Beginning with the wave now called the Black Death, plague appeared in Europe at least once every generation between 1350 and 1720. During the late fourteenth century, smaller communities may have been disproportionately affected, for depopulation and deserted villages were uniform phenomena throughout Europe. Indeed, smaller centers may not have remained economically or demographically viable settlements after an episode of plague, leading to the reaggregation of people in villages, towns, and cities. By the fifteenth century, however, no matter how uniform the distribution of rodent vectors responsible for conveying plague to smaller human settlements and however sophisticated the development of trade networks to supply food to nonagri-cultural centers, the written records of plague recurrence suggest that the human plague epidemics were largely confined to urban areas. 0. J. Bene-dictow (1987), however, has argued that a knowledge of the ecology and epidemiology of plague allows us to infer that there were heavy losses in the rural areas surrounding affected cities.

Bubonic plague epidemics were principally summer infections, no doubt augmented in severity by diarrheal diseases. Most surviving records of these epidemics suggest that overall mortality rates of 10 percent were common among the people who could not escape the city. Nevertheless, devastating population losses from plague epidemics, comparable to those from the Black Death, occurred in the sixteenth and seventeenth centuries in the heavily urbanized areas of north central Italy and Castille and may have led to the economic decline of the Mediterranean areas by the seventeenth century. During the seventeenth and eighteenth centuries, northern European countries witnessed the growth of cities and large towns, whereas Mediterranean centers slipped into a period of stagnation, probably because the epidemic waves of 1575-7, 1596, and 1630 were particularly severe in southern Europe.

Only during the fourteenth century do descriptions of plague note the loss of many principal citizens. After that period elites seem to have established effective patterns of flight. For those who did not flee, plague controls may have increased the risk of death, because both sufferers and their healthy contacts were isolated for weeks in pesthouses, temporary shacks, or, if they were lucky, their own homes. The maintenance of normal standards of hygiene and alimentation was difficult in such circumstances, and many undoubtedly died from less extraordinary causes than plague.

Whatever the individual causes of death in these mixed epidemics, for more than 300 years bubonic plague recurred in Europe at least every quarter-century. Then it disappeared during the late seventeenth and early eighteenth centuries, a phenomenon that has prompted two vexing, unsettled questions about diseases of the Renaissance and early modern Europe. First, why did plague disappear? Second, was its disappearance in any way responsible for the early phases of the modern rise of population? The first of these two questions has rather clearer options, if not firm answers. Some scholars argue that quarantine and other efforts to interrupt the spread of plague from town to town, region to region, or country to country effectively localized the outbreak of the plague. Admittedly these sanitary measures were designed to thwart a disease spread by human-to-human contact and did little to disturb rodent colonies that harbored the plague. But because rodents are commensal, rarely traveling far from human settlements, it is felt by some that the dispersal of plague ultimately depended on human actions. The proponents of this "quarantine-worked" model argue that humans inadvertently carried rodents and infected fleas in containers ranging from satchels to ships. This explanation has much to recommend it, but depends on the assumption that plague was always imported to Europe and that efforts to intercept and deter such importation ultimately succeeded even when quarantine stations were poorly maintained and were, at best, sieves straining out only gross contaminants.

Others argue that either climatic changes or changes in trade patterns led to the retreat of plague from Europe. The disease hit northern Europe for the last time in the 1660s and southern Europe (Marseilles and Provence only) in 1720. The interval between these last European plagues corresponds roughly to the "Maunder minimum" of sunspot activity and to the peak phases of the "little ice age." Insofar as global climate changes could have af fected rodent colonies in central Asia, where bubonic plague has a perennial home, the number of infected fleas and rodents reaching Europe could have declined independently of efforts to control plague. Alternatively, the fact that northern Europeans turned to an Atlantic-based trade, shifting markets away from the Mediterranean to colonies in the Western Hemisphere and to the Far East, may be related to the decline of plague first in Great Britain, Scandinavia, and the Low Countries. The plague was always conveyed east to west across the Mediterranean and principally by sea. The relatively later survival of plague in Italy and Spain, where plague surveillance and quarantines had long been used, adds some weight to these latter explanations.

Whether the retreat of plague had any measurable effect on subsequent population growth is more difficult to answer, for there is no easy way to frame a model showing what would have happened had plague continued its assaults. Urban population growth in northern Europe was well underway before the two great plagues of 1630 and 1665-6. Even if Benedictow is right in stating that bubonic plague epidemics claimed horrifying percentages, on the order of 40 to 85 percent, of both the urban and rural populations exposed, net European population growth was not reversed during the sixteenth and seventeenth centuries.

John Hatcher (1977) and others have claimed that the profound demographic depression of the late fourteenth and fifteenth centuries was due in part to the combination of plague with other lethal epidemics, often staggered in such a way that few children reached reproductive age. Nonetheless, the frequency of recorded epidemics of diseases other than plague increased during the later centuries, and yet did not bring on population stagnation, as may have been the case in the late Middle Ages.

Thus, the economic expansion of Europe, with some improvements in travel, trade, and communication and dramatic improvements in regional and interregional markets, seems to best account for the beginnning of the European mortality decline in early modern times. The Europeans found themselves increasingly insulated from local famines, periodic harvest shortfalls, and other crises that evoked great fear of accompanying plague and pestilence, and were gradually able to overcome the hemorrhagic demographic impact of recurrent epidemic plague. To understand how this could have happened, it is necessary to assess what other infections threatened human survival at this time and to ask whether improved nutrition because of regularly available food has a positive influence on human survival even in the presence of serious infectious diseases.

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