CAROL SYMES CAROL EXECUTIVE EDITOR THE MEDIEVAL GLOBE THE MEDIEVAL
PANDEMIC DISEASE IN THE MEDIEVAL WORLD RETHINKING THE BLACK DEATH
Edited by MONICA H. GREEN THE MEDIEVAL GLOBE
The Medieval Globe provides an interdisciplinary forum for scholars of all world areas by focusing on convergence, movement, and interdependence. Con need not encompass the globe in any territorial sense. Rather, TMG advances a newtributions theory to and a global praxis understanding of medieval studies of the medievalby bringing period into (broadlyview phenomena defined) that have been rendered practically or conceptually invisible by anachronistic boundaries, categories, and expectations. TMG also broadens discussion of the ways that medieval processes inform the global present and shape visions of the future.
Executive Editor Carol Symes, University of Illinois at Urbana-Champaign
Editorial Board James Barrett, University of Cambridge Kathleen Davis, University of Rhode Island Felipe Fernández-Armesto, University of Notre Dame Elizabeth Lambourn, De Montfort University Yuen-Gen Liang, Wheaton College Victor Lieberman, University of Michigan at Ann Arbor Carla Nappi, University of British Columbia Elizabeth Oyler, University of Illinois at Urbana-Champaign Christian Raffensperger, Wittenberg University Rein Raud, University of Helsinki & Tallinn University D. Fairchild Ruggles, University of Illinois at Urbana-Champaign Alicia Walker, Bryn Mawr College
Volume 1 PANDEMIC DISEASE IN THE MEDIEVAL WORLD RETHINKING THE BLACK DEATH
Edited by MONICA H. GREEN Copyeditor Shannon Cunningham
Editorial Assistant Ann Hubert
Page design and typesetting Martine Maguire-Weltecke
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ISBN 978-1-942401-00-1 e-ISBNwww.arc-humanities.org 978-1-942401-01-8 CONTENTS
List of Illustrations...... vii
Preface – The Black Death and Ebola: On the Value of Comparison Monica H. Green ...... ix
Introducing The Medieval Globe Carol Symes ...... 1
Editor’s Introduction to Pandemic Disease in the Medieval World: Rethinking the Black Death Monica H. Green ...... 9
Taking “Pandemic” Seriously: Making the Black Death Global Monica H. Green ...... 27
The Black Death and Its Consequences for the Jewish Community in Tàrrega: Lessons from History and Archeology Anna Colet, Josep Xavier Muntané i Santiveri, Jordi Ruíz Ventura, Oriol Saula, M. Eulàlia Subirà de Galdàcano, and Clara Jáuregui......
63 The Anthropology of Plague: Insights from Bioarcheological Analyses of Epidemic Cemeteries Sharon N. DeWitte ...... 97
Plague Depopulation and Irrigation Decay in Medieval Egypt Stuart Borsch...... 125
Plague Persistence in Western Europe: A Hypothesis Ann G. Carmichael ...... 157 vi
NewCONTENTS Science and Old Sources: Why the Ottoman Experience of Plague Matters Nükhet Varlık......
193 Heterogeneous Immunological Landscapes and Medieval Plague: An Invitation to a New Dialogue between Historians and Immunologists Fabian Crespo and Matthew B. Lawrenz ...... 229
The Black Death and the Future of the Plague Michelle Ziegler...... 259
Epilogue: A Hypothesis on the East Asian Beginnings of the Yersinia pestis Polytomy Robert Hymes ......
285 featured source Diagnosis of a “Plague” Image: A Digital Cautionary Tale Monica H. Green, Kathleen Walker-Meikle, and Wolfgang P. Müller. . . .
309 Index......
327 LIST OF ILLUSTRATIONS
Figures
Figure 1. Overview of the Communal Graves......
...... 73
Figure 2. Communal Grave (FS) 161...... 7475
Figure 3. Communal Grave (FS) 163...... 76
Figure 4. Communal Grave (FS) 54 ...... 77
Figure 5.6. Communal Grave (FS) 162......
Figure 7. Communal Grave (FS) 164...... 7879 CommunalDetail of a Communal Grave (FS) Grave166 Containing Primary and Secondary Deposits...... Figure 8. Figure 9. Bodies Lacking Feet...... 84
Figure 10. Example of Cranial Injury ...... 85
Figure 11. Example of Skeletal Injury ...... 87
Figure 12. Cranial and Skeletal Injuries to a Single Individual...... 87 89 Plates
Plate 1. Phylogenetic Tree of Yersinia Pestis......
. . 37 Plate 2. Lancing a Bubo (ChapelOmne bonum of Saint-Sébastien,. London, British Lanslevillard) Library, 230 ...... Plate 3. James le Palmer, MS Royal 6 E VI, vol. 2, fol. 301rb (detail) 310 Graphs
over Time as Measured against a Scaled Curve for Cairo. . . . . Graph 1. Al-Maḥallat al-Kubrā in 1460 CE: Graph of Plague Deaths 134 Graph of Rising Death Toll over Time...... Graph 2. Al-Maḥallat al-Kubrā in 1460 CE: 134 viii
LIST OF ILLUSTRATIONS ...... Graph 3. Minuf ‘Ulyā in 1407 CE: Graph of Estimated Plague Deaths over Time (as Measured against. Cairo. . . . Curve)...... 135 Graph 4. Estimated Agrarian Output of Egypt 148 Data Based on Wills and Testaments...... Graph 5. The Plague in London (1349–1361–1375): Graph 6. Proposed Multifactorial Model for Understanding the Impact246 of Biological, Ecological, and Social Factors on Human Immune Competence before, during, and after Plague Outbreaks. . . . . 251
Maps
Map 1. Egypt’s Nile Delta Showing Plague Outbreaks and the Principal Sultani Irrigation Canals......
Map 2. Flood Canals in Upper Egypt, c ...... 131
. 1800 ...... 136 Map 3. The Province of Buḥayra Showing Sultani Canals 149 ...... Map 4. Locales in the Southern Alps Reporting Plague Outbreaks to Milan (Spring 1567) ...... 163
Map 5. Distribution of Genetic Variants for IFN γ (+874) ...... 241 Map 6. Distribution of Genetic Variants for IL-10 (-1082) . 243 Tables
......
Table 1. Plague Outbreak of 1403...... 133
Table 2. Plague Outbreak of 1430...... 133 Table 3. Plague Outbreak of 1460 133 Compared to Nineteenth-Century Data...... Table 4. Fifteenth-Century Data on Number of Workers Table 5. Dike Lengths and Volume of Earthwork...... 139
Table 6. Estimated Agrarian Production over Time...... 141
...... 147 Table 7. States of “China,” 976–1644 286 PREFACE THE BLACK DEATH AND EBOLA: ON THE VALUE OF COMPARISON
MONICA H. GREEN
It was as if the voice of existence in the world had called out for oblivion and restriction, and the world had responded to its call.
Ibn Khaldun, d. 1406
make up Pandemic Disease in the Medieval World: Rethinking the Black Death The essays that to press a year later. Little did grew we know out of that dialogue by the first time begun the volume in 2009. would The volume itself began to come together in the spring of 2013 and was sent tious disease would have taken such an abrupt turn. At the time of this appear in November 2014, the world’s relationship to epidemic infec twenty-one thousand cases and taken over eight thousand lives.1 Declared writing, the 2014 West African Ebola epidemic has already caused over a Public Health Emergency of International Concern on August 8, 2014 by the World Health Organization (WHO), the Ebola outbreak prompted breaka United a “threat Nations to international(UN) Security peace Council and meeting security,” several garnering weeks the later. highest At levelthat session of support on Septemberin the history 18, of the the resulting organization. UN resolution The West called African the Ebola out outbreak has disrupted the economies and trade relations of countries in West Africa and beyond. It has decimated the already strained healthcare personnel of the three most affected countries. It has left hundreds of chil dren orphaned and disrupted the education and welfare of many thou sands more. For the families whose loved ones make up those statistics, no relativizing of numbers can offer solace. From the perspective of the devastated countries of Guinea, Sierra Leone, and Liberia, the Tunisian historian Ibn Khaldun’s bleak assessment of the world after the Black Death could just as well have been written today.
1
I will refer to this as the 2014 outbreak, even though evidence suggests it began in late 2013 and, at the time of writing, gives every sign of continuing well into 2015.ix–xx The Medieval Globe 1 (2014) pp. x
PrefPlagueACE is not Ebola Virus Disease. Many of the easy parallels that were
outbreak and the medieval Black Death were exaggerated or careless. In severaldrawn inrespects, the popular Ebola pressis better in mid-2014compared betweento other diseases. the unfolding The current Ebola demic, whose intercontinental spread was also abetted by airline travel; or theEbola ongoing epidemic HIV/AIDS has brought pandemic, back whichmemories has beenof the surrounded 2002–2003 by SARS intense epi debates about drug development and ethical provision of treatment.
cholera, though this virus is fragile in the extreme compared to the hardy bacterium,In its mode which of transmission thrives in openvia human brackish bodily water. fluids, In its Ebola current is similar form—a to virus passing directly from one human to another—Ebola more closely resembles smallpox, which made its zoonotic leap into humans several thousand years ago. Nevertheless, with comparable case fatality rates and rapid progress from infection to death, plague and Ebola elicit a terror few other infectious diseases have produced. With this re-issue of our essays in book form, it will be good to set the Black Death—or really, the Sec ond Plague Pandemic in all its immensity—into a larger context. And in that task, comparisons with the current Ebola outbreak are indeed useful, both for better understanding our collective past and for anticipating our common future.
If a Tree Falls? Invisible Pandemics tial growth were being made on the basis of mathematical modeling. One In August through October of 2014, dire predictions of Ebola’s exponen
particularly alarming model, released 23 September, predicted that the cases—fueledepidemic might by reach the 1.4documented million cases transfer by January of the 2015, disease in Sierra to Nigeria Leone lateand Liberiain July, followedalone (Meltzer by a similar et al. 2014). case thatSimilarly, reached predictions the United of exportedStates in September—raised fears of outbreaks not simply elsewhere in Africa, but in large population centers in Asia and Latin America, which might not have the public health infrastructure to identify and contain new cases. The West African Ebola epidemic has not, as of this writing, become a pandemic. But it certainly had the potential to become one. And that is the more important point. All pandemics start as local outbreaks. In the case of the West African Ebola epidemic, it is now understood to have started as early as December
2013 in a rural area of Guinea (Baize et al. 2014; Saéz et al. 2014/2015). It was not until March 2014 that the outbreak was officially acknowledged, xi and then only because the alarum had been raisedThe byBla localck De doctorsath an dand Eb olathe international medical charity, Médecins Sans Frontières (Doctors Without malaria. In the early, “silent” phase of transmission—when deaths were mountingBorders), whichbut no alreadydiagnosis had had a presencebeen made in toGuinea link them to treat to Ebola—the HIV/AIDS anddis ease was able to establish itself in three countries. A major objective of the present volume is to make the radical claim that the Second Plague Pandemic likely had “silent” phases, too. As awful as we have always thought the Black Death to be, the essays in this volume argue that it was likely even worse, because its full geographical or chron ological extent had never before been conceptualized. As Robert Hymes recounts in his essay here, many historians of China have long doubted whether plague was even present in medieval China. That debate is sure to continue, but it now has to take seriously the implications of the phy logenetics of Yersinia pestis, which point strongly not simply to Y. pestis’s origins in regions that now fall within China’s western borders, but also to a sudden evolutionary divergence of the organism around the thirteenth century. Just as historians of late antiquity have only recently realized how profound a role plague may have played in weakening the Roman Empire reason to suspect that it, too, had periods not simply when it was moving through(see particularly wild animal Mitchell communities 2014), so with with little the orBlack no humanDeath weinvolvement, now have but also periods when it produced human outbreaks that we have failed to recognize as indications of epidemic disease. As we fully acknowledge here, to date we have no explanation for how plague might have moved across central Eurasia in the thirteenth and early fourteenth centuries.2 And its postulated presence in sub-Saharan Africa still demands full inves tigation. ume, careful3 gathering and sifting of local historical data can produce evi dence suggestive But as both of plague’s Ann Carmichael stealthy focalization and Nükhet in Varlık new ecological show in this niches. vol
2
Despite the rapid growth of Mongol studies in the past two decades (Biran 2013), the few scholars who have engaged with the question of plague simply repeat findings from McNeill 1976 or draw on western sources; an exception is Schamiloglu (1993). Aside from Buell (2012) (who denies that there were any significant outbreaks of human engagementplague in Mongol with the China) genetics and research Hymes (inon Y.this pestis volume, by historians who asserts of Central that Asia.there were several, pushing their presence back to the thirteenth century), there has as yet been no 3 After these essays originally went to press, I discovered that Gérard Chouin, now at the College of William and Mary, has taken his earlier suggestions about the possibility of a Black Death impact in late medieval West Africa and expanded them into a full research project. See Chouin 2013. xii
PrefACE notice. But what if something like the Ebola outbreak had started a hun dredRelatively years earlier, speaking, before the cell 2014 phones Ebola and outbreaksatellites anddid thenot Internet?long escape We don’t know how old Ebola Virus Disease is, and have no way of knowing right now whether it has caused any large-scale human outbreaks prior to ever, the possibility of silent epidemics, or even pandemics. We already itsknow, official from biomedical the reconstructed discovery history in 1976. of We the do early not decadeshave to imagine, of HIV/AIDS, how how a local disease can become a pandemic—invisibly. HIV/AIDS did Pneumocystis carinii pneumo nianot inbegin Los Angeles.in 1981, Rather,when the it began first study in Cameroon by the Centers around 1920for Disease and spread Con soontrol described thereafter five to Leopoldville cases of unexplained in the Belgian Congo (now Kinshasa in the
Democratic Republic of the Congo) and beyond (Faria et al. 2014). By the peopletime the were first already published infected. clinical descriptions appeared in 1981, the virus had already spread to all five inhabited continents and at least a million Animal and Human Origins ing that many infectious diseases are of zoonotic origin. In some cases, Boththose plague viruses and or the microbial 2014 Ebola pathogens outbreak have reflect been our long recent 4accustomed understand to their animal hosts and cause only minimal disease. Once transferred into humans, however, these viruses or microbes become merciless killers. Ebola and plague are zoonotics in different senses, of course. Like HIV/ AIDS,5 the current West African Ebola outbreak seems to have arisen from one animal-to-human transfer of the virus, and then took off in a series of continued human-to-human transfers because of shared practices of care
contrast, can only maintain short bursts of human-to-human transfer and thentaking only in the under home two or conditions: preparations either for burial in the (Gire form et of al. septicemic 2014). Plague, plague, in when certain medical interventions—such as lancing of buboes (see the
4
zoonoticMorse origin.and colleagues (2012) estimate that roughly 80% of viruses, 50% of bacteria, 40% of fungi, 70% of protozoa, and 95% of helminths that infect human beings are of 5 I am referring here, of course, only to HIV-1, Group M, which has been responsible for the global pandemic and which, according to current understanding, passed to humans via a single transmission from a Pan troglodytes troglodytes chimpanzee. On
the Ebola virus, see Baize et al. 2014 and Gire et al. 2014. xiii
The Black Death and Ebola caretaker; or, as a more common mode, in the form of pneumonic plague, whenimage theon p.plague 230 of bacterium this volume)—can is transferred transmit in aerosolized the disease form from from patient a per to
However,son with infiltrated if we think lungs of plague to others not notas a yet single infected. organism Needing but crowdedas an ecologi (and caloften package—the cold) conditions, rodent pneumonic-arthropod plague-bacterium outbreaks nexus—then burn out situations quickly. that bring that package into close, commensal relationships with human populations can create sustained human disease at the population level. For both diseases, therefore, the potential to tap into human networks of communication is what allows them to turn from small outbreaks into widely disseminated diseases.
likely already present in the animal populations of at least twenty-two A study that appeared in September 2014 suggested that Ebola was as the main transmitters of the Ebola virus, bats are the likeliest sus African countries (Pigott et al. 2014). Although not yet definitively proven the disease across wide regions is distinctive. That Ebola was already a diseasepect (Saéz “underfoot” et al. 2014/2015); across wide as swathsflying animals, of Central their Africa ability was, to of transmit course, already known, a fact underscored by the second outbreak in the Demo leagues,cratic Republic and by of all the other Congo accounts in 2014, of which the Ebola caused outbreak sixty-six in cases, West includ Africa ing forty-nine deaths (WHO 2014). However, unnoticed by Pigott and col the late 1970s already documented that individuals in Liberia and Sierra Leonein the carriedsummer antibodies and fall of to 2014, Ebola was in their the blood.fact that It would studies seem, going therefore, back to that Ebola was already widely disseminated in animal populations in sub-
similar outbreaks to occur so long as animals infected with the virus are consumedSaharan Africa for food. (including6 West Africa) prior to 2013, and it is possible for Even before extensive genetics studies were done of the Ebola virus
circulating in West Africa, it was noted that the 2014 disease outbreak 6
Van der Waals et al. (1986) and Knobloch et al. (1982), neither of which were cited by Schoepp et al. (2014), which found nearly comparable levels of seroprevalence ofthat Ebola major antibodies. die-offs were Cf. Becquart occurring et from al. (2010) Ebola infor primate a similar populations study of Gabon in West based Central on samples taken in 2006–08. Importantly, scientists have noted for more than a decade no evidence of such die-offs in primate or other non-bat populations in the area of Africa; see Muyembe-Tamfum et al. 2012. Saéz et al. (2014/2015), however, found
Guinea where the 2014 outbreak is thought to have begun. xiv
wasPref differentACE from all previous ones, moving faster and into larger popu lations. But this is not because the virus those strains that had already caused several dozen outbreaks across Cen was significantly different from Africa was different. In seeking to understand what sparked the initial zoonotictral Africa transfer, since 1976; questions rather, have the 2014been outbreakraised as wasto whether different new because agri cultural practices or other interventions have disrupted ecosystems in West Africa, making certain kinds of human-animal contact more likely
(Wallace et al. 2014). More significantly, it has been noted that Africa in Whereas2014 was earlier different outbreaks from Africa had occurred in 1976 inmostly that therein isolated was greater rural regions, socio- whereeconomic there diversity were few and cars new or kinds other of connections interconnectivity to major (Osterholm population 2014). cen
urban areas, which in turn facilitated further spread both near and far. ters,Plague, the 2014 too, outbreakis now “underfoot” was characterized in many regionsby its quick of the linkage world. to How large it
but because the micro-environments which Yersinia pestis demands—the rodentcame to-arthropod be so was not-bact (soerium far as nexus—managed we know) because to of hook transmission into human by bats,net
That has happened at least three times in history, and (to judge from the works supporting the material exchange7 To of what goods extent (grain, the textiles, three known furs). plague pandemics—the Justinianic (so-called because it seemed to begin surviving genetic evidence) likely more.
in 541 CE, during the reign of the Roman emperor Justinian), the Second intensityPandemic by (commencing changing climate with theconditions Black Death), has not and yet the been Third pinned Pandemic down, (commencing in the mid-nineteenth century)—were all magnified in their
Justinianicthough evidence Plague is and mounting the Black for Death,a major the climatic climate element element in did the not first cause two thecataclysms pandemics. (Sarris Rather, 2012; it Campbellseems to have2013; served Brooke as 2014). an amplifier But for ofboth condi the
CE, which was followed by several years of cold weather and darkened skies,tions thatcan bewere called already the precipitator in the making. of the Even plague if the epidemics dust-veil that event broke of 536 out around the Mediterranean, that still does not explain how Yersinia pes- tis had already managed to wend its way from the Qinghai-Tibet Plateau into nearby territories like the kingdom of Aksum (encompassing parts of
7 Yersinia pestis, and also
tionSee of below,the so- calledpp. 40–41, MEDIEVALIS on the so-called strain across “Angola” much strain of Eurasia. of pp. 14, 39, 43n21, 199n12, 200n16, and 208n30, on the still unexplained dissemina xv
modern Yemen, Ethiopia, and neighboring statesThe at Bla theck mouth Death ofan thed Eb Redola
Sea), which was one of the main trading hubs linking Indian Ocean trade with that of the Mediterranean basin in the fifth and sixth centuries (Gebre sionSelassie of plague2011; Seland into new 2014). European Even if andthe extremeMediterranean weather environments, that Campbell (2013) has now documented for the 1340s precipitated the sudden explo plague in the European Alps as the chill of the Little Ice Age took hold, as and (if we can extrapolate) facilitated the focalization and persistence of we still must look at the extreme warfare, more than one hundred years earlierCarmichael in an suggests entirely differentin this volume, part of Hymesthe Eurasian (also thiscontinent, volume) to seesuggests what forces nudged Yersinia pestis out of its marmot burrows. And as Harrison
of(2012) trade has have documented continued to for play plague their and role. several other epidemic diseases thatWhether terrorized climate the world change in hasthe pastplayed five a hundredrole in the years, two humandozen Ebola networks out breaks known to have occurred since 1976 is not at all clear. Neverthe less, in assessing the pandemic potential of both diseases, we have to look to common human practices that facilitate disease transmission and the ways that local practices can connect to global networks. Seemingly inno cent practices of human provision—eating bats or chimpanzees and hunt ing marmots, whether for food or for furs—have created conditions ripe for disease transfer. But those individual circumstances of disease trans fer only develop pandemic potential when they are linked to wider net works of human exchange.
Comparing Crises The time is not yet ripe for a historical post-mortem on all we have seen in terms of political posturing, economic collapse, or human bravery and demic. Nor was Pandemic Disease in the Medieval World: Rethinking the Blackcompassion Death in the past few months of the 2014 West African Ebola epi not a general summary of the later medieval plague pandemic. The reader conceived specifically for comparative purposes, since it is social catastrophe narrated by Boccaccio and his contemporaries. We do notwill offerfind herean account no definitive of the history estimates of quarantine of total mortality nor, indeed, or rehearsals do we have of much to say about the history of medical remedies for plague. Rather, we present this as an opportunity to think through, in a new way, what it really means for infectious disease to emerge or re-emerge—to move quickly and widely through human populations which are never (whatever we like
to think to the contrary) wholly divorced from their ecological landscapes. xvi
PrefThereACE is an important trend now in historical studies: not only to move analysis beyond the limits of the nation-state and even the human organ ism, but also to move it into deeper time scales. Although some diseases
(like malaria and various kinds of parasites) have likely been with humans for many millennia (e.g., Webb forthcoming), increasing congregations of human populations into urban settlements have amplified the impact of frominfectious that history diseases of increasingin a shorter urbanization timescale, perhaps and the networkingsome 4,000 of to human 6,000 communitiesyears, in both throughthe Old Worldlong-distance and the trade.New. No Granted, definitive the shiftrevolution separates in sci us
late nineteenth-century revelations of germ theory did put us on a whole newentific footing understanding with respect of infectious to understanding diseases infectiousbrought about disease. by theBut great only
Malaria and tuberculosis are still high on the list of the world’s killers; plague,one infectious as we havedisease noted, has issince embedded been thoroughly in the landscapes eradicated of (smallpox).four conti nents, still regularly producing outbreaks in Madagascar, Peru, Vietnam, Central Africa, and China; cholera still rears its head in any number of places, most recently in Haiti and Ghana. And for all of these diseases, antibiotic resistance is weakening the arsenal of defenses we have. Ebola’s
in any way be dismissed. Rather, we should think of this as a real-time les “small”son in how numbers local diseases or (currently) become limited global. geography should not, therefore, Recent comparisons of Ebola and plague have often been accompa nied by an implicit shudder of horror: “How medieval.” Yes, the practice of quarantine—so discredited when it was invoked by the Liberian gov
many other nations as they closed their borders to travellers from West Africaernment and in cutAugust off air 2014 transport—is in its own capitalmedieval of Monrovia,in its origins, and evenimplicitly if prac by tices of segregation and exclusion of suspected infectious persons are
calls to mind the chilling stories of the Black Death’s devastation. When Centersmuch older for Disease(Grmek Control1980). Yes,director the sight Thomas of bodies Frieden being described piled in the streets situ
be forgiven for apparently eliding the description of hell in the Inferno (whichation in was West written Africa morein October than a2014 quarter as “something century before out ofthe Dante,” arrival he of canthe
would describe several decades later. But this derogatory deployment of Black Death in Europe) with the hellish8 scenes Dante’s Italian kindred 8
Sun et al. 2014: “Frieden had seen plenty of death over the years, but this was far worse than he expected, a plague on a medieval scale. ‘A scene out of Dante,’ he called it.” xvii
“the medieval” does not get us very far. UniversitiesThe Bla arec k“medieval,” Death and too, Ebola as are public health regulations, autopsies, and the licensing of medical prac titioners. The presence of a highly sophisticated biomedical infrastructure in the later twentieth century did not stop the HIV/AIDS pandemic from journal that gave birth to these essays, The Medieval Globe, was founded toexploding, ask what and it meansit has notfor (yet)the Middle stopped Ages the tocurrent stop being Ebola “Other” outbreak. and The to become knowable. With climate change, among other factors, pushing the homeostasis of our own world out of balance, the past—which is the only knowable guide we have to the future—merits revisiting.
* * *
My thanks to Robert and Saul Hymes for their very helpful suggestions. Once again, let me take this opportunity to thank Carol Symes, founding executive editor of The Medieval Globe, for taking a leap of faith in agree ing to let this volume inaugurate the journal. Thanks as well to Simon Forde and all the production staff at Arc-Medieval Press. Phoenix, Arizona
13 January 2015 xviii
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PrefmentsACE in Human History, ed. Michael Petraglia and Nicole Boivin (Cambridge:
Cambridge University Press) WHO (World Health Organization). 2014. “Ebola Response Roadmap Situation 9Report” Months (October of the Epidemic 31) and Forward Projections,” New England Journal of WHOMedicine Ebola Response Team. 2014. “Ebola Virus Disease in West Africa — The First
Monica H. Green medicine and global health. In 2009 and 2012, she ran a National Endowment for the Humanities Summer ([email protected]) Seminar in London on is “Healtha historian and of Disease medieval in the European Middle
and humanistic disciplines could engage in productive dialogue about the his Ages,”tory of which disease had and as health its central-seeking goal behaviors. the exploration During of this ways same that period, the scientific she has
speciesalso argued since for its the origin development up to the ofpresent a new day,field, and “Global the ways History that of human Health,” cultural which changesexplores havethe evolutionfacilitated of or the hindered major pathogensthose pathogens’ that have trajectories. afflicted Inthe addition human to many works on the cultural history of medieval medicine, she is the author of “The Value of Historical Perspective,” in The Ashgate Research Companion to the Globalization of Health and “The Globalisations of Disease,” which will be published in 2015. , ed. Ted Schrecker (Aldershot: Ashgate, 2012), pp. 7–37; Abstract grown insensitive to the threat of major epidemic infectious disease outbreaks. Looking forThe analogies, 2014 West popular African media Ebola that epidemic year often shocked invoked a the world Black that Death had as a comparison. In this preface to the book edition of Pandemic Disease in the Medieval World: Rethinking the Black Death, it is argued that while most of the extreme comparisons of the Black Death and Ebola were unhelpful, the largest pandemic in human history can be used comparatively to think through certain frameworks of global health and emerging disease analysis. All pandemics start as local outbreaks. Studying the processes by which local outbreaks (often invis
focuses our attention on the contingent historical circumstances that can move microorganismsible in their early through phases) vast grow human into networks disease events of contact of major and exchange. historical import
Keywords Plague Pandemic, HIV/AIDS, zoonoses pandemics, global health, 2014 West African Ebola epidemic, Second INTRODUCING THE MEDIEVAL GLOBE
CAROL SYMES
sive Indies, he was guided by two favorite books. We know one as The WhTravelsen aof certMarcoain Polo Genoese: the product mariner of sailed a collaboration southward to between find the thatelu Venetian merchant-adventurer and his cellmate in a Genoese prison, a purveyor of popular romances named Rustichello of Pisa. This book was
Italian,” but it was soon circulating widely in many different languages andcomposed editions. around (There 1298, is no in “original” a literary text;creole the designated copy owned today and as annotated “Franco- by that famous mariner was a later Latin translation.1
the middle of the fourteenth century, in the French dialect) The then other prevalent book, inattributed England. to It, one too, Johan survives (or John)in numerous de Mandeville, variants, was none published of which around is the “original” text. In its own time, the former work was often titled Le devise- ment du monde Le livre des merveilles Il milione also known as Le (The livre Descriptiondes merveilles of . the World), (The Book of Marvels), or (The Million). The latter work was characteristics: authorial and linguistic indeterminacy, a tangled history of transmissionAlong with their and titles,reception, these the influential tendency texts to imprint share some ancient other imaginar salient ies on a mesh of contemporary fantasy and observation. What were these books supposed to be about? How were they understood by generations of readers? To what extent do they constitute evidence for contemporary worldviews? Such questions are open to debate. In essence, these books are not travel narratives or practical manuals: they are mises-en-abyme. The mysterious conditions of their making underscore the challenges of culty, even, of talking about that world in terms that mirror its own con ceptualknowing categories. anything about(“Franco the-Italian,” world they “the purportFrench dialectto describe—the of England,” diffi the
many readers before me, I have drawn inspiration from one of these books. literary work as a fixed entity: all of these are anachronisms.) Yet like so
1
It is now in the library of the Institución Colombina in Sevilla (Spain). For an excellent introduction to this multi-layered text, see Gaunt (2013). See also Kinoshita (2013), whose new annotated translation of the text is forthcoming. On the reasons for the southerly course charted by Columbus, see Wey Gómez (2008). 1– The Medieval Globe 1 (2014) pp. 8 2
CarolOn Sythismes topic, I’ve many times recalled something I heard when I was young, about how a brave man once left our parts in order to explore the world. So he passed through India and the islands beyond India (where
land—so far around the world for so many seasons—that he found an islandthere are where more he than heard five his thousand own language islands) spoken, and went and evenso far heard by sea the and oxen by being called in the very same words as in his own country, so that he was much amazed. Because he did not know how that could ever be. But I say that he had gone so far by land and by sea that he had gone around the whole earth, that he had come right back around to his own borders. And if he had only gone a bit further on, he would have found his own lands and his own knowledge. But he went all the way back the way he had come and so lost much of his effort, just as he himself said, a great while 2
Thisafter, story when captures he finally the returned. alienation experienced by anyone who ventures beyond the bounds of homely knowledge. It warns that my own neighbor hood will come to seem so strange, in a global context, that I won’t recog nize it. But it also holds out hope that I’ll achieve, in time, a broader vision. The Medieval Globe is dedicated to exploring varieties of connectivity, communication, and exchange during a period central to human history: the millennium or so prior to 1500. It is an interdisciplinary journal for all scholars studying any aspect of this era, including those who work in parts of the medieval world that may seem well trodden and familiar (in
encompass the globe in any territorial sense. Rather, The Medieval Globe seeksmy case, to advanceWestern aEurope). new theory A global and approachpraxis of tomedieval medieval studies studies by need encour not aging the investigation of phenomena that have been rendered practically or conceptually invisible by modern categories and expectations: move
2 “Et pur ceo m’ad il souvenuz mointefoiz d’une chose qe jeo oÿ compter quant jeo fuy jeovenes, comment un vaillant homme s’em party jadis de noz parties pur aler ceercher le mounde. Si passa Ynde et les isles outre Ynde ou il y a plus de Vm isles, et tant ala par mer et par terre et tant envirouna le mounde par mointes saisouns q’il troeva un isle ou il oÿ parler soun langage et toucher les boefs en disant tieles paroles come l’em fait en son pays don’t il s’enmerveilla moult. Qar il ne savoit coment ceo poait estre. Mes jeo dy q’il avoit tant irré par terre et par mer q’il avoit environé toute la terre, qu’il estoit revenuz envyronant jusqes a ses marches, et s’il vousist avoir passé avant q’il eust troevé et son pays et sa connaissance. Mes il retorna ariere par illecques ou il estoit venuz, si perdy assez de ses peines si come il mesmes le disoit un c On the manuscript history and variants of this text, see the editorial introduction of grand piece après q’il fust revenuz”c (Mandeville [ . 1357]/2000: 337, my translation).
Christiane Deluz (Mandeville [ . 1357]/2000: 28–84). the Medieval globe 3 introducing forms of agency, systems of belief. This enterprise has the potential to expandments, networks,our understanding interactions, of long affinities,-term global borrowings, developments ways whileof knowing, simul taneously transforming the ways that we approach this particular age. Although “the medieval globe” might seem to be a contradiction in terms, its components have an old and complicated relationship. The “dis covery” of a “new world” unsettled Europeans’ understanding of their place in world history at a time when the expansion of the mighty Otto
East Asia, were also posing new threats and opportunities. Meanwhile, notionsman empire, of territorial and intensified sovereignty contact in Europewith the itself civilizations were being of South based and on
others. Although the terms “medieval” and “Middle Ages” were not coined powerful historical fictions that some states had a warrant to colonize tions that eventually crystallized in these terms were already forming in theuntil very the early early sixteenth nineteenth (Dagenais century and (Stein Greer 1995), 2000; the Summit complex and associaWallace
of legitimacy and identity, an object of reverence and nostalgia; on the other,2006; Davisit was 2008). construed On the as onea “feudal hand, age” this medievalof cruelty past and becameignorance. a source Non- European cultures were accordingly described as “medieval” in order to
The current use of “medieval” as a synonym for “primitive” or “inhuman” subordinate and denigrate them (Wolf 1982; Davis and Altschul 2009). Ages continues to be the cradle of the West’s vaunted superiority, the font ofcontinues romantic this mythologies trend (e.g., and Holsinger “natural” 2007); rights at (Geary the same 2002; time, Symes the Middle2011a;
In many ways, then, the concept of “the Middle Ages” made possible “theGeary and Klaniczy 2013).
mutuallymodern exclusive world-system” realms of heralded inquiry, bythat Wallerstein is because (1974); triumphal “the narramedi eval” and “the global” defined each other. If they now appear to denote
Nationalisttives of modernity origin storiesrequire andthem universal to remain teleologies separate (Abu-Lughoddo not work 1989;when eventsGaonkar and 2000; their Bennett outcomes 2006; are Goodyviewed 2006; as the Sassen products 2008; of chancy,Symes 2011b). contin ple, have Europe’s component regions—and “Europe” itself—been rec gent forces (Smail et al. 2011). Only in the past two decades, for exam
isognized still tremendous as colonized resistance and postcolonial to critical spaces approaches (e.g., Bartlett that would 1994; threaten Cohen claims2000; Fernández-Armestoof political autonomy and or Muldoon territory 2008;staked Murray in medieval 2009). precedent. Yet there New paradigms that would debunk the presumption of an essential binary 4 Carol Symes generate resistance, and are consequently all the more important (see, e.g.,between Lieberman “East” and 1999; “West” McCormick (or “Muslim” 2001; and Grabar “Christian,” 2006; for Komaroff example) 2006; also Lieberman 2007–09; Sizgorich 2009; Flood 2009; Foltz 2010; Mallette
For all of these reasons, the problem of how we conceptualize and study2010; aBeihammer global Middle 2011). Ages is not going to be easy to solve. How can we even discuss this era meaningfully, given the value-laden vocabulary we must use? What should we call the communities and regions of encounter that formed and reformed throughout this period when they do not map onto discrete territories or modern nation-states? What names might we
beliefs? How do we deal with the fact of asynchronous developments withingive to andpeoples between or religions societies that as diversebetter reflect as Heian indigenous Japan, classical identities Angkor, and the Delhi Sultanate, Song China, Carolingian Europe, the Emergent Mis sissippian Culture of North America, and the Aztecs of the Postclassical
it. No human endeavor can be divorced from global phenomena, and it is imperativePeriod? Yet that the difficultywe learn howof the the task interconnected is part of the pasts reason of medievalfor undertaking societ ies shaped the complex world we have inherited from them. In pursuit of this goal, The Medieval Globe (TMG arship in three related areas of study: the means by which peoples, things, and ideas came into contact with one another; the )deep will promoteroots of globalschol developments; and the ways that perceptions of “the medieval” have been TMG is also committed to support ing innovative, collaborative work in a variety of genres: full-length arti (andcles, scholarlyare) created dialogues, around multi the world.-authored discussions of critical problems, review essays, editions or translations of source materials, and other formats. The common denominator among articles accepted for publica tion will be their authors’ willingness to explore points of convergence or est, or to pioneer portable methodologies. movementThe need (potential for such ora forum actual), is to clear. address Many topics programs of broad and scholarly research inter cen ters traditionally devoted to the European Middle Ages are being recon
include my own Program for Medieval Studies at the University of Illinois, thefigured launching to enable pad thefor TMGstudy of co-eval cultures across the world; these and disciplines embraced by this globalized medieval studies will need to . Students entering the many specialized fields be trained accordingly (Heng 2009) and will also need appropriate out lets for their work. Scholars of other eras, dissatisfied with the modern ist (Western) perspectives that have dominated global studies to date, the Medieval globe 5
introducingTMG envisions a new place for “the medieval” in global studies, but it also insists that all ages havewill also been find fundamental a home in tothis the emerging formation community. of our world (Shryock and Smail medium ævum truly an “age between”. 2011;This Smail inaugural and Shryock double issue2013). of Its The role Medieval is to mediate, Globe isto a make special the showcase for these aspirations. Its editor, Monica H. Green, has assembled a team of experts from many diverse disciplines to address a global, medieval phe nomenon that is still affecting human beings and ecosystems around the world. She has also nurtured communication among these contributors and ensured that their work engages the broadest possible audience. The essays gathered here, individually and collectively, bring state-of-the-art
evidence. They greatly advance our understanding of the medieval Black Death,scientific and and they humanistic also reveal methods how much to bear our currenton both knowledge new and old of bodiesthis pan of demic—its causes, effects, and more recent manifestations—has been limited by assumptions that have not yet yielded to those methods. As
andimportant lays out and an far-reaching ambitious asagenda this issue for collaborative is, it is not intended research. to be I cannotdefini thinktive; rather, of a better it provides introduction a series to Theof firm Medieval footholds Globe. for future scholarship
Acknowledgments I am grateful to members of The Medieval Globe’s editorial board for their com ments on an earlier draft of this essay, whose shortcomings remain my own. I am also grateful to the many students and colleagues at the University of Illinois and at Harvard University, who helped me to grapple with the implications of this ini tiative. Special thanks are due to Megan McLaughlin, Elizabeth Oyler, D. Fairchild
the Program in Medieval Studies at Illinois, whose leadership made it possible to dreamRuggles, of and compassing Eleanora the Stoppino; medieval and globe. (above I also all) thank to Charles our College D. Wright, of Liberal director Arts of and Sciences for providing the funding for an editorial assistant and thus ena bling graduate student involvement in the production of this journal. The next issue of TMG tered by our conference on “The Medieval Globe: Communication, Connectivity, Exchange,” held in April of (2.1, 2012: forthcoming the source in of2015) inspiration will feature for thisarticles journal. fos I warmly acknowledge those who participated in that inspiring encoun ter: Jonathan Conant, Kathleen Davis, Margot Fassler, Geraldine Heng, Sharon Kinoshita, Linda Komaroff, Elizabeth Lambourn, Carla Nappi, Michael Puett, Christian Raffensperger, and Nicolás Wey Goméz. Finally, I thank guest editor Monica Green for approaching me with the idea for this special issue in the spring
of 2013, and for skillfully bringing it to fruition. 6
BibliographyCarol Symes Before European Hegemony: The World System, A.D. 1250–1350 Abu-Lughod, Janet L. 1989.The Making of Europe: Conquest, Colonization, and Cul tural Change,(Oxford: 950–1350 Oxford University Press) Beihammer,Bartlett, Robert. Alexander 1994. D. 2011. “Defection across the Border of Islam and Chris tianity: Apostasy and Cross (Princeton,-Cultural Interaction NJ: Princeton in Byzantine University-Seljuk Press) Relations,” Speculum Bennett, Judith M. 2006. History Matters: Patriarchy and the Challenge of Femin ism 86: 597–651 The Postcolonial Middle Ages (New York: St. (Philadelphia: University of Pennsylvania Press) Cohen,Dagenais, Jeffrey John, Jerome and Margaret (ed.). 2000. Greer. 2000. “Decolonizing the Middle Ages,” in DecolonizingMartin’s Press) the Middle Ages, ed. by John Dagenais and Margaret Greer, spe cial issue, Journal of Medieval and Early Modern Studies Periodization and Sovereignty: How Ideas of Feudalism and Secularization Govern the Politics of Time (Philadelphia: 30: 431–48 University of Davis, Kathleen. 2008. Medievalisms in the Postcolonial PennsylvaniaWorld: The Idea Press) of “The Middle Ages” outside Europe (Baltimore: Johns Hopkins Davis, Kathleen, and Nadia Altschul (eds.). 2009. Internal Colonization inUniversity Medieval Press) Europe Flood,Fernández-Armesto, Finbarr Barry. Felipe,2009. Objects and James of Translation: Muldoon (eds.). Material 2008. Culture and Medieval “Hindu-Muslim” Encounters (Farnham: Ashgate Variorum) Foltz, Richard. 2010. Religions of the Silk Road: Premodern Patterns of Globaliza tion, (Princeton, NJ: Princeton University Press) Gaonkar, Dilip Parameshwar. 2000. Alternative Modernities (Durham, NC: Duke 2nd ed. (New York: Palgrave Macmillan) Marco Polo’s “Le devisement du monde”: Narrative Voice, Lang uageUniversity and Diversity Press) Geary,Gaunt, Simon.Patrick 2013. J. 2002. The Myth of Nations: The Medieval Origins of Europe (Cambridge: D.S. Brewer) Manufacturing Middle Ages: The(Princeton, Entangled NJ: HistoryPrinceton of MedievalismUniversity Press) in Nineteenth-Century Europe (Leiden: Geary, Patrick J., and Gábor Klaniczay (eds.). 2013. Goody, Jack. 2006. The Theft of History Grabar,Brill) Oleg. 2006. “The Shared Culture of Objects,” in Islamic Visual Culture, 1100–1800: Constructing the Study (Cambridge: of Islmaic Cambridge Art II, 51–67 University (Aldershot: Press)
Heng, Geraldine. 2009. “The Global Middle Ages: An Experiment in Collaborative Humanities,Ashgate Variorum) or Imagining the World, 500–1500 C.E.,” English Language Notes
Holsinger, Bruce. 2007. Neomedievalism, Neoconservatism, and the War on Terror 47: 205–16
(Chicago: Prickly Paradigm Press) the Medieval globe 7
introducing Cosmo politanism and the Middle Ages Kinoshita, Sharon. 2013. “Reorientations: The Worlding of Marco Polo,” in , ed. JohnMarco Ganim Polo and ShayneRustichello Legassie, of Pisa: 39–57 The Description(New York: Palgrave of the World Macmillan) Kinoshita, Sharon (trans.). Forthcoming.Beyond the Legacy of Ghengis Khan (Cambridge,Beyond Binary MA: Histories:Hackett) Re-Imagining Eurasia to Komaroff,c. 1830 Linda (ed.). 2006. (Leiden: Brill) Lieberman, VictorVictor. (ed.).2007–09. 1999. Strange Parallels: Southeast Asia in Global Context, c. 800–1830 (Cambridge:, Cambridge University Press) Mallette, Karla. 2010. European Modernity and the Arab Mediterranean: Toward a New Philology2 vols. and (Cambridge: a Counter-Orientalism Cambridge University (Philadelphia: Press) University of
c Le livre des merveilles du monde, Pennsylvania Press) Mandeville,McCormick, John Michael. [Johan 2001. or Jean]. Origins [ . 1357]/2000. of the European Economy: Communications anded. Christiane Commerce, Deluz AD (Paris:300–900 Centre national de la recherche scientifique É� ditions) The Clash of Cultures on the Medieval Baltic Frontier (Cambridge: Cambridge University Press) Murray, Alan V. (ed.). 2009.Territory, Authority, Rights: From Medieval to Global As (Farnham:semblages Ashgate) Shryock,Sassen, Saskia. Andrew, 2008. and Daniel Lord Smail. 2011. Deep History: The Architecture of Past and Present(Princeton, NJ: Princeton University Press) Sizgorich, Thomas. 2009. Violence and Belief in Late Antiquity: Militant Devotion in Christianity and(Berkeley: Islam University of California Press) Smail, Daniel Lord. 2011. “Genealogy, Ontogeny, and the Narrative Arc of Origins,” French Historical Studies (Philadelphia: University of Pennsylvania Press) Smail, Daniel Lord, Clare Haru Crowston, Kristen B. Neuschel, and Carol Symes. 2011. “History and the Telescoping34: 21–35 of Historical Time,” French Historical Studies American Historical34: Review 1–55 Stein,Smail, RobertDaniel Lord,M. 1995. and Andrew“Medieval, Shryock. Modern, 2013. Post “History-Modern: and Medieval the “Pre’,” Studies in a Post-Modern Perspective” 118: 709–37 (paper presented at the conference “Cultural Fric tions: Medieval Cultural Studies in Post-Modern Contexts,” at Georgetown
University)
Carol Symes The Modern World-System: Capitalist Agriculture and the Origins of the European World Economy in the Sixteenth Century Wallerstein, Immanuel. 1974. The Tropics of Empire: Why Columbus Sailed South to the(New Indies York: Academic Press) Wey Goméz, Nicolás.Europe 2008. and the People without History (Berkeley: University of (Cambridge, MA: MIT Press) Wolf, Eric. 1982. California Press)
Carol Symes The Medi eval Globe. She is the Lynn M. Martin Professorial Scholar at the University of Illinois, where ([email protected]) she is an associate professor is the founding of history executive with jointeditor appointments of in medieval studies, global studies, and theatre. Her own research focuses on the history of documentary practices and communication technologies, the social and cultural history of Western Europe from c
. 1000 to 1300, and the abiding Abstractinfluence ofThe medievalism concept of in “the the medieval” modern world. has long been essential to global impe rial ventures, national ideologies, and the discourse of modernity. And yet the projects enabled by this powerful construct have essentially hindered investiga tion of the world’s interconnected territories during a millennium of movement and exchange. The mission of The Medieval Globe is to reclaim this “middle age” and to place it at the center of global studies.
Keywords Medieval, Middle Ages, medievalism, global studies, empire, postco lonial studies, colonization, nationalism, modernity, Columbus, Marco Polo, John Mandeville. EDITOR’S INTRODUCTION TO PANDEMIC DISEASE IN THE MEDIEVAL WORLD: RETHINKING THE BLACK DEATH
MONICA H. GREEN
Plague (c c called the First Plague Pandemic, the Black Death or Second Plague After the Justinianic . 541– . 750), which has been the name—affecting “all people” (pan demos 1 ityPandemic would bewas higher likely fromthe first several semi-global nineteenth phenomenon-century cholera that fully outbreaks, merits + ). Total (absolute) mortal when expressed as a percentage of the population, the mortality caused bythe the 1918–19 Black influenzaDeath is thepandemic, highest or of the any current large-sc HIV/AIDSale catastrophe pandemic. known But to humankind, save for the impact of smallpox and measles on indige nous peoples in first-contact events of the early modern period. The Black century.Death killed Its demographic an estimated effects 40% to are 60% well of known all people (particularly in Europe, with the respectMiddle East, and North Africa when it first struck there in the mid-fourteenth arship on population losses and the economic and political changes that ensued.to Western Such Europe), questions and about there its is aftermatha considerable are important, body of historical of course; schol but place and how it was sustained. For these questions, we currently have no so, too, are questions of why and how the pandemic happened in the first definitive answers. Even its full geographic extent is still unknown: we are only now beginning to engage with scientific and documentary evidence
1 who identify wide geographic extension, disease movement, high attack rates and explosiveness,On the modern minimal definition population of “pandemic,” immunity, see novelty, Morens, infectiousness, Folkers, and contagiousness, Fauci (2004), and severity as the most commonly used features in describing disease outbreaks as “pandemic”. Of these, only contagiousness does not commonly apply to plague since it is normally spread by an arthropod vector, except that pneumonic plague this essay, I use the term “the Black Death” as synonymous with the Second Plague Pandemic(one of plague’s as a whole. most Individuallethal forms) contributors is directly to contagious this special from issue person retain to the person. original In
Western Europe in the mid-fourteenth century. On the issue of plague’s chronology usage, applying the term to the first wave of plague that struck the Mediterranean and and periodization and the definition of “pandemic,” see below. 9–26 The Medieval Globe 1 (2014) pp. 10 Monica H. Green the disease might have also reached other regions of Afroeurasia as well. for Aplague catastrophe in East ofAsia, this and magnitude we can only demands suspect explanation. (as we will see) The whetherpresent collection of essays starts from the premise that studies of the Black Death
the past two decades, leapt past the barriers of the late nineteenth-cen musttury biological embrace alaboratory new reality: and the created fact that new the ways field to of explore microbiology the history has, inof pathogenic organisms. Microbiology has effected a transformation in our understanding of the disease’s history. It has reconstructed the phyloge Yersinia pestis, from modern molecular samples, and it has developed techniques to retrieve andnetic reconstruct (evolutionary) genetic history material of the of plague the pathogen organism, from historical remains. The question “What was the pathogen?” has been decisively resolved.
Inteins 2011, culminated over a decade in the reconstructionof innovative research of the full (and genome controversy) of Yersinia in pes the- retrievaltis, using andthe remainsanalysis of personsancient DNAburied (aDNA) in London’s fragments famed and Black other Death pro
cemetery (East Smithfield),2 Even ifwhich we cannot can be yet precisely rule out dated the possibilityto the first outthat breakthere wasof plague more in than London, one organism in 1348–50 or (Bosother et causative al. 2011; factorsee also leading DeWitte to 2014,the mass in thismortalities issue). in this period, there is no longer any question that Y. pestis was a key player. The Medieval Globe take the new micro biological consensus on the Black Death as a given. Yet the assembled con tributorsThe essays do not in thiscontest first a issue key pointof raised by so-called “plague deniers,” who in the past several decades have raised doubts about the role of Y. pestis in the pandemic. Their skepticism arose from the fact that the speed of the disease’s spread,3 and the level of well-documented human mortality it caused during the fourteenth century, in no way match the patterns seen in the Third Plague Pandemic, which is normally dated from
our modern bacteriological and epidemiological understandings of the pathogenaround 1894 and tothe the disease 1930s it and causes during in animals which theand foundation humans. There was laidis good for
2 A superb summary of the developments in microbiology as it relates to historical Y. pestis in remains from the
plagues can be found in Little (2011). The presence of time of the Justinianic Plague has now been documented as well. See Green (2014, in 3 thisarguments, issue) for reveals further how details contentious on the contributions the issue has become.of genetics to plague studies. Benedictow (2010) summarizes these perspectives and, in the tenor of his own Pandemic Disease in the Medieval World 11 reason, now,Editor to’ squestion introduction the role to that early twentieth-century epidemiol ogy has played in our general constructions of plague’s histories, because plague is not always or everywhere the same in its vectors or animal hosts
Nevertheless, rather than dismiss the skeptics’ focus on the discrepancies between(Royer 2014; twentieth see Varlık-century 2014 understandings and Carmichael of plague’s 2014, both epidemiology in this issue). and our medieval evidence, this collection of essays is motivated by an accep tance of the discrepancies. We concede that there is currently no plau sible, comprehensive theory that can explain in full detail how the non- motile, single-celled organism that modern science knows as Yersinia pes- tis— —could, in an age before steam-powered which may have originated as a new species as little as about 3000 to asian4000 yearsand North ago (Cui African et al. landscape 2013) in just a few decades. (letAdmitting alone jet) ignorance travel, have of thebeen full disseminated epidemiological across character so much and of amplifythe Eur ing factors of the Second Pandemic does not, however, mean that we have no useful knowledge at all. This may still be terra incognita, but we are of the strain of the Y. pestis bacillus found in fourteenth-century human remainsnot without and a the compass. organism Genetic as it scienceis found confirms disseminated the very now close throughout identity The organ ism itself, therefore, serves as a tracer element, a living chain4 of evidence mostthat can of the tie inhabitedtogether vastly world distant (Bos et times al. 2011; and Cui places. et al. To 2013). borrow a phrase when the possibilities of modern genetics analysis could barely be fan coined by the French historian Emmanuel Le Roy Ladurie (1973), back biological fact enables us to take an interpretative stance: given the same pathogen,tasized: we more have orhere less a “microbialthe same epidemiologicalunification of [half] parameters the world.” can That be inferred in terms of necessary environmental conditions, modes of trans mission, and symptomatologies in infected hosts. We may not yet know all the species of arthropod vectors or mammalian hosts we need to search out; we may not yet know all the climatic and other environmental factors that contributed to the propagation of Y. pestis. We certainly do not know
4 into phylogenetic understandings that have already been postulated for the evolution of AncientY. pestis DNAsince (aDNA) its divergence retrieved from from its themost period recent of common the Justinianic ancestor; Plague see Harbeckalso fits Y. pestis in the Third Pandemic, see Morelli et al. 2010. Plague foci currently exist in North and South America,et al. 2013 Africa, and Wagnerand Eurasia. et al. Although2014. On plague the dissemination reached Australia of in 1900, it does not seem to have established permanent foci there; see Curson and McCracken 1989. 12
aMllonica the human H. Green factors of trade in grains or textiles or other material goods and foodstuffs that created the microenvironments allowing Y. pestis to spread. But we do know that we need to search out those connections. Accepting the precepts of an evolutionary perspective on the history of Y. pestis graphic extent,suggests its chronological that the field extent, of historical and the plague methodological studies as itregisters relates towe the use Second to investigate Pandemic it. Themust essays be redefined in this volumein three pursue, dimensions: from variousits geo perspectives, all these agendas. First, the geography of the Second Pandemic must be expanded. Black ern and Central Europe, as is often depicted in maps, sourcebooks, and textbooks.Death studies5 Analyses can no longerof the beevolutionary defined as ifhistory the disease of Y. pestisstruck fromonly Westmod
the pathogen were likely on the Tibetan-Qinghai Plateau (Achtman et al. ern samples6 Y. pestis have had suggested to move sinceacross 2004 as many that animal the geographic species (arthropod origins of
2004).the massive mortality in human bodies that it did in the fourteenth cen vectors as well as mammalian hosts) as climatic zones in order to cause clear that it did move. Contributors to this volume cover geographic ter raintury from(and Chinaepisodically to all sides thereafter). of the Mediterranean But again, the and microbiology on to England. makes In my own essay, I suggest that even the Indian Ocean basin merits explora tion as a route possibly as important as the Silk Roads; at least, that is a possibility worth exploring given that genetics research ties sub-Saharan Africa to our premodern plague narratives. The call for an expanded geog raphy also includes calling for a veritable menagerie of possible hosts for the organism. Y. pestis always needs precise microenvironments to thrive and even more precise circumstances of transfer across species to create human plague. But limiting plague’s narrative to one or two kinds of rats ogy and zoology have brought forward, which reminds us repeatedly that humanand fleas plague occludes is a toorelatively much: rareit defies epiphenomenon the evidence inthat Y. pestismodern’s evolution. entomol Although humans have regularly been involved in plague’s long-distance spread, Yersinia pestis survives because it establishes itself in microen vironments that more or less replicate those of its origin. Marmots and
long-term survival than rats. gerbils (and guinea pigs and prairie dogs) are more important for that
5 6 A summary of debates on the geographic origin of Y. pestis can be found in Green Even for Europe, such maps pose major interpretative problems (Mengel 2011).
(2014, in this issue); see also Hymes (2014, in this issue). Pandemic Disease in the Medieval World 13
Second,Edit theor’ schronology introduction of ttheo Black Death must be expanded.7 The
term “Black Death” has often been used to denote just the first “wave” of ciallyplague when that struckexamining the Mediterranean many kinds of andsynchronous Western Europe sources between at the period 1347 ofand the 1353. highest Usage collective of the term human in thatmortality. narrow However, sense is beyond still justified, its Eurocen espe
the outbreak in Kaffa, where besieging Mongols are famously said to have hurledtricity, theinfected narrow bodies time over frame the beginning city walls—obscures in 1347—or two 1346, epidemiological if we include from some- where; and second, that plague did not simply come to Western Eurasia, it stayedfacts that must be addressed: first, that plague came to Kaffa
proposed. How a polytomy, much earlier a sudden than 1346/7 divergence we must or “Big look Bang” for the of “origin” Y. pestis of into the fourBlack new Death lineages, is not likelyyet clear. caused In 2013,because microbiologists it was moving Cui into and new colleagues host spe c loguecies (Cui to thiset al. collection, 2013). They “A Hypothesissuggested a on median the East date Asian of . Beginnings1268 with a of 95% the Yersiniaconfidence pestis interval Polytomy,” of 1142–1339. Cui and colleagues’ As Robert Hymesproposed suggests dating in coincides his epi
century near the edge of the Tibetan-Qinghai Plateau—events that might possiblyintriguingly serve with as theevents “disseminating taking place factor” in the firstnecessary decades to startof the the thirteenth process of Y. pestis’s spread to other environments. The possible role of climatic change in catalyzing the thirteenth-century polytomy, or, indeed, in any
evidence is increasingly suggesting that though small localized outbreaks ofother plague major occur outbreak regularly of plague, wherever has itnot has yet established been defined enzootic decisively, foci, butthe commonality of more widespread outbreaks is due to climatic factors. 8
7
This issue of chronological definition was addressed by Little (2011: 271): “the Black Death [is] a name that many historians restrict to the massive mortality throughout Europe between 1347 and 1353 but is better understood as a pandemic that began in centuries.”Central Asia And in the just 1330s, as this subsequently issue argues spreadfor extending through the Europe Second and Plague the Middle Pandemic East forwardstarting ininto the the late nineteenth 1340s, and century, made frequent arguments returns are also in those being regions made to for extend over four the Third Pandemic back into the eighteenth century; a beginning date of c. 1772 is implied
8 On the correlation of climate with widespread outbreaks, as established by modern byobservational Benedict (1996) science and and taken predictions as the foundation about what for current research climate in Xu etchange al. (2014). might do to plague dynamics in the future, see, e.g., Stenseth et al. 2006; Ben Ari et al. 2011; and
Gage 2012. In-progress work by Bruce Campbell (2013) suggests that major climatic 14
MonicaAs for H . theGreen end date of the Second Pandemic, we clearly must look well breaks continued to occur up through the early eighteenth century, but evenbeyond such 1353. oft -Forcited Western dates as Europe, 1679 (forwe havethe last long plague known outbreak that plague in Engout
land) and 1722 (for the Continent, following the last major outbreak in dateMarseille, for the 1720) Second may Pandemic be illusory becomes (Cummins, meaningless. Kelly, andOutbreaks Ó� Gráda in 2013;North Africa,Ermus the2014). Ottoman If, moreover, empire, we and add even in Russiathe Islamicate certainly world, continued the 1722 well intoend
the nineteenth century (Varlık 2014, in this issue; Mikhail 2012; Robarts Because2010). Were we currently all these lack outbreaks any aDNA repeated from sites importations in Central Eurasia, from enzootic we can notloci settle“elsewhere”? these questions Or do they now. reflect For example, local cases a strain of plague of Y. pestis persistence? recently documented in Libya comes from Branch 2 of the general phylogenetic tree, which diverged from Branch 1, the lineage involved in both the Black demic; this divergence occurred some seven hundred to eight hundred Death (as documented from London remains) and the global Third Pan mented in other parts of North Africa, the Libyan case suggests that we mayyears well ago be (Cui looking et al. at2013). the remnants Since strains of more from than Branch one pandemic 1 are also leaving docu its traces in that region (Cabanel et al. Y. pestis in the late medieval and early modern periods that have left living 2013). descendants There may, to thisin other day. Canwords, we havereally been say that multiple the Second amplifications Plague Pandemic of ever ended? Third, it is now obligatory that plague studies be broadened into a multidisciplinary mode. There is no single discipline or investigative approach that can be privileged: microbiologists may study the evolution or particular genetic characteristics of the pathogen, but that single-celled organism only creates “plague” when it passes through various environ ments, different hosts as well as different ecosystems. Entomologists must study the arthropod vectors, zoologists must study the many differ ent possible mammalian hosts for the disease, from the tiniest rodents up through carnivores and camels. Bioarcheologists are the guardians of
not only of humans and their artifacts but also all the species that form all aspects of retrieval, classification, and analysis of material remains,
have been a particular precipitating factor for the events that pushed plague into the Blackchanges Sea occurred and Mediterranean throughout basins.the northern On climate hemisphere and the in Justinianic the early 1340s,Plague, which see Green may
2014, in this issue. Pandemic Disease in the Medieval World 15 the chainsEd itthroughor’s intr whichoduction Y. pe stisto rians, but also linguists and art historians and others who painstakingly interpret the cultural products of human passes. societies—are And finally, humanists—histo needed to recon struct not only the ways in which humans contributed to the creation of Y. pestis on pandemic scales, but also the many human responses to plague and catastrophic mortality, be they medicalconditions or religious,ripe for amplification palliative or ofmurderous. The following essays attempt to lay out a forward path for studies of plague in this multidisciplinary and collaborative mode. In the opening what the implications are for our histories of the Black Death when we takeessay, into “Taking account ‘Pandemic’ the major Seriously: transformations Making the in Black the biologicalDeath Global,” sciences I ask the perspective of global health history allows the creation of frameworks ofduring analysis the pastthat fifteen are both years. richly I argue multidisciplinary that approaching and plague productive studies of fromnew for embracing broad expanses of both time and place, literally covering research agendas. The field of global history writ large is already known human origins—and, in some cases, beyond. Global history is also gen erallythe globe quite but interdisciplinary, also (in its mode recognizing as Deep History) that narratives going back at to those the time levels of of scale cannot rely solely on written documentation. But with different sources and methods come different research goals. What the microbiolo gist or historical epidemiologist wants to explain is different from what the historian of religious persecution or public health seeks to document. approaches has been historians’ aversion to agendas that smacked of “ret A major obstacle to fruitful dialogue between the humanistic and scientific especiallyrospective strong diagnosis”: among the recent imposition generations of modern of historians categories of medicine. of scientific My essaydisease suggests classification that using on evidencethe categories from ofthe modern past; this science aversion to reconstruct has been plague’s histories—adopting an outsider’s (etic rial history of plague—is actually essential to reconstructing the history of participants’ experiences of those material conditions) perspective and theon the resulting mate experiences of sudden death, economic devastation, and social chaos (an emic enterprise that unites the efforts of scientists and humanists alike. As perspective).has been noted, Both the are common valid, andpractices both ofare long necessary-distance to trade a historical or ani mal husbandry that facilitated the spread of Y. pestis to lands far distant from the Tibetan-Qinghai Plateau are yet to be discovered. But spread it did, and it is certain that human activities, unwitting though they may have been, were responsible. Epidemiologically, we would now “blame” 16
theMonica grain H. Gdistributorreen or the trader in furs or the second-hand clothes dealer for creating mobile microenvironments that facilitated the spread of Y. pestis. But these causes would not have been apparent to medieval actors, and it has long been known that, in their terror, people in the four teenth century looked in many directions to answer the question “Why?” In Christian Europe, reproachful eyes often turned toward resident Jew ish communities.9 In “The Black Death and its Consequences for the Jew ish Community in Tàrrega: Lessons from History and Archeology,” Anna
Eulàlia Subirà de Galdàcano, and Clara Jáuregui unite an emic approach Colet,to the Josep perspectives Xavier Muntané of historical i Santiveri, human Jordi actors Ruí�z with Ventura, the Orioletic approach Saula, M. implicit in archeology’s reconstruction of material culture. Beginning in 2007, excavations were undertaken on the Maset hill in a suburb of the
town’s medieval Jewish cemetery. Analysis of the human remains found Catalonian town of Tàrrega: a site subsequently identified as that of the shows that many had suffered a violent death. Linking this material evi dencein several to written communal documentation graves (a burial of attacks practice against rare amongthe Jewish medieval community Jews) lels between two very different kinds of evidence. Arriving in the port of Barcelona,of Tàrrega inthe July plague 1348, had Colet spread and inlandher colleagues to Cervera find and astonishing then to Tàrrega. paral And immediately on the heels of the plague spread waves of hate, accord
twenty Jews were killed in Barcelona, eighteen in Cervera, and three hun dreding to in official Tàrrega. records This contemporarykept by the Crown record of ofAragon, mass murderwhich reports in Tàrrega, that one of the earliest to be associated with the plague’s arrival on the Euro logical evidence published here. This evidence corroborates not only vio lentpean deaths mainland and inthe the postmortem spring of 1348, desecration is now of confirmed some bodies, by the but archaeo also the careful attempts, probably by the community’s surviving Jews, to give the deceased a ritually appropriate burial. Archeology takes us in a very different direction in Sharon DeWitte’s contribution, “The Anthropology of Plague: Insights from Bioarcheologi cal Analyses of Epidemic Cemeteries.” Bioarcheology is a relatively recent designation for archeological work that encompasses paleopathology (the
combines it with fuller contextual analysis to create a rich understanding determination of disease or nutritional deficits from human remains) and
9 It has long been recognized that minority Jewish communities were not targeted
explain the contagion, see Stearns 2011. in the Islamic regions of the medieval world (Dols 1974). On the varied attempts to Pandemic Disease in the Medieval World 17 Editor’s introduction to was believed that plague was one of the diseases that bioarcheology could notof how reconstruct. whole communities The “osteological lived (and paradox” died). As holds recently that as bone a decade only reactsago, it slowly to most stressors. Whereas violent trauma (as in the case of the
thatTàrrega kills victims) quickly (likewill immediately plague, which create can strike lesions a human in bone, down disease in anywhere or nutri tional deficits take time to work their destructive effects. Hence, anything cernible way. Now, of course, bioarcheology is at the forefront of historical plaguefrom two studies, to ten notdays) simply does because not have Y. time pestis to aDNAdamage can the be bone extracted in any from dis teeth excavated by archeologists, but because new innovative techniques of epidemiological analysis at the population level allows us to assess the health state of victims, and also the cultural attitudes and responses toward mass mortality as evidenced in burial practices themselves. Exca vations of mass gravesites in London have been particularly revelatory because the sites can be precisely dated and contextualized from support ing documentary information. DeWitte’s summary of current research
multidisciplinary work on plague and other epidemic diseases will take us(much in the of future.it her own) also allows us to see some of the directions in which In his essay, “Plague Depopulation and Irrigation Decay in Medieval Egypt,” Stuart Borsch examines plague depopulation’s very direct effect on the economic infrastructure of Egypt in the late medieval period. Several essays in this volume focus on the ecologies that facilitate plague mainte
plague can create a new ecology for humans. By eliminating human actors whosenance, amplification,agricultural practices or transmission. had regulated Borsch, the in environment, contrast, reminds plague us liter that ally transformed the landscape of Egypt. Irrigation systems and the social and technological institutions that had built them up over many millennia fell into ruin because major population losses, caused by recurrent out breaks of plague, severely circumscribed the amount of labor available to maintain this elaborate infrastructure, designed to control and exploit
the flooding of the Nile River. By 1468, Egyptian officials themselves could magnitudenot explain of why mortality their predictions from plague, for which the annual seems flood to have had been failed far for more the extremefirst time than since can records be documented began to be forkept, other in the disease third millennium pandemics, BCE. is likely The the key factor in Egypt’s drastic economic decline. In her essay “Plague Persistence in Western Europe: A Hypothesis,” Ann G. Carmichael explores an issue hinted at in Borsch’s account of recurrent plague in Egypt. Although we do not know the precise mechanisms of its 18
spread,Monica Hthere. Green is little reason at this point to doubt medieval reports that the “great mortality” in Western Europe and North Africa came via ships,
on the Atlantic and North Sea coasts. But our modern knowledge of Y. pes- arrivingtis first in the seaports of the Mediterranean and then at other ports ism in North and South America, Africa, and Asia—shows that Y. pestis can—drawn be readily from established studies of insylvatic rodent (or communities “maintenance”) within foci a offew the years organ of its introduction to a new geographic area. Often, those new foci are estab lished at high elevations.10 Carmichael raises the question of whether the Alps became one such area where local foci were established in Europe, causing recurrent plague outbreaks in the early modern period. That is, documented waves of the plague in later centuries came, not through reintroductions of the organism via long-distance trade networks linked
Europe’s own sylvatic foci in local mountainous areas. Beginning her nar torative Central with Asia a handful (though of thatdeaths may in alsosmall have mountain happened), villages but in from 1567, Northern Carmi chael moves both forward and backward in time, ending with the second As was noted at the time, this epidemic moved down from upland communities into metro politanwave of centersthe epidemic such as in Milan,Western not Europe, from coastal that of cities 1359–63. into the interior; this was the mortality so famously recorded and bemoaned by the poet Fran
incesco this Petrarca new epidemic. (d. 1374), In order who tohad lay already out this lost hypothesis his beloved (itself Laura a wonder to the fulBlack example Death ofin how1348, the and new who science was now of plague to lose can his stimulate son and newa good research friend
what animal species may have served as local hosts for Y. pestis. The fact thatquestions the European for historians), Alps, like Carmichael the Tibetan is impelled-Qinghai to Plateau, raise questions had a resident about species of marmot is, she suggests, likely one part of the answer to how plague came to persist in late medieval and early modern Western Europe.
what she calls “local knowledge” can, when set into larger frameworks Like Borsch and Carmichael, Nükhet Varlık shows how command of only contemporaries’ experiences of plague in one part of the world, but ourof epidemiological larger understanding and scientific of plague’s analysis, causes yield and resultseffects. thatIn her enlighten essay “New not Science and Old Sources: Why the Ottoman Experience of Plague Matters,”
10 This phenomenon has been noted for individual localities but has not been studied systematically, so far as I have been able to determine. See, for example, Eisen et al. 2010; Neerinckx et al. 2010; MacMillan et al. 2011; Eisen et al. 2012;
Andrianaivoarimanana et al. 2013; and Schneider et al. 2014. Pandemic Disease in the Medieval World 19 Editor’s introduction to rendered invisible the geographic and temporal extent of plague—and, thus,Varlık human begins experiencesby noting that of Eurocentric the disease—in narratives other ofareas plague of the history Eurasian have world. While the Second Pandemic may have started at approximately the same time in Western Europe and in the lands that would later form the Ottoman empire, outbreaks of plague continued in Ottoman territories well into the nineteenth century, far beyond the chronological parame ters that have been established with reference to European cases alone.
whether plague established urban or rural foci, allowing Y. pestis to per petuateLike Carmichael, itself independently Varlık explores of newly the historical imported importance infections. ofAnd determining like Green
models of plague-transmission, models which pay special attention to and Carmichael, Varlık stresses the importance of adopting more complex science itself as dynamic. Although the contributors to this special issue interspecies dynamics. Importantly, VarlıkY. also pestis gives’s evolution us a lesson or in ecology seeing or physiological effects, we recognize that this body of knowledge is ever regularlychanging. relyJust onas thescientific universalist claims claims about of science must be made locally
specific in the hands of the well-trained historian, so too must the scien sometific understandings basic tenets of of plague the past science be recognized were formulated as the products in the ofearly culturally twen tiethspecific century. moments. “These Varlık imagined suggests divisions the need of epidemiologicalto re-examine the experience,” ways that she says, “have resulted in separate histories of plague in Europe and the
Recognizing that plague remained a repeated threat in many commu nitiesMiddle into East/Islamic the nineteenth world” century—and (Varlık 2014, remains in this issue, a threat p. 205). today for those human populations living around established plague foci—Fabian Crespo and Matthew B. Lawrenz bring the perspectives of biological anthropology and microbiology to bear in their essay “Heterogeneous Immunological Landscapes and Medieval Plague: An Invitation to a New Dialogue between malian immune systems has been transformed in the past four decades, in partHistorians because and the Immunologists.” HIV/AIDS pandemic Modern made scientific such understandingknowledge desperately of mam urgent. Certain misunderstandings of immunity have been widespread in discussions about historical plague, among them the misleading idea that whole populations can suddenly and permanently “acquire” immu nity to certain pathogens if a part of that population survives an epidemic event. Crespo and Lawrenz are concerned, rather, to lay the foundation for experimental investigation of whether any immunological characteristics already present in Western Europe’s diverse gene
(innate and acquired) 20
poolMonica and H .ecology Green may have acted differentially in facilitating the survival dence for differential survival based on an individual’s prior exposure to compromisedof some exposed nutrition individuals or other rather stressors, than others. Crespo Just and as DeWitte Lawrenz finds wish evi to explore from an immunological perspective the basic question of differ ential survival that is the foundation of all epidemiological investigation. Crespo and Lawrenz’s articulation of these questions shows how fruitful dialogue between the many historicist disciplines can be. As they note, “historians must step in and help scientists put all these biological differ ences into context.” Our next essay, “The Black Death and the Future of the Plague,” written by Michelle Ziegler, a microbiologist and specialist in disaster prepared ness, considers the reasons why this most “medieval” of diseases remains of urgent concern today. As noted above, much of our modern understand ing of plague’s human epidemiology comes from studies made during the Third Plague Pandemic in the late nineteenth and early twentieth centu ries: right at the time when germ theory was establishing a new paradigm
simply to fears of biological warfare (already attempted earlier in twen for understandings of disease. Current scientific concerns are related not resistance, threats that have only become fully apparent since the 1990s. Thetieth complete century) reconstructionbut also to threats of the of genomedisease re-emergenceof Y. pestis from and fourteenth antibiotic- century samples shows that the organism as it existed then is not radically different from the organism that exists in numerous strains throughout the world in the present day. In other words, in terms of the pathogenicity
the Black Death could happen all over again today, given the proper condi ortions. virulence That raw of factthe organismis what propels (and, probably,millions of human dollars susceptibility of new research to it),on Y. pestis. The medieval Black Death, therefore, is far more than a mere his torical curiosity; it is, in all its complexity, the source of vital data that can help us to establish scenarios for pandemic disease now and in the future. Late in the process of assembling this collection, we had the good for tune to be put in touch with Robert Hymes, a historian of China whose epilogue now rounds out our narrative. While Ziegler brings the Black
its beginning—or, at least, the beginning as currently hypothesized by geneticsDeath’s narratives science. Hymes into the offers twenty-first a tentative century, rereading Hymes of Chinese takes us historical back to sources from the thirteenth century, more than a century before plague arrived in the Mediterranean basin. Historiography on China has long been reluctant to see plague as a factor in East Asian history, where refer ences to epidemics are abundant but descriptions of what could be inter Pandemic Disease in the Medieval World 21 Editor’s introduction to major genetics studies asserting an Asian origin of Y. pestis did not shake pretedthe fundamental specifically skepticism as “plague” of are those exiguous: who maintaineven the recent that human publication plague of
however, takes the sudden divergence of Y. pestis postulated by genet was not a major factor in China’s medieval history (Buell 2012). Hymes,
beginics in 2013assembling (the polytomy several piecesmentioned of a above,scattered estimated puzzle: to the have sequence occurred of betweenMongol raids the twelfthagainst andtowns early on fourteenththe northern centuries) border of as the an Tibet invitation-Qinghai to plateau starting in the 1210s; the reports that the Mongols themselves were experiencing unaccustomed illness on these campaigns; reports of epidemics in major cities, and so forth. He calls for a new reading of the Chinese sources from the period, one more sensitive to the claims that they themselves are making: including the claim that contemporaries were witnessing an epidemic that appears to have been new in its mani festations. Although Hymes’s study is, like Carmichael’s, presented as a hypothesis, the interpretative power of both essays comes from taking the historical sources as seriously as the science. Such meticulous scholar ship has the potential to recreate, at a level of detail never before imagin able, the paths that different strains of Y. pestis might have taken as they reshaped the populations and landscapes of Eurasia. Finally, in the interests of making new historical documentation avail able—and to allow students to see for themselves how historians craft understandings of the past—we offer a “featured source”: “Diagnosis
theof a Yersinia ‘Plague’ pestisImage: genome A Digital was Cautionary retrieved inTale.” 2011. This Much essay of thereturns work us that to London, the site of the Black Death cemetery at East Smithfield whence matic advances in computerization, which allow manipulation of many terabytesgeneticists of have genetic done data in the simultaneously. past fifteen years For has the been humanities, premised comput on dra semination of texts and images. That such new freedom should generate errors,erization, too, and is to specifically be expected. the The Internet, surprise has lies made in what possible we found the whilewide cordis recting the error of a “misdiagnosed” image of “plague” using appropri ate humanistic analysis of its manuscript context and situated meaning: we were soberingly reminded that plague was not the only disease that troubled people in the middle of the fourteenth century. Although science plays no role in this analysis, I and my coauthors—historian of medicine Kathleen Walker-Meikle and canon law specialist Wolfgang P. Müller— happily acknowledge our debt to scientists who for many decades have
been modeling the benefits of collaborative work. 22
MonicaThis Hvolume,. Green the inaugural issue of The Medieval Globe, is put forward in the belief that dialogue between historical records and modern science,
of humanistic method, is not an exercise in presentism but an opportunity tobetween take seriously quantifiable the task assessment of reconstructing of material the remains world that and historical the intangibles actors inhabited, right down to the microbes that killed them. In an earlier draft of her essay, Ann Carmichael quoted the environmental historian Richard C. Hoffman, who observed that we are dealing with events that “took place
in a position to see so much more now—from both emic and etic perspec beforetives—and we were what inwe a seeposition is an enlarged,to see [them]” more (Hoffmandynamic, and1995: more 59). complex We are medieval globe.
Acknowledgments I and all the contributors to this volume collectively owe thanks to several groups of people and institutions for making this work possible. Nine years ago at Arizona State University, I discovered in the Bioarcheology Program colleagues
about disease experiences in the past have set the standard for the work I aspire to(most here. importantly, That enthusiasm Jane Buikstra)was transferred whose for professionalism two wonderful and summers driving to curiosity London, where the Wellcome Library hosted my National Endowment for the Humanities lem of opening up dialogue between the humanities and the historicist sciences onSummer the huge Seminars; question the of participants plague’s history. there wereWe owe the firsta special to wrestle debt ofwith gratitude the prob to Jelena Bekvalac and Rebecca Redfern of the Human Bioarchaeology Centre at the Museum of London for allowing us to examine their collections from the London
our bioarcheological guide. In 2012, Michelle Ziegler created the Plague Working Black Death Cemetery, and to Rachel E. Scott (now of DePaul University) who was
incomparableGroup, an invaluable cohort smallof historians community from for across discussing the chronological the latest work and ingeographic the field. range,In 2013–14, together the with Institute intellectual for Advanced sustenance Study of atevery Princeton other kind; provided funding me whilewith an at the Institute was provided by the National Endowment for the Humanities and the Willis F. Doney Membership Endowment. The particular debt we owe collectively is to the World History Center of the University of Pittsburgh. By granting me an appointment as Visiting Scholar in
funds to subsidize conference travel critical to this project and, most importantly, 2013–14,to underwrite the Centerthe open provided-access publicationnot simply ofanother this volume. welcoming None audience of these individu but also als or institutions bears responsibility for statements made in this or the follow ing essays, though I hope all will recognize with pride their essential contribu
Humanities.tions. Any views, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect those of the National Endowment for the Pandemic Disease in the Medieval World 23
Finally,Ed weitor thank’s intr Carolod uctionSymes, foundingto editor of The Medieval Globe, for her belief that the Black Death could provide a valuable exploratory path between and beyond traditional geographic and disciplinary boundaries, and for investing extraordinary levels of patience and care in editing this issue.
