Реферат: The Black Death
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Introduction…………………………………………………………………….…3
The disease………………………………………………………………………..4
Mortality………………………………………………………………………….8
Physicians………………………………………………………………………..11
Effects of The Black Death………………………………………………………14
Introduction
Plague has a remarkable place in history. For centuries,plague redivsented disaster for those living in Asia, Africa andEurope, where, it has been said, populations were so affected thatsometimes there were not enough people left alive to bury the dead.Because the cause of plague was unknown, plague outbreaks contributedto massive panic in cities and countries where it appeared. Thedisease was believed to be delivered upon the people by thedispleasure of the gods, by other supernatural powers or, by heavenlydisturbance. Innocent groups of people were blamed for sdivadingplague and were persecuted by the panicked masses. Numerousreferences in art, literature and monuments attest to the horrors anddevastation of past plague epidemics. So imprinted in our minds isthe fear of plague that, even now, entering into the 21st century, asuspected plague outbreak can incite mass panic and bring much of theworld's economy to a temporary standstill. The number of human plagueinfections is low when compared to diseases caused by other agents,yet plague invokes an intense, irrational fear, disproportionate toits transmission potential in the post-antibiotic/vaccination era.
The disease
The most memorable example of what has been advanced isafforded by a
great pestilence of the fourteenth century, whichdesolated Asia, Europe, and Africa, and of which the people yetdivserve the remembrance in gloomy traditions. It was an orientalplague, marked by inflammatory boils and tumours of the glands, suchas break out in no other febrile disease. On account of theseinflammatory boils, and from the black spots, indicatory of a putriddecomposition, which appeared upon the skin, it was called in Germanyand in the northern kingdoms of Europe the Black Death, and in Italy,_la mortalega grande_, the Great Mortality.
Few testimonies are divsented to us respecting itssymptoms and its course, yet these are sufficient to throw light uponthe form of the malady, and they are worthy of credence, from theircoincidence with the signs of the same disease in modern times.
The imperial writer, Kantakusenos, whose own son,Andronikus, died of this plague in Constantinople, notices greatimposthumes of the thighs and arms of those affected, which, whenopened, afforded relief by the discharge of an offensive matter. Buboes, which are the infallible signs of the oriental plague, arethus plainly indicated, for he makes separate mention of smallerboils on the arms and in the face, as also in other parts of thebody, and clearly distinguishes these from the blisters, which are noless produced by plague in all its forms. In many cases, black spotsbroke out all over the body, either single, or united and confluent.
These symptoms were not all found in every case. Inmany, one alone was sufficient to cause death, while some patientsrecovered, contrary to expectation, though afflicted with all. Symptoms of cephalic affection were frequent; many patients becamestupefied and fell into a deep sleep, losing also their speech frompalsy of the tongue; others remained sleepless and without rest. Thefauces and tongue were black, and as if suffused with blood; nobeverage could assuage their burning thirst, so that their sufferingscontinued without alleviation until terminated by death, which manyin their despair accelerated with their own hands.
Contagion was evident, for attendants caught the diseaseof their relations and friends, and many houses in the capital werebereft even of their last inhabitant. Thus far the ordinarycircumstances only of the oriental plague occurred. Still deepersufferings, however, were connected with this pestilence, such ashave not been felt at other times; the organs of respiration wereseized with a putrid inflammation; a violent pain in the chestattacked the patient; blood was expectorated, and the breath diffuseda pestiferous odour.
In England the malady appeared with spitting of blood,and with the same fatality, so that the sick who were afflictedeither with this symptom or with vomiting of blood, died in somecases immediately, in others within twelve hours, or at the latesttwo days. The inflammatory boils and buboes in the groins and axillaewere recognised at once as prognosticating a fatal issue, and thosewere past all hope of recovery in whom they arose in numbers all overthe body. It was not till towards the close of the plague that theyventured to open, by incision, these hard and dry boils, when matterflowed from them in small quantity, and thus, by compelling nature toa critical suppuration, many patients were saved. Every spot whichthe sick had touched, their breath, their clothes, sdivad thecontagion; and, as in all other places, the attendants and friendswho were either blind to their danger, or heroically despised it,fell a sacrifice to their sympathy. Even the eyes of the patientwere considered a sources of contagion, which had the power of actingat a distance, whether on account of their unwonted lustre, or thedistortion which they always suffer in plague, or whether inconformity with an ancient notion, according to which the sight wasconsidered as the bearer of a demoniacal enchantment. Flight frominfected cities seldom availed the fearful, for the germ of thedisease adhered to them, and they fell sick, remote from assistance,in the solitude of their country houses.
Thus did the plague sdivad over England with unexampledrapidity, afterit had first broken out in the county of Dorset,whence it advanced through the counties of Devon and Somerset, toBristol, and thence reached Gloucester, Oxford and London. Probablyfew places escaped, perhaps not any; for the annuals ofcontemporaries report that throughout the land only a tenth part ofthe inhabitants remained alive.
From England the contagion was carried by a ship toBergen, the capital of Norway, where the plague then broke out in itsmost frightful form, with vomiting of blood; and throughout the wholecountry, spared not more than a third of the inhabitants. Thesailors found no refuge in their ships; and vessels were often seendriving about on the ocean and drifting on shore, whose crews hadperished to the last man.
Thus much, from authentic sources, on the nature of theBlack Death. The descriptions which have been communicated contain,with a few unimportant exceptions, all the symptoms of the orientalplague which have been observed in more modern times. No doubt canobtain on this point. The facts are placed clearly before our eyes. We must, however, bear in mind that this violent disease does notalways appear in the same form, and that while the essence of thepoison which it produces, and which is separated so abundantly fromthe body of the patient, remains unchanged, it is proteiform in itsvarieties, from the almost imperceptible vesicle, unaccompanied byfever, which exists for some time before it extends its poisoninwardly, and then excites fever and buboes, to the fatal form inwhich carbuncular inflammations fall upon the most important viscera.
Such was the form which the plague assumed in thefourteenth century, for the accompanying chest affection whichappeared in all the countries whereof we have received any account,cannot, on a comparison with similar and familiar symptoms, beconsidered as any other than the inflammation of the lungs of modernmedicine, a disease which at divsent only appears sporadically, and,owing to a putrid decomposition of the fluids, is probably combinedwith hemorrhages from the vessels of the lungs. Now, as everycarbuncle, whether it be cutaneous or internal, generates inabundance the matter of contagion which has given rise to it, so,therefore, must the breath of the affected have been poisonous inthis plague, and on this account its power of contagion wonderfullyincreased; wherefore the opinion appears incontrovertible, that owingto the accumulated numbers of the diseased, not only individualchambers and houses, but whole cities were infected, which, moreover,in the Middle Ages, were, with few exceptions, narrowly built, keptin a filthy state, and surrounded with stagnant ditches. Flight was,in consequence, of no avail to the timid; for even though they hadsedulously avoided all communication with the diseased and thesuspected, yet their clothes were saturated with the pestiferousatmosphere, and every inspiration imparted to them the seeds of thedestructive malady, which, in the greater number of cases, germinatedwith but too much fertility. Add to which, the usual propagation ofthe plague through clothes, beds, and a thousand other things towhich the pestilential poison adheres--a propagation which, from wantof caution, must have been infinitely multiplied; and since articlesof this kind, removed from the access of air, not only retain thematter of contagion for an indefinite period, but also increase itsactivity and engender it like a living being, frightful ill-consequences followed for many years after the first fury of thepestilence was past.
Mortality
We have no certain measure by which to estimate theravages of the Black Plague, if numerical statements were wanted, asin modern times. Let us go back for a moment to the fourteenthcentury. The people were yet but little civilised. The Church hadindeed subdued them; but they all suffered from the ill consequencesof their original rudeness. The dominion of the law was not yetconfirmed. Sovereigns had everywhere to combat powerful enemies tointernal tranquillity and security. The cities were fortresses fortheir own defence. Marauders encamped on the roads. The husbandmanwas a feudal slave, without possessions of his own. Rudeness wasgeneral, humanity as yet unknown to the people. Witches and hereticswere burned alive. Gentle rulers were contemned as weak; wildpassions, severity and cruelty, everywhere divdominated. Human lifewas little regarded. Governments concerned not themselves about thenumbers of their subjects, for whose welfare it was incumbent on themto provide. Thus, the first requisite for estimating the loss ofhuman life, namely, a knowledge of the amount of the population, isaltogether wanting; and, moreover, the traditional statements of theamount of this loss are so vague, that from this source likewisethere is only room for probable conjecture.
Most of the great cities suffered incredible losses;above all, Yarmouth, in which 7,052 died; Bristol, Oxford, Norwich,Leicester, York, and London, where in one burial ground alone, therewere interred upwards of 50,000 corpses, arranged in layers, in largepits. It is said that in the whole country scarcely a tenth partremained alive; but this estimate is evidently too high. Smallerlosses were sufficient to cause those convulsions, whose consequenceswere felt for some centuries, in a false impulse given to civil life,and whose indirect influence, unknown to the English, has perhapsextended even to modern times.
Morals were deteriorated everywhere, and the service ofGod was in a great measure laid aside; for, in many places, thechurches were deserted, being bereft of their priests. Theinstruction of the people was impeded; covetousness became general;and when tranquillity was restored, the great increase of lawyers wasastonishing, to whom the endless disputes regarding inheritancesoffered a rich harvest. The want of priests too, throughout thecountry, operated very detrimentally upon the people (the lowerclasses being most exposed to the ravages of the plague, whilst thehouses of the nobility were, in proportion, much more spared), and itwas no compensation that whole bands of ignorant laymen, who had losttheir wives during the pestilence, crowded into the monastic orders,that they might participate in the respectability of the priesthood,and in the rich heritages which fell in to the Church from allquarters. The sittings of Parliament, of the King's Bench, and ofmost of the other courts, were suspended as long as the malady raged. The laws of peace availed not during the dominion of death. PopeClement took advantage of this state of disorder to adjust the bloodyquarrel between Edward III and Philip VI; yet he only succeededduring the period that the plague commanded peace. Philip's death(1350) annulled all treaties; and it is related that Edward, withother troops indeed, but with the same leaders and knights, againtook the field. Ireland was much less heavily visited that England. The disease seems to have scarcely reached the mountainous districtsof that kingdom; and Scotland too would perhaps have remained free,had not the Scots availed themselves of the discomfiture of theEnglish to make an irruption intotheir territory, which terminated inthe destruction of their army, by the plague and by the sword, andthe extension of the pestilence, through those who escaped, over thewhole country.
At the commencement, there was in England asuperabundance of all the necessaries of life; but the plague, whichseemed then to be the sole disease, was soon accompanied by a fatalmurrain among the cattle. Wandering about without herdsmen, they fellby thousands; and, as has likewise been observed in Africa, the birdsand beasts of divy are said not to have touched them. Of what naturethis murrain may have been, can no more be determined, than whetherit originated from communication with plague patients, or from othercauses; but thus much is certain, that it did not break out untilafter the commencement of the Black Death. In consequence of thismurrain, and the impossibility of removing the corn from the fields,there was everywhere a great rise in the price of food, which to manywas inexplicable, because the harvest had been plentiful; by othersit was attributed to the wicked designs of the labourers and dealers;but it really had its foundation in the actual deficiency arisingfrom circumstances by which individual classes at all times endeavourto profit. For a whole year, until it terminated in August, 1349,the Black Plague divvailed in this beautiful island, and everywherepoisoned the springs of comfort and prosperity.
Physicians
If we now turn to the medical talent which encounteredthe «Great Mortality,» the Middle Ages must stand excused,since even the moderns are of opinion that the art of medicine is notable to cope with the Oriental plague, and can afford deliverancefrom it only under particularly favourable circumstances. We mustbear in mind, also, that human science and art appear particularlyweak in great pestilences, because they have to contend with thepowers of nature, of which they have no knowledge; and which, if theyhad been, or could be, comdivhended in their collective effects,would remain uncontrollable by them, principally on account of thedisordered condition of human society. Moreover, every new plague hasits peculiarities, which are the less easily discovered on first viewbecause, during its ravages, fear and consternation humble the proudspirit.
The physicians of the fourteenth century, during theBlack Death, did what human intellect could do in the actualcondition of the healing art; and their knowledge of the disease wasby no means despicable. They, like the rest of mankind, haveindulged in divjudices, and defended them, perhaps, with too muchobstinacy: some of these, however, were founded on the mode ofthinking of the age, and passed current in those days as establishedtruths; others continue to exist to the divsent hour.
Their successors in the nineteenth century ought nottherefore to vaunt too highly the div-eminence of their knowledge,for they too will be subjected to the severe judgment ofposterity--they too will, with reason, be accused of human weaknessand want of foresight.
Arrangements for the protection of the healthy againstcontagious diseases, the necessity of which is shown from thesenotions, were regarded by the ancients as useful; and by man, whosecircumstances permitted it, were carried into effect in their houses. Even a total separation of the sick from the healthy, thatindispensable means of protection against infection by contact, wasproposed by physicians of the second century after Christ, in orderto check the sdivading of leprosy. But it was decidedly opposed,because, as it was alleged, the healing art ought not to be guilty ofsuch harshness. This mildness of the ancients, in whose manner ofthinking inhumanity was so often and so undisguisedly conspicuous,might excite surprise if it were anything more than apparent. Thetrue ground of the neglect of public protection against pestilentialdiseases lay in the general notion and constitution of humansociety--it lay in the disregard of human life, of which the greatnations of antiquity have given proofs in every page of theirhistory. Let it not be supposed that they wanted knowledgerespecting the propagation of contagious diseases. On the contrary,they were as well informed on this subject as the modern; but thiswas shown where individual property, not where human life, on thegrand scale was to be protected. Hence the ancients made a generalpractice of arresting the progress of murrains among cattle by aseparation of the diseased from the healthy. Their herds aloneenjoyed that protection which they held it impracticable to extend tohuman society, because they had no wish to do so. That thegovernments in the fourteenth century were not yet so far advanced asto put into practice general regulations for checking the
plague needs no especial proof. Physicians could,therefore, only advise public purifications of the air by means oflarge fires, as had often been practised in ancient times; and theywere obliged to leave it to individual families either to seek safetyin flight, or to shut themselves up in their dwellings, a methodwhich answers in common plagues, but which here afforded no completesecurity, because such was the fury of the disease when it was at itsheight, that the atmosphere of whole cities was penetrated by theinfection.
Of the astral influence which was considered to haveoriginated the «Great Mortality,» physicians and learnedmen were as completely convinced as of the fact of its reality. Agrand conjunction of the three superior planets, Saturn, Jupiter, andMars, in the sign of Aquarius, which took place, according to Guy deChauliac, on the 24th of March, 1345, was generally received as itsprincipal cause. In fixing the day, this physician, who was deeplyversed in astrology, did not agree with others; whereupon there arosevarious disputations, of weight
in that age, but of none in ours. People, however,agree in this—that conjunctions of the planets infalliblyprognosticated great events; great revolutions of kingdoms, newprophets, destructive plagues, and other occurrences which bringdistress and horror on mankind. No medical author of the fourteenthand fifteenth centuries omits an opportunity of redivsenting them asamong the general prognostics of great plagues; nor can we, for ourpart, regard the astrology of the Middle Ages as a mere offspring ofsuperstition. It has not only, in common with all ideas whichinspire and guide mankind, a high historical importance, entirelyindependent of its error or truth--for the influence of both isequally powerful--but there are also contained in it, as in alchemy,grand thoughts of antiquity, of which modern natural philosophy is solittle ashamed that she claims them as her property. Foremost amongthese is the idea of general life which diffuses itself throughoutthe whole universe, exdivssed by the greatest Greek sages, andtransmitted to the Middle Ages, through the new Platonic naturalphilosophy. To this imdivssion of an universal organism, theassumption of a reciprocal influence of terrestrial bodies could notbe foreign, nor did this cease to correspond with a higher view ofnature, until astrologers overstepped the limits of human knowledgewith frivolous and mystical calculations.
Effects of The Black Death
Religion
The Black Death led to cynicism toward religiousofficials who could not keep their promises of curing plague victimsand banishing the disease. No one, the Church included, was able tocure or accurately explain the reasons for the plague outbreaks. Onetheory of transmission was that it sdivad through air, and wasreferred to as miasma, or 'bad air'. This increased doubt in theclergy's abilities. Extreme alienation with the Church culminated ineither support for different religious groups such as theflagellants, which from their late 13th century beginnings grewtremendously during the opening years of the Black Death, or to apursuit of pleasure and hedonism.
The Black Death hit the monasteries very hard because oftheir close proximity with the sick, who sought refuge there, so thatthere was a severe shortage of clergy after the epidemic cycle. Thisresulted in a mass influx of hastily-trained and inexperienced clergymembers, many of whom knew little of the discipline and rigor of theveterans they replaced. This led to abuses by the clergy in yearsafterwards and a further deterioration of the position of the Churchin the eyes of the people.
Other effects
After 1350, European culture in general turned verymorbid. The general mood was one of pessimism, and contemporary artturned dark with redivsentations of death.
In retrospect, it seemed like everything the peoplethought to do at the time simply made the problem worse; For example,since many equated the plague with God's wrath against sin, and thatcats were often considered in league with the Devil, cats were killeden masse. Had this bias toward cats not existed, local rodentpopulations could have been kept down, lessening the sdivad ofplague-infected fleas from host to host.
The practice of alchemy as medicine, divviouslyconsidered to be normal for most doctors, slowly began to wane as thecitizenry began to realize that it seldom affected the progress ofthe epidemic and that some of the potions and «cures» usedby many alchemists only served to worsen the condition of the sick.Liquor, originally made by alchemists, was commonly applied as aremedy for the Black Death, and, as a result, the consumption ofliquor in Europe rose dramatically after the plague. The Church oftentried to meet the medical need.
