Plague

There have been three major plague pandemics in recorded history: the plague of Justinian in the mid-sixth century, the Black Death in the mid-fourteenth century, and the Bombay plague in the late nineteenth century. Apart from the high mortality rates and the social dislocation caused by these pandemics, each initiated a long series of plague epidemics with significant cumulative effects.

Before the Arab conquests in the seventh century, plague had recurred cyclically in the Near East following the plague of Justinian, but it apparently had little effect on the Arabian Peninsula, where environmental conditions for plague were unfavorable. In 638-9, however, a plague epidemic struck the Arab army after its conquest of Syria and it spread to Iraq; the disease killed many soldiers of the conquering army as well as the native population. During the Umayyad caliphate (661-749), plague reappeared a number of times in Syria, Iraq, Egypt, and North Africa. Inexplicably, however, the disease disappeared after 749 and did not reappear again until 913, when it struck Baghdad. There were occasional outbreaks of "pestilence" until the fourteenth century, but they cannot be clearly identified as plague because of the imprecision of the Arabic sources and the lack of any distinct epidemic pattern.

In 1347 plague dramatically reappeared in the Middle East, being carried overland from central Asia to the Crimea in 1346. From the Black Sea region, it was transported by Italian merchants to Constantinople and from there to the major Mediterranean ports. Egypt was infected by the autumn of 1347 and Syria by the following spring. In addition, the plague spread inland; the central Middle East may have been infected from southern Russia as well. There is, incidentally, no evidence for the theory that the pandemic was transmitted from India via the Persian Gulf and the Red Sea to the Middle East and Mediterranean littoral. In 1348-9 plague attacked Arabia for the first time and infected Mecca. This pandemic was the same one that struck medieval Europe and is known familiarly as the "Black Death." From all indications, the effects of the Black Death in Muslim lands were as devastating as they were in Europe.

In both regions the Black Death also established a cycle of plague recurrences, but the reappearances in the Middle East (roughly about every nine years) were far more damaging because of the nature of the epidemics and their persistence. In the Near East, recurrences until the end of the fifteenth century included pneumonic plague (the form of plague that is most infectious and almost always fatal) as well as the other two forms, bubonic and septicemic; all three forms had been present in the Black Death. The result of these plague recurrences was clearly a sustained decline in population in the late fourteenth and fifteenth centuries. This decrease in population was the essential phenomenon of the social and economic life of Egypt and Syria in the later Middle Ages.

There is little evidence for pneumonic plague in Europe after the Black Death, except in isolated Russian epidemics. The recurrent epidemics in the Near East were frequent and lasted until the end of the nineteenth century, whereas epidemics of plague disappeared from most parts of Europe in the seventeenth century. Generally, the Middle East was at the crossroads of a number of endemic foci of plague, which accounts for the numerous and seemingly chaotic occurrences of the disease since the Black Death. By land and sea, the movements of men and their cargoes promiscuously carried the disease over the entire region, giving the appearance of endemicity throughout the Middle East. The endemic foci, however, that were the generators of recurrent plague before the twentieth century in the Middle East appear to have been the following: central Asia, western Arabia (Assir), western Asia with its center in Kurdistan, central Africa, and northwestern India.

Plague was a well-recognized disease in Muslim society after its first appearances in early Islamic history. Drawing on classical Greek medical works, physicians adequately described the disease, and although it had not been discussed by Hippocrates and Galen, they interpreted it according to humoral theory, attributing it to a pestilential miasma. Not until the Black Death, however, do we have relatively accurate medical observations of plague and historically reliable accounts in the Arabic sources, which are primarily plague treatises and chronicles.

Three of the treatises at the time of the Black Death in Andalusia were mainly medical works. Comparable medical tracts devoted to plague do not seem to have been written in the Middle East, but it was discussed in most of the standard medical compendia written both before and after the Black Death. Following the Black Death, Muslim scholars in the Middle East composed treatises of a largely legal nature that interpreted the disease according to the pious traditions of the Prophet, instructed the reader on proper conduct during an epidemic, and gave some peripheral medical advice. In addition, these works usually ended with a chronology of plague occurrences from early Islam until the writer's own time. These treatises virtually form a genre of religiolegal literature, inspired by the constant reappearances of plague from the time of the Black Death until the end of the nineteenth century.

The treatises are obviously important for their chronicling of plague epidemics but also for the evidence they provide of an ongoing concern of a religious elite that was split on the issue of the religious tenets regarding plague, some arguing for them and some against them. The tenets in question were the following: Plague is a mercy and a source of martyrdom for the faithful Muslim and a punishment for the infidel; a Muslim should neither enter nor flee a plague-stricken region; and plague is noncontagious.

There must have been serious doubts about the soundness of these precepts. The treatises are repetitive concerning this conflict between martyrdom and health, although they often supply original observations of the symptomatology of contemporary plague epidemics. In one respect, the series of tracts show an increasing interest in pseudomedical or magical methods of plague prevention and treatment. It would be hazardous, however, to conclude that this is evidence for the decline of medical practice in the Islamic world, because the discussion of magical practices may indicate merely a greater recognition by legal scholars of common folk practices, which had always existed side by side with professional medical practices. In any event, the treatises explain to a great extent the Muslim attitudes toward plague.

The historical chronicles are relatively abundant for the Black Death and the recurrences of plague during the latter half of the Mamluk period in Egypt and Syria (1250-1517), although we have only one complete eyewitness account of the Black Death itself. These chronicles diminish sharply in quality and quantity in the last half of the fifteenth century, and we are no longer supplied with the kind of specific descriptions of epidemics that enable us to determine with a fair degree of accuracy the duration and nature of the various epidemics.

From the late fifteenth century, the Arabic sources can be supplemented by information from European observers, including merchants and pilgrims, physicians and diplomats, whose reports increase in number with an increasing Western involvement in the

Muslim world. The subject of plague in that world alone inspired a large European literature, especially among physicians, who gave conflicting interpretations and advocated conflicting prophylaxes. By and large, this literature is surprisingly uninfor-mative despite some interesting accounts, such as those of the English physicians Alexander Russell and his brother Patrick Russell on plague in Aleppo in the mid-eighteenth century.

The immediate and long-term consequences of plague epidemics are difficult to judge, but in the cities of Egypt and Syria at the time of the Black Death and later plague recurrences, no serious breakdown of urban life was noted, although there were certainly disruptions in food supplies. The organization of large processions, funerals, and burials would suggest the maintenance, if not a heightening, of public order. There is evidence that, despite religious proscription, people did flee from infected regions -both to and from the cities - which doubtless aggravated the situation, because they would often have carried the disease to unaffected areas while exposing themselves to other illnesses and to starvation.

In the Egyptian countryside, by contrast, considerable evidence exists of depopulation through either death or flight from the land, and thus the most disruptive, long-term effect of plague epidemics appears to have been the changes that were wrought in rural areas. Reduced cultivation led to a decrease in the amount of food available for the cities, which depended on surplus rural production, as well as in tax revenues. The first consequence was less important than the second because (based on evidence suggesting that there was no long-term price inflation for agricultural products in Egypt in the aftermath of the Black Death) reduced agricultural production was apparently feeding a diminishing population. The government's attempts to maintain tax revenues, however, were disastrous because a larger share of taxes was imposed on a smaller rural population, which in turn encouraged peasant indebtedness and flight to the cities. Symptomatic of the social and economic plight caused by plague epidemics in Egypt was the virtual disappearance of Christian monasti-cism, which had begun in Egypt and thrived there for more than a millennium.

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