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, Research Paper

The coming of the Black Death, when in just two years perhaps one third to one half of Europe’s population was destroyed, marks a watershed in Medieval and Renaissance European History. Bubonic plague (Yersinia pestis) had been absent from Western Europe for nearly a millenium when it appeared in 1348. The reaction was immediate and devastating. Up to two thirds of the population of many of the major European cities succumbed to the plague in the first two years. Government, trade and commerce virtually came to a halt. Even more devastating to Europeans, there was hardly a generation which did not experience a local, regional or pan-European epidemic for the next two hundred years. There was virtually no aspect of European society that was not affected by the coming of plague and by its duration. At the most basic level, recurrent plague tended to skim off significant portions of the children born between infestations of plague, dampening economic and demographic growth in most parts of Europe until the late seventeenth century. The responses of Europeans are often treated as irrational or superstitious. Yet medical tracts, moral treatises and papal proclamations make clear that for most Europeans there were, within the medieval world view, rational explanations for what was happening. Plague stimulated chroniclers, poets and authors, and physicians to write about what might have caused the plague and how the plague affected the population at large the framing story of Boccaccio’s Decameron is merely the most famous of the writings. Nonetheless, in the wake of the first infestations there were attacks on women lepers and Jews who were thought either to have deliberately spread the plague or, because of their innate dishonor, to have polluted society and brought on God’s vengeance. The violence against outsiders demonstrated, in a tragically negative manner, the nature and the limits of citizenship in Europe. This was a society which defined itself as Christian and recurrent plague changed religious practice, if not belief. Christians had long venerated saints as models of the godly life and as mediators before God, in this case an angry and vengeful one. A whole new series of “plague saints” (like St. Roch) came into existence along with new religious brotherhoods and shrines dedicated to protecting the population from plague. The recurrence of plague also affected the general understanding of public health. Beginning in Italy in the 1350s there were new initiatives aimed at raising the level of public sanitation and governmental regulation of public life. And, finally, by the sixteenth century a debate over the causes of plague spread in the medical community as old corruption theories inherited from Greece and Rome were replaced by ideas of contagion. The story of plague in Renaissance society is not merely a medical, religious or economic subject. To properly understand the impact of plague it is necessary to consider almost all aspects of society, from art and music to science. Bubonic plague is caused by the bacterium, Yersinia pestis. It is also known as Pasteurella pestis. Other Pasteurella bacillus cause diseases such as tuberculosis.

There are two ways the plague is transmitted

1. Mostly by being bitten by an infected flea

2. Sometimes from exposure to plague infected tissue.

Once the bacterium, Yersinia pestis, enters the bloodstream, it travels to the liver, spleen, kidneys, lungs, and brain.The incubation period is commonly 2 to 6 days after exposure. Early symptoms include:

· shivering

· vomiting

· headache

· giddiness

· intolerance to light

· pain in the back and limbs

· white coating on tongue

Eventually, pain occurs in the groin, armpit, and neck. All the areas that contain lymph nodes. Later, there is painful swelling of the lymph nodes called “boboes”, hard lumps that begin to appear on the inner thigh, neck, and armpit. Blood vessels then break, causing internal bleeding. Soon, dried blood under the skin begins to turn black. Yersinia pestis , in autopsies, has been found in the pericardial sac, spleen, liver, lymph nodes, and bone marrow. If untreated, plague mortality is very high (up to 75%). Once a person is infected and recovers they become immune.

Bubonic plague has a vaccine. It lasts for about 6 months. Currently, plague vaccine is not available in the United States. A new vaccine is being worked on and could be licensed later this year. Travelers to plague infested areas should take prophylaxic antibiotics. The preferred antibiotic for prophylaxis is tetracycline or doxycycline, and for children 8 or less, sulfonamides. Bubonic plague is easily treated if caught early. Streptomycin is the preferred drug, but gentamicin, teracyclines, and chloramphenicol also are effective. Penicillin is useless on plague. Treatment shortly after exposure can reduce overall plague mortality from 60%-100% to 10%-15%. The most effective way to prevent plague is better sanitary conditions and precautions. These conditions and precautions include:

· rat populations should be controlled using rodenticide

· effective insecticides should be used to control the flea population that transmits plague to humans and rodents

· ships should be fumigated with hydrocyanic gas before arriving in port

· conditions around human dwellings should be made more sanitary, diminishing the food and shelter for rodents

· separate facilities should be used for livestock

· bubonic plague patients should be isolated as soon as diagnosed

The improvement of bubonic plague prevention has evolved over the centuries. The people of the 14th century were uneducated and susceptible to superstitions. Some early treatments included:

· bathing in human urine

· wearing of excrement

· placing dead animals in homes

· use of leeches

drinking molten gold and powdered emeralds

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