The Scented History of the Plague: A Primer

Hello my beloveds, over the next few posts we will be discussing the history of the plague, miasma, and their impact on olfactive culture. This turned into a gigantic undertaking so instead of dropping a 10,000-word brick in your inboxes I’ll be breaking up our tale over several posts. Before we get into the super smelly stuff, let’s have a quick primer on the history of the Black Death, define some confusing terms and talk about a fundamental shift in medicine that changed olfactive history.

The Scented History of the Plague Series:

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A Bad Beginning

While the totality of the Medieval plague pandemic was horrible it was the first five years, the Black Death, that fundamentally changed European society in every capacity. It weakened the foundations of absolute monarchy. It led to the widespread questioning of the authority of the church but also increased radical zealotry among the faithful. The plague changed the economic landscape. It caused shifts in migration and pernicious new kinds of xenophobia. Unable to cope with the sheer number of the dying it caused physicians to question medical wisdom held sacrosanct since the halcyon days of Ancient Greece. It also changed the olfactive culture of Christendom which Western society still holds vestiges of.


A Brief History of the Plague

The Plague, Pestilence, The Great Plague, Bubonic Plague, The Black Death. Lots of terms get thrown around, and it isn’t always clear what is what, so let’s start by clarifying some terms.

The disease commonly referred to as The Plague is caused by Yersinia pestis.  The Yersinia pestis bacterium causes severe flu-like symptoms and necrosis of the extremities. However, the likelihood of survival, as well as an individual’s symptoms, depends on the presentation of the infection, of which there are three:

  • Bubonic: infection of the lymphatic system (most common)
  • Pneumonic: infection of the pulmonary system
  • Septicemic: infection of the blood


In general, we can divide plague history into three pandemics. A pandemic is a global or pan-regional infection. Within a pandemic, there can be many epidemics or localised infection in smaller areas. Pandemics are epochs that can last centuries and cover the globe and epidemics are smaller events that often just last a few years in a contained location.

The First Pandemic began in 541 BCE with the epidemic of the Plague of Justinian. The Second Pandemic started in 1347 with the epidemic of the Black Death, and the Third Pandemic began in 1855 with the epidemic of the Yunnan Plague. In this series, we will be looking at the Second Pandemic and more specifically, the epidemics known as the Black Death and the Great Plagues.

The Second Pandemic

The impact of the Black Death can not be overstated. Fifty per cent of Eurasia’s population died in the 5 years of the Black Death. 50% of ALL of Europe AND Asia ate it in less time then it took for me to get my bachelor’s degree! It would be 200 years before the world’s population recovered. The Second Pandemic eventually tapered off to became seasonally episodic by the late 17th century, but would not be entirely eradicated in Eastern Europe until the 18th century. Its last truly terrible visitation began with the Great Plagues.

The strain of Yersinia pestis involved in the Black Death was particularly formidable when it first arrived in Europe and could easily go pneumonic (air born) in heavily infected areas. You have a 50%-50% chance of surviving bubonic plague without antibiotics, but pneumonic and septicemic plague are a guaranteed death sentence untreated. All three plague presentations were rampant during the Black Death. Leading to cities becoming reinfected multiple times. These multiple outbreaks were dubbed visitations. Poor Naples was visited by the plague over 100 times between 1347 and 1658. Unlike the Black Death, the Great Plagues didn’t get the chance to concentrate as tightly. So while thousands still died, it wasn’t millions, and after those visitations, the plague did not return to most of the infected cities.

Illustration: Bring Out Your Dead. (1667) Wellcome Images

The Great Plagues were a series of epidemics that occurred late in the Second Pandemic. Notable outbreaks during the Great Plagues are the Great Plague of Seville (1647–52); the Great Plague of London (1665–66); the Great Plague of Vienna (1679); the Great Plague of Marseille (1720–22), the Great Plague of 1738 (Eastern Europe), and the Great Russian Plague (1770–72).

A mixture of lowered virulency and improved public health protocols eventually turned the tide on suppressing the contagion. However, the strain did follow colonisers and would continue to have occasional outbreaks overseas into the 19th century. The Black Death strain of Yersinia pestis has never left us, it remains epizootic in wild rodent populations, and there are several hundred humans infected each year globally.

Painting: Saint Sebastian pleads with Jesus for the life of a gravedigger afflicted by plague during the Plague of Justinian. Josse Lieferinxe, (c. 1497–99)

Origins of the Plague

The origin of the Second Pandemic isn’t entirely certain. The story taught in school is that a merchant ship from an unknown eastern port arrived in Messina in 1347 carrying the plague. While this was widely believed in Europe at the time, there is little evidence to confirm it. An alternative explanation is that it travelled on the Silk Road. The contemporary Egyptian historians Ibn Al-Wardni and Al-Maqrizi both believed that the Black Death began in Mongolia in 1330 and travelled with the Golden Horde as it expanded West. When the defenders of Caffe, a town in Crimea and the last Italian outpost along the Silk Road, fled the Mongol’s siege in 1347 they brought the plague back with them to Italy.

Fresco: Dance of Death, Church of the Holy Trinity. Hrastovlje, Slovenia (c. 15th century)

There is documentation of the Caffe soldiers returning with an unknown affliction. However, parts of North Africa, the Levant, and Central Asia were already experiencing an outbreak. It indeed began in Europe on the Italian peninsula, though exactly where may never be clear. The Italian states dominated in both overland and sea trade. This increased global connectivity left them vulnerable to infection. While we may never know for sure, there were likely multiple points of contact that spread the illness to Europe starting in Italy and the Eastern Mediterranean region.

Illustration: The people of Tournai bury victims of the Black Death, in the Tractatus quartus by Gilles li Muisis. Pierart dou Tielt (c. 1353).

Forget About Phlegm, it is All the Stink!

The plague’s impact on olfactive culture began with its effects on medicine. Humorism was the orthodoxy going back to Galen and Avicenna. The Greek physician Hippocrates is often credited with developing the theory of the four humours. However, elements of Humorism can also be found in traditional Islamic, Ayurvedic, and Chinese medicines. So we can’t blame this on one group, we all basically had the same bad idea.

Engraving: The Four Humours, from ‘Quinta Essentia’ by Leonhart Thurneisser zun Thurn   (1531-96)

That idea being that the body was made up of four humours: Blood, Black Bile, Yellow Bile, and Phlegm. These humours had various attributes such as temperature, wetness, and seasonality that were supposed to say something about a person’s health. Ideally, all four humours would be in balance and the person would be healthy both mentally and physically.

Illustration: the Four Humours with the Head of Christ, in the Guild Book of the Barber-Surgeons of York (1486)

In Humorism, all disease was due to dyscrasia or a bad mixture of humours. While Humourism was THE system of healing for over a thousand years, it had a pretty big flaw. How do you explain hundreds of people getting sick at one time? Surely they can’t all be out of humours?

Starting with the Black Death, physicians had to admit that some outside contamination must be making everyone sick. Many saw it as a curse from God. People suspected it was caused by poisoning or sabotage. Many Jews, Romani, lepers, and poor people were killed during plague visitations by angry mobs needing a scapegoat. However, the theory that came to dominate the response to the Black Death and the Great Plagues was the Miasma Theory. A theory in which malodour, virtue and death would become intertwined in the psyche of Medieval Europe.

Read the next article in The Scented History of the Plague Series: