Texts in Context:
Behold, a Pale Horse

Not only was it highly lethal—the mortality rate vastly exceeded 50% in many places—but miserable and terrifying, and sudden. After infection, it was normal for untreated plague to kill the patient in about a week, and symptoms might not begin immediately. Early on, it resembled many other illnesses—fever, aches, a general sense of discomfort. Later symptoms varied a little, depending on which shade of Black Death one had the bad luck to get: bubonic (the limelight-hog of the three), pneumonic (outstanding in person-to-person transmission), or worst of all, septicemic ([phrase removed by editor]).

• Bubonic plague, the most common, occurred if the bacterium found its way into the lymphatic system. It was named for the buboes it caused: painful, egg-like swellings, mostly in the armpits, neck, or groin. These were in fact bloated lymph nodes, attempting to strain out the bacterium. One way plague can spread from there is … really gross! Let’s put off describing it for about forty seconds.
• Then we have pneumonic plague. In this form, Y. pestis has gotten into the lungs, causing chest pain, coughing, shortness of breath—basically “the things that can be wrong with lungs.” But wait, it gets worse! Now it’s in that mobile, juicy lung-air, the bacterium doesn’t need any of those hopelessly retro fleas to carry it from one host to another; it can go from human to human just fine, making the spread of the infection much faster.
• … by the buboes bursting and spilling infected blood everywhere, is where that sentence was going. Infected blood makes it septicemic plague. All versions of the disease tend to involve coughing up blood, but the septicemic form truly excels here. It also creates lots of little clots throughout the body, so one of this form’s bonus symptoms is good old-fashioned gangrene, principally in the fingers, toes, and nose.

The pandemic was not totally unprecedented. There was the Plague of Justinian in the sixth century; the disease is a candidate for the mysterious “Plague of Athens”; there appears to have been a plague epidemic during the Late Bronze Age Collapse, and perhaps one even further back. On the other hand, a few places went relatively unscathed—the vicinities of Milan and Santiago went almost unaffected; so did Brabant, most of Poland, the Basque country, and a few other spots. Nevertheless, the sheer scale of this outbreak was apocalyptic. The world’s population in 1346 was close to 475 million. Then the pandemic raged from 1347 to 1353, substantially impacting only Europe and North Africa; and in 1354, the world’s population was between 375 and 350 million.

Then, a decade later, the plague returned. Then it did so again. And, after a few extra years, it did it again; and so on. On the whole, recurrences of the Black Death decreased in virulence each time, as survivors passed on a hard-won resistance (though this was by no means absolute—the seventeenth century saw several especially severe eruptions of the disease). Still, they never entirely dropped off until the beginning of the nineteenth century.⁵

Spilt Black Ink

The long-term cultural effects of the plague are a favorite topic with Medievalists. Five people from our Author Bank lived through the Black Death—two as adults, two as children, and one as a newborn. The eldest and the youngest were Italians, Giovanni Boccaccio and Catherine Benincasa; the middle three were all from England, namely Fr. John Wycliffe, Geoffrey Chaucer, and Dame Julian of Norwich. Its effect on Boccaccio looks simple and clear: It serves as the background of his most famous book, The Decameron, a set of tales exchanged among a group of nobles while they spend a while holed up in a manor, isolating themselves from the pandemic. Its impact on St. Catherine seems to have been practical. Her work consisted chiefly in tending the sick; she cared for plague patients during Siena’s third outbreak, and one miracle attributed to her was curing a friend of the plague.

We will return to its influence on the English writers; the Black Death had its own proper effect upon contemporary literature. Yet how can one close such a piece but with this anachronism:

And now was acknowledged the presence of the Red Death. He had come like a thief in the night. And one by one dropped the revellers in the blood-bedewed halls of their revel, and died each in the despairing posture of his fall. And the life of the ebony clock went out with that of the last of the gay. And the flames of the tripods expired. And Darkness and Decay and the Red Death held illimitable dominion over all.

—Edgar Allan Poe, The Masque of the Red Death

¹For instance: A few writers have pointed out that Marco Polo says nothing about the Great Wall of China (and as we know, when someone writes about a place, they are obliged by law to mention what we would find interesting about it). However, contemporary accounts by other visitors to China do not mention it either, and since the Yuan dynasty controlled territory on both sides of the Wall, it may have been unimportant in Polo’s time, perhaps not even maintained.
²It was possible to take the southerly route overland, but sailing was faster and far less complicated. The southerly overland route meant traversing at least one of two hazards. Option one is the mangrove swamps of Bengal, Myanmar, and Malaya—which are very beautiful, and benefit the global balance of the world’s climate; but if you visit them, well, enjoy the dengue fever if you’re lucky, the malaria if you’re not. Option two is crossing the Southeast Asian Massif, a smaller sibling of the Tibetan Plateau (whose southern edge contains Mount Everest, so “smaller” is a load-bearing word). The Massif covers most of Indochina and the south of China proper, and much of it is karst, so it’s prone to having lots of concealed sinkholes; karst has not received the nickname “the traveler’s friend.” Just sail.
³Assyrian Christianity, a.k.a. Nestorianism or the Church of the East (not to be confused with Eastern or Oriental Orthodoxy—sorry, church terminology is just like this), was a branch of the faith which broke with the rest of the Church in 431, dissenting from the Council of Ephesus. The Assyrian Church was less prestigious than Catholicism in Europe, but astonishingly far-flung, with sees and monasteries from Cyprus to China. Manichæism was a Gnostic religion from third-century Persia that syncretized Buddhist, Christian, Judaic, and Zoroastrian elements. Its inroads into the Roman Empire were brief, while in Central and East Asia, it throve at least until the early Ming dynasty and perhaps longer.
⁴Edward’s claim to the French crown was based on the fact that his mother was the sister of the previous king, Charles IV. This made Edward III the closest male relative of Charles IV, and English law allowed males to inherit through the female line (under certain circumstances). The French, however, followed Salic law, which did not allow female inheritance at all; they therefore crowned Philip VI, the nation’s first monarch from the House of Valois, a cadet branch of the House of Capet.
⁵Ironically enough, it was also in the nineteenth century that a third historical plague pandemic began—i.e., a new strain of the disease, not just a new outbreak of the Medieval strain. This third pandemic mainly affected Asia, but also reached Africa, the Americas, and Europe; Y. pestis can be found in wildlife on every continent except Australia today. There are even modern cases of plague; however, these are extremely rare, and with antibiotics, infected humans have a 90% survival rate. The third pandemic as such was declared over once worldwide cases per year dropped below two hundred (which occurred in 1959).

Gabriel Blanchard—who is known to refrain from describing the Great Wall of China whenever suffering from plague (and at most other times)—is a proud uncle to seven nephews and godfather to one; he serves as CLT’s editor at large. He lives in Baltimore, MD.

Thank you for reading the Journal. If you enjoyed this piece, you might also like the Anchored podcast; or, if you’re in a reading mood and have happened upon our Texts in Context series here, you can find the beginning of our arc on the Middle Ages here (with a timeline of the Early Middle Ages later on), and our introduction specifically to the High and Late Middle Ages here.

Published on 19th May, 2025. Page image of Czterech Jeźdźców Apokalipsy or “Four Horsemen of the Apocalypse” (1941) by Polish painter Marcin Kitz, who was murdered by the Gestapo two years later for hiding Jews; photo by Wikimedia contributor TangoJohn, used under a CC BY-SA 4.0 license (source).