus fasciatus, was the main way the virus was transferred among humans. [10: ]

The pneumonic plague was the only variant of the contagious plague and would directly be transmitted from one individual to another.[footnoteRef:11] After the bacterias incubation...

pestis, the body temperature would drop for two to three days, followed by severe coughing. The infection would attack the lungs causing consolidation followed by a discharge of bloody sputum. The cough would result in the dispersal of the bacteria into the air. Further, the sputum had bacteria as well that increased the rate of transmission of te contagious disease. After the attack of the lungs, the victim would suffer neurological challenges and a coma.[footnoteRef:12] The Pneumonic variant had a fatality rate of 95 to 100%. [11: ] [12: Duncan, "What Caused the Black Death?" 317.Wheelis, "Biological Warfare at the 1346 Siege of Caffa."]

Migration and Spread of the Bubonic Plague

One of the earliest accounts of the black death was by Gabriele de Mussi, who practiced notary in the city of Piacenza between 13000 1349. His notary was mainly on the trade prevalent in Caffa (now Feodosija, Ukraine) due to the 1266 agreement between Genoa and Kahn of the Golden Horde. The accounts mainly covered the trade in the main port for the great Genoese connected by the Don River to the coastal shipping industry to Tana in central Asia. While most of his accounts were lost, one of his accounts which approximately dates 1367, documented that In the name of God, Amen. Here begins an account of the disease or mortality which occurred in 1348, put together by Gabrielem de Mussis of Piacenza. The account begins with an apocalyptic account of the depravity of human beings in the eastern countries and disease that cleared out the population as retribution by God.

In 1346, in the countries of the East, countless numbers of Tartars and Saracens were struck down by a mysterious illness that brought sudden death. Within these countries broad regions, far-spreading provinces, magnificent kingdoms, cities, towns, and settlements, ground down by illness and devoured by dreadful death, were soon stripped of their inhabitants.[footnoteRef:13] [13: ]

While Genoa was distant from the epicenter of the bubonic plague, the narratives of the destruction it caused in the Caritas where it began were evident in cosmopolitan and port cities as accounted by de Mussi. Current accounts of the Black Death began with J. F. C. Hecker, a German medical historian, in an extended essay in 1832 that branded the fourteenth-century pandemic. Heckers account held was a medieval chronicle of consequences of a pestilence, that extended from China to Iceland and Greenland.[footnoteRef:14] Notably, this account was informed by the geographical spread of the plague from the Chinese towns to Greek where he was a resident. His account traced the pestilence to an oriental plague that emerged from the bubbling cauldron of adversaries, such as famine, floods, drought, locusts, collapsing mountains, earthquakes, and epidemics in China that begun in 1333. [14: Wheelis, "Biological Warfare at the 1346 Siege of Caffa."]

The climatic changes during these times are also observed in his account as a core contributor to the spread and the infection of the human population with the Y. pestis bacteria. Due to the decline in the population of the rodent population, the rat fleas attacked the human population, resulting in an increase in the infection of the human population with the bacteria.[footnoteRef:15] Therefore, the miasmatic theory of disease is a more feasible explanation of the black death than the germ theory. Heckers account views the movement of the plague from the East to West as a consequence of progressive infection of the Zones on and beneath the earths surface rather than as a chain of contagion. [15: Welford and Bossak, "Validation of Inverse Seasonal Peak Mortality in Medieval Plagues, Including the Black Death, In Comparison to Modern Yersinia Pestis-Variant Diseases," 1177. ]

The fourteenth century witnessed a steep trajectory in trade between Europe, North Africa, and Asia. As trade grew, the settlement patterns began to change as more population began to assemble in cosmopolitan areas. As a result, the movement of traders in merchant ships between these three continents created channels.[footnoteRef:16] As established, the spread of the disease was mainly associated with the movement of the rat population rather than the contagion among people. The spread of infection among people was only limited to the pneumonic variant. As merchant ships docked for loading or loading of cargo, the rats that were hosts to the fleas carrying the Y. pestis would get on board. The ship population would get infected with the bacteria and arrive at their destination with an infected crew. The rats would get off the board during loading activities and the docking activities and infect the rodents population in these new locations. Due to the high population in the compliant areas, the local population would also be succumbing to the new bubonic plague.[footnoteRef:17] As a result, the populations that were most affected by the disease were those with the most commercial activity. For example, the cargo was ferried from Genoa and Venice through the Mediterranean and to the Asian, western, and northern European ports. The routes associated with the spread of the disease were the Silk Road and the Muslim pilgrimage routes. Figure 1 shows the trade routes and the areas that experienced black death in large numbers. [16: Wood, Ferrell and Dewitte-Avia, "The Temporal Dynamics of The Fourteenth-Century Black Death: New Evidence from English Ecclesiastical Records." 344.] [17: Welford and Bossak, "Validation of Inverse Seasonal Peak Mortality in Medieval Plagues, Including The Black Death, In Comparison To Modern Yersinia Pestis-Variant Diseases."]

Figure 1: Trade routes and cities that were pertinent to the spread of the bubonic plague.[footnoteRef:18] [18: "Chapter 11 The Black Death A 14Th Century Plague."]

The account of the spread of the bubonic plague in Asia and the European countries is complementary to the chronological account of historical events. In China, the outbreak of the bubonic plague is believed to have happened in the 1320s. The Province of Hubei was the first city where the first outbreak happened in 1334.[footnoteRef:19] The Mongol rule in the 1334s sought…