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Stenseth, N. Chr., N. I. Samia, H. Viljugrein, K. L. Kausrud, et al. 2006. “Plague DynamicsUniversity Press)are Driven by Climate Variation,” Proceedings of the National Academy of Sciences
of Plague Matters,” The 103, Medieval no. 35: Globe13110–15 Varlık, Nükhet. 2014. “New Science and Old Sources: Why the OttomanYersinia Experience pestis and 1: 193–227 Lancet Infectious Wagner,Diseases D. M., J. Klunk, M. Harbeck, A. Devault, et al. 2014. “ the Plague of Justinian, 541–543 AD: A Genomic Analysis,” portation 14, Routes no. 4: Accelerate319–26 Spread of Human Plague,” Proceedings of the Xu, RoyalL., L. Chr. Society Stige, B: K. Biological L. Kausrud, Sciences T. Ben Ari, et al. 2014. “Wet Climate and Trans The Medi eval Globe 281, no. 1780: 20133159 Ziegler, Michelle. 2014. “The Black Death and the Future of the Plague,” 1: 259–284 26 Monica H. Green Monica H. Green medicine and global health. In 2009 and 2012, she ran a National Endowment for the Humanities Summer ([email protected]) Seminar in London on is “Healtha historian and of Disease medieval in the European Middle
and humanistic disciplines could engage in productive dialogue about the his Ages,”tory of which disease had and as health its central-seeking goal behaviors. the exploration During of this ways same that period, the scientific she has
speciesalso argued since for its the origin development up to the ofpresent a new day,field, and “Global the ways History that of human Health,” cultural which changesexplores havethe evolutionfacilitated of or the hindered major pathogensthose pathogens’ that have trajectories. afflicted Inthe addition human to many works on the cultural history of medieval medicine, she is the author of “The Value of Historical Perspective,” in The Ashgate Research Companion to the Globalization of Health and “The Globalisations of Disease,” which will be published in 2015. , ed. Ted Schrecker (Aldershot: Ashgate, 2012), pp. 17–37; Abstract Extraction of the genetic material of the causative organism of plague, Yersinia pestis, from the remains of persons who died during the Black Death has
This then opens up historical research to investigations based on modern science, whichconfirmed has studied that pathogen’s Yersinia rolepestis in from one ofa variety the largest of perspectives, pandemics ofmost human importantly history. its evolutionary history and its complex ecology of transmission. The contribu rative approach to the many remaining mysteries associated with the plague’s geographicaltors to this special extent, issue rapid argue transmission, for the benefits deadly of outcomes, a multidisciplinary and persistence. and collabo
Keywords Yersinia pestis, Second Plague Pandemic, Afroeurasia, anti-Jewish vio lence, bioarcheology, biological anthropology, microbiology, historical method. TAKING “PANDEMIC” SERIOUSLY: MAKING THE BLACK DEATH GLOBAL
MONICA H. GREEN
the most recent major monograph was published on life in an Italian city of the mid-fourteenth century, its author deferred In 2009, when
judgment on whether the disease that struck Italy in 1348—“an infinite tributingmortality tothe this, likes the of inaugural which ha[ve] issue never of The been Medieval seen on Globe earth”—was, no longer in factfeel plague as defined by modern science (Wray 2009: 1). The authors con microbiologists have tested and contested the possibilities for establish ingthat the such presence caution ofis necessary.plague’s causative Since 1998, organism, several Yersiniainternational pestis teams, in the of physical remains of Europeans who died at various moments in premod ern history when major epidemics were raging. The reason that there is
developments, both of them having to do with trajectories in genetics researchscientific inconsensus the past thirtynow, when years therethat have was comenot before, together is a quite function recently. of two On the one hand, researchers have been exploring methods to capture rial from older remains. Because Y. pestis would be circulating through outand theanalyze bloodstream “ancient” byDNA the (aDNA), time it by kills which a person, they mean and becauseany genetic the mate hard enamel of intact teeth could potentially preserve small amounts of blood found within the dental pulp, teeth became the focal point of attempts to retrieve Y. pestis from human remains. But the challenges of develop
ing viable methods of extraction and analysis were significant. DNA, like
In addition to the individuals and institutions thanked in the Editor’s Introduction to this volume, I would here like to acknowledge my debt to the participants at a conference held in Oxford, “Proto-Globalisation in the Indian Ocean World,” in
guidance on incorporating Africa into this narrative. Funding for this project was providedNovember by 2013, fellowships and to Patrickfrom the Manning, Institute Mark for Advanced Horton, and Study Neil at Kodesh Princeton for (withtheir funds from the National Endowment for the Humanities and the Willis F. Doney
Membership Endowment) and the World History Center of the University of Pittsburgh (which has also subsidized open-access publication of this volume). Any views, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect those of the National Endowment for the Humanities. 27–61 The Medieval Globe 1 (2014) pp. 28
everyMonica other H. Green part of the body, begins to decay immediately after death, so tered by researchers. For example, the full genome of Yersinia pestis is degradationabout 5.6 million of the basegenetic pairs material long. Thewas thefragments first of thethat challenges researchers encoun have
to this issue the problems of the material’s possible contamination (which had to deal with are rarely even fifty to seventy-five base pairs long. Add
thecould “aDNA occur debates” when collecting of the late it in1990s the field,and 2000s or in the were lab, so or intense. at any pointAlready in between), and it is quite understandable, looking back on them now, why tested for an antigen produced uniquely by Yersinia pestis—was shown toin be2004, useful however, in determining another thediagnostic presence mechanism—a of Y. pestis not protein simply inassay modern that diagnostics and epidemiological surveys, but also in historical samples. Meanwhile, studies reporting success in extracting Y. pestis aDNA kept
that the complete genome of Y. pestis, assembled from fourteenth-century appearing, each with more confidence, and by 2011 it was announced At the same time as this aDNA work was being pursued, highly sophis ticatedremains, studies had been were sequenced being done (Bos of etmodern al. 2011; samples Little 2011).of Y. pestis, which is Y. pestis have been going on since the late nineteenth century, but have increased in pacenow aand globally intensity distributed in recent pathogen.years, both Scientific because Y. studies pestis isof a useful model for studying pathogen virulence, and also because there are heightened
Y. pestis’s modern concerns of bioterrorism and disease re-emergence (Ziegler 2014, in this issue).struct theOne organism’s main objective evolutionary of phylogenetic history. studies The principle of is simple: by categorizinggenome (which like wasgenetic first variations fully sequenced with like, in the 2001) modern has samplesbeen to reconcan be grouped into clusters, from which phylogenetic relationships can then be inferred. In other words, different modern strains are placed at different end points of a family tree, with inferred branches connecting back down to a common root. Doing this on the basis of long sections of the genome (or now, more commonly, using multiple samples of the whole genome
individual base-pair changes (what are called single nucleotide polymor itself) allows for analysis of the organism’s phylogeny down to the level of The most critical development comes from the fact that both of these linesphisms, of researchor SNPs). have now converged. Fusing the phylogenetic work and
onto a branch of the phylogenetic tree that had already been postulated the aDNA work showsPlate that 1 thebelow fourteenth-century genome does in fact fit
(Cui et al. 2013; see ). In other words, the organism found in 29
historical humanTaking remains “Pandemic is not” S eriouslsimply Y.y: pestisMaking, but th ea Blakindck of De Y.at pestish Glo bnotal
the organism known in the world today. Is it possible that other patho genstoo far were distant involved in its geneticin causing structure the extreme (and in mortalityits potential levels virulence) of the fourfrom teenth century, in addition to Y. pestis? Yes, or at least we cannot rule out that possibility now. Is it possible that other strains of the organism might be found that complicate the narrative I have sketched above? Absolutely. Is it possible that science will keep doing what it always does, making new discoveries? We should hope so.1 But the microbiological science, whose rigorous methods are becoming standardized and are proving equally fruitful in exploring the histories of other pathogens and organisms, is building up a mounting body of evidence.2 enough about the history of Y. pestis as a biological organism to structure research programs around certain shared assumptions This confirms about that its we charac know ter and behavior. This is not “fringe” science. It is leading-edge work and it demands the serious attention of historians and all others investigating plague in history.
died of Y. pestis infections in disease outbreaks of the past? How does that changeBut the the skeptic work of will historians ask: So whator those if we working can say indefinitively other historicist that people dis ciplines? It is the purpose of this special issue of The Medieval Globe to argue that the new microbiology matters not simply because it solves the question “What was the disease?,” but because in solving that question (as ously know we needed to ask. First and foremost, it grounds plague history inI believe the eastern it does) part it opensof the upEurasian entirely landmass. new questions, As will ones be explained we did not in previ more detail below, study after study is narrowing in on the Tibetan Plateau and Qinghai as the likely place where Yersinia pestis diverged from the rela
1 I have omitted from this assessment a survey of climate science that may even tually implicate major geological or other events in the disturbed ecosystems that initiated the premodern pandemics. Although there is now compelling evidence for coincidental events (e.g., the dust-veil event of c Plague, and a volcanic explosion c . 535 as background to the Justinianic forth that would link such events directly. 1257 as to well the asbiological major climatic evolution events of Y. in pestis the 1340s. Such thatevidence may mayhave soon contributed be forthcoming, to the Black however, Death), since no itevidence is clear thathas yetalterations been brought in the
of the spread of Y. pestis. weather (like excessive rain) contribute to flea production and hence to the possibility 2 On continuing efforts to make aDNA research as methodologically rigorous as
work on modern genetic materials, see Seifert et al. 2013, and papers presented at the 2013 aDNA conference at the Royal Society in London. 30
tivelyMonica harmless H. Green soil pathogen Y. pseudotuberculosis and became one of the
the map in a way it has never been before, and that (as well as other con most highly lethal organisms in the world. Plague’s history is now firmly on to date about the disease. As historian Lester Little noted, referring to the siderations) demands that we rethink almost everything that has been said
significance of the Tübingen-McMaster study of 2011 that reconstructed theThey Black are Death calling genome for work from on thea London contexts cemetery of particular (Bos epidemics, et al. 2011): includ ing such factors as climate, presence and characteristics of vectors, inter actions with concurrent diseases, living conditions, and means of com
munication and travel. If nothing else, this finding is an open invitation Thatto “fray”historians, is already among quite others, active, to re-enter with variousthe fray. participants(Little 2011: 289–90)coming from different disciplinary backgrounds and, with some cause, bringing with them a wariness of differing approaches. At the conference “Human Evolution, Migration and History Revealed by Genetics, Immunity and Infection,” which was held in London in 2011, the organizers (two biolo
known to historians offered too limiting a view of the history of pathogens andgists human and a physician) evolution. expressed concern that relying on what was already
line to which we seek to tether the twists and turns of the biological story. The[W]e warning have, often, is that an we equally should fragmentary resist the temptation account of to the link historical relationships time casually through cherry picking those milestones in human history that are best recorded. While it is tempting to look for the correlates in evolu tionary selection of the Black Death, the fall of the Roman Empire or the colonization of South America, how many equally or more dramatic bot tlenecks have been imposed in the past millennia by pathogens, climate change or natural disasters for which we lack a good historical record (or
Altmannany awareness and colleagues at all)? (Altmann then go on et al.to 2012:suggest 765–66, that Yersinia my emphasis). pestis should be excepted from this caution on the grounds that it is of relatively recent
humansorigin and and genetically only secondarily monomorphic the pathogen—plague’s (not showing significant history levels is still of stunninglygenetic diversity). lacunous. Yet Yes, from there the ishistorian’s no question perspective—we that a major plague who study out
break happened between 1347 and 1353 in the Mediterranean basin and Western Europe. Whether we estimate its highest mortality rates at 30%, 40%, or 60% (as have variously been proposed), its effects were cata 31 strophic. ButT whileaking we“Pan maydemic have” Seriousl good—iny: M someaking cases, the Bla excellent—recordsck Death Global to document human fatalities from plague in those areas, the new plague science tells us that there is much about this disease of which we still lack awareness, including most of the factors that caused it to become, for
Europe, North Africa, and the Middle East, but also in Russia, India, and Eastmany and centuries, Central aAfrica: defining all featurethe latter not being only placesin the landscapewhere it still of Westernremains in enzootic foci. As will be noted below, most of the new plague science is also relevant to studies of the First Plague Pandemic, the Justinianic Plague which raged, at least in the Mediterranean basin, from c c This essay, then, argues that it is no longer helpful for historians. to541 take to . 750 (Little 2007; Mitchell 2014). I will focus here mainly on the Second Pandemic, sketching out two areas wherea posture we ofhave scientific yet to agnosticismsearch fully forwhen plague’s it comes historical to the history effects: of its plague. range across different host species and its geographical extent outside of the Tibetan Plateau and Qinghai region. The revised zoology reminds us to take into account not only the incidental animal species that immediately spread Y. pestis to humans in epidemic outbreaks, but also the many other species involved in the long-distance spread of the disease. Taking the genetics sci ence seriously also demands that we revise our geography of plague’s his tory. This new geography is not limited to the Mediterranean and the lands surrounding it. It extends from the Tibetan highlands and Western China overland into Western Eurasia but also, I will suggest, southward, into the Indian Ocean basin and nearly all points connected to it. 3
An Elephant of a Disease: Widening the Zoological Lens The Indian tale of the six blind men and the elephant is a useful metaphor for thinking about plague. Believing that the elephant was like a fan (by individual blind men could not perceive the huge and complex beast in itstouching entirety. only In itsthinking ear) or about like aplague, tree trunk we too (by need feeling to keeponly itsin playthick all legs), the elements that allowed a single-celled, non-motile bacterium to become a
(semi-)global pandemic. There is plenty of scientific literature to explain 3 On the possibility that plague spread east and southeast from the Tibetan-Qinghai evidence—genetic, skeletal, or documentary—that suggests that plague reached eitherPlateau Madagascar in the medieval or Australia period, prior see Hymes to the Third 2014, Pandemic in this issue. radiation To date, at the I know end ofof the no nineteenth century. 32
theMonica mechanisms H. Green connecting pathogen, natural hosts, accidental (or inter
On some issues there is widespread consensus; on others, research is only beginning.mediate) hosts, Here, environmental I wish to focus and on climaticthe need factors, for more and historical human elements. study of the animal hosts that may be involved in plague transmission. We need to look at more than the elephant’s tail. The Tibetan-Qinghai Plateau, whose average elevation is several thou sand meters above sea level, is as far removed in its climatic and ecologi cal environment from most of the areas hardest hit by plague in the four teenth century as it is in geographic distance. Y. pestis had to move across
as well as climatic zones in order to cause the massive human mortality many animal species (arthropod vectors as well as mammalian hosts) Y. pestis across many animal species will be a necessary part of retracing thatits geographical it did in the fourteenthspread. That century includes (and re episodically-examining thethereafter). role of one Tracing par ticular species, Homo sapiens, who is likely responsible for plague’s most extensive dissemination. But we’ll get to that species later.
plague modes usually cited in historical accounts—bubonic, pneumonic, andAs septicemic—needs Michelle Ziegler explains to be broadened (2014, in now this toissue), include the thetrifold gastrointes litany of tinal. As Ziegler notes, these different presentations of plague are better thought of by their method of transmission: insect bite and abrasion or
Theycutting are (bubonic all caused and by septicemic), Y. pestis. They inhalation differ only (pneumonic), in the path and by whichingestion the (gastrointestinal),organism enters the respectively. body and the These speed are with not different which it diseases,reaches the of course. blood stream, and, in clinical terms, by the symptoms induced when different immune responses are triggered, depending on what tissues the organ
this distinction, because while any or all of these modes of transmission mayism firstbe operative encounters in a (Pechousgiven outbreak, et al. 2013). each can It ishave important its own characteristicto begin with microenvironment.
mode of transmission that was documented early in the Third Pandemic at theMost turn historical of the twentieth work has century.focused Buton bubonic rats are plague,not the andonly the carriers rat-flea of tionary survival. There are several hundred animal species that can be plague: they are not4 even efficient ones in terms of the organism’s evolu
4 A new line of research has raised the question of whether human lice might also
increase the importance of studying practices of clothing exchange and resale, be a factor in plague’s spread (e.g, Ayyadurai et al. 2010). If so, this would radically 33
infected withT aplague.king “P5an Fordemic studying” Seriousl humany: M outbreaks,aking the interestBlack De hasath focused Global on “commensals,” those species that “share our tables,” living around human settlements, eating our foodscraps. But the new geography of plague tells us they we need to look at much wider biological systems to understand how Y. pestis moved many thousands of miles across varying ecological environments to reach large human population settlements. Beyond commensal rodents, we need to look at wild rodents, lagomorphs
well as the carnivore species that prey on them. (hares, rabbits, etc.), and ruminants (cattle, goats, sheep, camels, deer), as Y. pestis theFor organism, their 2013 which study had ofbeen historical collected variations from nineteen in the differentmutation mamma rates of lian genera, Cui infected and colleagues with Y. pestis drew on 133 complete genome sequences of
of the mammalia were rodent species,, as well one as was from a type a variety of lagomorph, of fleas, ticks, and and lice that prey on them (Cui et al. 2013, supplemental data: 10). Eleven
thethen list there of susceptible were other animals various is grazing far larger animals than that.(sheep, A surveillance bharals) and study carni in vores (badgers, weasels, canids, and foxes). There wereTatera also indica humans. cuvieri But
India carried out between 1989 and 2007Rattus found rattus that rufescens Gray and Rattus(Hardwicke), rattus the wroughtoni Indian gerbil, made up the highest percentage of plague- infected rodents (41.9%), followed by ent relations to human populations, Hinton, and the finally rats being the lesser “peri- bandicootdomestic,” ratwhile or Indian “Mole-Rat” (Biswas et al. 2011). These several species have differ how transmission could occur across rodent populations and move from ruralthe gerbils enzootic are foci wild. into But proximity all of them with shared humans. two species of flea, showing ties has been going on for over a century and has shown repeatedly that Similar field surveillance of plague transmission in rodent communi research showing the importance of looking beyond rodents. Camels have beenmultiple known species to be are plague involved carriers (e.g., forDavis over 1953). a century, Especially but theyimportant seem tois infect humans for the most part when sick animals are slaughtered and eaten, thus producing gastrointestinal plague. Such a case has been doc
and their implications for transmission of disease among humans, without the 2012 for the connections between
intervention of a flea vector. (See Veracx et al. 5 human head and body lice.) transAnisimov,mission. Lindler, and Pier (2004) note that over two hundred species of wild rodents and over eighty different flea species are known to be involved in plague 34
umentedMonica H. asGreen recently as 2009 (Federov 1960; Christie, Chen, and Elberg
in plague transmission in the past has yet to be explored. But we can see the1980; possible cf. Ziegler scenarios. 2014, in Small this issue).rodents How called commonly jirds (in camels the genus were Meriones involved are known to live around the tents of nomads and have been documented as being infected but plague-resistant, most recently in Algeria. This raises) the specter that even isolated nomadic herders or traders might have helped transmit plague across wide expanses not otherwise thought hos pitable to Y. pestis Meriones are found from Northern Africa to Mongolia, in a variety transmission of different (Bitam climatic et al. 2010;environments. see also VarlıkJirds can 2014, be commensalin this issue). as Various well as species sylvan, ofmaking possible plague transmission from enzootic foci to human communities. Since camels were domesticated as
beast of burden for overland trade in the Middle East from about the sec early as the fourteenth or fifteenth century BCE and served as the major tored into our calculus of how Y. pestis moved as far as it did. ondI amcentury not proposing of the Common a grand Era new (Bulliet monocausal 1975), they thesis should here. surely Few of be these fac species, by themselves, make sense as plague-transmitters across the wide terrains of Afro-Eurasia,6 and the climate science needed to help understand ning to emerge. But it is important to stress that historical research, likely combiningfaunal dispersals the efforts (independent of historians of workinghuman herding with documentary or trade) is sourcesonly begin and bioarcheologists working with biological remains (and climatologists as
more plausible than others. The phylogenies of commensal animals are nowwell), being will bestudied necessary as bioproxies to assess for whether human some histories: of these that possibilities is, tracking arethe histories of animals that have moved at great distances along with humans can serve to document human movements even when all other traces have
movements of such commensals are important in their own right, since thesevanished species (Jones can et serve al. 2013). to recreate But asfairly the homogenouscase of plague microenvironments makes plain, the in many different parts of the world.7 Introduce even a limited number of Yersinia pestis the ingredients for epizootics that spill over into human populations. -bearing fleas into such populations, and you may well have
6 A conference on precisely this issue was held in Leipzig in 2010 (Franz, Riha, and
7 Anthropogenic replication of microenvironments has likewise been key to the Schubertglobal spread 2010). of other vector-borne diseases, like malaria and dengue fever. See Green
(forthcoming) for an overview. 35
Reaching Africa:Taking “PYersiniaandemic pestis” Seriousl in Evolutionaryy: Making the Bla Timeck De andath GPlacelobal As noted above, one of the key developments in genetics has been the construction of robust phylogenetic trees that postulate the evolution ary relationships among various strains of Y. pestis, as documented from aDNA and modern samples. Evolution, of course, is a historical phenom enon par excellence, involving that most essential object of the historian’s quest: change over time. Earlier calculations of Y. pestis’s history, working from the assumption that there was a biomolecular clock that “ticked” at a regular rate, postulated that Y. pestis diverged from the most recent com mon ancestor it shares with Yersinia pseudotuberculosis anywhere from
The complete sequencing of1,056 the yearsfourteenth before-century the present genome—which (50% confidence at 8last putlimit) a timeto 20,436-date stamp years on(95% one confidence point of the limit) organism’s (Achtman premodern et al. 1999). evolutionary tree—allowed a recalibration of that molecular clock. A new history of Y. pestis was pro posed, which estimated its emergence as having taken place as recently as
about 3335 years before the present, with 95% confidence intervals still withinThe thecalculation range of ofrecorded time using human molecular history evidence(4394 BCE is tostill 510 a highlyCE) (Cui con et al. 2013).
tested area of paleogenetics (Ho and Larson 2006; Larson 2013). The isphrase now seeming“about 3335 like ayears red herring:[ago]” has genetic no calendrical change likely authority, occurs but for is various rather reasonsjust a computational and at various cipher. rates, In and fact, is the therefore notion ofhistorically a fixed “molecular variable. clock”9 Still, the phylogenetic tree of Y. pestis (as it has been refined over the course of the past decade and a half) does offer important chronological infor 8 basis of changes observed under laboratory conditions in Enterococcus coli and StaphylococcusThese biomolecular enterica clock type typhimuriumrates were initially. The lower calibrated limit cited in the here, 1980s 1056 on years the before the present, would, if true, obviously put Y. pestis out of the running as the causative agent of the Justinianic Plague. But the authors, assuming that the First Plague Pandemic was caused by Y. pestis, simply adjusted the clock back: “Justinian’s plague was 1,500 years ago, and, therefore, Y. pestis is at least 1,500 years old”
(Achtman et al. 1999: 14047). A revised calculation was offered in Achtman et al. 9 See, for example, Wagner et al. 2004, and again in Cui et al. 2013, which I discuss below. for Y. pestis rate variation, these data suggest that2014, previous which offersmolecular a second-clock fixed-deri vedpoint estimates in time of the timescale’s historical of Y. pestis genome evolution, and suggests including that the “[w]hateverdate of its divergence the cause fromof this Y. pseudotuberculosis, might be erroneous.” 36
mationMonica inH. Gthatreen it suggests a sequence of chronological change: “this” hap pened before “that.” And once we tie that relative chronological informa
for the historian becomes apparent: the fact that approximate place in tion to fixed geographic space, the real value of the new work in genetics The question of plague’s geographic origins has long troubled histori ans.time Oddly, can be the connected lines of argumentto specific haveplace gone in space. in different directions: for the Justinianic Plague, the standard argument had been to assume an Afri can origin;10 for the Black Death, its genesis has been placed more or less vaguely in “the East.” Given a confused historical record and the current distribution of Y. pestis across most of Asia and Africa (World Health Orga
long been unresolved. In 1976, McNeill, who placed the origins of Y. pes- tisnization “at some 2008, perhaps Neerinckx geologically et al. 2008), ancient it is littletime,” wonder chose tothe remain question on hasthe fence: “There appears to be no basis for deciding which of these two natu
11 For McNeill, the obscure geographic originsral reservoirs of Y. pestis [Central could Africa be shrugged or northeastern off so long India, as iti.e., was the seen Himalayas] to exist “timeis the outoldest” of mind.” (McNeill Even 1976: the emerging 139). evolutionary narrative in the 1990s
dating from the 1950s, collapsed African and Asian strains into a single left the question ambiguous because a widely used classification system,
ofsubspecies Yersinia grouping,pestis as it the is currentlybiovar “Antiqua” found throughout (Giuyoule et the al. world,1994; Achtmanallowing theet al. pathogen’s 1999). Extensive evolutionary work historyhas now to been come done more on clearly the genetic into view. diversity That work does not prove in any absolute sense where Y. pestis originated as an organism. But as a hypothesis, it accords with the emerging evolution ary and historical understanding of the organism.
10
evidenceHorden has 2005;yet been Sarris gathered 2007: that 120–23; can push and plague’s Sallares presence 2007. in McCormick sub-Saharan (2007: Africa 303–04), relying on Actman et al. 1999, defers judgment on the question. No written 11 For reasons that I will address in the last section of this essay, I consider all of this priorback definitivelywork “retrospective before 1877; diagnosis” see Neerinckx in the older et al. sense,2010. based exclusively on textual
not robust. It is for this reason, too, that I will not engage here with the many maps thatsources have whose been publishedability to properly in history document textbooks a andspecific elsewhere, microbiological “plotting pathogenthe course” is of plague’s spread with arrows and routes that have no foundation in documentary evidence, let alone material remains. On the many pitfalls in mapping as it relates to plague’s histories, see Mengel 2011. 37 Taking “Pandemic” Seriously: Making the Black Death Global
1.ANT – Central and East African 1.ORI – strains; diverged documented from the main line of Branch 1 cause of the c. 1499 CE 3rd Pandemic (CI 95% : c. 1377 to c. 1650)
0.PE3 – the “Angola” strain
Branch 0, between nodes 03 and 05, position of The polytomy (“Big Bang”) Justinianic Y. pestis strain just before the Black as established by Harbeck Death (c. 1268 CE, 95 et al. 2013; Wagner et al. CI: 1142 CE to 1339 CE) 2014 refine location to a position between 0.ANT1 Minimum spanning and 0.ANT2 phylogenetic tree of = c. 3335BP 133 Y. pestis genomes
Plate 1. Phylogenetic Tree of Yersinia Pestis. Adapted with permission from Cui et al. 2013.
A basic principle of evolutionary theory is that the greatest subspecies
longest. This is no constant, of course, since changed environmental con ditionsdiversification can drive will any be lifefound form in outthe ofarea its whereoriginal the habitat. species And has strains lived the go extinct, erasing from view certain lines of development. But as a rule tion generates valuable hypotheses. For Y. pestis, the current hypothe of thumb, the association of geography with subspecies diversifica since then—is that the organism took its origin in the Tibetan-Qinghai sis—firstPlateau, now proposed a part ofon modern genetics China. grounds12 If thisin 2004 is true, and then elaborated all narratives further of plague’s history must be connected to that place of origin. And if it is true,
is one of the biggest game-changers in historical studies of plague since it resolves definitively the Africa vs. Asia dilemma of plague’s origin. This
12 suggest, on epidemiological grounds, that Yersinia pestis had its origin within the The Chinese plague researcher Wu Lien-teh seems to have been the first to
boundaries of what we now call China (Wu 1924). The hypothesis was first advanced on genetic grounds by Achtman et al. 2004; see most recently Li et al. 2009, Morelli et al. 2010, Cui et al. 2013, and Yan et al. 2014. 38 Monica H. Green But the emerging evolutionary narrative has a second result, and that is to suggestthe identification that we should of the broadenrat-flea nexus our narratives at the turn of of the the Second twentieth Pandemic century. to include sub-Saharan African and, by implication, the Indian Ocean basin. The phylogenetic tree shown in Plate 1 comes from Cui and colleagues’ Y. pestis and summarizes the entire history of the organism as it is understood from 2013 study of historical variations in the mutation rate of
genetics. The historical significance of its five major branches (or13 lin eages)lates, and which, twenty-five with the subbranches exception of(or the phylogroups) oldest strain, is as0.PE7, follows. are found • Branch 0 (the main stem of tree) contains almost all pestoides It alsoiso 14 primarily in voles (groups 0.PE1, 0.PE2, 0.PE3, 0.PE4, 0.PE7). includes the earlier strains of the ANT group (0.ANT1-3). Bavaria, established that the strain that caused the Justinianic Plague • Harbeck and colleagues (2013), working from human remains found in
seemed to lie on branch 0 between nodes 03 and 05. Wagner and col leagues (2014) have refined that conclusion to put the Justinianic strain specifically between nodes 04 and 05 (that is, between the cur rent extant strains 0.ANT1 and 0.ANT2). c • Node 07 is the polytomy event (‘Big Bang’) that leads to branches 1-4. Cui et al. (2013) calculate a date for the polytomy at . 1268 (95% CI: 1142, 1339). • bothBranch the 1 Blackcontains Death African and theAntiqua Third (1.ANT) Pandemic. and 1.ANT all of the is localized Intermediate now in(1.IN) Central and and Orientalis East Africa. (1.ORI)15 strains. Strains on this branch caused
13 The trifold categories of biovars—“Antiqua,” “Medievalis,” and “Orientalis”— formulated in the 1950s according to the ability of different strains to reduce nitrate and to ferment glycerol, have been shown to be misleading and are now otiose
with the strains likely to have caused the three plague pandemics. The labels “ANT,” “MED,”(Achtman and et “ORI” al. 2004); are, thesenevertheless, phenotypical still found categories on laboratory have no meaningful samples, relics relationship of that
14 olderin Mongolia, classification and suggested system. the possibility of yet another strain, 0.PE9 found in Tajikistan,In 2012, Uzbekistan. Riehm et Theal. proposed species from an additional which the strain,samples 0.PE8 were (MNG collected 2972) were found not
15 267.”reported. Assuming Neither this strain is not is simplyshown ona labeling the diagram error, of it Cuiwould et al. be (2013). the only known case of Seifert et al. (2013: 5, table 2) refer to one sample of 1.ANT as “NCTC_570 Bombay 39 Taking “Pandemic” Seriously: Making the Black Death Global
• Branch 2 contains all of Medievalis (2.MED) and yet another “Antiqua” strain (2.ANT). These strains are currently found throughout much of Eurasia, including India (cf. Kingston et al. 2009) and as far west as Turkey and Libya (Cabanel et al. 2013). by Cui and colleagues; to date, these have been found only in China • andBranches Mongolia, 3 and in 4 marmots (3.ANT andand 4.ANT)in the genus were Merionesfirst announced, which includesin 2013 many kinds of jirds as well as gerbils. ard premodern history: that is, the narrative centered on plague’s arrival inThree the Mediterraneanfeatures of this and evolutionary Western Europe. tree are At significant the center for of the plague’s tree, at stand node c 16 This 07, is the polytomy (“Big Bang”) datedY. pestis by Cui (possibly and colleagues caused byto the. 1268 organ CE, with a 95% confidence interval ranging from 1142 CE to 1339 CE. periodpreceded of rapidthe Black diversification Death, whose of genome (taken from the London Black ism moving into new climatic environments and new hosts) immediately
Death cemetery) lies near the root of Branch 1 (the maroon-colored trian gles). Below the great polytomy, on Branch 0, lies the strain involved in the JustinianicThe phylogenetic Plague, which tree producedseems to fall by betweenCui and colleagues nodes 04 andwas 05constructed (Harbeck et al. 2013; Wagner et al. 2014). Y. pestis. Two of these (the two maroon triangles near the base of Branch from information drawn from the complete genomes of 133 samples of
1) are medieval samples from the London Black Death cemetery. All the nowothers within (131) the are political samples boundaries collected between of China the and late Mongolia. nineteenth The and outliers early twenty-first century; and all of these, save seventeen, come from areas
come from Russia (2), other areas within the former Soviet Union includ wishing Georgia to focus (3), on theAfrica three (3), samples India (1), from the Africa. United States of America (2), Myanmar (1), Madagascar (3), Nepal (1) and Iran/Kurdistan (1). Here I
the African strain 1.ANT being found outside of Africa. Amann (2007: 22) gives the provenance of NCTC_570 Bombay 267 as “G. Liston in 1920 / fatal bubonic plague, humans.Bombay.” I W.have Glen not Liston been able(1872–1950) to determine was anything a leading further plague about researcher the provenance in Bombay of this(Mumbai) sample. and helped establish the role of the flea in transmitting plague from rats to 16
See Hymes (2014, in this issue) for the significance of this date. 40
MonicaLittle H .genetics Green work has been done on sub-Saharan Africa on a scale comparable to what has been done in China and Mongolia, a lacuna in research that makes the following speculations tentative in the extreme.17 Nevertheless, such hints as are now available from Y. pestis genetics work suggest that a premodern history of plague in sub-Saharan Africa might be worth exploring. The earliest of the three African samples is also the single most problematic part of the phylogenetic tree of Y. pestis as it is
All provenance infor mationcurrently has understood. been lost, and This it strain,is not knowncalled “Angola”whether18 it(0.PE3), was collected comes from a laboratoryhuman being, sample a rodent, collected or an in arthropodor before 1984.vector. It is in every sense a conundrum, because no other samples from this region have yet entered into the genomics databases for Y. pestis. The “Angola” strain is distinc tive in two respects. First, it is the most divergent of all the strains thus
Yersinia pestis shares with its closest related species, Yer- farsinia studied. pseudotuberculosis 548 SNPs separate. All other it from strains, the mostsave two,recent of Y.common pestis that ancestor were (MCRA) that
thestudied ultimate from outlier.complete Second, genomes “Angola” by Cui alsoand colleagueslies very close have to less the than base 300 of theSNPs phylogenetic that separate tree them of Y. from pestis the. Just MRCA how (the old itmean is as is a 248).strain “Angola” is unclear, is but it clearly derives from some very ancient form of the organism. Only
17 Work coming out of the Institut Pasteur in Paris in the 1990s (e.g., Guiyoule et
recent genetics work, however, has focused mostly on Madagascar, where a radiation al. 1994) drew heavily on samples from Kenya and the (then Belgian) Congo. More to the World Health Organization, foci exist in the Democratic Republic of the Congo, Kenya,of one ofLesotho, the Third Libya, Pandemic Mauritania, strains Mozambique, predominates Namibia, (Morelli Senegal, et al. Tanzania,2010). According Uganda,
and probably Egypt (World Health Organization 1999: 16 and 26–31). I return to the implications of this sampling and research bias at the end of the essay. See also Varlık 18 2014, in this issue. sic . However,Dos Santos others Grácio believed and Grácioplague (2011:was already 1) claim there, (without and that offering a sylvatic citations) cycle withthat the “first reference to the occurence [ ] of plague in Angola was made in 1921. . .
wasa reservoir sequenced in wild in 2010 rodents and canwas be already found onlinepresent at in
(2013) on the basis aDNA retrieved from a gravesite in Bavaria. 41 two phylogroupsTaking that “Pan havedemic yet” beenSeriousl sequencedy: Making are th moree Bla cbasal,k Deat andh G ltheseobal come from Eurasia.19 So, how long has “Angola” been in sub-Saharan Africa? There is sim ply no way to tell at this point. But here is where a multidisciplinary per spective would allow us to take the question seriously, even if we cannot yet answer it. We actually have a least one account from a Greek writer described a “pestilential fever” characterized by swollen glands in the neck,in the armpits,first century groin, CE, and Rufus back of ofEphesus, the legs. reporting According on toother Rufus, writers this conwho dition was reported in Libya, Egypt, and Syria—in other words, around the Mediterranean littoral—at least six centuries before the Justinianic 20 By itself, Rufus’s report
AfricaPlague around arrived the at the beginning port of ofPelusium the Common in 541 Era. CE. And connecting the Med isiterranean insufficient to subfor -aSaharan clear determination Africa is even of more the presence problematic of plague for this in period North of time. But we can see why the historiographic tradition linking plague with Africa in ancient times cannot be dismissed out of hand. The real surprise that comes from genetics, however, is the possibility that it might help us to reconstruct a medieval or early modern history of plague in sub-Saharan Africa. The other African phylogroup represented
1.ANT,on Plate also 1 is called 1.ANT “Africa (gray Antiqua,” triangles, is top the center), group of which strains breaks of Y. pestisoff from found the nowmain in stem East of and Branch Central 1 just Africa, above from (i.e., Kenya just after) to Uganda the 1348 and London into the genome. Demo cratic Republic of Congo. In 2010, Morelli and colleagues proposed an age thefor theAfrican origin clades of this had branch branched somewhere off from between the main 628–6914 Black Death years clade ago. at In a later2013, time: Cui and c colleagues recalibrated this biological clock,c suggestingc. 1650. that
. 1499, with a 95% confidence interval of . 1377 to
19 Allactaga sibirica ChineseThese province are 0.PE7, of Qinghai; which was and sampled 0.PE2, which for the was study sampled of Cui from et al. voles (2013) in an from area the of theMongolian Former five-toedSoviet Union jerboa and (Georgia. ) and a human patient, both in the 20 Rufus’s original work no longer survives; rather, the excerpt describing buboes is reported by the fourth-century CE writer Oribasius, in his Collectionum. See Sallares
(2007: 251) for the Greek text and, for an English translation of the passage, Simpson (1905: 4); see also Simpson (1905: 281) for an image of a popliteal (behind the knee)pace bubo. My thanks to Heinrich von Staden for confirming the reading of the Greek and advising me on the identification of the authorities Rufus cites, none of whom ( Sallares) can be dated before the first century BCE. 42
MonicaAgain, H. Gasreen stressed above, the chronology established by genetics is more valuable in suggesting relative position in time than absolute posi
in terms of its place on the Yersinia pestis phylogenetic tree, one of the tion.most Itclosely establishes related a “descendants” historical sequence: of the strainX happened that killed before the Y.individuals 1.ANT is, plete sample of the Black Death genome. Or, one could say that it is a “dis tantin London cousin” whose of the remains London were strain, studied rather in than reconstructing a direct descendant. the first com This distinction is important, since the phylogenetic tree does not show us all the dead ends, the extinct sub-branches that may have moved into new geographic terrains or new hosts but then failed to establish mechanisms of long-term survival. The Black Death genome from London is an incred
organism as it existed seven hundred years ago, before it hit a “dead end” inibly the lucky human find: beings that rare it killed one-in-a-zillion in fourteenth fossil-century that captures London. a Thestrain modern of the specimens of 1.ANT, in contrast, have had seven hundred more years to evolve. And like the “Angola” strain, they show that 1.ANT has undergone considerable unique evolution: on a differently calibrated tree, one where physical distance more closely approximates genetic difference, 1.ANT is the furthest spanning subbranch of lineage 1, representing up to 100 mon ancestor of Y. pestis SNPs from the 07 polytomy and 300–305 SNPs from the most recent com (Cui et al. 2013: 579 and supplementary data 8, ingfig. S3,that A). it hadMoreover, been established a study of this in the East area and for Central a considerable African strain period done of timeback (Guiyoulein 1994 found et al. a considerable level of local genetic diversity, suggest According to current biological theory, when populations diverge from a common ancestor, 1994).genetic differences between them can arise for sev eral reasons. One of those reasons may be adaptations necessary for sur vival in a new host species. There are no marmots (one of the main host genera for Y. pestis sal rodents, does there seem to be any major overlap in the known host species of Y. pestis onin Easternthe Eurasia Eurasia) and African in Africa, continents. nor, aside In from other commen words, adaptation to new host species may well account for the stark divergence of 1.ANT from other strains on Branch 1, none of which are currently known in Africa save for the modern 1.ORI strains. So, to summarize, genetics currently tells us three things about 1.ANT. First, it does not derive directly from the “Angola” strain. Hence, when ever “Angola” did arrive in Africa, it did not give rise to 1.ANT. The his
Africa, can thus be separated. Second, 1.ANT is older than the strains dis tory of those two strains, and specifically the history of their arrival in 43 Taking “Pandemic” Seriously: Making the Black Death Global
canseminated be separated worldwide from (includingthe narratives to parts of the of Third sub-Saharan Pandemic. Africa)21 And during third, 1.ANT,the Third the (modern) strain of Y. Pandemic, pestis the 1.ORI strains. So the history of 1.ANT with Central and Eastern Africa, is most closely related to the Black Death strain now documented from associated the London (so Black far as Death we currently cemetery. know) only So when did 1.ANT arrive on the African continent? And by what route? As will be discussed in the next section, the arrival of plague into the Med
period was almost certainly via the Red Sea, where trade would have con nectediterranean the basinMediterranean (and so into to theNorth Indian Africa) Ocean. in the Whether ancient plagueGreco-Roman moved further south into the African continent, beyond the Horn of Africa, during the ancient Greco-Roman period is as yet unclear. Clearly, trade was occur ring across the Sahara and, up to a point, in the Nile Valley, but we do not yet have strong evidence either for the presence of commensal rodents or for developed urban communities that would have facilitated plague’s spread south of the Sahara before the seventh century CE. By the time of the later medieval plague, however, the situation in sub-Saharan Africa was different. Considerable trade occurred across the Sahara in exchanges of gold, slaves, salt, and probably also ivory (McDou
tripgall 1990;whose Guérin timing 2013). should Mansa not go Musa’s unnoted. famous For justpilgrimage a few decades from Mali later, to Mecca in 1324 remains symbolic of those medieval trade networks, a been thriving metropolitan centers. The sudden late medieval abandon mentwe find of abandonmentearthwork settlements of sites in at sub-Saharan Jenne-Jeno andAfrica Akrokrowa, that had previously in what is tosh mused on the possibility that plague may have been involved in present-day Ghana, has proved a puzzle to archeologists. In 1998, McIn
widespreadJenne-Jeno’s abandonment: abandonment (McIntosh 1998: 247–50), while Chouin and DeCorse (2010) were willing to speculate openly about it as the cause of Looking at world history during this period, it seems that only one event can possibly explain such a large-scale phenomenon: the occurrence of
21 The historical works of Myron Echenberg on plague in Senegal and South Africa
emerging. Nevertheless, subsequent genetic analysis suggests that the strains of plague that(Echenberg hit northern, 2001 northwestern,and 2007) do andnot southerndraw on theAfrica genetics in the workstwentieth that century was only were then of the 1.ORI phylogroups, and hence distinctive of the Third Pandemic; see Bitam et al. 2010; Morelli et al. 2010. On the recent discovery of a MED strain (found on Branch 2
of the phylogenetic tree in Cui et al. 2013) in Algeria, see Cabanel et al. (2013). 44
Monicathe Black H. Green Death or Great Plague. . . . In affecting societies living in forest areas of southern Ghana, the Plague would have had exactly the same effect as in other parts of the world: it would have destroyed a large por tion of the population living in densely populated settlements, resulting in their abandonment—a well-documented phenomenon in many other
Butcontexts. in placing (Chouin plague and in sub DeCorse-Saharan 2010: Africa, 143) Chouin and DeCorse were over
22 interpretingTo date, there the is neithersuperficial bioarcheological and unsubstantiated research claims nor aDNA of a non-academicto tell us what bookhappened published to these nearly societies thirty which, years earlierit seems, (Cartwright left no written and Biddiss records. 1972). Hence, the question of plague’s possible penetration across the Sahara to West Central Africa must remain for the moment an open question. The situation for East Africa is different. Here, the likely point of entrance for the strain of Yersinia pestis that now dominates in Central and East Africa, 1.ANT, was the Indian Ocean coast, where from the sev enth century on there is increasing evidence of a “a deeply networked
two exceptions, Indian Ocean transit of Y. pestis to East Africa below the Horntrade andhas contactnot previously situation” been (Boivin suggested et al. 2013: for plague 1; cf. Horton prior to 2004). the Third With Nevertheless, we have cause to raise the question of the timing of plague’s23 arrival. For in Eastern Africa, we have a phenom (modern)enon similar Pandemic. to that in West Africa, at virtually the same time: at least four important trading centers suffered major decline. On the coast, Shanga (on
the Lamu Archipelago off the coast of modern-day Kenya) and Tumbatu 22 In fact, Cartwright and Biddiss never said anything about sub-Saharan Africa per
just summarizes the impact of the Black Death on Europe. se, referring only generically to “Africa” (1972: 32 and 51). Their narrative typically 23 decline of these towns, but implies that the latter is due to the general collapse of the Horton (1996/2012) notes the coincidental timing of the Black Death and the
supportinternational of their economy claim that at that plague time. spread Horton “throughout and Middleton the Middle (2000: East 82) offerand the a passing Indian Oceansuggestion world,” that but plague Dols may in fact have claimed indeed that reached transmission East Africa. through They cite the Dols Indian (1977) Ocean in
by the microbiologist Mark Achtman, who proposed in 2010 that Y. pestis might have was unlikely (Dols 1977: 43–44). The other claim of Indian Ocean transport was made
ofbeen its broughthistorical to or East epidemiological Africa by the Chineseimprobability, explorer but Zheng rather He because (1371–1433) he recalibrated (Morelli hiset al. biological 2010). Achtman clock, pushing has since the retracted divergence that of suggestion 1.ANT from (Cui the et main al. 2013), branch not to because a later era and thus making Zheng He’s role less likely. 45 Taking “Pandemic” Seriously: Making the Black Death Global (on Tumbatu Island) were abandoned, while Kilwa on the island of Kilwa mortarlessKisiwani (modern-day structures, wasTanzania) abandoned. became The derelict. dating Inland,of Great Great Zimbabwe’s Zimba bwe (near present day Masvingo, Zimbabwe), known for its monumental in the early 1990s showed that Great Zimbabwe’s growth had stopped abandonment has been intensely debated; carbon-14 dating performed by the sixteenth, at the latest (Huffman and Vogel 1991; Pikirayi 2001: by the mid-fourteenth century, and the site was abandoned definitively
and150–51). an upland While region there (Greatwas not Zimbabwe complete is devastation on a plateau, of theover East a thousand African coast in this period (e.g., Wynne-Jones 2013), the pattern of coastal areas
plague’smeters high) spread being were simultaneously there: intense humanaffected trade bears in the various distinctive commodities stamp acrossof plague the (Carmichael Indian Ocean 2014, and inthe this arrival issue). of AsianMoreover, commensal the conditions rodents for in East Africa.
Reaching Tibet: A New Geography of Plague
And the coral which is brought from our homeland is sold more in this land than any other kind. 24
brought Mediterranean coral all the way to Kashmir (where he made this Marco Polo (d. 1324) was a latecomer to the vast trade networks that there, too.25 Polo’s Description of the World, read from the perspective of whatobservation) we know and now to Tibet,about wherethe global he noted spread that of coralpathogens, brought opens “great a windowdelight” onto the material connections of the premodern world. Coral was one of the few precious yet easily transportable substances that the Mediterranean world could trade eastward in exchange for so many kinds of materials and
well as that of other substances like Tibetan musk, Indian pepper, or East Africangoods coming ivory, helps from usEast reconstruct and South human Asia (Sibon exchanges 2012). otherwise Tracing its lost trade, to his as
24
Chapter 48, on Kashmir (“Thesimur”): “Et le coral qui se porte de nos contrees thisse vent statement moult toen my ceste attention, contree and plus to Markus que en Cruse autre” for (Polo providing [and meRustichello with the citation. of Pisa 1298–99]/2003: 7, emphasis added). My thanks to Barbie Campbell Cole for bringing 25 chier, car il le meitent au col de leurs fames et de leur ydres par moult grant joie” (Polo Chapter 115, on Tibet (“Tebet”): “En ceste prouvince s’espant le corail et est moult
[and Rustichello of Pisa 1298–99]/2003: 71). 46
tory.Monica By Hthemselves,. Green these luxury goods were probably innocuous in terms of disease transmission.26 and their excrement far beyond where their animal hosts would have taken But add in the furs that may have carried fleas ersthem full while of locally living traded (Ducène grain, 2005); and thethe rodentsbeasts of they burden attracted; laden and with a medithese evalgoods, taste with for their luxury own textiles fleas andthat ticks;drove the international shipholds tradeand storage (but also contain could
transport fleas and their excrement), and we have a web of connections that make up Le Roy Ladurie’s “microbial unification of the world” (Le Roy contributionsLadurie 1973). to We make, cannot, archeology of course, and be history casual evenin our more. use ofBut globalizing together, theyframeworks. suggest Specificsthat a whole in time world and region space should matter be hugely. added Genetics to our narratives has some of the Black Death, a region that would connect the Tibetan Plateau and Qinghai to sub-Saharan Africa: the Indian Ocean basin. It is nothing new to connect the Black Death narrative with trade, of course; it has long been suggested that plague moved to Western Eurasia and thence the Mediterranean and North Africa “via the Silk Road.” That is simply a statement of its trajectory, however, rather than an actual docu mented mode of transmission, since it is likely that (whether carried by Y. pestis followed the topography of mountain passes, rivers, and valleys that traversed Central Asia and servedrodents as or the humans network or ofother trade species) connections that we aggregate under the
course, as trajectories for plague’s arrival in the Black Sea region, whence itrubric spread “Silk into Road” the Mediterranean.(Beckwith 2009). But Overland an important routes question make most needs sense, to beof asked: did it go in other directions as well? Arguments have been made by
orBuell India. (2012), Hymes’s Sussman contribution (2011), andto this Anandavalli issue challenges (2007) thesethat plague claims (or with at respectleast major to the human Gansu outbreaks) corridor and cannot areas be of documented China further in medievaleast. Moreover, China as science reminds us, there can be plague without “plague.” Even in the absence of human outbreaks, Y. pestis can subsist and thrive in mamma lian communities normally beneath the notice of humans. A new genet ics of plague—especially the fact that the African 1.ANT strain demands explanation—suggests that southern routes of plague in the late medieval period merit further consideration.
26 Or perhaps one should say “usually innocuous.” A twelfth-century Latin account
explains that musk (both real and fake) was often sold in the skin of the musk deer (Wölfel 1939: 79–80), so perhaps it posed the same problem as the transmission of furs. 47
First of all,T aitk ising likely “Pan thatdemic we” Shaveeriousl underestimatedy: Making the the Bla roleck De ofat a southernh Global route, via the Indian Ocean, for the First Plague Pandemic itself. Contrary to assumptions made by historians of late antiquity, it would seem that plague manifested first at the Egyptian port city of Pelusium (in the same27 Thesite asport modern-day of Clysma Tellin the el-Farama) Red Sea has not recentlybecause beenit “came proposed out of Africa”as the pos(i.e., sibleEgypt), entrance but because gate of it Yersinia came via pestis traffic into from the the Mediterranean Red Sea (Little (Tsimias 2007). et geography, but the need to plot a route for Y. pestis out of the Tibetan al. 2009). This argument was based solely on considerations of ancient trade in the Indian Ocean basin, which can now very easily account for an Highlands fits both the emerging genetics data and the newer research on its Central Asian home into the very different environments of the Indian Oceanintensity and of ultimately travel that the (however Red Sea slowly) and the might Mediterranean have moved littorals. plague out of been transformed radically in the decades since the main lines of argu Secondly, the field of Indian Ocean studies is one of the areas that has Periplus of the Ery- thraeanment in plagueSea, a Greek historiography report on wereIndian laid Ocean down trade (Seland and navigation, 2014; Beaujard writ 2005 and 2012). We have long known about the example, the import of coral at the Skythian port of Barbarikon/Min nagar,ten in whichthe mid-first was at centurythe mouth CE of by the an Indus, Egyptian and merchant.the export It of notes, “Chinese for withpelts” ancient (Seland inscriptions. 2010: 59). More These recent have beendiscoveries determined include to thebe byexistence sailors on Socotra Island (off the coast of modern Yemen and Somalia) of a cave CE. Texts written in Indian Brahmi script, and South-Arabian, Ethiopian, Greek,who visited Palmyrene, the island and Bactrian between scripts the first and century languages BCE give and evidence sixth century of the breadth of Indian Ocean trade up to and including the time of the Justini remarkable letters and other documents of Jewish traders from the Cairo Genizahanic Plague that (Strauch show an 2012).intense For and the thriving later Middletrade across Ages, thewe Indianhave equally Ocean
Periplus(Goitein and Friedman 2008). The Socotra and Genizah finds are unusual, however, as is the Greek . For the most part, we have neither identifiable individuals nor 27 The claim that rats carrying plague brought the disease from the Tanzanian coast discussed below, the archeological evidence now suggests the arrival of rats in East Africaup to the somewhat Red Sea later.in the sixth century was premature (Horden 2005: 153). Instead, as 48
anyMonica written H. Green records at all. However, as with Marco Polo’s coral, tracking unique commodities in their travels allows us to glimpse how intense per was, throughout antiquity and the Middle Ages, produced primarily onIndian the OceanMalabar traffic Coast was. of whatTake pepperis now andsouthwest musk, forIndia. example. Pepper’s Black history pep has long been told in terms of trade with the West, but it is apparent now that China was one of the main markets for pepper in the Middle Ages. In other words, pepper was going both directions from the Malabar Coast,
Similar motives in the trade of musk connected Tibet with the Indian Oceanconnecting world China and parts with beyond. all points The in Egyptian the Indian encyclopedist Ocean (Prange and historian 2011).
wasal-Nuwayr broughtī� (677/1279–732/1332), down to the Arabian Sea for via example, the Indus explained Valley, whence that Tibetan it was shippedmusk (deemed to various far superiorother ports to thatin the that western came Indianfrom China Ocean or (Akasoy elsewhere) and
pottery, beads, tableware, and so forth—is stark witness to the intensity andYoeli-Tlalim extent of 2007: trade, 221). both In short fact, a- andwhole long array-dist ofance, archeological throughout evidence— much of the Indian Ocean basin.
it stands to reason that we should also look for commensals that traveled withWhere these there traders: is extensive a scenario human perfect traffic for across the establishment a geographical of expanse,Y. pestis in new terrain (and amply documented from modern studies of Y. pes- tis’s very rapid establishment in North and South America and Madagas
are readily found. The Asian house shrew, Suncus murinus; the black rat car during Rattusthe twentieth rattus ;century). and the houseAnd in mouse,East Africa, Mus suchmusculus commensals, are all Rat- (shiptus rattus rat),, the black rat, have been found in archeological remains from documented as imports from Asia (Boivin et al. 2013). The bones of and Shanga along the Swahili Coast of East Africa. Rattus rattus may have arrivedUnguja thereUkuu, as Tumbatu early as the(one seventh of the centuryabandoned and seemssites mentioned to have been above), com mon in urban contexts in the fourteenth. Hence, we have two parts of the “elephant”28 of plague here: the mecha nisms of trade across the Indian Ocean basin, and the presence of a “rodent infrastructure” in East Africa to support a vector-borne disease when and if it arrived. We currently have, however, no paleogenetic work from this part of Africa; and indeed, very little genetics work has been done at all on
28
Nina Mudida and Mark Horton, personal communication (February 10, 2013). 49 the modern TY.a kpestising “P organismandemic” Saseriousl it currentlyy: Making exists the throughout Black Deat hmuch Glob alof sub-Saharan Africa, and where it still causes the second largest number of human cases per year. Indeed, we do not even have clear evidence of a trail of human plague from the Tibetan highlands down to the Indian Ocean theports presence in the fourteenth of plague orin fifteenthmedieval centuries, India. Yet a we point should used be by reminded Anandavalli of the(2007) mantra and Sussmanof bioarcheologists: (2011), in their absence respective of evidence studies, is tonot argue evidence against of given a history in India that goes back three thousand years. absence. In a 2006 report of the 1994 plague outbreak in Surat, plague is
recorded in Bhagvata Purana whenThe first the disease known reached outbreak India of plague from Central occurred Asia from following 1500–600 the invasion BC as . The plague was seen again in 1031 AD have been destroyed by a plague epidemic in Malwa. (Dutt, Akhtar, and of Sultan Mahmoud. In 1403 AD, Sultan Ahmed’s Army was supposed to
No McVeighsupporting 2006: documentation 757–58) was offered. But other, less extreme claims of the antiquity of plague in India, in some cases pushing it back to the eleventh century, occur in plague literature of the nineteenth and twenti 29 For India, then, we are at the same stage of feeble retrospective diagnosis from a handful of opaque written sourceseth centuries as we (e.g., were Simpson when studying 1905: 40). the history of plague in Europe prior to recounts1998. The how first “the “clinical” plague description (taun that meets Anandavalli’swaba criteria for plague is a 1689 report by a historian, Khafi Khan, writing in Arabic, who ) and pestilence ( ), which had been bananaravaging under Dakhin the (South arms, India) behind for the several ears, years,and in had the spread groin’” to (Anandavalli Bijapur. He describes the visible marks of the plague: ‘swellings as big as a grape or 30 2007: 25). For Sussman, the “first” clinical report is that of the Mughal emperorAt this Jahangirtime, again, (d. it1627), appeared who from reported the reports in 1619 of thethat loyal that the dis ease of the plague was prevalent in Agra, so that daily about 100 people,
29 The possibility of a hitherto unrecognized pandemic in the eleventh/twelfth century merits more examination. There is a story of “epidemics (wabā plague (ṭā‘ūn ’) and the Yemen, and Egypt)” in inearly the eleventh-centurytwelfth century. Tunisia “which carried off the greater part of the population” (Talbi 1981: 221). Dols (1977: 33) reports an outbreak in the Hijaz, 30 For the latest assessment of the semantic weight carried by these Arabic terms, see Stearns 2011. 50
Monicamore H or. G less,reen were dying of it. Under the armpits, or in the groin, or below the throat, buboes formed, and they died. This is the third year that it has raged in the cold weather, and disappeared in the commencement of the
Is ithot possible season. that (Jahangir, it was as only quoted in the by seventeenth Sussman 2011: century 336) that Yersinia pes- tis Sometimes absence of evidence really does signal absence of the phenomenon.31 But India’s first proximity came down to the from Tibetan the Tibetan highlands, highlands the well into-documented India? networks of trade that connected much of south and southeast Asia throughout the ancient and medieval periods, and, now, the evidence of deep genetic links between the strains of Y. pestis found in East and Central Africa and those that came out of Central Eurasia in the fourteenth century: all of these fac tors raise new questions about India’s history with plague. Anandavalli and Sussman are right to be cautious of reading too much into the ambiguous evidence of the few written sources they had at their disposal. Plague is hardly the only disease that presents in epidemic form, and careful interpretation of such sources always demands the expertise of scholars skilled in the nuances of the original languages. But it has been the objective of this essay to argue that historical narratives can be crafted from other sources, too. Transmission of plague through India (whether ously the emerging narrative derived from genetics, and posit an arrival of plaguevia the Indusin late Valley medieval or the East Ganges) Africa. begins to look plausible if we take seri centuries were periods of intense upheaval32 in many areas of Asia, and it may be worthwhile to consider the possibility Indeed, the that fourteenth a major social and fifteenth disrup tor such as plague contributed to that upheaval (Lieberman 2011; Hymes
ience2014, amongin this issue). different kinds of historical evidence is openly embraced In the field of climate and environmental history, a search for consil
31
Ansari (1994, also citing from Jahangir) says that the emperor first reported the disease not in 1619 but in 1615, noting that “the king wrote that it was the first time that the disease had occurred in India.” Catanach (2001: 141) similarly identifies the seventeenth century as the time of the first outbreak of plague in India, when he notes 32 Granted, at this point we cannot rule out another possible narrative, unlikely thoughan outbreak it may in 1631be given among the handloom distances weaversinvolved in and Gujarat. the fact that shipping of trade goods was not a factor: that plague reached East Africa via the Portuguese, who
soonarrived in Englishin 1498. translation. On the experience My thanks of toplague Iona McCleeryin Portugal, for see this da information. Costa Roque 1979. The chronicles of Fernão Lopes, a fifteenth-century chronicler, are due to be published 51 Taking “Pandemic” Seriously: Making the Black Death Global contrast, might be more immediately served by focusing not just on points where(McCormick the narratives 2011). A of multidisciplinary different disciplinary approach approaches to disease converge history, (as, in for example, in the case of the genetics, historical, and bioarcheological but also on areas where they seem to be in utter disagreement. As Altman33 and his colleagues havework warnedon the Londonus, we should Black Deathbeware cemetery), of “cherry picking those milestones Y. pestis strains in just three areas of India in 2009 showed three very different in human history that are [already] best recorded.” A study of there more than once. Much more research on the genetics of the modern Africanlineages and (Kingston Indian 2009),strains making of plague, it likely in addition that plague to much has beenmore importedcombing of historical archives and sampling of archeological evidence to look for extinct Y. pestis tions I have made here about a late medieval impact of plague in India and sub-Saharan Africa strains, are plausible.will be necessary But we wouldto confirm have whether never seen the this sugges as a possible line of research had there not been a convergence of many differ ent disciplines on questions of plague’s histories in recent years.
Reclaiming Retrospective Diagnosis: Sources, Methods, and Goals for a Global History of Health
If we want to understand what health and illness meant for past suffer
ers, we have to accept their labels, not impose ours. (McCleery 2013: 90) What was invisible to the [peoples of the past] need not remain invisible Thesefor ustwo as statementswell. (Stathakopoulos about what 2011: is called 95) “retrospective diagnosis” cap ture the historian’s dilemma: is our task to reconstruct the world as his torical participants perceived it (what anthropologists would call an emic in a positivist mode, is our task to use the methods and categories of mod approach) and reject modern (biomedical) understandings of disease? Or, frame of reference, that of modern science (an etic erntion science haunts tothe find historian out what working “really” with happened, cultural as remains judged in from a way an itexternal would not haunt the microbiologist reconstructing aDNA fragments.approach)? For This the ques his torian, both of these perspectives are “real,” since human experience and
33
See DeWitte (2014, in this issue) for a review of research on the London Black Death cemetery at East Smithfield. 52
theMonica motives H. Green for human actions are major objects of our quest. But among historians, too, there are different motives and different objectives.34 “Plague,” as Andrew Cunningham has most incisively pointed out, is a construct of modern biomedicine, built on a foundation of laboratory sci ence, epidemiological studies, entomology, and zoology which together have contributed to our understanding that “plague” is a disease caused by an infectious microorganism (Yersinia pestis or other means, presenting certain characteristic clinical signs and affect ing the human body through physiological processes), transmitted known by fleathrough bites
and animals both pre- and postmortem. Absent that laboratory, there is nocountless “plague” clinical in this observations sense (Cunningham and laboratory 1992; studiescf. Arrizabalaga of afflicted 2002 humans and
suffering, experiences that even those suffering might not have put into a singleCunningham category 2002). of a namable All we have disease. are Thetexts “linguistic that describe turn” variousthat has kindsaffected of most Anglophone historiographical traditions over the past thirty years has reinforced a sense that we can never fully break free of the conceptual
I do not contest this interpretation; on the contrary, I accept it whole heartedlycategories in of soour far historical as it applies texts toand histories reconstruct drawn a “real,” from unfilteredhuman cultural past. products like written documents or works of art (cf. Green, Walker-Meikle,
possibilities, of a multidisciplinary history face us. Microbiologists have brokenand Müller through 2014, the in thisnineteenth issue). -Butcentury here barrieris where of the laboratory challenge, medicine. and the Nearly all modern laboratory samples of plague and other pathogens have been collected in just the past 150 years. But aDNA research reaches beyond that chronological limit, reconstructing and identifying old organ isms in a way that microbiologists themselves now believe is possible (even nects plausibly with the narratives of pathogen evolutionary history cre atedif they by still genome argue-bas amonged phylogenetics. themselves about “Retrospective best methods) diagnosis,” and that in other con words, now has a completely new meaning, one based on assessment of a material substrate of the past rather than cultural products alone. 35
34 The bioarcheologist, who draws on both cultural and material remains, stands somewhere in between these poles, a point I address below. 35 I have foregrounded here the diagnostic possibilities of molecular microbiology, but in diseases other than plague (most notably, leprosy as caused by Mycobacterium leprae also has methods to draw plausible “retrospective diagnoses.” See Green 2012 and forthcoming, discovered for an overview.by Armauer Hansen in 1873), the older field of paleopathology 53
Taking “Pandemic” Seriously: Making the Black Death Global cance of the new plague science posed at the beginning of this essay. My responseSo, to returnis: “Because to the it skeptic’sgives us something “So what?” to questionthink with.” about The thebroadened signifi narrative of plague I have sketched out in this essay suggests the possible world that have never before been part of Black Death narratives. And the othersignificance essays ofin animalthis special species issue and push human those populations boundaries and of new areas thinking of the on the histories of plague even further. In a typical anti-retrospective diag nostic stance, historian Iona McCleery says that “If we want to understand what health and illness meant for past sufferers, we have to accept their labels, not impose ours.” But what if those sufferers are populations of the destroyed African civilizations of Zimbabwe or possibly Jenne-Jeno and Akrokrowa? What “labels” have we to interpret when these vanished soci eties left no written records? As Anna Colet and her colleagues make clear is sheer chance that we now have both documentary records and physical in their study of the communal graves of Tàrrega (2014, in this issue), it For so many victims of the Black Death—both those who died of plague andevidence those for who the died slaughter at others’ of the hands—we Jewish community have no testimony of that town of their in 1348. suf fering other than their physical remains or other traces. And even those are rare, especially in parts of the world where archaeological traditions
Reconstructing the history of the Black Death can proceed from many motives,are still nascent and methodologies (Campana et will al. 2013).be chosen according to the objectives that various researchers wish to achieve as well as their training and resources. Some possible methods for exploring plague’s histories have not even been discussed here, such as the use of historical linguistics, which has already proven a powerful ally to both archaeological and genetics work demands the efforts of many blind men and women to assess its full, huge, and(e.g., awful de Luna, expanse. Fleisher, Yersinia and McIntosh pestis has 2012). established Plague itselfis an as“elephant” a worldwide that circulating in human bodies. Rather, it exists today in every continent save Australiapathogen andnot becauseAntarctica (like, because say, measles it was carried or tuberculosis) far from its it isapparent continually site of origin in the Tibet-Qinghai Plateau by combinations of human and ani mal carriers who recreated microenvironments in which Y. pestis could thrive. It was then able to establish foci in new areas, moving from com 36
36 establish permanent foci thanks to aggressive public health measures. See Curson and Plague did reach Australia during the Third Pandemic (if not before), but it did not
McCracken 1989. 54
Monica H. Green
mensalThis rodentessay presents populations the new(transported face of the by Blackhumans) Death, into a new,medieval rural panspe demiccies where that themay organism have spared could Oceania find permanent and North hosts. and South America only because those areas had not yet been brought tightly into the networks of Afroeurasian trade. A global approach to the disease’s history—thinking across time and space37 and our own methodological perspectives, taking in the full evolutionary history of the pathogen and the full human impact of the disease—will give us a mechanism to explain how plague reached those last corners of the world, what it did when it got there, and how its many stories compare to those of other global diseases. A “global” approach will also facilitate greater understanding of a disease38 that still affects several thousand people every year and could threaten many
above has been based on modern samples collected in China, and on the effortsmore (Ziegler of Chinese, 2014, Russian, in this andissue). North Much American of the geneticsscientists, work who described for many decades have prioritized plague research because it exists as an enzootic parable genetics work has yet been done in other areas where plague is enzootic:(and even in bioterrorist) India, Southeast threat Asia, in their South own America, countries. and mostBut very parts little of Africa. com
imbalance in molecular research infrastructure on the study of another globalJohanna disease, T. Crane HIV/AIDS. (2011), among This examination others, has ofnoted the Blackthe effects Death of suggests such an
may not simply broaden our historical knowledge, but help us reconceive thethat world framing we pandemics live in today. both widely (in geography) and deeply (in time)
