The European Middle Ages and After

The thousand years following the second- and third-century Roman and Chinese pandemics witnessed recurring bouts of disease upheaval, but generally these were confined to specific geographic areas. In particular, it seems that the Mediterranean world experienced major epidemiological assaults during the middle to later centuries of the first millennium A.D., due in large part to that locale's openness to migrations and seaborne contagions. To some extent in response to this, European civilization began a slow northward shift (Biraben and Le Goff 1969).

The early medieval period in northern Europe was one of a relatively large number of disease outbreaks, but few of major epidemic consequence (Bonser 1944). As McNeill (1976) notes, "A pattern of increasing frequency but declining virulence of infectious disease is exactly what a population learning to live with a new infection experiences as the accommodation between hosts and parasites moves toward a more stable, chronic state." In sum, a parasite-host equilibrium was emerging. To be sure, by modern standards mortality from endemic diseases was high - and the urban centers were still unable to maintain growth without significant in-migration from the countryside — but overall the population of Europe probably tripled during the half-millennium between 800 and 1300.

By any standards, however, the fourteenth-century population of Europe was far from robust. The famous agricultural revolution of the Middle Ages had greatly increased European nutritional levels, thus undergirding the relatively rapid population growth (White 1962), but it was a precarious foundation for population maintenance. England, for example, was hit by major famines between 1315 and 1317, although less disastrous times of starvation were common as agricultural yields declined by nearly 20 percent in the first half of the century (Braudel 1973). Then, in midcentury, plague struck.

For some centuries migrations from Europe to the Middle East had been growing, beginning with small pilgrimages and culminating in the Crusades. These population movements generated trade networks, which themselves gave impetus to the creation of new and larger urban centers in Europe -centers of extreme crowding and extraordinarily poor public health conditions. As one English legal statute of the fourteenth century described things, as a prelude to a futile effort at correction:

So much dung and filth of the garbage and entrails as well as of beasts killed, as of other corruption, be cast and put in ditches, rivers, and other waters, and also in many other places, within, about, and nigh unto divers cities, boroughs, and towns of the realm, and the suburbs of them, that the air there is greatly corrupt and infect, and many maladies and other intolerable diseases do daily happen. (Robertson 1968)

The worst of those "many maladies and intolerable diseases" descended on Europe from China through the trade routes of the Mediterranean, moving through southern Russia and the Crimea between 1331 and 1346, finally exploding across the length and breadth of the Continent between 1346 and 1350. By the time this first wave of the bubonic plague pandemic, the Black Death, had passed, at least a third of the population of Europe had died. Then it returned in the 1360s and 1370s to kill again, though each new visitation brought progressively lower death rates as immunity to the disease began to develop.

The weight of evidence suggests that in the wake of the plague nothing remained the same. It is perhaps an exaggeration to label the Black Death the "cause" of events ranging from the Peasants' Revolt to the Reformation, as some have done, but there is no doubt that spiritual and political faith were profoundly shaken by it. Certainly this disequilibrium - when, as one nineteenth-century historian put it, "faith disappeared, or was transformed; men became at once skeptical and intolerant" (Jusserand 1891) - made an important contribution to the great social changes that occurred in Europe from the fifteenth to the seventeenth century.

During those later centuries epidemics continued to haunt the Continent, and population recovery was slow (Flinn 1981). As before, the cities could not sustain themselves without constant in-migration from the countryside. As one writer has flatly stated, during these centuries "immigration to the towns was vital if they were to be preserved from extinction" (Mols 1973). Until the eighteenth century, however, the geographic extent of most Europeans' internal urban migrations appears to have been quite small: Apart from the forced migrations caused by warfare, as one large study has shown, the majority of those people who moved at all during their lifetimes were unlikely to have migrated more than 10 miles from their original home (Clark 1979).

The crucial point, however, for present purposes at least, is that by the close of the fifteenth century, Europeans had accumulated and exposed one another to an enormous number of what had evolved into chronic infectious diseases - including measles, mumps, influenza, chicken pox, smallpox, scarlet fever, gonorrhea, and tuberculosis, to name but a few. Although occasionally breaking out in epidemic episodes, these diseases had principally become slow killers, many of them preying largely on children, nearly half of whom died before reaching their tenth birthday (Flinn 1981), or the aged.

It was neither children nor the aged, however, who manned the sailing ships that, near the turn of the fifteenth century, began the most extensive explorations and migrations the world had ever witnessed and, as already mentioned, in the process created what may well have been the worst series of human disasters in history.

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