The Black Plague or Black Death is one of the most horrible contagious diseases that led to millions of casualties. The disease spread during the 1300s when medical practitioners mostly relied on medieval medicine. The lack of information regarding the causes and treatment of diseases made it difficult for the physicians of the time to control the Black Plague. However, as physicians continued to treat the infected, they began to develop a more accurate understanding of diseases, contagion, and medicine. The effects of the Black Plague led the medical practitioners of the time to experience a shift from relying on medieval medicine to empirical approaches. Even today, as the coronavirus pandemic affects the world, the implications of the Black Plague prove integral in controlling the disease. The experiences of medical practitioners from the Black Plague outbreak led to the creation of medical writings, medical regulations, medical hierarchies, understanding contagion, implementation of quarantines, and better education.

History of the Black Plague

While the public associates the Black Plague with Europe, the disease originally came from China and Inner Asia in 1347. According to historians, the Black Plague entered the west through ships coming from Asia and into the Mediterranean ports. The plague-infested ships came from the trading port of Kaffa which Kipchak khan Janibeg’s army attacked. The army utilized plague-infested corpses as ammunition for their catapults in an attempt to weaken the city’s defenses. This biological attack led to the spread of the Black Plague to various countries, such as Africa, Italy, Spain, France, Austria, Hungary, Switzerland, Germany, England, East Anglia, Scotland, Scandinavia, and the Baltic countries. Since the disease was foreign, the European countries were unaware of the capability of the plague nor the treatment for its symptoms. This led to multiple outbreaks that greatly affected the west.

There were multiple Black Plague pandemics throughout the late 1300s which affected various places and classes, including royalties. As mentioned earlier, the outbreaks were due to plague-infested ships which conducted trade in western ports. Climate fluctuations, an effect of global warming, also affected the behavior of rodents that were hosts to plague-carrying fleas (Brittanica, 2021). These factors led to the fast spread of the disease and the pandemics that occurred during 1361-1363, 1369-1371, 1374-1375, 1390, and 1400. During these periods, the Black Plague infected peasants, commoners, and the higher classes. Royalties like “Eleanor, Queen of Peter IV of Aragon”, “Archbishop John de Stratford”, “Archbishop Thomas Bradwardine”, and “King Alfonso XI of Castile” died of the disease. Despite these pandemics, there were still places that avoided outbreaks, perhaps due to isolated positions and low plague-carrying rodents.

Implications of the Black Plague to Modern Medicine

While the Black Plague pandemics led to millions of deaths, it is noteworthy that the disease played an integral role in the development of modern medicine. Before and during the Black Plague pandemics, medical practitioners relied on medieval medicine which included beliefs in superstitious causes of diseases. This misinformation may have contributed to the large casualty during the period. The Black Plague compelled physicians to conduct an empirical approach to medicine which resulted in a better understanding of diseases. Medical professionals at the time began to write medical writings to provide treatment instructions and store information regarding the plague. Physicians and universities began to establish strict medical regulations and hierarchies to control the authority of medical practitioners. A better understanding of contagion led to the implementation of quarantine methods to control outbreaks. Lastly, the leap in medical practice led to better education in most universities at the time.

Understanding of Contagion and Implementation of Quarantines

One of the most important concepts that medical practitioners learned from the plague was the possible causes of the disease. Through their observations and experiences in treating plague victims, medical practitioners understood that certain diseases are due to contagion (Brooke, 2020). Contagion is a disease’s ability to spread through close contact with an infected source. During medieval times and even during the plague, physicians strongly believed that diseases are due to star or planet alignments, spirits, and other superstitious beliefs. If this type of information persisted, plague physicians may not have been able to control the disease which could have led to more casualties. However, since medical practitioners grasped the concept of contagion, they were able to establish preventive measures to control the outbreak.

Understanding contagion allowed medical practitioners to develop the practice of quarantine. The first quarantine occurred in 1377 at the Adriatic port city of Ragusa (Brooke, 2020). The city required ships and caravans from plague-infested areas to spend a month on the islet of Mrkan or in Cavtat. These places were isolated areas where potential plague carriers can stay for the quarantine period. The city authorities monitored the visitors to identify symptoms of the plague. It is noteworthy that the legislation specifically stated that visitors must stay for a month in the quarantine areas. This 30-day duration is sufficient to determine if an individual is asymptomatic. This showcases that the Black Plague allowed medical practitioners to develop a deeper understanding of diseases and move away from medieval approaches.

The plague physician’s understanding of contagion may have set the foundation of modern scientists’ and doctors’ better and accurate understanding of diseases. As the world experience the effects of the coronavirus pandemic, concepts like quarantine and contagion play a significant role in controlling the outbreaks. This implies that the knowledge from the Black Plague pandemics has helped in controlling diseases succeeding the plague. However, certain individuals may argue that the absence of the Black Plague will still result in humans understanding medical concepts at a later date. While this statement has merit, the early understanding of contagion must have helped in reducing casualties from other outbreaks.

