The Black Death Plague in China in the 1300s

The Black Death Plague in China in the 1300s

The cause of the black death was only recently hypothesized and proven to be the Yersinia pestis with scientific advancement made in the 18th and 19th centuries. The pandemic that wiped out the Chinese population from 120 to 60 million people is now recognized as the bubonic plague. In the 19th century, the epidemics that riddled Asia, the Middle East, and Europe were attributed to the Bubonic Plague between 1347 and 1670.[footnoteRef:1] The ancient medicine that was practiced in China, where the plague had a devastating impact on the population, was still rudimental and stemmed from the cultural practices and the advancements in medicine made by Aristotle and Hippocrates in the 4th century[footnoteRef:2]. The origins of the plague were traced to Siberia and Mongolia. This study will explore the pathology, spread, the socio-economic and political impact of the bubonic plague, including a review of the black death in China. [1: Duncan, \"What Caused the Black Death?.\" 315.] [2: Legan, \"The Medical Response to The Black Death,\" 25.]

Pathology

The black death was a result of a variety of bacteria that fall under the Yersinia pestis classification. The origin of the bacteria is not known to be the Mongolian Steppes around 1331. Between 1347 and 1350, the bacteria had spread across Asia, Europe, and North Africa.[footnoteRef:3] The bacteria typically live in the stomach of rat fleas and might also live in the stomach of the human flea. The bacteria block the digestion of the flea, and as the flea feeds, they regurgitate the bacteria from their stomachs into their victim[footnoteRef:4]. The bacteria, Y. pestis, point of entry into the human body is the skin breakage, but access into the human is limited if one’s skin is healthy. Since rodents infested with fleas are the main carriers of the bacteria, such as marmots, tarbagons, and susliks in Asia, and were virtually in every household in the 14th to the 16th century, would attack human beings after they ran out of rodent hosts. Therefore, humans were victims of epizootic disease. [3: Jedwab and Koyama, Negative Shocks and Mass Persecutions: Evidence from The Black Death, 5.] [4: Legan, 6.]

The survival conditions in the absence of rodent hosts for a year are active between 59 and 68?F with humidity between 90% and 95%. Where humid drops below 70%, the rodent fleas (Xenopsylla cheopis) are unlikely to survive.[footnoteRef:5] This explains why the plague and the black death were experienced at lethal rates during late summer and early in the spring when the climatic conditions were suitable for the fleas. When the rodent population would increase due to food availability, the bubonic place would surface again.[footnoteRef:6] Once the population of rodents decreased, the bacteria, Y. pestis, would survive in the rodents’ burrows for prolong periods since they are dark and moist. Once a new population of rodents would move into these caves, they would be infected, leading to a new epidemic. As a result, the black death in China was not due to a cyclic occurrence of epidemics that made the disease more fatal than its virulence alone and explained the population catastrophe of the black death. [5: Legan, \"The Medical Response to The Black Death,” 6. Duncan, \"What Caused the Black Death?\" 315.Wheelis, \"Biological Warfare at the 1346 Siege of Caffa.\"] [6: ]

Variants of the Plague

The bubonic plague had three main variants, septicaemic, pneumonic, and bubonic. The variants of the plague occurred in different regions across Europe, the Middle East, and Asia.[footnoteRef:7] The bubonic plague had been the most common and recurrent form of the plague. The bubonic plague had an incubation period of size days and would be followed by the appearance of a blackish gangrenous pustule on the site of the skin where the victim was bit by the flea. Another symptom that would follow was the swelling of lymph nodes in the neck, groin, and armpit region, depending on which location was the closest to the location of the bite.[footnoteRef:8] As the disease advanced, a subcutaneous hemorrhaging would begin, eventually causing the swelling and development of purple hinted or black blotches in the lymphatic nodes, thus, the name ‘’Black Death”. The hemorrhaging would cause intoxication and neurosis of the nervous system resulting in psychological and neurological disorders.[footnoteRef:9] The bubonic variant victims would often have diarrhea, committing, and pneumonia. The bubonic plague had a 50% to 60% fatality rate among the infected. [7: ] [8: Legan, \"The Medical Response to The Black Death,\" 7.Duncan, \"What Caused the Black Death?\" 317.Duncan, 317.] [9: Legan, 5.]