37 Though here, too, tracing commensal rodents shows medieval human movements.
38 As this essay will have made plain, it will be necessary to gauge the hows and Seewhys Wilmshurst of plague’s et global al. 2008. history not in terms of human witnesses alone, but from other kinds of evidence. Moreover, all of the methods and perspectives surveyed here can be applied to other conundra in disease history, for example, the still mysterious case
As outlined in Green 2012 and Green forthcoming, a global approach to the history of thedisease cocoliztli is not epidemic simply multidisciplinary of 1544–50 in Central but deliberately America (see seeks Warinner out parallels et al. 2012). and interactions between different diseases. 55
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In 2009 and 2012, she ran a National Endowment for the Humanities Summer ([email protected]) Seminar in London on is “Healtha historian and of Disease medieval in the European Middle and humanistic disciplines could engage in productive dialogue about the his Ages,”tory of which disease had and as health its central-seeking goal behaviors. the exploration During of this ways same that period, the scientific she has speciesalso argued since for its the origin development up to the ofpresent a new day,field, and “Global the ways History that of human Health,” cultural which changesexplores havethe evolutionfacilitated of or the hindered major pathogensthose pathogens’ that have trajectories. afflicted Inthe addition human to many works on the cultural history of medieval medicine, she is the author of “The Value of Historical Perspective,” in The Ashgate Research Companion to the Globalization of Health and “The Globalisations of Disease,” which will be published in 2015. , ed. Ted Schrecker (Aldershot: Ashgate, 2012), pp. 17–37; Abstract This essay introduces the inaugural issue of The Medieval Globe, “Pandemic Disease in the Medieval World: Rethinking the Black Death”. It sug gests that the history of the pathogen Yersinia pestis, as it has now been recon Plague Pandemic. Historiography of the Black Death has hitherto focused on a limitedstructed number by molecular of vector biology, and hostallows species, for an andexpanded on Western definition Europe of the and Second those parts of the Islamicate world touching the Mediterranean littoral. Biological con siderations suggest the value of a broadened framework, one that encompasses an enlarged range of host species and draws on new archeological, genetic, and historical researches to look for the presence of plague in the premodern Indian Ocean basin and East Africa, areas where it has previously not been suspected. Keywords Afroeurasia, Indian Ocean, zoonotics, retrospective diagnosis, Black Death, Justinianic Plague, global history of health. THE BLACK DEATH AND ITS CONSEQUENCES FOR THE JEWISH COMMUNITY IN TÀRREGA: LESSONS FROM HISTORY AND ARCHEOLOGY* ANNA COLET, JOSEP XAVIER MUNTANÉ I SANTIVERI, JORDI RUÍZ VENTURA, ORIOL SAULA, M. EULÀLIA SUBIRÀ DE GALDÀCANO, and CLARA JÁUREGUI an exhibit opened at the Museu Comarcal de l’Urgell in Tàrrega, commemorating a tragedy that had occurred in that Catalan Itownn M nearlyarch seven2014, hundred years earlier.1 This tragedy—the murder of a large number of the town’s Jewish inhabitants—has been acknowledged reached the ruler of the Crown of Aragon almost immediately. Legal pro ceedingsfor centuries. continued Reports for of severalthe events years that thereafter, transpired not in theso much summer to identifyof 1348 ments that had been destroyed or stolen in the rioting.2 Meanwhile, con andtemporary prosecute reports the murderers of the events as toin restoreTàrrega property circulated and among financial the instruJewish communities of Catalonia. Stories of the event were also handed down among subsequent generations of Jews when they emigrated to Italy known for some time. after their general expulsion from Spain in 1492. All of this, too, has been * This essay, originally drafted in Catalan, has been translated and revised for publication by Monica H. Green and Carol Symes. 1 Museu Comarcal de l’Urgell-Tàrrega, “Tragèdia al Call. Tàrrega 1348” living(i.e., there descendants. are no burialAll the recordsresearch forat the this site cemetery has been orconducted coffin plates in accordance that identify with theinterred Llei 9/1993,individuals de by30 name),de setembre, and thus del this Patrimoni research Cultural does not Català constitute and theany Decretrisk to 78/2002, de 5 de març, del Reglament de protecció del patrimoni arqueològic i Paleontològic. 2 Much of this local documentation, created by Christian authorities, was assembled and published by López (1956); see below. –96 The Medieval Globe 1 (2014) pp. 63 64 et al. ANNABut C oletwritten accounts tend to take on a certain abstraction, which is why the discovery of the Jewish cemetery in Tàrrega in 2007 occasioned such interest. Within it were found six communal graves that seemed to These graves are the only material evidence of the violent acts perpe3 tratedhold the against victims the of town’s the 1348 Jewish uprisings minority. (Muntané In the following 2007b, 2009, essay, 2012a). a team of archeologists, historians, and scientists lays out the evidence for the cal documentation and examine it for evidence of the exact timing and circumstancesevents of 1348 of from the aevents; new perspective: then, we turn first, to thewe reassemblematerial evidence the histori from dencethe cemetery, of the nature examining of the it, attack, too, to the confirm identities the date of the of victims,the events and that the pro cir cumstancesduced these incommunal which they graves; were andlaid finally,to rest inin morethis cemetery. detail, we look for evi Part I: The Documentary Evidence was an escalation in attacks on social minorities, including clerics, beggars, personsOne of the suffering acknowledged from leprosy, consequences and foreigners, of the plague who epidemicwere blamed of 1348–51 for the inexplicable mortality. In Catalonia, as in many other regions of Western Europe, Jews stood out as being the most powerful minority group and, as such, suffered disproportionally when the Black Death reached the area. What makes the Catalan case distinctive is that we now have an example cal data of an uprising against the Jewish community of Tàrrega in July of the documentary record being confirmed and extended by archeologi directly4 related to the Black Death.5 The brutality of those uprisings is wit nessed1348, makingin various it onereports of the written first bycommunities contemporary to suffer Jews. such an assault 3 Here and elsewhere, the Catalan term fossa comuna has usually been translated as “communal grave” rather than “mass grave.” As the evidence summarized in this article indicates, aspects of the burials discovered at Les Roquetes were carefully planned, if hasty. This was not a haphazard disposal of bodies. That said, the editors’ decision to render this ambiguous term as “communal grave” should not mask the fact that those buried in these graves were victims of a massacre. 4 In the original Catalan version of this essay, the authors used the term avalot, a “popular uprising” or “seditious tumult” (cf. Diccionari de la llengua catalana de l’Institut d’Estudis Catalans been more complicated than the epithet “popular” can adequately capture, and yet the term pogrom seems too heavily). The exactfreighted motivations to be used behind unproblematically. these attacks Therefore, may have we have settled on the term “uprising.” 5 Earlier attacks in April of 1348 occurred in Toulon, Hyères, and several other 65 With respect toTh thee Bla uprisingck Deat inh anTàrrega,d the J ewewis haveh Communit the testimonyy in Tàrreg of a contemporary rabbi, Hayyim Galipapa (b. Montsó, c c vived due to its incorporation into the historical narrative. 1310–d. of Pamplona, an Italian . 1380), then living in the town of Huesca, in Aragón. His account has sur of the Jewish people during the Black Death in his Emeq ha-Bakha (Valley ofJew, Grief Joseph ha-Kohen (1496–1578), who commemorated6 Two points the sufferings of infor mation provided by Galipapa help to contextualize the attack on the Jews of Tàrrega, 1557–58) and correlate (ha-Kohen it with 1557–58/1981: the spread of the27). plague epidemic. The tions, in the following order: Barcelona, Cervera, Tàrrega. This same order first has to do with the route connecting the three Catalan towns he men recordis confirmed attacks by onseveral Jews official in each documents of these towns. from the Barcelona, royal chancery Cervera, of Pere and TàrregaIII (r. 1336–87) were connected of Barcelona by the (Pere main IV eastof Aragon),-west road, documents and the whichorder thusalso Galipapa’sreflects the second direction informative that the plaguecontribution took, moving helps to westward establish fromthe date the ofcoast these toward three the incidents. interior According of the principality to the rabbi, (López there 1956, was 1959a, an uprising 1959b). at Barcelona on a Saturday afternoon, followed by another at Cervera on an 7 unspecifiedEstablishing date, the and link by between yet another the arrivalat Tàrrega of plague three anddays the after attacks the sec on ond.these For three this Jewish last, he communities assigns a specific is not date: straightforward. the 10th of the First month of ofall, Av. we must accept that our sources will only record human cases of plague, and not the actual spread of the pathogen through rodent populations or contaminated foodstores. What we can see from the documented human cases is that plague seems to have arrived in Catalonia only recently, in then by May at Girona, to the northeast of Barcelona. It also reached Tar the spring of 1348, having been reported first at Perpignan in April, and ragona and Valencia (other port cities to the southwest) as well as the Onsmall the towns latter, in see Provence. most recently See Crémieux Cohn 2007. 1930–31; Shatzmiller 1974. The more widely known attacks in Savoy and the Rhineland did not start until later in the year 1348. 6 Ha-Kohen also incorporated Galipapa’s narrative into another work, Dibre ha- Yamim le-Malke Zarfat we-‘Otoman sharing his work with them, and also (Chronicles Susan Einbinder of the forKings alerting of France them and to thisTurkey), (and published in Venice in 1554: see Barzilay 2011. The authors thank Mr. Barzilay for .כה line מח.and p טו line מז 7 other) pertinent publications. See ha-Kohen 1557–58/1981: p. 66 et al. island ANNA C ofolet Mallorca in the month of May (López 1956: nos. 2 and 5; see also By mid-May, at the latest, deaths are documented in 8 theGuilleré Barcelonan 1984: 106). Jewish quarter (call theBarcelona arrival (Gyug of the 1983; plague, Guilleré since 1993–94, it seems 1:171–72).that Jewish The-Christian uprising relations against ) therefore took place shortly9 Accord after ing to the information we can extract from the royal chancery documents, remainedthe attack stablewas vicious: up through “On Saturday May 15 (Nirenberg last, some people1996: 237–38). incited by an evil temper, having set their fear of God and our dominion aside, gathered as a riotous mob and entered into the call of the Jews of Barcelona. And there they destroyed and despoiled many dwellings and they killed many Jews.” ture of the perpetrators of the uprising and the strengthening of security aroundThat was the on Jewish May 17, quarter 1348. in Just Barcelona. five days10 later,A week Pere later, III onordered May 29—con the cap cerned lest there be further attacks – the king issued an order of protec Penedès, and Cervera.11 Almost two months after these precautions were tion to officers of the Jewish quarters in Montblanc, Tàrrega, Vilafranca del ity, as uprisings had already reached the towns of Cervera and Tàrrega.12 taken, however, a document completed on 24 July shows their ineffectual 8 9 ingly,In Tarragona, that there the was plague “a great began procession the first of of May: many see priests Trenchs from 1969. the cathedral and parishesThe historian and monasteries Esteve Gilabert and many Bruniquer other people” (c. 1608/1915, on May 2, 4: but 319) he claimed,then linked confus that ceremony to the great mortality in June. 10 “Die sabbati proxime preterita, nonnulli maligno spiritu concitati, Dei timore postposito at in nostre dominationis conceptum per modum aualoti intrarunt in Callem Judaycum Barchinone et inibi, plura hospitia fregerunt et disraubarunt ac 11 eachmultos and judeos every inibi Jew occiderunt”; of the Jewish see Lópezquarter 1956: of the no. city 8 (May and 22, of 1348).his realm and their possessions“The king and ordered goods hisvigorously officials andthat earnestly ‘you are tofrom maintain all disturbances, and protect molestations, and defend et singulos Judeos aljame Judeorum ville eiusdem et collectorie sue ac res et bona eoruminjuries, quecumque, inconveniences manuteneatis, and offenses’” protegatis (“El rei et manava deffendatis als seus viriliter oficials et potenter,que ‘omnes ab infestationibus, molestiis, injuriis, grauaminibus et offensis indebitis quorumcumque nec ipsos uel eorum aliquos in personis et bonis ipsorum, per modos supra specifficatos uel aliter, permittatis a quo quam contra jus et justitiam agrauari seu 12 “Hiis diebus proxime lapsis, propter rumores nobis subito venientes, qualiter peretiam nonnullos molestari’”); civitatis see López Barchinone 1956: no. et 9villarum (May 29, Cervarie, 1348). Tarrage, contra aljamas et singulares dictarum civitatum et villarum, casu fortuito et inopinato, concitato populo, extitit suscitata occasione cuius strages seu neces, percussiones et vulnera 67 The Black Death and the Jewish Community in Tàrrega cise date for the attack on the Jewish quarter of Cervera. For Tàrrega, how Like Galipapa’s Hebrew account, these official documents offer no pre Since we have already seen ever, we have Galipapa’s date: 10 Av of the year13 5108, which would fall in July,the first the datehalf ofwe July, can probablydeduce from around Galipapa’s 6 July. testimony seems credible. thatThis Pere causal III was relationship reacting to between the assaults the occurrenceon all three of communities the epidemic by and 24 during what is generally seen as the second wave of the plague in Western attacks on Jewish quarters is even clearer in a document of early 1362, caused by the arrival of a new outbreak of the plague, the secretary of the TàrregaEurope (see Jewish Carmichael community 2014, requested in this issue). protection Trying fromto pre-empt the king. the For alarm “as in the time of deaths, by divine judgment, which took place long ago, the Jewish community and its members were despoiled and many of them put of the deaths that have occurred and are still occurring in some parts of theto a kingdom, sword by they some fear people that theyof this will town again and be others,damned so and now plundered [...] because and Obviously, the same degree14 of alarm did not exist in the minds of Cata killed as fiercely as before.” ever,lan Jews understanding before 1348, of so this we causal find no relationship documents was (contemporaneous rapidly discerned with by the arrival of the plague) that indicate a fear of attack by Christians. How varia et diversa rapinie ad destructiones domorum, adversas aliamas predictas et quampluribus singularibus ex ea fuerunt diversimode subsecuta”; see López 1959b: wanted to avoid an attack similar to the one in Cuirassa (one of the two Jewish no. 5 (July 24, 1348). This document is addressed to the authorities of Lleida, who neighborhoods of Lleida). It was of no use, as a document dated August 11, 1348 of(included Cervera, in Tàrrega, one of Julyand 18,in the 1349, city no. of Lleida12) indicates and other that places” the wave (“Et ofspecialiter attacks spread nuper primoelsewhere: in civitate “And especially Barchinone recently, et nunc first noviter in the in city villis of CervarieBarcelona et and Tarrege now etin thein civitate towns 13 Ilerde et in aliis etiam locis”). See “Hebcal Jewish Calendar”, online at nostriviguerunt regia vigentque clementia nuncsubuenire”; in aliquibus see López partibus 1956: regni nostri iterato dampnificari, depredari et interfici et immaniter prout prius dignaremur eisdem super hiis de no. 150 (January 12, 1362). 68 et al. ANNA Colet Jew Moixé Nathan wrote: the survivors of that uprising. A few years later, the influential Tàrregan On the day that any plague or famine occurs which threatens the earth, lentlythe people thoughtless cry ‘All thisway happensto destroy because the unfortunate of the sins Jews. of Jacob!15 Destroy this nation, kill them!’ And during the disaster [...] they undertake in a vio 16 So did Galipapa, who describes news of the plague spreading through Popeout Catalonia Clement andVI (1342–52) Aragon, in and conjunction his successor with expressed false accusations similar views.against a deadly poison into the world. From them is the fault and it is the cause Jews: “‘For the sin of Jacob all this has passed, because they have taken מח aboutof the wellgreat-poisoning misfortune or that projecting afflicts laterus now!’” concerns (ha-Kohen back onto 1557–58/1981: the past, he captures). Whether a sense Galipapa of radical was changesaccurately occurring voicing contemporaneousin Catalonia and Aragon. concerns17 numberOne final of Jews point killed of information in Tàrrega exceededgleaned from three Galipapa’s hundred. account The royal (as chancery’sreported by references ha-Kohen) to needsthe death to be toll assessed are often here: vague. his19 Atclaim one18 thatpoint, the it is stated that almost all of Tàrrega’s Jewish citizens were exterminated: 15 Nathan, Accords § 1b, signed in the month of Tevet of the year 5115 (between December 16, 1354 and January 13, 1355). For an edition of the original Hebrew text, see Baer (1929: no. 253). For a Catalan translation and introduction, see Feliu 270v–272v.and Riera i Sans (1987). See also Pieters (2006), which includes a photographic reproduction of the manuscript Oxford, Bodleian Library, MS Bodley 2237, fols. 16 See Clement’s letter to prelates of the Church in Simonsohn 1998: no. 373 (November 26, 1348). See also a surviving Spanish translation of the papal bull issued מז 17 by Innocent VI at Avignon on January 21, 1356 (Simonsohn 1998: no. 378). no contemporaneous Ha-Kohen 1557–58/1981: . Nirenberg (1996: 236–37) argues that there were accusations of poisoning in Catalonia in 1348. In other words, 18 See the excerpt from Galipapa’s testimony provided in the documentary appendix below.Galipapa’s temporal distance from the events of 1348 may be significant. 19 plurium judeo rum ipsius ville nequiter perpetratarum et aliorum criminum et excessum”: López E.g. (emphasis added) “ratione pluresseu occasione ex ipsis neciumglaudio intrucidati”: personis López 1956: no. non pauci crudeliter1959b: no. interfecti 11 (June et26, disraubati 1249); “et fuerunt” with “aliqui Judei ville Cervarie interfecti 150 (January 12, 1362). Compare (emphasis added) “ Judei [de Tàrrega] et disrobati fuerunt”: López 1959b: no. 29 (May 31, 1352). 69 “the greater part ofTh thee Bla Jews,ck Demenat hand an dwomen the Jew both,ish C ofommunit the saidy intown Tàrreg werea ferociously slaughtered in the invasion of the Jewish quarter.”20 Another report mentions “uprisings, murders, and despoiling done and perpe trated against the Jews of Barcelona and Cervera and especially those in the town of Tàrrega, of whom more than three hundred were viciously murdered.”21 The stress placed on Tàrrega (specialiter ville Tarrage gests that most of the deaths occurred there. This accords closely with ) sug uprisings: twenty dead in Barcelona, eighteen in Cervera, and three hun Galipapa’sdred in Tàrrega. account, Although, which givesas we specificwill see, mortality the archeological figures for evidence each of can the not fully support this large number, we must remember that the cemetery in Tàrrega has not been fully excavated. side effect of the plague that is often forgotten, because it almost exclu sivelyArchival affected research the economic is also allowing status of us a to social refine minority. and understand In Catalonia, another an ongoing crisis was already being felt some decades before the arrival of the plague. By the time the Black Death struck, the region had suffered madea long by period Jews, of with famine borrowers and economic increasingly instability drowning starting in debt in 1333 while (“the try first bad year”). This crisis, in turn, led to a substantial growth in loans disease struck at a time when the population was already weakened, both ing to overcome their continued losses (Abad 1999). In other words, the assaultsphysically on and local financially. Jewish communities It is therefore were significant accompanied that byJewish the looting sources, of theiras well homes as the and official property records and the of theextensive chancery, destruction corroborate of documentation the fact that relating to these debts. In all three of the cases noted above, the violence was not only focused to greater or lesser degree on the Jewish population, but also on the financial instruments in Jewish archives. For the summer of 1349, furthermore, there is extensive notarial evidence of Jewish citizens filing claims to recover debts that remained 20 maxima ipsorum parte atrociter trucidarunt in quorum Judeorum invasione” (emph López 1959: no. 18 (15 April 1350): “judeos et iudeas aljame ville pretacte in in Tàrrega at the time, which we cannot know with any certainty according to Riera i asis added). The magnitude of this number depends on the number of people living 21 “inSans facto (1987). concitationum, necium et raubariarum factarum et perpetratarum contra judeosLópez Barchinone 1959b: no. et 10 Cervarie (document et specialiter of March 23,ville 1349 Tarrage, found ex in quibus one of Juneultra 13, trecentos 1349): fuerint nequiter interempti.” 70 et al. unpaid ANNA Colet after the plague and the attack on the Jewish quarter of Barcelona.22 The fact that most of these claims specify the amount to be repaid with out factoring in accrued interest suggests that these are references to debt instruments that were destroyed or lost, the intention being to recover at least the capital that had been initially invested. Among these we can also ing to recover investments they had made while living in these towns, but whofind instrumentswere registering held theirby Jews claims from in Cervera Barcelona—probably and Tàrrega, who because were they try did not yet dare to do so at home. (Among them was Moixé Nathan, who 23 moved to Barcelona after the attacks.) Indeed, the claims that begin to inappear collecting in mid-1349 debts for are which supported they do by not a royalpossess mandate the original (dated instruments September of the same year) that absolves Jews from fines or possible errors incurred (López 1959a: 335). By contrast, references to debt instruments do not beenappear more in the different: documentation while the for attack Tàrrega on theuntil Jewish the years community 1352–54 in (LópezBarce lona1959a: was 354). not as The brutal, atmosphere and there in was Barcelona clear legal and recourse Tàrrega for could the notrecovery have of Jewish property, the magnitude and memory of the Tàrrega massacre may have continued to frighten survivors for many years, delaying any such claims to what was their own. 22 overArxiu sixty Capitulardebt instruments de Barcelona which (hereinafter allow us to glimpseACB), Notaris legal actions de la ciutat,undertaken Jordi deby survivorsVilarrubia, of vol. the 221 attacks (1347–51). on the callIn this of Barcelona. volume, between Other similar pages 97documents and 128, (althoughthere are not so many) can be found at ACB, Notaris de la ciutat, Francesc de Puig, vol. 233 23 (1348–49). ACB, Notaris de la ciutat, Jordi de Vilarrubia, vol. 221 (1347–51), fols. 99r, fol. 128v, and fol. 166v. 71 ThDOCUMENTARYe Black Death and t APPENDIXhe Jewish Communit y in Tàrrega Description of the Uprising according to the Secretaries of the Tàrrega Jewish Community, as Documented by the Crown of Aragon The following is an excerpt from a longer document created in the chan cery of Pere III which lays out the formal complaints of the Jewish com munity of Tàrrega, whose survivors were seeking restoration of property seized or destroyed in the attack of 1348. This passage summarizes the events as reported to royal officials. Arxiu Reial de Barcelona (ARB), reg.24 658,Anno fol. proxime52r–v (December lapso, nonnulli 2, 1349); ipsius ville,excerpted populum from eiusdem López fortiter 1959b: concit no. 14.- ando, Dei timore et nostre correctionis postposito, nostram magestatem offendere non verentes, diabolico spiritu incitati, manu armata et mente deliberata ad callum ipsius aljame hostiliter accesserunt et ausibus inde- bitis violenter ostias ipsius callis tamen securibus et allis armorum generibus fregerunt et etiam destruxerunt ipsumque callum intrarunt unanimiter et potenter clamosis vocibus emittentes “Muyren[sic] los traydors” et, hiis non contenti, sed mala peyoribus comulantes, hospitia ipsorum judeorum nequiter dimitarunt lanceis, lapidibus et sagitis et demum in eis intrantes, res et bona omnia eorumdem tamquam raptores secum per- peram asportarunt et plura instrumenta ac scripturas ipsorum judeorum diversorum contractuum laniarunt et etiam conburserunt et plures judeos ipsius aljame inaniter occiderunt et quosdam alios atrociter percusserunt et etiam vulnerarunt et plura alia dampna gravia et inmensa, injurias, ofensas, raubarias molestias et violentias ipsis judeis fecerunt. aroused its people to put aside the fear of God and our authority, not hesitating(In the year to just offend passed our [i.e.majesty. 1348], Incited some by individuals a diabolical of thisspirit, town with strongly armed hand and deliberate intent, they came maliciously to the call of the Jewish aljama broke down and destroyed the gates of this call with axes and other communitytypes of weapons, [ and] and they with even unwarranted destroyed therecklessness call itself, theyentering violently into it all together and shouting loudly with raised voices, “Kill the traitors” Muyren los traydors . acts with even worse things, they ruthlessly raided Jewish homes with [ ] And not satisfied with that, but rivaling terrible took away all the goods and property of the Jews, just as if they were spears, stones, and arrows. And, finally entering the said houses, they 24 The quoted passage is couched as a reported speech clause (introduced with quod traitors” is quoted in Catalan, not in Latin. A different English translation of a longer ), which explains the verb forms used here. Note that the incendiary cry “Kill the selection from this document can be found in Aberth (2005: 142-43). 72 et al. ANNAthieves, Colet and lawlessly they tore and burned many legal instruments and various written contracts of the Jews and they senselessly murdered many Jews in this community, and others were beaten mercilessly and were wounded, and they inflicted many terrible evils, grave injuries, offenses, robberies, harms, and atrocities and on these Jews.) Description of the Uprisings of Barcelona, Cervera, and Tàrrega by Hayyim Galipapa, as Preserved in the Chronicle of Joseph ha-Cohen .מח–מז ויהי ביום השבת לעת ערב ויקומו על עם ה' אשר בבארצילונה :58/1981–1557 ויהרגו מהם ha-Kohen כעשרים from נפש ובביזה Excerpted שלחו את ידם ואין אומר השב עודם נלחמים וח' נתן קולות ומטר וגשם שוטף ואש מתלקחת וית־ בהלו הקמים עליהם בלל ה' שפתם וילכו גם שרי העיר וגדוליה ויצלו הנשארים מידם ולא עצרו כח להצילם בטרם היות הקולות והמטר כי רבו הקמים עליהם האומרים נכחידם מגוי ולא יזכר שם ישראל עוד ייטיב ה' לטובים והמטים עקלקלותם יוליכם את פועלי האון אמן ואמן. ויהי לימים עוד ויקומו על היהודים אשר בעיר צירבירה ויררגו כשמנה עשרה נפש ובביזה שלחו את ידם והנשא־ רים ברחו לנפשם ויענו בצום חייתם ושק ואפר הציקו לרבים ויהי לימים עוד שלשה ביום העשירי לחדש אב ביום ענות נפשם ויקומו גם יושבי טאריגה ויכו ביהודים ואבד יותר משלש מאות נפש ויסחבום אל בור רק ובביזה שלחו את ידם ודנשארים ברחו לנפשם אל בית מכריהם במתן בסתר עד עבור הזעם וישארו ערומים מכל קנינם ולא יתבוששו ביום הנמהר ההוא. (He arrived Saturday evening, which was when the Lord rose against the people who were in Barcelona. About twenty people were killed and despoileda b The uprising was continu ing when a storm broke outc and then, before the rain fell and lightning struck, those and who nobody had risen said up “Hold against back!” the Jews took fright. The Lord confused their speech.d Then came the elders of the city and the leading men and they rescued the survivors. Before the thunder and the rain had scared them, there were many who were rioting against the Jews and say remembered no more.”e May the Lord reward the good and may he tort ingment “Exterminate those who turned them from themselves among theinto nations! malefactors. Let thef Amen, name Amen. of Israel be After some days, people in the town of Cervera rose up against the Jews, killing about eighteen of them and despoiling them.g tifying their souls with fasting and sack cloth and ashes and suffering greatly.h And after three more days, in the tenth day of the The month survivors of Av, fled, which mor is Jews. They killed more than three hundred people and dragged them to ana day empty of mortification, cistern, and despoiled the inhabitants them. iof Tàrrega also rose up against the acquaintances and remained hidden until the fury subsided.j On that rash day, they remained naked of all their possessions The survivors but fledwithout to the shame. homesk of a b c d Esther 9. 10, 15, 16 1 Samuel 12. 11 Genesis) 11. 7 e f g Esther 9. 10, 15, 16 h i Esther 9. 10, 15, 16 j IsaiahIsaiah 26.42. 2022 k Genesis 2. 25 Psalms 83. 4 Psalms 125. 4 Esther 4. 1, 2 73 The Black Death and the Jewish Community in Tàrrega Figure 1. Overview of the Communal Graves Part II: The Material Evidence The Site In 2007, in preparation for the construction of a housing development in the town of Tàrrega. It had already been reported that skeletons had been foundan area in classified the area, asduring an historic prior worksite, excavations on the street began leading at the to theMaset develop hill in ment, so an anthropologist was present when the archeological dig began. conducted an assessment of the Llibres d’estimes for the year 1501,25 from In conjunction with this investigation, historian J. X. Muntané (2007b) 25 In medieval Catalan municipalities, the property registers called llibres d’estimes (books also known as del manifest or de valies ) were used to assess taxes on their 74 et al. ANNA Colet Figure 2. Communal Grave (FS) 161 which he deduced the possible location of a medieval Jewish cemetery on that same site, which is known as “Les Roquetes.” This hypothesis was other remains indicative of Jewish burial customs (Colet at al. 2009; Colet confirmed by the discovery of two rings bearing Hebrew inscriptions and and Ruí�z 2014), as evinced by similar findings in the Jewish cemeteries of ValladolidThe archeological (Moreda excavations and Serrano in 2009), the western Barcelona sector (Duran of the and cemetery Millas revealed1947), and a concentration the street of Nové of anthropomorphic Město in Prague tombs,(Wallisová of a kind2011). resembling sunken baths, covered with slabs of rock. This may be considered the old est part of the cemetery, based on the typology of similar tombs found on ered were six communal graves containing the remains of at least sixty- Montjuicnine individuals in Barcelona (Figure and 1 in Girona (Casanovas Miró 2003). Also uncov all of these graves cannot be determined at the present time, because the graves clearly extend to the). south, The total beyond number the excavated of individuals area. interred in The Graves The communal grave shown in Figure 2 that of the other graves, is roughly rectangular.(designated The north FS and[fossa south comuna] walls of161) this is particular located furthest pit have to been the lost,west perhaps of the excavated due to erosion area. of Its the shape, hillside’s like steep northern slope; erosion could also account for the destruction of the made a detailed declaration, under oath, of real estate held in the municipality, and a valueinhabitants’ was then property established (houses, as the gardens, basis for mills, calculating fields, the vineyards, tax owed. etc.). Each owner 75 The Black Death and the Jewish Community in Tàrrega Communal Grave Figure 3. (FS) 163 south wall. However, there is another possible explanation for the absence originallyof the grave’s an empty north spacewall: itbetween could be the that groups this graveof bodies and interredFS 163 (situated here. immediatelyOne feature to evidentnorth: see in this below) comunal formed grave a single is the pit, limited and thatbreadth there of was the theeast-west bodies axis. contained (This iswithin the case it. Placement in all of the of gravesthe bodies except in thefor pitsFS 54: there see forebelow.) involved In this either grave, bending the shaft the is only legs about or forcing 1.5 meters the heads wide, downward, constraining to adapt them to this narrow space. The position of these bodies is sugges tive of the speed with which they were buried. In this particular grave, at least ten individuals were interred, among them a child aged between seven and twelve, an individual of indetermi nate sex between seventeen and twenty-five years old, three men and a bodieswoman (EU all 26aged between twenty-five and thirty-five years, two men aged forty and fifty, and one adult individual of indeterminate sex. One of the The grave 1173) shown was in Figurefound with 3 a set of five buttons located under the right collarbone. (See the further discussion of this evidence below.) 27(FS in accordance163) is unusual with whenJewish compared burial prac to the others. In the first place, a wooden cover was found beneath the land fill.26 InThis Catalan, cover EU was is themade acronym of pine, for the stratigraphic unit associated with every 27 Dr. Raquel Piqué, of the Universitat Autònoma de Barcelona, has made a study of theseindividual remains. in a communal grave (FS). 76 et al. ANNA Colet Figure 4. Communal Grave (FS) 54 the degree of anatomical disarticulation exhibited by the human remains tices (de Vries 1929/2001: 253). Another special feature of this grave is been found in this grave, only one has remained partially articulated. withinAnalysis it. of Of the the skulls (at least yields eight)28 the distinctfollowing individuals information whose about remains the victims: have one child aged three or four, two young women between twenty and thirty years of age, a man and a woman between the ages of thirty and forty, a woman aged between forty and forty-four years, a woman aged between Also found in this grave were artifacts that might constitute the pieces fifty and sixty years, and an adult woman of undetermined age. facts might be considered amulets, either on the basis of the material from of a necklace associated with the child buried here (EU 1185). Such arti The child in question appears to have suffered from a slight malforma tionwhich of they the lowerare made limbs, or thewhich manner may accountof their productionfor the necklace (Colet of et protective al. 2010). charms, meant to safeguard or heal the child. The communal grave shown in Figure 4 its west wall. Unlike the rest of the graves, the breadth of its east-west axis suited the heights of the individuals buried (FS 54)there, has since retained their onlylegs 28 In Catalan, the NMI or minimum number of individuals. 77 The Black Death and the Jewish Community in Tàrrega Figure 5. Communal Grave (FS) 162 individuals whose body were carefully prepared for burial. However, the are unbent and their skulls intact. It contains the remains of at least five ing disarticulation of the skeletons and depositing some remains atop the rightbodies leg of ofindividuals the individual EU 1051 EU and1052. 1053 Individual appear to EU have 1055 been also moved, appears caus to have been moved slightly. All of these movements could be interpreted as the result of successive burials or the later reopening of the graves, This grave contains two individuals of indeterminate sex, one between tenactions and whichtwelve (voluntarily years old and or theinvoluntarily) other around displaced seventeen, the aremains. young woman aged between seventeen and twenty-five, a man aged between twenty- fiveThe and grave thirty-five shown years,in Figure and 5 a woman aged between thirty-three and forty-five years. Due to the limited breadth of the(FS latter 162) axis, has thosea north-south burying axisthe individuals measuring contained5.4 meters, in while it had the to east-west force their axis bodies ranges into between the grave. 1.3 Yetand these 1.51 meters.burials to the north. Noteworthy features of this grave are the discoveries of a whitedo not glazed fill the ceramicentire grave, jar, buried which extendsnear the about bottom a meter and almost and a half intact, further and also part of a white glazed ceramic lid, found on the north side. Interest atingly, the a same fragment time, of but the the same unusual lid was presence discovered of these in the ceramic landfill materials of another in thegrave graves (FS 166: has seenot below).yet been This explained. proves that both graves were covered over 78 et al. ANNA Colet Figure 6. Communal Grave (FS) 164 This grave, FS 162, contains the remains of at least twenty individuals. remainsAs in the includecase of FS those 161 of(see a perinatal Figure 2 above),or newborn the mangled child of positions indeterminate of the sex,bodies a child indicate who wasthe speed about withsix months which old,burial two was children performed. aged between Identifiable two sex between the ages of six and seven, a boy and a girl between thirteen and three years, a child of five to six years, two children of indeterminate and fifteen years of age, two young men and two young women between minateeighteen sex. and twenty-five years old, two men and a woman between twenty-fiveThe communal and thirty grave years shown of age, in Figure and four 6 adult individuals of indeter the largest number of remains. However, it has not been excavated in its entirety, because it extends to the south of the(FS area 164) that has could yielded, be accessed so far, in 2007. Moreover, the north side has been destroyed, possibly by ero in length. The east-west axis measures approximately 1.56 meters. The mostsion. Theobvious excavated of this lengthgrave’s of noteworthy the north-south features axis is themeasures fact that 7.74 the metersbodies placed further to the south display a lower degree of anatomical articula tion than those to the north. While the latter are clearly individualized, those in the sourthern edge of the grave have been jumbled together, although they maintain a certain uniform orientation, with the heads placed toward the west. In this grave, buttons have been recovered among the remains of two (designatedindividuals: MCUTa female29 of undetermined age (EU 1201) and an adult male (EU 1211). A number of coins and the key to a chest have also been found 4653). A minimum of twenty-five individuals can be 29 The acronym denoting the artifact’s number in the inventory of the Museu Comarcal de l’Urgell-Tàrrega. 79 The Black Death and the Jewish Community in Tàrrega Figure 7. Communal Grave (FS) 166 yearsidentified. of age, Among three themyoung are women a child and aged two approximately young men between six years, twenty six chil and thirtydren aged years between of age, aseven woman and and twelve, two mena girl aged between between thirteen thirty and and fifteen forty years, two women and three men aged between forty and sixty years, a man in his sixties, and three individuals of indeterminate age (two men The grave shown in Figure 7 and an individual of indeterminate sex). the grave extends beyond the range(FS of166) the is archaeological located farthest dig to and the was east not of fullythe area excavated. excavated The at north Les Roquetes.wall has been As with destroyed, FS 164, either the southern due to erosion arm of or previous human efforts to prevent water from leaking into the area (a teryproblem noted that above, persists identifed today). as Thepart breadth of the lid of to the the grave’s ceramic east-west jar found axis in FSvaries 162, between another 1.42set of and coins 1.57 was meters. also found. In addition to the fragment of pot FS 166 contains the remains of at least twelve individuals of both sexes, children between the ages of seven and twelve, two adolescents between twelveas in FS and 161 twenty and 162. years Among of age, them three are individualsa child aged aged five betweento six years, twenty two and thirty, and four aged between thirty to forty. 80 et al. Summary ANNA Colet Analysis of the Archeological Evidence above have allowed us to draw up the following hypotheses. The excavation of these communal graves and the findings described The fact that one of the skeletons in FS 161 (Figure 2) has retained a haveset of been five buttons clothed (locatedat the time under burial. the rightThis possibilitycollarbone), is andreinforced the discovery by the of additional buttons in FS 164 (Figure 6), indicates that these bodies may werediscovery contained of sets in of receptacles coins in two of graves perishable (FS 164 material, and FS such 166: as Figures purses, 6 thatand could7). The have way been these hidden coins were within found, outer clustered garments. together, indicates that they All of the burials in these communal graves conform to the orientation characteristic of Jewish ritual, with the heads to the west and the feet to the east. We wish to highlight that this was so in all cases, even in those graves where decomposition has caused the skeletons to fall apart. Cer tain care can also be discerned in the placing of individuals’ remains: efforts were taken to avoid piling them up. We believe that the careful ori entation and disposition of the bodies indicates that they were buried by the surviving members of the Jewish community. violent trauma visible to the naked eye. The later anthropological study of In one of the graves (FS 164: Figure 6), the bones show evidence of six communal graves show signs of violent trauma as the cause of death, whichthe remains occurred (summarized either immediately below) showed or in the that hours over following half the bodies the attack. in the The demographic distribution of the people buried in these commu nal graves reveals that they include all age groups—from a newborn to adults over the age of sixty—and that both sexes are equally represented: evidence that suggests an indiscriminate attack on those interred in this section of Les Roquetes. A numismatic study of the two sets of coins found in graves FS 166 and FS 164 proposes a date no later than the mid-fourteenth century (Clua 2009). This chronology is backed by the Carbon-14 dating of one ofassessments the skeletons accords (EU 1220) with what found is inknown grave30 about FS 164, the which uprising is datable in Tàrrega. to the years 1280–1391 CE (CNA1644 cal 2σ ). The dating obtained from these 30 This has been established by the Centro Nacional de Aceleradores attached to Consejo Superior de Investigaciones Científicas (CSIC). the Universidad de Sevilla–Junta de Andalucí�a and the Spanish 81 The Black Death and the Jewish Community in Tàrrega against the Jewish community of Tàrrega, which is well documented in writtenAll of sources, these indications is now documented, lead us to too, propose in the communalthat the 1348 graves uprising found in Tàrrega’s Jewish cemetery. The survivors of the uprising—who, as the historical documentation implies, were almost all from the Jewish com munity—had to bury their dead. But the magnitude of the violence must to lay the slain members of their community to rest immediately. At the samehave generated time, the considerablemassacre had fear occurred among at the high survivors, summer making and in it the difficult con text of the plague epidemic, which means that the survivors would have worked quickly once it seemed safe to do so. All of this explains the deci sion to bury a large number of bodies in communal graves that were not always of a suitable size. Communal burial is not common in Jewish burial rites, under most documented conditions. There are, however, notable exceptions. In the medieval Christian territories of the Iberian Peninsula, a contemporary31 example can be found in Valencia, where the Jewish community was also mass grave was roughly polygonal and it contained forty bodies, heaped upthe andtarget mixed of violence together. (Calvo As can Gálvez be inferred2003). But from in this the case,disposition the shape of ofthose the bodies that have retained anatomical articulation, the dead were gathered and buried within a brief period of time, since rigor mortis had not yet Theseset in, lesionsin the majority are especially of cases. discernible A significant in skeletons percentage of tenof the male individu adults, andals buried were causedin the Valencia by fatal andgravesite intentional (30%) wounds. also display The traumaticother individuals lesions. in this grave may have died of plague, as their bodies show no signs of violence. The majority were adult males, and only one child and one ado Unlike the uprising in Tàrrega, the attack on the Jews in Valencia is not documentedlescent have beenin either identified. Christian or Jewish sources. However, the discov ery of two coins among a pile of materials dumped into the upper part of thosethe grave at Les suggests Roquetes that highlightsthe most feasible several dateimportant for this differences mass burial between is 1348 them.(Calvo In Gálvez Tàrrega, and the Lerma attack 1998). on the Comparing Jewish community the Valencian was indiscrimate, grave with since representatives of the entire Jewish population (men and women of all ages) are found in the communal graves. In Valencia, the attack was 31 Multiple burials have been found at Córdoba: see Larrea and Hiedra 2010. See also the study of the medieval Jewish cemetery in Prague by Wallisová (2011). 82 et al. selective ANNA Colet and most of the individuals in the grave were adult men, some of whom may have been victims of the plague and not of violence. The differ ences between the distribution of the bodies in the two sites also shows at the Tàrrega site, where it is highly likely that survivors of the attack therethat the buried Jewish their burial own customs dead. were observed (to at least a certain extent) Elsewhere in Europe, evidence for the mass or communal burial of Jews also tends to confirm that such burials result from violence. In 2004, a well containing seventeen skeletons was dicovered in Norwich, England: the remains of eleven children (between the ages of two and fif controversial,teen) and six adults, and the all resultsdated between of ancient the DNA twelfth testing and thirteenthgenerated centumuch debate,ries. Although subsequent the initial analyses identification suggest that of thesethey wereindividuals indeed as the Jews victims was of violence, and they have since been given a Jewish burial. Excavations 32 poraneous evidence of communal burials: in this case, a series of tombs holdat the more Jewish than cemetery one body, of Jewburyand this may(York, be England) interpreted have as revealed a solution contem to the burial of family members who died at the same time, or of people who died on the same day. Although it is unclear whether such unusual mea sures were taken as a result of an attack on the Jews of York, it is undeni able that there was a marked increase in violence there during the late Other communal and mass burials dating from the fourteenth cen33 twelfthtury have and been thirteenth found incenturies the lands (Lilley of Christian et al. 1994: Europe, 338–39 mostly and 380–81).connected signs of violence are discernible on the remains of those buried in these graves(as shown makes by itaDNA plausible analysis) (in cases with wherethe arrival DNA ofstudies plague. have The not fact been that car no ried out) that they died from infectious disease (Ollich 2012; Kacki and Castex 2012). Yet attacks on Jewish communities occurred in places other than Tàrrega and Valencia during 1348. The first documented assaults 32 See the summary “Bodies in Norwich Well Buried in Jewish Cemetary, published online at The History Blog Jews of England did not occur during the Black Death; Jews had already been expelled from1190, the see realm Jones in and 1290. Watson (2013). It should be noted that violent attacks on the 83 occurred in Toulon,Th ine BlaApril,ck Deandat hthen and in th othere Jew isplacesh Communit in Provence.y in Tàrreg Thea 34 archeological evidence from Tàrrega thus helps to substantiate the docu mentarywave of attacks records later of all spread these toevents. Swiss and German cities (Cohn 2007). The Anthropological Field Analysis This section will focus on the particular features of the bodies buried in the six communal graves at Les Roquetes. As noted above, the archeo logical excavation uncovered the remains of at least sixty-nine individu als interred in this section of the Jewish cemetery and revealed the care ful arrangement of the bodies in these graves. The bodies were oriented with the heads to the west and the feet to the east, in accordance wth Jewish burial practices. The individuality of the bodies was maintained insofar as was possible, by avoiding the piling of corpses. These facts, again, make it likely that the surviving members of the Jewish commu nity took charge of the burial, despite the tense atmosphere that no doubt prevailed in Tàrrega after the uprising. However, the condition of those human remains which do not maintain anatomical articulation suggests long. This evidence allows for differentiation among the graves, depend that the period between the time of death and final burial must have been study accordingly offers some hypotheses about events that occurred at theing timeon the of degreedeath and of articulationburial, based displayed on this data. by certain bodies. This field Graves containing primary deposits—that is, bodies that have remained the decomposition process took place entirely on site, after burial. Once deposited,intact up to these the timebodies of wouldexcavation not have (e.g., been FS 54: shifted, Figure aside 4)—indicate from the northat mal movement caused by natural taphonomic processes. If there had been excavated skeletal material, which would then be considered secondary deposits.any outside intervention, these displacements would be reflected in the suggest that these bodies had started to decompose prior to burial, prob ablyGraves in a different that contain place, bodies before displaying they were significant brought to joint the site. disarticulation The graves discernible anatomical articulations. The burial of these remains would thereforeFS 163 and have FS taken166 (Figures place some 3 and time 7) aftercontain the remainsdeath of thewith victims. little or This no period would have been long enough to allow the process of decompo 34 See note 5. 84 et al. ANNA Colet Detail of a Communal Grave Containing Primary and Secondary Deposits Figure 8. sition to begin, thus explaining the loosened joints leading to disarticu elapsed before burial, it is important to note that the remains found in thislation. secondary Despite thestate difficulty were still of carefully establishing disposed. the amount Special of care time was that taken had to arrange the skulls of the victims, and to align all heads and feet on the west-east axis. This further demonstrates the intention to follow the pre cepts of Jewish burial in laying out these remains, as well as the intention to avoid overcrowding. Graves of a mixed type, containing the remains of both primary and Fig- ure 8 secondaryindividuals deposits, whose remains are represented display relatively by FS 161, good FS 162, anatomical and FS 164 articula ( ). These graves are characterized by the burial of a core group of grave by secondary deposits of bones. Although skulls and limbs have oftention (primary become disconnected, deposits), accompanied the disposition on oneof these side remains or both stillends adheres of the to Jewish burial customs. As already noted, the differing degrees of joint articulation exhibited in all cases is remarkable and provides information that allows for study of the time elapsed between the death of an indi Although the reasons for this variety in the burial pattern are still unknown,vidual and histhe ortwo her decisive final burial. variables are the location of an individual corpse during the interval between death and burial as well as the amount of time elapsed during that interval. During the time of chaos and inse curity immediately following the uprising and the assault on the Jews of the victims. They would have had to wait for a certain degree of security toTàrrega, be re- itestablished is difficult byto imagineroyal authorities that survivors before would preparations have dared for to ritual bury 85 The Black Death and the Jewish Community in Tàrrega Figure 9. Bodies Lacking Feet (Detail of Figure 4) burial could begin. During this period, the bodies of victims could have been kept in a secluded place away from the town, so as to prevent the spread of disease and also to protect the bodies. In fact, Galipapa’s testi mony refers to a cistern where bodies might possibly have been stored preserveduntil the moment during thisof the period, burial are (Muntané likely to 2009: explain 175). the Thus,different both degrees the time of anatomicalbetween death articulation and final found burial, in andthe bodiesthe conditions of several in graves.which bodies were Before we move to assess evidence for the circumstances of the victims’ deaths, it is important to emphasize that the feet of many individual bod ies were missing at the time of their interment (see Figure 9 enty-one recovered legs displaying good overall anatomical preservation and articulation, only thirty-six retain the foot connected with). Ofthe the rest sev of the limb. The explanation for this phenomenon is not related to the attack itself, since the affected limbs do not show any evidence of violence: that is, the missing feet were not amputated during the assault on the call. On the contrary, the disappearance of the feet occurred after death and prob the legs in question do not show signs that would lead us to infer that theably feet before were the removed corpses’ by final a cutting disposal tool. in theRather, graves. the The perfectly distal preservedregions of state of anatomical articulation could suggest that the feet were acciden tally pulled off when those preparing the corpses for burial attempted to remove shoes by tugging at them: an action that would not have severed the connective tissues, were they still intact. Moreover, the fact that no iso lated foot bones were recovered during the excavation indicates that feet were removed when the bodies were already skeletonized, and that this occurred before the time of burial. 86 et al. ANNAWe C oletcan offer possible hypotheses that relate this phenomenon to the time elapsed between death and burial. As previously mentioned, this period must have been relatively long, and some of the bodies were clearly affected by advanced decomposition. It may well be, then, that some of these individual bodies lost their feet in the course of their transfer to the grave. We might also consider the possibility that it was necessary to reuse footwear in a time of crisis, such as that which prevailed after the uprising, provided that the removal of shoes from severely decomposed bodies did not affect the rest of the skeleton. Alternatively, the removal by Christians of the town, but performed so skillfully so as to leave no anatomicalof shoes (and evidence feet) could of damage be35 interpreted to the distal as a part posthumous of the legs. act In of any revenge case, no separate foot skeletons were retrieved, and we await further evidence that might lead to the resolution of this mystery. Anthropological Laboratory Analysis This section summarizes the results of the laboratory analysis of human remains recovered from the Tàrrega cemetery at Les Roquetes, data that helps to reconstruct the events that occurred during the assault on the Jewish call at leasy sixty-nine in number—whose remains have been recovered so far and from which in July a ofdemographic 1348. This study reconstruction accounts for could all of be the made individuals— (with the Those individuals represent all age groups and both sexes, and present proviso that the cemetery has still not yet been completely excavated). parts of the cemetery. Therefore, it seems clear that the attack was per apetrated demographic against profile the Jewish very populationsimilar to that as a of whole, the people without buried any apparent in other intentional selection of victims. Focusing on the age of the victims, we find that 32% are subadult indi ageviduals has (i.e.,not yet individuals been determined below the due age to of the approximately poor preservation twenty of years) those remains.and 67% Theare individualspattern of mortality of adult age,shows leaving that younga remainder adults (agedof 1% twentywhose communal graves. to thirty) are in the majority, making up 30% of the people buried in the 35 For example, the narrative account of the pogrom against the Jews in the Provençal Jews, who had been left dead in the streets, were stripped of their clothes (“et suis town of Toulon, an event which occurred during April 1348, notes that the massacred vestibus spoliatos projessiaverunt”). See Cremieux 1931: 59. 87 FigureTh e11. Bla Exampleck Deat of hSkeletal and t Injuryhe Jewish Community in Tàrrega Figure 10. Example of Cranial Injury Regarding the distribution of sexes, we should highlight the imbalance found between the proportion of males (31%) and females (50%). Per haps the 19% of individuals whose sex could not be determined figures in atthis this disparity, time. Indeed, but poor individuals preservation for whom of some it was remains not possible and the to difficulty determine of diagnosing the sex of subadult individuals prevent further identifications munal graves. This means that we cannot establish whether individuals of aeither particular age or sex sex or constitute age group 32% were of targetedthe total duringnumber the of uprising.buried in However, the com the evidence overall suggests that the attack was perpetrated against the community at large, with no discrimination as to age or sex. Laboratory analysis strengthens this hypothesis because it shows that the majority of individuals buried in the graves (at least thirty-seven out counted 155 injuries in total, both cranial (105 cases: see Figure 10 of sixty-nine) suffered injuriesFigure traumatic11 enough to mark the bone. We ) and skeletal (fifty cases: see ). The characteristics of these lesions andof the the attack, number which of injuries seems identifiedto have been in each intended case (upto eradicate to twenty-two the Jewish inju riescommunity were afflicted of Tàrrega. on a As single for the individual) thirty-tw ofurther individuals establishes for whom the nobrutality injury of this type can be discerned, this lack of evidence may be due (on the one 88 et al. ANNA Colet to cases where the fatal injury occurred in soft tissue without penetrating tohand) the tobone, the thuspoor leaving state of no preservation visible traces of someon the remains skeleton. or Moreover,(on the other) this hypothesis is supported by the fact that individuals who exhibit no such markings were buried simultaneously and alongside those whose wounds are evident, thus indicating that all those buried in the communal graves died within the same period of time. In addition, some of those without evi dent wounds could have died of plague or other infectious diseases during that time, and would then have been buried with the rest of the victims. Unfortunately, no aDNA tests have been performed, but comparison of the paleodemography of Les Roquetes with other cemeteries bearing witness to catastrophic episodes may hint at the effects of plague on the pattern of mortality here (Margerison and Knüsel 2002; Gowland and Chamber often closely aligned with that of the population at large, because all the individualslain 2005). haveThe demographican approximately profile equal of aprobability community’s of dying, plague irrespective victims is Tàrrega and the plague epidemic masks the effects of each. of ageOf theor sex thirty (Keckler-seven 1997). individuals However, who the were simultaneity detected of to the have uprising injuries in caused by violence, ten are children and the remaining twenty-seven are sameadults. equity As for mentioned the distribution in the bydemographics gender, twelve of those female buried and fifteenin the massmale graves.individuals Thus, could there be isidentified no discernible with this difference type of injury, between maintaining the injuries the inate attack that the Jewish inhabitants of Tàrrega suffered. It is important inflictedalso to acknowledge on any age group the evidence or sex, demonstrating of cruelty towards once the again defenseless, the indiscrim such restas the of male the body individual (Figure EU 12 1215, found in grave FS 164. This man sustained thisat least individual twenty-two had an injuries, old fracture twelve in inflicted his right on leg the that skull had and healed ten poorly,on the ). A careful study of the remains revealed that andwith thus osteomyelitis would have in beenthe right an easy tibia target. and fibula. This isThis further old injury evidenced would by have the extensivemade escape leg injuriesdifficult, that since he theapparently victim would suffered not during have beenthe attack. able to run The detailed study of such trauma and speculation about the weapons exisiting scholarship and to begin reconstructing the events that occurred. and tools used during the attack enable us to fill an important gap in the sures, and so forth—allows us to extrapolate information about the types Examiningof weapon thatthe types were ofused imprints during left the on assaults the bones—cuts, on each individual, fractures, pro fis 89 The Black Death and the Jewish Community in Tàrrega Figure 12. Cranial and Skeletal Injuries to a Single Individual (EU 1215) vided that the mark has not been degraded by the passage of time and the conditions of burial. Thus, in the case of perimortem trauma (i.e., injuries most common injuries are those made by sharp objects such as swords, axes,sustained and aroundsickles, theall oftime which of death produced that could a clean be thecut causeto the of bone. death), These the the injuries documented. In these cases, the cut is seen to follow a more orappear less straight in 153 cases line, indicating(out of 155 the visible energy injuries), and skill representing behind the blow.98.7% Based of all on the cuts observed both on the skull and the rest of the skeleton, it can 90 et al. ANNA Colet with a lot of energy, using tools that were quite sharp. In some cases, the forcebe determined of the blows that was such so injuriesgreat that were all theincurred bone wasby sharp sectioned, blows amputat inflicted the impact of a blunt instrument, again with considerable weight behind theing ablow, limb. but We made also find at a crush slower injuries speed orthat fractures. fails to Thesepenetrate are causedthe bone. by These objects could be stones or heavy objects that were thrown, causing injury that radiated widely and resulted in contusions. In the graves of Les Roquetes, there is only one such case: an injury to the skull. There was also a unique case of a skull injury caused by the impact of a rectangular object wielded with so much strength and energy that it penetrated the bone, leaving a characteristic mark. This injury can be seen in the skull of shatter the skull. The shape and position of the lesion (just on the cranial the individual EU 1215 (Figure 12) and was dealt with a force sufficient to or the handle of a sword. In this case, the bone fragment resulting from thevault) impact allows was us recovered to surmise inside that the the weapon skull. could have been an ax handle In conclusion, therefore, we can say that laboratory analysis has results of the anthropological analysis undertaken on site. It also corrobo ratesallowed the usexisting to clarify documentary and confirm narratives the archeological of the events thatevidence occurred and dur the ing the uprising and proves that many of those buried at Les Roquetes lost their lives during that bloody attack. Part III: Conclusions cal record of events previously documented only by written accounts. To The significance of the Tàrrega site is clear. It is an exceptional archeologi both documentary and archeological evidence have been found, helping todate, substantiate the attack reportsagainst thethat Jewish many Jewishcitizens communities of Tàrrega is sufferedthe first foratrocities which The excavation of the communal graves has enabled us to reconstruct, inbetween part, the 1348 events and 1349.that occurred during the attack on the Jewish quar ter and to compare archeological evidence with that of the documentary sources. As the remains show and the sources explain, not all of the vic tims were buried immediately after the uprising. The sources mention that some of the dead were tossed into a cistern—a fact that the arche ology and anthropology cannot substantiate, but that is consistent with the varying degrees of anatomical articulation exhibited by the bodies recovered so far. We think that all of the individuals found in the com 91 The Black Death and the Jewish Community in Tàrrega but those whose remains exhibit a higher degree articulation were buried munal graves were victims of the attack on the Jewish quarter in 1348, a period of time, long enough for the process of decomposition to advance. first,During while thethose archeological whose remains excavation, are disarticulated it was not remained possible tounburied document for the different phases of the burial process. However, the evidence of graves initial excavations, these were interpreted as two different structures; FS 161 and 163 (Figures 2 and 3) is suggestive in this regard. During the but given the fact that they are adjacent—and the fact that field work did not uncover the north wall of FS 161 or the south wall of FS 163—they earth,could correspondthis grave was to two then different used to initiatives.bury the bodies The first we ofinitially these wouldassigned have to been the burial of the bodies in FS 161. Having been partially filled with burials and the second set. (The space between the individuals in FS 161 FS 163. This suggests that a prudent gap was left between the first set of theand remainsFS 163 is displaying 1.5 meters.) a high degree of anatomical articulation are sep aratedThe bysame 50 hypothesiscm from those is plausible that had for begun the grave to decompose. FS 164 (Figure The 6): former here, group of bodies could have been placed in the grave and covered with earth. The rest of the bodies were then added, towards the southern end of the structure, when they had already begun to decompose. In general, the care with which all of these individuals were originally interred leads us to surmise that they were buried by the surviving mem bers of the Jewish community in Tàrrega. Although full observance of all funeral rites was impossible, bodies were arranged with the heads to the west and care was taken not to heap the bodies on top of one another. Study of the written sources referring to the medieval Jewish commu nity of Tàrrega reveals evidence that could not be gleaned from archaeol The study of the documentation also enabled the location of the Jewish ogy or anthropology (Muntané 2007a and 2012b; Ruí�z and Subirà 2009). logicalquarter evidence and its cemetery and anthropological to be determined analysis (Muntané have supplied 2014a). further The inforlatter has now been confirmed by the excavation in Les Roquetes, and archeo mation about aspects of Jewish funeral rites and beliefs (Colet 2014; Colet andnection Ruí �zwith2014). the PerhapsBlack Death most and importantly, the ongoing our economic combined crisis efforts within have the made it possible to confirm both the occurrence of the uprising, its con Crown of Aragon (Garcia Biosca 2014), and the resulting severity of the attack on Tàrrega’s Jews in 1348. 92 et al. 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She has led many archaeological digs in the prov ince of Lleida,([email protected]) and in 2007 she directed graduated the excavation from the of LesUniversitat Roquetes. de She Lleida is cur in rently a member of the research team created around this site and a technician at the Museu Comarcal de l’Urgell-Tàrrega Josep Xavier Muntané i Santiveri He has published two books related holds to the a JewsBA from of Tàrrega the Pontificio and forms Istituto part Biblico of the research(Roma) and team a PhD created in Hebrew by the MuseuPhilology Comarcal from the de Universitat l’Urgell-Tàrr deega Barcelona on the occasion (2010). of the discovery of the Jewish cemetery. He has held a postdoctoral research fel for a project entitled “The Legal Status of Religious Minorities in the Euro- lowship at the Maison des Sciences de l’Homme Ange Guépin in Nantes (France), Mediterranean World (5th–15th centuries),” funded by the “Ideas” program of theject Europeandevoted to Research the transcription, Council’s edition, Seventh and Framework study of documents (FP7/2007-2013/ERC). related to the He currently works as a researcher at the Institut d’Estudis Món Juï�c, on a pro CatalanJordi Ruíz Jewish Ventura communities earned an of MSc Tàrrega in Physical and Verdú Anthropology (1295–1492). from the Universitat anthropological evidence during the excavation at Les Roquetes. Autònoma de Barcelona. He directed the fieldwork and laboratory analyses of Oriol Saula graduated with degrees in Geography and History (specializing in currently the technical director of the Museu Comarcal de l’Urgell-Tàrrega. Since 1990,prehistory he has and led ancient different history) archeological from the Universitatdigs in the deprovince Barcelona of Lleida, in 1989. and He his is research focuses on medieval Jewish society in Iberia. In 2007, he coordinated the excavation of the Jewish cemetery in Tàrrega and is a member of the research team that has formed around this site. He has participated in various congresses and cations. He is the co-director of the journal Urtx: revista d’humanitats de l’Urgell. scientific meetings related to this project, and he has also worked on several publi M. Eulàlia Subirà de Galdàcano holds a PhD in Biological Science and an MS in Human Biology, and is Professor of Human Biology in the Unitat d’Antropologia Bio lògica at the Universitat Autònoma de Barcelona. Her areas of specialization include offield the and Associació laboratory Catalano anthropology-Balear de(the Paleopatologia morphological de and l’Acadèmia chemical de analysis Ciències of Mèdiqueshuman remains). de Catalunya From 2001 i Balears. to 2005, She she is was the First author Vice-President of many books and then and President articles. Clara Jáuregui holds a BA in History from the Universitat Autònoma de Barcelona and an MA in Medieval Cultures from the Universitat de Barcelona. She is cur rently writing a doctoral dissertation on Jewish medical practice in Barcelona ated with the Institute for Medieval Cultures. She has also researched and curated anduring exhibition the fourteenth for the Museu century d’Història at the Universitat de L’Hospitalet de Barcelona, de Llobregat. where she is affili 96 et al. Abstract ANNA Colet In 2007, excavations in a suburb of the Catalan town of Tàrrega identi feredfied the violent possible deaths. location The present of the studymedieval argues Jewish that cemetery.these communal Subsequent graves excava can be connectedtions confirmed to a well that-documented multiple individuals assault onburied the Jews in six of communal Tàrrega that graves occurred had suf in to the Black Death, but never before corroborated by physical remains. This study places1348: longtextual known sources, as one both of Christianthe earliest and episodes Jewish, ofalongside anti-Jewish the violencerecently discovrelated ered archeological evidence of the violence. Keywords Pogrom, anti-Jewish violence, Catalonia, Jewish cemeteries, communal graves, bioarcheology, Black Death. THE ANTHROPOLOGY OF PLAGUE: INSIGHTS FROM BIOARCHEOLOGICAL ANALYSES OF EPIDEMIC CEMETERIES SHARON N. DEWITTE through Eurasia and Northern Africa in the mid-fourteenth century, was Thonee of B thelac mostk D eatdevastatingh, the first epidemics outbreak in ofhuman medieval history. plague1 The that epidemic swept killed tens of millions of people in Europe alone within a very short period graphic,of time (Benedictowand economic 2004; changes Cohn throughout 2002; Dols Western 1977; Eurasia Wood, and Ferrell, Northern and DeWitte-Avina 2003). This disease initiated or enhanced social, demo interestAfrica (see, of a for variety example, of researchers essays by Borsch for decades. 2014, Carmichael In addition 2014, to its Coletimpor et tanceal. 2014, in shaping and Green events 2014—all hundreds in ofthis years issue), ago, and the thusBlack has Death attracted continues the to be of interest today, in part because the epidemic was caused by the same pathogen that causes modern plague, the bacterium Yersinia pestis. Given molecular evidence that the Plague of Justinian (c. sixth to eighth Y. pestis centuries CE) was also caused by (Harbeck et al. 2013; Wagner dredet al. years.2014; TheWiechmann continued and existence Grupe 2005), and threat the Black of plague Death means was a that terrible it is crucialmanifestation to understand of a disease the extent that has of affectedthe geographic humans and for temporalnearly fifteen variation hun of the disease so that we might best be prepared for its effects on our spe cies in the future. This paper focuses on the reconstruction of medieval Black Death mor tality patterns, particularly those patterns that have been estimated using I am grateful to Jelena Bekvalac and Rebecca Redfern at the Museum of London’s tons; and to Jesper Boldsen, Syddansk Universitet Odense, for providing access toCentre the Danishfor Human cemetery Bioarchaeology samples. Ifor am providing also grateful access to to Monica the East Green Smithfield and the skele two anonymous reviewers for reading and providing comments on an earlier version of this manuscript. Funding for my research, which is summarized in this paper, was provided by the National Science Foundation (grant number BCS-0406252) and the 1 ofWenner-Gren the Second PandemicFoundation of for plague Anthropological during the mid Research-fourteenth (grant century. number 7142). Here, and throughout this paper, the “Black Death” refers only to the first outbreak 97– The Medieval Globe 1 (2014) pp. 123 98 theSharon skeletal N. DeWitte remains of victims of the epidemic in the mid-fourteenth cen tury. Such research is essential for several reasons. Though it is now clear from molecular evidence, particularly the results of recent whole genome sequencing studies, that the Black Death was caused by Y. pestis (Bos et al. 2011; Drancourt and Raoult 2002; Haensch et al. 2010; Raoult et al. most convincing and least controversial molecular studies, which have 2000; Schuenemann et al. 2011),Y. pestis this is and a relatively used samples recent clearly discovery. dated The to the fourteenth-century epidemic (rather than merely suspected victims or yielded sequences specific to Priorvictims to of these more new recent molecular historic insights, epidemics), the causehave all of beenthe Black published Death since was much2009 (Bosmore et hotly al. 2011; debated, Haensch and researchers et al. 2010; were Schuenemann motivated et to al. clarify 2011). in exacting detail how the historic and modern diseases differed epidemio logically. The ultimate goal was determining whether Black Death was, in fact, plague (and if so, whether the strain of Y. pestis that caused it was of other disease, such as anthrax or viral hemorrhagic fever (Scott and Dun exceptionally heightened virulence), or whether it was caused by some can 2001; Twigg 1984). plagueThe excitingmatters natureat all. Nowof the that molecular we know findings (insofar has as made anything many ispeople truly forget why the identification of the specific causativeY. pestis agent, research of medieval can clarify the temporal and geographic variation associated with the disease, known in scientific research) that it was caused by hostto further-pathogen broaden interactions and improve (e.g., howour understanding did host population of: first, dynamics plague affectviru lence (e.g., why was mortality during the Black Death so high?); second, this particular disease might manifest in the future (e.g., is it possible that futurethe disease outbreaks dynamics of Y. during pestis medievalwill ever plagueapproximate epidemics?); medieval and patterns third, how of Clarifying the human context of the Black Death via bioarcheological researchmortality is and essential transmission?). to these goals. Bioarcheology is the study of human skeletal remains excavated from archeological sites with the aim of fur thering our understanding of the demography, health, and ways of life of people in past populations. Bioarcheologists examine these remains to determine the ages at which people died, whether they were male or female, what foods they regularly consumed, how healthy or unhealthy they were prior to their deaths (based on the presence or absence of experienced interpersonal violence, and other phenomena that leave evi certain markers of physiological stress on the skeleton), whether they 99 dence on or in the skeleton. Through the directThe observationAnthropolog andy of analysis Plague of human skeletal remains, bioarcheological research can provide demo graphic data that are crucially important for contextualizing the results of both Y. pestis and the humans affected by historic plague epidemics. Such thecontext ongoing is particularly molecular important analyses (e.g., given DNA recent and evidence immunological that the studies) medieval of the genome associated with virulence. This suggests that factors other thanand modern genetic changesstrains lack in the significant causative functional pathogen differences are responsible, in regions at least of in part, for changes in plague epidemiology (see also Ziegler 2014, in this issue),The whocombination argues thatof demographic research should and molecular focus on factorsdata will other allow than for a disentanglementgenetic “smoking ofgun” the to factors further that our affected understanding medieval of healthplague and virulence). demog raphy—that is, a determination of whether it was the biological effects of plague or the social and economic consequences of the epidemic that primarily shaped demographic and health patterns in the surviving pop ulation. Such interdisciplinary research on the Black Death also has the potential to clarify population dynamics and human biological responses to disease episodes in general, and thus can contribute to our understand ing of precisely how and why diseases shape human demography (includ evolution (e.g., acting as forces of natural selection resulting in relatively ing age and sex structures, and population density and growth) and human heterogeneityrobust immune in responses immune competence or genetic resistance during the to Blackdisease). Death Regarding might have the affectedlatter phenomenon, risks and levels Crespo of mortality and Lawrenz during (2014, the epidemic, in this issue) and detailhow Black how Death mortality might have shaped variation in immune function in the surviving population. In addition to improving our understanding of the dynamics of the Black Death in particular, bioarcheological studies of the epidemic are rel evant to current concerns about emerging diseases. Emerging diseases are those that increase in frequency after being introduced into a new, immu in the past thirty years, including HIV/AIDS, West Nile Virus, and SARS, andnologically new diseases naï�ve host will emergepopulation. in the More future than (Cleaveland, fifty diseases Haydon, have emergedand Tay was an emerging disease in the fourteenth century, and the persistence of thislor 2007; ancient Morens, emerging Folkers, disease and to Fauci the present2004; Morse day provides 1995). The an idealBlack oppor Death tunity to examine, from an anthropological perspective, long-term trends in emerging disease dynamics, and thereby understand the effects such 100 diseasesSharon N. have DeWitte had on human populations and predict how they can affect us in the future. In addition to improving our understanding of plague, bioarcheological research on the Black Death can provide much needed data to evaluate models of the evolution of virulence in emerging patho about whether changes in emerging disease epidemiology are the result ofgens human (Ebert adaptation, and Bull changes1999; Frank in human 1996) or and non help-human to resolve host demography questions or behavior, or evolution of the causative pathogens (Alizon et al. 2009; Furthermore, Black Death bioarcheological research contributes toAndré efforts and toHochberg understand 2005; the Grenfell phenomena et al. 2004). of heterogeneous frailty (an individual’s risk of death, relative to other members of the population: Vaupel,lation dynamics Manton, inand living Stallard and 1979)past populations. and selective Because mortality individuals (dispropor dif fertionate in their deaths susceptibility of those with to disease highest and frailty), death and as ahow result they of shapegenetic, popu bio logical, environmental, socioeconomic, or other causes, differences in nonfrailty-catastrophic exist among conditions; individuals that within is, becausea population of differences (Aalen 1994; in frailty, Wood theet al. individuals 1992). Mortality who die is atexpected each age to willbe selective, not be a atrandom least under sample normal, of all the individuals living at that age, but rather will be disproportionately selected from among those with the highest risk of dying (the highest Many researchers are interested in revealing the sources and conse quencesfrailty). of heterogeneous frailty in living populations so that health and mortality disparities can potentially be ameliorated or eliminated (Olden in the past, particularly in the context of parasitic and infectious disease (whichand White were 2005). the most It is justcommon as important causes of to death understand for most these of human processes his howtory andbiological continue factors be the such most as age,significant sex, and causes history of of death physiological for many stressliving populations), in order to understand modern human biology. By revealing during one of the most dramatic disease epidemics in human history, Black(such Deathas malnutrition research hasor infectiousthe potential disease) to clarify affected why risksand how of mortality affected populations have changed in the intervening centuries. The Black Death also offers a case study of how heterogeneous frailty and selective mor tality operate during times of crisis mortality, which characterized much of the mortality experience of pre-industrial populations throughout the world (Gage 2005). 101 Documentary Evidence of Black DeathTh eMortality Anthropolog Patternsy of Pla gue tating nature of the Black Death and have shown that mortality during the epidemicStudies using was dataperhaps from even historical higher documents than previously have confirmedthought (Benedictow the devas 2004; Cohn 2002; Dols 1977; Scott and Duncan 2001; Wood, Ferrell, and yearsDeWitte-Avina and older 2003). living Usingon manors data from in Essex. court He records found of that payments several made manors by residents, Poos (1991) estimated the annual totals of males ages twelve priestslost as much in the as Lincoln 54% of diocese their male in England.residents In during the eighteen the Black months Death. beforeWood, Ferrell, and DeWitte-Avina (2003) analyzed data on deaths of beneficed during the twelve-month period beginning with the outbreak of the Black the Black Death, the mean mortality rate for priests was 38.9 per 1000, but During the Black Death, annual mortality rates for priests were eleven timesDeath higherin Lincoln, and, morethe mean dramatically, mortality monthly rate increased mortality to rates463.6 were per about1000. ulationthirty-five in affectedto forty-five regions times of higher Europe. than Following in the pre-epidemic the Black Death, period. plague Total mortality fromdecreased the Black steeply Death and was steadilytypically with30% tosubsequent 50% of the outbreaks total pop the population was generally less frail, that there were changes in suscep tibility(Carpentier to plague 1971; following Cohn 2002; the epidemic, Hatcher 1977), or that which there weremight factors indicate involv that ing nonhuman animal hosts that affected plague epidemiological patterns in humans. It is clear that the mortality caused by the Black Death was extraordi narily high. What has not been as clear is how this excess mortality was distributed by age, sex, socioeconomic status, and other biological and social factors. Several medieval European chroniclers suggest that the Black Death killed people indiscriminately, irrespective of age or sex. For as “a pestilence among men of every condition, age and sex” (cited and example, Matteo Villani (Florence, d. 1363) described the Black Death “sotranslated heavy that in Cohn sex and 2002: age 126). made According no difference, to the but chronicler everyone Micheledied alike” da Piazza (Sicily, fourteenth century), the mortality from the Black Death was gest indiscriminate mortality, at least with respect to age and sex. Some contemporaries,(cited and translated however, in Horrox believed 1994: that 41). the Both epidemic of these was statements selective, and,sug for example, killed more women than men, and that in subsequent out breaks of plague (which are believed to be the same disease) men were 102 killedSharon in N. greater DeWitte numbers than were women (Cohn 2002: 210–12; Horrox friar and chronicler, “the young were more likely to die than the elderly” 1994: 85). According to Jean de Venette (1307–70), a French Carmelite the age pattern of subsequent outbreaks was quite different from that of (cited and translated in Horrox 1994: 54). Many chroniclers noted that lence of Children,” as young people were more severely affected than were the Black Death. For example, the 1361 outbreak was called the “Pesti Deathadults (Cohnhas been 2002: attempted 212–15; usingCohn 2008:historical 86–87; data. Holmes Based 1971: on information 92). Reconstruction of age-specific mortality patterns during the Black Blackfrom inquisitionsDeath in England. post mortem,2 These wereRussell royal (1948) inquisitions produced into life-table the cause esti of deathmates ofof tenants age-specific-in-chief, mortality people among who held high-status land directly individuals from the during king. Thethe inquisitions provide a wide sample of the highest rank of landholders. When a tenant died, if the heir was underage, the king assumed guardian ship of the property until the heir came of age. Such guardianships were quite lucrative, and it was in the interest of all parties to establish accu rately the age of the heir; thus, the age estimates provided by the inquisi tions the samples are too small to provide useful life-table estimates, particu larly forare intervals supported below by multiple the age documentsof twenty; indeed, (Russell for 1948). some Unfortunately, age intervals, Russellthe 95% concluded confidence from intervals the life -fortable probability estimates ofthat death age didinclude have negativean effect onvalues Black (Wood Death et mortality. al. 2002a). He Despiteargued thatthe limitationsolder men were of the particularly available data, sus ceptible (although individuals over the age of sixty apparently fared bet ter than those in their late fifties), and children between the ages of ten and arguedfifteen werethat the at adata reduced do not risk support of dying the fromconclusion the disease that mortality compared var to iedother by age age groups. during Ohlinthe Black (1966), Death. however, has criticized Russell’s approach Using manorial court records from the English village of Halesowen (West Midlands), Razi (1980) estimated ages at death among the peas 2 Life tables are frequently used in demography to display the numbers of deaths ages, and other related demographic measures for a particular population. Model lifeat each tables age are or constructed age interval, using age-specific data from mortality living populations rates, survival and can rates be atapplied various to small samples obtained from living or past populations to compensate for missing data. 103 antry during the epidemic. Individuals appearTh ine A thenth manorialropology court of Pla rollsgue multiple times, and the last appearance of each individual is the death duty (heriot ing possession of the deceased’s property. Razi assumes that each indi ) payment made by heirs to the lord of the manor before tak paymentvidual appeared in order for to theestimate first time ages inat thedeath. court His rolls age atestimates the age areof twenty there years and counted forward from this first appearance to the death-duty fore imprecise, and by definition no information is available for individu als younger than twenty. Estimating age-specific mortality rates for males during the Black Death, he finds, similar to Russell (1948), that for males werebetween lower twenty than those and fifty-nineof younger years men. ofSuch age, a patternmortality of mortalityrates increased is typi calwith under age, butconditions that age-specific of normal mortality mortality, rates though for thosea plateau over in sixty mortality years Given the small samples available for Razi’s study, the results might not be generalizableis usually observed to the atentire later English adult ages population. in living populations (Gage 1988). As limited as the reconstructions of Black Death age-patterns have been using historic documents, such sources are even less forthcom ing with respect to the effects of other biological or social factors. For example, the determination of whether one sex was disproportionately affected or both sexes faced equal risks of death during the epidemic is even more problematic than that of age patterns given that there is very little documentary data on age-at-death for women and children at thesethe time data of dothe not Black allow Death reconstruction (Razi 1980; Russell1948).of sex differences Though in mortalitythere are acrossdata on the sex lifespan. ratios during There the is medieval also no information, period (see, e.g.,as far Kowaleski as I am aware,2013), from any documentary sources about whether pre-existing health condi tions had any effect on an individual’s risk of death during the epidemic. Historical records, therefore, do not provide a clear and complete pic ture of Black Death mortality patterns. Without such data, our ability to learn more about the ways in which the Black Death, and other diseases, have the power to shape human demography, biology, and evolution is severely hindered. Fortunately, skeletal material exists that provides empirical evidence about mortality patterns that is not available in written records. Though human skeletal samples are not without their own limitations, they can, about the individuals who died during the Black Death. when analyzed properly, reveal much more (and more direct) information 104 BlackSharon Death N. DeWitte Cemeteries During the Black Death, existing cemeteries proved inadequate to accom modate the overwhelming numbers of people killed by the epidemic, and providing normal burials for all the victims of the epidemic became dif were buried in existing cemeteries, mass burial grounds were established acrossficult (Horrox Europe 1994: during 21, the 64, Black 268–71). Death Though to accommodate many victims the of excess the disease mor London. tality.The One Black such Death mass was burial apparently ground was introduced the East toSmithfield England cemetery during the in wassummer recorded of 1348 in the via suburb the Dorsetshire of Stepney, port two milesof Melcombe east of the Regis, city andwalls, it reached the suburbs of London as early as September 1348 (the disease thein December Black Death 1348). was Thespreading epidemic towards ravaged London, the city “substantial throughout men 1349 of andthe city”ended ordered by the springthat emergency of 1350 (Gasquet burial grounds 1977; Hawkins be established 1990). priorAware to that its inarrival East (GraingerLondon, northeast et al. 2008; of the Hawkins Tower 1990).of London, The onEast land Smithfield that had cem pre viouslyetery was been established used as ina vineyard.late 1348 orThe early exact 1349 dimensions just outside and the location city walls of the cemetery are provided by the cartulary of the priory of Holy-Trinity- without-Aldgate, and it was originally called the Churchyard of the Holy Trinity, as the land was acquired from the priory (Grainger et al. 2008; largerHawkins Royal 1990). Mint Site, by the Museum of London’s Department of Greater East Smithfield was partially excavated in the 1980s, as part of the ernLondon area Archaeology with two mass (now burial Museum trenches, of London a mass Archaeology burial pit, and [MOLA]). individual The burialsgraves arranged in East Smithfield in several parallelwere concentrated north-south in rows; two andareas: second, first, ana west east ern area with one mass burial trench and individual graves arranged in excavated from the cemetery, a fraction of the estimated twenty-four hun several parallel rows (Hawkins 1990). Over six hundred skeletons were curated by the Museum of London Centre for Human Bioarchaeology. The cemeterydred individuals could have originally accommodated buried in many East moreSmithfield, burials, and but they the epidemic are now waned before it was necessary to use all the available space. Excavation were buried carefully. Almost without exception, the bodies were bur of the cemetery revealed that the individuals interred in East Smithfield 105 ied in standard medieval Christian fashion: extendedThe Anth ropologon their ybacks of Pla withgue their heads oriented west and feet oriented east. Some of the skeletons were missing limbs at the time of excavation, indicating that these indi viduals had been partly disarticulated as a result of putrefaction before ies were buried in the standard Christian fashion and were treated with apparentburial (Grainger care, rather et al. than 2008; tossed Hawkins hastily 1990). into a However,burial trench. even these bod East Smithfield was one of two known emergency burial grounds established in London (Grainger et al. 2008; Hawkins 1990). The other houseburial groundSquare wasand atthus West will Smithfield, not be excavated which later in its became entirety the (or site even of the in London Charterhouse. The West Smithfield site is now beneath Charter cemetery were recently uncovered during construction of a new London large part) in the foreseeable future, though a few individuals from the several hundred individuals, is thus one of a very few large excavated cemeteriesUnderground in lineall of (Palmer Europe 2013). with unambiguous The East Smithfield documentary site, which and archeoyielded logical evidence linking it to this outbreak of the medieval disease. At the time of writing, to my knowledge, the only other large, excavated burial grounds that are clearly associated with the Black Death are the Hereford Cathedral cemetery in England (Gowland and Chamberlain 2005) and the ousHeiligen-Geist researchers, Hospital according mass to burialthe number in Lübeck, of publications Germany (Lütgertrecorded 2000). in the WellcomeOf these, East Osteological Smithfield Database. has been investigated most extensively by vari The ability to study the skeletal3 remains of victims of the Black Death and other medieval plague burial grounds yields insights that are simply notand supportedsubsequent by plagues existing that historical have been documents. recovered The from advantage East Smithfield of bioar cheological research is that the information derived from skeletal remains of victims is not subject to the same biases that are inherent in histori cal documents, thereby allowing bioarcheologists not only to reveal what is missing from historical data, but also to challenge narratives based on those conventional sources (Perry 2007). 