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Disease in the 14th Century (Classroom Activity)

Disease in the 14th Century (Classroom Activity)

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A great deal of medical treatment in the 14th century was based on ideas developed by the Greeks and Romans. The most important aspect of this was the theory of the four humours. It was argued that the body had four humours: blood, phlegm, yellow bile and black bile. These humours were associated with different parts of the body and had different qualities: blood (heart: hot and moist); phlegm (brain: cold and moist); yellow bile (liver: hot and dry) and black bile (spleen: cold and dry).

It was believed that when someone was ill, the four humours in the body were not evenly balanced. A patient was usually advised to rest to allow the body to restore its natural balance. If this was unsuccessful, the patient's diet was altered. For example, if the patient felt cold, he or she would be given hot food.

If the change in diet failed to achieve success, and the patient was fairly prosperous, a surgeon would be called in. If the patient did not have much money, a barber-surgeon (an untrained doctor who spent most of his time cutting hair) would be used instead.

The surgeon would examine the patient and if he or she were hotter than usual it would be claimed that there was too much blood in the body. The solution to this problem was to remove some of the blood by opening the patient's veins with a knife. As well as blood-letting, surgeons could also carry out minor operations and deal with simple bone fractures.

Death from disease was a constant fear of people living in the Middle Ages. Probably the disease that worried them most was leprosy. Although it did not always kill its victims, the consequences of leprosy were horrifying. Extremities and facial features slowly rotted away and the face eventually becoming terribly disfigured. People suffering from the disease were treated very badly. "They were forbidden all normal social contacts and became targets of shocking rites of exclusion. They could not marry, they were forced to dress distinctively and to sound a bell warning of their approach."

There were also hospitals in the early Middle Ages. However, they were mainly used to isolate rather than to cure the sick. When people went into a hospital, their property was given away as they were not expected to survive.
One of the main ways of dealing with disease in the Middle Ages was by prayer. It was believed that people suffering from disease were probably being punished by God for sins they had committed in the past.

Doctors became aware that it was important to build up a body of knowledge about disease. Scholars obtained copies of books written by doctors in other countries and had them translated into English. This was an important development, as in the past medical books in England were only available in Latin, which restricted the number of people who could read them.

In this way information was passed on about the successful treatment of diseases. For example, the Hotel Dieu, a large hospital in Paris, pioneered a new approach to dealing with patients. The hospital was divided into wards. Each ward dealt with different problems. People with broken bones would be treated in one ward while another dealt with infectious diseases.

The Hotel Dieu took great care over hygiene. All patients were given clean gowns to wear and had regular baths. Like all hospitals, patients still slept three or four to a bed but the sheets were changed every week. The floors of the wards were kept clean and the walls were washed down with lime.

Information about the successful treatment of patients in the Hotel Dieu soon spread to other countries. It was not long before doctors began to introduce similar reforms to their hospitals.

During very hot weather phlebotomy (blood-letting) should not be undertaken because humours flow out quickly as the bad. Nor should phlebotomy be done in very cold weather, because the good humours are compacted in the body and difficult to draw out, and the good came out quicker than the bad... If the blood appears black, draw it off until it becomes red. If it is thick, until it thins out: if watery, until it becomes thick... Phlebotomy clears the mind, strengthens the memory, cleanses the stomach, sharpens the hearing, develops the senses, promotes digestion, produces a musical voice, feeds the blood, rids it of poisonous matter, and brings long life. It gets rid of diseases, cures pains, fevers and various sicknesses.

Leprosy became highly stigmatized. They were forbidden all normal social contacts and became targets of shocking rites of exclusion. They could not marry, they were forced to dress distinctively and to sound a bell warning of their approach.... They were segregated in special houses outside towns... Leprosy provided a prism for Christian thinking about disease. No less a religious than a medical diagnosis, it was associated with sin, particularly lust, reflecting the assumption it was spread by sex.

The knowledge of anatomy is acquired in two ways; one is by books... the second way is by dissecting dead bodies, namely, of those who have been recently beheaded or hanged. By this means we learn the anatomy of the internal organs, the muscles, skin, veins and sinews.

