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By Root 1605 0

augmented the sense of horror. Of the real carriers, rats and fleas, the 14th century had no suspicion, perhaps because they were so familiar. Fleas, though a common household nuisance, are not once mentioned in contemporary plague writings, and rats only incidentally, although folklore commonly associated them with pestilence. The legend of the Pied Piper arose from an outbreak of 1284. The actual plague bacillus, Pasturella pestis, remained undiscovered for another 500 years. Living alternately in the stomach of the flea and the bloodstream of the rat who was the flea’s host, the bacillus in its bubonic form was transferred to humans and animals by the bite of either rat or flea. It traveled by virtue of Rattus rattus, the small medieval black rat that lived on ships, as well as by the heavier brown or sewer rat. What precipitated the turn of the bacillus from innocuous to virulent form is unknown, but the occurrence is now believed to have taken place not in China but somewhere in central Asia and to have spread along the caravan routes. Chinese origin was a mistaken notion of the 14th century based on real but belated reports of huge death tolls in China from drought, famine, and pestilence which have since been traced to the 1330s, too soon to be responsible for the plague that appeared in India in 1346.

The phantom enemy had no name. Called the Black Death only in later recurrences, it was known during the first epidemic simply as the Pestilence or Great Mortality. Reports from the East, swollen by fearful imaginings, told of strange tempests and “sheets of fire” mingled with huge hailstones that “slew almost all,” or a “vast rain of fire” that burned up men, beasts, stones, trees, villages, and cities. In another version, “foul blasts of wind” from the fires carried the infection to Europe “and now as some suspect it cometh round the seacoast.” Accurate observation in this case could not make the mental jump to ships and rats because no idea of animal- or insect-borne contagion existed.

The earthquake was blamed for releasing sulfurous and foul fumes from the earth’s interior, or as evidence of a titanic struggle of planets and oceans causing waters to rise and vaporize until fish died in masses and corrupted the air. All these explanations had in common a factor of poisoned air, of miasmas and thick, stinking mists traced to every kind of natural or imagined agency from stagnant lakes to malign conjunction of the planets, from the hand of the Evil One to the wrath of God. Medical thinking, trapped in the theory of astral influences, stressed air as the communicator of disease, ignoring sanitation or visible carriers. The existence of two carriers confused the trail, the more so because the flea could live and travel independently of the rat for as long as a month and, if infected by the particularly virulent septicemic form of the bacillus, could infect humans without reinfecting itself from the rat. The simultaneous presence of the pneumonic form of the disease, which was indeed communicated through the air, blurred the problem further.

The mystery of the contagion was “the most terrible of all the terrors,” as an anonymous Flemish cleric in Avignon wrote to a correspondent in Bruges. Plagues had been known before, from the plague of Athens (believed to have been typhus) to the prolonged epidemic of the 6th century A.D., to the recurrence of sporadic outbreaks in the 12th and 13th centuries, but they had left no accumulated store of understanding. That the infection came from contact with the sick or with their houses, clothes, or corpses was quickly observed but not comprehended. Gentile da Foligno, renowned physician of Perugia and doctor of medicine at the universities of Bologna and Padua, came close to respiratory infection when he surmised that poisonous material was “communicated by means of air breathed out and in.” Having no idea of microscopic carriers, he had to assume that the air was corrupted by planetary influences. Planets, however, could not explain the ongoing contagion. The agonized search