Ole J. Benedictow’s 2004 monograph, The Black Death, 1346-1353: The Complete History, is an analytical and synthetic demographic, social, and medical history of the plague’s spread from Eurasia across Western Europe during the 14th century. This book was republished by Boydell Press in 2021, but page numbers refer to the first edition.

Summary

Benedictow challenges previous scholars’ assertions about how the plague spread and what form of the disease infected Europeans. He argues that bubonic plague, not pneumonic, was the major form of the disease that swept through Western Asia, the Middle East, North Africa, and Europe and that it killed far more than one third of Europe’s populace, as others have suggested. Shipping was the major way that the plague spread, but heavily trafficked roads also acted as highways of transmission. Black rats, rather than other types of rodents, were the major carriers of the bacteria that causes the plague, and much of Europe was infected, with only a few areas spared. Some areas of Europe that scholars previously believed were unaffected by the pandemic, such as Poland, in fact suffered. Through analysis of a variety of primary sources—documents produced during the period—including letters, chronicles, annals, wills, and church burial registers, as well as via the employment of epidemiological methods, Benedictow plots the plague’s migration, morbidity, and mortality.

Bubonic plague, which is carried by black rats and spread by fleas, was the primary cause of the pandemic known as the Black Death. Benedictow argues that the plague was brought to Western Europe on Genoese ships fleeing the plague’s appearance at the city of Kaffa on the Caspian Sea. Kaffa was an important trading post that linked the east and west and was besieged by the Mongol Golden Horde who wished to drive out the Italian merchants. Plague broke out in the Mongol encampment around Kaffa and soon breached the city walls. This outbreak led the Genoese merchants to flee westward. As they did, they passed through the Byzantine capital, Constantinople (modern-day Istanbul), thus infecting this urban center. When they reached Italy, they likewise—and unknowingly—brought the plague with them.

Plague henceforth spread north via shipping lanes and overland travel and trade networks. The plague made multiple “metastatic leaps” from its original epicenters to other urban centers, either by ship or over land, albeit at shorter distances and at a slower pace when by land. Shipping was the main way goods moved during the Middle Ages, so plague jumped from one port to another and moved along rivers, such as the Rhine. Rat colonies infested ships, and fleas burrowed into goods, luggage, and clothing. Plague spread when crews unloaded and passengers disembarked in their destination ports. By 1349, the Black Death appeared as far north as historians can track it: in Nidaros, now Trondheim, in northern Norway.

Highly populated areas took longer to infect and were, thus, more slowly “conquered” by the Black Death than rural settlements where rat fleas moved swiftly from humans, host-to-host. For example, medieval Denmark’s size

was only a small fraction of the territories of Norway and Sweden, but its population was much larger, quite likely nearly as large as the populations of the two other Scandinavian countries combined […] Conspicuously, the Black Death needed as much time to finish its grisly work in Denmark as the two other countries, which again shows the significance of population size and population density for the spread and duration of a disease with plague’s specific properties. (232)

The fact that plague’s spread decelerated during winter months indicates that the Black Death was primarily a pandemic of bubonic plague, instead of pneumonic plague, which spreads irrespective of season. Any primary source descriptions of symptoms that scholars have interpreted as pneumonic plague are accounts of secondary pneumonic plague, which develops from the primary bubonic infection.

Data derived from local studies shows a European-wide death rate of 60%. The Black Death was, thus, a cataclysmic event in which millions upon millions of people died, greatly reducing the population and leaving survivors to rebuild. Population numbers, however, did not immediately rebound because the plague returned throughout the Late Middle Ages. The poor were especially vulnerable, as were women and children, both to plague infections and to the secondary effects of the pandemic.

In the years after the Black Death, Europe suffered a labor shortage due to the high death rate. This population decrease led to upward social mobility for peasant survivors who could now demand higher wages and lower rents from manorial lords. Landlords had no choice but to comply, although they sought ways to supplement their falling incomes by extending wars—such as the Hundred Years’ War in France—since they could impose wartime taxes and collect the spoils of war. The same happened with the English War of the Roses and the Spanish Reconquista. These changes contributed to Spanish colonization and imperialism in the Americas as the wealthy sought new sources of riches. The Black Death also changed Europeans’ view of death. Post-pandemic artwork reflects their obsession with death’s imminent appearance and constant presence. New rational thinking about disease and medicine, because of the experience of the Black Death, eventually led to the development of European public health initiatives, starting with those created to suppress the plague and care for its victims. Modern public health care owes much to this medieval disaster.