The Septicaemic variant of the plague was the rarest and most hazardous variant of the plague. Like the bubonic plague, this variant was transmitted by fleas, X. cheopis, rather than from person to person. This variant occurred when a victim’s bloodstream was saturated with the bacteria but only for several hours. Due to the high fatality rate of the bacteria, the victim would succumb to this variant before any of the symptoms identified in the bubonic variant of the plague emerged, such as imperfections in the lymphatic glands.[footnoteRef:10] Notably, the concentration of bacteria in the bloodstream of the victim was saturated. When a human flea bit an infected person, it would contract the bacteria and transmit to other people who would later be its host. In this form, the human flea, Cortophylus fasciatus, was the main way the virus was transferred among humans. [10: ]

The pneumonic plague was the only variant of the contagious plague and would directly be transmitted from one individual to another.[footnoteRef:11] After the bacteria’s incubation period of the bacteria, Y. pestis, the body temperature would drop for two to three days, followed by severe coughing. The infection would attack the lungs causing consolidation followed by a discharge of bloody sputum. The cough would result in the dispersal of the bacteria into the air. Further, the sputum had bacteria as well that increased the rate of transmission of the contagious disease. After the attack of the lungs, the victim would suffer neurological challenges and a coma.[footnoteRef:12] The Pneumonic variant had a fatality rate of 95 to 100%. [11: ] [12: Duncan, \"What Caused the Black Death?\" 317.Wheelis, \"Biological Warfare at the 1346 Siege of Caffa.\"]

Migration and Spread of the Bubonic Plague

One of the earliest accounts of the black death was by Gabriele de’ Mussi, who practiced notary in the city of Piacenza between 13000 – 1349. His notary was mainly on the trade prevalent in Caffa (now Feodosija, Ukraine) due to the 1266 agreement between Genoa and Kahn of the Golden Horde. The accounts mainly covered the trade in the main port for the great Genoese connected by the Don River to the coastal shipping industry to Tana in central Asia. While most of his accounts were lost, one of his accounts which approximately dates 1367, documented that “In the name of God, Amen. Here begins an account of the disease or mortality which occurred in 1348, put together by Gabrielem de Mussis of Piacenza.” The account begins with an apocalyptic account of the depravity of human beings in the eastern countries and disease that cleared out the population as retribution by God.

“…In 1346, in the countries of the East, countless numbers of Tartars and Saracens were struck down by a mysterious illness that brought sudden death. Within these countries’ broad regions, far-spreading provinces, magnificent kingdoms, cities, towns, and settlements, ground down by illness and devoured by dreadful death, were soon stripped of their inhabitants.”[footnoteRef:13] [13: ]

While Genoa was distant from the epicenter of the bubonic plague, the narratives of the destruction it caused in the Caritas where it began were evident in cosmopolitan and port cities as accounted by de’ Mussi. Current accounts of the Black Death began with J. F. C. Hecker, a German medical historian, in an extended essay in 1832 that branded the fourteenth-century pandemic. Hecker’s account held was a medieval chronicle of consequences of “a pestilence, that extended from China to Iceland and Greenland.”[footnoteRef:14] Notably, this account was informed by the geographical spread of the plague from the Chinese towns to Greek where he was a resident. His account traced the pestilence to an oriental plague that emerged from the bubbling cauldron of adversaries, such as famine, floods, drought, locusts, collapsing mountains, earthquakes, and epidemics in China that begun in 1333. [14: Wheelis, \"Biological Warfare at the 1346 Siege of Caffa.\"]

