The Asian Bubonic Plague, known as the Black Death, hits London.
No one knows why the bubonic plague, or Black Death as it came to be known in England, broke out in eastern Siberia in the 1300s and spread westward. There was very little knowledge, at that time, of the ways by which diseases are carried from place to place, so many of the efforts to get rid of them were ineffective. In later years it was discovered that infected fleas were the carriers. They passed on the disease to rats and when the rats died the fleas attacked humans. In 1347, a ship sailing from a Black Sea port to Messina in Italy, arrived at its destination with every person on board dead. It appears that the last to die were able to get the ship into port before they died. The port authorities in Italy, as soon as they saw what happened, had the ship carried out of the harbor, but their action was too late to stop the spread of the disease. Most of the people of Messina were already infected and, from this city, the disease spread quickly across Europe and across the English Channel, reaching London a year later, in 1348, where it killed close to half of the city’s people. Within the following three centuries London suffered several different epidemics but these and even the experience of 1348 were relatively benign compared with the violence of the outbreak of Black Death that swept across London in 1665.
The name by which the bubonic plague came to be known was related to the formation of black boils in the armpits, neck, and groin of infected people, which were caused by dried blood accumulating under the skin after internal bleeding. People first experienced the bacterium of Black Death as chills, fever, vomiting, and diarrhea. Frequently, the disease spread to the lungs and almost always in these cases the victims died soon afterward. The name pneumonic plague was given to these cases. In all victims the disease spread easily from person to person through the air and, in the vast majority of instances, death ensued. London’s population in 1665 was half a million; it was the biggest city in Europe. The first victim of the Black Death was diagnosed late in 1664 but it was in May of the following year that significant numbers of infections were being observed. By June, in the wake of a heat wave, more than seven thousand lives were being claimed by the Black Death every week. Those who could leave the city as the wave of death swept over it did so. The king and his retinue left. So did many of the clergy and nobility. The biggest surprise and the one that everyone condemned was the departure of the president of the Royal College of Physicians. All who were unable to leave the city, the vast majority, had to cope as best they could.
The usual practice of burying the dead in what was known as consecrated ground; that is to say, the cemetery on the grounds of the church, had to be abandoned as the number of dead mounted. Plague pits came into use to cope with the problem. As many as 100,000 lives were lost before winter killed the fleas and the epidemic began to taper off. The peak total of deaths came late in September, 1665, an interesting parallel with the time frame of the 1918 flu pandemic which lasted for a similar stretch of time. Presumably, those who are afflicted with such diseases develop antibodies after a time and fewer and fewer people then succumb. Doctors of the time could provide no explanation for the sickness, and most of them were afraid to offer treatment. In an attempt to keep from being infected, the few physicians who did risk exposure wore leather masks with glass eyes and a long beak filled with herbs and spices that were thought to ward off the illness. So terrified were the authorities that even if one person in a household showing plague-like symptoms a forty-day quarantine in the form of a red cross on the main door was imposed on the whole home. In many cases, it was a virtual death sentence for everyone living in the home because the black rat, the usual carrier of the disease, was an old inhabitant of London’s homes. When these rats died from the disease the fleas used people as their hosts.
Daniel Defoe, who was a youngster in 1665, later wrote extensively of the effects of the Black Death. He described London as a city abandoned to despair, a place where every home and every street was a prison. One area near the center of the city that had no buildings on it became a mass grave where the dead were dumped unceremoniously and covered with loose soil. Every day, thousands of bodies were brought to this spot in what was described as dead carts. Farther out from the center of the city, as the disease spread, a burial pit was dug, forty by sixteen feet and twenty feet in depth, and this served as a mass grave. Defoe stressed the eerie silence everywhere. There was no traffic except for the dead carts. Anyone who risked going outside always walked in the middle of the street, at a distance from any building and as far away as possible from any other person. London’s economic success, as evident in its huge population of half a million, led to overcrowding and neglect of hygiene, both conditions that encouraged the spread of diseases. Rat-infested slums that lacked running water added to the risk of infection. Paradoxically, the worst set of circumstances for those who showed initial symptoms was the five pest houses outside the city to which these people were sent. The unavoidable close contact with other patients made for easy transfer of the bacteria through breathing.