3 WORD Database (Wellcome Osteological Research Database) 2013: PreviousSharon N. DeWitteBioarcheological Studies of the Black Death etery to discern the mortality patterns of the Black Death (Gowland and Several researchers have analyzed the East Smithfield Black Death cem of some of these inquiries was to determine whether Black Death ceme teriesChamberlain are more 2005; representative Margerison of and the Knüsel demographics 2002; Waldron of a living 2001). population The aim than is generally true of mortality samples derived from other cemeteries. As discussed above, normal causes of mortality are expected to be selec tive, targeting the weakest individuals in a population, such as infants, the elderly, and those with immune systems compromised by disease or tive mortality, skeletal assemblages are inherently biased samples of the oncemalnutrition living populations (Milner, Wood, from whichand Boldsen they derived. 2008). For Because each age of thisgroup, selec the individuals within a cemetery are not a representative sample of all the individuals who were once alive at that age, but rather those individuals infer the characteristics of the once-living population in a straightforward mannerwho were based at the on highest observations risk of dying of the at thatcemetery age. This assemblage. makes it difficult However, to some researchers have suggested that the Black Death might have been so virulent that it killed indiscriminately, rather than selectively, such that mortality samples resulting from the epidemic would contain relatively healthy, robust individuals not usually found in normal cemeteries. If this were the case, Black Death cemeteries might provide a true cross-section of the once-living population not typically available in normal mortality tocemeteries that of the (Chamberlain St. Mary Graces 2006; cemetery Margerison (c and Knüsel 2002). Waldron (2001) compares the mortality profile from East Smithfield and to the age distribution of the living population. 1350–1538), of medievalwhich was London estab aslished predicted in the samefrom locationa model aslife East table. Smithfield after the Black Death ended, 4 He finds no systematic differences Waldronbetween arguesthe mortality that the profiles skeletal of evidence the two doescemeteries. not support Furthermore, the idea that the anyprofiles particular of both age cemeteries or sex was differed at an elevatedfrom the riskexpected of dying living during age structure. the Black Death. Waldron also finds that the two cemeteries had generally similar frequencies of skeletal pathologies. He concludes that the East Smithfield 4 Model life tables are constructed using data from living populations and can be applied to small samples obtained from living or past populations to compensate for missing data. 107 cemetery is not representative of the once-livingThe Apopulation,nthropolog asy oneof P mightlague expect if the Black Death killed people indiscriminately. at-death distribution more closely resembles a model living population ageHowever, distribution several than researchers the age-at -havedeath found distribution that the ofEast a normal Smithfield mortal age- the St.-Helen-on-the-Walls cemetery in York, northern England, a nor mality sample. non-epidemic Margerison cemetery and inKnüsel use from (2002) the latecompare twelfth East century Smithfield to 1550. to St.-Helen-on-the-Walls cemetery, but generally resembles the living age distributionThe East Smithfield from a modelmortality life profile table assumed differs significantly to be representative from that of the manyage distribution young people of a and living few (poor) older medievalindividuals. urban Gowland population; and Chamberlain in particu lar, that is, East Smithfield, like a living medieval population, contained (2005) compare East Smithfield to a pre-Black Death sample from Black moregate cemetery closely resembles in Newcastle, a model northeastern life table livingEngland. age They distribution, also find suggest that the ingEast that Smithfield all age groups distribution were differsequally from affected the normalby the Black mortality Death. sample and More recently, I have examined the age and sex patterns associated with the epidemic and the health of the victims, as evidenced by skeletal pathologies (or, more generally, skeletal stress markers, which are visible anomalies of the skeleton that indicate exposure to physiological stress, however,such as infection differs in or several malnutrition key ways at somefrom pointthe studies in life) described (DeWitte above.2009; DeWitte and Hughes-Morey 2012; DeWitte and Wood 2008). My research, dateWith thethe Blackexception Death. of GowlandThis is potentially and Chamberlain problematic (2005), because other studiesthe Black of DeathEast Smithfield itself initiated use comparison profound demographic samples that changes partly orthroughout completely Europe. post strophic mortality may have effects on age-at-death distributions that last forPaine several (2000) generations. finds, using Further, population as my work modeling, has indicated, that episodes if the mortality of cata during the Black Death was selective with respect to preexisting health conditions, it is possible that the epidemic altered patterns of health, as indicated by skeletal stress markers, in the surviving population. It is thus possible that post-Black Death samples, at least those dating to just after they do typical medieval mortality patterns. Therefore, in order to deter minethe epidemic, whether themore Black strongly Death reflect killed selectively the effects and of thehow Black its mortality Death than pat terns differ from normal medieval mortality, I have used an exclusively 108 preSharon-Black N. DeWitteDeath comparison sample composed of people who died in the two centuries just before the Black Death arrived. Another way in which my research has differed from most other inves is my use of a relatively unbiased method of adult age estimation. Paleode mographictigations of ageEast estimation Smithfield in (except adults for is basedthat of on Gowland observations and Chamberlain) of the mor phology of certain parts of the skeleton that change in fairly predictable These include changes to parts of the pelvis and to the skull. Studies of waysknown with-age age-at- (thoughdeath reference the timing samples of such have changes yielded can various be highly age variable).-estima involve assigning a skeleton to one of several stages based on the mor phologytion methods of a particular (which I hereafter skeletal feature.refer to Eachas “traditional” stage has amethods) corresponding which mean age at death and an age interval, both of which are estimated from known-age individuals in the reference sample who display the mor phological features distinctive of each stage. Unfortunately, traditional paleodemographic age-estimation methods have a built-in bias. They tend to lead to underestimations of older adult ages because the age estimates are biased toward known-age reference samples, which are often com posed predominantly of young individuals (Bocquet-Appel and Masset the1982; McKern Buikstra-Stew andart Konigsberg Korean War 1985; reference Milner sample and Boldsen is made 2012; up primar Müller, Love, and Hoppa 2002; Van Gerven and Armelagos 1983). For example, means that the numerous paleodemographic adult age-at-death distribu tionsily of thatyoung have men been (Milner, estimated Wood, for and cemetery Boldsen samples 2008). Thisare nearly “age mimicry” identical regardless of their temporal or geographic context. Such biased distribu tions hinder informative comparisons of paleodemographic mortality pro files. Another potential limitation of traditional age-estimation methods is the use of broad terminal age intervals, for example, those fifty years or older, because of the difficulty of estimating age in older adults (Boldsen andet al. a 2002; ninety Buikstra-year-old, and tw Konigsbergo ages for which 1985). one These would methods, expect verytherefore, different are morbiditynot capable and of mortalitymaking distinctions regimes, at between, least in living for example, populations. a fifty-year-old Because of these limitations of traditional age-estimation approaches, I have estimated ages using the method of transition analysis described estimates that are biased toward the known-age reference sample. It also by Boldsen et al. (2002). Transition analysis resolves the problem of age yields point estimates of age and their corresponding 95% confidence intervals (rather than broad and fixed interval estimates), even for older 109 adults. In transition analysis, data from a knownThe A-agenth referenceropology collectionof Plague are used to obtain the conditional probability that a skeleton will exhibit a particular age indicator stage, or suite of age indicator stages, given the individual’s known age. Using Bayes’s theorem and maximum likeli hood estimation,5 this conditional probability is combined with a prior distribution of ages at death to determine the posterior probability that an individual in the cemetery sample died at a particular age given that the skeleton displays particular age indicator stages. In transition analy sis, the prior distribution of ages at death can either be an informative prior based on documentary data or a uniform prior, and I have used an informative prior based on data from seventeenth-century Danish rural parish records. By combining the conditional probability from a known- age reference sample with a prior distribution of ages at death, transition analysis avoids imposing the age distribution of the reference sample on the unknown-age cemetery sample (Boldsen et al. 2002). I have applied transition analysis to East Smithfield data using the Anthropological Database,Lastly, myOdense research University differs (ADBOU)from that Ageof others Estimation by incorporating software (Boldsen hazard et al. 2002). patterns, rather than using life tables as a standard of comparison. Life tablesanalyses are (statistical typically constructed assessment for of living risks populationsof death) to using examine huge mortality datasets that include, among other things, the number of individuals alive at each age and the number who die within a particular interval. They have been used for several decades in paleodemography to examine intra- and inter- population demographic variation (Acsádi and Nemeskéri 1970; Wood et 6 The construction of paleodemographic life tables is based on the assumption that the age-at-death distribution in a cemetery is equiva al. 2002b). 5 Bayes’s theorem allows for the estimation of the probability of a trait (such as but which is associated with another trait that can be observed (such as a skeletal the unknown age of an individual in a cemetery) that cannot be directly observed, association between age and skeletal indicators of age, which is derived from known- age referenceindicator). samples In the case in which of age-estimation, both the ages thisof individuals requires information and their skeletal about agethe indicators are observable. The joint distribution of ages at death and the skeletal age indicators for all individuals in a reference sample is used to determine the probability that an individual in a cemetery sample (for whom only the skeletal age indicator can be observed) is a particular age given the skeletal age indicators observed for that 6 individualpatterns, such (Milner, as mortality Wood, and and Boldsen fertility, 2008). in past populations using skeletal samples. Paleodemography is a subfield of bioarcheology that examines demographic 110 lentSharon to the N. DeWittecohort age-at-death column in a life table;7 however, this is true only under a set of stringent criteria that many past populations do not infulfill paleodemography (e.g., no migration is complicatedand no changes by insmall age-specific sample sizesfertility and or a mortal lack of quantitativeity rates) (Milner, information Wood, and about Boldsen the original 2008). Further,population the atuse risk of life of death.tables make use of the data that are available from cemetery samples, as these samplesLife tables are are almost considered always by too many small researchers to allow forto be unbiased an inefficient estimates way toof the numerous parameters necessary to construct a life table (Buikstra 1997; Hoppa and Vaupel 2002; Konigsberg and Frankenberg 2002; Milner, Wood,life-table and approach Boldsen by 2008; applying Wood a ettheoretical al. 2002b). life Some table paleodemographers,that matches or pro includingvides a baseline previous comparison researchers for of the East age Smithfield,-at-death havedistribution adopted observed a model paleodemographic age-at-death distribution will often match more than onein a modelcemetery life (Weisstable, and 1973; uncertainty Wood et exists al. 2002b). about Unfortunately,which model life a singletables areIn most light appropriate of these problems, to use (Gage many 1988; researchers Milner, Wood, argue and that Boldsen rather 2008; than usingWood lifeet al. tables, 2002b). some form of hazard analysis is the most reliable way to derive information from the small samples typical of paleodemogra and Frankenberg 1992; Konigsberg and Frankenberg 2002; Wood et al. phy (Buikstra 1997; Gage 1988; Hoppa and Vaupel 2002; Konigsberg a2002b). useful alternativeMost human to age-at-death life tables in distributionspaleodemographic can be studies described (Holman, using five or fewer parameters, and parsimonious parametric models provide examples of such models are described below. Wood, and O’Connor 2002). This is the approach I took in my research and Hazard Analysis of Black Death Mortality Hazard analysis of Black Death mortality patterns has, for the most part, cemeteriesinvolved comparison of St. Albani of theChurch, East Odense,Smithfield and cemetery St. Mikkel to Church, a normal Viborg (i.e., (non-epidemic)c. mortality sample from the medieval Danish urban parish collection (DeWitte and Hughes-Morey 2012; DeWitte 2010; DeWitte and 1100s to mid-1500s), both of which form part of the current ADBOU 7 A cohort in this context refers to individuals who were all born at the same time. 111 The Anthropology of Plague ofWood the 2008).hazard Themodel advantages parameters; of using the generally the Danish good sample preservation as a compari of the son for East Smithfield include its large size, which allows for estimation ability to accurately date skeletons and, thus, to select a predominantly (if Danish skeletons (which facilitates estimation of age and sex); and the andnot exclusively) thus provides pre-Black a baseline Death of sample. normal, The non Danish-epidemic sample mortality contains onlypat individuals who died before the Black Death arrived in Denmark in 1350, and Southern England at this time were similar economically, socially, andterns demographically for comparison (Benedictowwith East Smithfield. 1996; Poulsen The populations 1997; Roesdahl of Denmark 1999; Death and Danish normal mortality samples were drawn from two differ entSawyer geographic and Sawyer regions 1993; means Widgren that 1997). possible However, population the fact differences that the Black have to be considered when interpreting the results of these studies. An ideal and therefore, in future research I will use exclusively London samples, somecomparison of which sample have beenfor East made Smithfield available shouldto researchers be drawn only from recently. England, I have previously examined the age patterns of Black Death mortality,8 and how they compared to those produced by normal mortality condi tions, by using age-at-death data from each sample to estimate the param eters of a parsimonious model of human mortality: the Siler model. The Siler model of mortality describes the typical pattern of population-level risk of mortality across the lifespan, which begins relatively high at birth, drops rapidly during childhood before leveling off between late child hood and young adult ages, and then increasing again during later adult declines and increases in mortality can vary tremendously across popula ages (Siler 1979). Though the absolute levels of mortality and timing of observed in nearly all human populations (and even nonhuman animal tions, this same general pattern (the so-called “bathtub9 curve”) has been The results of this research indicate that the Black Death did not kill populations)indiscriminately for whichwith respect data are to availableage. The results(Gage 1989). of estimation of the Siler model in the East Smithfield and normal mortality samples indicates that 8 The Museum of London Centre for Human Bioarchaeology, which provides access in future research were made available for general research following the publication ofto thethese corresponding samples, was site established report in in 2012. 2003, and some of the samples that will be used 9 Further details about the Siler model can be found in Gage (1988 and 1989) and Wood et al. (2002b). 112 forSharon both, N. the DeWitte risk of death increased with advancing adult age. This means that elderly adults faced higher risks of death compared to their younger peers during times of both catastrophic Black Death mortality and under the Siler model did not yield convincing estimates of the parameters of the normal medieval mortality conditions (DeWitte 2010). However, use of populations, the juvenile risk of mortality is initially relatively high at juvenile component for the East Smithfield sample. Typically, in human birth, but it declines very rapidly with small changes in age for the first few Theyears estimated of life; this juvenile change risk might for thereflect normal increases mortality in immune sample competenceconforms to with age and thus consequent decreases in risks of infection (Gage 1989). risk was initially low at birth and increased slowly with age, with no drop insuch risk expectations; during early childhood.however, for At facethe East value, Smithfield this might sample, suggest the that juvenile infants faced relatively low risks of mortality during the Black Death; however, the the small sample of infants and children available, as they only made up estimated juvenile pattern in East Smithfield might have been the result of the8% juvenileof the East component Smithfield of sample mortality (which is based might primarily reflect poor on individuals preservation in of these bodies or different burial practices for children). Estimation of cult to estimate accurately the juvenile risk with small sample sizes (Wood the sample who are between the ages of zero and five years, and it is diffi etthe al. Black 2002b). Death Such awaits small further sample work sizes with in East larger Smithfield samples. means that clari ficationAssessment of mortality of whether for the theyoungest Black Deathindividuals differentially in the population affected one during sex has been limited to adults, given the lack of current methods to accurately assess sex in immature individuals. Thus in my previous work, I modeled sex as a covariate affecting the parameters of the Gompertz-Makeham during the young adult ages and an increasing risk of death with increas model, which fits the general human pattern of relatively low mortality eled in such a way that it was free to take on values indicating either an elevateding adult orage decreased (Wood et al.risk 2002). of mortality The effect for of females the sex compared covariate wasto males, mod or a complete lack of differences in risk between males and females. The results indicate that, under both conditions of the Black Death and nor mal medieval mortality, males and females did not differ significantly in their risks of death (DeWitte 2009). It should be noted, however, that the acrossway I modeled adult ages, the andcovariate thus thiseffect approach (i.e., the cannotproportional detect hazard potential specifica cross tion) does not allow for variation in differences in risk between the sexes 113 overs in mortality. It is possible that femaleTh mortalitye Anthropolog was highery of Pla thangue that of males during reproductive ages, as some diseases, such as malaria, disproportionately affect pregnant women. However, examination of such variation in sex differentials across adult ages requires further analysis using larger sample sizes. To determine whether the Black Death disproportionately affected people already in poor health, I used the Usher model, which allows for variation in the risk of death between individuals with and without skele makingtal stress the markers conventional (see DeWitte assumption and Wood that the2008 presence for a description of stress markersof these alwaysmarkers) indicates (Usher poor 2000). health The andUsher similar model or allowsidentical researchers levels of frailty to avoid for all individuals in a particular population, an assumption that might not tobe form.justified Thus, (Milner, an individual Wood, andmust Boldsen be minimally 2008; healthyOrtner to1991; survive Wood a physi et al. ological1992). Most stressor detectable long enough skeletal for stress an associated markers takestress a minimummarker to ofdevelop. weeks Some individuals in a skeletal sample might lack stress markers despite exposure to physiological stress because they were very frail and died before skeletal stress markers formed. Alternatively, individuals in the sample might lack stress markers because they were fortunate enough to avoid exposure to a particular stressor or had immune systems robust lackenough a particular to fight off stress disease marker before might stress have markers had higher formed, or lower both oflevels which of frailtyreflect comparedrelatively tolow individuals frailty. Under who thesehave them.circumstances, Thus, the presenceindividuals of skelwho etal stress markers might actually indicate relatively good health in some cases, but this will not be apparent in a simple dichotomous comparison of stress marker frequencies. The Usher model allows for an explicit examination of the relation ship between skeletal stress markers and risks of mortality, and thus the determination of whether, in a particular context, stress marker presence is indicative of good or poor health. The model has three non-overlapping states: State 1 includes people with no stress markers; State 2 includes presencepeople with or absencestress markers; of visible and stress State markers 3 is death. indicates Individuals which of in the a cem two livingetery arestates observed they were after in they just have before made they the died. transition Transitions to State between 3, and the presence of stress markers allow for the estimation of the model param eters.states Theare governed model allows by age-specific for differences hazard in rates,the risks and ofdata death on age associated and the 114 withSharon State N. DeWitte1 and State 2. The model thus enables one to estimate whether individuals with stress markers are at an elevated or decreased risk of dying compared to those without them. skeletal markers of physiological stress within the Black Death cemetery. I have applied the Usher model to data on a variety of nonspecific othersSome of can these manifest stress in markers response reflect to stressors exposure at anyto physiological point during stressorsthe lifes (such as malnutrition or infectious disease) strictly during childhood, and agepan. and (See the DeWitte presence and of Wood these 2008stress and markers DeWitte in the and normal Hughes-Morey mortality 2012sam plefor detailsreveals about that these these stress stress markers markers.) are, Fitting at least the underUsher normalmodel to medieval data on mortality conditions, indicative of frailty or poor health, and that the risk of mortality was higher for people with the markers compared to those Death disproportionally killed people who had them. That is, people who experiencedwithout them. physiological The results stressors,from East and Smithfield who developed indicate stressthat the markers Black the arrival of the epidemic were subsequently more likely to die during thein response Black Death to those compared stressors, to their at some peers point who (perhaps lacked the even stress long) markers before 10 Together, the results of analysis of age and frailty reveal that contrary (DeWitteto the common and Hughes-Morey assumption that 2012; the DeWitte Black Death and Wood killed 2008). indiscriminately, there was variation in risks of dying during the epidemic. This means we should question any historical, molecular, or bioarcheological study that implicitly or explicitly assumes that the Black Death was not a selective mortality cemeteries indicate that we should expect mortality to be selec tivekiller. and Further, for people the tosimilarities differ in their between risks ofthe death East underSmithfield all mortality and normal con ditions, even in the event of catastrophic mortality. This has implications, not just for our understanding of the effects of disease in the past but also for our expectations of and preparedness for disease outbreaks in living populations. 10 Initial analysis, using the Usher model, of the effect of physical stature on risk of death found no effect in either the Black Death or the normal mortality sample approach to assess stature. Reanalysis using a more appropriate and simpler (DeWitte and Wood 2008). However, the Usher model is an unnecessarily complicated analytical approach did find an effect of short adult stature on risk of death (DeWitte and Hughes-Morey 2012). 115 Bioarcheological research on the Black DeathThe hasAnt hrevealedropolog noty of only Pla guethe mortality patterns of this particular historical epidemic, but also more gen erally it demonstrates that bioarcheological research has important contri butions to make to lines of inquiry that have traditionally been the purview of historians. The unique contribution of anthropology to medieval plague studies is that it allows the victims themselves (or, more precisely, their alive and to the context of their deaths—in this case, how an individual’s ageskeletal and healthremains) status to bearelevated witness or reduced to their his experiences or her risk ofwhile mortality they were dur ing the Black Death. This is particularly important for our understanding of the experiences of those who are not typically included in the historical record: that is, the vast majority of people who lived in the past. Future Directions in Black Death Bioarcheology The results of bioarcheological research on the Black Death raise ques tions about the demographic and health consequences of the epidemic. The very high levels of Black Death mortality, and the results from haz ard analysis which indicate that this mortality was selective and targeted frail people of all ages, means that the epidemic might have exerted a strong selective force on the European population, removing the frailest, unhealthiest individuals on a very large scale. If the post-Black Death pop ulation included individuals who were exposed to and survived the Black Death, this episode of selection might, at least in part, explain the very rapid apparent changes in medieval plague epidemiology. These changes include the apparent decline in plague mortality as described in contem poraneous historical documents. As explained by Carmichael (2014, this humansissue), patterns to plague. of human However, plague in thedeaths case might of medieval reflect the plague, disease the dynam lower ics of nearby animal host populations, which can influence exposure of estimated mortality rates in later outbreaks of plague (Carmichael 1986; Furthermore,Cohn 2008; Russell health 1966) might might have reflect been stronglylower average shaped frailty by the among apparent peo improvementsple who survived in standardsthe first outbreak, of living asthat well occurred as among after their the descendants. Black Death and that resulted primarily from the massive depopulation caused by the epidemic. Such changes in standards of living included improvements in diet for people of all social classes (Dyer 2002; Hatcher 1977; Poos 1991; competence, dietary improvements and decreases in social inequities in Rappaport 1989; Stone 2006). Given the effects of nutrition on immune access to food (which might have strongly benefitted the lower social ech 116 Sharon N. DeWitte reduce average levels of frailty within affected populations. elonsThere who is made some up evidence the bulk ofto the suggest English improvements populace) might in havesurvival acted and to comparisons of British and Spanish documentary data (tax records and thus health following the Black Death. Russell (1966) found—based on grounds primarily from Central Eastern Europe—that the ratio of indi inquisitionsviduals above post the mortem)age of sixty to relativeskeletal todata those from between seventy-seven ages twenty burial to sixty increased after the Black Death in some areas. However, a com parison of pooled skeletal data from a wide geographic region (mostly ideal. Among other potential problems, each source is subject to differ entEastern sources Europe) of bias to (e.g., documentary poor skeletal data preservation from Western of children Europe in is some not cemeteries, biased skeletal age estimates, or underrepresentation of the Thus, this line of inquiry needs to be further pursued using large skeletal samplespoorest individuals from cemeteries in some that tax pre records)- and postdate which complicates the Black Death, comparison. prefer ably from one relatively circumscribed area, and the application of newer, unbiased age-estimation methods and rigorous quantitative approaches such as hazard analysis. Ongoing bioarcheological research is examining temporal trends in survival, risks of mortality, and patterns of skeletal stress markers using samples from London cemeteries that date to the ods. Thus far, initial results using these samples indicate improvements pre-Blackin survival Death and health(1000–1300) in general and followingpost-Black the Death Black (1350–1540) Death (DeWitte peri Not only is there much to learn about the ways in which the Black Death2014). shaped the demographic and health characteristics within surviv ing populations, there are also questions about the epidemic itself that Death burial grounds that have been excavated or that will potentially be excavatedremain unresolved, in the future. and As which mentioned could benefitabove, the from relatively study of small other propor Black reconstruction of the risk of death for infants and young children during thetion Black of children Death. inLarger the East sample Smithfield sizes of cemeterychildren would has prohibited allow for theaccurate clari is particularly important given evidence from historical sources that the fication of patterns of mortality for children during the Black Death. This In order to understand precisely how and why mortality patterns might second outbreak of plague in 1361 disproportionately targeted children. clarify what the risks for children were during the former. have changed between the first and second outbreak, it is essential to 117 The Anthropology of Plague tation of plague based on local conditions. Thus, it is crucial to repeat and expandAs noted the bioarcheological by Varlık (2014, inwork this that issue), has there been is done variation with the in the East manifes Smith might have produced geographic or temporal differences in the mortality patternsfield sample by age, using sex, samples frailty, fromand other other factors areas toduring reveal medieval how such plague variation epi demics. Given the Eurocentric perspective common to Black Death schol arship highlighted by contributions to this issue of The Medieval Globe, it is particularly important to examine plague mortality using cemetery samples from regions outside of Europe if they become available. Bioarcheological analysis also allows us to better understand the againstsocial responses the Jewish to thecommunity Black Death. of the For Catalan example, town Colet of etTàrrega al. (2014, following in this theissue) epidemic’s describe arrivala cemetery in the containing region. This the cemetery victims of provides violence rare perpetrated insights withregarding the victims’ the specific burial. victims In the ofcase the of violence Black Death perpetrated cemeteries, against such the as Jewthat ish minority (which was blamed for the disease) and how survivors dealt of the individuals interred therein are informative about how the living treatedof East Smithfield, the victims the of organizationthe epidemic of and the howburial this ground treatment and the might positions have differed from practices discernible during conditions of normal mortality of(Grainger care similar et al. to 2008; what Hawkinsthey would 1990; have Kacki received et al. during 2011). times In East of normalSmith field, for example, we have evidence that individuals were afforded a level alsomortality provide (Grainger opportunities et al. 2008). for expanding molecular analyses of the medi evalBlack plague Death pathogen. cemeteries, As mentioned including above, and in the addition integration to East of Smithfield,bioarcheo logical research with paleomicrobiological approaches (e.g., ancient DNA epidemiology, the effects of other circulating diseases on the emergence andanalyses) epidemiology will provide of plague, a powerful and tool human for understanding-pathogen coevolution, changes in thereby plague addressing questions of great interest to a variety of researchers, includ ing historians, anthropologists, and evolutionary geneticists. Bioarcheol ogy is ideally suited to bridge historical and molecular research on plague ing(or, fromindeed, other on anyapproaches, important but disease which inultimately human history). makes plague More thanresearch any relevantother field, both bioarcheology to the study providesof human the history human as contextwell as thatto the might study be of miss bio logical variation and responses to infectious disease among living people. 118 BibliographySharon N. DeWitte Statistical Methods in Medical Research Acsádi,Aalen, O. G., O. and 1994. J. Nemeskéri. “Effects of Frailty1970. Historyin Survival of HumanAnalysis,” Life Span and Mortality 3, no. 3: 227–43 Alizon, S., A. Hurford, N. Mideo, and M. Van Baalen. 2009. “Virulence Evolution (Budapest:and the Trade Akadémiai-Off Hypothesis: Kiadó) History, Current State of Affairs and the Future,” Journal of Evolutionary Biology André J.-B., and M. E. 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DeWitte with interests in bioarcheology, paleodemography, paleoepidemiology, and infec tious and epidemic diseases.([email protected]) For over a decade she is ahas biological been investigating anthropologist the mortality patterns, demographic context, and consequences of medieval plague large skeletal samples from Europe, Dr. DeWitte is able to examine population- levelepidemics, phenomena including associated the Black with Death past ofcrisis 1347–51. mortality By applyingevents, including hazard analysis the effects to of biological factors like age and sex on risks of death during epidemics as devas tating as the Black Death, how and why those risks change over time, and how epi demics shape demography and health. Her Black Death research is summarized in publications such as “Selectivity of Black Death Mortality with Respect to Pre- Existing Health,” co-authored with James Wood in Proceedings of the National Academy of Sciences USA Journal of Archaeological Science 105 (2008): 1436–41; and “Age Patterns of Mortality duringand evolution the Black of Deaththe pathogen in London, that A.D. caused 1349–1350,” the Black in Death, Yersinia pestis, and 37 (2010): 3394–3400. She is also interested in the molecular biology professoris part of ain collaborative the Department project of Anthropology that has produced at the theUniversity first complete of South genome Carolina. of the fourteenth-century bacterium (Bos et al. 2011). She is currently an associate Abstract Most research on historic plague has relied on documentary evidence, but recently researchers have examined the remains of plague victims to produce a deeper understanding of the disease. Bioarcheological analysis allows the skel etal remains of epidemic victims to bear witness to the contexts of their deaths. This is important for our understanding of the experiences of the vast majority of people who lived in the past, who are not typically included in the historical record. This paper summarizes bioarcheological research on plague, primar anthropology uniquely contributes to plague studies. ily investigations of the Black Death in London (1349–50), emphasizing what Keywords Black Death, medieval London, paleodemography, osteology, hazard models, plague cemeteries, East Smithfield. PLAGUE DEPOPULATION AND IRRIGATION DECAY IN MEDIEVAL EGYPT STUART BORSCH vides us with a substantial account of the Black Death in his historical Thnarrativee fifteent of severalh- thousandcentur pages:y Egy thepti Kitāban chronicler al-sulūk lī -al-Maqrma ‘rifaī�z duwalī� pro al-mulūk (The Book of Methods for Understanding the Kingdoms [of the World] muhtasib inent historian. His extensive works have therefore provided modern scholars). Al-Maqrwith a greatī�zī � was deal a marketof information inspector about ( Egypt’s) aseconomic well as ahistory. prom pestilenceConcerning “worse the plague’s than any arrival seen inbefore Egypt, in al-Maqrthe Islamicī�zī�’s world” narrative began describes with a shipa sequence full of corpses familiar drifting to historians into Alexandria. of the Black There Death: were how, a few in sailors1347 CE, still a alive; they died soon after—and Egypt’s experience with the Black Death al-Sulūk begandred people (al-Maqr a day,ī�zī�, and that, 2: the 772–73). death toll subsequently doubled to two hundredAl-Maqr a day.ī�zī� reports As the plaguethat in outbreakAlexandria reached the plague its peak, began there killing were a masshun funerals for as many as seven hundred people. The plague then spread throughout the Nile Delta, where “no one was left to gather the crops.” al-Sulūk, In the city of Bilbays at the eastern edge of the Delta, al-Maqrī�zī� reports that “mosques, shops and lodges were left empty” (al-Maqrī�zī�, mosques2: 777–79). and When the cemeteries. the plague struckWhen theCairo, plague the sultanreached and its leading peak around mem bers of the ruling regime fled the city, as mass prayers were held in the December of 1348, it was reported that something like 7,000 peopleal-Sulūk died, per day. The plague finally abated the following February; in the quiet that followed, Cairo was like a graveyard, still and empty (al-Maqrī�zī�, become2: 780–84). all too common in Egypt. Plague depopulation in the instance of theScenes Black Deathof devastation had a deep like and that long of- tCairoerm impact in February on Egypt’s 1349 economy. were to This article examines the manner in which plague shaped the economic history of Egypt. It assesses the relative scale and scope of rural mortality and argues that plague depopulation led to the collapse of Egypt’s eco nomic infrastructure; the analysis that follows is intended to show exactly 125–156 The Medieval Globe 1 (2014) pp. 126 howStuart and Bor whysch this happened. In so doing, this essay illustrates an impor tant lesson to be learned from the historical study of plague: the economic impact of massive depopulation could vary greatly from region to region throughout the affected areas of the medieval globe. These economic responses to exogenous demographic shocks were, moreover, shaped by and dependent upon diverse social, institutional, and environmental vari ables. In this case, emphasis falls on the dependent variable of geography; but other variables, such as political institutions rooted in social struc tures, also demand attention. While it might sound obvious that we should comforting conceptual trap of familiar and well-established trajectories: thatkeep is, our the theoretical well-known expectations European flexible,pattern itof is falling all too prices, easy to rising fall into wages, the social mobility, and improved nutrition discernible in the aftermath of the Black Death. Egypt offers a very different picture of the outcomes stem ming from rapid, plague-induced demographic changes. Studying the Economic Impact of the Black Death in Egypt brought depopulation and change not only to Egypt but also to the Middle EastThe Blackin general. Death Whileof 1347–50—and it is accurate the to cyclessay that of plaguethis process that followed of transfor it— mation and evolution is only partially understood, it is worth examining what progress has been made; the following is a review of the scholarship (largely focused on Egypt) that pertains to economic developments influ Blackenced Death by plague was devastatingdepopulation. to Egypt The work has never of Eliyahu been seriouslyAshtor (1949, challenged, 1969, 1976, 1977) is the best place to start. Ashtor’s broad conclusion that the in this period. In 1970, Abraham Udovitch (together with Robert Lopez and he is still the most cited source for the specifics of economic decline trajectory of Egypt in the late Middle Ages (Lopez, Miskimin, and Udovitch and Harry Miskimin) summed up what was known about the economic 1970). Udovitch concluded that economic decline was quite severe dur tioning the to the1350 problems to 1500 interval.posed by Around the adoption the same of coppertime, studies currency of monetary in Egypt transformation by Jere Bacharach (1971 and 1983) drew deserved atten Dolsduring included the late a fourteenthsection on theand economic early fifteenth impact centuries. of the Black The Death. formal As study was theof the case Black with Death Ashtor in Egyptand Udovitch, began with his Michaelconclusions Dols about(1977). the In economic his book, impact of plague depopulation were altogether negative. Later work by Dols (1979, 1981) focused primarily on the plague outbreak of 1430. As 127 the data thatP laguewe have Depopulation for this outbreak and Irrigation is much more Deca yextensive in Medie vthanal E gthatypt for the Black Death itself, Dols made a case study of Cairo and concluded that overall mortality in that city was on the order of 90,000.1 Black Death in Egypt—or the Middle East—until my own comparative After Dols’s work, there were no studies dedicated specifically to the the economic history of Egypt that examined the problem indirectly. The monograph (Borsch 2005). However, there were a number of studies in ably expanded the data on prices and exchange rates for late medieval Egypt,work of focused Boaz Shoshan on the role (1983) of monetary on grain factors prices, in from the economic which he turbulence consider of the 1400s. Shoshan was one of a series of scholars—Giles Hennequin the(1974), wake Adel of the Allouche Black Death. (1994), Among Warren this groupSchultz there (1998, seems 2011), to have and been John a Meloy (2001)—who studied various aspects of the monetary system in quietchapter consensus of his work that to the the monetary economic woes trajectory of the 1400sof Egypt were in the in manypost- Blackways boundDeath period,up with paintingfalling economic a bleak production.picture of economic Carl Petry events, (1994) especiallydevoted a when it came to the political economy of corruption and its impact on the economy as a whole. From a very different perspective, Sato Tsugi tion system during the Mamluk period, and his work is indispensable for anyonetaka (1977) studying was reallyeconomic the firstchanges scholar in the who rural studied economy the Egyptian in the interval irriga depopulationbetween 1347 via and an 1517. examination of famine relief in the Mamluk period Adam Sabra’s work (2000) indirectly addresses the subject of plague is an indispensable guide to the economic trajectory of Egypt at this time. Atof ruleroughly (1250–1517). the same Histime, detailed two Egyptian analysis historians of Egypt’s producedinflationary detailed cycles and innovative studies of Egyptian economic life that included a great deal of detail about the rural economy of Egypt after the Black Death. Egypt,‘Imād Abūexplored Ghāz īthe� (2000), changes a historian in the agrarian who produced economy what that was arose effectively because ofthe land first sales archive-based conducted bymonograph the cash-strapped dedicated Circassian to the rural Mamluk economy regime. of 1 Dols (1977: 204–12) initially examined the outbreak of 1430 and provided a table that attributed 91,845 deaths to plague for that year, a figure in close proximity to that includedgiven by thea thorough fifteenth-century re-examination chronicler of population Ibn Taghr levelsī�birdī�, forwho Cairo. had estimated 100,000 deaths (Popper 1954–63, 4: 72, 181). Dols’s later analysis of this epidemic (1981) 128 Stuart Borsch overlooked aspects of the rural economy, breaking ground in terms of the depthThe work and of detail ‘Ā� mr given Najī�b toMūsā rural Nasir economic (2003) change addresses in the a hostwake of of hitherto plague depopulation. In terms of archival work on the rural economy, it should ofalso waqf be noteddocuments that the(created Japanese by formal scholar institutions Daisuke Igarashi established (2006, by chari2008, 2010, and forthcoming) has extensively investigated archival collections monograph on the political economy of waqf foundations deals with the economictable donation) change in related order to to study plague agrarian depopulation. developments; his forthcoming divergence and its relationship to plague depopulation. Since then, he has Meanwhile, Sevket Pamuk (2007) has taken up the subject of east-west following plague outbreaks (Shatzmiller 2012; Pamuk and Shatzmiller (with Maya Shatzmiller) published analyses that study wage trajectories economic2014). Two developments other recent contributors at the very end to this of thearea Mamluk of economic period, history and theare the Malaysian scholar Wan Kamal Mujani (2008 and 2011), who studies novel examination of prices, an examination that employs methodological toolsSwedish new economist to the study Johan of the Söderberg Black Death (2006), in the who Middle has produced East. a new and Another recent work in Arabic, indispensable for anyone studying the economic impact of plague depopulation in Egypt, is that of Muhammad analysis of economic developments—particularly developments in the ruralal-Zāmil sphere. (2008). Perhaps This the book most is fullinnovative of insightful recent observations study is by Julien and Louiseau detailed Reconstruire la maison du sultan, 1350–1450: ruine et recom- position de l’ordre urban au Caire, Louiseau conducts a detailed mapping of(2011). Cairo Inthat examines the areas of the city most affected by the khirāb, or economic decline of Egypt. Using a broad archeological reconstruction of math of the Black Death and its effects on the built environment, including gravesfifteenth-century as well as ruined Cairo, palaces,this massive mosques, two-volume and housing work structures. studies the after Finally, looking at the subject of plague in the longer term, there is Ottoman Egypt. Mikhail, whose work studies the trail of plague mortality stretchingnew work byall Alanthe way Mikhail to the (2008, nineteenth 2011, century,2013) and focuses Sam Whiteattention (2010) on the on environmental history of plague, and his innovative use of archival court records gives him a unique perspective on the disease’s long-term tenure in the eastern Mediterranean. Long after plague had been banished from Europe it endured in the Middle East, and it continued to haunt Egypt, with outbreaks recurring approximately every nine years for over half a millennium, from 1347 to 1894 (see also Varlık 2014, in this issue). 129 MeasuringP Rurallague DepopulationDepopulation and Irrigation Decay in Medieval Egypt beyond—andThe Black Death some was of thus these the outbreaksfirst of many were blows nearly that asstruck bad theas the Egyptian Black population; cycles of plague outbreaks2 continued into the 1400s and well century carried away enough victims that they left deep scars in the col Death itself (Dols 1977: 305–14). The many outbreaksal -ofSulūk the fifteenth lective memory. An account narrated by al-Maqrī�zī� ( , 4: 227) دالب ترمدت و ةزيجلا و ةيبرغلا:terms مظعم و following ةيقرشلا the رثكأin و 1412 ةريحبلاof دالب و the outbreak ةيردنكسإلا تبرخف describes موي يف ماقت تناك ةبطخ نيبرأ ىلع ةدايز اهنم لطب ثيحب ديعصلا دالب بارخلا مع و مويفلا و ريبك ال و ريمأ هب ىقبي ملف .نيملسملا روغث مظعأ نم ناك و – ناوسأ رغث رثد و .ةعمجلا ىلع ةدايز اهرهاوظ و ةرهاقلا نم برخ و .اهلك ديعصلا نئادم تشالت و .تيب ال و قوس ال سانلا ىثلث وحن ءابولا و عوجلاب رصم ميلقأ لهأ نم تام و .اهكالمأ فصن. (Alexandria was laid waste [by these troubles] and so was [the Nile Delta province of] al-Buḥayra. The greater part of [the province of] al-Sharqī�ya tionwas ruined,was widespread and the majority in Upper of Egypt [the two as well provinces] – so much al-Gharb so thatī�y morea and thanGiza fortywere desolated.sermons that The were[province held of]on theFridays Fayyum were was abrogated. devastated. [The Destruc intent here is to convey that more than forty villages/towns large enough to have a congregational mosque were abandoned.] The port city of Aswan was destroyed, and it was once one of the greatest of Muslim port cities; houses. Most of the cities of Upper Egypt have been obliterated. Cairo and itsnow outskirts nothing have remains lost halfin it their of amirs, wealth. influential And two people,-thirds ofmarketplaces, the population or of Egypt has been wiped out by famine and plague.) demographic devastation, though a mortality of two-thirds was probably onlyAl-Maqr witnessedī�zī� is trying at times to describe and in places the scale where and plague scope outbreaks of economic were and at outbreaks: they were the worst to follow the Black Death. Both lasted for their most intense. The plague cycles of 1430 and 1460 were two such about four and a half months. In Cairo, the plague of 14303 claimed about 90,000 lives and the 1460 outbreak some 70,000 lives. 2 Dols provides a fairly detailed appendix of the outbreaks that followed the Black Death, to the end of the Mamluk period (1517 CE). He concludes (1977: 223–24) that there were some twenty-eight outbreaks in Egypt in the interval 1349–1517 CE, with 3 cycles of recurrence every five and a half years. al-Sulūk Quantitative primary evidence (including figures for daily death tolls) supports this conclusion. For the 1430 plague, see al-Maqrī�zī� ( , 4: 822–26), Ibn Ḥajar 130 StuartWhat Bor wesc knowh about these plague outbreaks—qualitatively and quan titatively—are details provided by eye-witness observers, like Ibn Ḥajar al-‘Asqalānbers of the īelite� and class al-Maqr of urbanī�zī� for scholars. the 1430 What plague they and record Ibn areTaghr theī�bir numberdī� for theof plague 1460 plague.deaths Theseper day three (and men sometimes (among theother totals witnesses) for certain were periods mem of time). These numbers were conveyed to them by high-ranking mem bers of the Circassian (Mamluk) military regime and its civilian bureau ancracy. account The bureaucrats of deaths listed themselves by name obtained and registered the figures by for the the Department number of ofplague Inheritances. deaths per But day this by wasone onlyof two a partialmethods. record, The first perhaps was derived one-third from of all urban deaths, because the vast number of anonymous and property- less poor were not counted. The second method was more comprehensive and consisted of counting corpses that were brought to a muṣallā, which might best be translated as “prayer site” or “oratory.” The muṣallā was an open place with a more limited ceremonial scope than a mosque. It was often located at a city’s gates, with a designated wall for the prayer niche (mihrab muṣallā most often referenced in the course of these two outbreaks was that of the Bab al-Nasr at the northern end of Fatimid Cairo. Here,). The bodies were brought for the brief “funeral prayer” (janāza these funeral prayers were performed with great haste over long lines of ) that preceded actual burial. In 1430, however, bodies.Ḥawādith This mass blessing was thenmuṣallā followed,, of which in 1430, Cairo by burialhad about en masse, four with graves dug out for forty or more corpses at a time (Ibn Taghrī�birdī�, were recorded, 14: 341). by civilian From bureaucrats—sometimesthese under the direction ofteen leaders in 1430 (amirs and seventeen in 1460, the total number of deaths per day and conducted with as many as three independent witnesses. Sometimes rounded and sometimes) of the not,regime. the Thesenumbers tallies present were a apparently complex picture detailed of different urban sectors in which there were mosques, markets, and gates that served as muṣallā. Inbā’, Badā’i‘, Ḥawādith, Ḥawādith, al-‘Asqalānī � ( 9: 200), Ibn Iyās ( 2: 113), and Ibn Taghrī�birdī � ( (14:Badā’i‘ 339–43). The primary sources for the 1460 plague are Ibn Taghrī�birdī � ( 16: 130–47; see the translation by Popper (1954–63, 4: 90–100). See also Ibn Iyās , 2: 357). On the 1430 plague, see also Dols (1981: 404–11), who had clearly intended to study the 1460 plague as well (1981: 409). 131 Analyzing Pthelague Data Depopulation for Rural an Plagued Irrigation Mortality Decay in Medieval Egypt Thanks to these contemporary records, urban death tolls (numbers of and the resulting ratios indicate the data’s probable validity. Once a con deaths per day) from different sources can be compared with one another, extrapolating from a single data point (such as a datum from one of the muṣallāfirmable ratio is established, one can calculate total deaths per day by graphed, to represent the number of deaths per day over time. The graphs). From for these rural mortalityratios, final from death plague counts outbreaks can then (Graphs be posited 1–3, on and pp. noted that compiling rural depopulation statistics presents more of a chal lenge.134–5, The below) same are sources based on available this method for Cairo of calculation. can also beHowever, mined itfor should data onbe al-Sulūk, rural plague outbreaks in 1430 and 1460, as well as for one in 1403–04 and systematic,another in 1407 so we (al-Maqr must assessī�zī�, the scale3: of1126 rural and depopulation 4: 43). But the by mortalityadapting andfigures applying that we the have plague for townscurves anddetermined villages outsidefor Cairo. of Moreover, Cairo are muchwe do lessnot that the muṣallā Islamicknow precisely practice, how worked these in ruralroughly figures the same were mannercompiled, in abut village it seems as in logical a city. funeral rite (and associated body count), as a generalized Map 1. Egypt’s Nile Delta Showing Plague Outbreaks and the Principal Sultani Irrigation Canals. Sketch by author with data taken from multiple sources. 132 StuartMap Bor 1 onsc hthe previous page shows the distribution of rural outbreaks that have so far been documented. Tables 1–3 opposite display data col nesseslected from who therecorded available them. sources Hence, for the threegoal here outbreaks is to convey (1403, a1430, sense and of scale1460). and These scope figures are rough estimates, as attested by the urban wit thousands? : did hundreds die in large towns like al-Maḥallat al-Kubrā (below)—orFor estimating was themortality total mortality in these ruralin the locations, thousands—or Cairo’s even peak tens death of Table 3: 250 per day in February rates for 1430 and 1460 were scaledGraph down 1. These to the twotwo curves,death rates which that align we closelyhave for with al-Maḥallat that of the al-Kubrā scaled- downin 1460 curve ( for Cairo, can then be averaged and combined300 per day into in one March): curve: see see Graph 2. Summing up the interpolated areas suggested by this amalgamated curve yields an estimated total number of deaths: approximately 10,000 for the plague outbreak of 1460 in al-Maḥallat al-Kubrā alone. This total mortality can then be tested against the total deaths of the 1430 outbreak in the same locale, for which we have a figure of some 5,000 deaths by January of 1430, some sixty days into the epidemic (Table 3). The sixty- day mark in the 1460 graph above (Graph 2) reads as 4,000 total deaths. The fact that the two figures are comparable suggests that the scale is cor rect—even if the figures themselves are rounded estimates. We also have estimated death tolls for the Nile Delta town of Minūf al-‘Ulyāing the Cairo (see Madplagueī�na curve Minūf (see on MapGraph 1, above)3 in 1407 CE: a peak death rate of 140 per day and a total death count of 4,400. The same method of adapt ), takes a peak death rate of 140 and agenerates coincidence, an estimated but it more total likely deaths suggests, of 4,652. again, The closeness that the ofscale the ofestimated the toll total deaths (4,652) and the reputed actual total deaths (4,400) could be reported in our sources is correct—and that for Minuf al-‘Ulya, a total mor tality between 4,000 and 5,000 for this epidemic is a realistic estimate. thisIn method sum, Minūf of estimating al-‘Ulya was rural subjected depopulation to a series is effective, of major then outbreaks some in 1403, 1407, 1430, and 1460, each claiming several thousand lives. If must have suffered a similar fate. Prior to this unfolding catastrophe, populationsother towns andfor villages—likethese provincial al-Naḥririyya centers were and likelyal-Maḥallat in the al-Kubrā—range of (mutawassita ‘aẓīma 5,00020,000 to to 10,000 40,000. inhabitants Al-Qalqashand in successiveī� describes blows Minūf suggests al-‘Ulyā depopulation as “medium” ) and al-Maḥallat al-Kubrā as “large” ( ). The loss of 133 Plague Depopulation and Irrigation Decay in Medieval Egypt , 4: 821) 4: , 4: 93) 4: 93) 4: 93) 4: 93) , 14: 338) , , , , Sulūk - al , 16: 139); , 16: 139); ( � � ī Nujūm �z ī - 4: 93) , al Nujūm � ( � - ī d al ( � ī �bir ī d �bir ī 16: 140); Popper (1954–63 16: 140); Popper (1954–63 16: 140); Popper (1954–63 16: 140); Popper (1954–63 16: 140); Popper , 14: 338) , 14: 337–39); al-Maqr 337–39); 14: , , 4: 825) , 4: 827) (1954–63 4: 829); Popper , 4: 821) , 4: 824); Ibn Taghr , 3: 1126) for 806/1403 , 3: 1126) for 806/1403 , 3: 1126) for Nujūm, Nujūm, Nujūm, Nujūm, Nujūm Nujūm 4: 93) ------, al al al al al al ‘, 2: 357); Ibn Taghr ‘, ( � ( � ( � ( � ( � � ( � � � ī ī ī ī ī ī Sulūk Sulūk Sulūk Sulūk Sulūk Sulūk Sulūk ------al al al al al al al �bird �bird �bird �bird �bird � ( � ( � ( � ( � � ( � ( � ( � �bird ī ī ī ī ī ī ī ī ī ī ī ī ī Badā’i ‘, 2: 138) 2: 138) Badā’i ‘, �z �z �z �z �z �z �z ī ī ī ī ī ī ī Ibn Taghr Ibn Taghr Ibn Taghr Ibn Taghr al-Maqr Ibn Taghr al-Maqr al-Maqr al-Maqr al-Maqr al-Maqr al-Maqr Taghr Ibn Sources ( Ibn Iyās Sources Sources Popper (1954–63 Popper Ibn Iyas ( Ibn Iyas March 1430 March April 1430 Month January Month 1429 December Month February 1430 February March 1430 March January 1430 March 1430 March February 1430 February March March March February 9000 5000 17,000 11,000 Sum of plague Sum of plague deaths to date deaths to deaths to date deaths to Sum of plague deaths to date deaths to 400 300 200 250 200 600 100 Daily rate of of rate Daily plague deaths Daily rate of of rate Daily plague deaths of rate Daily plague deaths �riyya ī Fuwwa, Bilbays Fuwwa, Siryaqus Egypt Upper Table 3. Plague Outbreak of 1460 3. Plague Outbreak Table Maḥallat al-Kubrā Asyūṭ of 1430 2. Plague Outbreak Table Minufiyya, Qalyubiyya Minufiyya, Naḥr Locale Table 1. Plague Outbreak of 1403 1. Plague Outbreak Table Locale Locale Alexandria Sharyqiyya, Gharbiyya Sharyqiyya, Delta (Damanhur, Nahririyya) Delta (Damanhur, Qūṣ Siryaqus Maḥallat al-Kubrā Madinat Minuf Maḥallat al- Kubrā Maḥallat al- 134 Stuart Borsch against a Scaled Curve for Cairo Graph 1. Al-Maḥallat al-Kubrā in 1460 CE: Graph of Plague Deaths over Time as Measured Graph 2. Al-Maḥallat al-Kubrā in 1460 CE: Graph of Rising Death Toll over Time whosubstantially closely examined higher than rural the Egypt one-third via archival estimated documents, by Dols suggests (1977) that for Egypt as a whole. The Egyptian historian ‘Imād Abū Ghāzī � (2000: 65–66), ruralistic. EgyptGeography lost more argues than for 40% it as of well: its population the layout from of Egypt’s 1347 to rural 1517. areas suggestsThe numbers that it facilitatedderived above the spreadsuggest of that plague. Abū GhāzEgypt’sī�’s estimate Nile Valley is real is a thin strip of arable land, bounded by desert, hugging the Nile River at all points, while Egypt’s Delta is crisscrossed with canals and inland water ways that were used for transporting grain on small ships. These spatial 135 Plague Depopulation and Irrigation Decay in Medieval Egypt Graph 3. Minuf ‘Ulyā in 1407 CE: Graph of Estimated Plague Deaths over Time (as Measured against Cairo Curve) configurations are ideal for the dissemination of plague-bearing rats and fleas. The annual Nile flood would then have abetted plague mortality by thatdrowning plague the outbreaks fields surrounding continued the to strikevillages, Egypt forcing with rats substantial to seek shelter force wellin human into tohabitations the nineteenth located century on higher may ground itself be (Conrad largely 1981).attributable The fact to geography (Mikhail 2011: 214–21). The Irrigation System and the Rural Economy If rural depopulation was severe, what did it spell out for Egypt’s econ omy? This is where the subject of irrigation plays a major role: to study Egypt’s medieval irrigation system is, essentially, to study the economy of preindustrial Egypt. No other aspect or foundation of Egyptian economic activity had a larger impact on its overall economic output. A few words on the system itself and how it functioned are in order here. Medieval Egypt’s irrigation system relied on the spring monsoon over the western Indian Ocean: the monsoon, which fell on the highlands of Ethiopia in June, caused the Nile to flood inkhalīj the , earlytura, autumn.and baḥr As the Nile rose some seven meters up from its low-water level, floodwater was channeled to flood canals (called variously: ) that 136 Stuart Borsch Map 2. Flood Canals in Upper Egypt, c 4 . 1800 (Nile River at Right, Baḥr Yūsuf at Left) led water from the Nile River and collected it in enormous basins (Arabic: ḥawḍ or aḥwād see Map 2 The walls containing the water4 in these basins were enormous dikes (Arabic: jisr or jusūr) ( ). soak into the soil over a period of about a month and a half. Alluvial sedi ), and they held the water in the basin, allowing it to ter also settled into the soil, which accounted for Egypt’s rich agricultural fertility.ment that5 When washed this down period from of soakingthe Ethiopian the soil highlands was complete, with the the floodwa remain 4 Map by M. Schouani, printed in Pierre Jacotin’s Déscription de l’Égypte (1826); 5 reproduced by kind permission of the David Rumsey Map Collection, no. 3964022. acid,The and British other colonial nutrients. hydraulic There engineer were 1.5 William kilograms Willcocks of suspended (1913, 1: alluvial 302) analyzed matter the floodwater’s sediment and determined that it contained nitrogen, phosphoric deposited, one millimeter a year, as a layer on Egypt’s soil. The deposition of alluvium, per cubic meter of floodwater and two-thirds of this came out of solution and was 137 Plague Depopulation and Irrigation Decay in Medieval Egypt for the winter crop would commence. So Egyptian agriculture was funda mentallying floodwater dependent was allowed upon its to irrigation flow back system—and into the Nile damage and sowing to the of irriga seed tion system meant severe damage to Egypt’s agrarian sector. sayfī nīlī weirs,Canals that themselves they were ablewere to classified provide wateras either year perennial-round, while canals the ( latteṛ ) or flood canals ( ). The former were deep enough, and/or had gated canals, the dikes, the dams, and the weirs, were controlled by and main tainedwere only by filledthe provincial during the walī flood season. These irrigationmubāshirūn components, (roughly, the governor and his staff acted as (governor)authority and and liaison his for the irrigation sys tem.staff Inor theirbureaucrats) interactions in the with respective village elders provincial (shaykh capital., mashāyīkh From there the lage experts (among them the khawlī role as both coordinator and coercer. ) and vil While much of the agricultural work), thein medieval provincial Egypt authority was compara played a tively light, this was not so for the irrigation system. Enormous labor was required to keep the system going. The village irrigation system itself demanded a heavy toll of labor, but so did the large-scale sultani system that connected the villages to one another—and to the Nile. During the Mamluk period, Egypt’s irrigation system fell into two neat baladi system, was the local, village-level system. The village community was supposed to take care of it, without categories. The first of these, the if the irrigation bureaucracy still played a prominent role in that process. Thethe help sultani of any system, broader by contrast,(communal) was or everything higher (coercive) the baladi authority, system even was not: it was outside the boundary of the village; it was a non-local system; it was a regional system; it was controlled from a remote center; it linked larger parts of the system together; it linked one part of the baladi system to other parts of the baladi system; and it connected the baladi system, at most points, to the Nile River. dating some 10,000 years back to the last Ice Age, formed a layer roughly ten meters thick in Egypt’s Nile Delta. See also Beaumont (1993: 25–29), Ward (1993: 229 and farmers.231), Bowman The scholarly and Rogan, elite (1999: of Mamluk 2), Stanley Egypt and were Warne well (1998: aware 797–804), of the cause and Baroisof the (2010: 25). The rich muddy water, the “red water,” was highly prized by Egyptian offlood, spring the watersource and of the the alluvial enriching matter, quality and itsof theproperties. Nile mud. Ibn His Iyās, testimony writing at is the one end of manyof the fifteenthin a long century,tradition discusses of Islamic the natural crucial philosophers difference between who examined the barren the prospects various Nuzhat aspects of Egypt’s Nile flood ( : 101–04, 108–12). 138 StuartThe Bornumberssch of irrigation laborers that were needed to maintain the sultani Ḥusn, system, accordingKhitat to three differentNuzhat fifteenth-century authors, are 50,000 for Upper Egypt and 70,000 for Lower Egypt (al-Suyūṭ�, of2: 320;the annual al-Maqr revenueī�zī�, income, 1: 60; of theIbn nonIyās,-hereditary : 137). iqṭā’ There landholdings, are also whichreferences would to add the uptotal to severalcost of irrigationmillion gold maintenance, dinars. It is notestimated clear, however, at 25% how the expenditures were supposed to break down. If one takes labor- to-population ratios as a guide, 120,000 irrigation laborers out of a rural population in the millions—where the ratio of labor to total population workforce for a country with such a large and rich arable terrain. How was in all likelihood on the order of 70%—would seem a rather paltry connecting sultani system, and not to the thousands of village systems ever,that fed this into figure the ofsultani 120,000 system. clearly6 applied only to the larger-scale inter As it turns out, these numbers are quite realistic. If we compare them to nineteenth-century statistics, they match quite closely (see Table 4 which means that contemporary reporters were probably talking to someone close to the source, in a diwan of the central regime, who under), stood the system well. For example, after the British occupation of Egypt in 1882, the colonial irrigation engineer William Willcocks (1913, 2: 815) reported that some 400 adult males per village, that is all males between fifteen and fifty years of age, were liable for seasonal corvée work. Will cocks’s estimate may have been on the high side; the real figure might hoveringhave been between less than 1000 350, and given 1500. a likely adult male labor pool (aged fifteen to fifty)What consistingwas the exact of perhaps nature of25% this to labor, 30% and of a why total did village it carry population a heavy toll? It seems clear from both modern and medieval sources that the bulk of the work was composed of the annual “reconstruction” of the system in the spring, starting in the Coptic month of Ṭūba.kāshif This al- jusūrannual (provin spring cialwork, sultani which was needed to undo the damage wreaked by the Nile flood itself,rotating was in (in appointment the Mamluk on period) a year -directedto-year basis.by the The provincial governor (wālī system inspector) of which there was one for each province, sected with that of the kāshif al-jusūr ) also played an important role here, and his mandate often inter (Baḥr 1999, 38–52). 6 Subḥ Zubdat Khitat See al-Qalqashandī� ( , 3: 515–16); Ibn Shahī�n al-Ẓāhirī� ( : 129); and al- Maqrī�zī � ( , 1: 101). See also Cooper (1973: 77), Tsugitaka (1977: 183–84), and Nāṣir (2003: 172, 177). 139 Plague Depopulation and Irrigation Decay in Medieval Egypt Compared to Nineteenth-Century Data Table 4. Fifteenth-Century Data on Number of Workers Year Laborers Days Labor Earthwork (m ) Source 3 120,000 Ḥusn Khitat Nuzhat 1400s al-Suyūṭī� ( , 2: 320; , 1: 60); 120,000 152 29,000,000 Ibn Iyās ( : 137) 165,000 100 1879 Barois (2010: 68) 125,000 100 Willcocks (1913, 2: 815) 100 Willcocks (1913, 2: 815) 125,000 150 29,000,000 95,093 Willcocks (1913, 2: 815) 91,000 117 21,000,000 1884 Willcocks (1913, 2: 815) 1885 Barois (2010: 69) There were two principal tasks that took up the lion’s share of the spring labor requirements: dredging canals and rebuilding dikes.7 The dredging of canals meant, for the larger canals, the use of a kind of shovel ing device called a jarrāfa, which was a large box-like scraper for the bot toms of canals, triangular and measuring eighty centimeters to the side. One or two men would sit on this box to weight it down and dig into the accumulated silt, and when full it would be emptied at the side of the canal Zubdat dredging of smaller canals usually involved peasants using shovels, and (Ibn Shahī�n al-Ẓāhirī�, : 128; see also Shaw 1962: 227–28). The seems to have been measured for each individual village (Tsugitaka 1997: there was a “shovel levy” (a reference to equipment of various Dredging kinds) that the 8 230). There was a levy of oxen as well (Abū Zayd 1987: 62). 7 the dikes and canals occupied the time of repair crews about equally. In Upper Egypt, Julien Barois (2010: 37), writing in the nineteenth century, makes it clear that he counted 3,550,000 cubic meters of earthwork on the dikes and 4,650,000 in the canals; in all, 8,200,000 cubic meters. He also provided an estimate of the volume of earthwork per hectare for dikes (5.5 cubic meters) and canals (8.7 cubic meters), for 8 The shovel levy was assigned in units called qita’, perhaps one apparatus per qita’, buta total I suspect of 14.30 it cubiccame metersto have of some earthwork other standardizedper hectare. meaning that was becoming disassociated with the actual equipment, and may eventually have referred to money payments—or levies of manpower in corvée. See “Rural Society in Medieval Islam,” a website maintained by the College of Queen Mary, University of London: siltationStuart Bor buildupsch in the irrigation supply (sawq maṣraf nīlī ṣayfī took up a huge amount of time and heavy labor.) and Rates drainage of siltation ( var) iedcanals, widely, whether and were they oftenwere anywhereflood canals between ( ) or 0.5 perennial to 1.5 meters canals per ( year), a hundred sultani canals for Lower Egypt, and at least half as many for Upper(Willcocks Egypt, 1913, it is 1:easy 320). to seeConsidering how the dredging that there of were all of probablythis silt made well forover a 9 The second task, equally daunting, was to repair the dikes (jusūr brokenvery heavy (qa’ manpowerta requirement (Willcocks 1913, 1: 329). the shāqq, involved rebuilding the dikes, usually with )a thatmaterial had beenknown cut/ as labsh ) to let water in and out in the flood season. This process, The places where cuts and breaches in the dikes had been made and then mended (approximately, were known asa mixturequtū’ and of formedmud and irregular straw) (Abūjoints Zayd that gave1987: these 64). dikes a zig-zag pattern. The dikes, like the canals, amounted to a very sub stantial volume of earthwork, and some of them could be as much as 20 kilometers in length (see Table 5 One medieval source estimates). that the shoring up of dike breaches (maqāTheseti tasks ate up a lot of man-days (irrigation laborers were all male). : made to let water into thejarārīf basins)—and presumablymiḥārīth repairs to flood damage elsewhere along the dike—required the labor of about a hundredthe number men of and sultani fifty oxendikes with in the Delta (shovels) numbered and in the several (plows) hun dreds.for five From months these (Baḥr sources,1999: we 50–51). can estimate Medieval something records also on indicatethe order that of sultani 350 dikes in the Delta. This (350 × 100 laborers) would account of qita’ discusses, vary an instance from a low where of .083 a hundred for one jarrāfa village ( qitot a’a high of 9 for a particularly large village. The average for the Fayyum is 1.16 and the sum total 104.66. Al-Nābulusī � also in numerous sources. One example is two hundred )qi wereta’ levied levied for from the the construction Fayyum as a whole, with ninety-five being the number actually collected. Other totals are found dinars, employed 12,000 in labor, and lasted three months. So 1 qita’ of jarrāfa was of the Jisr Shī�bī�n in Qalyūbiyya in the early 1300s, a job that cost about 60,000 gold al-Sulūk presumably a fairly substantial amount by itself. For detail on the Jisr Shī�bī�n, see al- 9 Even with half of Upper Egypt’s arable given over to perennial irrigation, there were Maqrī�zī � ( , 2: 466–67). sultani in the medieval period, as they each seemed to have served more still forty-five major flood canals in use, and presumably all of these would have been Andclassified then, asgiven that Lower Egypt had a much higher density of irrigation components, itthan is easy one tovillage. see why Given something that, one well should in excess double of the a hundred figure to wouldforty-two be reasonable.for Upper Egypt. 141 Table 5. Dike LengthsPlague and Depopulation Volume of Earthwork and Irrigation10 Decay in Medieval Egypt Locale Name of Dike Length (m) Total Volume of Earthwork (m3) 592,196 Mallawi Kudyah Al-Minyā Ṭahnashāwī� 23,450 Donhea 175,000 14,000 1,376,000 17,500 Asyūt 8750 Maharriq 17,500 Manfalūt Banī� Kalb 551,638 15,750 Manfalūt 551,638 Upper Egypt Annual Girgā Manshī�yah 1,935,000 183,390 11,999,208 for half of the 70,000 men required for work in the Delta, with canal- are not intended to be exact, but rather to approximate the scale and scopedredging of manpower. probably requiring The nineteenth another-century 35,000 datamen. provides Again, these a very estimates impor work for 100 to 150 days, suggesting the validity of these medieval num tant cross-reference, with figures ranging from 95,000 to 150,000 men at Table 5 bers. Egyptian flood dikes were enormous, and the data on dikes from the guide1800s to ( the dimensions) give a good of spring idea reconstruction.of the volume of10 earthwork that medi evalWhen Egyptians the manpower accomplished capacity, every the spring. volume The moved figures per in man the- daytable (which are a again that the total labor requirements were imposing and would eas ilyaveraged add up about to the 1 120,000to 1.5 meters estimated cubed), by is the applied medieval to these sources. figures, Medieval we see earthwork, and man-days employed. accountsWhat this also means, match forthese our dike purposes, figures is in that terms the ofdecay length, of this total labor volume-inten of sive system was a very likely result of the scarcity of rural labor caused by plague mortality. There were, moreover, a number of contributing factors to have been maladaptive responses to the economic shock of depopu lation.that greatly Egypt’s intensified military theelite irrigation played a systemrole here: collapse, these andelites, these essentially appear synonymous with the urban landholding caste at this time, added to the crisis by forcing rents upward, coercing corvée in the place of wages, redi recting irrigation-system taxes to their own coffers, and in essence loot direct damage of depopulation and irrigation labor scarcity, making for a ing the rural economy (Borsch 2005: 42–60). These things added to the 10 Sources: Clot-Bey (1840: 473–74) and Rivlin (1961: 285). 142 poisonousStuart Bor combinationsch of factors whose effects on the irrigation system this period testify to these problems.11 became quite apparent by the early fifteenth century. Many witnesses of nance of the baladi The encyclopedist al-Qalqashandī�, writingof the sultani in the early fifteenth century, notes that “in our times, the mainte repairs that have little(local impact village) on systemsproduction.” are being Furthermore, neglected, he and continues, upkeep “the level of the(interconnecting) Nile has, at many system times, has been been aslimited high toas the 19 mostor even trivial 20 cubits, and despite this, the irrigation system does not provide adequate Subḥ floodwater and agrarian production is weakened” ( , 3: 516). Al-Qalqashandī�’s intention, in emphasizing the height of the annual Nile flood,anxiety is forquite Egyptians clear, and whose his meaning prosperity is echoed rose and by fellseveral with other the outcomes contem porary chroniclers. The subject of flood heights was a source of endless endof the of annualthe scale flood. on the The Nilometer: ideal flood a stone level pillar at this used time to measurewas between the Nile 17 and 18 cubits (a cubit was a linear measure of .462 meters) on the upper wafā’ flood. The level celebrated by old tradition was 16 cubits, at which mark the flood was said to have reached fulfillment—or completion ( )—12 at a point in the flood season, usually in August, when there was a pub lic ceremony and the main canal (Khalī�j Amī�r al-Mu’minī�n) was opened. thanAbove 17 that, cubits 17 tomight 18 cubits risk leaving was regarded areas under as a sufficient-watered level and fordry. providing On the floodwater to the majority of the agricultural areas, whereas a level13 lower couldother wreakhand, aa levellot of higher damage—to than 18 the cubits, irrigation somewhere system, andin the to villagesrange of and 19 to 20 cubits, was considered potentially dangerous: an overly high flood Nuzhat al-umam Khitat, 1: homes; an over-inundation could also drown a significant portion of the cultivable region (Ibn Iyās, , 88–89; al-Maqrī�zī�, 60;tative Barois rules 2010: have 24). been changed: that a level of 19 to 20 cubits, far from Clearly, then, al-Qalqashandī�’s narrative suggests that these quanti 11 al-Sulūk Nuzhat Ḥawādith See al-MaqrBadā’iī�zī � ( , 4: 564, 618, 646, 678, 709–10, 750–53, 806–09, 834, 863, 874, 903–04, 931, 950); Ibn Iyās ( , 182); Ibn Taghrī�birdī� ( , 4:573); Ibn Iyās ( ‘, 5: 114–15); Suyuti (Husn, 2: 302). See also Petry (1994: 114–15 and 12 124–25). Al-Maqrī�zī� (Khitat, 1: 55); see also Abū Zayd (1987: 18) and Nāṣir (2003: 173). Traditionally, the flood was said to begin its rise on the night of the Feast of Saint 13 Michael (‘Ī�d Mī�kā’ī�l), on the twelfth day of the Coptic Month of Ba’una (June 20). Specifically, 12 to 13 cubits was considered dangerously low (Said 1993: 98). 143 providing tooPlague much Depopulation water, was in anfactd notIrrigation providing Deca enough;y in Me ddespiteieval E ghighypt was not to blame, nor even the sediment that built up on the river bed, sedimentflood levels, that much caused of the its agriculturalnatural crest land level was to risegoing every dry. year.The NileIt was, itself in fact, the irrigation system itself that was causing the problem. When canals the irrigation basins, even when the Nile level was far more than adequate became siltedal- upSulūk and blocked, floodwater was prevented from reaching greatest(al-Maqr importanceī�zī�, ,was 4: 903). the role And of when the dikes. dams Theand weirsNile reached were in its disrepair, peak in floodwater was no longer being provided according to schedule. And of the Coptic month of Tūt (approximately September).14 When15 Any the shortening flood was at or near peak, water was led into the flood basins. The floodwater was thenwatering held thein these winter enormous crop. When basins the for Nile forty began to fifty to days.descend in the Coptic of this time period would mean that the basins were insufficiently full for month of Bābih (roughly October, in the fifteenth century), it was essential that the dikes held the water in as the flood went down (Willcocks16 It meant 1913, 1:that 307, water 311). would Any failureleak from in the the dike system system before (cuts the in proper the dikes, time, holes and therein the dikes, breaches in the dikes) meant a failure to check this flow. adequate watering for the critically important winter crop.17 fore meant a failure to irrigate the flood basins and a failure to provide 14 The schedule called for specific, targeted openings at different times, such as at Nawrūz (New Year’s Day), on the first day of the Coptic month of Tūt (corresponding to September 12) and on the ‘Ī�d al-Ṣalī�b (the Festival of the Cross) on the seventeenth day of the Coptic month of Tūt (corresponding to September 29). See Abū Zayd (1993: 15 18–19) and Willcocks (1913, 1: 304). The reported average time is forty-five days (Willcocks 1913, 1: 301). Other 16 The management of the sultani system included provisions for watchmen who durationswere assigned are also to monitor given (Barois, the canals 2010: and 25). dikes carefully, to watch for any breaks in the dikes or problems with canals. See the roles of the khufarā’ and ḥurrās in Ibn Qawānīn Mammātī� ( : 229). See also Cooper (1993: 229), Tsugitaka (1977: 333), and 17 Abū Zayd, (1983: 13). places where they were broken open were called qutū’. From the same Arabic root, we getWhen the flood word was for toopen be ruptureslet into a inconfined the dikes area, (maqā the dikesti’ were broken open. The ) that were repaired in the waterearly spring. in, were In sealedthe Coptic up again months using of Ṭubihharrows (January (jarārīf 10 to February 8) and Amshī�r ((Februarylabsh 9 to March 9), dikesQawānīn that had been broken open in the early autumn, to let ) and mud mixed with straw ). See Ibn Mammātī� ( : 244–45); see also Abu Zayd (1987: 17, 64–65) and Cooper (1973: 103). 144 Stuart Borsch not being observed. Damage to the system, failure to maintain and repair dams,In this dikes, instance, and canals, al-Qalqashand was causingī � indicat it toes malfunction. that this delicate The failure process of was the canals to supply the water, along with the failure of the dikes to hold the water in, was causing the basins to go dry. Hence, damage to the system So in this sense, damagewas causing to the a very irrigation high flood structure level (19was to not 20 only cubits) wreaking to look18 havoc like a verywith lowthe operationflood level, of leaving the system, much but of alsothe withagricultural the level land indicators dry. that allowed for proper control of the system.19 Managers of the system, depending upon a adequate.traditional It corpus is clear of from knowledge, this account thus mightthat serious anticipate harm flood had damagecome to andthe irrigationrespond accordingly, system. when in actual fact, the level of the flood was barely to all observers. Plague depopulation, coming in cycles for the last half- century,By the had early been fifteenth taking itscentury, toll, denuding irrigation the system rural labor decay force was of apparent its num with those of other witnesses, suggest that the irrigation system in Upper Egyptbers. The had notesbeen gravelytaken by impaired Ibn Iyās by in that the time,late fifteenth and that century,the Lower coupled Egyp Furthermore, the changes in the indicators—this confusion by which tian system had been affected in a similar manner (Borsch 2000: 137–39). this time. To know that serious maintenance was needed was one thing, butflood to levels realize could that no a longertraditional be read—is timetable, also developedpalpable in overthe sources centuries, for It was malfunctioning, was another thing altogether (Nāṣir 2000: 170). was recognized that the time-tested ways of controlling the flood were reputedlynow failing. stunned There waswhen also their a sense predictions that the based traditional on patterns system of ofalluvial flood prediction had gone awry. During the flood of 1468, Nile officials were deposit18 failed for the first time since the Islamic conquest of Egypt in 640 If, for whatever reason, flood levels were too low, the impact of abandoned land could affect the afflicted rural areas for years. ‘Abd al-Laṭ�f al-Baghdādī�’ furnishes us watered,with an account and before of the the two convenient years that time, followed because a disastrously there was lowno one flood to in arrest the year the 1200, when the flood waters, “receded without theKitāb country al-’ifāda having been sufficiently 19 Openings and closings of the canals and dikes followed a very complicated and waters and keep them on the land” (al-Baghdādī�, : 253–54). precise schedule set down in the qawānīn al-riyy (the rules, also called “logs” or Qawānīn al- Sulūk, “registers” for irrigation). See Ibn Mammātī� ( : 205–32) and al-Maqrī�zī� ( 1: 61, 171). See also Cooper (1973: 397) and Thayer (1993: 123). 145 Plague Depopulation and Irrigation Decay in Medieval Egypt arriving half a month early on the twenty-ninth day of the Coptic month, CE. Other events, such as the highly unusual crest of the river in 1479— Abī�b (August20 in a 6)—added single day—and to the generalthis apparently level of anxiety had happened (Petry 1994: only twice123). For the year 1508, we are told that the flood surged “fifty fingers” (1.125 meters)The magnitude of the crisis and the uncertainty it was causing thus loomedsince the very Arab large conquest in the (Petryeyes of 1994: these 123). contemporaries. It seemed to them that the Nile, as well as the irrigation system, could no longer be trusted. But as bad as the psychological impact may have been, the physical effects the only concern here, as level indicators went awry. It seems clear that were of course more immediate—and bone-dry flood basins were not as did episodes of drought, involving, as these episodes did, the destruc episodes of destructive flooding made at least as much of an impression tion of dikes that were caught in the flood’s wake. One record from the year 1432 CE notes that “dikes were ruined and many lands drowned, and water rushed into many of the villages before the properal time-Sulūk (for filling the basins). Summer crops such as cucumbers, sesame, and indigo were all wateringruined—to was the done, loss soof thousandstoo could they of d īfail�nārs” to hold(al-Maqr backī �zhighī�, levels ,of 4: water, 874). asJust they as broken were designed dikes could to do.allow Hence, floodwater just as to a leakhigh from crest basins could beforestill leave the many lands dry, a normal crest could swamp low-lying villages with a tor rent of water.21 More distressing were times when these two curses were incompounded, many areas, and the aopposite flood too was high occurring was also in a otherflood partstoo low. of theIn the country: same year that a destructive flood was sweeping through and ruining villages was surging in places where dikes failed to protect low-lying lands, and areas were being left dry by the absence of this same flood. Floodwater al-Sulūk pouringconfusion out and of dismay.areas where22 dikes were failing to retain water (al-Maqrī�zī�, , 4: 874). The combination of the twin evils added to the sense of 20 (dhirā One finger on the Nilometer was 2.25 centimeters or 1/24th of a .541 cubit 21 Nuzhat Taysīr Subḥ, ’) (Allouche 1994: 88). al-Sulūk ZaydIbn Iyās ( , 88–89), al-‘Asqalānī� ( : 171), al-Qalqashandī� ( 3: 515), and al-Maqrī�zī� ( , 4: 806–09, 874). See also Barois (2010: 36), Abū 22 Under these conditions, it seems likely that there were problems with salinity as (1987: 61), and Nāṣir (2003: 171–72). well. The land category of sibākh was designated for areas that could not be cultivated Qawānīn al-Sulūk, 2: due to high salt content: see Ibn Mammātī� ( : 204); al-Maqrī�zī� ( 146 StuartMost Bor witnessessch seem to have been aware that these twin disasters of drowning and parching were connected to the underlying irrigation sys al-Sulūk makes a clear connection between these problems and system damage temand notesdecay. that For thethe decayyears of1432 the andsystem 1435, was al-Maqr compoundingī�zī� ( and multiply, 4: 874) ing the natural vulnerability of Egypt’s inundation agriculture. Chronicles Andof the system fifteenth failure, century when are, it occurred, in fact, replete could happenwith very on specifica very large examples scale. Problemsof what went with wrong the larger, with interconnectingthe system as it (fellsultani apart (Borsch 2005: 44). profound effect not only on downstream villages, but on the local, village (baladi ) system could have a mous toll of damage. Disaster struck the villages of Zifta, Shubra, and their outlying) areassystems, and too. was In blamed the year upon 1428, the for neglect example, of the there irrigation was an system enor maintenance. In 1477, the chronicler al-Ṣayrafī� tells how major parts of Cairo were badly damaged by floods because of dike failure in the area sultani(cited by Nāṣir 2003: 173). Separate reports from Ibn Ḥajar al-‘Asqalānī � and Ibn Iyās inform us that a major disaster occurred when the enormous dating during dike of times the Baḥr when Ab theī � al-Man systemajjā was failed functioning and numerous well, becamedownstream cata villagesstrophic wereas the drowned system fell by apart. floodwater. Frequently, And violent large sectionsflood surges, of the intimi baladi system were taken down as parts23 of the sultani system failed. This is hardly surprising, bearing in mind that the sultani dikes and canals were just as important for protecting the baladi system from water as they were for supplying it. The vulnerability of the baladi system meant that others130, 166); have see far also more Tsugitaka than their (1977: share 230) of rich and mud,Cooper and (1973: the greater 33, 37). part Willcocks have nothing (1913, 1: 308) says that “If the distribution is bad […] some basins receive little but sand, but the finest particles of mud with a large proportion of salts; especially is this the 23 mightcase where only be white 2 meters water above has stood the ground for any canlength wreak of time major without havoc any when perceptible a large volume flow.” It is important that one visualize the flow dynamics of the system. A flood which the system in the nineteenth century, noted that “when one of these dikes becomes brokenof the water by the is pressure penned ofback the by water, a major great dike. havoc Julien may Baroisresult, (2010:because 33), in general observing the parts of the Delta the high water reaches normally 2 meters above the soil of the valley.”level of Some the flood sultani much dikes exceeds were of that huge of proportions.the riparian Onelands, dike and in especiallythe suburbs in ofcertain Cairo So too would depressions created by ruined canals pen up water, where it could apply stresswas 16 to meters already high weakened and built dikes. to a depth of 32 meters. See Tsugitaka (1977: 229–30). 147 Table 6. EstimatedPlague Agrarian Depopulation Production overand Time Irrigation Decay in Medieval Egypt Year Agrarian Output (CE) (1315 = 1) Source 1.00 1315 0.50 Borsch (2005: 77) Zubdat 1400 Extrapolated from treasury figures (Ibin Shahī�n, : 107) 14101517 0.45 Mujani (2008: 1113) 0.42 Borsch (2005: 80–88) 15971528 0.36 Michel (2002 : 197–251) 0.45 Borsch (2005: 80–88) sections would go down like dominos, the failure of one set of basin dikes meaning that the entire chain, as many as eight basins in length, would be Problems appeared at intervals. Calm could prevail for decades only to bethreatened suddenly with followed collapse by catastrophic(Borsch 2000: and 459–60). unpredictable crashes of whole segments of the system. This cycle seems to have continued through to 24 economy, and not just the rural sector. It was in this context, we can say, that Egypt’sthe end irrigationof the fifteenth system century, collapsed and via it had a process a number of punctuated of effects on equilibrium the wider have persisted in a state of slow change/slow neglect until sudden and dra matic(Borsch episodes 2004: 461).of regional Egypt’s collapse fifteenth-century occurred. Each irrigation time the system system’s seems func to tioning was punctuated by an episodic crash, repair costs escalated and the beentask oflargely restoring ruined the by system the direct became and significantlyindirect impact more of plaguedaunting. depopula By the end of the Mamluk period (1517 CE), Egypt’s irrigation infrastructure had chroniclers—and the data for irrigation labor—estimates of total agrarian productiontion. In addition (Table to 6 the and evidence Graph 4 that we have from the fifteenth century Here, data points gleaned from sources composed in the course of ) lead to the same conclusion. era, which also recorded irrigation system decay. For example, the Otto the fifteenth century are supplemented by data from the early Ottoman Map 3 man land survey, conducted in 1528, offers data for the northwest Delta province of al-Buḥayra ( ), which allow us to compare the irrigation system’s performance in that year with that of the 1315 land survey con 24 Ḥawādith al-Taysīr (Badā’i‘ Nuzhat Ibn Taghrī�birdī� ( , 4: 67), al-‘Asādī� ( : 92–93), and Ibn Iyās , 5: 114–15; : 182). See also Borsch (2000: 461). 148 Stuart Borsch Graph 4. Estimated Agrarian Output of Egypt (1.0 = Land Survey of 1315 CE) ducted when the Mamluk Sultanate was at its economic peak. The spatial patterns of decay (villages with little or no output on the downstream ends of the provinces’ sultani canals) indicate system decay in excess of century.60% (Michel The death2002). toll If we of the look plague much outbreak further ahead, in Cairo, we infind 1791 a scene CE, was of mor one tality and economic disruption that seems to resemble that of the fifteenth of the worst of the Ottoman period; it is evocative of the terrible 1430 and outbreaks,1460 outbreaks, it seems with unlikely peak mortalities that these peakof 1,500 mortality and 2,000 rates deaths were exagger per day ated;(Mikhail total 2011: death 221–23). tolls forGiven Cairo, the reported analysis as above well forover the 50,000, fifteenth-century are realis tic. The city of Alexandria can serve as a special example of demographic catastrophe over this long term, its population dropping from an estimated 25 100,000 in the Mamluk era to some 6,000 to 8,000 by the early nineteenth century (Le Père 1818: 10; Panzac 1978: 85; Panzac 1987: 86-87). 25 We do not have any reliable population data for the medieval population of rough sense of the scale of population at this time, and two separate accounts provide estimatesAlexandria, that but are Mamluk-era close to one figures another. for the If there number were of silkover weavers 10,000 silkin the weavers city give in us the a minimum population levellate thirteenth might be andreasonably early fourteenth close to centuries100,000, (onewhich report would lists assume some 14,000that a very for 1380, high another some 12,000 for 1295) one might guess that a very But given the plethora of trades in Alexandria and other cities of the Mamluk Sultanate atpercentage this time, of it seemsthe adult unlikely (presumably that silk male) weaving population comprised was so engaged high a share in silk of weaving.the total working (again presumably male) population. 100,000 would be a minimum. 