She laid the blood-irons to Robin Hood's vein
And pierced the vein, and let out the blood,
And afterwards the thin,
And well then knew that there was treason within.

When passing along the Thames, we have seen dung and other filth piled up in several places. We have also noticed the fumes and other terrible stenches... To preserve the honour of the City, we command that you cause the banks of the river and the streets and lanes of the city to be cleansed of dung and other filth without delay. And public proclamation is to be made that no one shall place dung or filth in the streets and lanes.

So much dung and filth... as well as dead beasts... are in the ditches, rivers and other waters... the air is greatly corrupt... Many intolerable diseases do daily happen... to the great annoyance, damage and peril of the inhabitants, dwellers, repairers and travellers... All dung, garbage, entrails and other odour in ditches, rivers, waters... shall be removed and carried away... upon pain to lose and forfeit to our Lord the King £20.

All the streets of London are so badly paved that they get wet at the slightest quantity of water, and this happens very frequently... on account of the rain, of which there is a great deal in this island. Then a vast amount of evil-smelling mud is formed, which does not disappear quickly but lasts a long time, in fact nearly the whole year round.

Questions for Students

Question 1: Select a passage from the sources that help to explain how doctors developed ideas on how to treat their patients.

Question 2: Study sources from this unit that provide information on phlebotomy (blood-letting) and trephination (brain surgery). Explain how these treatments worked.

Question 3: What were the symptoms of leprosy? Why do historians believe source 1 shows a man suffering from leprosy?

Question 4: Select information from the sources to explain why the standard of public health in the 14th century was so poor.

Question 5: In 1159 John of Salisbury commented: "We (scholars) are like dwarfs sitting on the shoulders of giants. We see more, and things that are more distant, than they did, not because our sight is superior or because we are taller than they, but because they raise us up, and by their great stature add to ours." Use the example of the growth in medical knowledge during the Middle Ages to explain what he meant by this statement.

Answer Commentary

A commentary on these questions can be found here.

Disease in the 14th Century (Classroom Activity) - History

This website offers a thematic approach to the past 3,000 years in the history of medicine that foregrounds the study of material culture. Each theme is made up of an essay tracking continuities and changes over time embedded with links to related objects and biographical descriptions of persons mentioned, as well as in-depth information on four sub-topics and an interactive feature.

Themes include: belief and medicine, birth and death, controversies and medicine, diagnosis, diseases and epidemics, hospitals, mental health and illness, practicing medicine, public health, science and medicine, surgery, technology and medicine, medical traditions, treatments and cures, understanding the body, and war and medicine. In total, the website contains close to 4,000 annotated objects.

The website’s materials do not trumpet a grand narrative of medical “progress” with the eventual “triumph” of biomedicine in the late 19th century, but rather present a more nuanced view of continuity and change in the practice of medicine. The essay accompanying the “Belief and medicine” theme, for example, concludes by recognizing that while spiritual origins of disease have fallen out of favor within the biomedical establishment, medicine “is always part of the belief systems of specific cultures and time periods, and is only one of many linked ways in which people encounter and explain disease.”

Website materials also pay careful attention to the history of medicine outside of Western contexts. For example, an introductory section on “What it means to be well” challenges students to think historically and cross-culturally about notions of wellness and illness—a good starting point for any class on the history of medicine. It points out that ideas surrounding when humans become “ill” are influenced by, for example, available treatment regimens, the prerogatives of insurance companies and employers, and spiritual beliefs.

But, indeed, it is the website’s emphasis on objects and material culture that breathes life into these ideas. Through the “belief and medicine” section, for example, users are pointed to 366 well-photographed “related objects.” Browsing through these reveals that several were used for warding off the “evil eye”—the belief that a person’s deliberate “look” or feeling of envy can cause bad luck, illness, or death. This includes a necklace constructed from “hands of Fatima” dating to the 19th century discovered in Palestine, and metal, coral, and bone amulets displaying the fig or mano fica gesture from 18th-century Italy. Gazing at these objects, well-contextualized within the “belief and medicine” essay, users see that those adorning themselves with these items might well imbue them with the same power as any biomedical intervention.