The climatic changes during these times are also observed in his account as a core contributor to the spread and the infection of the human population with the Y. pestis bacteria. Due to the decline in the population of the rodent population, the rat fleas attacked the human population, resulting in an increase in the infection of the human population with the bacteria.[footnoteRef:15] Therefore, the miasmatic theory of disease is a more feasible explanation of the black death than the germ theory. Hecker’s account views the movement of the plague from the East to West as a consequence of “progressive infection of the Zones” on and beneath the earth’s surface rather than as a chain of contagion. [15: Welford and Bossak, \"Validation of Inverse Seasonal Peak Mortality in Medieval Plagues, Including the Black Death, In Comparison to Modern Yersinia Pestis-Variant Diseases,\" 1177. ]

The fourteenth century witnessed a steep trajectory in trade between Europe, North Africa, and Asia. As trade grew, the settlement patterns began to change as more population began to assemble in cosmopolitan areas. As a result, the movement of traders in merchant ships between these three continents created channels.[footnoteRef:16] As established, the spread of the disease was mainly associated with the movement of the rat population rather than the contagion among people. The spread of infection among people was only limited to the pneumonic variant. As merchant ships docked for loading or loading of cargo, the rats that were hosts to the fleas carrying the Y. pestis would get on board. The ship population would get infected with the bacteria and arrive at their destination with an infected crew. The rats would get off the board during loading activities and the docking activities and infect the rodent’s population in these new locations. Due to the high population in the compliant areas, the local population would also be succumbing to the new bubonic plague.[footnoteRef:17] As a result, the populations that were most affected by the disease were those with the most commercial activity. For example, the cargo was ferried from Genoa and Venice through the Mediterranean and to the Asian, western, and northern European ports. The routes associated with the spread of the disease were the Silk Road and the Muslim pilgrimage routes. Figure 1 shows the trade routes and the areas that experienced black death in large numbers. [16: Wood, Ferrell and Dewitte-Aviña, \"The Temporal Dynamics of The Fourteenth-Century Black Death: New Evidence from English Ecclesiastical Records.\" 344.] [17: Welford and Bossak, \"Validation of Inverse Seasonal Peak Mortality in Medieval Plagues, Including The Black Death, In Comparison To Modern Yersinia Pestis-Variant Diseases.\"]

Figure 1: Trade routes and cities that were pertinent to the spread of the bubonic plague.[footnoteRef:18] [18: \"Chapter 11 The Black Death — A 14Th Century Plague.\"]

The account of the spread of the bubonic plague in Asia and the European countries is complementary to the chronological account of historical events. In China, the outbreak of the bubonic plague is believed to have happened in the 1320s. The Province of Hubei was the first city where the first outbreak happened in 1334.[footnoteRef:19] The Mongol rule in the 1334s sought peaceful trade with Europe, the Middle East, and North Africa. As the Mongol rule grew in influence in Central Asia led to increased transmission of the disease. The mogul rule sought to expand trade within Asia and other continents. [19: Siuda and Sunde, \"Disease and Demographic Development: The Legacy of the Plague.\"]

With the expansion of trade, both internally and externally, the bubonic plague spread can be traced to trade routes used to transit goods internally and externally. For example, the Silk Road facilitated trade between China and Europe[footnoteRef:20]. The expansion of the trading routes increased the access to more European states that resulted in the spread of the disease. The Mongols could not control the trade; they attacked these territories to control the main trading channels. Mongols, Tartar warriors attacked eastern Europe and created more room for the spread of the bubonic plague. [20: Wood, Ferrell and Dewitte-Aviña, \"The Temporal Dynamics of the Fourteenth-Century Black Death: New Evidence from English Ecclesiastical Records,\" 433. ]