149 Plague Depopulation and Irrigation Decay in Medieval Egypt Sketch by author after maps in Jacotin (1828). Map 3. The Province of Buḥayra Showing Sultani Canals. An Agenda for Future Studies of Plague’s Impact in Egypt and Elsewhere The case of medieval Egypt calls for further examination of the irrigation system in a long-term perspective that includes the Ottoman period as well as the Mamluk era considered here; study of the early nineteenth ures as well as on land survey data. It also goes without saying that the impactcentury of would plague provide in the Middle a valuable East comparisonas a whole calls based for on much population more atten fig tion, especially given its role in shaping the long-term divergence between the economies of this region and that of Europe. Indeed, this article’s analysis of Egypt’s demographic and economic response to plague out breaks suggests that other irrigation systems might have been similarly affected. An agenda for future research would therefore include analo gous systems like that of Mamluk Syria, Iran’s network of underground 150 canalsStuart ( Borqanatssch tion systems could also extend to case studies of plague depopulation and ), and the irrigation system of Iraq. Comparisons of irriga itsomy potential of Cambodia’s economic Angkor impact Kingdom in South is anAsia especially (e.g., Sri interestingLanka) and candidate East Asia asfor well. future In additionresearch, to precisely China’s irrigationbecause Angkor’s system, the sophisticated flood recession irrigation econ This collapse has hitherto been attributed to its extreme complexity, but thenetwork study fell of populationapart in the levels fifteenth could century: suggest an other event causes. suspect26 Paying in its timing. atten tion to changing irrigation economies, more broadly, could therefore help us to trace the impact of plague depopulation in world history. Egypt’s long-term response to plague-induced demographic decline proves that outcomes differed drastically from place to place, contingent upon dependent variables like social structure and environment. But there are other important lessons to be learned from future studies of plague in this area. For example, Egypt has the potential to teach us something new about plague’s biology. After all, its experience with plague lasted for a very long time: it was still tormented by the disease in the eighteenth and truly global approach to the study of this pandemic complicates the neat Eurocentricnineteenth centuries. periodization As Nükhet of plague’s Varlık history observes and (2014, must be in factoredthis issue), into a new narratives and future scholarly approaches. So what made Egypt’s disease trajectory (and perhaps that of the Middle East as well) so dif proposeferent? My this tentative as another answer agenda would item be for that future Nile research flood geography (see Carmichael and its influence upon insect and rodent vectors played a substantial role, and I mass graves, which we suspect were as plentiful there as in Europe, might supply2014, in bioarcheological this issue). Furthermore, data comparable it is worth to that considering derived from how the Egypt’s East Egypt’s famous aridity, and the process of desiccation that has yielded so manySmithfield well -cemeterypreserved of bodies medieval from London antiquity, (see isDeWitte an important 2014, in factor this issue). here. Consider the multitude of sandy graves amid the two huge cemeteries (the Qarafatayn tissue residue, they as wellwere as called) skeletal ringing remains the worthyeastern of edge careful of Cairo. study. 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Craig, 229–64 (Oxford: Oxford University Press) Egyptian Irrigation 42: 549–67 Willcocks, William. 1913. al-Taḥawwulāt, 3rd aled.,-’iqtiṣ 2 vols.ādīyah (London: fī Miṣr Spon ‘awākhir and al-Chamberlain)Uṣūr al-Wus tá al-Zāmil, Muhammad Fathī�. 2008. ‘ (Cairo: al-Majlis al-A‘lá lil-Thaqāfah) Stuart Borsch the economic history ([email protected]) of the medieval Islamic is anworld. associate Among professor his previous of history works at isAssumption The Black College Death in Worcester,Egypt and Massachusetts.England His primary field of research is how plague depopulation produced different economic outcomes for two coun tries, Egypt and England. Whereas England(2005), was able a studyto recover aimed from at explaining the Black Death, it is clear that Egypt did not, and the root cause was the difference in social structure and landholding practices. Borsch now works on projects related to the Alexandria canal during the medieval and early modern periods. He is also stud Egyptian irrigation system. Most recently, he finished a piece on the history of the Other recent work focuses on historical changes in the rural markets of Egypt and monetaryying long-term disruption changes following in the theirrigation Black Death. system of the province of al-Buḥayra. Abstract Starting with the Black Death, and continuing over the century and a half that followed, plague depopulation brought about the ruin of Egypt’s irriga tion system, the motor of its economy. For many generations, the Egyptians who survived the plague therefore faced a tragic new reality: a transformed landscape that of plague survivors in Europe. This article looks at the ways in which this transformationand way of life significantlytook place. It worsened measures bythe plague, scale and a situation scope of veryrural different depopulation from ture and economy. and explains why it had such a significant impact on the agricultural infrastruc Keywords Medieval Egypt, irrigation, plague, depopulation, economic decline, agrarian economy. PLAGUE PERSISTENCE IN WESTERN EUROPE: A HYPOTHESIS ANN G. CARMICHAEL Yersinia pestis Hvectoruman-borne plague infectious out diseasesbreak sthat occur have after been fleas described infected as with “spillovers,” becausecan humans find no are other not directlypreferred involved hosts. Thus,in the plagueprimary is ecological similar to pro the cesses that govern pathogen persistence (McMichael 2010; Ostfeld 2011; reservoir hosts, such as Eurasian great gerbils and marmots. This hidden, silentQuammen stage 2012). of plague Plague transmission persists via transmissionsis now called within“maintenance a population phase” of plague,1 provide protected microenvironments for temporary survival of both and involves only burrowing rodents and their fleas. Burrows bacteria and flea larvae (Anisimov, Lindler, and Pier 2014; Wimsatt and Biggens 2009). The precise mechanisms and ecological triggers that cause a wider, explosive “amplification phase” of plague, when highly sus ceptible animals begin to die, are not yet fully understood (Gage 2012). maintenanceIntensive laboratory host population and field to research rapidly projectswidening focus rodent on dieevents-offs, early spread in a “transmission shift”: from ongoing flea-borne transmission within a Today, several low-tech, early-alert surveillance systems teach peo byple many living flea near species plague (Buhnerkempe hotspots how etto al. notice 2011). deaths among the rodents laboratory and/or autopsy investigation of sudden human deaths in a plagueinvolved-endemic in plague region amplification. become the Should next -thebest warning alert that signs it is escape time to notice, inter I owe an incalculable debt to Monica Green and Carol Symes, for their editorial inter on various points of my argument; and to George Sussman for his very helpful suggestionsventions; to Fabianand edits. Crespo, During Nükhet the earliest Varlık, and formulations Michelle Ziegler of this for paper, detailed my colleague feedback Ellen Dwyer provided critique crucial to my eventual argument; her comments at that inchoate stage proved invaluable. 1 The terms “sylvatic” or “enzootic” are still used to refer to plague transmission exclusively among animals. More uncommonly, maintenance phase plague is called “primary plague,” and amplification (the spread to highly susceptible animal hosts), “secondary plague.” On the shifting scientific terminology, see Gage and Kosoy (2005). 157–191 The Medieval Globe 1 (2014) pp. 158 ruptAnn G. plague’s Carmich spread.ael The remedy in both cases is the same: using pes or worksites (Dennis and Staples 2009; Duplantier 2012; Stenseth et al. ticides Yersiniato kill the pestis fleas and flea larvae in areas near human habitation 2008). persists because it can infect a wide range of fleas, many of which do not feed on humans (Hinnebusch 2010). Environmental conditions that favor flea activity and replication are Yersinialinked to pestisplague evolvedamplification from (Wimsattits ancestor, and Yersinia Biggins 2009;pseudotuberculosis Adjemian et al., 2007; Davis, Calvet, and Leirs 2005; Keeling and Gilligan 2000). Indeed, Y. pseudotuberculosis is able to live and replicate freely, typically in water, itthrough needs thegenes acquisition that allow of itDNA to utilize permitting environmental the infection resources of fleas. asBecause nutri ents. The new species Yersinia pestis lacks such capacity: it is an obli Y. pestis’s sur gate pathogen. Instead, flea-borne transmission permits DNAvival, molecules as well as withinits capacity the bacterium, to survive butat the separate body temperaturefrom the DNA of chro fleas (26°C/79°F), a capacity which is conferred by two unique plasmids (i.e., the same in both organisms, the “extra-chromosomal” or plasmid DNA is essentialmosome ofto thethe organism).extraordinary Even virulence though slightly of Yersinia over pestis 90% of(Hinnebusch the DNA is 2 are able to clear Y. pestis infection from their gastrointestinal system 2005;relatively Keim quickly, and Wagner evolutionary 2009; Eisenpressure and selectsGage 2009). for strains Because of plague most fleasthat overwhelm mammalian immune defenses, ensuring high concentrations most of these insects can become transiently infected, able to transmit the organismof bacteria to in a newthe bloodstream. mammalian host When (Perry fleas and feed Fetherston on an infected 1997; mammal, Stenseth vival of Yersinia pestis andet al. dispersal 2008; Suntsov changes 2012). how Inwe sum, historians knowing can that approach the evolution the problem and sur of plague’s four-hundred-yeardepends persistence upon conditions in Western favoring Europe. flea replication 2 Many of the genes which Y. pestis shares with Y. pseudotuberculosis became “pseudo genes” serving no known purpose. Some of the novel virulence genes that Y. pestis develops after the flea bite are genes that block many of the systemic immuneY. pestis defenses lost or scrambledthat warm-blooded key components mammals of thedeploy. chromosomal These genes DNA are of turnedthe ancestor on (“upregulated”) organism, and atit acquireda temperature the two of additional 37°C/98.6°F. plasmids Similar unique to other to the emergent killer bacterium, pathogens, possibly in separate Y. pestis transmission, but some included virulence factors in mammals, particularly the ability stages (Hinnebusch 2005). Many of the functions new to related to flea-borne to cause an overwhelming pulmonary infection (Price, Jin, and Goldman 2012). 159 Bio-historical interestPlague in Persistence European inplagues Western typically Europe :concentrates A Hypothesis arily, interdisciplinary interest once centered on the possible reasons for plague’son the origins eventual and disappearance nature of the diseasefrom Western that appeared Europe: ina region 1347. that,Second for the purposes of this historical study, I will limit to medieval Christendom. appearance subsequently became a relatively less interesting locus of interdisciplinaryNicely summarized debate. a generation The best ago-suppo by Stephenrted arguments Ell (1984), for plague’s dis appearance pointed to historical factors (such as modernization, change teenthin interregional-century Europe. trade patterns, targeted public health measures) rather thanUntil specific very recently,identifiable biologically biological oriented or environmental analysis of the changes cause, inspread, eigh and decline of plague outbreaks in Europe also focused on the habitats and habits of the genus Rattus, the species of rodents assumed to be fun damental to understanding medieval and early modern plague. Those who strongly supported the view that the Black Death was caused by Yersinia pestis (e.g., Benedictow 2004; Audoin-Rouzeau 2003), as well as those whoXenopsylla equally vigorously cheopis and opposed Pulex irritans that view were (Twigg required 1984; for Cohn the 2002; Christakos et al. 2005), assumed that black rats and two anthropo philicmodel fleas made ( the rapid temporal and spatial diffusion) of human mortality inspread the Black of plague Death across Europe. The constraints imposed by the rat/flea “metastasizing” to epidemicsettlements of 1347–53along rivers a site and of roads,intense gradually historical diffusing debate. intoBenedictow the agrarian (2004) spaces concluded that surrounded that plague towns: could an spreadargument very consistent quickly, with some earlier work on British India. That is, passive redistribution of Rat- tus rattus infected fleas and rats could infect sizeable populations of black rats ( ) in cities, towns, and market centers. Europe,My analysis just as isassumes the case that today. many Now more that mammalian we are sure and that flea the species excess mortalitywere involved of the in greatplague mid maintenance-fourteenth3 and century amplification epidemic in was late caused medieval by 3 present research. I agree with his shift in emphasis to non-Rattus plague host species, Bolton’s helpful, very recent (2013) essay appeared too late to fully inform my do not become “blocked,” a classic mechanism for plague described in Bacot and and will not here repeat his important summary of plague transmission by fleas that Xenopsylla cheopis, was the primary insect vector in plague epidemics. Martin (1914). Their work led to a long-standing assumption that one flea species, 160 YersiniaAnn G. Carmic pestish,ael it is vitally important to understand the ecological features of areas where high levels of human mortality are discernible. Ecology is the study of interrelationships among all living organisms, as well as with their physical surroundings. This means that the anthropocentrism of familiar contagion-based diffusion analyses hinder our full understanding of the initial catastrophe. Contagion-based understanding of Black Death plague mortality tends to elide evidentiary lacunae, in order to claim that the epidemic was uniform, sparing only a few cities, towns, and regions. But given that Y. pestis logical and historical questionshas been that identified we must asnow the confront. primary cause of the overallFor example,pandemic, the this apparent molecular-archeological speed of plague’s finding spread redraws across different the eco European regions and within human populations has traditionally been calculated by mapping accounts that offer very little more than a brief driven model of Black Death diffusion. Retheorizing and problematizing mapsallusion of toBlack an epidemic: Death mortality these have is thereforebeen staple an findings important of the next contagion- step, as initial mid-fourteenth century epidemic cannot be explained by appealing toDavid a uniquely Mengel virulent (2011) emergenthas shown. strain Meanwhile, of Y. pestis it is at now the timeevident of the that Black the Death. The archaic Y. pestis DNA recovered from Black Death plague pits still extant today. Further study of the plague genome in its ecological con textsshows is noconsequently significant anothergenetic differencesimportant next from step, bacterial as we trystrains to understand of plague pathogen to one capable of pandemic human infection on the scale of the “the genetic changes involved in [plague’s] transformation from a sylvatic But genomic and molecular-archeological studies cannot account for Blackthe initial Death” demographic (Bos et al. 2011:collapse 506; and and the see lingering Green 2014, population in this issue).stagnation that characterizes many areas of Western Europe in the century follow ing the Black Death. We must look to other historical factors to explain mortality patterns, indeed, bringing to the foreground many that have long been a part of more complex understandings of the late medieval period. For example, DeWitte’s analysis of Black Death victims buried in strong evidence that poor prior health status increased an individual’s riskEast of Smithfield, dying during London a plague (2009, epidemic. 2010, andRecent 2014, syntheses in this ofissue), economic provides and demographic evidence suggest that the surviving population was not a more privileged one that escaped a Malthusian trap; epidemics and fam ines recurred, exacerbated by warfare in many regions. Borsch (2014, in this issue), meanwhile, analyzes the processes of social and economic 161 collapse, underminingPlague the stability Persistence of crucial in Western infrastructures Europe: A Hsupportingypothesis bell’s recent synthesis of northern hemisphere climate change to be most urban populations. I find the global framework provided by Bruce Camp on plague outside urban centers by Campbell’s suggestion that the long secularpromising decline (Campbell in population 2010, 2011, numbers 2013). and Overall, overall Ipopulation was inspired health to focus dur climatic context. ingWith the period the knowledge 1300–1800 that CE Yersiniaare best situatedpestis accounts in a wider for ecological the dramatic and mortality levels seen in the Black Death, we should expect that differ ent localities would have experienced mortality crises of quite different dimensions. Yet historians of European plagues have shown a strong ten dency to connect only the bigger data-rich dots, remaining unimpressed by patchy and problem-ridden evidence from rural hinterlands. As a con sequence, a common claim is that plague became almost exclusively an Renewed, detailed study of the paths and timing of recurrent waves of plagueurban phenomenon in Western Europe in Europe is necessary, by the fifteenth given century.what we (e.g., now Alfani know 2013). of the ecology of Y. pestis. maintenance reservoirs, which are “heterogeneous at global, regional, and Plague first spills over around a limited number of rural areas, small market centers, and larger cities? The papers by Nükhet local scales” (Eisen and Gage 2012: 63). How, then,4 does it travel between Varlık (2014) and Michelle Ziegler (2014, both in this issue) offer detailed observations on amplifying rodent host species (Varlık) and the circum stances and locations in which flea “super-production” would have ampli forfied a flea-borne possible plague transmissions maintenance to susceptible host. mammals, including humans (Ziegler).Plague Heretoday I iswill found direct on attention most, but to not a remote all, continents. region serving It was eradicated as habitat from Australia by the mid-1920s but persists in both North and South America, in many regions of Africa, and across Eurasia east of the Black Sea. On continents where plague is found, reservoirs are heterogeneously arrayed: thus, transmission hotspots are discontinuous. Were there simi 4 Not all waves of plague in Europe would have been generated by spillovers from remote maintenance foci. In an extraordinarily valuable case study of endemic plague in London, c plague persisted for up to a century in London, without requiring reintroduction of the pathogen from rural. 1550–1665, hinterlands Cummins, or maritime Kelly, commerce. and Ó� Gráda A city (2013), the size showof London that (population c Rattus rattus . 60,000 in 1550) would have supported a heterogenous population of rodents, some surviving and resistant, others susceptible. When fleas could not find a nearby rodent host, however, humans would serve. 162 larAnn zones G. Carmic in Europehael where plague could have been maintained in a res ervoiring to thehost, infamous readily amplifiedblack rat by(Rattus fleas torattus involve susceptible wild rodentsPulex irritansand lagomorphs (e.g., squirrels, voles, rabbits), and eventually extend sistence in Western Europe begins with archival) and/or sources human indicating fleas ( that plague could) to cause have a persisteddramatic plaguein the southernoutbreak? Alpine My restudy region, of inplague just suchper natural reservoirs. Europe’s alpine zones are not often discussed in his torical work on the Black Death and its recurrences, because research understandably centers on devastating late-stage zoonotic spillovers, the epidemics. Evidence nonetheless exists for plague in Europe’s alpine uplands, suggesting a new approach to the larger story. A Few Plague Deaths along High Mountain Roads, 1567 frontier.Milan’s public Traditional health Milaneseoffice, an impressiveplague surveillance and extensive evolved bureaucracy by concentrat since theing on1400s, principal systematically trade routes monitored and nodes plague linked cases to the on militarythe state’s boundaries northern of Lombardy, including those roads leading toward various Alpine passes collapsed during the half-century of horrors attending the “Italian Wars” (Pracchi 1971: 5–14 and 165–72). But surveillance over upper Lombardy Foreign(1499–1559), troops whichrepeatedly subjected crossed all the of mountainsnorthern Italyinto northernto recurring Italy, food and oftenshortages, it seemed plagues, that and plague pestilences came with (Mallet them. and Shaw 2012; Alfani 2013). By the late winter and early spring of 1567, after hostilities had ended, According to a well-placed Dominican, Gasparo Bugati, they assumed that publicthe city health of Lyon officials presented in Milan the greatestresumed danger aggressive of plague plague this surveillance. particular Roman Emperor in 1565. The following year, plague spread eastward over theyear. Savoyard Italian princes-controlled had fledwestern Lyon Alps, after ravagingpaying homage areas involved to the new in mostHoly transalpine commercial and communications networks. When Bugati pub lished his massive history of Milan up to the year 1569, he believed that these heightened precautions proceeded from a constant fear of another 5 In that catastrophic plague like that of 1524, the worst in living memory. 5 incrudelità poi per l’Alpi, che traversano la Savoia ne gli Suizzeri, & ne’ Grigioni: tanto che“[. in . Chiavena, .] partì� di & perlungo quei pel suo timor contorni della morirono peste gia gi huominiper queste de’ dieciparti gli principiata, otto: cagione e 163 Plague Persistence in Western Europe: A Hypothesis Map created by Theresa Quill for Indiana University Libraries, 2013. Map 4. Locales in the Southern Alps Reporting Plague Outbreaks to Milan (Spring 1567). year, almost 50,000 had died, out of a population fewer than 100,000, and economic recovery was fitful, crippled further by protracted regional war wefare know (Bugati that 1570: the Milanese 1047; d’Amico expected 2012: that 11–13, plague 33; would Zanetti funnel 1977). through the From more specific surviving archival documents in the health office, southern Alpine market towns reported recent plague cases in hamlets to theirmountains. north. 6In Although 1567, letters many sent of these in early Italian spring-speaking from local settlements officials in can three no lache pieta à Milano d’Iddio si conservossifecero strettissime intatta.” guardie, come quello che ricordavasi della infinita strage dell’anno del 1524. passato, & si per questa diligenza, come principalmente per 6 All of the letters referenced here come from records of the Conservatori alla bundle labeled peste. Unnumbered letters are cited by date. For example, a letter from Sanità in the Archivio di Stato of Milan, p.a. [parte antiqua], n. 279: a box containing a Bellinzona, dated March 30, 1567, notes new plague cases in three settlements in the hadLeventina fallen ill.valley, one place named Tortengho (two deaths, two ill), another named Calpiogno (a woman died), and a third called Mairengho, where “some little children” 164 longerAnn G. Cbearmic foundhael on modern maps, the reporting centers are still important today. Domodossola, Locarno, and Bellinzona all had centuries-long ties to Milan, and informants in each town provided some details about each suspected plague case. The map locates principal places either named in these letters or relevant to itineraries by which travelers from Lyon would have reached Milan. These three mountain towns were vital to Milan’s strategic and economic interests because they were situated on Ticino River tributaries that emptied into Lake Maggiore near Locarno, thirty miles west of Bellinzona. The Ticino reforms south of the lake, crossing the plains to meet the Po River. Control of the Ticino River, which often served as a geographical boundary between Lombardy and the Italian Piedmont, was a vital eco nomic interest to Milan during the Middle Ages. Milan’s rise to power and prominence as a regional state capital was due to novel water-man agement strategies: because no great river ran through the city, its eco nomic expansion depended on sustained innovative, hydrological proj ects, binding all these areas into a network of cities and regions with dif Milan became one of the richest cities in Europe, able to exploit the Alpine riverferent tributaries local resources within (Boucheron an already vast2001). canal By thesystem. late Thethirteenth famous century, vie dei marmi—the marble routes—brought great marble and granite stones, and the men who carved them, from the mountains to the cities (Soldi theRondinini sixteenth 1989). century, Canals migrants transported from thebuilding southern supplies, Alps stillmeat, found pelts work and asa steady porters infusion and domestic of immigrants servants from in Milan; the Alpine other hillregions-town (Grillo people, 1994). includ In centuries, resettling in the metropolis or living half of each year in each ing skilled artisans (e.g., stone masons), followed patterns established for bonnets, and caps which were sought after around Europe. locationIn 1567, (d’Amico plague 2012: appeared 55). Alpine in different furs lined mountain some ofvalleys the Milanese that were gloves, sep arated east to west by formidable peaks.7 Not only would it have been nearly impossible, given the season and the distances, for these sporadic cases to be transmitted by human contact, the cases of plague show no 7 Many of the tiny places named in these letters had connections to Milan stretching back many centuries. Initially, the tie was to the distinctive Ambrosian Church of the earlier Middle Ages; much of today’s Swiss Canton Ticino, still Italian-speaking, was once called the vallate ambrosiane signorie, they each independently established pacts and agreements tying them to (Ambrosian valleys). With the Visconti and Sforza the regional state of the fourteenth and fifteenth centuries: see Chittolini 1985. 165 straightforward movementPlague Pofersistence infection alongin Western one or E uropeanother: A Hrouteypot hfromesis archival evidence, some preliminary historical and geographical back groundLyon which is useful. humans could have used. To appreciate the significance of the ters that served travelers connecting to mountain passes, but the routes Bellinzona and Domodossola were (and still are) Italian-speaking cen Bellinzona moving up into the Leventina Valley, was more frequently used northward diverged significantly. The Gotthard Pass, 45 miles northeast of the Uri Canton and the Reuss Valley, at the headwaters of the Rhine River. Domodossolaby German-speaking (so named merchants because andit is migrantsat the head (Racine of the Italian2004). Ossola It led intoVal Canton, through the Great St. Bernard Pass. Heavily used since the early Middleley) instead Ages, connected the Great St. Lombard Bernard travelers route linked to the Mediterranean French-speaking Italy Valaisto the Low Countries and British Isles via the Rhineland. Many of the travelers easily(and armies) proceed moving south through through Ivrea the St.and Bernard Aosta, and Pass to andTurin the and Mont Genoa. Cenis In thePass mid (further-sixteenth to the century west and these thus cities not and on thelands, map today provided) part of wouldItaly’s morePied mont province, were controlled by the counts of Savoy, and were not areas the Milanese could monitor easily. A third major Alpine pass essential to Milanese trade was the Simplon town than was the route to the Great St. Bernard Pass, reaching the Sim plonPass, involvedjust 41 km a steep(25 miles) climb away into thefrom Lepontine Domodossola. Alps. WhileThis was closer the to most the direct route if plague were spreading between Lyon and Milan by a series of contacts. Access to the Simplon route had been created by medieval Milanese merchants eager to circumvent tolls exacted by agents of the Simplon route followed the upper Rhône River as it passed by Martigny. Fromcount thatof Savoy, important in control medieval of the hub,western one Frenchwould continueAlps (Bergier toward 1997). Geneva The and alternate routes north through the Jura Mountains, toward Burgundy, Champagne, and Paris. By comparison, it was the longer, and in several ways more rigorous journey—especially as it presented various seasonal challenges—but the Simplon route did not necessarily entail higher trans port costs. The Romans had not used the Simplon, and the Gotthard Pass and the St. Bernard Pass were also used more in the medieval centuries than in antiquity. (The Romans had instead cleared and exploited passes in the far western Cottian and Graian Alps, for the conquest and adminis pulled the axis of transalpine communications eastward to the Central tration of Gaul.) During the later Middle Ages, Milanese trade thus steadily Alps (Frangioni 1983: 18–22; Ugolini 1985; and Bergier 1997). 166 AnnThe G. C saliencearmichael of these complex geographical features to the Milanese plague surveillance of 1567 is their connection with routes and passes along Ticino River tributaries. However, long before this time, larger eco logical and political changes to the region had affected the entire southern establishment of plague maintenance foci. An historical ecology of Alpine- regionAlpine plaguezone during cannot this respect period: the changes political, that linguistic, (as I argue) and social facilitated boundar the ies that have hitherto shaped most historical study of the past. Essentially, hamletswe should that first may understand look close that to one different another Alpine on some passes maps, threaded but were north- not actuallysouth traffic in easy through trading different distance Alpine one from valleys, the other.thereby passing towns and At the beginning of February 1567, health deputies in Locarno (situ deaths in the Val Maggia. Two women had died suddenly, one of them withated abetween bugnone Domodossola and Bellinzona) relayed news of suspicious had implemented plague controls, but did not describe their actions fur ther. In mid-February,(bubo) a behind frustrated one ear.health The commissioner officials wrote in to Domodossola say that they independently complained of costly trade and travel restrictions, claiming that he had been on the lookout for plague for the previous three years, guarding the roads day and night. He expected that travelers from Lyon or Savoy would bring plague, but had no knowledge of events in Locarno. Two months later, a more detailed letter from Bellinzona, dated April 25, reported cases near a larger settlement in the Leventina valley, halfway to the Gotthard pass: The day before yesterday we wrote to you about some cases occurring in Faido in which we suspected plague. To be certain, we sent out one of our deputies and he provided a written report certifying that in this place of who had the disease in one armpit. Faido a little boy died of plague, [and8 that he had also] discovered a man implemented appropriate procedures, they volunteered details of uncon Reassuring Milan’s health office that they (officials in Bellinzona) had 8 Milano, Archivio di Stato, Conservatori alla Sanità , p.a., n. 279: “L’altro ieri una dell[ette]ra. quale scrivessemo[…]lefatta la sua rellatione certi che casi subito occorsi ne haressemoin Faido dubiosi scritto di la peste, verità et a quelle.per sapper Cosi sicuramenti come era il fatto haveramo man[dat]ti uno de n[ost]ri Deputati al ritorno uno putto di peste, et uno huomo essergli scoperto tal morbo sotto una sella. ¶ Dipui cheè gionto nelle dettoMontagne n[ost]ro d’esso Deputato luogho certificandonedi Faido à quelli ch luoghi fa esso dove luogho già muolt’ di Faido giorni è morto fa la peste anchor regnava fa progresso. Il tutto si fa per reguardarsi v[ostri] s[ignori]. . .” 167 nected cases in threeP laguetiny settlements Persistence where in Western they found Europe other: A H ypresumppothesis cials,tive plague dispatched cases; by they orders verified from oralMilan, reports to investigate by undertaking the full extent direct of bod the infectedily inspection zone. of the victims; then they prepared to receive district offi From other reports this same year, the Milanese knew that the geo graphical scope of the plague threat was not limited to the Canton Ticino. cialsDuring in theBergamo spring and and mountain early summer areas months, as far to the the health east as office Trent. and Plague even well-informed citizens received a steady stream of similar alerts from offi further east, in a region connecting Milan to the Splugen Pass by way of Chiavenna.menaced the9 Still Grigioni other cases(Grisons), popped a German-speaking up along the roads Swiss that doubledcanton much back eastward into the Venetian Trentino. Plague reports coming to Milan from these areas further east included similar postmortem descriptions of con spread preemptively on travelers or undesirable migrants, or on infrac tionsfirmed to plague good order deaths, by smugglers,but (with practiced tax evaders, facility) and delinquent they blamed watchers. plague’s Thus in 1567, plague menaced Milan’s Alpine fringe: west, east, and Lyon were elusive. Despite consistent and worrisome news, cities and townscenter. ofYet the specific northern trade Italian and travel plains connections did not confront to the an known epidemic plague later in that year. From the end of winter into the summer, the Milanese authori ties received and responded to plague reports. Spared the worst, they eventually filed away letters that required ultimately no assessedfurther action. these There mountain is no- evidenceregion plague (at least threats. in the Considering box of papers the now letters containing strictly these as historical letters) conevi cerningdence, we how know Milan’s that the health Milanese office had mostly well-established routines of remote, rural-area surveillance in place by the mid-sixteenth century. The control that Milan could exert was impaired during the decades of war, but economic integration of upper Lombardy and the southern Alps had not been fractured either by warfare or the shift in political boundaries when the Canton Ticino became part of the Swiss Confederation. Officials 9 principiata, e incrudelità poi per l’Alpi, che traversano la Savoia ne gli Suizzeri, & ne’ Grigioni:Bugati (1570:tanto che 1047): in Chiavena, “. . . partì � &di per lungo quei pel suo timor contorni della pestemorirono gia per gi huominiqueste parti de’ dieci gli otto: cagione che à Milano si fecero strettissime guardie, come quello che come principalmente per la pieta d’Iddio conservossi intatta.” ricordavasi della infinita strage dell’anno del 1524. passato, & si per questa diligenza, 168 Ann G. Carmichael Milan, regardless of their transient political allegiances. in theMore hinterlands detail about were the indiffusion the habit of ofsporadic reporting plague plague outbreaks to the officethrough in the southern Alps might lead us to a better understanding of the begin nings of the great epidemic that pummeled northern Italy later, in the 1570s. The point of this preliminary excursion is, instead, to show that early spring cases could not have been connected to one another by nor mal channels of human communication and interaction. All these routes, through high mountains and treacherous late winter Alpine climes, seem labyrinthine paths for plague to travel from one known-infected city, Lyon, to another large and vulnerable city, Milan. Endemic Plague in Alpine Europe during the 1560s Sporadic Alpine plague cases in the Canton Ticino illustrate that conta gion-based transmission scenarios for the spread of plague do not map onto the evidence from 1567. The zone at risk was too wide, the known Contemporary with these Milanese records, archival evidence of endemic plaguecases disconnected, in other areas ofthe Alpine terrain Europe too difficult, actually suggeststhe season plague uncooperative. persistence in this general region during the mid-sixteenth century and for at least a century before that. In the Haute-Maurienne, this evidence is illuminated by some extraordinary dramatic and artistic artifacts.10 In 1567, a village near the northern outlet of the Mont Cenis Pass, Lanslevillard, orches trated the performance of a traditional mystery play, the Mystère de Saint Sébastian, in honor of the saint frequently invoked in times of plague. This two-day dramatic event was probably based on a much older template which(Symes also 2011) document scripted this in the village’s early fifteenthlong experience century, ofbefore recurrent the painting plague outbreaksof the murals (see in Plate Lanslevillard’s 2 chapel of Saint-Sébastien (1446–1518), cated to that saint were mounted elsewhere in the Maurienne in the mid- 1560s, as they had beenon a generationpage 230). earlier,Other performances when the plague of plays last circudedi lated there. Indeed, there is widespread evidence of many other artistic and theatrical responses to plague in this region (Leandri-Morin 1997). In a few instances, we have specific archival evidence to show that such per formances fulfilled a community’s prophylactic vow (made at a time when 10 The Maurienne follows the Arc river valley and connects Lyon to Turin across the Mont Cenis Pass, by way of Susa and the Susa Valley. Outbreaks here are typically explained by its proximity to trade. 169 Plague Persistence in Western Europe: A Hypothesis of this evidence points to the plague’s wide diffusion into the transverse Maurienneplague raged) valley, to honor as well the as alongsaint (Chocheyrasthe longitudinal 1971; ones Lebègue of Canton 1975). Ticino. All Study of plague in an ecological zone such as the Alpine region is dif political domain, or urban setting. Many different kinds of boundaries— political,ficult. Historians linguistic, tend religious, to search social, for plague economic—frustrate within a specific attempts archive, to a gather and evaluate evidence from ecologically similar regions of Europe that sprawl across these boundaries. Thus, the rather limited evidence presented here can be usefully compared to that uncovered by William Naphy, mostly from Genevan archives, and by Edward Eckert, using prin cipally south German parish records. Naphy’s research found that 1567–72 was the single worst plague frominterval the inwestern Geneva’s Alps history provided (Naphy dramatically 2002: 13–16, increasing 18–19, reports 108–19, of plague and deliberately163). He initially spread wanted by “greasers” to understand (engraisseurs why, from .1470 This toaccusation 1530, records was a manifestation of the popular notion that plague could be transferred by oily substances, carried by persons who themselves) did not contract had emerged in the western Alps at the time of the Black Death (Guerch plague (see also Preto 1987). Though similar fears of plague spreaders carriers in the western Alps coincided with a surge in witchcraft perse cutions.berg 1948; Prior Arrizabalaga to Naphy’s 1994; research, Cohn scholars 2007), laterhad arguedmedieval that fear witches of plague- and “greasers” were variant expressions of general popular anxiety during an age of rapid social and economic change to the countryside. After all, turies.Geneva Situated was still alonga small the city dangerous (less than confessional 20,000) that fault served lines as ofa refuge the Prot for estantdisplaced Reformation, country people Geneva during and the its lateleaders fifteenth had andto discern early sixteenth heresy from cen superstition, even in plague times. But contrary to his expectation, Naphy found that the fear of persons spreading plague was fueled by a gradual recognition that plague was Geneva’s governing elite treated each outbreak as a new external threat. Accordingly,endemic. Between they applied 1470 and costly 1530, reactive local plaguemeasures epidemics to each increased,newly discov but ered case of plague. When their de facto approaches failed, they made little effort to stanch rumors that plague workers (nurses, launderers, order to hang onto their high, hazard-pay wages. By 1567–72, frustrated gravediggers, barber-surgeons, and so on) were seeding new cases in city managers finally adopted the more proactive, remote surveillance 170 approachAnn G. Carmic Milanhael had long taken. They began to treat plague as something spread in the city by persons hoping to sustain the plague. Accordingly, theyflowing spent from money the countryside during quiescent all around intervals. them, notThey something funded the deliberately retention of pest-housenew plague staff cases over and winter put brakes months on and commercial required medical ties between certification these peopleof cause and of death.places Theyand the applied general sustained urban community. attention to After the identification1572, “greas century-long grip. ers”In finally a study became focused harder on a regionto find, just and north the plague of the seemed Alps, epidemiologist to release its atEdward the local Eckert level, (1996) he found analyzed two distinctive parish death pathways records implicated that covered in plague an outbreakseighty-year within span, fromthe region. 1560 to He 1640. argued Mapping that larger intervals-scale of tradecrisis corridorsmortality transmitted plague from maritime areas to southern, German-speaking European towns and villages. But once plague reached the interior, out system”: that is, without a new plague wave coming from the maritime breaks moved around the entire region in pathways defining a “closed Eckert emphasized different spatial and temporal differences between localepicenters. crisis mortalityThese internal in the cycles German repeated-speaking every regions five to north ten years. of the Thus, Alps terns of plagues that originated in European maritime cities. He argued (stretchingthat we should from look the atRhine regional river clusters to today’s of plagueCzech Republic)rather than and study the onlypat focal epidemic outbreaks, and see that plague moved by “traveling waves” from one cluster to another contiguous cluster.11 Eckert parsed evidence from hundreds of parish registers, spanning a century and covering a generous portion of Central Europe, but focused entirely on Protestant records that provided no evidence of similar events in the Alps, Catholic Bavaria, or Slavic-speaking regions further east. His mapping of temporal plague patterns within larger regions is neverthe less quite valuable, because it helps us to see that plague outbreaks were neither random nor sporadic. (Lacuna-ridden documentation and uncer tainties about the historical diagnosis of plague deaths can otherwise lend 11 historically interesting spatio-temporal review of the eastward expansion of plague fromThe western characterization coastal cities of of“traveling the United waves” States comes in 1900, from from Adjemian which it et spread al. (2007): across a the Rocky Mountains, and then extended as far east as Kansas. Within forty years, plague traversed 2250 km (nearly 1400 miles). 171 Plague Persistence in Western Europe: A Hypothesis evidence is consistent with my hypothesis that Alpine plague foci existed, Ithe question impression his assumption that plagues that followed plague no had clear to bepattern.) repeatedly Although reintroduced Eckert’s to the coastal cities of Western Europe in order to set these regional plague cycles in motion. In a subsequent evaluation of the factors lead ing to bubonic plague’s retreat from Central Europe over the long eigh teenth century, Eckert accordingly emphasized the decline of exogenous plague introductions to the maritime coasts in order to explain plague’s on plague in the Ottoman empire makes untenable Eckert’s backdated assumptioneventual disappearance that trade with (Eckert Anatolia 2000). could Here, have Nükhet been Varlık’s the proximate recent work ori gin of late medieval European plagues.12 The path of plague spread in the ice and its hinterlands eastward into the Balkans and Black Sea littoral fifteenth and sixteenth centuries instead moved the other way, from Ven (Varlık 2012 and 2014, in this issue). The Western Alps and Black Death Mortality Interdisciplinary application of recent plague ecology to historical investi gations of the Black Death requires a regional focus in addition to research at the global and local levels. The southeastern region of what is now France is happily an ideal place13 to begin such inquiry. Those familiar with narrative histories of the Black Death—in particular, with Rosemary Horrox’s collection of sources—know that striking accounts of the Black Death in Marseille and Avignon illustrate different aspects of the catas trophe than the accounts that we have from Tuscan and English sources. The magnitude of the demographic catastrophe and social disruption in a range of texts generated in and around the court of Pope Clement VI includeMarseille staple has Blackbeen wellDeath studied accounts (Smail by the 1996; natural Michaud philosopher 1999). Conrad Similarly, von Megenberg (Gotschall 2003); the physician Guy de Chauliac (1363/1997: 2, 119); and the musician Ludwig van Kempen, a close friend of Francesco Petrarca, writing in Avignon (trans. in Horrox 1994: 41–45). Petrarca him self had fled Avignon, taking refuge from the pestilence in the Vaucluse, 12 point, and her ideas on how altitude and Mediterranean ecology, as environmental I am especially grateful to Nükhet Varlık for correspondence with me on this issue. determinants, might support possible Alpine plague foci. See her essay (2014) in this 13 Here, as elsewhere throughout this essay, I use “Black Death” with temporal specificity, to refer to the singular epidemic wave 1347–53. 172 rightAnn G. at C armicgroundhael zero of plague’s spread into the French Alps. From the Provençal region broadly, including also southwestern France14 and north ern Iberia, we possess the notorious written accounts of the early, wide spread riots and massacres of Jewish communities (Cohn 2007; Foa 1992: 7–23; Nirenberg 1998: 231–49; Shatzmiller 1974; and Biraben 1975: 54–71),Plague now seeped further into substantiated these temperate by alpinethe work regions of Colet from and early colleagues-infected Mediterranean(2014, in this issue). port cities, moving toward Europe’s upland interiors, high plains, and Massif Central. Alpine regions included the Pyrenees (linked to easterntionately Iberian more urbanports), archival the Julian evidence Alps (in of Venice’s the plague’s hinterlands), spread and,and abovesocial all,effects the thanmaritime elsewhere. and western The Apennine (French) chain Alps, in whereItaly is wealso have an alpine dispropor zone, but one characterized by a Mediterranean climate regime (Nagy, Grabherr, where we have substantial and diverse documentation about the Black and Thompson 2003). I am limiting discussion here to the alpine region centers in upland Iberia could illustrate a similar pattern of severe Black DeathDeath, mortalitybut Tàrrega in (Colet regional et al. market 2014, in centers this issue) connected and many to alpineother market zones Historical evidence and contexts are as fundamental to the new inter disciplinary(Emery 1967; study Phillips of past 1998). plague as are the ecological and environmen weretal determinants not uniform, of regionalbut instead plague varied amplification. according Biraben’s to the season monumental during plague history (1975) argued that plague’s effects during the Black Death inwhich mortality the plague experience first arrived. is far more Evidence characteristic subsequently of the wrested previous from diffu the sionSavoyard of Yersinia archives pestis confirms than ithis is observation.of human infection Such geographical spread by contagion. variation Evidence of plague’s incursions into Alpine Savoy is, for this time period, abundant, permitting some demographic study of Black Death mortality different important social and political changes overlap the Black Death’s in rural hinterlands (Carrier and Mouthon 2002). At the same time, many 14 We do not know precisely when Petrarca was at his villa in Vaucluse. He was in Avignon until November 1347, when he left for Parma and Verona.Secretum He learned of the deathThat year, (in Avignon) he went toof Romethe woman for the whom Jubilee his and love returned poems made to the famous Vaucluse (Laura) for the while last he was in Verona, and was likely in the Vaucluse to finish his in 1349–50. time, 1351–53, before moving to Milan. See Kirkham and Maggi (2009: xix–xx). 173 diffusion through theP laguewestern Persistence Alps: for example, in Western the E mosturope brutal: A Hy potphasehesis of and military career of the extraordinary young duke of Savoy, Amadeus the Hundred Years’ War (Sumption 1990: 6–13) and the rising political localVI, who resources, created aprimarily transalpine caused feudal by state demobilized (Cox 1967). soldiers From coalescing the late 1340s into mercenarythrough the companies. 1360s, the entire region was subjected to new stresses on Given the number and variety of potential mammalian hosts for Yersinia pestis in these human-churned landscapes, it is reasonable to postulate the establishment of enzootic plague foci, although not with geographical pre cision. Thankfully, unusually detailed accounts of Savoyard district admin istrators allow historical reconstruction of the multi-century processes of the region’s occupation, cultivation, and late medieval abandonment from Savoyard archival sources that high mortality during the Black Death epidemic(Carrier and occurred Mouthon in the 2010: bailliages 11–30 andof Chambéry, 171–205). Chablais, For example, Bugey, we Bresse, know the Viennois, the Maurienne, the Tarentaise, and in the Italian Piedmont, the Val d’Aosta, and the marquisate of Susa. Two especially useful social and demographic studies of localized Black Death mortality in Savoy show that plague mortality was greater in the surrounding countryside than in the towns, that the season at which the plague arrived affected the sever ity and duration of the epidemic interval, and that the Alpine population establishes that Martigny, an important market town connecting travel fromsteadily either declined the Mont in the Cenis fourteenth Pass or and the fifteenth Simplon centuries.Pass to Geneva, Gelting suffered (1991) ofrural larger population centers—in losses their up case, to 45% Lausanne during and the Geneva—wereBlack Death. Andenmatten greater than withinand Morerod urbanized (1987) settlements. likewise show As I have that alreadyBlack Death suggested, losses evidencein hinterlands from remote villages in the Maurienne indicates that these communities contin and well into the sixteenth centuries. uedA to regionally struggle withintegrated recurrent analysis plague of outbreaks economic throughoutand ecological the fifteenthchanges within the western Alps following the Black Death would be most wel come, since the many extant surveys concentrate instead on individual French départements or Swiss cantons. Even histories of the duchy of Savoy, which Amadeus VI transformed over the central decades of the fourteenth century into a transalpine state, are similarly fragmented of some of the events commonly described in political and military his toriesalong modernof the region national suggests divides that (Vester the Black 2013). Death For now, accelerated the storied a profound version 174 reversalAnn G. Carmic and hdeteriorationael of human occupation of Savoy’s mountain regions, with the disappearance of cultivation and settlements fundamen tal to Savoy’s rise as a regional power during the twelfth and thirteenth centuries. We know so much about these rural areas because the young Amadeus’s advisors moved quickly to stabilize his tax base and central administration, documenting revenue collections from both autonomous and comital landholdings in each castellany. The Count himself was busy exerting military power to keep the dynastic holdings intact. During the deusseven traveled years between tirelessly 1348 with and huge 1356, entourages, when he had entailing reached all twenty-two the horses andyears all of the age grain and requiredmade his to first keep important these large diplomatic mammals treaty, well provisioned.Count Ama forage for survival. Neither the stranded and hungry English and French soldiersMeanwhile, from throughout the Provençal the 1350s, wars, mountainnor Amadeus people and in his his retinue,domain wouldhad to have confronted the protracted subsistence crises that locals endured. Even where the plague did not strike directly, tax burdens multiplied and local environmental conditions deteriorated in the upland commu nities. In both Lombardy and Savoy, the most 15destabilizing reflection of thelarger foliage climate of semi change-arid was Alpine the recurrencevalleys, thus of feeding crippling small spring rodents flooding and providing(Tropeano abundant and Turconi humidity 2004; for Bravard the replication 1989). andSpring activity floods of theiramplified vari a “trophic cascade” (e.g., Salkeld et al. 2010, on changing vacillations of ous fleas. In plague ecological16 The field preconditions studies, this for sequence a rural plague is referred epizootic to as were amply supplied in the years surrounding the Black Death. prairieThe Blackdog populations). Death did not affect all regions of Europe equally; even neigh boring, or similarly situated, towns experienced quite disparate overall mortality. In analyzing the spread of the Black Death via spotty mentions of high mortality, some scholars have inferred equally catastrophic losses from comparable places where we have no documentation. We should 15 Important recent historical studies of multi-decadal climate change includes for the late medieval period; but neither focuses on the Alpine regions nor the great riversthose ofthat McCormick originate there.et al. (2012),This is surprising, for late antiquity, because or climatologists Campbell (2011 today and see 2013), global alpine regions as sentinel areas of large ecological change: see Allainé and Yoccoz (2003). Squatriti (2010) usefully couples written documentation of northern Italian 16 flooding to climate changes of late antiquity. One of the earliest mentions of Alpine marmots is in 1339, by a Benedictine prior imposing restrictions on peasants’ hunting (Carrier and Mouthon 2010: 141). 175 resist this temptation.Plague Filling Persistence in the map in between Western localities Europe: Awhere Hypot somehesis evidence of plague exists is not without foundation when estimating the true costs of the Black Death pandemic in Europe, but we do need to exer cise considerable caution when drawing conclusions about the in-between borneareas of and these overland maps (Mengel routes of 2011). human Not communications. unreasonably, tracing Indeed, the histori path of ansplague must in usually1347–53 follow typically human inspires-gene ratedcareful sources, researchers as I did to followin describing water sinuous mountain back roads where the plague cases of early 1567 were located. But diffusion of Yersinia pestis, spreading via rodents and their fleas,The “Seconddoes not replicate Pestilence” human of itineraries. 1359–63 The lack of evidence for some places, such as Bohemia (which Mengel urbanized2011 has studied), Lombardy may and not especially be evidence from for Milan, the absence its capital, of plague is differently during problematic.the 1347–53 epidemic.We know However, from the the famous dearth account of Black of Death Gabriel evidence dei Mussis from likely as plague spread inland along the Po River. Piacenza was fewer than (trans. in Horrox 1994: 14–26) that Piacenza was severely infected, most contemporary evidence of the Black Death in Lombardy is almost non 42 miles south of Milan, a city of nearly 100,000 people. And yet secure and cities to the north of the Po River, all of which were larger than most ruralexistent market (Albini centers 1982: anywhere 14–17). Whyin Europe would and Milan Britain, and bemany spared other a disease towns supposedly spread by contagion? Oddly, many historians accept the claim by a Florentine plague survivor, Matteo Villani, that Milan escaped cata strophic mortality in 1348–49 because its ruler took cruel and aggressive isolationist measures to board up infected houses when the first cases of the new disease appeared (e.g., Benedictow 2004: 95; Christakos et al. Rome2005: this215). Jubilee While year, a few no places evidence in Milanese of these outbreakssuburban districtsis unambiguously reported epidemic outbreaks in 1350, during the high traffic caused by pilgrims to plague-related (Albini 1982: 15–16; Michaud 1998). Instead, the first devastating plague in Milan and the major cities of enceLombardy with theoccurred catastrophic in 1361–63 new (Delepidemic. Panta His1982: son 118). remained Francesco behind. Petrarca Long disappointedfled Milan in bythe the late young spring man’s of 1361, adolescent as the choicescity faced and its limited initial achieve experi ments, Petrarca consigned his nuanced remorse to pages of a precious manuscript copy of Virgil which his own father had given him: 176 AnnOur G. CGiovanni,armichael born to my toiling and my sorrow, brought me heavy and constant cares while he lived, and bitter grief when he died. He had known th year of his age, in the night between Friday and Saturday the 9th and 10th of July. Thefew happynews of days. his deathHe died reached in the yearme in of Padua our Lord late 1361,on the in afternoon the 25 of the th. He died in Milan in the unexampled general devastation wrought by the plague, which hitherto had left that city immune from such evils, but 14 Thenow other has deathsfound it Petrarcaand has invaded recorded it. (Kirkham in this manuscript 2009: 5). are of those he loved most: Laura (in Avignon, April 1348, of plague); his closest friend, Ludwig van Kempen, also called Louis Heiligan (in Avignon, 1361, of correspondentplague), and his and grandson a former Francesco, tutor of his aged son, while2 years, he was4 months still grieving (in Pavia, for Ludwig,1363, toward Petrarca the dedicated end of a plague). his Letters Writing of Old to Age Francesco to his friend’s Nelli, amemory: favorite lier one in many regions, especially here in Cisalpine Gaul, and has almost [T]his year [1361/62] has not only equaled but even surpassed the ear and populous Milan, untouched until now by these disasters. (Petrarca completely emptied along with many other cities the most flourishing Many1361–73/1992: of Petrarca’s 1). other correspondents survived the initial wave of plague, only to die in the next epidemic. Francesco Nelli subsequently died Seen from the perspective of England or Florence, this “second plague” isof oftenplague, called in Avignon, the “plague in 1363. of children,” likely because a very large baby- boom generation dominated the population at risk a decade after the 17 Otherwise, occurrences of the “second plague,” and the places where it firstwas severe,epidemic, have in thosereceived places the wheremuted itacclaim had caused consonant substantial with its mortality. “second” sobriquet. Glénisson long ago observed that some areas in France’s Mas had been at the time of the Black Death. Moreover, he traced the north-to- southsif Central overland were itinerary far more of devastated the second during epidemic’s the 1360s spread, plague noting than the theysub highstantially upland different communities pattern of from the westernthe Black Alps, Death down (Glénisson to great 1968; metropolitan see also Albini 1982: 14–18 and 82). Plague’s initial spread from the alpine and 17 New perspectives on population immunity, as discussed by Crespo and Lawrenz adapt when living near plague enzootic foci. (2014, in this issue), are likely to change our understanding of how human populations 177 centers such as Milan,Plague seems P ersistencemost likely in to Western have occurred Europe during: A Hypot theh secesis ical evidence led me to locate persisting plague foci in a way consistent withond wave modern of plague, plague not ecology. the first, This and second this anomalous wave of plague temporal-geograph in Europe, as well as the even more neglected later European plague recurrences over the following centuries, may claim a greater importance in plague history generally if we reposition plague within larger ecological and environ mental contexts. The Alpine Marmot: A Potential Host for Persisting Plague in Europe The western Eurasian alpine system is vast, and its temperate-zone mountains include the Pyrenees, the alpine groups variously referred Allto asthese maritime, mountain western, regions south-central are connected (or to Italian), the Mediterranean Julian, Dinaric climate and zone,Carpathian, where andundershrubs the Apennines are prominent (Nagy, Grabherr, and winters and Thompsonare mild and 2003). wet. regions, and provides habitats for many nesting and burrowing rodents. Undershrub vegetation survives better than forests in these fire-prone indigenousMild, wet winters rodent support and lagomorph year-round hosts flea foractivity, plague. and allThe the French way up Alps to havethe high a now mountain-dwindling pastures variety the of fleaslikely would plague have-susceptib found18 lea greatspecies, variety includ of voles, and both Rattus rattus and Rattus norvegicus Manying lagomorphs other mammalian (hares), sciuridaegenera and (squirrels), species implicated mice, dormouse in maintaining species, plague elsewhere also inhabit, or once inhabited, the southern(Ariagno and 1976). west Alpine regions linked to Mediterranean plague ports were therefore, Iern contend, European ecologically Alps (Armitage ideal homes 2013). for the introduction and propagation of the plague bacillus. At the time of the Black Death, moreover, all these upland zones were under considerable ecological stress, both chronically (following centuries of intensive development of the uplands and alpine pastures) and acutely (due to destabilizing flooding events). The longer- 18 Generally, I rely here on a model for the spatial diffusion of plague epizootics plague from coastal regions into the Mediterranean and western alpine hinterlands offered by Davis et al. (2008). Full elaboration of the hypothesized movement of of the rodents inhabiting zones from the mountains to the great city of Istanbul. would require a separate study. Varlık (2014, in this issue) provides illustrative detail 178 termAnn G. anthropogenic Carmichael changes to land use and settlement are important to foldtransformations into our understanding in the French of medievaland Italian history Alps during (Hoffmann the medieval 2014). Nich era, describingolas Carrier how and theseFabrice different, Mouthon contiguous (2010) have ecological summarized regions ecological became fundamentally connected through human activities. Beginning in the elev enth century, communities of monks vied with local lords and autono mous civilian communities for control of the use and access to high alpine pastures. Alpine meadows were given over to pastoral farming, not only to exploitation by transhumance, but (by the mid- to late thirteenth cen and more extensive forest-clearing on slopes leading up to these pastures. Wheretury) to pastoral the multiplication activity was of permanent not easy, the settlements peaks attracted in the high new pastures mining investments. Mountain peoples who once farmed lived much of the year very close to famine, scratching their meals from the ground. Once these alpine communities were linked to the grain-rich plains, theciaries extraction of economic of mountain trade integration, resources intensified; people in the even mountainous more uplands areas were of exploitedEurope became for products ecologically which bound the plainsmen to urban wantedregions inoutside return. these As benefi zones, and cereals were staple imports to the region during the seasons when travel was easier. Over the colder months, the hunting of larger rodents mon across the region since early Neolithic times, but remodeling the and carnivore competitors (both for food and pelts or fur) had been com the last millennium. Medieval monastic documents occasionally mention flora and fauna of the entire European Alpine region occurred only during suremarmots on larger (von faunaTschudi of the1870: region, 750–69; when Shopkow great feudal 2010: lords 242), feared which that is sigthe nificant (see below). As early as the 1330s, edicts indirectly refer to pres spectacular changes to the Alpine region’s ecology and human settlement patternspeasants couldoccurred compromise over the their fourteenth sport hunting through (Blache seventeenth 1922). Even centuries more In sum, diverse regional stressors and the creation of vital economic ties(Carrier and andnew Mouthon demands 2010; on high Viazzo mountain 1989). pastures made an easier entry for Yersinia pestis at the time of the Black Death. The upland landscapes were fragmented by human occupation and early commercialized live stock rearing, here and there connecting commensal rodents to the mechanisms for a very rapid wave of epizootic die-offs during the Black Deathfleas of epidemic a great remainmany other elusive, plague-susceptible requiring further mammals.research if Thethe primaryprecise 179 hypothesis presentedPlague in this P ersistencepaper—the in existence Western of E uropea suitable: A Hy reservoirpothesis host for plague—offers a plausible model for plague persistence in Con tinental Western Europe more generally. If plague were well established in Europe’s southern alpine region, the circumstances under which occa sional early spring plague cases would occur—such as those suggested in Tilling and/or living in Alpine valleys might have brought the occasional subsistencethe letters to farmerthe Milanese into contact health office with inburrowing 1567—can rodents, be readily and imagined. if those hosts maintained plague infection, sporadic human plague outbreaks One candidate species for plague maintenance in the uplands would be thewould Alpine have marmot occurred (Marmota (Ariagno marmota 1976). nating species that is a favorite of tourists in Switzerland today (Tomé and ), a highly social, burrowing, hiber M. marmota is morphologicallyChaix 2003). The similar species to is theclosely M. bobac related species to rodent common hosts inof Kazakhstan,plague else whereand to inthe Eurasia Manchurian (Allainé marmots and Yoccoz (M. sibirica2003). For example, Teh’s investigations of plague in Manchuria during 1910–11 (Summers ) made famous by Wu Lien- did2011: not 107–29). survive unmolestedMarmot popoulations thereafter. expanded Between 10,000during andthe last7000 glacia BCE, earlytion across hunters the rid temperate the upper Alpine Rhone zone area (Zimina of the western and Gerasimov Alps (e.g., 1973), the Jura but pasturage and resource extraction during the medieval era created new habitatsmountains) for marmotsof marmots, within ibex, higher and chamois. elevation At forest the sameclearings. time, Because intensified the mot habitats were created when trees were felled or burned for increas roots of trees make burrow-formation quite difficult, potential new mar alonging pasturage with two (Armitage species of 2013). voles, butSurviving their steady alpine disappearance marmot colonies is a todaymuch moreinhabit recent the region process, above further the treelinethreatened (altitude today byvaries global by warmingAlpine location) and by competition for the highest alpine pastures and slopes. Human uses of Alpine marmots can only be documented over the last half-millennium. Beginning with the sixteenth-century naturalists, we have direct testimony of marmots being captured and kept as pets. Felix Platter, the famous Protestant Swiss printer of the early sixteenth cen iststury, and briefly travelers had a encountered captive Valais marmot marmot pelts, in his used collections, for luxury as bedding we learn in from his daybook entries of the early 1560s (Katritzky 2012: 20). Tour the mountain region, the rodent had already become a familiar performer nineteenth-century chalets (Raverat 1872: 14–20; Gayot 1889). Outside 180 inAnn French G. Carmic cities.hael During the eighteenth and nineteenth centuries, moun tain people from the one-time kingdom of Savoy migrated seasonally to France’s cities and towns, desperately poor and eking out a winter living by offering services that lowlanders found either necessary or amusing— for example, sweeping chimneys, killing rats, or begging for pittances by entertaining passersby with trained ferrets and marmots, memorialized as the “marmotte en vie.”19 Because these economic migrants returned to the high meadows come spring, they were not seen as intrinsically dangerous, in contrast to feared, rootless vagabonds of the pre-Revolutionary period. Poster illustrations captured the quaint dress and humble activities of the became fascinated with marmots as a hibernating species, reporting local knowledgeSavoyards (Hufton of their 1972).habitats European and the easenaturalists of extracting of the nineteenthanimals from century their erated on the eve of the so-called “Third Pandemic” of plague. burrows soon after the first snowfall. Species-targeted exploitation accel Epilogue: Global and Historical Perspectives on Ecological Change and Plague Persistence in Europe The Alpine marmot was not necessarily uniquely responsible for plague maintenance in that region, as seems to have been the case with the Siberian marmot during the pneumonic plague catastrophe of 1910–11 in Manchuria. In most of today’s permanent plague foci, Yersinia pestis can maintenanceinfect a local arrayhost for of plague’ssmall mammals evolution and as their a species, fleas. theAlthough burrow Suntsov struc ture(2012) of greatargues gerbils that Eurasian (Rhombomys marmot opimus species, generally, were the original plague was newly introduced during the) “Thirdhas also Pandemic,” made them a candidates variety of (Randall et al. 2005; Wilschut et al., 2013). As in regions of the globe where in the Mediterranean and temperate Alpine zones during the second pan demic.amplifying Rather hosts than and focusing their fleas entirely would on have M. marmota promoted, we plague should persistence note the general characteristics of Alpine zones and the high meadowlands that marmots favor. Thus equally important would be the wide range of poten tial amplifying hosts common throughout the Alpine foothills and high massif regions of Western Eurasia, species that Varlık details in her dis 19 For an eighteenth-century image of a young man with a trained marmot and what appears to be a street organ, see Claude-Louis Desrais, designer, “Petits métiers, cris de Paris,” available online at Plague Persistence in Western Europe: A Hypothesis thecussion southern of rural face plague of the transmissionsEurasian Alpine (Varlık system, 2014, linked in this to Mediterranean issue; specifi climatescally for theand westernecology, Alps,bears see important Allainé ecologicaland Yoccoz similarities 2003 ). In toparticular, modern areas where newly introduced plague persisted. Grove and Rackham zones across the globe: a mosaic of landscapes, predominant undershrubs and(2001: savanna, 11–65) steppes emphasize with commonmore grasses characteristics than woody of plants,“mediterraneoid” warm wet winters, hot dry summers. Almost all of California, Chile, and, to a lesser extent, South Africa have regions comparable to Mediterranean uplands, and all became areas where plague established new, permanent mainte nance foci during the late nineteenth and early twentieth century. Temperate-climate alpine rodents better survive occasional bitter win ters because snowfall is heavy, protecting the ground from sheet ice that impairs their survival. But whether many colonies could have survived the aggressive and prolonged winters during the Little Ice Age (roughly could have shortened the reproductive season of most burrowing rodents, especially1550–1830; marmots, see Parker but 2013)the species is difficult could to have say. survived Early and and late thrived snowfalls if it were not targeted by hunters and hungry mountain dwellers. The his torical evidence at present offers greater support for sustained habitat destruction and/or human-driven landscape alteration, profound since 1700 throughout Europe. With or without northern hemispheric cooling during the Little Ice upland regions steadily declined, processes that continue today. By the timeAge, theFrench fauna and and English flora biodiversityinvestigators of rushed the Alpine to East, and West, Mediterranean and South and animals once commonly known in earlier centuries had disappeared. Europeans,Asia to investigate including outbreaks scientists, of foundplague the in thenatural 1890s, and a humanworld ofenviron plants ments of the strikingly “other” colonial metropoles utterly foreign spaces black house rat—much less the ibex, chamois, badger, and bear of the westerna century Alps—had ago. Was onceit also been difficult fairly for ubiquitous them to imaginearound European that the humble human on, may have cleared the way for the rat species dominant there today, Rattussettlements? norvegicus In Britain, the aggressive use of rat poisons, from the 1680s ish zoologists had noted the disappearance of the “old English rat,” which we now know was (KonkolaRattus rattus 1992). At least as early as 1800, a few Brit ers in British India had no knowledge that the Indian or “tropical plague (Burt 2006). But most plague observ rat” was once a domestic species back home. A flea that renowned ento 182 mologistAnn G. Carmic N. Charleshael Rothschild named Pulex cheopis Egyptian pyramids where he found it, became Xenopsylla cheopis within xeno capturing itsin 1903,“foreign” for thestatus great as Public Health Reports R. rat- fivetus andyears, X. itscheopis Greek- once derived had prefixa cosmopolitan ( ) distribution across Eurasia an “Indian rat flea” ([U.S.] 1907). But both Today, the single most active plague maintenance focus causing human (McCormick 2003). genus (Synopsyllus deaths is in the uplands of subtropical Madagascar,R. rattus is thewhere dominant a different species flea ) spreads plague continually among highland rodents ests,”(800 metersbut hedgehogs, or more insectivores, above sea level). and small mammals such as shrews and there, “found everywhere: in houses, villages, fields, and also in the for tenrecs help to amplify plague (Andrianaivoriamana et al. 2013: quotation at e2382; see also Rahelinirina et al. 2010, and Vogler et al. 2013). High leaddegrees to high of poverty, and persisting the difficulty plague inof Madagascarrecognizing today: atypical the human consequences plague infection, and insufficient governmental resources to apply to surveillance In other words, the famous British Commission for the Investigation of of which Michelle Ziegler’s (2014) contribution to this issue makes clear. Plague in India (1906/07), used by many different historians of the Black twentiethDeath (e.g., century Cohn 2002; (e.g., BenedictowChandavarkar 2004) 1992; might for betterFrench reflect Indochina, its impe see rial (European) historical context than the ecology of 20plague Katherine in the Royer early Latour 1988: 59–110; and recently Au 2011: 29–49). (2014)discarded has by shown Bombay how-based the observationsscientists from of London. colonial Hence, physicians actual and plague sur geonsexperience (who throughout had long lived the northernand served Indian in British subcontinent India) were may rejectedneed to beor reconstructed historically, based on her work. The historical moment of the Black Death introduced a highly virulent nomic and ecological stressors. A wide variety of potential plague hosts flea-borneand vectors pathogen intrinsic toto thedensely Alpine settled regions regions faced crippleda combination by multiple of climate eco- driven and anthropogenic destabilization in the years surrounding the beginnings of the great plague: massive spring flooding events, intermit tent droughts, and high traffic of demobilized soldiers and camp support ers after the English victory at Crécy (1346). All were likely factors in the 20 generated by the 1906/07 Commission provides a misleading picture of the magnitudeMathematician and temporal Nicolas progression Bacaër (2012) of the human has even epidemic shown on how Bombay the plague Island. data 183 Plague Persistence in Western Europe: A Hypothesis demicdevastating was at and least uncharacteristically partly caused by rapid Yersinia spread pestis of plague, the study between of plague 1347 historyand 1349. is notNow at that an weend; know only that a narrow mortality and in protracted this great, debate catastrophic about epithe presence of the plague pathogen has been resolved. An altogether differ ecology, must begin to bridge the local, the regional, and the global. Inter disciplinaryent set of historical historical questions, study of prompted evidence by for the prior findings global of climate modern change, plague seems to point a way forward. exemplified by Campbell (2010, 2011, 2013) and McCormick et al. 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She is currently completing a study of mortality Abstractand public Historicalhealth in Sforza-era sources documenting Milan (1450–1535). recurrent plagues of the “Second Pan demic” usually focus on urban epidemic mortality. Instead, plague persists in remote, rural hinterlands: areas less visible in the written sources of late medi which serve as “maintenance hosts,” to an array of more susceptible rural mam mals,eval Europe.now called Plague “amplifying spreads hosts.” as fleas Using move sources from relativelyrelevant to resistant plague in rodents, thinly populated Central and Western Alpine regions, this paper postulates that Alpine Europe could have been a region of plague persistence via its population of wild rodents, particularly the Alpine marmot. Keywords Plague, vector-borne disease, Alpine Europe, Marmota marmota, Milan, Savoy, Petrarch. NEW SCIENCE AND OLD SOURCES: WHY THE OTTOMAN EXPERIENCE OF PLAGUE MATTERS NÜKHET VARLIK historic moment for plague historians and scientists. At pre sent, a growing consensus in the international scholarly community iden This is a Yersinia pestis.1 This consensus marks the end of a long controversy over the pathogenic tifiesagent the of theBlack pandemic—a Death as a pandemic controversy of plague that occupied caused by the front stage of scholarship for decades.2 Having left this behind, plague historians can now afford to explore new issues as well as revisit old questions with a fresh eye. They can draw from a wealth of research supplied by the “new science”demiology—and of plague—by seek novel which ways I refer of to integrating the flurry ofit intostudies historical in the last inquiry. dec Inade effect, or two this in fieldsmoment such heralds as bioarcheology, the beginning microbiology, of a new chapter genetics, in and plague epi relationshipsscholarship as between it invites the new new avenues science of of inquiry plague (seeand theGreen “old 2014, sources”— in this byissue). which One I mean such the pathway written worth sources pursuing historians is the are task trained of calibrating to use. the The new science and the old sources do not always concur, unless the historian makes an effort to make them speak to each other. With this in view, this essay will draw from the Ottoman experience during the so- I owe a tremendous debt of gratitude to Monica Green, who has provided inspiration and encouragement throughout the process of writing this essay. I would also like to acknowledge Ann Carmichael, George Sussman, Carol Symes, Michelle Ziegler, and the anonymous reviewers of The Medieval Globe, with thanks for their invaluable comments and suggestions. 1 Y. pestis as the causative agent of the Black Death (e.g., The consensus is firmly in place in the geneticist community.Y. pestis genomes Multiple have groups been of reconstructedresearchers have from confirmed the ancient DNA recovered from the Black Death cemeteries in Haensch et al. 2010; Tran et al. 2011). Sequences of London (Bos et al. 2011). Informed by recent scientific studies, a growing number of historians have acknowledged this consensus (e.g. Little 2011; Bolton 2013). For its 2 A concise presentation of the controversy can be found in Little 2011. Most recently, significance in bioarcheology see DeWitte (2014, in this issue). strain of Y. pestis caused the Black Death. historian Samuel K. Cohn (2013) remains unconvinced that any currently existing –227 The Medieval Globe 1 (2014) pp. 193 194 calledNükhet Second Varlık Plague Pandemic (i.e., the Black Death and its recurrent in working with sources that can shed light beyond the spotlight of scien waves) and seek to highlight the critical importance of the historian’s craft ence matters for an understanding of the Second Pandemic, the essay will tifictackle research. two sets In of order intertwined to demonstrate problems. why On thethe Ottomanone hand, plague it will experiengage with a historical and historiographical discussion of why the Ottoman epidemiological experience has been imagined as the European alterity and how this legacy has obstructed this experience from being studied as part of the larger Afro-Eurasian disease zone of the Second Pandemic. My goal here is to underscore the Eurocentric nature of plague studies by demonstrating how spatio-temporal epidemiological boundaries were constructed in the scholarship. On the other hand, this essay will examine the Ottoman plague experience during the Second Pandemic with a view to offering observations and insights about the Ottoman disease ecolo ence are explored in detail: persistence, foci/focalization, and patterns of transmissiongies that sustained of plague. plague. My More goal herespecifically, is to illustrate three aspects how the of new this scienceexperi of plague can be put in dialogue with historical sources. Part I. New Science and Old Sources: Challenges and Opportunities From where we stand today, some may believe that the new science of plague puts an end to historical inquiry. Because the new science can explain the pathogen and its genetic history,3 one may wonder why we still need to study the old sources. The reasons for this are to be sought in the very etiology of plague that involves a complex system of entanglements in with other organisms, as well as the surrounding environment. Thus his which every organism (as host, vector, or pathogen) constantly interacts ease manifests itself at local and regional levels. Such ecological and envi ronmentaltorians must variations now account make for it all variations the more between compelling the to specific pay attention ways the to dis the “local knowledge” of plague, in the form it appears in the historical sources. 4 3 The recent engagement of the geneticist community in the debate seems to have been taken by some historians as a threat to the territory of their discipline and led them to react. A recent article written with that conviction has suggested: “Historians primary sources and should not allow the glamour of science to make us forget our are uniquely qualified to assess the value and analyse the content of medieval 4 The emphasis on the “local knowledge” of plague and “plague experience” in own expertise” (Pobst 2013: 814). 195 It is now clear that plague studies will haveNew toScience transcend and O theld Sboundources aries of individual disciplines; adopting an interdisciplinary approach is practically inevitable. The student of plague therefore needs to face up to the stipulations of interdisciplinary work. For example, there is a pressing need to keep up with the all-too-quickly-changing findings of the scientific literature, especially in the fields of genomics and evolutionary biology. bioarcheology.It is necessary Itto also understand, means reckoning interpret, with and what utilize appears the research to be a growingfindings imbalancesupplied by between allied disciplines the new science and fields, of plague ranging and from the old climate sources. history Even to if one leaves aside differences in content, the disparity between publication cultures in the sciences and in the humanities cannot be overlooked. The former prefers short, rapidly-produced, multi-authored technical notices that may seem impenetrable to the nonspecialist; the characteristics of humanist publications are almost the opposite (except, in some cases, for nottheir produce degree researchof impenetrability). that can be Motivated easily reconciled. by different How, questions, then, can conthis newcerns, science and agendas, be used thein conjunction historical and with scientific historical scholarship accounts? ofHow plague can the do historian put them into dialogue? This imbalance becomes all the more still relatively undeveloped. There is a wealth of primary sources pertain ingchallenging to plague in in those non- Westfieldsern where languages, the historical but it is scholarshipstill in manuscript of plague form. is Until these sources are edited, published, and translated in a manner accessible to researchers, our knowledge of past plagues will continue to suffer from this imbalance. As a result, there remain a number of important gaps in the scholar man experience of plague during the Black Death and its recurrent waves. Judgingship of historical from modern plague Ottomanist epidemics scholarship,that need to bethe filled. vast Onearea is that the cameOtto under Ottoman control—stretching at its height from southeast Europe to ure as a breeding ground for plague until the last centuries of the empire’s history:the Persian the Gulf only and extensive from the study Black covers Sea basin the periodto the Yemen—did between 1700 not andfig 5 For the plague outbreaks before this era (i.e., from 1850 (Panzac 1985). anthropologist Margaret Lock and the recent discussions of this concept in the context this essay has benefited from the concept of “local biologies” developed by medical 5 Panzac’s study has been largely ignored by mainstream historical scholarship. Whileof global it washealth. unanimously See, for example, recognized Lock as1993 a great and 1995;accomplishment Brotherton withand Nguyenrespect 2013.to its 196 Nükhet Varlık and spatial scope or effects, or even considered how the Ottoman epide 1347miological to 1700), experience no systematic may be study integrated has hitherto into the surveyed broader their history temporal of the Second Pandemic in the Afro-Eurasian zone.6 This is curious because the spatial and temporal correspondence between the empire and the plague can hardly be ignored. Ottoman his tory almost squarely coincides with the time frame of the Second Plague Pandemic, and evidence suggests that Ottoman power and the plague coexisted for half a millennium, from the Black Death of the mid-four teenth century to the mid-nineteenth century or so. Yet the ubiquitous presence of plague in the Ottoman world over that half millennium has what follows, we shall seek to disentangle the web of historical and histo riographicalremained mostly problems invisible that in have both obstructed historical andthe scientificOttoman scholarship.plague experi In studies of plague sheds light on how European epidemiological imaginar iesence fashioned from becoming the Ottoman visible. experience A critical asreading the “other” of scientific by constructing and historical spa tial and temporal epidemiological boundaries; so it is to the construction of these boundaries that we turn now. The Historical Fiction of Epidemiological Boundaries The historical scholarship on the Black Death is largely Eurocentric. In this body of scholarship, Europe has occupied a privileged position, compared to other parts of the world that may have been at least as badly affected by plague, if not more so. Our current knowledge about the plague in East Asia, South Asia, Central Asia, the Middle East, and North Africa before the Third Pandemic is at best fragmentary and disconnected.7 As such, extant documentation of the occurrences of plague outbreaks, their frequency, and methods of spread, its representation of the demographic and economic effects of plague was debated. Historians of the Ottoman empire and the Middle East have been especially critical of the absence of Ottoman sources (e.g., Owen 1986; Dols 1987; Issawi 1988; 6 Fisher 1992). For its absence from European scholarship, see also below. See, e.g., Ü� nver 1935; Panzac 1973, 1986, 1987, and 2009; Jennings 1993; Lowry 2003; Schamiloglu 2004; Kılıç 2004; Mikhail 2008; 2012; Shefer-Mossensohn 2009 and 2012; White 2010; Varlık 2011; Bulmuş 2012. For a study of the outbreaks between 1347 and 1600, see Varlık (forthcoming). For a call to study the Second 7 Pandemic in this larger Afro-Eurasian disease zone, see Green (2014, in this issue). bringEven together though in there view are of their fine temporalhistorical and studies spatial devoted breadth to ofthe coverage. epidemiological See, e.g., experience of these areas during the Second Pandemic, they are difficult to 197 scholarship has cultivated a lasting impressionNew that Science the Blackand O lDeathd Sour wasces a European phenomenon and that the European epidemiological experi ence was to be studied sui generis. In this epidemiological imagination, non-European epidemiological experiences would only be worthy of scholarly attention if commensurate with that of Europe. In other words, the lacunae in historical plague scholarship are not haphazard; what was studied and what was not can be best understood in the light of European notions of public health and efforts for disease control that came in the form of quarantines, plague commissions, sanitary missions, and inter national conferences at the dawn of the modern era. Those areas whose plague experience was believed, in the twentieth century, to have been of direct relevance to that of Europe (and perceived as having an impact on while others remained rather obscure. EuropeanThe European public health epidemiological concerns) cameexperience under thus the spotlightcame to be of understoodscholarship in the periodization of plague, a system that purports to be global but whichwithin actually certain situatestemporal Europe and spatial at the boundaries,center and only and capturesboth are Europeanreflected experiences. By now, it has become commonplace to study three discrete pandemics: the First Pandemic, known as the Justinianic Plague and its c. turies;recurrent and waves the Third (541– Pandemic750); the that Second spread Pandemic, globally knownin a few as years the Black after Death (1346–53) and its recurrent waves Although that continued the idea forthat several the Plague cen of Justinian and the Black Death were8 two separate waves of epidemic its appearance in Hong Kong in 1894. 2007;Hrabak Stearns 1957; Krekic 2009 and1963; 2011; Langer Frandsen 1975; Dols 2010; 1977; Buell Norris 2012. 1977; Also Alexandersee works 1980; cited inSchamiloglu notes 5 and 1993; 6 above. Ansari For 1994; a study Kōstēs that 1995; ambitiously Manolova-Nikolova tries to offer 2004; a wider Anandavalli (but still comparative perspectives, see Biraben 1975; Borsch 2005; Sussman 2011. There isEurocentric) also a substantial scope, seebody Benedictow of literature 2004. devoted For tostudies the First that Pandemic, have adopted including larger but or not limited to Biraben and Le Goff 1969; Dols 1974; Conrad 1981, 1982, and 2000; 8 For this conventionally accepted periodization, see Little 2011. The term Christensen 1993; Stathakopoulos 2000 and 2004; van Ess 2001; Little 2007. references it only three times in over seven hundred pages: for example, “there are instances“pandemic” of whatappears are tocalled have pandemics, been used orinfrequently universal epidemics, before 1894: of sickness. Creighton The (1891) Black Death was one such” (p. 397). Interestingly enough, it was the cholera and influenza pandemics that helped spread its use, and by 1918 the term had become common parlance (Morens, Folkers, and Fauci 2009). 198 activityNükhet wasVarlı becomingk common in the nineteenth century, it was not until plague bacillus that these epidemics were retrospectively placed in a his toricalthe outbreak timeline. of plagueTwentieth in (British)-century epidemiologistsHong Kong and theand discoveryepidemiological of the historians alike seem to have subsequently adopted this schema.9 Nev ertheless, this vision of past plagues can hardly be taken to represent the rhythm of plagues as experienced across the Afro-Eurasian zone. It offers cially with regard to the “in-between” outbreaks. littleThe insight Ottoman for thecase ebb in particularand flow of seems epidemic to complicate waves in thisother periodization, areas, espe as it blurs the assumed boundaries between the end of the Second Pan demic and the beginning of the Third—just as it blurs a supposed distinc tion between West and East. After plague receded from Western Europe early in the eighteenth century, sporadic outbreaks continued to occur in untilSouthern the nineteenthand Eastern century. Europe Those(e.g., 1743 occurrences in Messina, were 1815 noted in Bari),in many in Rus late sia (e.g., 1770–72 in Moscow), and more persistently in the Middle East nineteenth- and early twentieth-century works (e.g., Simpson 1905: 36–39; Sticker 1908). Modern scholarship has also convincingly shown that plague persisted in the Ottoman empire and Russia (Alexander 1980; Panzac Second1985; Robarts Pandemic. 2010). Plague Nevertheless, outbreaks the in theGreat eighteenth Plague of and London nineteenth (1665) cen and turies,that of outsideMarseille of (1720–22)Europe, were continued only recently to be seenrecognized as marking as being the partend of the 10 Second Pandemic (Walløe 2008; Cohn 2008; Bolton 2013: 15). 9 It appears for the first time around the turn of the twentieth century. For example, Simpson (1905) identified three pandemics: “The first [ . . . ] recorded to have originated in Pelusium in Egypt” (p. 5); “The second [ . . . ] later called the Back Death” (p. 21); and “The pandemic of the present day” (p. 6). Other early twentieth-century works used the term “pandemic” without a system of enumeration (e.g., Eager 1908; Sticker 1908), but by the mid-twentieth century this system of periodization seems to be in place (see e.g., Hirst 1953). However, it probably did not become conventional 10 A similar pattern of persistence of plague can be observed between the First and theuntil Second the 1970s Pandemic, (Ziegler roughly 1969: in25; areas Dols where 1977: the14). Ottomans would come to rule. These recurrent outbreaks also complicate the parameters of these earlier pandemics. See in Anatolia under Seljuk rule (though the diagnosis of these outbreaks is not always Dols 1974 and 1977: 13–35; McNeill 1976: 70; Conrad 1981. For a list of outbreaks Pandemic,clear), see seeArık Morony 1991. For2007. a brief description of an outbreak in Tunisia in 1004–05, see Talbi 1981: 223. For a critique of the year 750 as the definite end of the First 199 The question of when the last outbreak ofNe thew S cienceSecond an Pandemicd Old Sour tookces prevailing habits of thought. Plague continued in Ottoman areas until the midplace-nineteenth therefore century,seems difficult if not longer, to answer since based recorded on extantcases in sources Mesopota and mia and the Arabian peninsula appear until the turn of the twentieth cen 11 Especially in view of the fact that the Third Pandemic also made its appearance around the same time, the question of whentury (Simpson the Second 1905: Pandemic 38–39). ended may need to be re-evaluated with the Y. pestis involved in the Second Pandemic are still with us today, as demonstrated helpin the of example scientific of studies. a recent In outbreak effect, it inis Libya.possible12 that the strains of Shifting our focus from temporal to spatial boundaries may also involve questioning what we think we know about plague’s past. Once again, the Ottoman case is telling, and it underscores the degree to which the new plague science has maintained or reproduced these spatial boundaries. As noted above, the scarcity of historical studies on Ottoman plagues has rendered it invisible to practitioners of the new science. In the absence of historical studies to guide bioarcheological research, there is no evidence from former Ottoman areas comparable to what has been found for West ern Europe. Obviously, this has implications for studying the genetic history of the13 pathogen. In the absence of aDNA specimens, the plague history of this particular area/era cannot be integrated into the narra tive of the new science because the aDNA specimens of Y. pestis mostly come from excavations in Europe (France, Germany, Italy, England, and Reconstructing the phy the Netherlands)—places close to centers of molecular14 biology, centers of information and calculation (Latour 1987). 