Medical Writings

During the Black Plague, medical practitioners began to write plague tractates, surgical manuals, and other writings to share theoretical and practical information about the disease. University members wrote plague tractates to discuss causes, preventions, and cures for the Black Plague. However, the medieval beliefs during the time led writings to contain inaccurate information about the disease. Certain plague tractates stated that planet alignments, the wrath of God, and the corruption of the air caused the Black Plague (Vanneste, 2010). These superstitious causes would also include superstitious treatment, such as avoiding corrupted air. As plague physicians began to acquire first-hand knowledge regarding the plague, the tractates began to focus more on practical treatment instead of speculative causes.

The shift from writing about speculative theories to practical cures led to other medical writings like surgical manuals and practical tractates. The Paris Medical Faculty is one of the institutions that provided some of the most influential pieces of medical writing (Vanneste, 2010). The medical writing from the institution did not focus on describing causes but on practical treatment.  Most of their medical writings became the basis for other tractates and manuals regarding diseases. Additionally, vernacularization of medical writings became common at the time. Some researchers associate vernacularization with the decay of the Latin language while others state that it is to provide an ease of access to important medical information.

The written medical materials of the time along with the practice of recording medical information contributed to the progress in medicine. As mentioned earlier, the written materials became the basis for other medical writings which are important factors in the development of modern medicine. Information regarding the spread of diseases and preventive measures provides insight into dealing with outbreaks and pandemics. Certain writings may even have information regarding the different effects of the plague which can provide insights on the long-term implications of the Covid-19 pandemic. Most importantly, the medical writings contain historical records which are helpful in learning about the past and the development of modern medicine.

Establishment of Medical Standards and Hierarchies

The Black Plague’s effects led universities and other authorities to establish strict standards in the medical field. Before the plague, there was already existing regularization in the medical field. However, the effects of the Black Plague compelled authorities to focus on the regularization due to the important roles of medical practitioners. The physicians, royal authority, and papal authority created regulations to control and oversee all medical practices (Vanneste, 2010). The authorities required physicians, surgeons, barber-surgeons, apothecaries, and other medical practitioners to acquire licenses before they can practice in the field. The practitioners also needed to take oaths to state their loyal service towards their trade (Vanneste, 2010). The authorities banned individuals from practicing medicine if they do not have proper training. This led to the pursuit of education and preventing unregulated medical practices. Also, regular inspections ensured that medical facilities follow regulations that contributed to proper and ethical medical practices.

While the regularization in the medical field may have indicated concern for proper medical practices, it also focuses on establishing a hierarchy. During the time, physicians and other authorities created legislation that benefited the physicians and place them as head of the medical hierarchy (Vanneste, 2010). The physicians had authority over surgeons, apothecaries, and other medical practitioners. The regulations required these practitioners to abide by the instructions of physicians regarding all medical matters. The physicians wanted to gain superiority over other practitioners since they often depend on these individuals during medical treatments. During the time, physicians did not engage in manual labor like surgery or the preparation of medicine. They perceive these tasks as harmful to their status and, thus, leave it to others. Despite their refusal to perform the tasks, they desire to oversee the operations and have access to manual laborers. 

The Black Plague led to the intensified regularization in the medical field which may have contributed to the prestige and authenticity of the field. Today, medical professionals must complete and achieve certain qualifications and requirements before they can practice medicine. For example, the practice of oath-taking became integral in setting the foundation for the responsibilities of medical professionals. The medical hierarchy, despite some of its motivation, contributed to standardized systems in the field. The Black Plague did not only affect human’s understanding of diseases but aided in the establishment of organizational systems.

Better Education

The introduction of more medical writings and a better understanding of diseases led to better education after the Black Plague pandemic. The effects of the Black Plague forced universities to include medical teachings that they planned to release at later dates (Vanneste, 2010). The university curriculum experienced changes that included the addition of dissection, anatomy, and surgery practices.  However, some universities continued to not teach surgery but allowed students to learn outside the curriculum. Other universities, such as the University of Padua, create separate departments that they dedicate to medical theories and medical practices. Additionally, universities began to experience an increased demand for practical courses. These shifts in university education showcase the effects of practical experience that plague physicians encountered during the Black Plague pandemic.

The Black Plague’s effects on the education system indicate that it may have helped push human progress. Since universities changed their curriculums ahead of their plans, the earlier generations were able to benefit from the new medical materials. One can speculate that the early release of these materials may have led to early medical innovations. If the Black Plague did not occur, human medical knowledge may experience a delay of a few years. The medical writings, practical courses, and strict standards in the field may have also come at a later date which could have impacted human progress.

Conclusion

The Black Plague pandemics are some of the most morbid times in human history due to massive casualties. Peasants and royalties alike experienced the effects of the disease. However, the increased demand for medical practice during the time led to innovations in medicine. Medical practitioners gained a better understanding of contagion and diseases which led them to create medical writings and implement quarantines while authorities established medical regulations and hierarchies to form a standard system. The Black Plague, despite the atrocities it brought, pushed human progress forward and herald a medical revolution.

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