There have always been epidemics and outbreaks of sicknesses in London. This particular outbreak, the worst of all, had a predecessor in 1348, as has already been mentioned, which seemed to be the worst ever in its own time. A thousand years before the events of 1665 there was an earlier outburst of what must have been similar to the Black Death but was described differently at that time. Between the years 1550 and 1600 there were five severe attacks of Black Death, the last of which killed 30,000 Londoners. There were good reasons for these catastrophic experiences of diseases. Very little was known about public hygiene and open sewers were the norm. Homes were small and so tightly packed together that bacteria quickly moved around from person to person. Furthermore, London had for a long time been the center of national life and the place where there were opportunities in business and professional work. It had the biggest population of any English city. People kept arriving and living places became more and more crowded together in every part of the city.
There was a side effect from the frequency of diseases—the growth of what might be called healers. Charts were produced and circulated to show how the dates of saints or predictions about astrology related to the efficacy or otherwise for healing of different herbs. All kinds of superstitions were embraced, even the one about being cured if you touched the hand of a dead man. For centuries, the priests of the church were the doctors until the pope forbade them from drawing blood in any way. After that all kinds of lay doctors multiplied. Once a person managed to secure widespread publicity as a healer, large numbers of people accepted his cures without questioning them. The atmosphere of fear about new waves of disease was so great that the strangest type of cure was accepted. William Samson, a healer, practiced his art near the gates of Bartholomew’s Hospital, a much-respected institution. Because of the location, his proposed remedies were readily accepted at the price he asked. Samson happened to be a bit of a psychiatrist and had evidence of people whom he claimed to have cured.
Before the Black Death had run its course an unexpected “cure” appeared in a rural setting in September of 1665. A tailor received a parcel of cloth from London that also contained some plague-infected fleas. Four days later the tailor was dead and, by the end of the month, five others died. Everyone had heard of the tragedy in London and panic set in after the deaths of the five. The whole community gathered together and arranged to have their village quarantined to prevent the disease spreading throughout the region. It seemed like suicide yet, a year later, when the first outsiders entered the village, they found that most of the residents were alive and healthy. How did so many live through the attack of a disease that had been consistently taking the lives of almost all those infected? It is here that two extraordinary stories from 1665 emerged, stories that affect life today. The first relates to Isaac Newton, the famous scientist who was studying at Cambridge when the Black Death began to reach that city. His mother took him home to northern England for two years and it was during that time of enforced isolation that he did most of the work on his Principia, meaning mathematical principles of natural philosophy, often regarded as one of the greatest scientific works of all time.
The second story relates to the survivors of Black Death. In London, as well as in the village where the tailor received the cloth with fleas, there were accounts of people who survived the Black Death in spite of close contact with family members who had been infected and died. Elizabeth Hancock was one of these. In 1665, she had buried her six children and her husband within a single week but never became ill. The village gravedigger who had close contact with hundreds of dead bodies also survived. Were these people somehow immune to the Black Death? In the last few years, as concern mounted over the possibility of a flu pandemic reaching North America, Dr. Stephen O’Brien of the National Institutes of Health in Washington, DC, decided to investigate the accounts of seventeenth century survival. He searched for descendants of the village where a number of infected people had clearly survived the disease. This was not easy as a dozen or so generations of families had successively spanned the long period of time. He finally succeeded and took their DNA record.
Dr. O’Brien had already been working with HIV patients and had discovered in 1996 that the modified form of a particular gene in these patients, one known as CCR5 and commonly described as Delta 32, prevents HIV from entering human cells and infecting the body. Based on this finding and convinced that the way in which Delta 32 protects the body from infection might apply to other diseases he took DNA samples from the surviving relatives of the lucky ones in 1665. As he examined them he made two startling discoveries based on both his work with HIV patients and the experiences of the surviving relatives. One copy of the mutation enables people to survive although they get very sick. Two copies, that is to say one gene from each of two parents, ensure that an individual will suffer no infection of any kind. Delta 32 has not been found in parts of Asia or Africa or other areas where bubonic plague or Black Death did not occur so this, for Dr. O’Brien, raised an interesting question: did some natural event create this mutation so that some would survive? It has been said that a destructive bacterium or virus does not want to destroy all of its hosts so that it can continue to infect others later. Was this what happened in the case of Delta 32?