October, 1347. Twelve ships entered the harbour of Messina, Sicily:
“The people who gathered on the docks to greet the ships were met with a horrifying surprise: Most of the sailors aboard the ships were dead, and those who were still alive were gravely ill.”
This is the standard passage telling of the Black Death arriving in Europe. While doing research for Leo’s story, I had my doubts about the accuracy of this description. After all, these were large ships. If most sailors were dead and the others too ill to manage them, how was it possible that these ships – or at least the majority of them – made the journey to Genua, Venice and even Marseille?
More likely, it was but one ship where the plague had manifested so severely. But it was enough. In the years that followed, millions of people in Europe and the Middle-East would die of this plague.
Naming the Culprit
The symptoms of the Black Death are the stuff of nightmares even now: horrendous pains, black blisters, coughing and vomiting blood. Patients writhe in agony for hours or even days, knowing it could only end in death.
But while we now know what causes diseases, and have adequate treatment that saves lives, our medieval ancestors had no idea what had brought down such suffering on them. Much was blamed on the influence of bad stars: ‘influenza’. It was as good a guess as any. With the treatments Leo and his colleagues had at their disposal, a more accurate diagnosis wouldn’t have made a difference.
To this day, scientist are not completely certain which disease was responsible for decimating Europe’s population in the mid-14th century, but the most likely culprit is the bacterium Yersinia pestis.
This tiny murderer wreaks enormous havoc on a human or animal body. Depending on where it attacks first, it infects your lymph nodes until they swell and turn black (bubonic plague), liquefies your lungs until you drown in your own blood (pneumonic plague), or rides the bloodstream where it causes fatal septicaemia (septicemic plague).
Black Death in all its nasty variations still exists today. Fortunately, Yersinia pestis responds to antibiotics, which dramatically increases the patients’ chances of survival.
If you find treatment in time.
A Nefarious Killer
Normally when your body is infected with pathogens, the immune system kicks into gear and fights the intruders.
To the death. Yours or the intruders, whichever comes first.
Yersinia pestis is such a dangerously effective killer because it not only knows how to avoid your immune system, but cuts off your body’s ability to control that defence mechanism. What white blood cells do try to fight Yersinia pestis have no effect, no matter how hard they try to fight the infection.
Then, as an extra insult to that injury, the bacteria corrupt your already paralysed immune system by settling down and multiplying inside the key parts of your defence system: the lymph nodes. From there, the bacteria spread to the rest of your body, damaging your tissue where they go.
This tissue damage causes the pain and (internal) bleeding. Only if the progress of that damage is stopped in time by means of medication or an inordinate amount of luck can you survive. For the people of the Middle Ages, such luck was in short supply.
Except perhaps for one man…
Leo cried out as another bolt of agony shot through him, this time spreading from the other side of his body. Another wave of putrid odours rose into the fetid, spinning atmosphere. Desperate, he snatched his commandeur’s words like they were lifelines.
‘You will live,’ he grated. ‘You will. It is in your blood.’
‘No, sir. The pestilence is in the blood.’
‘Yes, in the blood…’ Leo panted. ‘That is why he will live…’
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