The siege of Caffa, the Italian trading city of Genoa, was orchestrated by the Mongols with the support of the rival states of Genoa. Amid the siege, the tartars began to fall sick and die in large numbers[footnoteRef:21]. Consequently, the siege began to fall apart as the Tartar soldiers began to fall sick and die fast in large numbers. The diseased bodies would be tossed over the city walls as the soldiers began to retest from the city. The Genoans who had escaped the city also contracted the disease. Therefore, the disease’s epicenter spread the disease to other trade cities and spread into other internal cities. [21: Wheelis, \"Biological Warfare at the 1346 Siege of Caffa.\"]

The environmental condition in the Mongolian residence in the Gobi Desert, Karakorum, contributed to the spread of the Y. pestis bacteria from the rat fleas and the human population. The climate of Karakorum led to the rise of the environmental theory that held that the spread of the bubonic plague began due to harsh climatic conditions.[footnoteRef:22] The environmental theory holds that the hot, dry Saharan air was blown into central Asia, which was also dry. However, from the evaluation of the pathology of the Y. pestis bacteria, this theory does not explain the spread of the bacteria since it would only be spread from the bites of fleas that infested bite black rats, Xenopsylla cheopis. [22: Jedwab and Koyama, Negative Shocks and Mass Persecutions: Evidence From The Black Death, 25.]

Alternatively, what could have led to the spread of the disease into the central regions of China was the migration of the infected rats with the flocks as the Mongolians migrated with their flocks in search of pastures.[footnoteRef:23] The spread of the disease into the west of China has explained the migration of the Mongol and Turkic nomads in search of the pasture, while the spread of the disease coincides with the growth of eastern trade routes. The elaborate trading routes were under the guard of Mongolian rule. Therefore, the bubonic spread across China was simultaneously happening was the growth of the Silk trade, drought, and expansion of the Mongol rule. Gabriel de’ Mussis’ account of the bubonic plague is accurate about the chronology of its spread and its arrival in Genoa with the attack of the Mongolian warriors. [23: Legan, \"The Medical Response to the Black Death.\"7.]

Black Death in China

As established, the black death began on the Mongolian steppes in 1331. It is hypothesized that the black death began in 1320 when stints of drought were witnessed. But the records of the black death’s population impact only began to be observed when the impact was widespread and some leaders, such as emperor Jayaatu Khan of the Yuan Dynasty.[footnoteRef:24] This hypothesis is predicated on the inaccuracy of the Chinese census system that counted houses instead of the houses, which could have acknowledged the pandemic late to the point until the pandemic had begun its devastating impact on China’s population. This claim is based on the fact that the first epidemic in China was in Hebei, where it cleaned 90% of the population[footnoteRef:25]. Notably, three epidemics had cleared out the Mongolian population from an estimated 120 million people in 1200 to 60 million in 1390. These dramatic drops in the population had political, economic, and social repercussions. For example, the prevalence of drought, rebellions, banditry, and floods was viewed as a failure on the ruling class.[footnoteRef:26] As a result, the governance had between 1200 and 1390 power had moved from the Yuan Dynasty to the Ming Dynasty. [24: Sussman, \"Was the Black Death in India and China?\" 351.] [25: DeWitte, \"Mortality Risk and Survival in The Aftermath Of The Medieval Black Death,\" ] [26: Sussman, \"Was the Black Death in India and China?\" 347. ]

The emergence of the black death caused the change in power, but other interests also led to the changes in the ruling dynasty. The conviction among the people and society-at-large attributed adversaries, such as drought and epidemics, as retribution by God for the iniquity of the rulers and the community. While Christianity was not practiced within the Asian continent, they also had a religion that the rulers were bound to adhere to remain in favor of their states.[footnoteRef:27] These religious convictions also informed the medical practices that were used to cure the diseases. The medicine practices invented in Europe were being adopted, although reluctantly, but neither of these options was suitable to treat the bubonic plague. As a result, the medical practitioners also succumbed to the illness. They were exposed to rat fleas more than other people due to the visitations by patients who had already been infected. [27: DeWitte, \"Mortality Risk and Survival in The Aftermath of The Medieval Black Death.\"]