11 Twentieth-century scholarship seems to have grown more confident about announcing the “end of plague.” For example, Pollitzer (1951: 478) hailed “the gradual disappearance of the disease first from Western and then from Eastern Europe until in of1841 the Turkey, twentieth the century,last stronghold news of of plague the pest, in becameIstanbul free.” was Drawingnoteworthy from enough this scholarship, to receive internationalPanzac (1985: coverage 446–517) (British also held Medical that the Journal last plague was in the 1840s. But at the turn 12 Recent genetics research on the 2009 Libyan outbreak has demonstrated that a 1900, 1902a, and 1902b). branch of the medievalis Third Pandemic, could be one that was active during the Second Pandemic (Cabanel strain (2.MED) was involved. This strain, independent of the 13 Bioarcheology and aDNA research have only recently started being used in the et al. 2013; Green 2014, in this issue). field of Near Eastern studies. For a discussion of the state-of-the-field, including 14 For a list of the areas of excavation, see “Toward a Molecular History of Yersinia reasons for its belated development, see, e.g., Sołtysiak 2007; Baca and Molak 2008. 200 logeneticNükhet Varlı historyk of the pathogen depends on identifying modern Y. pes- tis isolates. Some of these specimens have been preserved since the late nineteenth century, others have been isolated more recently. The major ity of these modern specimens come from places where plague is (or has United States, Russia, Mongolia, and China; fewer from India, Madagas car,until Eastern recently and been) Central enzootic. Africa, Among and elsewhere. these, a large15 For number our immediate come from area the of interest, only a small number of isolates from former Ottoman areas recent phylogenetic analyses and studied in relation to where they stand within(including the Turkey,evolutionary northern subdivision Iraq, and of western Y. pestis. Iran)16 Owing have to been this included imbalance in in data collection and analysis, the new science of plague—along with the historical scholarship that informs it—privileges some areas over others.17 This ongoing Eurocentricity of plague scholarship has been largely determined by research produced in the nineteenth and twentieth cen turies—research with a strong colonial pedigree. On the eve of the Third pestis ,” available online at of infectious substances, see WHO 2012. According WHO’s protocol, Y. pestis is listed asregulations a “Category issued A” infectious by the World substance Health whose Organization transport (WHO) is strictly regarding regulated. the transport 15 For information on these isolates and their provenances, see the phylogenetic 2010. tree in Cui et al. 2013, reproduced in Green 2014, in this issue; also see Morelli et al. 16 2.MED1, isolated from this region, evolved sometime before 1775, i.e., before the fourThird Y. Pandemic. pestis 1.ORI3 is thought to have come from Madagascar during the Third Pandemic,orientalis most probably via the pilgrimage route (Morelli et al. 2010: fig. 1). Of the isolates that were preserved in Turkey, three were defined as biotype outbreak in(Golem two Turkish and Ö� zsanvillages 1952). on theOne Syrian of the border.four was In known the months to have of Februarybeen isolated and March,from a humana total of case thirteen of plague deaths in thetook Akçakale place out (Urfa) of a total outbreak of eighteen of 1947: persons a small affected. plague This appears to be the last recorded outbreak of plague in Turkey. 17 Either resulting from current concerns about the disease’s reemergence and the assessment of its risks or due to privileging areas that can produce aDNA specimens, the “molecular politics” of Y. pestis rather than representing the breadth and intensity of past plagues as experienced across different areas. For an insightful reflect exposition past and current of the global“molecular inequalities politics” of ofhealth HIV demonstrating how the global inequalities of the AIDS epidemic can be observed at the molecular level, see Crane, 2011. 201 Pandemic, European scientists were concernedNew S ciencewith “unusual” and Old S ourplagueces activity in East and South Asia (Creighton 1891: 166–70, 172–73; Suss man 2011: 324). What they considered a new pandemic then signaled rushednew opportunities there to study for the research: epidemic as onsoon site; as theplague discovery broke ofout the in pathogen (British) Hong Kong in 1894, as noted above, scientists from different countries then in Pune, Karachi, and Calcutta, soon to be followed by many major followed shortly. In 1896, plague This was situation reported alarmed in British European India (Bombay, colonial 18 portthe colonies. cities across For example,continents). a special committee was formed to investigate plaguegovernments, in India: which observing sent plague the plague, researchers producing and laboratorypublic health experiments, officials to ship that continued to develop over the course of the last century. Both historiansand publishing and scientiststheir findings. are still The dealing result was with an the immense effects ofbody this of problem scholar atic legacy in one way or another. From the Ottoman “Laboratory” of Plague to the Colonial Science of Plague The body of knowledge drawn from the Third Pandemic, as much as it has informed current research, has also hindered it (Royer 2014). This spread.plague science The legacy was ofthe colonial product plague of a certain science configuration also has important of power, implica which tionsis still for reflected the study in ofsome Ottoman critical plagues, assumptions because about it retrospectively plague’s origins shaped and the perception of Ottoman experience in historical scholarship. To under stand how this occurred, we need to recognize that early modern obser vations of Ottoman plague had come to constitute a working knowledge of the disease in Europe. When the Third Pandemic broke out, this body of knowledge lost its primacy at the expense of colonial plague science, backed by the germ theory of disease. And yet, certain epidemiological assumptions drawn from European analysis of Ottoman plague continued to be used in modern scholarship. Before the Third Pandemic, both scholarly and lay opinion in Europe maintained that the “seat of the plague” was the Near East, the “Orient” which, at that time, largely coincided with dominions of the Ottoman 18 For the origins and spread of the epidemic in China, see Benedict (1996: 1–130). For its global spread, see Echenberg 2007. For plague in India, see Arnold (1993: chap. 5). 202 Nükhet Varlık teenth centuries onwards, Europeans observed that devastating plague empireepidemics (Sussman were becoming 2011: 324). less From frequent the late on seventeenth the continent. and When early eighMar seille witnessed what is regarded as the last major outbreak of plague widespread belief that the disease was being imported from the eastern Mediterraneanin Western Europe, port incities 1720, of thethis Ottoman experience empire, only suchconfirmed as Constantinople the already writings of early modern European travelers, merchants, diplomats, and naturalists(Istanbul), hadSmyrna no small (İ�zmir), share and in Alexandriashaping this (Takeda belief. But 2011: above 115–17). all, we Thecan cians who, after major plague outbreaks receded from Western Europe, point to the influence of a substantial number of Western European physi and write about their experiences. wentAmong to Ottoman the most cities prominent to observe of these plague, physicians gather werefirsthand the Russell information, broth ers from Edinburgh, who spent several years in Aleppo and published their observations on plague in the latter half of the eighteenth century.19 Simi larly, Mordach Mackenzie, who worked as the physician of the Levant Com pany in mid-eighteenth-century Istanbul, regularly reported his observa Such accounts continued to be published in the nineteenth century.20 For tionsexample, about William plague Wittman, in the Ottoman a Royal Artillerycapital (Mackenzie surgeon sent 1752 to the and Ottoman 1764). empire following Napoleon’s invasion of Egypt, published his observations posedon the aplague comprehensive in 1804. A moretwo-volume detailed work, testimony which comes includes from his A. observaBrayer, a French physician residing in Istanbul between 1815 and 1824, who com The knowledge acquired in the Ottoman “laboratory” of plague appears totions have on been the causes, well received types, and in Europe, treatment since of plaguemost of (Brayer these physicians 1836). pub 19 Alexander Russell worked as physician of the Levant Company in Aleppo from Natural History of Aleppo—including a special section on plague—appeared in print, goingabout through1740 to several1753. In editions 1756, soonafterwards. after his His return younger to London, brother Patrickthe first followed edition ofin his footsteps, practicing medicine in Aleppo where he lived between 1750 and 1772. In 1791, he published his Treatise of the Plague, in which he included his observations during the outbreak of 1760–62 and 120 individual case studies in Aleppo. On the life 20 Two Italian physicians, Eusebio Valli and Antonio Pezzoni, who served in the and works of the Russell brothers, see van den Boogert (2010). Greek hospitals of Istanbul during an outbreak of plague in 1803-4, published their individual observations (Valli 1805; Pezzoni 1842 and 1847). See Sarı and Etker (2000) and Yıldırım (2010: 59); see also below. 203 lished their work promptly and some of thoseNe publicationsw Science an wentd Old into Sour sevces eral editions and translations. Their impact on European scholarly circles is also discernible in the way that these authors used their knowledge to acquire recognition and advance their careers. For example, Alexander Russell’s experience in Aleppo, advertised in his writings, helped him to be elected to the Royal Society of London. Later on, his brother Patrick also became a member. Mackenzie’s account of the plague in Istanbul was not only published by the Royal Society, it also opened the doors of member is that of Charles Maclean, an English physician whose career stagnated ship to him (van den Boogert 2010: 146). A more remarkable case in point until he traveled to the Ottoman capital in 1815 to observe the plague. edgeHis observations was especially were valuable swiftly published in promoting in London the empirical (Maclean approach1817). Since to plague had receded from Western Europe, this body of firsthand knowl the direct observations of physicians with overseas experience came to medicine that was flourishing in early nineteenth-century England; hence in this context that cases from the Ottoman laboratory, that “last vestige acquireof plague,” more continued weight than to be theoretical observed, knowledge studied, and (Kelly discussed—until 2008: 569). It wasthe Third Pandemic broke out.21 When this occurred, the attention of European scholarship largely shifted from Ottoman areas to European colonies in South and East Asia. (The fact that plague had largely disappeared in the Ottoman empire by assumptions about the origins, movement, and directionality of epidemic diseasesthis time which may have had alsobeen contributed drawn from to the this Ottoman shift.) Nevertheless,laboratory were certain now being transplanted into a colonial context. One such assumption was that the geographic origin of epidemics could be traced to remote areas, far away from centers of knowledge. The nineteenth-century English physi cian and medical historian Charles Creighton aptly observed: According to the dominant school of epidemiologists it is always enough to have traced a virus to a remote source, to the “roof of the world” or to the back of the east wind, and there to leave it, in the full assurance that there must have been circumstances to account for its engendering there, perhaps in an equally remote past, if only we knew them. (Creigh 22 ton 1891, 1:149; also quoted in Norris 1977: 10) 21 There were a series of international “sanitary” conferences from the mid- nineteenth century to the mid-twentieth, although their main focus was cholera rather 22 In this era, discussion of plague’s “origin” usually meant the geographic origin, than plague. The third was held in Constantinople in 1866 (Howard-Jones 1975). 204 FromNükhet this Varlı it followedk that disease would spread in a particular direc tion and, not surprisingly, this spread was conceptualized as being uni directional: plague flowed from “less civilized” places to the “centers of somethingcivilization.” inherently Colonial anxieties wrong with thus such found lands a scientific or peoples justification and that in their this contagionemphasis oncould the affectdisease’s civilized place peoples of origin, and which places. confirmed that there was While this framework could conveniently be adopted23 to explain plague plague in Europe itself. It was not easy to elucidate whether plagues had occurredepidemics there outside spontaneously of Europe, it due was to still local, difficult regional, to explain or underlying past cases uni of versal circumstances, or whether they had been transmitted from certain “endemic” areas outside Europe. It may help to remember that through out the early modern era, the European24 imagination of plague’s origin was being constantly replenished by news of plague from the port cities of the eastern Mediterranean, which led to durable associations between plague and the Ottomans. The implications were twofold. On the one hand, the European imagination dissociated itself from plague by projecting the locus of the disease somewhere outside; on the other, it fashioned the Ottoman empire as a plague-exporter, against which Europe had to pro tect itself. By the Enlightenment, this paradigm was ingrained in scholarly inwritings Europe, and a turn popular typically opinion associated alike (Gordon with their 1999; defeat Lammel at the 2010;second Varlık, siege forthcoming)—even as the Ottomans ceased to be seen as a military threat the course of the eighteenth and nineteenth centuries, it came to be seen asof Viennaa dead in or 1683. dying As body the empire’s in the European landholdings geopolitics: in Europe “the shrank sick through man of Europe.” In the contemporary European imagination, the empire’s health scape not only represented a sickened land and peoples but also an inabil ity to deal with ill-health in a rational and orderly manner. the “endemic focus,” not the biological origin of the “virus” later named Y. pestis. 23 For a discussion of how the site of the plague shifted from the landscape to the 24 pherichuman changesbody (the that colonized would havebody) made in India, “spontaneous see Arnold plagues”(1993: 200–39). possible everywhere, For example, J. F. C. Hecker (1859: 17–19) attributed plague-causation to atmos spontaneouseven in Europe. plagues Towards in Europe the end altogether, of the century, but did physiciannot dwell onAdrien it much Proust either (1897: (see 113)—father of the celebrated French novelist—did not deny the possibility of also Panzac 2003). 205 Some of these nineteenth-century conceptionsNew Science continue and toOl dbe S ourreproces duced in historical scholarship of the twentieth century. For example, the absence of a known plague reservoir in modern Europe seems to have ret rospectively erased that possibility from Europe’s medieval past. Modern scholarship has treated plague as a temporary “invasion” or “alien” pres ence and has focused heavily on the effects of this “foreign” visitor, instead of examining plague’s interaction with the natural and built environment. The enduring vision of the European epidemiological past is one of dif- ference that singled it out from the rest of the larger disease zone (Car ship accordingly had to develop ways of explaining this difference. Most visibly,michael since 2014, the in 1970s,this issue; plague see scholarshipalso Bolton 2013:has approached 34). Historical the Mediterscholar ranean world with epidemiological divisions in mind, such as “Christian vs. Muslim” or “Oriental vs. Occidental.” For example, in his authoritative work on the history of plague, Jean-Noël Biraben posited a divide between regions he calls “north-occidental” and “south-oriental” and legitimized this bipartite view by citing differences in climate, fauna, and attitudes Subsequent scholarship seems to have maintained epidemiologi caltoward zones disease corresponding (Biraben 1975:to those 106). of the early modern period: that of the with religion as the single most dividing factor (see, e.g., McNeill 1976; Ottomans (read: Muslims)25 and These that imagined of the Europeans divisions of(read: epidemiological Christians), experience have resulted in separate histories of plague in Europe and the DolsMiddle 1977; East/Islamic Panzac 1985). world. Even in studies that encompass the Mediter ranean, these divisions play an important role in explaining the very dif ferences in the spread of plague and the responses it engendered. This bipartite epidemiological imaginary not only sustains essentialist bina ries, it regards the Ottoman epidemiological experience as timeless, uni form, and thus unworthy of historical inquiry. Part II: The Problem of Plague Persistence in Ottoman Lands As noted above, plague persisted in Ottoman areas for at least half a mil lennium: a phenomenon that requires a closer look. By persistence, I refer to recurrences of plague in a given area, resulting from local, regional, or long-distance spread of the infection, either imported from outside or transmitted from local enzootic reservoirs. In studying the persistence 25 Recent studies have shown that religion cannot be accepted as the sole deter minant in responses to epidemic diseases (Stearns 2009 and 2011). 206 ofNükh plague,et Varlı wek are at the mercy of our sources. There was no systematic recording of plagues in the Ottoman empire before the eighteenth cen tury, when Western diplomats started regular reporting to quarantine authorities in Europe.26 For earlier centuries, the nature of the sources rarely affords observations on plague’s persistence at the local level. First, there is the problem of plague’s visibility. In its enzootic form (when the infection is transmitted between partially resistant rodent hosts and their detect.27 Only when the disease assumes epizootic and epidemic form, causingfleas), there rodent is no and substantial human mortality, rodent “diecan off,”historical which sources makes makeit difficult plague to visible to us. Second, only rarely do premodern accounts mention where fromplague imprecise came from, knowledge. so as to Third,enable the us importationto trace the ofknown the infection (or suspected) to port citiesorigin. as Even a result then, of this maritime reflects contacts local rumors with andother reports, infected which cities may makes result it ther complicated by the likelihood of the infection being introduced from multipleeven more areas difficult and/or to trace through the originsmultiple of channels. a particular For outbreak. any given This outbreak, is fur it is possible that we are looking at more than one strain of the pathogen circulating through different channels. that plague spread across the empire along complex sets of trajectories Indeed, what can be more confidently ascertained from the sources is thatOttoman developed cities toand the consolidated infection throughout over the course the Second of the Pandemic, fifteenth andturning six themteenth into centuries established (Varlık centers 2011). of This plague. resulted For example, in the repeated Istanbul exposure witnessed of years on average over half a millennium. Similarly, Salonica witnessed at least 230 outbreaks during the Second Pandemic, recurring about 2.2 suchoutbreaks as Alexandria, about 142 Cairo, times Aleppo, over Damascus,the course and of theTrabzon same all period, experienced about every 3.5 years on average. Other major urban centers of the empire, some of those cities sustained the plague on their own, independent from frequently recurring outbreaks (Varlık, forthcoming). It is possible that 26 the Ottoman plagues of the eighteenth and nineteenth centuries. It was mainly this body of documentation that Panzac (1985) used to reconstruct 27 Scientific studies inform us about the critical importance of rodent hosts and vectors for the maintenance of plague. As long as there is a sufficient number of rodents and fleas, plague seems to be maintained indefinitely in enzootic form (Gage and Kosoy 2005). Other ecological factors such as climate also matter significantly (Nakazawa et al. 2007; Stenseth et al. 2006; Ben Ari et al. 2011) 207 incoming infection—that is, they functioned asNe wurban Science reservoirs and Ol dof S plague.ources disease alive from one epidemic season to the next, sustained by commen salSome rodents Ottoman and/or cities ectoparasites. (or their immediate hinterlands) may have kept the At this point, it may be helpful 28to consider whether commensal rodents Rattus rattus over time and can therefore function as temporary reservoirs. The ecolog ical(specifically scholarship colonies has placed of greater emphasis) are capable on the of role sustaining of ground plague-bur rowing wild rodents in sustaining infection over the long term, and com mensal rodents’ ability to function in the same manner has not been suf promising studies which suggest that plague can be maintained over long timeficiently periods explored in small (e.g., commensal Keim and Wagner rat subpopulations, 2009). Nevertheless, without thereany con are tact with wild rodents. For example, plague is calculated to persist for a hundred years in a commensal rat population of 60,000, without the need of importing new infection (Gage and Kosoy 2005; Keeling and Gilligan tion of rats, the infection could be kept alive for a long time. This research also2000a suggests and 2000b). that plague In other would words, persist even even if plague if quarantine killed a certainmeasures popula were in place, and thus has tremendous implications for explaining the his torical persistence of plague in large urban centers such as Istanbul. This may have become their own self-perpetuating engines of epidemic activ itymeans and thatas such urban served areas as withtemporary significant reservoirs commensal of plague. rodent populations Plague Foci and the Process of Focalization But even if urban reservoirs could independently sustain the disease, they were never isolated. On the contrary, early modern Ottoman towns were connected both to their immediate hinterland and to more distant areas through a complex network of maritime and overland routes. It was this set of connections that facilitated the circulation of plague within the empire and beyond it, since at least some of those connections linked the urban areas to rural plague reservoirs (foci). As mentioned above, areas tantwhere to identifya sufficient where number such foci of werewild locatedrodents in and the ectoparasites empire’s vast reach.live can maintain the disease indefinitely in its enzootic form. Hence, it is impor 28 hinterland in the eighteenth century. For example, Panzac (1973) showed that İ�zmir received the infection from its 208 NükhAtet present, Varlık we know of several plague foci in or around former Otto man areas such as Libya, Yemen, Iran, the Transcaucasian and the north These were active plague reservoirs during the Third Pandemic, and per hapswest Caspianeven before. regions According (WHO 1999: to Panzac, 16; Anisimov, the highlands Lindler, between and Pier western 2004). Iran, northern Iraq, and southeastern Turkey, as well as the mountainous areas of Hijaz and Yemen were permanent plague foci that caused out breaks in the eighteenth and nineteenth centuries. Panzac equally identi temporary plague foci, including the western Balkans, Moldavia and Wallachia, Istanbul, the Anatolian peninsula, and fied what he thought were to when each of these foci came to existence.29 EgyptIdentifying (Panzac 1985:pre-ei 105–33).ghteenth -However,century Ottomanhe did not plague offer an foci explanation is challeng as ing. The fragmentary nature of modern Y. pestis specimens isolated from these regions does not allow us to determine how old the foci were and how long they remained active. Plague science informs us that enzootic foci are not to be taken as timeless;30 rather they are dynamic entities that emerge, expand, shrink, or disappear over time. Myriad changes ranging from rodent migration to changes in their predator population, and from fluctuationsAll these factors in climate make toit necessarymodifications to pay in landscape, attention tocan the affect circumstances plague foci31 (Gratzthat favor 1999; their Li formation,et al. 2009; that Karimova is, the processet al. 2010; of focalization—the Eisen and Gage 2012).process by which plague forms reservoirs in the natural environment to perpetu ate itself, independent of imported infection. 29 as a nineteenth-century phenomenon. He postulates that plague had been an Panzac (1985: 128–33) singles out the focus of Egypt (“le foyer égyptien”) He noted that both permanent and temporary foci in or near Ottoman areas were “importation” to Egypt until the 1820s when it went through a process of focalization. 30 However, it is interesting to note that most of modern Y. pestis isolates of the concentrated in the highlands (Panzac 1985: 105–33). See further discussion below. biovar medievalis areas, such as Turkey, Iraq, Iran, and Libya. These scattered isolates seem to represent a genetically related (2.MED) cluster come of strains from evenformer though Ottoman they territories were isolated or its from neighboring different areas at different times. The links between these strains should be sought in the region’s history during the Second Pandemic, i.e., in the Ottoman plague experience. See nn. 12 and 16 above. See for example Cabanel et al. 2013: fig. 4; Achtman et al. 2004: supplementary fig. 7. 31 For a discussion of problems and biases involved in determining historical foci, see Ben Ari et al. (2012: 8200). 209 Since the beginning of the twentieth century,New there Science was an a certaind Old S ourunderces standing that at least some plague foci were situated in highlands. Writing in 1905, for instance, English epidemiologist W. J. Simpson suggested that plague originated in some highland areas such as in Assyr in the western Arabian peninsula and in the highlands of what is today southeast Turkey their high altitudes.” But the reason he offered was more a cultural con structand northern of highlanders’ Iraq: “[t]he customs endemic than areas a real [. .observation .] are chiefly about distinguished the disease for ecology of those areas that differentiated them from that of the lowlands. Simpson reasoned that plague occurred in those areas “for the poverty and inhabitants, and for the promiscuous manner in which the cat tle, fowls, and domestic animals are permitted to live in close association withfilth ofhuman the beings, the former often occupying the same room as the lat Chinese epidemiologist Wu Lien-Teh regarded highland locations as “endemic”ter” (Simpson foci. 1905: In reference 38, 117–18). to the KumaonAbout two and decades Garwhal later, areas the of renowned northern India, in the foothills of the Himalayas, for example, he wrote, “[t]his local ity Lookingis highly situatedexclusively and forsparsely human populated, cases of mostplague, of the these inhabitants epidemiolo [. . .] gistsare poor failed and to dwell see enzootic promiscuously plague within these their highland cattle” (Lien-Teh foci and 1924:the disease 292). ecologies that governed them. Hence, no clear explanation (free of cul Recent research from Madagascar has since shed light on the mechanisms thattural support bias) could this be process. offered In as this to why island’s focalization ecology, took plague place is insustained highlands. in (Xenopsylla cheo- pis and Synopsyllus fonquerniei the highlands (above 800 meters) where flea vectors understanding the focalization of) plagueare more and abundant the transmission (Vogler etof al.enzootic 2011; Andrianaivoarimanana et al. 2013). This research offers new insights for plague from the highlands to the lowlands (see also Green 2014 and Car plaguemichael reservoirs, 2014, both including in this issue). those Certainlocated typeson higher of landscapes altitudes, areacross found all incontinents places with favor “low a high annual number precipitation, of rodent or reservoirs where dry and seasons their fleas.inhibit Most the growth of thick woody vegetation and lead to the formation of deserts, linessemi-deserts of plague and foci steppes among (savannas, diverse eco prairies,-regions pampas across andthe reachso on)” of (WHO Otto 1999:man domains. 13-14). TheDrawing mountain from rangesthis, it ofis thepossible Anatolian to discern and Balkan the basic peninsu out las, as well as the neighboring highlands of the Caucasus and the Persian plateau, may be identified as areas with ecological factors suitable for the 210 focalizationNükhet Varlı ofk plague, once introduced. As we shall see below, several rodent species—currently known to be plague hosts—inhabited these highlands, making them likely ecological zones for plague maintenance. sparsely populated Ottoman highlands were connected to the densely pop ulatedWhat lowlands. remains One to bepossible identified link bridgingis how the these plague disease ecologies ecologies of wasthe the seasonal movement of pastoralist nomads of Anatolia and the Balkans between highland summer pastures and lowland winter encampments. The customs and economic activities of pastoralist nomads could have brought them in close contact with plague-hosting animals and their ecto parasites. An Ottoman document from 1571, reporting high plague mor tality among the nomads, may be taken as evidence that plague’s focaliza tion had already taken a strong hold in the empire’s highlands. Despite the general belief expressed in current scholarship, that nomads32 of Ana tolia and the Balkans remained mostly free from plague (e.g., Schamilo only their risk of contracting the disease but also of propagating it across glu 2004; McNeill 2012), recent research on North Africa highlights not A similar suggestion was made by the nineteenth-century French physi considerable distances (Bitam et al. 2010; Ben Néfissa and Moulin 2010). spread of plague in eastern Anatolia, western Persia, and Mesopotamia. cianThere J. D. Tholozan were myriad (1874) ways with in whichregard nomads to the movement interacted of with nomads settled and soci the eties in the Ottoman domain, directly or indirectly. For example, nomads were not only indispensable for supplying raw materials for the textile in the process of producing carpets, rugs, and various other textile prod ucts.and leather Similarly, industries they were (e.g., the wool, suppliers dyes, and of transportation hides), they were animals, also involved such as donkeys, horses, mules, oxen and buffaloes, and camels—a known plague in harvests in western Anatolia, as migrant workers, or could serve in var carrier (Faroqhi 1984: 49–50; de Planhol 1969). They would participate Nomads came into contact with town-dwellers most repeatedly in the outskirtsious military of Ottoman undertakings towns, ofwhere the Ottomanbusinesses state such (Kasaba as tanneries, 2009: soap 31–35). fac tories, and slaughterhouses were located, and low-income families and a great number of commensal rodents, exposed laborers to potentially infectedday laborers materials, resided and (Ayalon, thus functioned forthcoming). as possible These gatewaysbusinesses of attractedinfection leading to urban outbreaks. 33 32 Document from Mühimme Defteri, dated 14 March 1571, published in Yılmaz 33 It is generally held that some professionals in premodern cities were at higher and Yılmaz (2006, 2: 60). 211 Patterns of Plague Transmission New Science and Old Sources Recent research has demonstrated that a number of media and forms of mediation might be concurrently involved in plague transmission—espe cially during pandemics—along with the basic rodent host-vector-human transmission. For example, it has been shown that Y. pestis feces, in post-mortem hosts, in soil, and in plants (Gage and Kosoy 2005; survives in flea recognizedDrancourt, Houhamdi,that humans and may Ranoult become 2006; infected Eisen by etplague al. 2008; as a resultAyyadurai of con et sumptional. 2008; Easterday of infected et food, al. 2012; wounds Pawlowski (such as et those al. 2011). caused Also, by animal it has beenbites growing awareness of the need to complicate the patterns of plague trans mission,or scratches), with aor recent exposure plea to being airborne that “thebacteria. epidemiology With this ofin plaguemind, there must is be a seen in a much less diagrammatic manner than in the past” (Raoult et al. Similarly, historical scholarship on plague has very recently moved beyond2013: 19). an exclusive reliance on models of rodent-host-vector-to-human transmission. In particular, the recent turn in the humanities toward rec ognizing the role of animals and other nonhuman agents has stimulated novel avenues of inquiry in plague historiography (e.g., Catanach 2001; rable change can be observed in Ottomanist historiography, which has informedStathakopoulos recent 2011;studies Campbell of Ottoman 2010 environmental and 2011; Kelly history 2013). (White A compa 2011; plague outbreak in Egypt illustrates this trend well, by exploring plague’s Mikhail 2011, 2013a, 2013b). In particular, a recent case study of the 1791 isconnections imperative to to flooding, recognize rodent the role behavior, of human and agency other in climatic the spread conditions, of plague, so itas is to equally situate important it in its environmental to broaden our context vision (Mikhail to the larger 2008, environment. 2012). While it This is another problem for the historian: the ground-burrowing rodents of the early modern Ottoman landscape are barely visible in the sources. An interesting piece of anecdotal evidence comes from the six 34 risk of infection. Among these were butchers, bakers, millers, artisans of cloth and paper, by virtue of their handling meat, grains, and textiles, all instrumental media in 34 Further research is needed to clarify the taxonomy of rodents in the Ottoman the dissemination of plague. See Audoin-Rouzeau 2003: 233-8. arvicola arvalis dipus aegyptiuslandscape. A nineteenth-centuryarvicola amphibius Ottoman Turkish lexiconarclomys (Redhouse marmotta 1880) includes (themyodes following lemmus species: short-tailedmyodes field glareolusmouse ( ); jerboa ( ); water vole ( ); marmot ( ); lemming ); and bank vole ( ). 212 teenth Nükhet-c Varlıenturyk German traveler Hans Dernschwam, who left a detailed description of an animal he saw in northwest Anatolia: It is slightly larger than a mouse, smaller than a vole, with delicate and well-proportioned limbs. It looked like a hare. Its head, mouth, and ears were well-balanced; its back was rather long and elegant. It had a very long tail. The tail was like a lion’s tail with a little ball on its end. It held up its tail in the air. This way it looked like an African monkey. (Dernschwam This[1553–55]/1987: depiction brings 307–08) to mind the jerboa, which is known to be a plague Jerboas do not occur in this part of Anatolia today; only the Euphrates carrier.jerboa (Yet,Allactaga it is difficult euphratica to identify what type of jerboa it may have been. that inhabited Anatolia in the) cansixteenth be found century marginally but is innow southeastern extinct, it Turkey (Arslan et al. 2012). If this species were indeed a type of jerboa of this animal and the disappearance of plague. wouldThe be seventeenth interesting- toce nturyreflect Ottoman on the relationship traveler Evliya between Çelebi the extinction(c bank vole, the ground squirrel, the water vole, and probably the .Persian 1630– jird83/1996) (Meriones documented persicus the types of rodents he encountered, Writing such asin the 35 species of rodents occurring)—known in Aleppo to be at a the plague time, carrier. along with their names ineighteenth Arabic and century, Latin. NotAlexander seeing anyRussell reason (1794, to discuss 2: 180–82) commensal listed different rodents, Russell simply noted: “There is nothing remarkable in the Rat, and the Mouse. Most of the houses are infested with them.” As for wild rodents, he water rat, and the jerboa (which supports the above-mentioned observa mentioned the short-tailed field mouse, the dormouse, the hamster, the tions of Dernschwam). Furthermore, an English traveler in Anatolia testi fied to seeing marmot-like rodents in Ilgın (modern day Konya, in Turkey) duringThe plaina plague swarmed epidemic with ain species 1836: of burrowing animal about the size of a squirrel, which I had also seen in other parts of Asia Minor; but whether a species of marmotte, jerboa, lemming, or hamster, I could not ascertain. . . . Their colour is a light yellowish brown, and they abound in the southern provinces of Russia, where the variety or species is known by the name of “Rat des steppes.” (Hamilton 1842, 2: 189; cf. Panzac 1985: 123) 35 The Persian jird (meriones ) has been identified as a “real reservoir of plague” by Baltazar et al. (1952), who believed that they were able to keep plague “permanently enzootic.” See also Green 2014 and Carmichael 2014, both in this issue. 213 New Science and Old Sources (Neotoma albigula This rodent species may be identified as the white-throated woodrat species documented), by which early no modern longer sources occurs are in thiscurrently part ofknown the world to be plague(Wrobel carriers. 2006: 339). The What fact that is important most of tothose note species here is thathave several now become rodent extinct in Anatolia and the Balkans, where plague no longer occurs, invites further questions. Whether those rodent species became extinct due to plague or by other causes, it may be valuable to consider this connection. Along with rodents, a number of animals (e.g., cats, dogs, rabbits, cam els, and goats) can become infected by plague and transmit it to humans of(Fedorov plague may1960; have Ell noticed 1979 and this 1980;phenomenon. Christie, One Chen, such and testimony Elberg comes1980; fromSalkeld the and English Stapp physician 2006; Raoult Charles et al.MacLean, 2013). Somealbeit premodernto mock and observers discredit rupeds, the shaggy horse, or horse with long hair, is alone exempt from suchcontracting beliefs. the In 1815, infection in Istanbul, of plague. he Other claims animals, to have andheard birds that of “Of every all quad kind, point deserves some attention, because Maclean’s informants believed thatcan receive,a wide varietyand communicate of animals werethe infection” known to (Maclean contract the1817: infection 202). This and recognized their role as intermediaries in its transmission. At least one mitter of plague. This keen observation comes from the memoirs of H.other G. O. nineteenth-century Dwight, an American testimony missionary identified in Istanbul a dog who as alost putative his wife trans and noted that the dog of their neighbor—a family that had recently lost a childson to to plague plague—often during an came outbreak to their in house1837. Inyard one to of play his with letters, his Dwightyoung ingest son,the notoriously John, who later large contracted street dog thepopulation disease inand Ottoman died (Dwight cities, above1840: all23). in Such Istanbul. testimonies European are travelers rare, yet oftendeserve commented further attention on the street consider dogs of the Ottoman capital as a typical feature of the city until the modern era. Perhaps the best known of these accounts is that of the Italian writer that “the dogs constitute a second population of the city.” This does not necessarily mean that Edmondodogs were de the Amicis principal (1896: hosts 108–13), to plague,36 who but noted their presence may be taken 36 as a sign of the Ottoman incapacity to regulate a sanitary urban space. For a discussion of streetTheir dogs presence, of Istanbul however, and thecame efforts to be to seen eliminate (at the them turn as of a the “measure twentieth of progress,” century) see Brummett 1995. 214 intoNükh considerationet Varlık when thinking about the patterns of plague transmis sion in early modern Ottoman towns. In addition, the role of mammalian carnivores (feeding on rodents, sideration. It has been noted that carnivores can act as transitory hosts, transportingsuch as marmots, infected ground arthropods squirrels, between and voles) different may requirerodent populations.further con Recent research also suggests that mammalian carnivores exhibit some characteristics as plague hosts that can sustain the infection in enzootic vores would include wolves, foxes, jackals, and hyenas. Although these speciesform (Salkeld mostly andavoided Stapp crowded 2006). humanIn the Ottomansettlements, landscape, there are these references carni to foxes and jackals sighted in the outskirts of Ottoman towns by early the infamous tendency of hyenas to dig up and desecrate graves. Hyenas modern observers (Russell 1794, 2: 183–85). Perhaps more to the point is areas governed by the Ottoman empire, and may deserve closer attention inwere the surprisingly context of plague common studies. in parts One of sixteenth Eurasia (Meserve-century testimony 2012), including comes from the account of the Habsburg ambassador Ogier Ghiselin de Busbecq, who mentioned hyenas that dug up human bodies from graves in Anato heavy stones on top of graves to protect them from hyenas. Hyenas were alsolia. Busbecq observed (1554–62/2005: by the Russell brothers48–49) notes in Aleppo that locals and its of surroundingsthat area placed in the eighteenth century, where they were commonly known by the locals who sometimes caught them alive “in the hills at no great distance from still known to the late nineteenth-century town-dwellers on the north town” (Russell 1794, 2: 186–88). It appears that the threat of hyenas Another was example of a mammalian carnivore that fed on small rodents is37 the wea ern coast of Anatolia, as suggested by an official document. abundance of weasels—presumably the Egyptian weasel (Mustela sub- palmatasel. The fifteenth-century Spanish traveler Pero Tafur commented on the inter-species)—in interactions Damietta both of carnivores in the streets are importantand inside for the the house local (1926: trans mission68). Even of thoughplague, theespecially historical in linking evidence the isplague fragmentary, ecologies both of urban intra- areas and to their hinterlands. 37 west of Sinop, claimed that “a hyena monster was stealing children from houses.” See According“The Hyena to Monster this document, of Sinop dated and the 1872, Vagaries the population of Ottoman of Populationthe town Çatalzeytin, Accounts,” available online at New Science and Old Sources TheseEven are more predator significant birds is that the casefeed ofon animals rodents, that including can potentially large birds trans of port infected fleas over long distances and cause metastatic leaps of plague. aprey connection (such as between hawks, falcons, the behavior and owls) of migratory and migratory birds andbirds epidemics. (Benedictow For 2004: 47). Sixteenth-century Ottoman plague treatises loosely observed Jewish physician who came to Istanbul in the early sixteenth century, reportsexample, that the outbreaks plague treatise of disease composed were preceded by İ�lyas by bin environmental İ�brahim, an Iberian events cies(e.g., of earthquakes, burrowing astrologicalanimals and and insects meteorological was also regarded events) andas a thesign flight of a comingof certain plague. animals and birds (1894: 28). Increased visibility of certain spe The plague treatise of the sixteenth-century Ottoman theologian and biographer Ahmed Taşköprizade mentioned the arrival of migratory birds, especiallytory birds thatand ofthat the of white the plague stork, wasas a aprecursor keen observation to plague in(Taşköprizade the absence 1875; Ü� nver 1935: 70–71). This association between the arrival of migraCico- nia ciconia of the linking knowledge about the transfer of fleas. White storks ( garbage dumps) are predatoryand nest on birds roofs, that poles, feed andon small straw rodents stacks, (such making as voles,them aand prime possibly candidate rats) in for addition carrying to variousdiseases sorts (van of den insects. Bossche They etalso al. feed 2002; at gests that migratory birds can be a factor in disseminating plague-infected Hubálek 2004; Malkinson et al. 2001 and 2002). Recent research also sug of their migration seem to have coincided with those of plague. The migra toryfleas route(Heier followed et al. 2011). by theFurthermore, white stork in fromthe Ottoman Europe case, to Southeast the trajectories Africa crisscrossed the Ottoman lands from northwest to southeast, and largely corresponded to the main pilgrimage and caravan route in the eastern Mediterranean, before crossing over the Sinai peninsula to Egypt, Sudan, this migratory route passed right over Istanbul and across the Bosphorus. and further south into Africa (van den Bossche et al. 2002). Incidentally, storksHistorical near sources Edirne sometimes in the mid mention-sixteenth flocks century. of storks. This For correspondence example, Hans betweenDernschwam the trajectories([1553–55]/1987: of migratory 44) notes birds seeing and that flocks of ofpilgrimage thousands and of caravan routes seems to further complicate the pathways of plague’s dif to surmise that migratory birds can be associated with metastatic leaps of thefusion. infection Given betweenboth scientific remote and and anecdotal isolated evidence,enzootic fociit should and urban be possible areas. 216 ThisNükh etdoes Varlı notk suggest that they were the sole agents for transmitting the infection; rather this was one among many routes that helped circu late plague over land, sea, and air. This reminds us of the importance of expanding our vision to develop a “bird’s-eye view” of plague’s diffusion, in addition to envisioning its spread along trade routes or by other means that place human agency at the center. Conclusion Studying the Ottoman plague experience during the Second Pandemic offers three important insights. First, it underscores the critical impor tance of focalization. Such processes may be helpful in studying the plague experience of even those areas that are historically imagined to have received the infection from outside: for example, Europe. Second, it draws attention to the necessity of adopting more complex models of plague transmission, with a special emphasis on interspecies dynamics and the local species that serve as hosts, vectors, and as intermediaries. In order to better understand local plague ecologies, it may be invaluable to expand our vision to include a wider spectrum of rodent species and consider the role of domestic and commensal mammals, mammalian car nivores, predator and migratory birds in plague transmission. Third, it urges the elimination of old models of assumed/imagined epidemiologi constructs, such as those that have been inherited from nineteenth-cen caltury boundaries Eurocentric and notions trajectories and colonial that have plague been science. built Instead,on flawed it highlightshistorical studying larger disease zones, such as the Afro-Eurasian zone during the Secondthe importance Pandemic. of adopting The Ottoman more unifiedepidemiological epidemiological experience perspectives is not only for eminently comparable to those other contemporaneous experiences, but also indispensable for a full understanding of plague in this larger disease ecology. Finally, the new plague science, as valuable as it is, should be con sidered as a set of guidelines in studying the plague. Historical sources suggest that the disease could manifest itself in different forms and have different effects, depending on local circumstances. 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Stathakopoulos, Dionysios. 2011. “Invisible Protagonists: The Justinianic Plague from a Zoocentric (Aldershot: Point Ashgate) of View,” in Animals and Environment in Byzantium (7th–12th c.) dopoulou, , ed. Ē� lí�as Anagnōstákēs, Taxiarchēs G. Kollas, and Eutychia Papa Stearns, Justin87–95 K. 2009. (Athens: “New Directions Centre for in the Byzantine Study of Research, Religious NationalResponses Hellenic to the BlackResearch Death,” Foundation) History Compass Stearns, Justin K. 2011. Infectious Ideas: Contagion in Premodern Islamic and Christian Thought in the Western 7: 1363–75 Mediterranean (Baltimore: Johns Hopkins Stenseth, N. Chr., N. I. Samia, H. Viljugrein, K. Linné Kausrud, et al. 2006. “Plague DynamicsUniversity Press)are Driven by Climate Variation,” Proceedings of the National Academy of Sciences 103, no. 35: 13110–15 226 Nükhet Varlık Abhandlungen aus der Seuchengeschichte und Seuchenlehre Sticker,Sussman, Georg. George 1908. D. 2011. “Was the Black Death in India and China?,” Bulletin of the(Gießen: History Töpelmann) of Medicine Tafur, Pero. 1926. Travels and Adventures, 1435–1439, ed. Malcolm Letts (New 85: 319–55 Takeda, Junko Thérèse. 2011. Between Crown and Commerce: Marseille and the York:Early Harper)Modern Mediterranean Islamic Century: Agriculture and (Baltimore: the Role of Johns Slaves Hopkins in the Country’sUniversity Economy,” Press) Talbi,in The Mohamed. Islamic 1981.Middle “Laws East, and700–1900: Economy Studies in Ifr inī�qiya Economic (Tunisia) and in Social the Third His tory Risalah al-Shifa li-Adwa al-Waba’ , ed. Abraham Udovitch, 209–49 (Princeton: Darwin) Taşköprizade, Ahmed. 1875. Histoire de la peste bubonique en ([Cairo]: Perse; ou, al- Matba’ahDétermination al-Wahbiyah) de son origine, de sa marche, du cycle de ses apparitions et de Tholozan,la cause Joseph de sa prompte Désiré. 1874.extinction Tran, T.-N.-N., M. Signoli, L. Fozzati, G. Aboudharam, et al. 2011. “High Throughput, Multiplexed Pathogen Detection (Paris:Authenticates Masson) Plague Waves in Medieval Venice, Italy,” PLoS ONE Tedavi Kliniği ve Laboratuvarı Mecmuası 6, no. 3: e16735 Ü� nver, Süheyl. 1935.Sulla “’Türkiyede peste di Costantinopoli Veba (Taun) Tarihçesi del MDCCCIII; Ü� zerine, giornale” 5: 70–88 Valli, Eusebio. 1805. ([Mantova?]: Società tip. all’Apollo) The Ottoman World, ed. Christine Woodhead, Varlık, Nükhet. 2011. “Conquest, Urbanization, and Plague Networks in the Ottoman Empire, 1453–1600,”Plague in and Empire in the Early Modern Mediter 251–63ranean World:(New York: The OttomanRoutledge) Experience, 1347–1600 (Cambridge: Cambridge Varlık, Nükhet. Forthcoming. Vogler, A. J., F. Chan, D. W. Wagner, P. Roumagnac, et al. 2011. “Phylogeography and MolecularUniversity Press)Epidemiology of Yersinia pestis in Madagascar,” PLoS Neglected Tropical Diseases Continuities,” in Pestilential 5. no. 9: e1319 Complexities: Understanding Medieval Plague, Walløe, Lars. 2008. “Medieval and Modern Bubonic Plague: Some Clinical White,ed. Sam.Vivian 2010. Nutton, “Rethinking 59–73 (London: Disease inWellcome Ottoman Trust History,” Centre International for the History Journal of Medicineof Middle atEast University Studies College London) White, Sam. 2011. The Climate of Rebellion in the Early Modern Ottoman Empire 42: 549–67 Distribution,(Cambridge: CambridgeSurveillance University and Control” Press) WHO/CDS/CSR/EDC/99.2 WHO [World Health Organization]. 1999. “Plague Manual: Epidemiology, WHO [World Health Organization]. 2012. “Guidance on Regulations for the Transport of Infectious Substances 2013–2014 (Applicable as from 1 January 2013)” WHO/HSE/GCR/2012.12 227 Travels in Turkey, AsiaNe Minor,w Science Syria, an andd Ol dacross Sour cesthe Desert into Egypt during the Years 1799, 1800, and 1801, in Company with Wittman,the Turkish William. Army, 1804. and the British Military Mission. To Which Are Annexed, Observations on the Plague, and on the Diseases Prevalent in Turkey, and a Meteorological Journal Elsevier’s Dictionary of Mammals (Amsterdam: (Philadelphia: Humphreys) Wrobel, Murray (ed.).A 2006.History of Healthcare in Istanbul: Health Organizations, Epidemics,Elsevier) Infections and Disease Control, Preventive Health Institutions, Yıldırım,Hospitals, Nuran. Medical 2010. Education Osmanlılarda Sağlık, 2 vols. (Istanbul: Istanbul University) Ziegler,Yılmaz, Philip. Coşkun, 1969. and The Necdet Black Yılmaz, Death (eds). 2006. (Istanbul: Biofarma) (New York: Harper & Row) Nükhet Varlık at Rutgers University-Newark in New Jersey. She studies the early modern history of medicine, epidemic ([email protected]) diseases, and the rise of public is Assistant health in Professor the Mediterranean of History Plague and Empire in the Early Modern Mediterranean World: The Ottoman Experience, 1347–1600world. She is, is the forthcoming author of several from Cambridge articles and University her first Press.book, entitledShe is also editing a collection of articles entitled Plague and Contagion in the Islamic Mediterranean courses on epidemic diseases in world history, with a particular focus on plague. (contracted by Ashgate Press). In conjunction with this research, she teaches and climate history. She is the recipient of an NEH Fellowship for study at the AmericanIn her teaching, Research she Instituteincorporates in Turkey, research a Senior findings Fellowship from bioarcheology, from Koç University’s genetics, Research Center for Anatolian Civilizations, and a Turkish Cultural Foundation Post-Doctoral Fellowship. She holds a PhD from the University of Chicago. Abstract Reconstructing the Ottoman plague experience is vital to understand ing the larger Afro-Eurasian disease zone during the Second Pandemic. This essay deals with two different aspects of this experience. On the one hand, it discusses the historical and historiographical problems that rendered this epidemiologi cal experience mostly invisible to previous scholars of plague. On the other, it reconstructs the empire’s plague ecologies, with particular attention to plague’s persistence, focalization, and transmission. Further, it uses this epidemiological experience to offer new insights and complicate some commonly held assump tions about plague history and its relationship to plague science. Keywords Anatolia, Black Death, Mediterranean, pandemic, periodization, hyena, Ciconia ciconia. HETEROGENEOUS IMMUNOLOGICAL LANDSCAPES AND MEDIEVAL PLAGUE: AN INVITATION TO A NEW DIALOGUE BETWEEN HISTORIANS AND IMMUNOLOGISTS FABIAN CRESPO and MATTHEW B. LAWRENZ I have been asked by some of my friends to write something about the cause of this general pestilence, showing its natural cause, and why it affected so many countries, and why it affected some countries more than others, and why in some countries it affected some cities and towns more than others, and why in one town it affected one street, and even one house, more than another, and why it affected nobles and gentry less than other people. WhF en the rench astrologer and physician Geoffrey de Meaux (fl. principles1310–49) wrote of the these science words of around the stars 1349, to hethe was very trying particular to assess, task from of explaininga scientific why perspective, some people the survivedgreat challenge while others of applying around the them universal died in “notthe wake all those of the who Black adopted Death these(Horrox diverse 1994: opinions 165). His died, close nor contemporary, did they all the Florentine author Giovanni Boccaccio (1313–75) similarly wrote that complex selective process was at work during a plague outbreak. escape”In his (Boccaccio treatise on [1353]/1982:surgery, Guy de 9): Chauliac suggesting, (d. c as Geoffrey did, that a cal authority and physician to three successive popes, described the causes of mortality as twofold in his discussion of the. 1368), bubonic a leading plague: medi one active and universal, one passive and particular. Regarding the latter, Guy wrote: “The particular, passive case was the disposition of each body, such as cachocymia, debility, or obstruction, whence it was that the working can argue that Guy explained that cases of heterogeneous mortality were men and those living poorly died” (1363/1974: 774). In other words, we The authors would like to thank three anonymous reviewers whose comments helped all her help and constant feedback; her support made this project possible. Finally, weto improve would like this to article thank significantly.Ann Carmichael, We wouldGregory also Demas, like to Sharon thank DeWitte,Monica Green Michelle for Ziegler, and Carol Symes for their suggestions and valuable comments on earlier versions of this paper. 229–257 The Medieval Globe 1 (2014) pp. 230 Fabian Crespo and Matthew B. Lawrenz PlateThe image 2. Lancing above a showsBubo (Chapel a physician of Saint-Sébastien, (with a case for Lanslevillard) medical implements hanging at his abelt) bubo lancing under a his bubo arm, on readying the neck himselfof a woman for the afflicted same withlancet. plague. A small A young boy also man holds (probably up his arm,his assistant) perhaps indicatingsteadies the that patient; he, too, meanwhile, feels a bubo her developing. husband strips A smaller off his child tunic lies to in reveal bed, ill orThis asleep. is one Above of a the series scene, of extraordinarya devil brandishes murals a lancet that ofdecorate his own—one a chapel that dedicated will inflict to St.plague, Sebastian rather and than located treat it—but in the an remote angel deflectsAlpine village his aim. of Lanslevillard, in the Haute- Maurienne region (modern département of Savoie, France), where plague became byendemic those seekingin the later to be Middle cured Ages or spared (see Carmichael from plague. 2014, According in this toissue). legend, The Sebastian murals were had sufferedpainted between martyrdom the yearsat the 1446 hands and of 1518.the Roman St. Sebastian emperor (like Diocletian. St. Roch) Because was venerated he had died from the wounds of numerous arrows, his intercession was sought by those who wanted to ward off the sting of deadly pestilence. Caption: Carol Symes. Photo: Paul Smit. due to the previous biological conditions of infected individuals. More over, Guy’s description of his own infection offers clear evidence that not all exposed individuals died: “I was ill for six weeks, in such a great dan ger that all my friends believed I would die; but the aposteme ripened, and was treated as I have described, and by God’s will I survived.” A con 231 Heterogeneous Immunological Landscapes and Medieval Plague oftemporary his pains physician and fully healed”and poet after from different Almeria treatments (Spain), Abū (cited Ja‘far in AhmadAberth Ibn Khātima, also described several cases where the individual “was rid als responded differently to the plague. 2005:During 60). theAll of Black these Death, witnesses not everywere wellperson aware within that differenta family, individutown, or region was exposed to the plague pathogen. Moreover, if we accept that the major causative organism was Yersinia pestis, we must assume that exposure to the bacillus depended upon a complex interplay of factors: exposure to another human being who had expelled Y. pestis-ridden aero thesolites presence from their of pathogen-bearing lungs, or exposure tofleas the (orlancet possibly of a surgeon lice) and who rodents, had just Plate 2 These factors suggest that those exposed to the fourteenth-century plague probablylanced the did buboes not experience of another the patient same symptoms(a common and/or practice) disease (see progress.). In this essay, we accordingly focus our attention on those individuals who were exposed to the pathogen but had differing fates: survival or death. Paleo-epidemiologist Sharon DeWitte, with other colleagues, has carefully explored Black Death mortality using bone markers that indicate was not an indiscriminate killer. This research showed that people var ieddegrees in risk of mortalityphysiological during stress the andepidemic, health, and finding that thatthe medievalthe Black plague Death especially targeted individuals in poor health (DeWitte and Wood 2008; peopleDeWitte more 2010; at riskDeWitte than others?and Hughes-Morey We could argue, 2012; in keepingDeWitte with 2014, common in this epidemiologicalissue). Some individuals assumptions, survived that babies,and others elders, not. or But weak why adults were would some normally not survive, once infected. Usually, we suggest that “weak” indi ing plague epidemics because of poor nutrition, stress, and prior disease assaultsviduals (or or evenongoing populations) co-morbidities. would Howhave canhad wea higher link (biologically mortality rate speak dur when infected by plague? Clearly, we must explore with more nuance the ing) all these factors together with poor health and higher risk of death and that differentiated human responses to them. specificBut is factors today’s that science differentiated any better historical at answering epidemics such from questions one another, than the science of the medieval practitioners? We need to probe more deeply into the human immune system in order to discover how different bio logical, environmental, and social factors could have affected its function and impacted human health. For part of the answer to the conundrum of differential mortality could depend on which individuals (once infected) 232 wereFabian able Crespo to mount and M aantt appropriatehew B. Lawren immunez response. This is especially important because it is not a problem isolated in the past. When talking about plague, we are talking about a pathogen and its interaction with that has a common universal pattern which determines how the patho severalgen tries hosts to survive (not only and humans), spread,1 and abouthow the a pathogen-host host will contain interaction or stop that process. However, each exposed human host is immersed in a spe on her/his capacity to counter the plague pathogen. We must therefore attemptcific environment to reconstruct and social medieval context environments that could have and ademographics significant impact with the understanding that they changed constantly in time and space, as did host-pathogen interactions. In the last century, many historians and scientists have studied the problem of immunological responses to plague by focusing on “immunity” as an acquired and long-lasting response.2 dence is strong enough to show that exposure to plague does not generate a long-lasting immunological memory that The will historical protect theand exposed scientific indi evi viduals from future plague infections. It is time for a more comprehensive approach to the role of the immune system. In order to explain the differ ential mortality detected during medieval plague, we must consider the immunological status of individuals when exposed to the plague pathogen. to the plague pathogen, we propose that studying the individual immune system’sTo answer responsiveness, (or try to answer) or immune the questioncompetence of who died when exposed differential mortality during medieval plague. In this essay, IC represents the capacity of an individual to generate an appropriate (IC), can immune help to response explain involving innate and/or acquired mechanisms (we will explain these dif ferences below). However, IC is not only a biological concept. As noted above, humans are immersed in specific environments and social contexts 1 That is, all interactions taking place between a pathogen and its host (i.e., human, comprehensiveanimal, plant). analysisHost-pathogen of this concept. interactions can be described at the population, individual, or molecular levels. See Casadevall and Pirofski (2000) for a more 2 Contributions to the discussion of human immunity and plague include: Hirst Duncan 2001; Cohn 2002; Sallares 2007; Benedictow 2010. The acquired immune response1953; Pollitzer involves 1954; two Ziegler different 1969; processes:McNeill 1976; clonal Appleby selection 1980; Ellof B1984; lymphocytes Scott and (heightened production of those that have the “right recipe” to combat the pathogen immunological memory lymphocytes will retain and remember the “recipe” in case of a future encounter with antigens); and the development of (meaning that specific the same infection). 233 that can beHeterogeneous heterogeneous Immunological within the same Lan dpopulations,scapes and Mtowns,edieval and Pla evengue within the same families. During the fourteenth century, some individu als infected with plague survived without modern antibiotics and modern medical treatments: how and why? these questions. Some historians study nutrition, stress, and health in medievalWe must daily reconcile life; and historical scientists and should scientific take account information of these to answerhistori during plague epidemics due to a lower IC. Simply put, immunologists shouldcal findings be aware when of attempting the heterogeneous to understand environments who had higherand social risk contextsof dying of human populations across time and space, and how these factors can of the complexity of the immune system, and the fact that it does not only consistinfluence of theacquired IC of individuals. immunity but Historians, also changes for their constantly. part, should Neither be awarepopu Demographic variables such as age, sex, socio-economic status, and living lations nor individuals are fixed entities, either biologically or culturally. populations, and we must also consider environmental and ecological fac conditions can play a significant role in shaping the IC of individuals and epidemic is as misleading as assuming that all populations will develop thetors. same Assuming type ofthat immunity all populations or immunological had (and have) memory the sameafter ICexposure before anto a pathogenic insult. We can’t hypothesize a uniform IC for all individuals and human populations. Therefore, the goals of this essay are: to reformulate the immunological questions regarding differential mortality in those individuals and popu lations exposed to plague in order to consider the role of immunological framework in which historians and scientists can meet and collaborate on acompetence more comprehensive in determining approach their to fate; immunity and to and define plague. a new theoretical The Later Middle Ages as a “Great Transition” In the introduction to his recent lectures, “The Great Transition: Climate, Disease and Society in the Thirteenth and Fourteenth Centuries,” Bruce 3 the Old World, the late thirteenth and fourteenth centuries witnessed profoundCampbell and(a specialist sometimes in abruptmedieval changes economic in the history) trajectory observes: of established “Across 3 The Ellen McArthur Lectures in Economic and Social History at the University of Cambridge, 2013: andshould were reflect differentially the fact that more poor susceptible people who to were the disease in their thanthirties those and who for hadties duringbeen adults the plague during had the been famine young or were children born in after the theperiod famine 1315–1322 abated. 4 Jordan clearly invites scientists to join him in substantiating his hypoth esis. Why and how did some individuals present higher susceptibility? Did climate influence IC? What kinds of social and biological differences can logicalwe find immunology between populations are helping of high us to and connect low susceptibility? the dots and explain how Emerging scientific disciplines such as developmental biology and eco Middlehealth, Ages,nutrition, as should stress, consideration and climate of can the affectcomplex immunological transition that fitness. medi evalThese populations findings should faced and inform its subsequent our understanding impact on of their plague IC. during the The Human Immune Response and Yersinia pestis: Cytokines as Crucial Players and Markers for Immune Competence As we explained above, IC represents the capacity of an individual to generate an appropriate immune response involving all immunological defense against pathogens are simple physical barriers (skin and mucous barriers and mechanisms, innate and/or acquired. While the first line of membranes), a complex network of immunological responses deflects 4 Jordan arrived at these conclusions based on studies of nutritional biology during famines (e.g., Rivers 1988). 235 Heterogeneous Immunological Landscapes and Medieval Plague immune system reacts to infection via two mechanisms: the cellular responsepathogens, which if the is physical commonly barriers associated fail (Sompayrac with the innate 2008). immune In general, response the and destroy pathogens; and the humoral response, which is commonly associatedand involves with white the bloodacquired cells immune (called responsephagocytes), and that involves recognize, the secretion engulf, concert and effectively protect us from infection through a complex multi layeredof protective network molecules of cooperation (called antibodies). that blurs the These distinction two responses between work innate in tem lies in the comprehensive capacity of the system to recognize and respondand acquired quickly responses to different (Danilova pathogens. 2008). To The achieve power this, of the immune sys ity”: the capacity to change and adjust responses depending on intra- and extracellulartem depends conditionson fine tuning and/or and environmentala high degree of circumstances. “immunological Extensive plastic genetic and experimental data (of which we will present only a fraction in cessive manifestations, all individuals who are exposed to the pathogen willthis notessay) have demonstrate a similar immune that, when system facing responsiveness a pandemic orevent IC. and its suc Plague is a zoonotic infectious disease, caused by the bacterium Yer- sinia pestis.5 If we consider the classic ecological model of plague out breaks, Y. pestis is maintained in the wild, mostly in rodent populations, theand mammalian transmitted host, by flea Y. pestisvectors; utilizes humans a variety are incidental of mechanisms victims to of evade the dis or ease (Perry and Fetherston 1997; Gage and Kosoy 2005). To survive inside overcome the immune system (Li and Yang 2008). At the site of infection (e.g.,teria aare flea killed bite), by the neutrophils, cells of the innateY. pestis immune is able response to survive (neutrophils when ingested and bymacrophages) macrophages try and to controlcan be transportedthe infection. to Although other tissues, many especiallyinvading bac the lymph nodes. Eventually, Y. pestis escapes from these macrophages and begins to proliferate, ultimately entering into the blood stream to cause a Normally, when invading bacteria are recognized by cells of the innate immunesystemic system,infection these and cellsdeath produce of the host proteins (Amadei called et al.cytokines. 2011). 6 Cytokines 5 Yersinia pestis is a gram-negative facultative intracellular bacterium, mostly living into the extracellular environment. intracellularly (usually within macrophages), but after proliferation can be released 6 The term “cytokine” usually refers to hormone-like messengers which facilitate communication between cells of the immune system (Sompayrac 2008). 236 signalFabian to Crespo other an cellsd M thatatth anew infection B. Lawren isz in progress and recruit additional However, Y. pestis has developed mechanisms to inhibit or alter the pro immuneduction of cells these to cytokines,the site of essentiallyinfection to allowing help fight the the bacterium invading to bacteria. hide or evade recognition by the innate immune system. For example, proteins produced by the plague pathogen have been shown to inhibit the expres 7 pro sion of an important cytokine: tumor necrosis factor-alpha (TNFα), virulenceduced by hostfactor macrophages named LcrV alsowhere enhances TNFα is the a crucial release pro-inflammatory of interleukin-10 cytokine involved in the innate whereresponse IL- 10(Boland is being and exploited Cornelis to1998). down A- 8 (IL-10) by host immune cells, 9 regulate or decrease the production of pro-inflammatory cytokines such tionas TNFα of Y. andpestis interferon-gamma in a mouse model, (IFNγ) showing (Brubaker that both 2003). cytokines Interestingly, were cru cialtreatment for the with absolute exogenous or longer IFNγ survival and TNFα of infected have inhibited hosts (Lukaszewski the multiplica et In recent years, additional research has further suggested that the indi al. 2005; Nakajima and Brubaker 1993). response to plague infection is an important co-determinant in the ability vidual capacity of the host to produce the cytokines TNFα and IFNγ in10 Most human populations differ in the type and intensity of their immuno oflogical the individual responses, to which mount can an effectivebe observed immune by differences response (Linin the et expressional. 2011). of different immune proteins, such as cytokines.11 Cytokines profoundly 7 necrosis of tumors in vivo TNFα was originally identified and named after a molecule that caused the gram-negative bacteria suchwithin as Y. pestis specific experimental conditions. Today, TNFα is considered the principal mediator involved in most acute inflammatory responses to 8 The term “interleukin” refers to the chemical way that different leukocytes communicate with each other. It is now(Abbas recognized and Lichtman that many 2005). interleukins can also activatedcommunicate immune with cells,other controlling non-immune most cells. innate Different immune interleukins reactions have and been cell- mediatedclassified using numbers. IL-10 is one of the main inhibitors (within the immune system) of 9 immunity (Abbas and Lichtman 2005). microbes. The term interferon derives from the ability of these molecules to interfere withIFNγ the isinfection. a crucial cytokine that mediates cell immunity against intracellular 10 Y. pestis. Therefore, we can consider that having an appropriate production of TNFα and 11 We will expand on this below in the section entitled “Lessons from Immuno IFNγgenetics is a Studies.”significant immunological component of the host IC when fighting 237 Heterogeneous Immunological Landscapes and Medieval Plague and regulate the immune response, and ultimately affect the states of influence growth, differentiation, and activation functions that determine are produced during an immune response determine the effector mecha nismshealth thatand diseasewill predominate. (Borish and The Steinke development 2003). The of types appropriate of cytokines cytokine that networks to combat infections depends on the nature of the pathogen, the genetic background of the individual (Wilson, Seymour, and Henderson 1998),At the as endwell of as the developmental last century, thefactors study during of cytokine growth genetic and environmen variants or tal factors (Nelson et al. 2002). 12 captured the atten tion of many researchers trying to explain differences in the success of single nucleotide polymorphisms (hereafter SNPs) human tissue transplants (Hutchinson et al. 1998a; Hutchinson et al. 1998b; Sankaran et al. 1999). Preliminary results showed that ethnicity influences cytokine genetic variation at the level of single nucleotide poly icantmorphisms cytokine (SNPs) SNP variation(Hoffman was et al. observed 2002; Meenagh in tribes et and/or al. 2002; ethnic Delaney groups et withinal. 2004; the Raj, same Govindaraju, region, suggesting and Chakraborty that moderate 2007). In differentiation some regions, among signif disease-causing factors could occur even among evolutionarily and geo graphically related ethnic populations (Gadelha et al. 2005; Raj, Govinda and this must beraju, understood and Chakraborty as a crucial 2007). factor The cytokine for IC. For genetic example, make-up a study13 thus conducted has a sig bynificant Linda impact Larcombe on the and immune colleagues response found that that is some mounted, Canadian aboriginal populations present a high frequency of cytokine SNPs commonly asso ciated with the low expression of cytokines that promote inflammation an(Larcombe environment et al. in2005). which The helminthic, authors postulated parasitic, and that fungal the evolution infections of prethat dominated.unique cytokine Therefore, genetic depending profile may on be the linked regional to aboriginal interaction adaptation of host and to lations. We can assume that, during the Middle Ages, not all populations werepathogens, exposed we to find the different same pathogenic immunological experience, profiles and among the consequence human popu of that is the emergence of different immunological backgrounds in different regions and populations. 12 Most genetic variants are associated with “point” or single mutations that affect 13 The cytokine genetic make-up is the observed differential cytokine SNPs distributionthe genetic code in human (“recipe”) populations. for the corresponding cytokine. 238 FabYetian we Crespo must an recognized Matth ethatw B .because Lawren plaguez has such an inherently com would have gone into determining whether a given individual was even exposedplex ecology, to the it isdisease. exceedingly Despite difficult all that to reconstructwe know today all of about the factors the trans that mission of Y. pestis between arthropod vectors and mammalian hosts, we cannot necessarily explain, as Geoffrey de Meaux put it, “why in one town it affected one street, and even one house, more than another.” Beyond those basic epidemiological variables of exposure to the pathogen, how ever, there are also questions arising from the differing immune responses Not all populations, or even individuals, are able to generate the same immuneamong those responses who did when have encountering the bad luck an to infectionbe bitten (Nelson by an infected et al. 2002; flea. McDade 2005; French, Moore, and Demas 2009; Martin, Hawley, and Ardia ferent individual capacities to generate an appropriate immune response against2011). Therefore, pathogens it can is possible help us that,to understand assuming equalthe differential risk of infection, mortality dif within and between populations during plague outbreaks. Historical Perspectives on Human Immunity and Medieval Plague: The First Dialogue between Historians and Immunologists Many historians and scientists of the plague have recognized that the study of the immune system and its corresponding mechanisms could be an important factor in understanding the differential mortality exhibited by medieval plague outbreaks. However, such studies have not focused on IC. As noted above, these early studies were focused on acquired immunity clear statement due to here: previous most exposure historians to usethe theplague term pathogen “immunity” (Hirst to 1953;mean acquiredPollitzer 1954;immune Ziegler response 1969; McNeill 1976). Indeed, we must make a innate or cellular response nological barrier, especially when (explained mounting above) an effective without and considering fast response the to the plague pathogen. To take(also an explained example: above) Andrew that Appleby, is a crucial a historian immu specializing in agrarian history and demography, suggested a hypotheti cal scenario in which “those people with little natural resistance died when they caught plague, while those with greater resistance lived, and for those populations that were not previously exposed to plague, what doespassed it onmean their to naturalhave a “natural”resistance or to “greater” their children” resistance? (Appleby It is 1980).important But to highlight again that, from an immunological perspective, the term “resistance” does not solely imply the physiological capacity to recognize 239 Heterogeneous Immunological Landscapes and Medieval Plague ate immune response that usually leads to a short- or long-term memory a pathogenic antigen (a non-self molecule) and to mount an appropri an important component of the individual IC and must also be taken into consideration(i.e., acquired immunewhen conducting response). historical The innate research or cellular on past response plagues. is also Until very recently, this type of scholarship was stymied because argu ments over human immunity and medieval plague also revolved around a different kind of debate: what disease was plague? This question has since been resolved, yet it is worth revisiting how historians’ understanding of “acquired immunity” has impacted that debate to date. In fact, one power ful argument against Y. pestis as the pathogen that caused the Black Death has been based on the human lack of a capacity to develop immunological memory once exposed to the plague pathogen (again, “immunity” in this case has been understood solely as acquired uel Cohn has insisted that medieval plague cannot be compared with mod immunity). Most notably, Sam ern bubonic plague, citing early bacteriological studies (e.g., Burgess 1930) bilitywhich of pointed differential out that immunity humans when (unlike comparing rats) cannot the medieval develop “Second immunity Pan to demic”plague (Cohnwith the 2002: “Third 33). Pandemic” Moreover, that he beganhas been in the skeptical late nineteenth about the century: possi Why would human populations that once possessed natural immunity to a bacillus with the ability to adapt to it with remarkable speed in the fourteenth to eighteenth centuries have then lost all traces of that ability Butby if theour end approach of the nineteenth to IC is correct, century? we (Cohnmust expect2002: 249) that not all individuals within and between populations will be able to develop the same type of in the same population at a later time. immunologicalWhen the medieval memory, historian thus enabling and demographer the same disease Ole Benedictow to flourish triedeven to answer and critique Cohn’s arguments in an extensive monograph, he referred to acquired immunity and pointed out that epidemic diseases which do not produce good persistent immunity in survivors will have much larger powers of spread, recurrence and mor tality than diseases conferring persistent immunity. Consequently, other factors being equal, they will also tend to produce much higher mortality rates over time, since the whole population will be at risk every time they Stephenrecur. (BenedictowEll, a medievalist 2010: and207) specialist on plagues, may have been one of the first historians to employ a more nuanced concept of immunity as a 240 Fabian Crespo and Matthew B. Lawrenz He suggested that “Human immunity to plague probably helps to account14 for much of the agefactor and in sexthe distributionepidemiology and of geographicalmedieval plague variation (Ell 1984). of plague.” While Ell focused his attention on the human host’s capacity to develop immunolog he argued against the idea of “uniform immunity or resistance,” meaning thatical memorynot all populations (acquired immunity) were able afterto develop exposure the sameto the typeplague of immunity.pathogen, Scientist Robert Sallares followed this line of thought when he wrote that “the fact that different plague epidemics were caused by essentially the same organism at the DNA level does not necessarily mean that the epide is worth remembering that, in the mid-twentieth century, microbiologist miologyG. B. Mackaness of plague clearly must pointed always outbe the that same” the process (Sallares involved 2007: in256). the Anddevel it opment of acquired immunity also depends on the “state of immunologi As we have now established, instead of focusing on one aspect of the immunecal reactivity” response—either of the host (Mackaness as a genetic 1964), legacy or or what as an we acquired now refer long to -aslast IC. ing response—historians and scientists can adopt a more comprehensive and collaborative approach, analyzing and estimating the IC of medieval be used to help us understand and respond to future outbreaks. The chal lengepopulations that remains and their is how susceptibility to study variation to plague. in TheseIC within findings, and between in turn, hiscan torical populations, and to determine how we can apply modern immuno logical models while carefully considering that populations do not repre sent fixed entities. Lessons from Immunogenetic Studies: Can We See the Whole Picture without Looking at Historical Contexts? We have already established that the most common immunological rea soning employed by historians and scientists to explain the differences in mortality during plague epidemics is a diverse history of exposure to different regions. In response, we have argued that differences in IC could helpplague to (resultingexplain differential or not in acquiredplague mortality. immunity) This between means populations that we must in search for evidence that human populations present different immuno genes that code for cytokines and other immune proteins. As we explained logical profiles, and the first evidence will come from genetic analyses of 14 Stephen Ell received a Master’s degree and PhD in medieval history from the University of Chicago, and later he received a medical degree from Loyola University. 241 Heterogeneous Immunological Landscapes and Medieval Plague Map 5. Distribution of Genetic Variants for IFN γ (+874). Based on Contemporaneous Populations (www.allelefrequencies.net). above, heritable cytokine SNPs are common in human populations, and some SNPs can alter how much of that cytokine will be produced (either at Y. pestis during infection (Brubaker a basal level or in response to infection). Since the levels of cytokines, such ascould IFNγ, be arean importanttargeted and contributing reduced by factor in mounting an effective innate immune2003), differences response againstin the basal the plaguelevel of pathogen cytokine production(again, without by individuals necessar 15 To demonstrate cytokine genetic variation in human populations we used a worldwide database ilyof modernimplying populations acquired immune responses). tion for England and Italy.16 The goal here is not to attempt an historical to calculate the genetic variants in IFNγ distribu 15 While these studies were conducted on animal models (mouse and rat) we could 16 Allelefrequencies.net is an internet database maintained by a consortium com potentiallyposed of the extrapolate Royal Liverpool these andfindings Broadgreen to generate University novel hypotheses Hospitals and on humans.the University of Liverpool in the United Kingdom. Most samples come from regional hospital and clinical studies all around the globe. While these samples do not represent past demographic scenarios and can show high admixture levels, they can be used to show regional trends for immunological profiles. One of these variants has a specific 242 reconstructionFabian Crespo an usingd Ma ttmodernhew B . populationsLawrenz but to highlight the heteroge neity of any population (Map 5 For example, combined modern populations in northern Italy show a ). higher frequency of individuals with low IFNγ systemic expression (possi catingbly associated that we withshould a weaker not underestimate innate inflammatory regional response). immunological Meanwhile, varia tion.modern Another populations cytokine, in Englandsuch as showIL-10, regional presents differences genetic variability in IFNγ, indithat can impact the amount of cytokine an individual can express (Turner et 17 IL-10 is also exploited by the plague pathogen to inhibit the foral. 1997).IL-10 also shows high variability within the same region and among theimmune neighboring response cities (Brubaker of Milan, 2003). Torino, Interestingly, and Pavia (Map the 6genetic variation This analysis demonstrates that not all modern populations have the ). erating an appropriate immune response to Y. pestis. Since this data high samelights baselineregional productiondifferences, of we IFNγ, must and consider IL-10, two historical cytokines and crucial demographic to gen contexts to make sense of this regional diversity. Moreover, we cannot extrapolate from this data to make assumptions about past populations in the same regions. Therefore, this is a perfect example of one of our key points: historians must step in and help scientists put all these biological differences into context. But let us now pose a new question: how do we translate these immu nogenetic maps into epidemiological scenarios for a historical plague epidemic? The most simplistic approach is to consider that a population combining a high frequency of individuals who are high producers of IL-10 (an anti-inflammatory cytokine that usually tries to counterbalance an excessive inflammatory response) with a high frequency of individu als who are low producers of IFNγ and/or TNFα (both pro-inflammatory spreadcytokines) of the could pathogen face a inweak their innate bodies (cellular) and the communityresponse at at the large. site of the infection (e.g., the site of a flea bite), thus facilitating the replication and “address” in the IFNγ gene: +874. In that specific position (+874), human populations can differ in one chemical component: nitrogen base T (thymine) or nitrogen base A (adenine). Because each human has two copies for each nitrogen base (what in biology is called “diploidy”) an individual can be coded AA, TT, or TA. If a human possesses AA, the baseline production of IFNγ is low; if a human has TT, then baseline production of IFNγ is high; finally, TA represents an intermediate production of IFNγ 17 (Pravica et al. 2000). In this case, the specific genetic “address” for the SNP in this cytokine is -1082. 243 Heterogeneous Immunological Landscapes and Medieval Plague Map 6. Distribution of Genetic Variants for IL-10 (-1082) Based on Contemporaneous PopulationsAs we’ve (www.allelefrequencies.net). made clear, these maps represent modern genetic data, and we cannot argue that a similar genetic distribution pertained during the Middle Ages. The challenge that remains is to study the cytokine SNPs in medieval populations in conjunction with the distribution and impact of plague in those populations. But the challenge could be met if techniques CCR5, have been analyzed in this way, using data from medieval popula tions.of ancient 18CCR5 DNA belongs (aDNA) to a analysis group of are immune applied. proteins Similar similar molecules, to cytokines. such as Called “chemokines,” most act to induce “chemotaxis” or chemical-induced cell movement. (Basically, immune cells that release chemokines will call for “help” to other immune cells, which will migrate to the site of infec past ten years is both interesting and controversial, but it does establish thetion). technological The research foundation conducted for on studying CCR5Δ32 and and expanding plague resistance the genetic over anal the ysis of other immune genes, such as those producing cytokines. 18 CC stands for “Chemo-Kine,” and R stands for “Receptor.” 244 Fabian Crespo and Matthew B. Lawrenz CCR5 has a SNP named Δ32 that is commonly associated with human peanimmunodeficiency populations can’t virus be (HIV) explained resistance. by HIV’s Initially, recent some arrival researchers and selective sug process.gested that It was the furtherhigh frequency suggested of thatCCR5Δ32 past epidemics detected in of modernplague (espeEuro mentcially wasthe Blackcontested, Death) due generated to ambiguous the selective results andprocess the uncertainty that can explain as to the high frequency of CCR5Δ32 (Stephens et al. 1998). But this argu applywhether aDNA CCR5Δ32 technologies really offers to the some problem type ofand resistance to estimate to plague the frequency (Mecsas et al. 2004; Elvin et al. 2004). It did not take too long for researchers to of CCR5Δ32 in the past (Hummel et al. 2005; Kremeyer, Hummel, and Herrmann 2005). Preliminary results have (so far) rejected the idea that Asthe historian increased Samuel frequency Cohn of and CCR5Δ32 scientist in L. European T. Weaver populations have put it: was“The due excit to ingplague, correlations but ongoing discovered studies have by geneticists revived the and debate epidemiologists (Biloglav et al.between 2009). present-day genotypes in human populations, and varying levels of resis tance to diseases, now demand a new cooperation between scientists and Recently, a more complex immunogenetic reconstruction was pub lishedhistorians” using (Cohn modern and populations Weaver 2006). but inferring a selective process gener exploited what they called “a special historic demographic situation in Europe”ated by medieval represented plague by two(Laayouni populations et al. 2014).with different In this study, genetic the ancestry: authors European Romanians and the Rroma people (commonly known as “Gyp bly shared the same geographic region for the past thousand years, have thereforesies”). The experienced authors argue similar that environmentalthese two populations, conditions, who including have ostensi infec tious diseases. The Rroma people migrated into Europe before the last mil lennium from northern India, but they intermarried little with European Romanians. Even after one thousand years, there is still a clearly detect able genetic similarity between the Rroma people and people from north ern India. However, not all genes of these two groups showed that corre 19 spondence.These immune Toll-like genes receptor play a crucial (TLR) rolegenes in arerecognizing among those and launchinggenes which an differed significantly between the Rroma and present-day north Indians. 19 TLRs are proteins localized on the cell membrane of immune cells which recognize (directly or indirectly) molecules that are characteristic of broad classes of invaders (Sompayrac 2008). 245 Heterogeneous Immunological Landscapes and Medieval Plague gens, such as Y. pestis. Conversely, and surprisingly, the authors found immunestrong genetic response, similarity especially in TLRs in fighting between back the a broadRroma spectrum people and of patho Euro pean Romanians, despite their distinctiveness. Laayouni and colleagues ties between the Rroma and the European Romanians, on the grounds thatidentified both populations plague as the were selective exposed factor to the that Second shaped Plague the genetic Pandemic. similari20 Crucial to this analysis is the assumption that the Second Plague Pan demic did not impact northern India. That assumption may now be open into whichquestion there (see is Green cross -2014,fertilization in this ofissue). biological But even data though and historical some of evithis study’s findings are controversial, we must welcome this kind of research, dence. This kind of study can help us to identify specific selective agents (such as plague) when understanding the reshaping of immunological pro dynamics,files in human or past populations. environments, Precisely all immunogenetic because today’s reconstructions demographic andwill onlyenvironmental make sense data within does the not environmental reflect past populationand historical structures contexts and/or recon structed by historians, paleodemographers, and bioarcheologists. Accord ingly, to test the hypothesis proposed in this essay, we must understand the complex dynamics of medieval populations and how environmental and social factors affected the IC in those populations. While we can argue that different factors at different times can have different impacts on the inregional human variation populations. of IC,21 we must consider that climatic fluctuations and famines could have played a significant role in constantly reshaping the IC Differential Immune Competence: The Potential Role of Climate and Famines The role of seasonality has been the most frequently cited factor when cor Ziegler 1969; McNeill 1976; Slack 1990; Scott and Duncan 2001; Cohn relating climate with the incidence of plague (Hirst 1953; Pollitzer 1954; 2002 and 2008; Benedictow 2004; Campbell 2013). However, it is not 20 The authors of this study acknowledge that other infectious diseases (such as these infections were as common in India as in Europe. tuberculosis and leprosy) were common in the region at that time; but they argue that 21 We must understand that climatic fluctuations (for example, environmental temperature) could represent seasonal variation within the same year, as well as long-lasting climatic shifts with longer and probably more significant stress on the IC. 246 Fabian Crespo and Matthew B. Lawrenz Modified from Cohn 2002: 184–85. Graph 5. The Plague in London (1349–1361–1375): Data Based on Wills and Testaments. fully clear that all plague outbreaks followed a seasonal pattern. Basing his assessments on the study of medieval testaments, Cohn asserted that plague in Mediterranean Europe was a “summer event” peaking either by Cohn, we found a different seasonal pattern throughout the northern in June or July (Cohn 2002: 28). But when we inspected the data used London (Graph 5 hemisphere,Seasonal variationexemplified in infectionby data from and threedisease successive prevalence waves may of represent plague in ). decade, growing evidence based on animal models suggests that sea fluctuationssonal variation in either is most the often host, duethe pathogen,to changes or primarily the vector. in But the in host, the lastnot cal study of IC. For example, the circulating immune cells helper T-lym phocytesthe pathogen and (NelsonB-lymphocytes et al. 2002). (important This is veryfor antibody significant-media for theted histori immu nity) are usually elevated in winter, but cell-mediated immunity (which involves key players in immune response to plague, such as phagocytes) variationis higher inwas the detected summer in (Nelson neutrophils et al. 2002).(phagocytes A recent that study play conducteda key role in Poland, using healthy male subjects, found that a significant seasonal tericidal activity of these immune cells observable in summer (Klink in killing plague pathogen at the site of infection), with the highest bac 247 Heterogeneous22 Such discrepancies Immunological of immune Land cellscapes function and M amongedieval modern Plague et al. 2012). “energy”human populations implies the reflect energy differences that an organism in environmental is able to expendand physiologi for con cal factors, such as energy balance (Nelson et al. 2002). In this context, all necessary immune responses. ducting all physiological activities at a specific time, including mounting the energetic balance of an organism. Famines or catastrophic subsistence haveNutrition clearly impacteddeficiency the is energyamong balancethe most of important individuals factors and populations that affect throughout history, and have consequently impacted the energetic sup ply of the immune system. Most medieval chroniclers and other witnesses, as well as modern historians, have suggested that human fragility due to famines preceding or coincident with plague outbreaks have accounted tions, plague followed good harvests, likely because the increase in grain for the peak in mortality (Herlihy 1997: 32). However, in some popula rule out the link between famines and plague outbreaks in some European regions,production we boostedalso need the to ratconsider populations the long (Cohn-term 2002: impact 31). of faminesWhile we and cannot mal nutrition on the immune system, and their contribution to mortality rates. The age at which individuals experience famines may also contrib ute to IC: this is demonstrable even before birth. The fetus is not a pas sive organism, and environmental factors during pregnancy will have a scenarios encountered by the growing fetus generate immediate adaptive responsesstrong influence that may on thepromote biological survival profile but ofmay the also individual. leave the Threatening individual with a potentially disadvantageous phenotype that s/he must “cope with” for life. Simply put, the fetus will receive environmental signals (through the mother) thatAs noted can “reprogram” above, historian different William biological Chester components Jordan cited (such sci as the immune23 system) during development (Gluckman, Beedle, and Han son 2009). 22entific This evidence study included (Rivers 155 1988) healthy when male he pointedsubjects outwho that had “there been donorsare long- of neutrophils. It has been conducted by the Institute of Medical Biology at the Polish 23 The discipline of developmental biology is also calling for our attention when Academy of Science (Lodowa, Poland) since the year 2000. biological development. As an example, a fetus whose mother faces famine (as well we attempt to understand how (and when) environmental factors can impact our signals compared to a fetus that receives an appropriate food supply and/or is not exposedas other biologicalto infections stressors, during such pregnancy. as infections) (Interestingly, will receive if a differentfetus will environmental receive more food than necessary, that can also affect the future of the individual.) 248 termFabian effects Crespo in an childrend Matth whoew B survive. Lawren famines,z long term effects that are considerably more severe than those on adults who survive starvation ing development of the immune system can have long-term effects on how therations” immune (Jordan system 1996: will 186). respond The toshort-term maintain impactthe body’s of malnutrition homeostasis dur and especiallyJordan’s how insights it will have fight been infections further (Suskind, supported Lachney, by more and recent Udall 1994;work. Paleo Chandra-epidemiologist 1996; Roseboom Sharon et al. DeWitte 2001). and historian Philip Slavin pub lished an interdisciplinary study on patterns of health in the pre-Black Death population of London by examining the effects of the Great Fam thoseine (1315–17) who ultimately and the died Great during Bovine the PestilenceBlack Death, (1319–20) and they included(DeWitte indi and Slavin 2013). They focused on health or heterogeneity inin health utero among might have been negatively impacted by the famine. Preliminary analysis viduals born around the year 1319 because their24 growth revealed no significant differences in skeletal markers among the pre- famine, famine, and post-famine generations of Black Death victims, 491 smallof whom sample were size, buried they in also a cemetery concluded at East that Smithfield. While DeWitte and Slavin argued that the lack of significant results could be an artifact of the the Great Famine could have reduced the proportion of the frailest indi lowed soon after and resulted in a catastrophic and long-term dearth vidualsof dairy between products 1315 and andfertilizer 1317. for The crops, Great did Bovine not Pestilence,produce high which human fol mortality, whether selective or indiscriminate, but it could have created a generation of relatively weak people who were less resilient than those Herewho is survivedan important the famine. argument (DeWitte that and speaks Slavin to 2013: the central57) hypothesis of our essay: “weak people who were less resilient” can have a compromised IC, while a weak or compromised immune response could result from infection or disease later in life. 24 In this study, adult ages were calculated using a skeletal age-estimation pro skeletal-age markers such as the pubic symphysis, iliac auricular surface, and cranial suturecedure closure.called “transition For individuals analysis.” younger This analysis than twenty was applied years, (forthe adults)age was on estimated different using epiphyseal fusion, dental development, and eruption. 249 Plague WasHeterogeneous Not the OnlyImmunological Infectious Lan Disease:dscapes an d Medieval Plague Co-Infections and Immune Competence pathogen, and such a “co-infective state” will condition the IC and immune responsesMost (if not to all) individual mammals pathogens. are usually We co-infectedcannot assume with that more pathogenic than one loads within and between human populations are always similar over time and space. As Ann Carmichael, a specialist in historical epidemiology, has put it, “All pre-industrial epidemics, including plagues, had multiple infectious diseases exacerbating morbidity and mortality” (Carmichael important role in determining pathogen distribution and the immuno logical2008: 51).responses Furthermore, of human a populations. number of ecologicalA study on factorshuman pathogenslikely play has an suggested that macroscale distribution patterns of human diseases and human populations exposed to a higher diversity of pathogens display higher genetic diversity for some immune proteins (Guegan, Prugnolle, 25 where higher genetic anddiversity Thomas is detected 2008). This in areas is the with case higher for the pathogen major histocompatibility abundance and diver com plex (MHC) or human leukocyte antigen (HLA), While not all infectious diseases occur at once in any region, or affect thesity same(Guegan, populations, Prugnolle, we and can Thomas speculate 2008; that Parham co-infections 2005). happened fre modulatory perspective,26 isquently due to duringhelminths. the HelminthsMiddle Ages are (as parasitic they do worms today). that From cause an a wide immune- vari perhaps the most significant chronic infection etyinfections of infectious cause diseases an overall and down may- beregulation classified or into hypo nematodes-responsiveness or round of worms,the immune trematodes system, or consequently flatworms, andaffecting cestodes the immuneor tapeworms. reaction Helminth to con comitant infections that occur with high frequencies in helminth-endemic areas, such as malaria and tuberculosis (Van Riet, Hartgers, and Yazdan and cannot be analyzed apart from their corresponding environmental bakhsh 2007). Such chronic co-infective scenarios can be very complex 25 consequentlyThe MHC triggeringproteins (or the HLA immune when reaction specifically or response. applied Simply to humans) put, more are thediversity ones ofthat pathogens “present” implies the non-self more antigen antigen diversity (pathogen that must proteins) be recognized to other by immune more diverse cells, MHC proteins. 26 That is, considering factors that can “modulate” or alter the systemic immune response, creating a quasi-permanent shift in the immunological response and affecting the IC with respect to other pathogens. 250 andFabian social Crespo contexts. and M Foratt hexample,ew B. La wnutritionistsrenz have recognized that para sitic infections can have an impact on the nutritional status of the host, but it was also recognized that malnutrition could be a predisposing fac When paleo-parasitologists Evilena Anastasiou and Piers Mitchell analyzedtor for parasitic the twelfth infections-century (Kolski latrine and of Scott a crusader 2001). castle on Cyprus, they found eggs of two species of parasitic intestinal helminths. They con cluded that “The discovery of these parasites highlights how mediaeval crusaders may have been at risk of malnutrition at times of siege and famine as these worms competed with them for nutrients” (Anastasiou infections may also affect the IC against Y. pestis, exacerbating the produc and Mitchell 2013: 218). Shifting the immune response, chronic helminth scenario could have played a role in the differential mortality detected duringtion of anti-inflammatorymedieval plague. Itcytokines remains such to be as determinedIL-10. This anti-inflammatory whether popula tions that had a higher burden of helminthic infection were the ones with higher mortality during plague epidemics. However, not only parasitic medieval populations and its potential impact on differential mortality. It(macroparasite) has also been suggestedinfections shouldthat leprosy be considered could, in whenmany studyinginstances, the gener IC of ate a “hyper-immune state” (overreactive immune system with increased vidual IC and the corresponding response to the plague pathogen. levels of pro-inflammatory proteins) (Ell 1987) and thus impact the indi A Historical-Ecological-Immunological Model for Studying Plague The immune system is characterized by a high degree of plasticity and icalmarked immunology fluctuations can thereforecan occur help as aus reaction to understand to environmental how ecological factors and social(French, factors Moore, affect and and Demas reshape 2009). our An immune emerging system. discipline While such most as prelimi ecolog nary studies produced by this young discipline deal with non-human ani mals, the last decade has seen a growing number dealing with the transla tionHowever, of such findingsimmunological to human studies ecology in laboratory and immunology settings (McDadedo not account 2003, for2005; social McDade and ecologicalet al. 2010; factors Trotter that et al. operate 2013). within and between popu lations. This is problematic, because populations are not static entities fixed in space and time, either biologically and culturally. If malnutrition, climatic fluctuations, and co-infections can have a significant impact on the IC of an individual, how can we apply these findings to past societies? 251 Heterogeneous Immunological Landscapes and Medieval Plague Graph 6. Proposed Multifactorial Model for Understanding the Impact of Biological, after Plague Outbreaks Ecological, and Social Factors on Human Immune Competence (IC) before, during, and And can we extrapolate from individual data to a population at large, or to an entire region? We have also stressed that the human immunological response is not uniquely conditioned by the acquisition of (or failure to Y.acquire) pestis atlong-lasting the site of theresistance infection, after and exposure the individual’s to a particular health and pathogen. IC will As we have explained, the innate immune response is crucial to fighting mount a quick and effective primary/innate response, seconds after the play a significant role in determining which individuals will be able to Every plague outbreak occurs within a unique environmental, biologi cal,infection and social (for example, context. byEach flea outbreak bite). then reshapes the environmental, more comprehensive and accurate reconstruction of medieval demogra phybiological, and ecology and cultural will be profile the only of waythe affectedto reconstruct population the IC and of individuregion. A als and populations in this era (Graph 6 enable us to build better models for understanding how and why plague outbreaks occur now, and in the future. The). proposedIf this can model be achieved, offers an it invi will to human health by helping us to study the factors that impacted human immunologytation to medievalists: in the past, the thus opportunity helping to to combine make a significantmodern immunological contribution knowledge with the disciplines of history, anthropology, bioarcheology, paleoepidemiology, and paleoimmunology. We are witnesses to an increasing interest in the study of past disease and the search for lessons that we can apply to the future. As this spe cial issue of The Medieval Globe insists, scholars and scientists have a unique opportunity to generate a truly interdisciplinary agenda for future research. 252 BibliographyFabian Crespo and Matthew B. Lawrenz Abbas, A. K., and A. H. Lichtman. 2005. Cellular and Molecular Immunology, 5th Aberth, John. 2005. The Black Death: The Great Mortality of 1348–1350. A Brief Historyed. (Philadelphia: with Documents Saunders) Amedei, A., E. Niccolai, L. Marino, and M. 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Death 1998. “Bacterial Perturbation of Cyto 66, no. 6: 2401–09 (London: Collins) 257 Heterogeneous Immunological Landscapes and Medieval Plague Fabian Crespo specializing in human evolutionary immunology. In 2001, he moved from the University of Buenos ([email protected]) Aires to the Department of Anthropologyis a biological at anthropologist the University of Louisville, Kentucky, where he began to develop the working hypothesis that different pathogenic experiences in the past have shaped the immune systems enced this research: his participation in the Global History of Health Project at thein different Ohio State human University, populations. and the Since NEH 2010, Summer two Seminar, experiences “Health have and greatly Disease influ in the Middle Ages,” directed by Dr. Monica Green and Dr. Rachel Scott, in 2012. He is currently working on the Black Death’s impact on the immune systems of human populations and testing the potential role of cross immunity in the decline of medieval leprosy in Europe. Matthew B. Lawrenz Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, Department of Microbiology ([email protected]) and Immunology, at the isUniversity a microbiologist of Louisville’s at the School of Medicine. He is interested in understanding how bacterial pathogens ing the interactions between Yersinia pestis (the bacterium that causes human are able to infect and cause disease in humans, and since 2003 he has been study identify the factors that allow Y. pestis to cause disease and to understand how theplague) bacillus and is mammalian able to avoid hosts. detection Specifically, and elimination Dr. Lawrenz’s by the laboratory innate immune works sys to from these studies to aid in the design of new vaccines and therapeutic treat mentstem (i.e., to bycombat macrophages). bacterial infection.Dr. Lawrenz’s Prior long-term to his work goal with is to Y. use pestis the, Dr.information Lawrenz studied Lyme Disease, an emerging bacterial infection that is transmitted by ticks, and helped develop the serological test used to diagnosis this infection. In 2012, Dr. Lawrenz began collaborating with Dr. Crespo to understand the poten tial impact of the Black Death on the evolution of the immune system in human populations. Abstract Efforts to understand the differential mortality caused by plague must account for many factors, including human immune responses. In this essay we are particularly interested in those people who were exposed to the Yersinia pestis pathogen during the Black Death, but who had differing fates—survival mount an appropriate immune response as a result of biological, environmental, andor death—that social factors. could The depend proposed on whichmodel individualssuggests that (once historians infected) of thewere medieval able to especially the role of human immunology in past environments and societies, by helpingworld could to reconstruct make a significant these conditions. contribution to the study of human health, and Keywords Plague, immunology, differential mortality, medieval Europe, Black Death. THE BLACK DEATH AND THE FUTURE OF THE PLAGUE MICHELLE ZIEGLER Yersinia pestis, unique among pathogens, is based more on its history than on modern case numbers. When new outbreaks Th of plaguee gra arevit reportedAS of in the media, journalists are quick to link these incidents with the horrors of the medieval Black Death—and then to claim that there is no real threat to society, because we now have modern antibiotics. Walking a thin line between stirring up interest and not caus ing panic, reporters are only half right on both counts. On the one hand, modern plague cases are caused by the same lethal bacterium, Yersinia pestis; and yet the phenomenon of the Black Death was far greater than any of the isolated cases or small outbreaks that usually attract such attention today. On the other, antibiotics are not a panacea that can wholly protect us from the next pandemic. Plague is re-emerging in a world of growing antibiotic resistance, economic interdependence, and rapid tran sit. Yersinia pestis is found in enzootic foci on every inhabited continent except Australia, and it was found in the arsenals of some states in the twentieth century. Political instability and weak economies can prevent the growth of adequate public health infrastructures that would enable rapid response to large infectious disease outbreaks, natural or not. Air travel makes pneumonic plague quickly transferable from one site to diligence, an isolated case in the United States (or in most other coun another. If public health officials and environmental services do their due andtries) 2005, should was not almost be cause ignored for panic. by the However, media even the outbreakthough this of overwas a hunseri ousdred risk pneumonic to regional plague health. cases, Sensationalizing something that the occurred plague indoes Congo not inhelp 2004 us to deal with these realities, but neither does the lack of attention given to plague in areas of the world that are often beneath our notice. This essay addresses three basic questions. First, what does it mean for Iplague would liketo be to classifiedexpress my as sincere a re-emerging gratitude to infectious Monica Green disease? and Ann Second, Carmichael, what who both took me under their wings and introduced me to the medieval history of Fabian Crespo, Carol Symes, and the anonymous reviewers for their helpful comments onmedicine. an earlier They draft have of thishad paper.the patience of saints. I am also grateful to Nükhet Varlık, 259– The Medieval Globe 1 (2014) pp. 283 260 Michelle Ziegler do we unite study of the plague in the past and present to create a better understandingis the human incidence of plague of dynamics, plague around to better the world prepare today? for the And future? finally, how A Re-emerging Infectious Disease manyFrank supposedSnowden (2008)that the has conquest argued and that even the publiceradication health of successes pathogens of was the justtwentieth a matter century of time. led Before to an theera AIDsof over-confidence pandemic, it was in medicalunthinkable science: that this progress was illusory or temporary. But the growing awareness of the threatitable norposed irreversible. by the human Then, immunodeficiency between 1991 and virus 1995, (HIV) the returnin the of1980s two wasold bacterial the first widelyfoes and recognized the emergence indication of a thatterrifying progress new was virus neither delivered inev the western hemisphere for a century when large new epidemics broke outa one-two in Central punch and toSouth public America, confidence. eventually Cholera claiming had been four thousandundetected lives in outbreak in Surat, India, was followed by the discovery, the following year,and raising of antibiotic fears of-resistant infrastructure strains failures. of plague In 1994,isolated a pneumonicin Madagascar. plague In 1995, spread of the Ebola virus in Zaire (now the Democratic Republic of of its gruesomely high fatality rate in a country without an adequate sur Congo) also gained the attention of the global health community because modern society’s sense of security was shattered; hence, the new focus on “emergingveillance network. and re-emerging” Within ten infectious years, from diseases. the mid-1980s to mid-1990s, ple of what can happen when a naturally ocurring epidemic is not brought underThe control. 1994 plague Like manyepidemic other in countries,Surat has sinceIndia becomehad discontinued a textbook plague exam surveillance in1 the 1980s, believing that it was no longer necessary after thisthe endoutbreak of the appearsThird Pandemic to have resulted(Garrett from2000: a 5;natural Barrett spillover, 2008; Sivaramak but it was greatlyrishnan exacerbated 2011). As medical by temporary anthropologist and permanent Ron Barrett human (2008) settlement has argued, pat mental failures. The outbreak was triggered by an earthquake that reac terns,tivated insufficient a bubonic plaguehealthcare focus and in urbanthe rural infrastructure, village of Mamla, and other in the govern Breed 1 consensus that it ended in the 1950s. The Third Pandemic has never been officially declared “over,” but there is a general 261 The Black Death and the Future of the Plague then transferred the plague to Surat, a city of over 1.5 million people, wheredistrict. it Social quickly interactions became a (probably pneumonic the epidemic. movement Plague of migrant did notworkers) move through the city homogenously: 78% of confirmed cases were first-gen cialseration even immigrants struggled to to the identify city, living the individualsin slum communities who were (Barrett, infected 2008). (Dutt, But India’s public health system was not up to the challenge, and offi while,Akhtar, the and media—rehashing McVeigh 2006). Physicians lore of “the fled Black clinics Death” in the and most invoking affected the lossdistricts of some and ten antibiotic to twelve shortages million Indianswere common during the(Barrett plague 2008). pandemic Mean of the early twentieth century—helped to spur a mass exodus from the city. 160 kilometers away from Surat, respectively; eventually, over half a mil Those traveling by train carried the plague to Delhi and Calcutta, 80 and stilllion peoplecannot fledbe reliably to all parts determined: of India, potentially all told, there bringing were plague 5,150 withsuspected them (Dutt, Akhtar, and McVeigh 2006). And yet the extent of the epidemic cases of pneumonic and bubonic plague but only 53 confirmed deaths, laboratorywhich suggests analysis, that especiallyover-diagnosis in developing inflated the countries, number andof cases. the absence During ofan adequateepidemic, laboratory it is not uncommon support means for only that a everyfew cases febrile to becase confirmed is assumed by to be pneumonic plague and is treated as such with antibiotics (Barrett whose cultures tested positive for Yersinia pestis 2008: 53). In Surat, pneumonic plague was confirmed in eighteen patients , and this finding was confirmed by the World Health Organization in 1994 and then by genetic outbreakanalysis in was 2000 caused (Dutt, byAkhtar, a strain and McVeighof Yersinia 2006). pestis descended from a That same subsequent analysis in 2000 also confirmed that the Surat Third Pandemic strain (1.ORI) now endemic in Indian foci (Kingston et al. 2009). In 1994, however, the U.S. Centers for Disease Control and Preven natelytion (CDC) leant had backing reported to rumors that the of Suratbioterrorism plague was that caused had begun by a to previously circulate earlyunknown on. Surat’s strain Muslimsof the pathogen—and were accused of to poisoning Indian officials the city’s this water unfortu sys temtransferred and causing plague many response more deaths to the than Department actually occurredof Defense (Barrett (Price -2008).Smith Indian officials even blamed a local Islamic group for the epidemic and Muslim clashes that had fueled distrust in the local government, on both 2002: 242). Only two years before, Surat had been the scene of Hindu- sides; the rumor that officials were planning to quarantine the city was 262 Michelle Ziegler tent public health measures and pre-existing social tensions, heightened bytherefore fear and another rumor, factortherefore that exacerbated led Surat’s citizensan outbreak to flee. of plagueA lack ofthat compe could have been controlled. impact of the Surat plague was so great that it degraded the state capacity of IndiaAndrew and Price-Smith impeded or (2002: weakened 235) relations has argued with that countries the psychological around the world.2 India paid a high price for the panic. Its neighbors (China, Nepal, tions on people, imports, and in some cases mail were also imposed by Bangladesh, and Pakistan) completely closed their borders. Travel restric midstother countriesof the plague, around the theIndian world. stock India market lost anplunged, estimated and 420costs million of blocked dol lars in trade from the United Arab Emirates alone (Barrett 2008). In the theexports plague, and an lost economic tourism collapserevenues in have one beencountry estimated becomes at rapidly$1.8 billion, conta a gious,significant triggering blow foreconomic a developing instability country and consequently(Price-Smith political2002: 242). instabil Like strainsity around of Yersiniathe world pestis (Price-Smith were discovered 2002; Koblentz in Madagascar 2010). (Welsh et al. Only one year after the outbreak in Surat, the first antibiotic-resistant in that same offshore African island, including one that is resistant to all of2007). the known From 1995 antibiotics to 1998, used more for antibiotic-resistantplague treatment and strains prophylaxis were isolated (Gali resistance from a process called “lateral gene transfer,” acquiring genes frommand, other Carniel, species and Courvalinof bacteria 2006). that carry Like otherantibiotic bacteria, resistance plague plasmids gains its Yersinia pestis readily accepts such plasmids from other enteric bacteria like Escherichia coli and Salmonella enterica. (small circular DNA shuttles). Yersinia pestis AlthoughFor example, similar the antibioticmulti-drug resistance resistant has (MDR) not been plasmid found found in human in cases outside is of“nearly Madagascar, identical” plague to those isolates found must in Salmonella now be vigilantly(Welsh et al.screened 2007). for naturally occurring antibiotic resistance (Urich et al. 2012; Stenseth et al. 2008). At the media briefing for the CDC’s first threat-assessment on antibiotic resistance, in 2013, its director Dr. Tom Frieden warned: 2 government, and its level determines the state’s ability to satisfy the most important needs:According survival, to protectionPrice-Smith of (2002:its citizens 339), from “State physical capacity harm is asthe a capabilityresult of internal of the or external predation, economic prosperity and stability, power projection, and ideological projection.” 263 “If we are not careful, we willThe Blacsoonk be Deat in ha anpostd t-hantibiotice Future era.of t h. .e And Plague for some patients and for some microbes, we are already there” (quoted by antibiotics’ capacity to play a role in plague containment can no longer be McKenna 2013). Although Freiden was not speaking specifically of plague, assumed (Oyston and Williamson 2013; Stenseth et al. 2008). Maintaining State Capacity and the Threat of Plague Challenges to state capacity (the ability of the state to maintain basic func and economic costs of these recent plague outbreaks are simply modern manifestationstions) have existed of trends since thethat beginning began with of settledthe sixth civilization.-century “PlagueThe social of Justinian,” or First Pandemic. For the premodern world, as for our own, plague was not just a health crisis. All plagues are a threat to civil society; they jeopardize not just individuals but the fabric of communities and the institutions that maintain order. Plagues also decimate workforces, caus ing transformations in land use and the environment (see, e.g., Borsch networks: those of the Roman Empire in the sixth century, the mercan tile2014, empires in this of issue). Italian In city the-stat past,es theyin the spread fourteenth through century maritime (Wheelis economic 2002; ifHorrox there 1994:is one, 14–26), will likely and bethe via British airline Empire networks, at the as turn was of the the case twenti for eth (Echenberg 2007). Long-distance transmission of the next pandemic, which appears to be the case for the unfolding threat of MERS (Middle the Severe Acute Respiratory Syndrome (SARS) pandemic in 2003 and role played by “super spreaders”: individuals who transmit disease to far East Respiratory Syndrome). SARS has also directed our attention As Myron to the Echenberg has observed, “comparisons between the beginnings3 of the greater degree than the average infected person (Stein 2011). third [plague] pandemic in 1894 and the arrival of severe acute respira torySince syndrome, the late or 1990s, SARS, pandemics in 2003 are of remarkable all kinds have and been suggest considered that we mat can tersdo better of national at applying and international the experience security of the past” on the (Echenberg same level 2007: as military 308). and terrorist threats, climate change, and refugee flows (Koblentz 2010). On January 10, 2000, the United Nations (UN) Security Council designated 3 When super-spreading is tied to a particular place, it is designated as a disease hotspot. For example, for plague, sites of grain storage are likely hotspots where increased number of human cases linked to that location. See further discussion below. infected rats and fleas are found in higher than average numbers, resulting in an 264 theMic hHIVelle pandemic Ziegler as a global security issue, moving it beyond the pur set a precedent for allowing the UN to intervene in the governance of a sovereignview of the state World if it Healthdoes not Organization mount an adequate (WHO) (Price-Smithpublic health 2002).response This to disease. Within this international security framework, plague is regarded as both a pandemic threat and a terrorist threat, given its potential to be used as a biological weapon. Indeed, Yersinia pestis is one of only three bacteria to have been labeled a “category A” biological weapons agent (the is also shared by botulinum toxin, along with several hemorrhagic viruses others being anthrax and tularemia). This top-level security designation tribution or transmission, high mortality rate, likelihood of causing social disruptionand smallpox. and Traits panic, thatand thedefine necessity a “category for special A” agent public include health ease prepared of dis Major American initiatives are currently helping to build up global diseaseness (CDC detection n.d.). and response networks. For example, the United States has upgraded or rebuilt former Soviet anti-plague stations in the now- independent states of Kazakhstan and Uzbekistan, equipping them for improved surveillance and biosecurity (Koblentz 2012: 138; Pasternak 2013). The U.S. government also budgeted $5.54 billion for biodefense and disasterhas already preparedness been used toin answer2012–13, historical of which questions $574.2 million relating was to specifiplague: cally dedicated to biodefense (Franco andYersinia Sell 2012). pestis Some in specimens of this funding from a sixth-century Bavarian cemetery and the reconstruction of the ancient genomeancient DNAwere (aDNA) supported confirmation in part by of the Department of Homeland Secu work, the Microbial Detection Array, which can screen aDNA for mul tiplerity (Harbeck pathogens, et al.was 2013; developed Wagner in et conjunction al. 2014). The with latest the advanceLawrence in LiveraDNA response drills conducted to date, two of the exercises simulated plague attacksmore National in multi Laboratory-agent scenario (Devault exercises et al. 2014). (TOPOFF Of the 1 in full-scale May 2000 federal and TOPOFF 3 in April 2005; Inglesby, Grossman, and O’Toole 2001). These exercisesYet pneumonic involved plaguethousands remains of participants, a bioterrorism4 from concern local “first for responders” several rea tosons. cabinet-level With plague officials being endemicand governors. and enzootic in foci scattered around the world, natural sources cannot be fully identified or effectively controlled. 4 For an accessible review of biosecurity drills, see Armstrong (2012). 265 Furthermore, many enzooticThe Blacfoci kin Deat Centralh an dAsia, the Ftheuture Middle of t hEast,e Plague and Africa are located in poor, politically unstable areas where basic national security and public health institutions are already vulnerable or under developed, as well as in several states that have known programs or have used biological or chemical weapons in the past, such as Syria, Iran, and North Korea. Moreover, Y. pestis can be processed into a crude weapon al-Qaeda operatives in Algeria were discovered to have died of plague, perhapswithout sophisticatedas the result oftechnology a failed experiment or expensive in biologicalequipment. weapons In 2008, devel forty But as we have already noted in the case of Surat, plague does not have toopment be deployed (Lake 2009; as a weapon “40 al-Qaeda to be a Terrorists”threat. War 2009). and infectious disease have a reciprocal effect. War weakens a society’s ability to respond adequately to infectious disease by disrupting the social order, destroying civic infra structure, and causing mass movements of people. Conversely, epidemics destabilize society and reduce state capacity, creating the conditions for political and social unrest. A recent instance of the former was the self- limiting outbreak of plague that occurred during the Libyan revolution thein 2011, Democratic which couldRepublic not ofbe Congo—over clinically confirmed ten thousand or effectively cases between treated 2000because and of 2009—were ongoing hostilities also clearly (Cabanel exacerbated et al. 2013). by ongoing Plague political outbreaks insta in thebility loss (Butler of thousands 2013). ofThe lives violence and the and creation social of disruption endemic foci caused that persistby the Vietnam War fostered a plague outbreak from 1966 to 1974, resulting in during the Korean War led to accusations that the United States had used biologicalto this day weapons(Price-Smith against 2009: North 172–73). Korean Outbreaks and China. of plague These and accusations smallpox were later shown to be intentionally false; but here, again, environmental and institutional devastation contributed to the severity and persistence of disease (Hamblin 2013). Plague Incidence and Causes Today Plague is considered a re-emerging infectious disease because the number longof cases, intervals overall, of has quiescence. been climbing Moreover, since endemicthe 1980s poverty (see, e.g., and Neerinckx, political unrestBertherat, in developing and Leirs 2010). countries Old plaguewith plague foci are foci, producing the appearance new cases of afteranti biotic-resistant strains of plague, and the potential use of plague as a bio logical weapon are major concerns. 266 MicThehelle incidence, Ziegler causes, and mortality rate of plague vary widely. Between 2000 and 2009, there were 21,725 cases reported to the WHO, with a case butfatality it can rate also of manifest 7.4%. Of as all primary these septicemiccases, 97% plague, came fromprimary Africa pneumonic (Butler plague,2013). Bubonic gastrointestinal plague makes plague, up and the plague vast majority pharyngitis. of these The reported most common cases, of these presentations are perhaps better classified by their primary mode of exposure: insect bite or the entry of infectious bodily fluids through cuts and abrasions (bubonic and septicemic), inhalation (pneumonic), documentedand ingestion and (gastrointestinal long-standing andevidence pharyngeal), that other respectively. pathways Whileof human the exposure“classic” rat-flea-human were common inpathway past outbreaks is currently and dominant, could become there common is well- Pulex irritans, has again under certain conditions (Stenseth et al. 2008; Green 2014, in this issue; Carmichael 2014, in this issue). The human flea, been implicated in Tanzanian plague outbreaks between 1986 and 2004 human(Laudisoit body et louseal. 2007) has alsoand maybeen have shown been to bethe capable agent of of plague transmitting epidemics Yer- siniain medieval pestis andnorthern is another Europe, hypothetical as well (Hufthammer medieval vector and Walløe (Houhamdi 2013). et The al. that combined epidemics of plague and louse-transmitted typhus were 2006; Drancourt, Houhamdi, and Raoult 2006). Here, it may be significant reported by contemporary physicians in Seville, in 1582 (Bowers 2013: medieval50). It may cases also ofbe co significant-infection thatwith aDNA Y. pestis testing and oflouse individuals-transmitted buried Bar in- atonella Venetian quintana mass grave and in graves from Bondy, France, have identified (trench fever) (Tran et al. 2011a and 2011b). today.Like In cases the past, of plague they may transmitted have been by more human common ectoparasites in areas where (fleas cam and lice), gastrointestinal plague and pharyngeal plague are relatively rare and even a source of food. An outbreak of pharyngeal plague in 1997 was els were the primary beast of burden (Christie, Chen, and Elberg 1980), outbreakthe first plague of pharyngeal occurrence plague in Jordan occurred since in before Saudia the Arabia, foundation both caused of the bymodern the consumption state in 1921 of (Arbaji infected et camel al. 2005). meat Three (Bin Saeed,years earlier,Al-Hamdan, a similar and recorded outbreak in Afghanistan in the modern era and also the larg estFontaine known 2005). outbreak An outbreak to date. Inof gastrointestinalDecember of that plague year, ineighty 2007-thr is theee indi first viduals developed probable cases, some manifesting pharyngeal lesions, caused by consuming a visibly ill camel. The total case fatality rate was 267 The Black Death and the Future of the Plague consumption20.5%, and the of attack camel rate meat among has also those been who reported ate the cookedin Libya, camel and meatfrom thewas consumption approximately of 80% guinea (Leslie pigs et in al. Ecuador 2010). andGastrointestinal Peru (Leslie plague et al. 2010; from asStenseth a possible et al. route 2008). of Consumptioninfection for historic of diseased plagues, meat too, was especially not uncommon during foodduring shortages. the Middle Moreover, Ages (Newfield gastrointestinal 2012), and plague this is should not necessarily be considered rare among other animals. Carnivores can contract the plague from the blood uncommon in cats, which can in turn then transmit plague pneumatically of their prey as well as from the prey’s fleas. Pharyngeal plague is also not Meanwhile, a recent upsurge in cases of bubonic plague heralds the re- emergenceto humans (Gageof very et old al. 2000).plague foci around the Mediterranean and in Cen distincttral Asia: from in Algeria those (2003of Algeria, and 2008),and also Libya different (2009 from and 2011),those of and the Kyrgyz entire stan (2013). The 2009 Libyan outbreak has been shown to be completely foci,Third having Pandemic gone (1.ORI unmonitored strains). for Instead, decades, the are plague now showingin Libya wassigns caused of life by the reactivation of an ancient plague focus (Cabanel et al. 2013). Such Iranian focus that had not been surveyed in thirty years (Esamaeili et al. in other places as well: plague has recently been confirmed in a western region of the Democratic Republic of Congo, which produces approxi 2013). Currently, the most active plague focus in the world is in the Ituri mately one thousand bubonic cases per year (Butler 2013; Neerinckx et al. 2010). Large outbreaks often display multiple presentations of dis ease.Clearly, For example, though, diagnosisa 127-case and Ugandan case reporting outbreak are in still2006 a majorproduced problem 88% inbubonic resource and-poor 12% countries, pneumonic which cases have (CDC widely 2009). divergent diagnostic abili ties and levels of treatment. This can lead to over-diagnosis that lowers delayed treatment can also cause extreme differences in case fatality rates betweenthe reported the casebeginning fatality and rate end (Neerinckx of a single et epidemic.al. 2010). LateSo if diagnosis the reported and case fatality rate is cumulative, it will not distinguish between fatalities that occurred before and after antibiotic treatment began. The incidence and case fatality rates reported to the WHO meeting in Antananarivo, Madagascar, in April of 2006 illustrate this problem (WHO 2008). At that meeting, the host country reported that plague cases between 2000 and 2005 were 94% bubonic with a fatality rate of 19%. The Democratic Republic of Congo reported a prevalent plague but 268 couldMichelle not Ziegleroffer reliable statistics for the years 2000 to 2005, because no Itrecords also reported were kept that between deaths 2002 in family and 2003.units wereTanzania the reportedresult of secondarythat about pneumonic90% of its cases plague were caused bubonic by delayed with antreatment, approximately5 10% fatality rate. Pulex irritans, was suspected as the vector in the absence of cat and dog and that the human flea, fleas. Mongolia reported that 90% of its 160 cases between 1971 and 2000 were bubonic, with an astounding 40% developing secondary pneumonic plague due to lack of treatment. However, its officials also reported that only 4.2% of cases were primary pneumonic and reported a fatality rate of “up to 70%” due to lack of treatment and healthcareY. pestis infrastructure. from southern Neigh foci boring China reported 630 casesX. cheopis between 1994 and 2004 with a case fatal itylow rate fatality of only rate 6.67%. due largely China alsoto the reported relatively that rapid provision of antibiotic treatment;(transmitted yet by Y. the pestis rat fleafrom its northern) caused foci bubonicwas primarily plague transmitted with a very to hunters who skinned animals, causing pneumonic and primary septi territory and delays in seeking and obtaining treatment. Little informa tioncemic on plague the Americas with a fatality was offered rate over at the 50% meeting, due to thebut “remoteness” Peru did report of the an epidemic of 1,248 cases between 1992 and 1994. Peruvian representa tives identified risk factors as “grain storage in the open air, which favors an abundance of rodents and fleas; promiscuity in housing; absence of rodent-proof devices, beds on the floor and infested with fleas; and the problematic.custom of raising All individuals guinea-pigs with for fataltheir cases flesh” of (WHO plague 2008: develop 20). a secondary septicemiaPlague reporting before death. on routes To put of it infectionsimply, primary (or presentations) septicemic plague is similarly skips the initial inoculation phase that creates a bubo or manifests as pneumo tion immediately. The total rate of primary septicemic plague is therefore unknown,nia, and instead because develops it is usually the systemic only diagnosed (body-wide) by blood blood-borne culture ininfec the United States, where it represents approximately 30% of all cases (mostly Itcontracted can be acquired by handling while or skinning skinning or animals) butchering (Butler animals 2013). via This small suggests cuts in thethat skin, primary giving septicemic Y. pestis direct plague access is significantly to the bloodstream. under-diagnosed People handling globally. 5 Secondary pneumonic plague is the development of plague pneumonia in a case of primary bubonic plague. Primary pneumonic plague outbreaks are begun by a case of secondary pneumonic plague in a human or animal index case. 269 plague victims or corpses Thcoulde Blac alsok Deat be vulnerableh and the F touture septicemic of the Pplaguelague variations in modern standards of diagnosis and reporting mean that the databy extant reported wounds to WHO coming is suspect, into contact serving with as infected a further body reminder fluids. In that short, we need to be cautious when we use medieval data, too. Although the vast majority of contemporary global cases appear to be bubonic, there have been a couple of recognizable pneumonic plague pneumonic plague outbreak in Madagascar was widely reported in the news,outbreaks but asin ofevery this recent writing decade. it has notDuring been this formally past winter reported of 2013–14, to the sci a entific community. There was a pneumonic outbreak in Ecuador in 1998, and two nosocomial (hospital-acquired) pneumonic cases in Peru in 2010 (Schneider et al. 2014). Between 2000 and 2009, there were five natu ral pneumonic outbreaks affecting a dozen or more people: India (2002), IndianCongo outbreak(2005 and in 2006), the Shimla Uganda district (2006), of Himachal and China Pradesh (2009) was (Joshi caused et byal. 2009; Butler 2013; Bertherat et al. 2011; and Wang et al. 2010). The 2002 a strain distinct from the 1994 pneumonic epidemic in Surat (Kingston aset al.a 1.IN2 2009). strain The 2009of Yersinia Chinese pestis outbreak (evolutionarily was chosen intermediate as a case study between for a microbial forensic investigation (Yan et al. 2014) and was characterized Qinghai region of northwestern China. the Second and Third Pandemic strain) and localized to Xinghai, in the future plague tracking and surveillance will look like when resources and databasesThe study mature. of Yan The and unusually colleagues low (2014) genetic allows diversity us ofto Yersiniaglimpse pestiswhat requires the comparison of whole genome sequences with reference to a global database of samples collected from animals and humans over the last century, in order to localize the source of the outbreak strain. This could be critically important for the success of a public health response. In the case of a biological attack, furthermore, the ability to trace the source of infection would also help the international community to identify the The seemingly random aspects of pneumonic plague transmission are typicalresponsible of pathogens state or terroristthat spread organization by heterogeneous (Koblentz transmission and Tucker (Lloyd2010).- pneumonic plague is a high-impact, low probability event that can be explosiveSmith et al.and 2005). catastrophic, Like other as it respiratory was in Manchuria “super-spreading” in 1910–11 (Summers diseases, multiple vectors, and the potential for super-spreading events, existing plague2012; Hinckley foci are fertileet al. 2012). grounds With for theinitiating variety the of nexttransmission large epidemic, methods, or even a pandemic, if the correct conditions emerge. 270 UnitingMichelle theZiegler Study of Past and Present, for the Future Learning what we can from past epidemics is the best way to predict and prevent the next major epidemic. The careful analysis and contextualiza tion of historical sources are therefore vitally important to our under standing of how plague functions as an epidemic pathogen. Combining study.historical It prevents data with researchers a modern in scientific all disciplines knowledge from stoppingalso has atthe the advan easy answerstage of providing and being checks stymied and by balances a mysterious to both aetiology. humanistic and scientific Ancient and modern Y. pestis genetics suggest that current Y. pestis strains are good candidates for investigation by researchers in historic epidemiology. But while our understanding and use of aDNA data will continue and expand, it is still unlikely that a “smoking gun” will be found in the genome to explain its virulence or transmission patterns. Plague is created, amplified, and transported in man-made environments, whether it is transmitted by commensal rat fleas, human ectoparasites, or personal contact. The global distribution of plague reflects human movements tomore know than as anymuch other as we host can (Achtman about human 2012; interactions Green, forthcoming). and global connec Plague tivityepidemics in the have distant human past: fingerprints hence, this allspecial over them,issue ofand The that Medieval is why we Globe. need In the Unnatural History of Emerging Infections anthropologists Ronald Barrett and George Armelagos identify suste nance, settlement, and social order as primary drivers in(2013), the emergence medical of epidemic disease throughout human history. They reintroduce the teenth and early twentieth centuries, “who increasingly believed in Germ metaphor of “seed and soil” (first used by physicians of the late nine relationship between microbes and the environment (Barrett and Armel theory but continued to practice environmental medicine”) to explain the egos 2013: 11). Whether or not genetically identical seeds (i.e., microbes) nutrition—areflourish is dependent historical upon issues the thatconditions science of alone the soilcannot (i.e., address. the environ If the humanment). componentsUnderstanding of epidemics these conditions—of are not understood settlement, (or are social misunder order, gate not only the widespread return of diseases like plague, but also new stood), then our expensive preparations for the future will fail to miti gives us the rare opportunity to study a single disease over an unprec edentedemerging period infectious of time. diseases (Barrett 2006). The long history of plague Exploring the effects of nutrition on plague dynamics is a prime exam ple of the need for interdisciplinary research. The expertise of historians is 271 The Black Death and the Future of the Plague agricultural yields and practices of animal husbandry, food shortages and essential to the identification and analysis of sources that provide data on famine, trade networks and the diversification of foodstuffs, and all of the onother the activities effects of that nutrition cultivate on human and sustain immunology, a food supply Y. pestis (e.g., itself, Newfield and rodent 2012 and 2013). These efforts should dovetail with those of biologists working contribute,population indynamics turn, by (e.g.,analyzing Crespo bones and forLawrenz signs of 2014, malnutrition in this issue; and disease,La Cava and tracingMatarese the 2004; sources Schaible and proportions and Stefan of2007). nutrients Biological via isotopes anthropologists (DeWitte for all of this historically informed research, by analyzing long- and short- term2014, climate in this issue).changes The and work their of environmental climatologists providesand economic a broader impact context (e.g., need to pull together—rather than talk past each other. Campbell 2010 and 2011). To understand the full complexity of plague, we whoA finerecently example co-authored of cross-disciplinary a study on the collaboration impact of theis that Great of anthroFamine pologist Sharon DeWitte and economic historian Philip Slavin (2013), mine(1315–17) whether and thesethe food catastrophic shortages eventsresulting had from an theimpact Great on Bovine plague Epizo mor otic (1319/20), which lasted until at least 1332. Their goal was to deter the Black Death were buried and where the full genome of Y. pestis was tality,reconstructed as reflected in 2011. in London’s Slavin analyzed East Smithfield manorial cemetery, accounts where in order victims to doc of ument the depth and length of the famine and the subsequent food short ages resulting from the loss of cattle, while DeWitte assessed the ages and nutritional status of those individuals who lived through these privations relation between cohorts of people who survived the famine and food shortages,only to die inand the increased Black Death susceptibility pandemic. Their to the failure plague to findseveral a strong decades cor later, is a good example of the checks and balances that the sciences and humanities can provide each other. The authors worked together to reach common conclusions, pose new questions, and suggest the next steps. Comparing bioarcheological evidence from one cemetery in the capital city of England to historical evidence from rural manorial accounts is a malnutrition on plague mortality, as they have noted. Many more collab orativegood start, studies but ofit doesthis kind not settleare needed. the question of the influence of previous Settlement patterns, the conditions in which people live, and social understood from an historical perspective. As we saw in the case of Surat stratification encompass another vast set of variables which must be 272 Michelle Ziegler large urban environment. What is the thread of social proximity that links togetherin 1994, socio-economicthe earliest cases status and therefore can explain shapes how the plague epidemic? moves Were through some a occupations at greater risk than others? What aspects of poverty might make people more vulnerable to plague? How are existing social, politi cal, and religious tensions catalyzed by the stress of an epidemic disas ter? How well does urban planning and the built environment correlate with plague incidence? What external factors (trade networks, new com These are questions that historians and anthropologists are best suited to answer.modities, Genetics immigration) and microbiology play a role tellin introducingus little about or these spreading issues. disease? In turn, the methods and observations of modern epidemiology can illuminate the study of historic epidemics. The transmission of infection is now understood to be a continuum across hosts and environments (Lloyd- 6 Smith et al. 2005). Heterogeneous transmission is defined as “variabil ity in the contribution of specific hosts or locations to the Yersiniaoverall rates pes- tisof ,pathogen as we have spread” observed, (Paull spreads et al. 2012);by heterogeneous extreme cases transmission, are better andknown the bypneumonic the more form common produces term such“super-spreading super-spreading events” events (SSE). (Lloyd -Smith et plague were also super-spreading events fueled by disease hot spots. al. 2005).Comparing It is thereforeplague to possibleother insect that-vectored some historic zoonotic outbreaks diseases of provides bubonic further insight into transmission dynamics. Super-spreading events of Dengue fever, which like plague is transmitted by an insect vector that remains close to the place where it hatches, have been linked to sites where vector super-production intersects with human density (Padma heterogeneous as would be expected of infection super-spreaders. More nabha et al. 2012). In this study, vector super-production sites were as mission as vector production. Short distance or circular movements over theover, course human of density a day or or week traffic by to humans these sites has was also as been critical linked to disease to increased trans risk of zoonotic disease transmission. For example, children at play or vis iting friends can be exposed to more aspects or corners of a community seemsthan adults reasonable. (Stoddard It has et al.often 2009). been A remarkedsimilar super-production that outbreaks of plaguerodent fleas at sites of grain storage, which also draws in high human traffic, 6 In contrast, homogenous transmission occurs when all hosts have an equal a discussion of some general principles of landscape epidemiology. chance of becoming infected. See also Lambin et al. (2010) and Paull et al. (2012) for 273 The Black Death and the Future of the Plague that(past poverty and present)-induced disproportionally grain hoarding inaffect crowded the poor homes more of poorthan constructhe afflu ent (e.g., Wrightson 2011; Carmichael 1986), and it has been suggested tion create an environment where plague can flourish: this was the case in suchSurat a(1994) hypothesis as well for as historic in Peru epidemics(1992–94) requires and in more good recent urban outbreaks environ mentalin Madagascar histories (Andrianaivoarimanana of multiple locations and et al.time 2013; periods, WHO as 2008). proposed Testing by vermin;Guy Geltner the historical(2012) and reality Carole is Rawcliffenot only much (2013). more We positive cannot relythan on these the traditional assumption that medieval cities were seething sites of filth and So if there were historic plague hotspots in the medieval world, it will takemodern much prejudices more research would credit, into the it ishistorical also more shaping complex of (Rawcliffe urban and 2013). rural environments in order to identify them: and this will require pulling ern Mediterranean has been the most fruitful place to look for such sites, together all available evidence, historical and scientific. So far, the east with the possible identification of an enzootic focus in the late antique Levant (Tsiamis 2010) and an environmental and documentary analysis inof anplague historical in Ottoman understanding Egypt (Mikhail of plague. 2008). And Indeed, importantly, Nükhet Ann Varlık Carmichael (2014, in this issue) argues convincingly for the Ottoman empire’s centralEuropean place plague focus. As part of an ongoing effort, the Environmental History Net work(2014, for in thethis Middle issue) Agesmakes is thebeginning first historical to gather argument the environmental for a stud ies that are necessary to a contextualization of the plague and other medi eval epidemics and epizootics.7 Patterns of land use constitute another critical factor in creating an environment suitable for the establishment of becauseplague. In they modern appear Madagascar, to disturb for enzootic example, foci deforestation (Andrianaivoarimanana and bush fires et (to clear land for agriculture) have been associated with plague outbreaks demographic effect of the Black Death substantially changed land use and agriculturalal. 2013). Looking methods at couldplague test incidence these observations. and severity in regions where the Related environmental change tends to occur after natural disasters haslike earthquakeslearned the importanceand floods. An of earthquakeplague surveillance and monsoon after flooding earthquakes were both key catalysts for the 1994 outbreak in Surat (Barrett 2008). China 7 ENforMA aroundMichelle the Ziegler Tibetan Plateau, where the plague is endemic and enzootic quakes goes all the way back to the First Pandemic: Tsiamis and col (and probably originated). The association between plague and earth breaksleagues that (2013) occurred found within an association a year of thesebetween respective five earthquakes events, in the in theera territories of the eastern Roman (Byzantine) empire and five plague out between 557 and 713. Extensive flooding was also associated with plague in Ottoman Egypt (Mikhail 2008), and the breakdown of infrastructures shortmeant-distance to regulate transmission flooding and during irrigation the entirewould haveThird made Pandemic matters in worseChina showed(see Borsch that 2014,wet conditions in this issue). facilitated The first spread quantitative of the plague: study displacement of long- and aof key people feature and in rodents all of these by floods natural was disasters proposed is that as theya major displaced factor potenin the increased velocity of transmission in South China (Xu et al. 2014). Indeed, Environmental histories should accordingly make historical epidemi ologytial hosts more (people, robust animals, and comprehensive, rodents, insects) because from theirplague normal transmission settings. is dependent upon the environment. It is necessary to approach the study of transmission from both the environmental context and the epidemiologi cal result. Looking at one variable in isolation will not produce an accu rate picture of transmission. If the epidemiological results do not match an expected plague pattern, then there is a missing piece to be found somewhere in the environment. For too long, plague researchers in both the sciences and the humanities were content to focus solely on the black and their parasites carry and transmit Yersinia pestis; the black rat may berat aand common its flea, host but butwe nowit is knowfar from that alone over (Eisentwo hundred and Gage rodent 2011; species Gage some, such as Oropysylla montana, transmit Yersinia pestis effectively and Kosoy 2005). Moreover, fleas may be less abundant in the winter but Yersinia pestis evolvedat temperatures on the cold as meadowslow as 6° of C the(42.8° Tibetan F)—better, Plateau. in It fact,is not than a tropical at 23° or C near(73.4° tropical F) (Williams disease. et al. 2013). We must remember that Another environment that needs to be accounted for in studies of plague virulence is the landscape of the human body itself, and its co- infections and co-morbidities. What was the disease burden, chronic 8 8 “Disease burden” is the total cost to a community of a type or category of disease. It can be measured in a variety of ways: mortality, birth rate and infant mortality, life expectancy, economic trends, declining productivity, etc. Each study should define its 275 and infectious, borne by theTh communitiese Black Deat hdevastated and the F utureby these of epidemics?the Plague Expanding aDNA work to include other pathogens not only yields a better understanding of the disease burden of these communities but also looks for potential synergistic effects, or syndemics, between pathogens affect ing the same populations (Barrett and Armelagos 2013). New methods infectionare making by theother identification unrelated pathogens, of all microbial such contributionsas malaria, is alsoin an impor aDNA tantsample in estimating better and the more overall efficient health (Devault of the population at al. 2014). and Considering its response co- to plague. But again, because archeological remains always represent only a subsection of the population, this data must be balanced by study of sur viving documentary sources. All of our evidence will always be a fraction of what once existed, so we must use all available sources to assess the overall health of earlier populations and their susceptibility to disease. Identifying other pathogens, like typhus, can also tell us more about the parasite burden of these same populations (Tran et al. 2011a and lice can transmit the plague (Houhamdi et al. 2006; Drancourt, Houhamdi, 2011b). For example, it has recently been shown (experimentally) that betweenand Raoult a dominant 2006; Tran typhus et al. phase 2011a; yielding Ayyadurai to a plague et al. phase2010). (Price During-Smith the Thirty Years’ War (1618–48), there was a clear epidemiological transition throughout2009). Could the the lands same of species Central of and louse Eastern that transmitted Europe—which typhus were during already the devastatedfirst half of bythe violence, war have forced been transmittingmigration, destroyed the plague crops, in the and second the other half, catastrophic side-effects of war? Conclusion Interdisciplinary work is always a challenge, and it takes courage. It is But it is worth the effort. And happily, there are sources and people who candaunting help toto bridgeconfront the another gap. In fieldhis Evolutionary with its own History:terminology Uniting and Historynorms. and Biology to Understand Life on Earth rian Edmund Russell lays out a methodology for integrating biological information into historical studies and provides(2011), multiple environmental examples histoof the difference that this makes. There are a variety of online forums for discus sion, as well: these include the Medieval Medicine listserve (MEDMED-L) criteria and methods for measuring disease burden, as appropriate for the community (and time period). 276 moderatedMichelle Ziegler by Monica Green, blogs (like my own Contagions reach out to a general audience, and the above-mentioned Environmental History Network for the Middle Ages.9 All are very welcoming) tothat people also from a variety of backgrounds, with diverse levels of expertise. As I hope to have shown, all kinds of plague studies are relevant to understanding the modern experience of plague and are crucial to the development of strategies for handling future pandemic threats. There are multiple opportunities for interdisciplinary work and the formation of multidisciplinary partnerships that can lower the barriers between the sciences and the humanities. Linking historical studies to our cur rent plague concerns is further proof of the important vital place of the onlyhumanities for the in burial our academic of Black curriculaDeath victims and in would the public have sphere. been impossible Confirma withouttion that thethe analysisEast Smithfield of surviving cemetery documents in London and was artifacts. founded Archeology and used alone, even with data from carbon dating, will not be able to date graves accurately enough to distinguish between plague epidemics separated by a twenty-year hiatus. We cannot discern the epidemiology of historic plagues without knowledge of the historical environment and human ecology. 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Ben Ari, et al. 2014. “Wet Climate and Trans Yersinia pestis 281, no. 1780: 20133159 PLoS ONE Yan, Y., H. Wang, D. Li, X. Yang, et al. 2014. “Two-Step Source Tracing Strategy of and its Historical Epidemiology in a Specific Region,” 9, no. 1: e85374 283 The Black Death and the Future of the Plague Michelle Ziegler infectious disease and in science communication. She is particularly interested in the ways that science([email protected]) and history can informis a biologist each other, with interests toward a in greater the history under of standing of plague. Her blog Contagions Abstract This essay summarizes what we know about the spread of Yersinia pestis today, assesses the potential risks of tomorrow, and suggests avenues for future collaboration among scientists and humanists. Plague is both a re-emerg ing infectious disease and a developed biological weapon, and it can be found in enzootic foci on every inhabited continent except Australia. Studies of the Black Death and successive epidemics can help us to prepare for and mitigate future preventoutbreaks us (andfrom other stopping pandemics) at easy answers, because andanalysis they offorce medieval us to acknowledge plagues provides that therea crucial is still context much forthat modern we do not scientific understand. discoveries and theories. These studies Keywords Black Death, epidemiology, biosecurity, global history, public health, re-emerging infectious diseases. EPILOGUE: A HYPOTHESIS ON THE EAST ASIAN BEGINNINGS OF THE YERSINIA PESTIS POLYTOMY ROBERT HYMES cal variations in Yersinia pestis mutation rates by Yujun Cui and others Fhsignalsor th ae new is departuretorian of in premodern the cumulative Eurasia, study the of2013 the study genetics of histori of the Y. pestis’s place of origin and dissemination only inbacillus a broad over chronological the preceding framework fifteen years. of up Whereas to 20,000 previous years (Achtman studies had et been moving to define cal claim of much greater precision: that the evolution of Y. pestis since itsal. 2004;divergence Morelli from et itsal. most2010), recent Cui and common colleagues’ ancestor work may makes have aoccurred histori within the past three to four thousand years, and more importantly that a polytomy (simultaneous or nearly simultaneous genetic divergence of rent strains of Y. pestis multiple lineage branches) or “Big Bang” that yielded most of the cur , as well as the 1348 Black Death strain, took place originatedbetween 1142 in or and near 1339 the (Cui Qinghai et al.-Tibet 2013: Plateau, 580, table offers 1; their historians time interval both a periodhas a confidence and place tolevel look of for 95%). human Their events further that finding, could produce that the a bacilluspunctu ated genetic divergence. I will offer as a hypothesis that the “Big Bang” can be placed in space and time in historical sources, too: that the pol “Tangut”ytomy first people manifests in the itselfearly 1200s,historically and continues in the long with destruction, the movement by the of theMongols Mongols under into Cinggis-Qan north China, (Genghis south China, Khan), and of much the Xia of stateEurasia. of the The Mi new or genetic evidence, I argue, merits revisiting the documentary evidence of epidemics in thirteenth- and fourteenth-century Central Asia and China, epidemics that earlier authors had proposed as possible Y. pestis out breaks. No piece of evidence I offer argues unambiguously for plague: in particular, the Chinese sources have little to say about clinical symptoms and nothing to say about rodents. The case I propose rests rather on how origin;bits of evidenceand I point fit togetherforward and,to the as need a starting for new point, research on their on fit China with andthe InnerCui team’s Asia. findings on the Big Bang’s timing and the region of plague’s – The Medieval Globe 1 (2014) pp. 285 308 286 Rtober Hymes TableNorthwest 7. States (Gansu of “China,” corridor) 976–1644 North China South China Song (Chinese) 976–1127 except for sixteen prefectures in far north under Liao (Khitan) Xia (Tangut) 1038–1227 Jin (Jurchen) 1127–1279 1126–1234 Song (Chinese) Yuan (Mongol) 1227/1234–1279 Yuan (Mongol) 1279–1368 Ming (Chinese) 1368–1644 In 1205, the Mongols under Cinggis-Qan’s leadership began a series of by the people whom some of their neighbors called (and historians usu incursions south 1into the state of Xia, founded almost two centuries before quest,ally call) and Tangut. in 1226–27 The Mongolsa pincer attackattacked by Xiatwo cities large in armies, separate from campaigns the west in 1205, 1206, 1209, 1217, and 1224. In 1225 Cinggis planned a final con capital, Zhongxing Fu, fell after a six-month siege. (For these campaigns, and from the north, attacked and captured almost every Xia city until the What may make this destruction of a now obscure state important see Wu 1982: 122–38.) dor between highlands encompassed today by the Chinese province of forGansu, the directlyhistory adjoinedof plague the is thatQinghai the- Tibetterritory Plateau of Xia, point lyinged to in by the Cui corri and mark the Plateau’s northern edge.2 The western pincer of the 1226 assault tracedcolleagues: a west Xia-east lay linejust verynorth close and tonortheast the Qilian, of thusthe Qilian to the mountains Plateau. Today, that Gansu lies within the range of the Himalayan marmot (Marmota hima- layana today is more or less stably resident, and is home to many other species of rodent )that that might lives carryon the or plateau serve as just intermediary to the south transmitters and in which of the plague dis 1 They called themselves “Mi” or “Mi-nia.” The name for the state more commonly applied by modern historians, Xi Xia Da Xia Xia, was its formal Chinese name. See Dunnell 1996: xiii–xiv. or its translation “Western Xia,” was an informal name used by Song scholars. “Great Xia” ( ), or simply 2 small region east of Qinghai Lake” as the possible origin point of Y. pestis. This area of The more recent article of Yan et al. (2014) points much more specifically to “a in the early thirteenth century. Qinghai happens to be the closest part of the province to the territory of the Xia state Yersinia pestis 287 ease asEpil well.OGUE A: twoThe- Eyearast campaignAsian Beginnings on separate of th routese by two large omPol armiesyt y surely damaged the natural as well as human economy of the region, and long encampments using carried provisions and producing heaps of refuse will attract rodent scavengers. When armies moved on, such hypothesis requires that Gansu, in the thirteenth century, lay within the bacillus’srodents and homeland their fleas posited may have by geneticists, hitched rides and in thatstores of andthe feedbags.rodents that My wardscarry it into today Jin and(questions Song China for futureas passengers research); in their and mystores. proposal The Chinese is that sourcesthe Mongols begin unwittingly recording newcarried deadly rodent epidemics plague hostsexactly and in thetheir3 years fleas of east the William McNeill argued forty years ago that the Black Death that struck CentralMongols’ and spasmodic Western andEurope then and systematic the Mediterranean Xia conquest. in the fourteenth cen Michael Dols showed that many Middle Eastern plague accounts at the tury began in East Asia, riding with the Mongols (McNeill 1976: 132–75). time assumed an eastern origin (Dols 1977: 38–43; for another view see neseNorris primary 1977; and sources see Dols’s directly, reply built in Dols a similar 1978 argument—thoughand Norris’s further placing rejoin theder plague’sin Norris geographic 1978; cf. also origin Sussmann in Mongolia 2011). itself In 1995, rather Cao than Shuji, positing using Chi the Mongol passage through Yunnan in the 1250s as crucial, as McNeill does I owe many primary source passages I cite here to Cao’s work, inwhich one hasversion4 been of a hiscrucial hypothesis. foundation (Cao for 1995; my own, McNeill though 1976: our 143, arguments but see alsodiffer 145). in important ways. Despite McNeill and Cao, historians of China remain skeptical about an East Asian origin of plague or indeed about any plague in China as early as the Song, Jin, or Yuan dynasties.5 The path-breaking volume on the Song-Yuan-Ming “transition” was noncommittal on the question (Smith and von Glahn 2003: 8–9); Timothy Brook’s recent general history of Yuan and Ming China is skeptical (2010: 64–66). In a more recent and thorough examination, Paul Buell (2012) has vigorously rejected the idea. Among 3 For known long-distance travel by plague-bearing rodents and/or fleas in bags 4 On Cao’s much more comprehensive 2006 treatment in collaboration with Li Yushang,of grain etc., see see the Benedictow afternote to 2010:this essay. 150–93. 5 which however takes very little account of even the genetic work already known at thatFrom time. outside the China field, see also the skeptical account in Sussman 2011, 288 Rtober Hymes takenhis arguments “at face value”—true, are: that early on Ming simple (1393) methodological population figuresgrounds; that that seem the recordsto show McNeill huge losses used sinceas evidence the end for of epidemics the Song (anddynasty those (1279) used incannot Twitch be ett 1979, an inquiry into possible plague in China in the seventh through faulty in other respects—true, and I attempt to improve to some degree on ninth centuries) are unevenly distributed across China, often vague, and from east to west in the fourteenth century was by no means as easy as someMcNeill’s have sources imagined, here; thanks that toMongol the division movement of their (and empire movement into often of trade) com peting domains; and that plague could not travel via the Indian ocean, as distance would burn out any shipborne outbreak. I return to each of these I plan to consider all of Buell’s arguments at length elsewhere, as there is notpoints room (except to treat the themproblem fairly of McNeill’shere. Taken sources) together, at least they briefly still seem below, to butme to leave room for an argument for plague drawing on evidence that Buell did not consider or have available. In particular, he seems unaware of Cao Shuji’s work on Song-Yuan epidemics, though he cites Cao’s later article on plague in the Ming and Qing (Buell 2012: 139). Buell’s assertion that “there was no demonstrable mass outbreak [of] tillplague very in recently, China” (2012:the same 129) assertion bids to would close thehave question held true prematurely: for Europe, asIs importantit “demonstrable” authors now?found No—but it far from this demonstrable is what we want that tothe find Black out. Death And itself was plague. That controversy is largely resolved after the multi threaded genetics work of this millennium, culminating (for my purposes 6 gests that the polytomy Cui et al. identify may have been “caused by the here)organism in the moving Cui team’s into new work. climatic Monica environments Green (2014b, and in new this hosts.” issue) If sug we look for historical opportunities for such movement, the fact that these This is the background against which to consider the materials on thir teenthdates span-century the first epidemics explosive in China expansion that Cao of the Shuji Mongols compiled is hard in 1995, to miss. along with two sources he does not cite (see points 2, 4, and 5 below). I treat these in chronological order. Note that items 1–3 emerge from exactly the period of the Mongols’ long conquest of Xia. 6 On the arguments against plague and the swing of the pendulum the other way in the last decade or so, see Little 2011 and Bolton 2013. The major challenges were mounted in Twigg 1984; Scott and Duncan 2001; and Cohn 2002. On the genetics work, see Green 2014b, in this issue; Bolton 2013; and Little 2011. Yersinia pestis 289 1. InE pil1211,OGUE the: Th chiefe Eas tminister Asian Beginnings of the Jin ofstat the ethat governed the omPol northyt y ern half of what is now China, then facing a Mongol incursion of its own, advised his ruler to submit to Cinggis to avoid costly direct con could not last: “I have heard that the men and horses of the Tar flict; and added, apparently as reassurance that Mongol dominance Yuanchao mishi tars [i.e., Mongols], not appropriate to the water and land [in which theyhis clear find themselves],opinion that arethe experiencingMongols had pestilence” not always ( suffered “pesti lence”1228/2005: but had 173; acquired see also it whileCleaves in 1982:new country. 184; Cao 1995: 186). Note 2. Theping, physician Taiyuan, LiFengxiang, Gao, in his and account other citiesof the of 1232 the KaifengJin empire epidemic in the that appears in item 4 below, reported major epidemics in Dong others,years between and does 1213 not citeand Li 1222. Gao. Cao (1995: 187) notes the Kaifeng epidemic, citing Tuotuo et al. (1345b/2004, 1: 309a), but not the 3. In 1226, the Yuan-period Chinese scholar Tao Zongyi (1316–?) tells us that the Khitan advisor Yelü Chucai (1190–1244) joined in the con severalquest of volumes two cities of in documents Chinggis Qan’s and two Xia camel campaign.-loads “The of rhubarb. commanders Later therecompeted was epidemicto seize boys, in the girls, army, jades, and onlyand thosesilks; [Yelü]who received alone took rhubarb only associationwere curable: of nearlyepidemic ten inthousand the Mongol men werearmy saved”with the ([1366]/1959: invasion of chap. 2; quoted in Cao 1995: 189, with no reference). Here, both the Xia and the strange mention of rhubarb as a medicine to treat it are important. On rhubarb see item 8 below. 4. The Jin dynasty doctor Li Gao, founder of the “internal damage” school of Chinese medicine, claimed to have witnessed the Mongols’ 1232 siegeAt the oftime the of Jin’s the changesouthern of eras,capital in theDaliang renchen (modern Kaifeng, Henan): 7 In all it had been half a month since year the [1232], enemy’s the arrival,capital wasand afterat maximum the siege readiness was lifted, by thenot lastone tenor two days out of theof ten third thousand month [Aprilof the 24 to May 4]. 8 7 According to the official Jin history, the siege began on April 28 (Tuotuo et al. 8 1345b/2004, 1: 309a). The siege was lifted on May 8 according to the official history (Tuotuo et al. 1345b/2004, 1: 310a). 290 Rtoberpeople Hymes of the capital did not become sick, and the sick who died followed sent out each day were two thousand at most and no less than one thou sandanother at fewest, without and end. this At was each so offor the almost capital’s three twelve months. gates, Could [the all dead]these million people have contracted wind-cold external damage? Needless to say, people in the besieged city had been harmed by irregular eating and drinking and by excess toil. From two or three months of hunger in the morning and gorging at night, rising and resting irregularly, and suffering cold and heat through displacement, their stomach qi had long certainbeen exhausted. to die. It wasSuddenly not only to eat in Daliangtheir fill that to great things excess were injures this way. people, Fur and if furthermore their [medical] treatment is inappropriate, they are Dongping, like Taiyuan, or like Fengxiang were all the same in the illness andther deathback, duringthey suffered the Zhenyou after their and Xingdingsieges were eras lifted. [1213–22],9 [cities] like “Wind -cold external damage” here refers to the “cold damage” school of Chinese medical theory and therapeutic practice, which had gained dom inance in the preceding two centuries precisely for its perceived value against epidemics; its therapeutic methods had naturally been tried against this one. Li Gao recounts several treatments he saw other doctors apply in accordance with the theory, noting that they elicited changes in presentation that mimicked real cold damage, though the patients all died. He thus writes an entire book to distinguish “external” cold damage from see in his account, by poor or erratic nutrition and by “excess toil” in the siege.the “internal What is damage” important he findsfor my in argument the 1232 events—damageis that he clearly caused,perceives as thewe phenomena he is confronting as new to medicine, requiring new meth ods. Further, he sees the same process at work in a number of cities of north China—he lists three, but signals with his recurrent “like . . .” that these are three of a larger number—starting about twenty years before. The three are major cities scattered widely across the north China plain: 9 Neiwaishang bianhuo lun, bian yinzeng, yangzheng is independent of Li’s, mentioning dates he does not and setting, in Li Gaodeaths (1247/1993: at 900,000 8–9). The Jin official history’s account (Tuotuo et al. 1345b/2004, 1: 309a–311a) estimates what by his own details would lie somewhere between 600,000 and 1.2 million.instead Iof thank a million. my student Li Gao’s Stephen account Boyanton has finer-grainedfor calling my attentionnumbers: to his this “million” passage. My translation has started from his but diverges on some points. I thank him also for several productive conversations on the question of plague and for other source help cited below. He is exploring the larger significance of Li Gao’s shift from “cold damage” to “inner damage” in work of his own. See Boyanton 2014 and forthcoming. Yersinia pestis 291 even takenEpilOGUE by :themselves, The East Asian let alone Beginnings if typical of ofth ae larger number omasPol heyt sugy gests, they and Kaifeng would represent mass death in north China spread across two decades. In Kaifeng itself, mortality seems to have been at least 10 40%, as its population when it finally surrendered to the Mongols the next yearcities was not about during 1.4 a millionprocess of(Song siege et butal. 1370/1976, at the lifting 11: of 3459]; a siege Cao (each 1995: a 187). Most important, Li Gao places the moment of outbreak in all four thus at a point of contact by Mongol troops either with city populations orstep with in the Jin twenty-year troops who Mongolthen relieved conquest the of cities. north11 ChinaThese and two the points—the Jin state), perception of the epidemics as something new, and their association with contact with the Mongols—are critical, and will recur. regions to submit fully to their rule. Some urged that Muslims from 5. In 1235, the Mongol court debated the failure of already-conquered northern Chinese to subdue Central Asia. Yelü Chucai opposed this, arguingCentral Asiathat (“the“the water western and regions”) land are be of used different to subdue appropriateness China, and (yiyi ); epidemics will arise” (Song et al. 1370/1976, 11: 3460; not cited in Cao 1995). Again, epidemic is blamed (now from experience, per haps) on movement of peoples into lands not “appropriate” to them. south of the Huai River, they faced long summer rain. Li Zhen, a scion 6. In 1241, when the Mongols attacked Shouchun, in Song territory just commander: “If we camp the army below the walls, in the summer rainof the an Western epidemic Xia will royal arise, house and whowe will had fail gone . . . overI ask tothat Yuan, you told retreat his 10 I say “at least forty per cent” because of probable increase over time in the deno their siege, was presumably greatly swelled by refugees from the surrounding countryside,minator. The probably population to a of considerable Kaifeng in distance.1232, at Athe million time peoplewhen the out Mongols of the resulting began population, Li tells us, died in the epidemic. But in the year between this epidemic and the Mongols’ final taking of the city, its population would presumably have been theincreased epidemic again a year by new before; refugees that number fleeing the may Mongols’ have been second considerably arrival. Thus smaller. one cannot treat the 1.4 million remaining in the city at its final fall as the number left over after 11 In Kaifeng, the official Jin history makes clear that the siege was lifted appears(temporarily) to have after been the lifted Jin aftersent battlea delegation with the out Mongols of the by city Jin to troops negotiate sent towith relieve the Mongols (Tuotuo et al. 1345b/2004, 1: 310a). For the other three cities, the siege Mongolthem, who troops would outside then havethe city entered was thus the citiescommon themselves to all four (Tuotuo cases. et al. 1345b/2004, 1: 253, 258, 263, 265, 270, 272, 278, 284–85, 292, 306–07). Direct contact with 292 Rtoberseveral Hymes li [a few kilometers], and I will go myself to invite them [to yield].” The plan worked, but of interest here is the connection that citesLi, who Li Zhenhad served for his in death the Kaifeng in the 1259 attack campaign in 1232, sawbelow, between but does sieges not and epidemics (Song et al. 1370/1976, 10: 3051; Cao 1995: 187, 7. Severalcite Li’s potentialtestimony references on sieges). to plague center on the Mongol inva sion of Sichuan in 1258–59. The official Yuan history records that,jiwei in 1258, the general Shi Yuanze “followed Xianzong [Möngke] to attack the Song, entering via western Shu [Sichuan]. In the summer of [1259] he camped at Mt. Diaoyu in Hezhou; there was a great epi demic in his army” (Song et al. 1370/1976, 12: 3660; Cao 1995: 187). The same year, Xianzong ordered another officer “to prepare medi cated leaven [yeastcake] to treat the epidemic in the army” (Song et al. 1370/1976, 11: 3279; Cao 1995: 187). Elsewhere we read that, waterat this andtime, land a Song and generalgrew sick “was and newly died inoccupying great numbers” [the Sichuanese (Song et city of] Chengdu, and his troops and horses12 Herecould it not is Songtolerate troops the inal. the1370/1976, text’s terms, 10: 3145;as Sichuan Cao 1995:for most 187). Song people was far from home.who suffer Song from accounts being inrecord places the unfit sudden for them; death but of thisthe Songmakes general sense 13 12 plague because it affected horses. That would be premature, I think, though the questionIt might is worth be asked asking. whether Horses this do notparticular commonly outbreak contract should plague be in disqualified the usual way, as Y. pestis is named, inbecause order fleasto produce do not infesta therapeutic them. But serum Alexandre against Yersin, plague. after Yersin whom “was able to obtain adid certain succeed degree in infecting of immunity horses in (the a horse usual by host injecting for serum small manufacture quantities of at the the plague time) bacillus subcutaneously, and afterwards, as this produced suppuration, by making intravenous injections of the plague bacillus, these injections being repeated from time to time as the temperature went down, the glandular enlargements and joint tender ness disappeared, and the animal came to its normal condition” (emphasis suppuration, fever, and glandular enlargements in a horse even with carefully graduated small quantities of the bacillus: see “Plague” mine).in The BritishThat is, Medical Yersin produced Journal of course, and it does not necessarily follow that horses can contract plague in other ways; but the possibility that they (6 February could become 1897: sick357). by This ingestion was by of direct the bacillus injection, in contaminated food at least deserves further investigation. 13 The text has earlier referred to large-scale nueli among Niulin’s own troops, a term that in modern discourse means “malaria,” and in the testimony of the Persian historian Rashid-al-din the epidemics of this campaign are called variously Yersinia pestis 293 EpilOGUE: The East Asian Beginnings of the omPolyt y and the night before was arranging army affairs when he suddenly Wang Deng: “He had agreed [with the Mongols] on Within a day formoments battle, 14 collapsed,that Wang emittingDeng’s troops blood hadfrom already all five been viscera.” suffering epidemic dis he died (Tuotuo et al. 1345a/1977, 35: 12385; Cao 1995: 188 notes ease, but offers no citation). minister Chen Yizhong for a last-ditch campaign against the Yuan, 8. Inbut 1273, died onas reachingthe Song Luofu state infell, Guangdong. a certain Liu Fu joined the loyalist disaster will spread, and nearly half the people will die; those who take rhubarbBefore this, will Chen live’. Afterwarddreamed someone a great epidemic told him: arose, ‘This andyear those a Heaven-sent who took [rhubarb] indeed did not die. When Liu was sick, [Chen] had him take it, but he could not be saved. (Tuotuo et al. 1345a/1977, 35: 12249; Cao This1995: is the 188) second mention of rhubarb as a treatment for these epidem ics we have seen. It may be that this was simply a regional folk remedy of brought with him from Gansu, and that knowledge of it had spread to the Songwhich side Yelü by Chucai the 1270s. gained Rhubarb knowledge is a commonplacein the conquest item of Xia in Chineseand which tradi he tional pharmacology, but almost always as one element in a compound: to use rhubarb alone is quite unusual. In the great imperially sponsored Song compendium of prescriptions, the Prescriptions by Imperial Grace of the Taiping Era of 992, I have found just seven listings for rhubarb alone out of the many thousands of prescriptions the work collects. Only one of these appears in a section directly concerned with epidemic diseases, in this instance called literally “seasonal ethers” (shi qi 15 ). There rhubarb is the sole component of a prescription specifically for “pea sores in epidemics.” in Chinese, and his term is huolan, the word for cholera in modern Chinese; but as he points“dysentery” out, none and “cholera”of these terms (Boyle can 1971: necessarily 228, 248). be Caotaken Shuji as equivalent quotes the to latter any modernpassage biomedical disease entity, and the diarrhea suggested by Rashid al-din’s “dysentery” and “cholera” as well as the high fever suggested by the Yuan history’s nueli are 14 consistent with plague (Cao 1995: 187). “Blood from the five viscera” in this context probably means that Wang Deng 15 bled from all bodily orifices. Wang 992/1958: 428; the description of “pea sores” appears on p. 427; another description in connection with “cold damage” disorders (also epidemics) appears on p. 285. Interestingly, three other prescriptions in the compendium that specify rhubarb 294 “PeaRtober sores” Hymes (wandou chuang bly meant to be understood as) are pea described-sized. Given as raised their size,sores, I think white there or red, is virtuallythat are shapedno chance like that a pea the (or “pea “emerge sores” describedlike a pea”) here and are that buboes, are proba and I would certainly not argue for plague as something widely enough known in China in 992 to make its way into an imperial compendium. If, how might consult this rather old but still quite authoritative volume, then the ever, one imagines that an official faced with an epidemic in 1226 or 1273 as a treatment was one intended specifically for an epidemic involving raisedonly entry sores for epidemic he would have found that specified rhubarb alone about an epidemic and came away with rhubarb as a sole treatment, he must have been. To putlooking it differently, for help with if an a official disease consulted that involved this compendium raised sores. He would have been generalizing somewhat from a prescription originally meant for an epidemic involving a different kind of raised sores; but surely this would be a rational procedure in the face of a new disease. Again, we cannot know that the rhubarb treatment came from consulting this work, China, or from sheer improvisation; but it is possible that the mentions of as opposed to from local knowledge in 1226 Gansu and/or 1273 south hint that the epidemics of this period involved raised sores. rhubarbCao Shuji in items judges 3 and the 8episodes may carry, he citesfor us, to a be tantalizing plague based though on indirectseveral factors: their mortality levels, clearest for 1232 Kaifeng (and the others teenththat Li century,Gao likens a series to it, whichthat he Cao appears does tonot see cite); as leading their timing, up to theas he spread goes ofon plague to trace to epidemic Europe; andrecords their in association, the Yuan official in two history sources, through with rhubarb— the four to which I return below. My own reason for urging that we take these scattered records as possible evidence of plague is also timing, but from a different angle: that the encounters with epidemic by Yuan armies, and then by those they invade, begin just when Mongol troops pass in force, and with great destruction, through a region that abuts the Qinghai-Tibet Plateau and where plague is now endemic in marmots and other mamma as the sole treatment also involve raised sores: these are a prescription against “fluid- sectionfilled vesicles” that includes on the this face one (p. mentions 1213); one “cold against damage” “vermilion in its introductory toxin sores,” matter, i.e., solarge we raised swellings on the skin (p. 2990); and one against “pox-like rash” in children: the The remaining three rhubarb-only prescriptions, none for epidemic contexts, are for must take it as intended for a context of epidemic as well, though specific to children. two kinds of jaundice and for delirious speech in fever (pp. 480, 1685, and 1686). Yersinia pestis 295 EpilOGUE: The East Asian Beginnings of the omPolyt y reported by the Jin history for Kaifeng, and by Li Gao for Kaifeng and three lian hosts. But one must also note (with Cao) the extraordinary mortality for no pre-nineteenth-century infectious disease but plague. otherThe cities: history 40% of or medicine, more is a some level attestedtime ago, in movedEurasia, away to my from knowledge, “retro spective diagnosis” toward attending to the constructions that histori cal actors themselves placed on the phenomena of illness or health they experienced and recognized. This approach has illuminated much, though as a sole lens it may also obscure. The present volume, of course, is pre the diagnostic capabilities of a new type of microbiological analysis. Yet cisely focused on redefining “retrospective diagnosis” by incorporating actors placed on the thirteenth-century epidemics in China. Since all our one would still hope to know just what construction(s) contemporary temporal distance from events,16 productssources (except of the stateperhaps and Li of Gao’s literati eyewitness elites, it is account) very unlikely lie at athat considerable they even come close to exhausting the constructions and (as works that of contemporaries official history) areplaced the on these illnesses; we can only ask what our sources “construct.” But that is still worth asking. First, they see simply epidemic: yi or wen. For Chi nese medicine at the time it was arguably “epidemicity” itself, and not had arisen to treat epidemics as a single category. More importantly, our specificsources—brief symptoms, mentions that most in chronicle dictated- classification:style accounts “cold or in damage”the biographies theory policy versus symptoms.of officials or Second, military very officers importantly, taking part they in see campaigns something or newin debates: for Li over Gao this required a the remaking enemy—are of the medicinethe kinds ofleast his timelikely because to be specific it was an about epi demic that resisted usual epidemic treatment; for others, it needed expla for them. Third, they see something connected to the lifting of siege, thus nation, significantly, in the movement of people into spaces not customary gestedto contact above with may the convey besieging indirectly Mongols. our onlyAnd hintfourth, about in twosymptoms. cases (nos. 3 and 8), they see something treatable with rhubarb, which as I have sug 16 One diary of the Kaifeng siege has survived, as far as I know, written by Liu Qi Guiqian zhi. Surprisingly, his more or less month-by-month and sometimes day-by-day record jumps from the fourth month of (1203–50) and included in his miscellany sources tell us encompassed the epidemic. It seems to me very likely that he had left the1232 city straight during to that the period.seventh I month,am grateful simply to skippingStephen Westthe entire for letting period me that know our ofother Liu Qi’s diary. 296 RtobIer would Hymes argue that, rhubarb aside, these are just the terms in which a Chinese -literate audience might well construct bubonic plague that they recognized as coincident with Mongol armies moving through their states and sacking their cities. They had no exact terms for it because, as they butsaw, perhaps it was new, these and simply older madeexact itterms a particularly were (according dangerous to Li yi Gao). Finally, failing. as CaoMost suggests, striking werethe epidemics its mortality presented (which shouldthemselves strike to us all too) involved and its as speed, con comitants of war and dynastic change, thus as just one of the forms of nese records do not proclaim a “Black Death” as European records do, this doesdeath not and tell destruction us that demographically prominent across damaging China (Cao plague 1995: was 190). absent: If Chi the Chinese could construct such damage in other terms. But is there, in any case, evidence of the demographic damage one would expect from plague? Were there large population losses in the Song-Yuan or Yuan-Ming transitions? Buell says no, but other serious scholars have thought so. In their book on Chinese population history, not (in Buell’s words) “taking at face value” official Ming totals but critically mining local sources as well, Zhao Wenlin and Xie Shujun place the com bined population of Song and Jin (ruling south and north respectively) in 1210 at just over 108 million; the total population under Yuan (ruling both north and south) at a bit more than 75 million in 1292 and about 87 mil lion in 1351; and the total under Ming (also ruling both north and south) in the1381 north at about from 67Song million to Yuan, (Zhao large and loss Xie in 1984: the south 310, 333,from andYuan 364). to Ming. Sig Itnificantly, is interesting the population to compare losses this distributionhave different to distributions: Cao Shuji’s material. massive After loss his discursive treatment of thirteenth-century outbreaks, Cao simply lists yearsepidemics and cover from manythe Yuan prefectures official andhistory all regions, for 1297 but through offer little 1362 detail, (Cao17 1995:most simply 190–01). noting These “great impressively epidemic” numberfor each thirty-oneplace, with for few the numbers sixty-five or percentages of dead. If we add Cao’s earlier cases to his post-1297 list, six cases of recorded epidemic emerge between 1211 and 1292 in the north, only two in the south (the 1259 Sichuan campaign and the 1273 Guang dong case), matching the higher northern population loss that Chao and Hsieh find across just those decades. At the other end the match is less 17 Cao does not provide citations for this list, but the relevant passages I have been able to trace are in Song (1370/1976, 2: 413, 416, and 559; 3: 603, 620, 625, 740, 764, 784, 800, 820, 912, 914, 918, 944; and 4: 1080 and 1111). Yersinia pestis 297 EpilOGUE: The East Asian Beginnings of the omPolyt y clear: between 1351 and 1381 (without Ming data for 1369 on), we find soeight that epidemics the Yuan recorded court in thein the far north north to was five in in a thepoor south. position The todifficulty record southernhere is that epidemics. by the 1350s Nor should China waswe expect in chaos, plague, with if civil it was war there, in the to south, do all the demographic work in a region constantly at war. We may never sort out the relative weight of war and disease here; yet no evidence we have excludes a role for plague in southern population loss. Gaps in this picture cry out for research. As epidemic records after the inYuan his conquest post-1297 are list (even) are plagueless circumstantial because he believesthan those he of has the shown Sung-Yuan that transition, Cao Shuji (1995) simply assumes that many of the epidemics by further evidence. Some obstacles that seemed serious to earlier plague researchers,earlier ones are. however, This is nohardly longer sufficient seem so.and No badly particular needs to speed be reinforced of local spread is too fast, any longer, to represent plague, as the potentially quite only one available mode: newer research on early-phase transmission by slow “blocked flea” mechanism of older theories is, we now know, not the plausible.“unblocked” Thus, ground-squirrel for plague tofleas, ravage prairie-dog a city the fleas, size and of Kaifengeven rat (swollen, fleas has settled that18 problem and made rapid person-to-person spread via fleas seriousas we have epidemiological seen, to something problem perhaps as far as near speed 2.4 ismillion concerned. by refugees All this from also the countryside) and to kill nearly a million within fifty days presents no things,means thatneither we dorat not epizootics need to norfind rats reports themselves of mass arerat deathnecessary in our to sources spread plague.to find plague19 The apparentplausible: patchy even if characterthe sources of wereplague likely in China to attend (if many to such of there—need not be a problem either, as we now know that plague can be carriedthese epidemics great distances are plague)—now even without here, rodents then sick silent enough for a towhile, die quickly: then over in food or feed contaminated by rodent or flea feces, or by fleas themselves 18 investigatedEisen et areal. 2006; of the Eisensame genus,et al. 2007; Oropsylla Wilder et al. 2008; for a general review of this point, see Gage 2012: 86–91. Note that the ground-squirrel and prairie-dog fleas 19 Katherine Royer shows brilliantly the process by which an awareness of a variety , as the marmot flea. plague researchers was transmuted into a collective and very long-lasting conviction of mechanisms for plague transmission among early twentieth-century scientific that rats, the rat flea, and mass rat death were essential features of plague (Royer 2014). 298 Rtober Hymes the(cf. disease:especially Gansu Benedictow rodents—like 2010: those150–93). that I I argue am suggesting that it may hitched also travel rides within (transported) the Mongols—having rodents from lived populations for a very withlong atime history in a of region coping where with the plague bacillus had long been present too, may offer this possibility.20 Finally, where other populations of potential host rodents are available, time without new epizootic or epidemic activity. Many such reservoirs, orthe more bacillus accurately may settle regional down assemblagesin a new (or old) of reservoirs, reservoir forare a known considerable in the world today. This is a central point. We know that the reservoirs of plague-bearing rodents in contemporary North America, for instance, are the result of and early twentieth centuries during the Indian and Chinese plague out movements of people, rodents, and fleas from Asia in the late nineteenthY. pestis. It is reasonable to assume (in fact it is the direct implication of Cui and breaks that stimulated the first scientific work on plague and the other reservoirs known to exist in China and Eurasia were created bycolleagues’ similar processes work), and of we movement should investigate in much earlier the likelihood, periods.21 that Ann some Carmi of in the Alpine marmot population can account for the periodic recurrence chael (2014, in this issue) proposes that the formation of such reservoirs of plague in Europe after 1348 without necessarily new imports of rats, 20 Wang et al. (2009) have shown the reservoir status of Himalayan marmots in theSichuan. idea Zhangof “truly et al.independent (2012) demonstrate epizootic actualand enzootic plague tolerancecycles” that and they thus notereservoir “has dominatedcapacity in the Central literature.” Asian Yetgreat there gerbils. seems Eisen no doubt and thatGage plague (2009: is 2)resident are skeptical long-term of and California ground squirrels among them, and Eisen and colleagues’ explanation byin certaindifference rodent of reservoirs,“rates of transmission Himalayan marmots and numbers (as in the of hostsWang etinfected,” al. 2009 thoughabove) replacing a dichotomy with a possible continuum, may offer an explanation for the phenomenon more than deny it. The question would then be what factors can affect these transmission rates and numbers of infected. 21 Cao Shuji (1995: 186) appears to assume that the Mongolian reservoir pre arguedates thefrom Mongol genetic conquests, data that the and Second McNeill Pandemic (1976: 145)strain appears did not tocome make to theMongolia same beforeassumption about forsix hundredboth Mongolia years ago, and and Yunnan. my hypothesis Yet Julia hereRiehm implies and her that team the Mongols (2012) brought plague from Gansu both to Yunnan in their incursion in the 1250s and back Ottoman context: “It may be erroneous to assume that the active foci of the eighteenth andto Mongolia nineteenth at some centuries later alsodate. existed Cf. also before Varlık that (2014, time.” in this issue), dealing with a late Yersinia pestis 299 EpilOGUE: The East Asian Beginnings of the omPolyt y den of my hypothesis is that at least some of the existing rodent reservoirs infleas, China or bacilliand the from rest port of Eurasia cities or were by major established trade routes. by the Part movements of the bur of Mongol armies and are thus historical, human (not merely biological or Riehmzoological) and colleaguesartifacts with shows specific that momentsMongolia itselfof origin seems that to new have research, become aboth reservoir genetic for and post historical,-polytomy may strains establish. only afterSignificantly, the Mongol the workconquests of Julia in the south.22 lations, historical human imports in some cases? On the human side we need archeological Are local work rodent combined populations with too,genetic or their ancient attendant-DNA analysis flea popu to determine whether Y. pestis can be found in thirteenth- and fourteenth- century Chinese and Central Asian bones or teeth as it has been found in Black Death victims in Europe. The hypothesis I offer here may not be finally confirmable except by such evidence. butI ifoffer the noMongol specific expansions solution for of howthe previous the plague century gets from or more East (or did Inner indeed or establishCentral) Asia new to rodent the specific reservoirs Mongols for plague at Caffa in in other 1346 parts (if that of Eurasia,story stands), there may be no reason to assume an immediate Chinese origin for the events this respect Buell could be right. Alternatively, and I think more probably, hisof 1347 point and about after the in Mongol the Mediterranean empire’s division basin couldand Western explain Europe; plague’s and pres in before it goes west to the Golden Horde, to produce the Caffa incident. But weence should in China also and consider Central the Asia possibilities for more thanof a second a century route. (1211–1340s?) In the south tinuous presence by that time; and merchant ships sailing to the Indian Ocean,there are which major since epidemics mid-Song in 1331, had carried 1333, 1344,an extensive and 1345, Chinese suggesting trade withcon both south Asia and the Middle East, departed from the south (Sen 2006; turesChaffee affected 2006; includedClark 1991; Songjiang, So 2000). Jiaxing, Especially and Hangzhou. interesting The in threethis connec lie in a northeasttion are the-to epidemics-southwest recorded arc along for the 1333 southeast and 1344.China Incoast 1333, in what the prefec is now Zhejiang; more importantly, the major Shanghai and Ganpu ports where to tax but also encourage trade with the south seas lay within Songjiang the emperor Khubilai had established official Offices of Maritime Affairs and Hangzhou respectively: here, then, were major epidemics in 1333 22 Riehm et al. 2012; see n. 21 above. 300 Rtober Hymes Yuan trade with the Indian Ocean passed. The most important of those fourat or ports,near two however, of the fourwas Quanzhouofficially sponsored in Fujian. ports through which most were concentrated in Fujian and affected Fuzhou,23 Yanping, Shaowu, and The epidemics in 1344 and Yanping bordered it directly, while Shaowu and Tingzhou were moun Tingzhou prefectures. Quanzhou is not specifically listed, but both Fuzhou theirtain prefectures feces could joined have byfound overland their tradeway from and downriverany of these traffic epidemic to the pre fecturesfecture in to which the Quanzhou Quanzhou port port and lay. onto Goods South infested Sea trading with rodents, ships. The fleas, con or siderations on distant transmission that I have already touched on seem to me to leave it possible that plague moved from China to, for example, the Persian Gulf by sea and thus contributed, if not to the European Black DeathThere is(it also may the be problemdifficult toof siegeposit conditions,plague’s passage and why north plague from would the Gulf seem to24 theso strongly Golden Horde’sassociated territories), with them perhaps in China. to This its Middle may go Eastern back to equivalent. the identity foci in Gansu and the Qinghai-Tibet Plateau, are unlike rats in being able to liveof the for rodent: extended if (for times instance) as stable marmots, carrier- populationsor other rodents for the from bacillus, the plague then perhaps it is siege that turns stable carriers into unstable ones. If so—and this is speculation apart from my main hypothesis—perhaps nutrition is key. Perhaps in sieges the rodents brought from far away, like humans, begin to starve, or switch to new foods, and this changes their relation to the bacilli that some of them carry. We still know too little about how enzootic turns to epidemic; and a key element that my hypothesis glosses over for now is the identity of the plague-carrying rodents I am propos the main, though not necessarily the only, carriers of plague in that region today;ing came but with does the Marmota Mongols fromhimalayana the territory descend of Xia. low Marmots enough seem from to the be 23 For Khubilai’s decree establishing Quanzhou, Shanghai, Ganpu, and Qingjiang as 24 thesites possibility of Offices ofof IndianMaritime Ocean Affairs, transport see Song of plague, et al. 1370/1976, though not necessarily94: 2401. from China, On the practicality of sea-borne transmission, cf. Benedictow (2010: 185–87); on the genetic evidence may support the notion of two sources for plague in Anatolia see Green (2014b, in this issue). See also her introduction, in which she suggests that showingand North that Africa distinct (Green strains 2014a, seeming in this to issue). belong This to separate possibility points is strengthened on the polytomy and extended to Europe by the work of Stephanie Haensch’s team (Haensch et al. 2010), may support the possibility of separate transmissions both overland and by sea. later identified by Cui’s team are both present in European Black Death victims. This Yersinia pestis 301 EpilOGUE: The East Asian Beginnings of the omPolyt y with the Mongols and their encampments? Are marmots capable of enter ingmoun somethingtain slopes like of athe commensal region to relationhave had with significant human enough beings, encountersat least for long enough to be transported into other regions of China in their store- wagons and feedbags?25 If not, could other rodents in the Gansu corridor have played this role? Studies of the distribution of plague among rodents in the larger region have concentrated more on Qinghai than on Gansu,26 so new work may be needed there. And ultimately we need to know about Gansu rodents in the thirteenth century more than now, which argues a Weneed have for bio-archeologicalseen it used twice work against in the oldepidemics territory I have of Xia. traced here, and I haveAs traced a final how point those for further mentions research might constitutethere is the a hintquestion as to ofsymptoms. rhubarb. But the story of rhubarb and plague in China may not end there. Cao Shuji cess in treating bubonic plague with very high rhubarb doses (Cao 1995: cites the traditional Chinese physician Li Jianshi who, in 1935, claimed suc physicians in China are currently undertaking research on why rhubarb is189; effective I have againstnot so far Y. pestisbeen able, apparently to obtain having Li’s book). already Biomedically concluded trained that it they tell us that everybody who took rhubarb survived in order to believe thatis (Bai some et al. ameliorative 2008). We effectneed notmay take have our been Song-Yuan at work. sources’Where did word Li Jianshi when and current researches get the idea of trying rhubarb against plague in 25 Voluntary stowing-away need not be the only plausible means for marmots to move with the Mongol armies into China. The Secret History of the Mongols, Marco Polo, and contemporary Chinese observers all report that the Mongols, in their native territory, hunted marmots for food (Cleaves 1982: 29; Smith 1984: 223; anBuell important and Anderson food for 2000: Mongol 45). armies It is likely on the that move, they and made concluded use of the that pelts they as “must well. haveJohn Massonbeen a supplementary Smith (1984: 227) rather has than considered a basic component the possibility of Mongol that marmots rations.” were But fora supplementary future use, either role as would food orsuffice as furs. for Ifthe Mongols purpose were of my already hypothesis eating ifor it clothing should motivate Mongol troops in Xia territory to capture local marmots and transport them begun there; but as this epidemic was likely also either to burn itself out or destroy thethemselves army outright in marmot on the in spot, Xia territory,it is probably a plague easier epidemic to account in fortheir the army pattern might of siege have- related epidemics in China if we suppose that marmots carrying the plague bacillus, but not yet sick and transmissive, were transported alive to China and transmitted the disease to humans later under siege conditions. 26 aware of this article. See for instance Yang et al. 2014. I am grateful to Monica Green for making me 302 Rtober Hymes Yelü Chucai and others in the thirteenth century? from the Prescriptions theby Imperial first place? Grace Did of a 992?belief from in its local effectiveness knowledge descend in Gansu? historically Does rhubarb from actually inhibit Y. pestis, and if so, how?27 There is historical, medical-his torical, and perhaps even medical investigation to be undertaken here. I am proposing, in sum, that we may need to place the “beginnings of the Black Death” more than a century earlier than we have been accus tomed to place them. My suggestion that the expanding Mongols were the 27 Here I might risk an even more speculative expansion on my speculative suggestion above, about nutrition in rodents. Oddly enough, the Qinghai-Tibet-Gansu region that is the original home of plague is a natural botanical home of undomesticated rhubarb carrier of plague in that region—are reported by contemporary travelers to eat large as well (Wang et al. 2010; Foust 1992). Marmots—again,: the most frequent rodent quantitieshunters of ofrhubarb rhubarb for leaves medical (Anon. purposes 2013 noted2). Awareness how commonly of a connection marmot betweenburrows weremarmots to be and found rhubarb surrounded in this and region shaded is bymuch rhubarb older, plants, however: and argued the first that European marmots were enabling the growth of rhubarb by aerating the soil with their burrowing toxicactivities: to humans see Burke because (1767: of their 84–85, high quoting oxalic acidJohn content; Bell’s memoirs the content of his of travels,the stems in this instance with regard to Mongolian marmots and rhubarb). Rhubarb leaves are used the root, dried; it should be noted however that drying vegetables typically and roots, though lower, is significant as well. (Traditional Chinese medicine always Y. pestis researchers to breed nondoubles-virulent the proportionstrains in vitro of oxalic acid; cf. Paul et al. 2012: 313, especially table I.) theirOxalic inhibited acid compounds reproduction (oxalates) on oxalate have- rbeenich agar used (Bhaduri, by Chaney-Pope, and Smith (Higuchi and Smith 1961) or to detect virulent strains by needs for its virulence plasmid: batches raised in calcium-poor conditions develop either2011). without This works, the plasmid it seems, or withbecause drastically oxalic acidreduced binds reproductive calcium, which rates. the Rhubarb bacillus is not the only plant food high in oxalic acid: two more are oats and buckwheat, which a train rides during the Indian and Chinese plagues of the last century (Benedictow horse-borne army might carry with it in grain bags, just the way rats and fleas hitched and2010: epidemic 160–61). the Alongside Jin government, rhubarb needing we have money seen “medicinalto repair the leaven” city wall, or yeastcakeput a special as a treatment for the disease in our sources (no. 7, above); and after the 1232 siege tax on tea-leaf sellers—along with coffin-makers, clergy, and physicians—because all forthese prayers had “arrogated and funerals, great of profitcourse; to butthemselves tea-leaf sellers?since the Tea epidemic-leaves, itbegan” turns (Tuotuoout, are extremelyet al. 1345b/2004, high in oxalic 1: 311a). acid, Coffin-makers and so are many for the yeasts. dead, Does doctors in vitro for the modulation sick, clergy of Yersinia pestis virulence or reproduction via oxalates work to some extent in vivo intoo? quite Had other Central ways, Asian in a thirteenthmarmots benefitedcentury crisis? from this for millennia, and did some Mongols, Jurchen, and Chinese benefit from it, though of course theorizing its benefit Yersinia pestis 303 agents Epil of OGUEplague’s: Th espread East A issian hardly Beginnings new, but of my th hypothesise places omP oltheyt crity ical moment neither in the Mongols’ emergence from their native steppe, but in their repeated assaults on and eventual highly destructive conquest ofin itself,a state nor that in theirsat cheek passage-by- throughjowl with Yunnan what theinto new Sichuan genetic fifty evidence years later, is framing of the hypothesis that the genetic evidence points not only to a telling us was probably the first home of plague. It has been crucial for the region but to a well-defined period. Most people in the world today have andnever then heard Jurchen of the states state forof Xia, almost or of two the hundredMi (Tangut) years. people But ifwho the foundedhypoth it and successfully defied or coexisted with powerful neighboring Chinese conquest outside of Mongolia has had enormous consequences for the historyesis I articulate of the medieval here is correct,and modern the Mongols’ worlds. choice to make Xia their first Afternote When Monica Green kindly invited me to contribute to the present issue, I had been away from the direct study of plague in Song-Yuan China for many years and had not followed all new developments. Thus, it was only Shuji’s more recent book on the history of plague in China and its associa when this article had reached its final stages that I was able to acquire Cao able to undertake only a quick review of the historical sections so far, and havetion with not yet war, tracked coauthored down with all the Li sourceYushang passages (Cao and that Li 2006).Cao and I haveLi cite. been On the Mongol-associated epidemics I discuss here, their evidence is essen potentially problematic is their position, new for Cao, on certain epidem tially the same as in Cao’s 1995 article (Cao and Li 2006: 79–99). More ics Spaceof the doesearly notJin (1139–48),allow a thorough which examinationthey also believe of their to be evidence, plague (Cao but and Li 2006: 60–65). datou wen, literally the “big-head epidemic” that their sources describe for the early Jinon myepidemics, examination is plague. so far Among I find itthe very sources hard tothey agree cite, that only the retrospective accounts of Yuan or even Ming date mention sores of any kind (by which time, on my hypothesis, plague was known from recent experience in north China and later in south China, and retrospection could conceivably sources seem to describe a condition of general swelling of the throat- andhave-neck conflated and often two differentof the face, epidemic-associated which they further diseases); describe andas regularly all their involving “the throat closing” and an inability to open the eyes, a “filling” 304 ofRto theber eyes Hymes and ears obstructing sight and hearing, and a “head like an ox.” I have not encountered any accounts elsewhere of blindness, deafness, inability to open the eyes, throat-closing, or generalized swelling of the neck -and-face area as standard symptoms of plague. A Ming source (cited epidemic” with the popular disease names “frog epidemic” and “cormo byrant Cao epidemic” and Li 2006: similarly 57–67 seems but especially to point 60–65)to a generalized that associates swelling “big-head of the throat-and-neck, since a frog puffs out its whole throat and a cormorant famously expands its throat when it swallows a large food item. Neither seems a likely simile for a discrete bubo on the neck. I am currently undertaking deeper research into the medical sources Cao and Li cite on these issues, as well as other medical sources of the The scholarly discourse on plague among non-Chinese scholars has yet sameto take period, any notice, and will as publishfar as I myknow, findings of this on book. them Norseparately has work elsewhere. in that noticediscourse is well (that overdue. I am aware of, other than my own) paid proper attention to Cao’s 1995 article and his first heroic assembly of sources there. 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Zhao, etJournal al.. 2014. of “[AnalysisPreventative on theMedicine Results of Etiology and Serology of Plague in Qinghai Province from 2001 to 2010],” Yuanchao mishi 元朝秘史 [ 鮑思陶 ] 48, no. 2: 124–27 Yersinia pes- tis and its Antibody Response. [1240?]/2005. in Great Ed. Gerbils Bao Sitao (Rhombomys (Ji’nan: opimus Qilu shushe) Zhang,cutaneous Y., X. Dai, Infection,” X.Wang, PLoS A. Maituohuti, One et al. 2012. “Dynamics of Zhao Wenlin 赵文林 谢淑君 Zhongguo renkou shi 中国人口) by Sub 史 7, no. 10: e46820 and Xie Shujun . 1988. (Beijing: Renmin chubanshe) 308 Rtober Hymes Robert Hymes History at Columbia University. He received his BA from Columbia College ([email protected]) is H. W. Carpentier Professor of Chinese Much of his work so far has focused on the social and cultural history of middle period(1972), andand earlyhis MA modern (1976) China, and PhD drawing (1979) questions from the Universityand sometimes of Pennsylvania. data from cultural anthropology as well as history, and using the methods of the local histo rian to study elite culture, family and kinship, medicine, religion, and gender. His publications include Statesmen and Gentlemen: The Elite of Fu-chou, Chiang- hsi, in Northern and Southern Sung Ordering the World: Approaches to State and Society in Sung Dynasty China (Cambridge,Way and Byway: 1987); Taoism, Local Religion, and Models of Divinity in Sung and Modern China (Berkeley, 1993, co- Statesmenedited with and Conrad Gentlemen Schirokauer); and Way and and Byway won the Joseph Levenson Prize of the Association for Asian Studies for the best book on (Berkeley,pre-1900 China 2002). in Boththeir simultaneously: one on the notion of “belief” (xin yearsperiod of China, publication. and one He on is the now origins working of the on Black two (heDeath hopes) in Central book-sized and East projects Asia, of which the present article is a preliminary product.) in the mentalités of middle- Abstract duced most existing strains of Yersinia pestis and locating its original home to the The work of Cui et al. (2013)—in both dating the polytomy that pro tion for historians of East and Central Asia to investigate from their own sources. TheQinghai-Tibet present article Plateau—offers offers the ahypothesis genetically that derived the polytomy specific historicalmanifests proposiitself in century and continues in the Mongols’ expansion into China and other parts ofthe Eurasia. Mongol Theinvasion hypothesis of the Xiarelies state to ina considerablethe Gansu corridor extent inon the work early of thirteenthCao Shuji than either Cao or William McNeill have previously posited. (1995), but argues for a different means and direction for the spread of plague Keywords Plague, Mongols, China, Black Death, Song Dynasty, Yuan Dynasty, Jin Dynasty, Xia, Gansu, rhubarb, oxalic acid. FEATURED SOURCE DIAGNOSIS OF A “PLAGUE” IMAGE: A DIGITAL CAUTIONARY TALE MONICA H. GREEN, KATHLEEN WALKER-MEIKLE, and WOLFGANG P. MÜLLER of this special issue of The Medieval Globe, “Pandemic Disease in the Medieval World: Rethinking the Black Death,” A particular objective histories can enrich and expand one another. Science, we have argued, hasis to developed interrogate methods how scientific to reconstruct and humanistic the deep approacheshistories of topathogenic plague’s organisms in addition to studying them as they exist in the present-day world. At the same time, the humanistic disciplines retain their power to reconstruct human activities that may have contributed to Yersinia pes- tis humans responded to that threat. All disciplines involved in the analysis of the’s amplification past have rigorous throughout standards the world of what and constitutes to describe evidence and explain and what how kinds of interpretations are valid. Multidisciplinary work demands due respect for those traditions. This short essay offers a lesson in caution. It is a story of error, but also an opportunity to be reminded of the care needed to properly contextual ize all our evidence—to be reminded, as L. P. Hartley famously said, that “the past is a foreign country: they do things differently there.” To negoti ate this country successfully, we need to learn its language. The image on the following page (Plate 3 past decade in a variety of popular media: Wikipedia, pamphlets for sale at tourist sites, the cover of an encyclopedia devoted) has been to the reproduced Black Death, in the an exhibit on the Black Death at the Museum of London in 2012, a NOVA docu mentary, and an essay in one of the world’s leading science journals. It even appeared in one of our own publications, inserted by an editor without con Our thanks to Lucy Freeman Sandler for her wise counsel on the correct “reading” of the Omne bonum images; to Peter Murray Jones, for help transcribing the manuscript; and to the members of the 2012 National Endowment for the Humanities Summer Seminar, “Health and Disease in the Middle Ages,” for help spotting popular uses of the “plague” image. Monica H. Green’s contribution to this study was written, in part, during a leave supported by the Institute for Advanced Study, Princeton, and funded by the National Endowment for the Humanities and the Willis F. Doney Membership Endowment. necessarily represent those of the National Endowment for the Humanities. Any views, findings, conclusions or recommendations expressed in this essay do not – The Medieval Globe 1 (2014) pp. 309 326 310 Monica H. Green, Kathleen Walker-Meikle, and Wolfgang P. Müller Omne bonum. London, British Library, MS Royal 6 E VI, vol. 2, Reproduced in accordance with the British Library’s guidelines for the Platereproduction 3. James of le images Palmer, in the public domain. fol. 301rb (detail). 311 Diagnosis of a “Plague” Image: A Digital Cautionary Tale bysultation priest.” (Green1 2011). It is accompanied by captions such as “monks, dis figuredwas an byinterpretive the plague, essay being in blessed Nature by accompanying a priest” or “Plague the announcement victims blessed of the complete Perhaps sequencing its most of the significant Yersinia usepestis was genome in Callaway retrieved 2011, from which the captionmid-fourteenth-century “Historical descriptions London of Black the Black Death Death Cemetery, have helped the first link pathogen Yersinia pestisfully sequenced with the disease.” from historic One could remains say (Bosit has et become al. 2011). the There, iconic it represen bore the tation of the Black Death. Available for download on the British Library’s website since at least 2007, it is ubiquitous, and people have accepted it as a representation of “plague” because they have been told that it is. There is certainly reason to connect the image to the Black Death, at least on chronological grounds. The medieval manuscript from which it comes has been securely dated to a couple of decades after the arrival of are represented with similar lesions would suggest, from our biomedical perspective,plague in England that this late is indeedin 1348. an Moreover, infectious the disease. fact that all the “victims” tions attached to the image offer several misreadings. First, medieval iconographicBut connecting conventions it specifically indicate with that plague the “priest” is wrong. is notThe a modern priest but cap a bishop, shown with the distinctive bishop’s mitre. Second, his hand ges ture tells us that he is not “blessing” the individuals in front of him but giving them instruction on the performance of their duties. The “plague victims” are all tonsured, indicating their clerical status, a fact one caption were tonsured, so “monks” is too precise. reflectedSo how by should identifying the image them be as “read?” “monks.” It is Butan illuminated clerics of various initial in statuses a man uscript (specifically, the letter “C”), meaning that we know precisely the clopediacontext for of whichknowledge it was called made. Omne The imagebonum (which measures 7.2 cm × 7.6 cm in the original manuscript) illustrates a passage in a two-volume ency , “All That Is Good,” an unfin2 ished opus by a London clerk, James le Palmer (b. before 1327, d. 1375), who was employed in the royal Court of the Exchequer (Sandler 1996). 1 The quotations come, respectively, from the British Library’s Images Online page Wikipedia (first accessed May 3, 2011) and the entry for “The Black Death” (first accessed February 12, 2007; most recently accessed April 24, 2014, where the 2 reference to the “priest” is now gone). On the British Library site, see below. initials.London, All Britishthe images Library, in the MSS two Royal manuscripts 6 E VI (letters can be A–D) consulted and 6 Efree VII of (E–Z), charge together at the comprising almost 1100 folios, more than 1350 entries, with more than 750 historiated 312 TheMonica topic H. Gofreen the, chapterKathleen which Walk iter illustrates-Meikle, an (transcribedd Wolfgang Pand. Mü llertranslated below) asks whether clerics should lose their leprosybenefices clerics on account below the of (chronic) infirmity or sickness. The general answer (which varies depend givening on an the assistant cleric’s whorank) receives is that ifpart the of debility the prelate’s is income. rankIf weof bishop look back should at the be imageremoved now—with from office, a full but understanding a bishop should of itsbe aaccompanying quickly lethal text—we disease seelike it plague. anew. We We notice, see no first, buboes that so the characteristic “victims” are ofstanding, the bubonic not lying form prostrate of that disease. as we would While expect that is werenot a theydecisive afflicted indicator with (after all, neither the quickly lethal pneumonic nor the septicemic plague dispersed spots on these “victims” are a telling trait. Petechiae and ecchy would necessarily have produced visible buboes), the prominent, widely thatmoses is (skinnot what hemorrhages spotted skin of varying meant insizes) medieval are known iconographic to be an occasionaltraditions. Depictingcomplication skin in as severe spotted cases was of the plague traditional (Carniel way 2008, of representing 118–19). However, leprosy tional iconography is found elsewhere in this same manuscript, used to in medieval European painted art (Boeckl 2011). Indeed, this conven cured of his leprosy when he converted to Christianity (MS Royal 6 E VI, depict the Emperor Constantine (d. 330 CE), who is alleged to have been dition—“correct” in terms of medieval Europe’s own categories of analy sisvol. (an 1, fol. emic 394r). In other words, a correct “diagnosis” of the depicted con shows victims of leprosy, not plague. At what point, approach; then, see did Green this image 2014, becomein this issue)—is a depiction that of this “plague”? image Medical historians have long referenced the Omne bonum’s useful images of anatomy, bathing, circumcision, dentistry, and surgery (MacKinney either leprosy or plague. In 1996, art historian Lucy Freeman Sandler’s 1965; Jones 1984 and 1998); but none associated its illustrations with masterfulThat correct two-volume association study ofwith Le Palmer’sleprosy seems work correctlyto have3 brokenidentified down, this imagehowever, as ain reference two stages. to leprosy In 2007, (Sandler the British 1996, Library’s 2: 110). online Catalogue of Illuminated Manuscripts, though drawing broadly on Sandler’s work, Omne bonum without any diag described the image on fol. 301rb of the British Library’s Catalogue of Illuminated Manuscripts site: 3 On le Palmer’s medical interests, which “fall into the category of the endemic rather thancatalogues/illuminatedmanuscripts/welcome.htm> the epidemic,” see Sandler 1996, 1:120-21. [accessed April 24, 2014]. 313 Diagnosis of a “Plague” Image: A Digital Cautionary Tale blessing four clerics with faces covered with spots.” That diagnostic void nostic specificity: “Detail of a historiated initial “C”(lericus)4 of a Imagesbishop Online photoin interpreting of the historiated the “spots” initial, was thenposted filled around in the the British same Library’stime, was newly interpreted webpage with the(where caption high “Plague quality victims images blessed are sold by for priest.” a fee),5 The when cap a tion is still there, at the time of this writing. Thus, the widespread error in “reading” the Omne bonum image as if it depicted plague is not an example of the dangers of retrospective diag nosis: the taking of modern diagnostic categories and projecting them into the past (an etic had in fact “diagnosed” it correctly as “leprosy,” a “reading” of the image supported by both the approach;surrounding see text Green and 2014,medieval in this iconographic issue). Sandler tradi tions. The confusion surrounding the Omne bonum image had its genesis rather in mundane, very modern phenomena: the mislabeling of the image in the act of separating it from its textual home in the British Library’s Images Online database, and then the willingness of users of that data base to accept the label rather than attempt to recontextualize the image in its original manuscript or historical context. Moved to an online venue, stripped of its textual surroundings, the image acquired a free-association viral. Had proper rules of analysis been applied when labeling the image, noconnection error would to plague. have been And generated.from there Butit went given (if the you’ll nature pardon of the the Internet, phrase) it will now have an extended life under that mistaken rubric. This error is instructive in reminding us how important context is to the evaluation of the often meager evidence that survives from the medieval past, whether that be fragments of microbial DNA or chance references to illness in chronicles. In the case of the Omne bonum, which gathered together all sorts of information that contemporary clerics might need, leprosy—a disease prevalent throughout Europe since the early Middle Ages and a topic of concern in canon law since the twelfth century—was the more pressing concern, as its slowly debilitating effects impinged on clergy members’ ability to perform their tasks. The issue took on new urgency in fourteenth-century England, since a few decades before the Omne bonum was assembled the abbot of St. Albans and noted astrono mer Richard Wallingford (d. 1336) had had a contentious period of rule, 4 British Library, Illuminated Manuscripts Online, 5 British Library, Images Online illuminatedmanuscripts/ILLUMIN.ASP?Size=mid&IllID=40313> [accessed April 24, 2014]. , started1375, must work certainly on the Omne have witnessedbonum. But plague what strikeimages England did he himselfin 1348–50, have whenof that he experience? was a young We adult, cannot and know. again The in crowded1361–63, cemetery when he he had depicts already in the Omne bonum corus- cacio corvus(fol. 267v) may havecrocus had no more personal resonance for him than the images of (to take other examples from the letter “C”) (lightning), (raven), or (the flower crocus). In contrast, istthe handsomely Belgian chronicler to include and abbotillustrations Gilles le in Muisit his Chronicle (d. 1353), who was himself Thesenearly includedblind at the three time images of the that Black rightly Death remain (Chareyron emblematic 1996), ofpaid the an social art disruptions of the Black Death: a depiction of the burning (d’Haenens of a community 1969). of 7 Gilles’s project was, to Jews, a procession of flagellants, and a mass burial. associatebe sure, unusual with the as experience an illustrated of plague monastic and chronicle a macabre (Vanderputten outlook on life 2005), take and it would not be until the fifteenth century that most of the images we No images that seem to depict plague are known from the late medi evalhold Islamicin Western world, European and none culture have (Boeckl yet been 2000 noted and in Gertsman Chinese sources.2010). In neither case does that absence of visual evidence constitute evidence8 of eignabsence country” of the whose disease. languages But it may we reflectmust continually differing understandings attempt to learn. of art or death or the functions of symbolism (Jones 2007). And that is the “for 6 British Library, MS Cotton Nero D.vii, fol. 20r; and MS Cotton Claudius E.iv, pt 1, fol. 201r.North On 2004;medieval cf. Rawcliffeleprosy generally, 2006: 253–54 see Rawcliffe and 266–67. 2006 Theand likenessesDemaitre 2007. are London, On the rich canon law tradition of discourse about leprosy among the clergy, see Fowler 1972. On bioarcheological and genetics work on the form of leprosy caused by Mycobacterium leprae 7 , see Mendum et al. 2014. Brussels, Bibliothèque royale de Belgique, MS 13076–77 (1349–52), fol. 12v, Jews being burned alive on a bonfire; fol. 16v, procession of Flagellants; and fol. 24v, plague 8 We thank Stuart Borsch, Justin Stearns, and Emilie Savage-Smith for their counsel (masson this burial) matter. in Tournai in 1349. APPENDIX 1 TEXT OF OMNE BONUM, “DE CLERICO DEBILITATO MINISTRANTE SEQUITUR VIDERE” of Omne bonum was transcribed from The following portion fromthe manuscript two sets of London, sources. British Library, Royal 6 E. VI, vol. 2, fols. 301rb– 302ra. Its author, James le Palmer, originally pieced this passage together Summa aurea Lines 2–63 (lines 2–64 of the English translation in Appendix 2, below) constitutenabula, and an early extensive modern excerpt printed from editions Hostiensis (including (d. 1271), Basle: apud Thomam X 3.6, a text which survives in numerous late medieval manuscripts, incu Guarinum, 1573, cols. 702–03, digitally available through the website of fromthe Bayerische the Glossae Staatsbibliothek ordinariae on in the Munich, Liber extraGermany). Lines 64–109 (in the English translation:Decretum lines Gratiani 65–112) are a miscellany of notes derived (lines 64–82; English: of65–83) Pope Bonifaceand the VIII, inserted under (linesthe same 105–109; title (De English: clerico debilitato107–112), inplus his an Liber extensive sextus quotation (lines 83–96; English: 84–98) from a statute Glossa ordinaria ) The Ordinary Glosses VI can3.5.1 be (compiled consulted 1298),in any editionalong with of the portions Corpus ofiuris its canonici published by before Johannes the Monachus1620s. (lines 97–104; English: 99–106). The spelling of the text follows the Latin original, except for consonan tion of words and the punctuation have been modernized. Textual emen tal ‘u’ and ‘i’, which have been regularized to ‘v’ and ‘j’; both the capitaliza dations are shown in pointed brackets (<…>). The shortened legal refer ences (in round brackets) are given in full in Appendix 2. [fol. 301rb] Clericus debilitatus ministrans. invenitur:Clericus debilitatus Morbus est per habitus infirmitatem cuiuscunque ministrans, corporis quid contra juris? Etnaturam primo sciqui usumendum eius est ad quid id facitsit infirmitas deteriorem sive cuius morbus. causa Aputnatura Sabinum nobis eius sic sanitatemdiffinitus 5 corporis dedit. Vel autem id in toto corpore accidit ut febris, alias in parte 316 utMonica cecitas. H. G Balbusreen, Ka autemthleen magis Walk erviscosus-Meikle dicitur, and W olfgangquam morbus. P. Müller1 Videtur autem morbus sonticus id est dampnosus scilicet recidivus qui incidit in hominem postquam sanatus est. Sontes enim nocentes dicuntur. 10 suum distingue utrum sit prelatus. Et is etiam propter lepram non [fol. 301va]An propter removetur, infirmitatem sed datur eisive coadjutor morbum cui amittatporcio competens clericus beneficium reddituum 15 episcopatus assignatur. Sic intelligas e physicisDe rectoribus relinquo. (X 3.6.3); Et potest aut divino esse divino judicio, judicio et sic quialoquitur cognovit capitulum, mulierem Tua 20 nosinmediate (X 3.6.4).3 post Cuiusleprosum cognicionem, determinationem et discrescionem 4 quamdiu potest quis in collegio, vii q. iiremanere c. Nuper non(C.7 removetur.q.2 c.2). Hec Sed tamen ex quo solutio non potestreprobatur removetur, vii q. isicut 25 fueritEt si inferior queras quidsive simplexfiet si servire dabitur non ei potest, vicarius respondeo: secundum si estGoffredum prelatus dabitur ei coadjutor ut in dicto capitulo, De rectoribus (X 3.6.3). Si vero administracionis.qui exponit illam Thomasdecretalem,5 notavit Tua idem (X 3.6.4) excepto sicut morbo Laurentius lepre, propterscilicet quemquod ibiremovetur removetur indistincte scilicet quicunquenon a titulo, ipsum sed incurreritab executione sive sit officii prelatus sue sive alius. Et hoc conprobatur in antiqua compilacione, De concessione 30 prebende et ecclesie non vacantis, capitulo Ex transmissa (2 Comp. Goffredum. Bazianus distinctit utrum morbus esset curabilis et sic 3.7.1); que hodie tamquam iniquitatem continens remota est secundum 35 loquitur capitulum, De rectoribus (X 3.6.3), vel incurabilis et sic loquitur Tua (X 3.6.4). Prior intellectus magis placet et ipsum magis approbo, eodem titulo, Ex parte (X 3.6.5). 1 A marginal entry to the right of this line reads: Nota hic plene et ex alia parte folii quando clericus amittit beneficium suum propter morbum et quando non videas (Note here in detail and also check on the next page of the folium when a cleric loses 2 MS: prevenerit. The likely formal source of Omne bonum, the Summa aurea of Hos his benefice because of disease and when he does not). tiensis, has provenerit. 3 MS: prohibitis; Hostiensis: physicis. 4 Cf. the commentary in Appendix 2 below, note 2. 5 MS: Thomas; Hostiensis correctly has: T Sed que est ratioDiagnosis quod specialeof a “Plague sit in” I mageepiscopis: A Digital quod Cpropterautionar lepramy Tale Quamvisnon removeantur, enim metropolitanus inferiores vero et episcopi removentur? possint Hoc cognoscere est quod dedifficulter crimine superremovetur quo accusaturepiscopus, episcopus ut extra, De non translatione, tamen possunt capitulo episcopum Quanto deponere(X 1.7.3). 40 sine legitima proprietate, iii q. vi Quamvis (C.3 q.6 c.7) et capitulo Dudum (ibid., c.9). Timendum enim est, ne concussis columpnis corruat sededificium. pocius Sed dandus minores est coadjutor ex levioribus etiam causis si paraliticus removentur. sit is Sed de quo propter agitur, alias ne 45 infirmitates quam propter lepram non sunt clerici privandi beneficiis suis, terreantur volentes Deo militare, ut e 6 7 MS: extra, de re iudicata, c. Omnium, is a garbled, non-existent allegation, prob A finger pointer appears here in the left margin of the ms. cites the passage from Justinian’s Digesta as given by Hostiensis. ably reflecting a lack of familiarity with Roman legal references. The text here properly 318 scandaloMonica H . propterGreen, Kathleen Walker-Meikle, and Wolfgang P. Müller 75 8 deformitatem, sed ceteris officiis sacerdotalibus fungi sumerepotest, e An archidiacono percusso morbo paralitico sit dandus coadjutor? extra, De homicidio, capitulo Tua nos (X 5.12.19). 80 Dic quod sic. Et idem est dicendum si amiserit officium oculorum, extra, nequeate vel incurabili morbo gravatus noluerit habere coadjutorem tunc nichil 90 innovabitsive coadjutores capitulum, ad dictum sed capitulum officium intimabit exeguendum. pape Sedstatum si episcopus et conditionem senio fuerit ordinatum et coadjutores isti habebunt sumptus moderatos de proventibusepiscopi et ecclesie episcoporum et facti incircumstancias quorum auxilium et tunc assumuntur. fiet quod per Sed papam bona prelatorum non alienabunt et reddituri sunt rationem episcopo si postea 95 fuerit sane mentis eidem seu successori episcopi, extra, e capitulo Pastoralis, libro sexto (VI 3.5.1). Nec isti coadjutores possunt[fol. conferre 302ra] beneficia Monachum vacancia et Guidonem. quia in generali 100 commissioneItem nec per non metropolitanum continetur beneficiorum est dandus collacio, coadjutor, e sibi decreta quod a jure reperitur concessum vel ex prisca consuetudine 3.5.1), nec mirum quia solum potest metropolitanus in sua provincia 105 An sacerdos leprosus posset licite missam celebrare? Dic quod populo nonintroductum, debet celebrare ut in dicto propter capitulo scandalum. (X 3.5.1) secundumSi autem velit Johannem celebrare Monachum. privatim non est prohibendus dum tamen non sit nimis debilis vel deformis. Et dicit Hugo quod cessabit a ministerio suo quoad sanos, sed leprosis poterit cantare et ministrare divina, xlix di. Hinc etenim9 (D.49 c.1). 8 At this point, the word debilitatem 9 MS: Sed hec entenim; corrected after Hostiensis. is first added and then deleted by the scribe. APPENDIX 2 OMNE BONUM, “ON MINISTRATION BY A DISABLED CLERIC” of this passage contains numerous ref erences to the textbooks of late medieval jurisprudence which, in accord anceThe withEnglis currenth translation scholarly convention, have been abbreviated as follows: 2 Comp. 0.00.00 Compilatio secunda, book 0, title 00, chapter 00, ed. Emil Friedberg, Quinque compilationes antiquae necnon Collectio canonum Lipsiensis C.00 q.00 c.00 Decretum Gratiani, part II: Causa (Leipzig: 00, quaestio Tauchnitz, 00, 1882). capitulum 00, ed. Emil Friedberg, Corpus iuris canonici 1 D.00 c.00 (Leipzig:Decretum Tauchnitz, Gratiani, part 1879). I: Distinctio 00, chapter 00, ed. Friedberg, Corpus iuris canonici 1 (Leipzig: Tauchnitz, Dig. 00.00.00 1879).Digesta Iustiniani, book 00, title, 00, lex 00, ed. Paul Krüger and Theodor Mommsen, in: Corpus iuris civilis, 1: Institutiones, Digesta VI 0.00.00 Liber sextus decretalium (Berlin:, book Weidmann, 0, title 00, chapter1895). 00, ed. Friedberg, Corpus iuris canonici 2 (Leipzig: Tauchnitz, 1881).Decretales Gregorii IX (Liber extra chapter 00, ed. Friedberg, Corpus iuris canonici 2 (Leipzig: X 0.00.00 ), book 0, title 00, For further informationTauchnitz, on 1881).the legal references and most of the juristic Omne bonum, authors quoted (indirectly) in the subsequent section of see Brundage 1995: 190–232. 320 Monica H. Green, Kathleen Walker-Meikle, and Wolfgang P. Müller On Ministration by a Disabled Cleric What is the law regarding ministration by a cleric who is disabled by ill is found in Sabinus1: A disease is an unnatural condition of a body which 5 weakensness? First, its it use has for to thebe known purpose what that an Nature illness assigned or disease when is. This it gave definition health to our bodies. This happens either to the whole body, as with a fever; or to one part as with blindness. Stuttering, however, is more of an impairment than a disease. A disease appears to be sonticus, that is harmful and caus 10 sontes means “harmful ones.” ing a relapse, when it inflicts a person after she or he has recovered. For not[The removed next question even because is] whether of leprosy, on account but he of is infirmity given a coadjutor or disease to awhom clerk ashould suitable lose portion his benefice. of the Itbishopric’s depends onrevenue whether is assigned.he is a prelate. This is Then how he you is 15 distinctionshould understand asks whether X 3.6.3. the Or diseasehe is a parish happens priest naturally, or lesser and minister this is disand someone like that is removed because of leprosy, as in X 3.6.4. Another 20 leavecussed to in the X physicians;3.6.3, or [whether and it may it happens] be by divine by divine judgment, judgment, because as heis saidhad in X 3.6.3. The recognition, assessment, and differential diagnosis of this2, C.7 I q.2 c.2. This solution, however, is rejected in C.7 q.1 c.2. Vincentius said sexthat with as long a woman as someone immediately is able to after stay (she in his has clerical had sex community, with) a leper he is3 not removed. But if he is unable to remain, he is removed, just as a judge is 25 changed if he is not able to render judgment. And if you ask what will be done if he is not able to serve, the answer is that if he is a prelate, a coadjutor will be given to him as explained in X 3.6.3. But if he is of a lower order or a simple priest, a vicar will be 1 Roman lawyer, in Dig. 21.1.1.7. The ensuing definition of illness (lines 4–8) is attributed to Sabinus, an ancient 2 This passage is problematic in its extreme brevity. Nevertheless, our rendering accords with certain medical understandings about the transmission of leprosy. For example, a quaestio c “Queritur si leprosus accedit ad mulierem mulier non leditur, qui vero post illum prius from the “Prose Salernitan Questions” ([ . 1200]/1979: 9) reads: a woman, the woman is not harmed, but if another man comes to her later, the latter ad eam accedit quare leprosus efficitur?” (It is asked: Why if a leper has relations with the woman’s womb, which is then sucked out by the penis of the next man with whom sheman has is affected?) sex. The answer explains that the “corruption” of the leper remains in 3 Medieval Canon Law Vincentius Hispanus (d. 1248); cf. Brundage, 228. 321 given to him accordingDiagnosis to Goffredusof a “Plague” Image: A Digital Cautionary Tale just as Laurentius5 does, that is to say,4 that he is removed there not from who explains this decretal, X 3.6.4, his administration. Thomas6 has noted the same except for the disease 30 ofthe leprosy, entitlement because to hisof which office everyonebut from whothe execution incurs it isof removed the office without under distinction, be he a prelate or another, and this is proved in the ancient Bazianus7 compilation, 2 Comp. 3.7.1, according to Goffredus. 35 distinguished whether the disease was curable, as in X 3.6.3, or incurable, as in X 3.6.4. The prior interpretation is more convincing ofand leprosy, I rather whereas approve those of it, in X lower3.6.5. ordersBut what are is removed? the reason This for is the because special it treatment of bishops in that they are not removed from office on account 40 is difficult to remove a bishop as in X 1.7.3. For although a metropolitan q.6and c.7 [his] and bishops c.9. Because are able it is to to investigate be feared that a crime by smashing of which the a bishop columns is accused, they cannot depose a bishop without legitimate due process, C.3 are removed for lighter reasons. But clerics must not be removed from the whole edifice [of the Church] will collapse. But those in minor orders 45 be given even if he who is concerned is paralyzed lest those wishing to be their benefices for other diseases than leprosy. Rather, a coadjutor must 50 God’sLikewise, soldiers if be he scared happens away, to becomeas in X 3.6.1, debilitated because through an affliction no fault must of nothis be added to those afflicted, as is explained there. where the defective body is considered. Others distinguish between a chronic8 own, as in X 3.6.2. It is different if the fault is his, as is noted below One topic I do not omit is what to do if a cleric suffers lightly or has an 55 inveteratedisease and fever one that comesrecurs andevery goes, fourth but daythis andis rejected can simply in X 3.6.5-6. be ignored, and who is willing to do his work? He will receive nothing unless he 4 Medieval Canon Law 211–12. 5 Medieval Canon Law 216. Goffredus de Trano (d. 1245); cf. Brundage, 6 Omne bonum Laurentius Hispanus (fl. 1215); Brundage, the Summa aurea “Thomas [Aquinas]” is a misreading in for “T(ancredus)” in Medieval Canon Law(ed. Basle, 1573), col. 702. It was uncommon for canonistic commentators like Hostiensis to cite theologians. On Tancred (fl. 1220), see Brundage, 7 227-228. Bazianus (fl. 1180–90) was a canonist not to be confused with the contemporary 8 MS: infra, ubi agitur de corpora viciato; Hostiensis, Summa aurea (ed. Basle, Roman lawyer, Johannes Bassianus; cf. Donahue 2003. supra, de corpore viciato 1573), col. 703, reads: (above, on the defective body), a legal reference to X 2.20. 322 serves.Monica WhatH. Green is said, Kat above,hleen though,Walker-M needseikle to, an bed understood Wolfgang P .in Mü theller case not 60 the sick cleric is able to perform his duties, unless he is vexed by a demon orof anthe imagined falling sickness illness, butand a falls real frequentlyand serious or one, with as confusedin Dig. 42.1.60. speech And and if foaming at the mouth, as in C.7 q.2 throughout. But if he rarely falls, he can celebrate Mass if he has no incident for a year9 that he has a coadjutor ready to help out, C.7 q.1 c.15. 65 , D.33 c.3, but in such a way 10. WhatLikewise if a abbots church who is not have able become to support useless both are removeda leprous entirely, cleric and as in his X substitute?3.6.4, according Say thatto the he Ordinary who serves Gloss will and keep Innocent the revenue and the bishop 70 the coadjutor given to the sick man has general and free administration, andwill providethe coadjutor for the leper is given as in even X 3.6.3, against according the tosick the man’s Ordinary will, Gloss. C.7 Andq.1, according to the Ordinary Gloss. palm is able to celebrate Mass, say that he cannot because he cannot do it 75 safely[If asked]due to thewhether debility a priest nor without who is scandal missing due his tofingers the deformity, with half but of his he Similarly, a sick person cannot take food or drink to weaken his body eithercan serve out in of the certain other knowledge priestly functions, or feigned as ignorance,in X 3.6.2. for he would do so against charity because he ought to take good care of his body so he may 80 beserve given God a incoadjutor? it, X 5.12.19. Say that he must be, and the same must be said if he [It is asked] whether an archdeacon struck by a paralytic disease must Likewise an aging bishop, or one aggrieved by illness so that he cannot performloses the hisuse duties, of his eyes, can by X 3.6.6, apostolic according authority to the assume Ordinary two Gloss. coadjutors to 85 does not wish to have a coadjutor, then his chapter or two thirds of it must assumehelp him by perform apostolic his authority office, and one if orthe two bishop curators has become or coadjutors demented in order and 90 But what if a bishop who is senile or burdened with an incurable diseaseto perform does the not said want office. to have a coadjutor? Then the chapter will not undertake anything, but the chapter will inform the pope about the state 9 MS: cum annua expectatione quousque unius anni spatio inveniantur ab incursu demonum liberati (provided they are found to be free of ; cf. the alleged D. 33 c.3: [...] 10 demonic possession for a year). Medieval Canon Law 225–26. Pope Innocent IV (Sinibaldo dei Fieschi, d. 1254), a famous canonist; Brundage, 323 and condition of Diagnosisthe bishop of and a “P thelague actual” Image circumstances: A Digital Cautionar of the church.y Tale And then that will be done which is mandated by the pope, and these coadjutors will have their moderate expenses covered by the bishops’ 95 income in whose aid they are assumed. But they will not alienate the prelates’ goods and must render account to the bishop if afterward he returns to his sound mind or to the successor of the bishop, VI 3.5.1. 100 Nor are these coadjutors able to confer11 and vacant Guido. benefices12 because in theirLikewise general the commission coadjutor the must collation not be ofgiven benefices by the is metropolitan, not contained, but as byin VI 3.5.1 according to Johannes Monachus surprising because the metropolitan can only do in his assigned province whatthe Apostolic is found Seepermitted or through by law its or authority, introduced as byin VIancient 3.5.1. custom, And this as is in not VI 105 3.5.1, according to Johannes Monachus. if he[It wishes is asked] to whethercelebrate a itleprous privately priest he ismust licitly not able be toprohibited, celebrate atthe least Mass? as longSay that as he he is must not too not disabled celebrate or before deformed. his flock And Hugoon account says of that scandal. he should But 110 cease his ministry among the healthy, but he may sing13 and minister the divine office to lepers, D.49 c.1. 11 Liber sextus; see Brundage, Medieval Canon Law Johannes Monachus, author of the Ordinary Gloss (of 1302) on the 12 218. sextus; Brundage, Medieval Canon Law Guido de Baysio (fl. 1300), who composed another gloss apparatus on the Liber 13 Medieval Canon Law 212–13. Huguccio (fl. 1188–90); Brundage, 214. 324 BibliographyMonica H. Green, Kathleen Walker-Meikle, and Wolfgang P. Müller Boeckl, C. M. 2000. Images of Plague and Pestilence: Iconography and Iconology Boeckl, C. M. 2011. Images of Leprosy: Disease, Religion, and Politics in European (Kirksville,Art MO: Truman State University Press) Bos, K. I., V. J. Schuenemann, G. B. Golding, H. A. Burbano, et al. 2011. “A Draft Genome of Yersinia (Kirksville, pestis MO: from Truman Victims State of the University Black Death,” Press) Nature Brundage, James. 1995. Medieval Canon Law Byrne, Joseph P. 2012. 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Omne bonum: A Fourteenth-Century Encyclopedia of Universal Knowledge (Woodbridge: Boydell) Vanderputten, Steven. 2005. “Une iconographie de l’historiographie monastique: Medieval, 2 vols Narrative (London: Sources:Harvey Miller) A Gateway into the Medieval Mind, ed. Jean Goossens, Ludo Milis, Werner Verbeke, 251–70 (Leuven: Leuven Réalité ou fiction?,” in Uni versity Press) Monica H. Green medicine and global health. In 2009 and 2012, she ran a National Endowment for the Humanities Summer ([email protected]) Seminar in London on is “Healtha historian and of Disease medieval in the European Middle and humanistic disciplines could engage in productive dialogue about the his toryAges,” of which disease had and as health its central-seeking goal behaviors. the exploration During of this ways same that period, the scientific she has speciesalso argued since for its the origin development up to the ofpresent a new day,field, and “Global the ways History that of human Health,” cultural which changesexplores havethe evolutionfacilitated of or the hindered major pathogensthose pathogens’ that have trajectories. afflicted Inthe addition human to many works on the cultural history of medieval medicine, she is the author of “The Value of Historical Perspective,” in The Ashgate Research Companion to the Globalization of Health and “The Globalisations of Disease,” which will be published in 2015. , ed. Ted Schrecker (Aldershot: Ashgate, 2012), pp. 17–37; Kathleen Walker-Meikle authoring, with Monica Green,([email protected]) a digital edition of the Antidotarium is magnumcurrently: a research assistant on the Tradamus project (Saint Louis University) and is co- focuses on the role of animals in medical texts and the interaction between natu rallarge history and influential and medicine late eleventh-century in the Middle Ages. pharmaceutical She is currently text. completing Her own research a study on learned medical treatment of animal bites in the Middle Ages, a project funded by the Wellcome Trust. Other recent work examines animal substances in experi mental literature. She holds a PhD from University College London. Wolfgang P. Müller University in New York City. His main research area is the legal history of Western Europe and especially([email protected]) medieval jurisprudence, is which Professor through of History its insistence at Fordham on sionals and science at the time. His most recent monograph, The Criminalization forensicof Abortion fact-finding in the West: was Itsinstrumental Origins in Medievalin fostering Law demand for medical profes on “Abortion Experts and Expertise”; writing it sparked an abiding appreciation for inquiries into the history of medicine. (2012), includes a chapter 326 AbstractMonica H . ThisGreen brief, Ka studythleen examines Walker the-Mei genesiskle, an ofd Wtheolfgang “misdiagnosis” P. Müller of a four teenth-century image that has become a frequently used representation of the Black Death on the Internet and in popular publications. The image in fact depicts another common disease in medieval Europe, leprosy, but was misinterpreted as digital dissemination. This mistake is a reminder that interpretation of cultural products“plague” becausecontinues of to a demandlabeling the error. skills The and error expertise was then of humanists. magnified Included because is of a full transcription and translation of the text which the image was originally meant to illustrate: James le Palmer, Omne bonum, cap. “De clerico debilitato ministrante sequitur videre” (On Ministration by a Disabled Cleric), London, British Library, RoyalKeywords 6 E. VI, Omne vol. 2, bonum fols. 301rb–302ra.; James le Palmer; Gilles le Muisit; art history; plague imagery; leprosy; canon law; Black Death, disability history. INDEX Abū Ghāzī, ‘Imād, 127,See 134 also Cui, Yujun, animals, 10–12, 15, 31–34, 46, 52–53, Achtman,et al.; Mark,Morelli, et G.,al., et 35n8, al. 37n12, 81, 101, 111, 115, 157, 180–81, 44n23, 208n30. 209–15, 232n1, 241n15, 246, 250, 267–71, 274, 292n12; consumed aDNA, 10–11, 14, 17, 27–29, 35, 40n18, for food, See12, 178,also furs;266, zoonotics301n25; 44,270, 51–52, 275, 299. 82, 88,See 117,also DNA160, 193n1, pelts of, 47, 164, 178–79, 210, Afghanistan,199, 210n17, 266 243–244, 264–66, 301n25. anthrax, 98, 264 anthropology,antibiotic resistance, 16, 83–91, 259–62, 97–117, 265 123, Africa, 11n4, 18, 35–48, 54, 161, 215, 251; biological, 16–23 265–66; Central, xiii, xiv, xvi, 31, 36, See also immune response 41–44, 50, 200; East, 37–38, 41–50, antibodies, xiii, 235. 200; North, 9–11, 14, 18, 31, 41–43, 46, 64, 97, 196, 210, 300n24; sub- anti-Jewish violence, 16–17, 53, 63–91 Saharan, xi, xiii, 12, 36n10, 38–41, antiquity, xi, xiv–xv, 1, 40–43, 47–50, 44–46,See 49–51;also Ebola Southeast, virus; Ebola 215; 99, 150–51, 165, 264, 267, 270, South,epidemic, 40n18, West 43n21, African 181; West, Apennines,320n1; 177late, 47, 174, 273 44. Aosta, 165, 173 216, 227 Arabian Peninsula, 199, 209 Afroeurasia,AIDS/HIV. See 10, HIV/AIDS 26, 34, 54, 61, 194–98, Appleby, Andrew, 232n2, 238 Aksum, xiv Arabian Sea, 48 Akrokrowa, 43, 53 Aragón,See also65, 68;bioarcheology Crown of 16, 63, 71, 91 archeology, 16, 46, 63–64, 73–91, 276. Aleppo, 202–03, 206, 212, 214 169, 172. See also documentary Alexandria,Allouche, Adel, 125, 127 129, 133, 148, 202, 206 archives,evidence; 51, 69–71, plague, 82, narratives 127–28, of Algeria, 34, 43n21, 265–67 Armelagos, George, 170 Alps, European, xv, 18, 157–83 See also Altmann, D. M., et al., 30, 51 armies, 49, 144, 165, 286–96, 299–302. Amadeus VI, 173–74 sieges; war(s) America, Central, 54n, 38, 260; North, art history,See 309–14 also 4, 11n4, 18, 48, 54, 161, 268, 298; arthropodAshtor, Eliyahu, vector, 126 xiii, xiv, 9–14, 32, 40, South, x, 11n4, 18, 30, 48, 54, 161, 238. fleas; vector(s); ticks 260, 268 Anandavalli, Lakshmikanthan, 46, Asia, x, 18, 36, 37, 48, 50, 285, 298; 49–50, 197n7 Central, 13n7, 18, 46–49, 196, Anatolia,ancient DNA. 171, See 198n10, aDNA 208–12, 227, 265–67, 285–87, 291, 299, 308; 300n24 East, 3, 10, 20, 150, 196, 203, 287, Angola. See Yersinia pestis, “Angola” Asia,299, West. 308; See South, Middle 45, East 50, 150, 181, Angkorstrain Kingdom, 4, 150 Assyr,196, 209 201, 299; Southeast, 54 328 Aswan,INDEX 129 Boccaccio, Giovanni, xv, 229 BlackBohemia, Sea, 175 14n8, 46, 161, 171, 195 Australia, 11n4, 31n3, 53, 161, 259 Avignon,Bacharach, 68n16, Jere, 126171–72, 176 bacteria. See anthrax; cholera; Bombay,271, 32n15,299 182, 201 Yersinia pestis bones, 17, 48, 63–91, 97–117, 231, BonifaceBos, Kirsten, VIII, et 315 al. badgers,Bangladesh, 33, 262181 Borsch, Stuart, 16–18, 147 Baḥr Abī al-Manajjā, 146 Bosphorus, 215 , 10, 28, 30, 98, 160, Barcelona, 16, 65–75 193n1, 311 Barbarikon/Minnagar, 47 Brayer, A., 202 botulinum toxin, 264 Barois,Barrett, Julien, Ronald, 137n5, 260, 270139, 145n21, See also England bats,146n23 xiii, xiv, xv BritishBresse, Commission173 for the Investi Britain, 175, 181. Bavaria, 38–40, 170, 264 Britishgation Isles, of 165Plague in India, 182 Bellinzona, 163–66 British Empire, 263 Benedictow, Ole, 10n3, 159, 197n7, 232n2, 239, 287n3, 300n24 British Library, 310–15 See also plague, bharals, 33 buboes,bubonic; xii, 41n20, Yersinia 50, pestis 166, 230–31, Bilbeis (Bilbays), 125, 133 268, 294, 304, 312. bioarcheology, 16–17, 26, 44, 51, 96–100, 105–06, 109n6, 114–17, Buell,buffalo, Paul 210 D., 46, 197n7, 287–88, 296, 123,model 150, of, 112;193–95, Siler 199, model 251, of, 271, Bugati,299, Gasparo, 301n25 162, 167n9 314n6; Gompertz-Makeham See also archeology 111–12; Usher model of, 113–14. Bugey,Burgundy, 173 165 See also anthropology; al-Buhayra, 129, 147–49 biologicalbioarcheology anthropology, 9–23. See also cemeteries burial practices, xii, 16, 53, 64, 73–75, 80–96, 105. biological weapons, 28, 261, 264–65, Busbecq,Caffa. See OgierKaffa Ghiselin de, 214 269, 283 biology, 61, 100, 103, 150, 195, Calcutta, 201, 261 199–200, 234, 242n16, 247, 275 Cairo, 47, 125–35, 146–50, 206 biosecurity, 264, 283 call Biraben, Jean-Noël, 172, 197n8, 205 California,See also 181, Jews, 298n20 communities of birds, 213–16 Cambodia,, 66, 70–71, 150 85–86. Black Death, ix–xi, xiv–xvi , 5, 9–23, 26, 29–30, 39–46, 51–54, 61–65, Cameroon, xii 69, 82n33, 91, 96–110, 113–17, camels, 14, 33–34, 210, 213, 266–67, 289 123–29, 156, 159–62, 171–78, 182, 193, 193–97, 227, 231, 239, 244, Campbell, Bruce,See also xv, dogs 13n8, 161, 248,mortality 257–61, of, 97–107, 271–73, 111–16, 276, 283–88, 174n15, 183, 233–34, 271 296, 299–302, 308–11, 314, 326; canids, 33. canon law, 21, 309–23 159–61,of, 160, 172–76. 172–73, See 229–31; also plague; origins Canton Ticino, 164n7, 167–69 pandemics;of, 13, 36, 129, Second 285–304; Plague spread CaoCarmichael, Shuji, 287–88, Ann G., 293–98, xi, xv, 17–22, 301–03, 115, 308 Pandemic; Yersinia pestis carbon dating, 45, 80, 276 212n35, 249, 273 329 INDEX See also foxes; etc. carnivores, 14, 33, 214–16, 267. ConstantineSee also IstanbulI, 312 cows.Constantinople, See cattle 202–03. Carrier, Nicholas, 178 Caspian Sea, 208 Catalonia, 16, 63–91 Crane, Johanna T., 54, 200n17 cats,CDC. 268See United States of America Crécy,Crespo, battle Fabian, of, 19–20,182 99, 176n17 cattle,Centers 33, 209, for 271 Disease Control and Creighton, Charles, 197n8, 203 Prevention Çelebi, Evliya, 212 Cui,Cyprus, Yujun, 250 et al., 13, 33–41, 200n15, 285–88, 298–300, 308 cemeteries, 10, 16, 21–22, 39, 43, 51, cytokine, 234–37, 240–43, 250 Cervera,63–91, 16, 97–117, 65–72 125–50, 193n1, 248, 264, 271, 276, 311, 314 Damascus, 206 Champagne, 165 Daliang, 289, 290 Chambéry,chemical weapons, 173 265 Dante Alighieri, xvi Damietta, 214 Chengdu, 292 chemokines, 243 De Amicis, Edmondo, 213 Chiavenna, 167 DeCorse, Christopher R., 43–44 Chen Yizhong, 293 deer,Democratic 33 Republic of Congo, xii, xiii, chimpanzees, xii n5, xv Delhi, 4, 261 Chile, 181 Denmark,40–41, 11, 260, 97, 265–67 109–11 China, xi, xvi, 4, 12, 20–21, 31, 37–40, dengue fever, 34n7, 272 46–48, 54, 150, 200–01, 262, 265, 268–69, 273–74, 285–303, 308 depopulation, 17, 115, 125–41, 144, cholera, x, xvi, 9, 197n8, 203n21, 260, 147, 150, 156 293n13 Dernschwam, Hans, 212–214 Chouin, Gérard L., x n3, 43–44 Christianity, 4, 16, 63, 66–67, 81–82, DeWitte, Sharon N., 16–17, 20, 51n33, Ciconia86, 96,ciconia 105,. See205, storks 312; 101, 160, 193n1, 231, 248, 271 and(Ciconia Jewish ciconia minorities, 66, 81, 96 diagnosis, 15, 21, 36n11, 49, 51–52, See61, 170,also plague,198n10, emic 261, approach 267–69, ) to;295, plague, 309, 312–14, etic approach 320. to; Cinggis Qan, 285–86, 289 retrospective diagnosis, Clement VI, 68, 171 problem of climate, xiv, xv, xvii, 13n8, 29–30, 34, 50, 161, 172–74, 177, 181–83, 195, 250, 257 See205–08, also furs;233–34, textiles 245, 263, 271 differential mortality, 231–33, 238, clothing, 16, 32, 72, 80, 86, 220, 301. Diocletian, 230 Clysma, 47 disability, history of, 326 Cohn, Samuel K., 65n5, 193n2, 232n2, disease(s), 9– 21, 27–34, 46–54, 61, 69, 239, 244–46, 288n6 82, 85, 88, 97–106, 113–17, 123, Colet, Anna, et al., 16, 53, 117, 172 128, 150, 157–59, 166, 175, 191, colonization, 8, 30 194–216, 227, 231–39, 244–51, Columbus, Christopher,See also cemeteries 1, 8 See259–67, also 293–304, 309–16, 320–22, communal graves,See also16, 53, Democratic 64, 73–74, 326; vector-borne, 157–63. 80–96.Republic of Congo See also aDNAvector(s) Congo,Conrad 40–41.of Megenberg, 171 DNA,doctors. 27, See 82, physicians99, 158, 262, 313. 330 INDEX documentary101–05, 109, evidence, 115–16, 9–11,14–18, 127–50, epidemics, 16–21, 27, 30–31, 31–36, 43–53, 63–72, 81–82, 89–94, 49–50, 54fn38, 64–67, 81, 88, 97–107, 110–11, 114–17, 123, 162–63, 170–74, 178–79, 195–96, 127n1, 132, 159–62, 167–78, 210–14, 266, 273–76, 285–308 182–83, 191, 195–207, 212, dogs, 213, 268 215,See also 231–33, 239–44, 249–50, Dols, Michael, 16n9, 44n23, 49n29, 97, 260–61,pandemics 265–76, 283–304, 312n3. 126–30, 134, 196–98, 287 epidemiology, disease(s); x–xvi, 11, Ebola20, 99–100, virus; Domodossola,donkeys, 210 164–66 Dongping, 289, 290 See also plague, imagery of Escherichia115–17, coli 193,, 262 211, 229–51, Dorsetshire, 104 Essex,270–76, 101 283 drama, 168. Ethiopia, xv Dwight, H. G. O., 213 Eurasia, xi, xiv n7, xv, 11, 19–21, 29, East276. Smithfield, See also 10, cemeteries 21, 51n33, 97, Ebola104–17, virus, ix–x,123, xii–xiv,150, 160, 260; 248, Ebola 271, epi 39–42, 97, 157, 161, 179–82, 214, 234, 285,See 295, also 298–99, Middle 308; East Central, 14, 50; Western, 13, 31, 46, Eckert,demic, Edward, 2014 169–71 West African, ix–xvii 97, 177, 180. Echenberg,ecology, 17–20, Myron, 26, 43n21,160–61, 201n18, 166, 171, 263 Eurocentrism, 2–5, 13, 19, 117, 150, 194–97, 200, 216 250– 51, 276. See also climate; Europe, 3–4, 9, 12n5, 18, 31, 44n22, 177–78,ecosystems; 181–83, human 209, ecology 216, 238, 49, 82, 97, 101, 104–07, 116–17, 128, 149–50, 156–64, 169, 172–81, See also plague, 195–206, 215–16, 234, 244–45, economy,economic 44n23, results 125–28, of 141, 147, 288, 294, 298–300, 312–13, 326; 150, 156, 287. Alpine, 157–83, 191; Central, 12, See also climate; ecology 170–71, 275, 287; Eastern, 116, ectoparasites,ecosystems, 5, 207,14, 29n1. 210, 266, 270. 198, 199n11, 275, 287; Southern, See also 198; Western, 2, 9, 13–19, 30, 39, Ecuador, 267, 269 61, 64, 67, 116, 158–62, 171, 179, Edirne, 215 fleas; lice; ticks Faido,198–99, 166 202–03, 299 See also food; Egypt, 17, 40–41, 47–49, 125–50, 156, famine,malnutrition 65, 69, 127–29, 178, 239, 182, 198n9, 202, 208, 211, 214–15, 245–50, 217. emerging273–74 diseases, xv, 99–100. Ell, Stephen,See also re159,-emerging 239, 240n14 infectious Fengxiang, 289–290 diseases First PlagueSee Pandemic,also pandemics; xiv, 9–11, plague; 14n8, Yersinia29–31, 35–41, pestis 47, 61, 97, 197, 263. empires, 3–4, 8, 14, 19, 30, 127–30, 137–38, 147–49, 165, 171, 195–98, fleas, 12, 29n1, 32–34, 38–39, 46, 52, 201–07, 208–10, 214, 227, 263, 135, 157–62, 174–82, 191, 206, 271–73, 286–303, 308 209–11, 215,Oropysylla 231, 235, montana 238, 242, England, 1, 12–14, 82, 101–05, 107, Pulex251, 263n3, irritans 266–74, 287, 292n12, entomology,111, 176, 12, 199, 52 203, 241–42, 271, Florence,297–302; 101, 176 , 274; Environmental311–14 History Network for , 159, 162, 266, 268 foci (plague foci), xi–xv, 11n4, 18–19, 53, the Middle Ages, 273, 276 161n4, 166, 171–73, 177, 180, 194, 331 INDEX 207–09, 261, 265–69, 298–300; global studies, 2–5, 8 enzootic, 13, 31–34, 173, 208, 215, globalization, ix-xvii, 2–5, 27–54, 61, See259, also 265, plague; 273, 283; Yersinia permanent, pestis Gotthard259–93 Pass, 165–66 11n4, 180–81, 208; rural, 19. goats, 33, 213 food,See 33, also 65, famine;98,115, nutrition162, 178, 211, 267, grain, xiv, 12, 16, 46, 127, 134, 271, 292n12, 297, 300–04, 322. 174–76, 211, 247, 263, 268, 272–73, 287, 302 foxes, 33, 214See also Gaul Great BovineSt. Bernard Pestilence, Pass, 165 248, 271 France, 65n6, 171–72, 176, 180, 199, Great Famine, 234, 248, 271 230, 266. Frieden, Thomas, xvi, 262–63 Green, Monica H., 5, 196n6, 212n35, Fuji, 300 See also animals, Guinea,276, x–xi, 288, xiii 300n24, n6 303 furs,pelts xiv, xv, of; 6, clothing 46–47, 164, 178–79, Guangdong, 293, 296 301n25. See also rodents guinea pigs, 12, 267, 268. Fuzhou,Galipapa, 300 Hayim ben Abraham, 65–69, gypsies. See Rroma people Guy de Chauliac, 171, 229–30 Ganges River, 50 72, 85 Haiti, xvi Ha-Kohen,Halesowen, Joseph, 105 65, 68, 72 Ganpu,Gaul, 165, 299–300 176 hamsters, 212. See also rodents Gansu, 46, 286–87, 293–94, 298–302, 308 Hangzhou, 299 Gelting, M. H., 173 Geltner, G., 273 Harbeck, M., et al., 11n4, 37–38, 40n18 genetics, 1–12, 20–21, 27, 30–31, hares,hazard 33, analysis/models, 177 109–16 35–43, 46–54, 193, 199, 270–72, Haute-Maurienne, 168–69, 173, 230 Genghis285, Khan.288, 314n6 See Cinggis Qan Genoa,Geneva, 165 165, 169, 173 health, 15–17, 51–53, 61, 98–100, 103, 107, 113–16, 159–63, 166–69, 182, 195–97, 200–01, genome(s), 10, 20–21,See also 28, aDNA;30, 33–42, DNA; See204, also 231–34, global 237, history 248, of 251, health 52,genetics 98–99, 160, 193n1, 264, 257–65, 269, 275, 283, 295, 320. 269–71, 311. See also genetics Heiligan, Louis. See Kempen, hedgehogs,Ludwig 182van genomics, 40, 195. Heiligen-Geist Hospital, 105 Geoffrey of Meaux, 229, 238 Georgia,See also 39, 41n19rodents Hennequin, Giles, 127 gerbils,germ theory, 12, 33, xvi, 39, 20, 157, 201, 180, 270 298. helminths,Hereford, 105 249–50 heterogeneous transmission, 269, Germany, 105, 199, 315 Hezhou, 292 Ghana,ghetto. xvi,See call43, 44 hides,272–73 210. See animals, pelts of; al-Gharbiya, 129, 133 clothing; furs Giza, 129 Himachal district, 269 Girona,Glénisson, 65, Jean, 74 176 global history of health, ix–xvii, 15, See also globaliza Himalayas, 36, 209 tion; health; pandemics HIV/AIDS, x, xi, xii, xvii, 8, 19, 54, 99 27–54, 259–76. Holy Roman Emperor, 162, 230 Hong Kong, 197–98, 201 332 Horrox,INDEX Rosemary, 171 See also empires IslamicateIsrael, 72 world, 14, 19, 61, 125, 129, horses,Huai River, 174, 291 210, 213, 289, 292, 204, 314. Huesca,302n27 65 human ecology, 250, 276. Istanbul,See also 177n18, Constantinople 199n11, See also ecology 202–03, 206–08, 213n36, 215. Ivrea, 165 Italy, xv-xvi, 27, 63, 162–73, 199, 241 Hundred Years’ War, 173, 182 hyenas, 214, 227 Jahangir (Nur-ud-din Mohammad Hymes, Robert, xi, xv, 12n6, 13, 20–21, 31n3, 39n16, 46 Jáuregui, Clara, 16 JeanSalim), de Venette, 49 102 Iberian Peninsula, 81, 172 Ibn Ḥajar al-‘Asqalānī, Aḥmad ibn ‘Alī , 130, 130fn3, 145fn21, 146 Jenne-Jeno, 43, 53 Ibn Iyās, 130n3, 133, 137, 139, 142n11, jerboas,archives 41n19, of, 69;211n34, as religious 212 144–47 Jews, 16, 47, 63–91, 96, 215, 314; Ibn Khaldun, Abū Zayd, ix Ibn Khātima, Abū Ja‘far Ahmad, 231 minorities, 63–91, 96, 117; Ibn Mammātī, Al-As‘ad, 143–45 burial customs of, 74–75, 80–84, Ibn Taghrībirdī, SeeYūsuf, also 127n1, Little Ice130, Age 133, 91; cemeteries for, 16, 63–64, 74, 142n11, 147n24 81–83, 96; citizenship of, 68–69, Ilgin,Ice Age, 212 137n5. 88–90;172; property communities of, 70; of, 16, 53, Igarashi, Daisuke, 128 63–71, 80–83, 87, 90–91, 117, immune competence (IC), 99, 112, Jiaxing,sources 299 for, 69, 81; 232–40, 245–51 violence against, 26, 63–91, 96 immune response, 32, 99, 232–51, 257 immune system, 19, 106, 113, 231–38, Jin Dynasty, 287–91, 295–96, 302–03, 247–50 208 immunity, 9n1, 19, 30, 176n17, 232–40, jirds,Jordan, 34, 266 39, 212 immunology,246, 29n12 229–51, 257, 271 Johannes Monachus, 315, 323 immunologicalimperialism. See profile, colonization; 237–41, empires; 245 Jura Mountains, 165, 179. See also Alps, postcolonial studies Jordan,European William Chester, 234, 247–48 Justinianic Plague. See First Plague Pandemic India, 2, 31–33, 36, 39, 46–51, 54, 61, 159, 181–82,See also 200–01, Asia, 204,South 209, 244–45, 260, 261–62, 269, 298, Kaffa,Karachi, 13, 201 299 302n27. Kaifeng, 289–97 Indies,Indian Ocean,1 xv, 12, 31, 38, 43, 44–49, 61, 135, 288, 299, 300 Kashmir, 45 Kazakhstan, 179, 264 Indus Valley, 47–50 Kempen, Ludwig van (Louis Heiligan), influenza, 8, 197n8 171, 174, 176 insectivores, 182 Kenya, 40–41, 44 Iran, 149, 200, 208, 265 KhafiKonya, Khan, 212 Muhammad Hashim, 49 Iraq, 150, 200, 208–09 Kilwa, 45 irrigation systems, 17, 127, 131, 135–50,See also Muslims156 KoreanKyrgyzstan, War, 266 108, 265 Islam, 16n9, 131, 137–39, 144, 261. Kurdistan, 39 333 INDEX lagomorphs, 33, 162, 177 al-Mahallat al-Kubra, 132–34 Lake Maggiore, 164 Malabar Coast, 48 Lamu Archipelago, 44 malaria, xi, xvi, 34n7, 113, 249, 275, Lanslevillard,Lawrence Livermore 168, 230 National Mallorca,292n13 66 Lausanne, 173 Mali, 43 Lawrenz, Matthew B., 19–20, 99, 176n17 271. See also famine; food; nutrition lemmings,Laboratory, 211–12 264 malnutrition, 100, 106–07, 114, 247–50, Mamluk sultanate, 127–30, 137–38, leprosy, 64, 32n35, 245n20, 250, 147–49 310–14, 320–21, 326 Manchuria, 179, 180, 269 Le RoySee Ladurie, also archives; Emmanuel, documentary 11, 46 Mandeville, John, 1, 8 letters,evidence 47, 68, 162–67, 176, 179, 213. al-Maqrīzī, Aḥmad Ibn ‘Alī, 125, 129–30, 133, 138–46 Levant Company, 202 marmots, xv, 12, 18, 39, 42, 157, Levant, 273 174n16, 177–81, 191, 211–14, Liberia, ix, x, xiii, xvi 286, 294, 297–302 Leventina Valley, 163n6, 165–66 Marseille,Massif Central, 14, 171, 172, 198, 176 202 Martigny, 165, 173 Libya, 14, 39–41, 199, 208, 265–67 lice, 32–33, 231, 266, 275 McCleery, Iona, 50n32, 53 Li Gao, 289–91, 294–96 McCormick,McKern-Stewart Michael, Korean et al., War 174n15, Reference 183 Li Jianshi, 301 McIntosh, Roderick James, 43 Lincoln (England), 101 Little Ice Age, xv, 181 Sample, 108 Little, Lester K., 10n2, 13n7, 30, 193n2, McNeill, William H., xi n2, 36, 198n10, 197, 288n6 232n2, 287–88, 298n21, 308 LiuLi Zhen, Fu, 293 291–92 measles,Médecins 8, Sans 53 Frontières Li Yushang, 287n4, 303 Mecca, 43 Locarno, 164–66 (Doctors Without Borders), xi Lombardy, 162–64, 167, 174–75 Mediterranean, xiv–xv, 9n1, 12–14, London, 10, 14, 17, 21–22, 29–43, 18–20, 30–31, 39–47, 61, 128, 165, 51, 97, 104–06, 111, 116, 123, 171–72, 177n18, 180–81, 202–05, 139n8, 150, 160–61, 182, 193n1, 215, 227, 246, 267, 273, 287, 299 198, 202–03, 246–48, 271, 276, medieval,See meanings also modern of, xvi-xvii, categories; 2–5, 8, 309–11, 314–15, 326; Black Death 285–86;modernity; world, periodization 1–8, 27–54, 169n9, cemeteriesSee also in, 10, 21–22, 39, 43, The 309.Medieval Globe, xvii, 51, 106, 114, 311; Great Plague of, Low198. Countries,165, East 199. Smithfield 1–8, 10, Louiseau,See also Julien, Netherlands 128 Medieval22–23, Medicine 27–29, 117,listserv 251, 270, 309 Lübeck, 105 medievalism, 8 Meloy, John, 127 (MEDMED-L), 275 Luofu, 293 Lyon, 14, 39–41, 199, 208, 265–67 Mengel,202, David, 215, 299. 36n11, See 160also trade Mesopotamia,merchants, 11, 199, 16, 24, 210 47–48, 161, 165, Mackenzie, Mordach, 202, 203 Maclean, Charles, 203, 213 macrophages, 235–236 methodologies, 5, 15, 22, 26–29, 32, Madagascar, xvi, 31n3, 39–40, 48, 182, 51–54, 83–90, 97–117, 125, 130–32, 200, 209, 260–62, 267–69, 273 196n5, 269, 272–75, 290, 309 334 INDEX dei Mussis, Gabriel, 175 See also rodents mice, 48, 177, 211–12, 236, 241n15. See also Islam Muslims,mules, 210 4, 137, 205, 261, 291. Microbial Detection Array, 264 Muṣallā, Middlemicrobiology, Ages. See 10–12, medieval, 19, 26, meanings 29, 52n35, 193,of; modernity; 272 periodization 130–31 MuseuCentre Comarcal for Human de l’Urgell, Bioarcheology, 63, 78n29 Museum of London, 22, 104, 309; Middle East, 9, 13n17, 19, 31, 34, See44n23, also 126–28, Eurasia; 149–50, Africa, North 196–98, 97, 104, 111n8 Middle205, East 263–65, Respiratory 287, 299–300. Syndrome Myanmar, 39 Naphy, William, 169 Napoleon,al-Nahririyya, 202 132–33 (MERS), 263 migration,See also 63, nomads 110, 180, 205, 215–16, 244, 272, 275; of birds, 215–16. Naṣir, ‘Āmar Najīb Mūsā, 128, 138n6, National142n12, Endowment 145n21 for the Mikhail, Alan, 128, 196n6 Nathan, Moxié, 68, 70 Milan, 18, 162–72, 175–77, 191, 242 modernMing Dynasty, categories 286–88, (applied 296–97, to the 303–04 Nelli,Humanities, Francesco, 22,176 27, 309 Minūf al-‘Ulya, 132–35 natural philosophy, 137 Netherlands, 199. See also Low pre-modern past), 2–4, 10–15, Nepal,Countries 39, 262 18–22, 27–29, 35–37, 51–52, 173, Newcastle, 107 195–98,See also medieval,201–05, 240, meanings 260–63, 273,of; modernity; 286, 292–93, period 311–12.ization; retrospective diagnosis, problem neutrophils, 235, 246–47 of; plague, emic approach to; Nile River, 17, 43, See125–38, also migration; 142–45, 150; plague, etic approach to RromaDelta, 125, people 129, 131–32, 137n5 See also periodization nomads, 34, 210. modernity, 3, 8. North America,Korea, 265 4, 11n4, 18, 48, 54, MongolMongolia, Empire, 34, 38–41, 299 200, 268, 287, 161, 268, 298 298n21 North Sea, 18 Montblanc,Mongols, xi 66n2, 13, 21, 285–295, Norwich, 82 298–303, 308 nutrition,See also 20, food; 115, malnutrition 126, 231–34, 247, 270–71, 290, 300–02. Mont Cenis Pass,See also165, rodents168, 173 Moldavia, 208 Odenseal-Nuwayrī, University 48 Anthropological mole-rat, 33. Database, 109–10 Morerod, Jean-Daniel, 173 Omne bonum Morelli, G., et al., 11n4, 37n12, 40n18, Oropysylla montana. See 41, 43n21, 200n15 , 309–26 Mouthon, Fabrice, 178 See also bones fleas Mughal Empire, 49 Oribasius, 41n20 Müller,le Muisit, Wolfgang Gilles, 314, P., 21 326 osteology, 123. Mujani,Wan Kamal, 128, 147 Ottoman Empire, 3, 14, 19, 171, 196–98, 202–06, 214, 273 Muntané i Santiveri, Josep Xavier, 16, oxalicSee acid, also 302n27, cattle 308 63, 73 oxen, 2, 139, 140, 210, 304. Musa, Mansa, 43 335 Padua, 176 da Piazza, Michele, 109 INDEX pelts. See animals, pelts of; furs Pakistan, 262 le Palmer, James, 310–15, 326 paleoepidemiology, 251 physicians 30, 168, 171, 182, 202–04, paleodemography, 88, 109–10, 123 213–15, 229–31, 261, 266, 270, paleoimmunology, 251 289–92,See also travel295, 300–02; and travelers Jewish, 215 paleogenetics, 35 pilgrimage, 53, 175, 200, 215. paleopathology, 16, 52n35 plague, amplification of, xi–xvii, 17, Pamuk, Sevket, 128 157–59, 172, 309; bubonic, 32, pandemics, ix–xvii , 5, 9–10, 13–15, 39n15,infections 171, with, 229, 266; 239, deniers 260–61, of, 17, 19–20, 26–54, 150, 160, 175, 266–69,xi n2, 10; 272, diagnosis 296, 301, of 15–16, 312; co- 22, 180, 193, 197, 201, 227, 235, 259, 260, 263–64, 269, 276; amplifying of, 15–17, 69, 97–99, 125–29, mortalityfactors of, of,15, 261, 180; 271; causes spread of, 160; of, 51, 260–69, 312; economic results definition of, 9n1, 197fn8; emic approach to, 15–16, 22, 51, See also Black Death; epidemics; 149–50,etic 199n5,approach 259, to, 262–63, 15–16, 22,272; 54,First 211, Plague 263, Pandemic; 285; types plague; of, 198. Second Plague Pandemic; 312; Third Plague Pandemic 51, 313; gastrointestinal, 32–33, 158, 266–67; geography of, 12, 31–33, 45; hosts of, 129, 159n3, parasites, 250, 274–75 182, 210, 214, 287; imagery of, 168, Paris, 40n17, 66n9, 165, 180n19 230,206n27, 309–14, 210; 326;mortality maintenance of, x, xv, of, pathogens, 10–12, 14, 19, 26–32, 17–18, 157–61, 166, 179–82, 191, 36, 45, 52–54, 61, 65, 100, 117, 157–58, 160–61, 182–83, 194, 199, 101, 115–17, 128, 131, 135, 141, 201, 206, 231–42, 245–46, 249–51, 160, 173, 210, 240, 271; narratives 257–61, 264, 270–72, 275, 311; of, 12, 18–19, 37, 53, 171–76, history of, 30, 36, 54, 61, 199, 200; 228–29, 314, 326; outbreaks of, host interactions with, 232, 237; 10, 13–14, 17–19, 30, 43, 49–50, genetic makeup of, 10, 14; 59n31, 65, 82, 101, 115–16, Seeorigins also of, Yersinia 12, 30, pestis 100; 129–32, 135, 148–49, 159, 162, spread of, 45, 65, 232, 242, 272. 168–70, 173, 179–81, 195–202, 211,pharyngeal, 229, 235, 266–67; 238, 246–47, pneumonic, Pavia,Pere III 176, of Barcelona/Pere 242 IV of Aragón, 251, 259–69, 272–74, 298, 311; pea 65–67,sores, 293–94 71 xiii,of, 9n1, 9n1, 150, 32, 180,197, 259,227; 260–61,resistance 175–76 264–69, 272, 312; periodization Petrarca, Francesco, 18, 171–72, to, 238, 243; responses to, 15, 168, Petry, Carl, 127, 142n11 232, 234, 261; seasonal factors of, phagocytes, 235, 246 245–46; septicemic, xii, 32, 266–69, pharmacology, 293 312; studies of, 10–17, 26, 37, 115, Pelusium,227. See 41, also 47, medieval,198n9 meanings 123, 149–50, 194–96, 214, 274, periodization,of; modernity 2–8, 9n1, 150, 197–98, 276; symptoms of, 231, 285, 304; Perpignan, 65 transmission of, 17–19, 32–34, 50, Persia, 210 See157–59, also Black181, 194, Death; 209–11, documentary 214–16, 227,evidence; 238, 269,foci 274, 297n19. PersianPiacenza, Gulf, 175 195, 300 See also anti-Jewish violence Peru, xvi, 267–69, 273 pogrom, 64n4, 82n33, 86n35, 96. 336 INDEX retrospective diagnosis, problem of, Poland, 246–47 See also plague, emic approach to; Polo, Marco, 1, 8, 45,See 48, also 301n25 Yersinia 27–54,plague, 285–304.etic approach to polytomy,pestis; 13, “Big 21, Bang,” 37–39, theory 42, 285, of 288, Reuss Valley, 165 299–300, 308. Rhine River, 65n, 165, 170 Rhone River, 165, 179 population, 9, 17–21, 33–34, 42–44, 49n9, 53–54, 65, 69, 81, 86–88, 98–103, 106–16, 127–29, 132, rhubarb, 289, 293–96, 301–02, 308 138–39, 148–50, 157–63, 173–76, roads and routes, 12, 26, 43, 46–47, See191, also 207–08, depopulation 213–14, 231–51, 65, 159, 162–68, 175, 200, 207, 271, 275, 288, 291 291, 296–300. 215–16, 267–68, 292, 299 rodents, 14, 18, 33–34, 40–48, 54, 65, 150, 159–62, 174, 177–82, Po River, 164, 175 187, 191, 206–16, 231, 235, 268, ports, 16–18, 41, 47–48, 65, 104, 129, 271–74, 285–87, 297–302 172, 177, 199, 202–06, 299–300 Rome,See 172n14, also First 175 Plague Pandemic Potter,Portugal, Felix, 50n32 179 Roman Empire, xi, 30, 165, 263. postcolonial studies, 3, 8, 182, 294 Roquetes, Les, 63–64, 74, 79–83, 86–91 PricePrague, Smith, 74, 81n31 Andrew, 262 Royal Society of London, 29n2, 203 prairie dogs, 12, 174, 297 RromaRuíz Ventura, people, Jordi, 244–45 16 Rufus of Ephesus,See 41 also camels ProvençalPulex irritans. Wars, See 174 Provence,Pune, 201 65n5, 83, 172 ruminants,Russell, Edmund, 33. 275 Pyrenees, 172, 177fleas Russell, Alexander, 202–03, 212 al-Qaeda, 265 Russell, Josiah Cox, 102–03, 116 Russell,Rustichello Patrick, of Pisa, 202, 1 214 Russia, 14, 31, 39, 54, 198, 200, 212 al-Qalqashandī, Aḥmad ibn ‘Alī, 130, Sabra, Adam, 127 138n6, 142–45 See also Africa, Qilian Mountains, 286 sub-Saharan Qinghai-Tibet Plateau, xiv, 12–18, 21, Sahara,St. Bernard 43–44. Pass. See Great St. Bernard 29–33, 37, 41, 46, 53, 269, 274, Pass quarantine,285–86, xv, 294, xvi, 300–02 197, 206–07, 261–62 St. Gotthard Pass. See Gotthard Pass Quanzhou, 300n23, 330 St. Helen-on-the-Walls, 1072 St. Mary Graces (cemetery), 106 rabbits, 33, 162, 213 St. Sebastian, 168, 230 rats, 12, 32–33, 38–39, 47–4, 135, Sallares,Salmonella Robert, enterica 36n10,, 262 41n20, 159, 162, 180–82, 207, 212–15, Rattus rattus Saula,232n2, Oriol, 240 16 239–41, 247, 263n3, 266–70, 274, 297–302;See also rodents , 33, 48, Saudi Arabia, 266 159, 161n4, 162, 177, 181–82, 207. Savoy, 65n5, 162–66, 172–74, 180, 191 Schultz, Warren, 127 Rawcliffe,re-emerging Carol, infectious 273 diseases, al-Ṣayrafī, 146 Red Sea, xv, 43, 477 See also Second Plague Pandemic, x, xi, xiv, 9–14, pandemics;xi-xvii, 259–60, plague 265, 283. See19, 26,also 31, Black 38, Death;61, 100, pandemics; 194–98, Reformation, disease(s); Protestant, epidemics; 169 plague;206–08, Yersinia 216, 227, pestis 239, 245, 298. 337 Severe Acute Respiratory Syndrome INDEX Switzerland, 179 Swahili Coast, 48 (SARS), x, 99, 263 Shanga, 44, 48 Symes, Carol, xvii, 23, 63, 157, 193, 229, Shanghai, 299, 300n23 230, 259 Shaowu, 300 Syria, 41, 149, 200n16, 265 al-Sharqīya, 129 Shatzmiller,Shimla, 269 Maya, 65n5, 128 Tafur, Pero, 214 sheep, 33 Taiyuan, 289, 290 See also merchants; trade Tangut people, 285–86, 303 ships,Shi Yuanze, 18, 46, 292 50, 134, 200, 287, Tanzania, 40n17, 45, 268 Shoshan,299–300. Boaz, 127 TaoTarragona, Zongyi, 65–66 289 See also rodents Tarentaise, 173 Shouchun, 291 shrews, 48, 182. Tàrrega, 16–17, 53, 63–91, 96, 117, 172 Tartars, 289 Shubra, 146 Tell el-Farama, 47 Sichuan, 292,See 296–98, also 303 tenrecs,See also182 clothing; furs Sierrasieges, Leone, 204, 250, ix, x,286, xiii 289–92, 295, textiles,Thirty Years’ xiv, 12, War, 46, 275 210–11. 300–02. armies; war(s) See also merchants; roads and Tibetan-Qinghai Plateau. Silk routes;Roads, 12,trade; 46, travel215, and travelers Tibet,See 31, Qinghai 45–50-Tibet Plateau SimplonSinai Peninsula, Pass, 165, 215 173 Ticino River, 164–66 ticks, 33, 46 Simpson, W. J., 41n20, 198n9, 209 Tingzhou, 300 Third Plague Pandemic, xiv, 10–14, 20, Sinop, 214n37 31–32,See also 38–43, pandemics; 53, 180, plague; 196–203, Skythia, 47 208,Yersinia 239, pestis 260–61, 267–69, 274. Slavin,Snowdon, Philip, Frank, 248, 260 271 smallpox, x, xvi, 8, 264, 265 Trabzon, 206 Toulon, 64n5, 83, 86n35 Socotra Island, 47 Söderberg, Johan, 128 trade, ix, xiv–xvi, 12, 15–18, 34, 43–50, Somalia, 47 See54, 148n25,also merchants 159, 162, 165–71, 178, SongSongjiang, Dynasty, 299 4, 286–88, 291–93, 216, 262, 271–72, 288, 299–300. 296, 299, 301–03, 308 travel and travelers, 1–2, 11, 22, Transcaucasus, 208 South America, 11n4, 18, 30, 48, 54, 161, 260, 268 See also Iberian 30, 47–48, 53, 161–70, 173–75, SovietPeninsula Union, 39, 41n19 178–79,See also merchants;200–03, 212–15, migration; Spain,Splugen 1n1, Pass, 63, 167 231. 259–62,nomads; 287–88,pilgrimage; 297, trade 302. See also rodents Tübingen-McMaster Study. squirrels, 162, 177, 212–14, 297–98. tuberculosis,See also Bos, 53, 245n20,Kirsten, et249 al. storks (Ciconia ciconia stateSubirà capacity, de Galdàcano, 263 M. Eulàlia, 16 ), 215, 227 tularemia, 264 Tumbatu, 44, 48 super-spreaders, 263, 269, 272–73 Tunisia, ix, 49n29, 198n10 Surat, 49, 260–65, 269–73 Turin,212. 165, See 168n10 also Anatolia Sussman, George, 46, 49–50, 57, 193, Turkey, 39, 65n6, 199–200, 208–09, 197n7, 287n5 338 Udovitch,INDEX Abraham, 126 Wellcome Library, 22; Osteological Database, 105 United Arab Emirates, 262 Uganda, 40n17, 41, 267–69 West Smithfield, 105 United Nations, ix, 263–64 White, Sam, 128, 196n6 Unitedfor StatesDisease of Control America, and 39, Prevention, 170n11, Wittman,Willcocks, William, William, 202 136n5, 138–39, 261;200, 259–61,Department 264–65, of Defense, 268; Centers 261; 143n14, 146n22See also rats, rodents Department of Homeland Security, woodrats, 213. University of Illinois Program in World Health Organization (WHO), ix, 264 36, 40n17, 200n14, 261, 264 University of Pittsburgh World History Wu Lien-Teh, 32n12, 129, 209 Center,Medieval 22, Studies, 27 4–5 Xia, 285–93, 300–03, 308 Xie Shujun, 296 Uzbekistan, 38n14, 264 Xinghai, 269 Val d’Aosta, 165, 173 Yanping, 300 Valencia, 65, 81–82 YersiniaYelü Chucai, pestis 289–93,, xi, xiv, 302xv, 10–21, 26, Varlık, Nükhet, xi, 18–19, 40n17, 117, Yemen, xv, 47–49, 195, 208 Vaucluse,150, 161, 171–72 171, 177n18, 180, 273, 298n21 29–30, 32–44, 49, 51–53, 97–99, 158–61, 173, 178–80, 183, 193, vector(s), 9–11, 30, 33, 61, 150, 159n3, 199–200, 231, 235–36, 241–42, 182, 194, 206n27, 209–11, 216, 245, 251, 257–65, 268–71, 274, 235,See also 246, 266–69, 272; vector- 285, 292n12, 298, 301–02, 308–11; Venice,borne 65n6, disease, 171–72, 34n7, 266 48, 157, 191. amplifications of, 14–15, 35, Viborg, 110 disease(s) 38–41, 44, 51, 199, 236, 261, 269, 309; “Angola” strain, xiv n7, 37 (plate 1), 40–41, 42; “Big Bang” Vietnam,Vienne, 173 xvi; Vietnam War, 265 theory of (polytomy), 13, 37–39, VilafrancaVienna, 204 del Penedès, 66 285; evolution of, 10–13, 19, 29, 33–35, 158, 200, 236, 274, 285, Villani, Matteo, 101, 175 308; identification of, 10–11, 21, Virgil,Villadolid, 175 74 269–71,27–28, 36, 299; 39–42, microenvironments 98, 158n2, 193n1, 199–200, 208, 235n5, 264, See also rodents voles, 38, 41n19, 162, 177–79, 214–15. of, 11–12, 18–19, 46, 53, 161, 254; origins of, xi, xiv–xv, 12n6, 36–37, Walker-Meikle, Kathleen, 21 285; outbreaks of, 20, 29, 98, 157, Wagner, D. M., et al., 11n4, 35n9, 37–38 285; phylogenetic tree of, 14, 28, 35–43, 200n15; spread of, 11–16, Wallachia, 208 21, 29–34, 44–50,See 158, also 172, Black 175, Wallerstein, Immanuel, 3 266–68,Death; pandemics; 274, 283; virulencepathogens; of, Wang Deng, 293 158–60,plague; polytomy 302n27. war(s), 108, 150n26, 162, 167, Yersinia pseudotuberculosis See173–74, also armies;182, 200, sieges 208–09, Waqf265, 275, 296–99, 303. , 30, 35, See also rodents 40, 158 West Niledocuments, Virus, 99 128 York, 82, 107 weasels, 33, 214. Yuan Dynasty, 286–97, 300–03, 308 Yunnan, 287, 298n21, 303 339 Zaire, 260 INDEX Zhao Wenlin, 296 al-Zāmil, Mohammad, 128 Zhongxing Fu, 286 Ziegler, Michelle, 20, 32, 54, 161, 182 Zifta, 146 See also animals Zimbabwe, 45, 53 zoology, 12, 31, 52. zoonotics, x, xii-xiv, 31–34, 48, 53–54, 61, 157–83, 206–16, 235, 272–73