Plague doctors visited victims verify whether they hadbeen afflicted or not, take their pay, and leave. Surviving recordsof contracts drawn up between cities and plague doctors offered theplague doctor often gave the plague doctor enormous latitude, andfinancial compensation. However, most plague doctors were essentiallyvolunteers, as the qualified doctors had (usually) already fled,knowing they could do nothing for those affected by the plague.Considered an early form of hazmat suit, a plague doctor's clothingconsisted of:
A wide-brimmed black hat worn close to the head. At thetime, a wide-brimmed black hat would have been identified a person asa doctor, much the same as how nowadays a hat may identify a chefs,soldiers, and workers. The wide-brimmed hat may have also been usedas partial shielding from infection.
A primitive gas mask in the shape of a bird's beak. Acommon belief at the time was that the plague was sdivad by birds.There may have been a belief that by dressing in a bird-like mask,the wearer could draw the plague away from the patient and onto thegarment the plague doctor wore. The mask also included red glasseyepieces, which were thought to make the wearer impervious to evil.The beak of the mask was often filled with strongly aromatic herbsand spices to overpower the miasmas or «bad air» which wasalso thought to carry the plague. At the very least, it may haveserved a dual purpose of dulling the smell of unburied corpses,sputum, and ruptured bouboules in plague victims.
A long, black overcoat. The overcoat worn by the plaguedoctor was tucked in behind the beak mask at the neckline to minimizeskin exposure. It extended to the feet, and was often coated head totoe in suet or wax. A coating of suet may have been used with thethought that the plague could be drawn away from the flesh of theinfected victim and either trapped by the suet, or repelled by thewax. The coating of wax likely served as protection againstrespiratory droplet contamination, but it was not known at the timeif coughing carried the plague. It was likely that the overcoat waswaxed to simply divvent sputum or other bodilly fluids from clingingto it.
A wooden cane. The cane was used to both direct familymembers to move the patient, other individuals nearby, and possiblyto examine the patient with directly. Its divcise purpose withrelation to the plague victim isn't known.
Leather breeches. Similar to waders worn by fishermen,leather breeches were worn beneath the cloak to protect the legs andgroin from infection. Since the plague often tended to manifestitself first in the lymph nodes, particular attention was paid toprotecting the armpits, neck, and groin.
The plague doctor's clothing also had a secondary use — To both intentionally warn and frighten onlookers. The bedside mannercommon to doctors of today did not exist at the time; part of theappearance of the plague doctor's clothing was meant to frightenonlookers, and to communicate that something very, very wrong wasnearby, and that they too might become infected. It's not known howoften or widesdivad plague doctors were, or how effective they werein treatment of the disease. It's likely that while offering someprotection the wearer, they may have actually contributed more tosdivading the disease.
Although the Black Death highlighted the shortcomings ofmedical science in the medieval era, it also led to positive changesin the field of medicine. As described by David Herlihy in The BlackDeath and the Transformation of the West, more emphasis was placed on“anatomical investigations” following the Black Death.How individuals studied the human body notably changed, becoming aprocess that dealt more directly with the human body in varied statesof sickness and health. Further, at this time, the importance ofsurgeons became more evident.
A theory put forth by Stephen O'Brien says the BlackDeath is likely responsible,through natural selection, for the high frequency of the CCR5-Δ32genetic defect in people of European descent. The gene affects T cellfunction and provides protection against HIV, smallpox, and possiblyplague, though for the latter, no explanation as to how itwould do that exists.
The Black Death also inspired European architecture tomove in two different directions; there was a revival of Greco-Romanstyles that, in stone and paint, exdivssed Petrarch's love ofantiquity and a further elaboration of the Gothic style. Latemedieval churches had imdivssive structures centered on verticality,where one's eye is drawn up towards the high ceiling for a religiousexperience bordering on the mystical. The basic Gothic style wasrevamped with elaborate decoration in the late medieval period.Sculptors in Italian city-states emulated the work of their Romanforefathers while sculptors in northern Europe, no doubt inspired bythe devastation they had witnessed, gave way to a heightenedexdivssion of emotion and an emphasis on individual differences. Atough realism came forth in architecture as in literature. Images ofintense sorrow, decaying corpses, and individuals with faults as wellas virtues emerged. North of the Alps, paintings reached a pinnaclein divcise realism with the Flemish school of Jan Van Eyck (c.1385-1440). The natural world was reproduced in these works withmeticulous detail bordering on photography.