Armed with this realization, users might come to feel that these ideas must be taken seriously historically, culturally, and biologically. All objects are keyword searchable (for example, a search for “evil eye” returns these objects), and browseable by theme, place, and person, making them easily imported into pre-existing lessons focused either on one geographic region or on cross-cultural comparisons.

In the context of the U.S. history classroom, this website might be most useful as a complement to undergraduate courses in the history of medicine, increasingly offered in schools throughout the United States as the number of history of science and medicine departments continues to grow. These materials also could be used to lend depth to themes and topics covered in world history courses, such as cultural interactions between societies, or the impact of disease and medical technologies on demography and the environment.

For those interested in other materials that might be used directly in the classroom, each theme includes an “interactive feature,” a short activity that requires some user input. The intellectual depth and innovative nature of these interactive features—understandably difficult to design—varies. One challenges students to think historically about the logic behind 14th-century plague remedies and regulations. Without adequate scaffolding, though, students will be left simply guessing why, for example, plague regulations forbade citizens from bathing or consuming meat.

“My Collection” further facilitates classroom application. Users can create an account, save images, and create documents and quizzes based on the objects.

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A project of the Center for History and New Media, George Mason University,
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Climate's influence on European history

We have all heard of the story of Hannibal crossing the Alps - but is it accurate? In 218 BC the Carthaginian general crossed the highest mountain range of Europe with 37 elephants, thousands of horsemen and ten of thousands of foot soldiers to fight Rome. All the elephants survived this ordeal. Is this possible?

Now more of the story is coming to light. A new study, published in Science magazine, provides year by year an accurate history of the climate in Europe for the past 2,500 years. As it appears from the study, in the summer of 218 BC, the weather was particularly warm. The story of Hannibal's crossing of the Alps gains in credibility.

Other events too can be checked against the study and acquire from it new arguments to consolidate or invalidate them: why did famines, wanderings of peoples, epidemics and wars occur? Often, drastic changes in the weather and in the climate may have effected equally dramatic changes in history, say historians.

Researchers Ulf Büntgen from the Swiss Environment Research Institut WSL in Bern and Jan Esper from University of Mainz have sorted the information contained in almost 9,000 pieces of wood - and constituted a unique archive of climate. The tree-rings inform us about the weather of the past: every year trees add a new ring, the breadth of which gives precious information about temperature and precipitation - depending on the location where the tree grew.

The most important results of the study are:

* Historical epochs fit into climatic cycles: the flourishing of the Roman Empire and of the German empire coincided with warm periods bad times like invasions, the Plague and the Thirty Years war happened in times of bad climatic conditions.
*Central Europe experienced in Roman times and in the high Middle Ages warm periods like those of today. Yet the summer of 2003 remains remarkable: it was the hottest Summer in the Alpine region in 2,500 years.
* The amount of precipitation in Central Europe varied considerably more from one year to the other in Antiquity and in the Middle Ages than it does today, moreover, extremes were more pronounced.

"The precise coordination between climate and history is left for historians to establish", says Ulf Büntgen. Yet the study shows remarkable parallels between weather and history. And everything that has happened in Germany and Europe during these past 2,500 years can be confronted with the data.

It was a new start after the cold: when in the middle of the first millennium BC Europe emerged from the final throes of the last ice Age, the yearly average temperatures in Europe lay one to two degrees Celsius lower than today.

When in 300 BC the weather slowly improved and rains became more abundant, the Roman Empire came to flourish. Climate helped the ascendancy of Rome. The yield of crops improved, mines could be opened. When the Alps could be crossed all year, Northern Europe became accessible and was absorbed.

From this period alone Büntgen and Esper and their teams have analyzed some 550 wood samples. From the breadth of rings in oak they read the amount of precipitation in the Spring and in June, from the rings in larks and pines, the summer temperatures. They cannot provide information about the weather in other seasons, as trees grow only in summer.

Each ring can be matched exactly with a particular year. For researcher have now at their disposal series of dated tree-rings of the past millennia. Büntgen et al. have fitted their own samples into these series.

Tree trunks for the history of precipitations were lifted mostly in Germany and Eastern France, for instance in river beds and in archaeological digs. For the archives of temperature, only the trees at the edges of forests could be taken into consideration for their growth is dependent on temperature. All the other trees are more dependent on precipitation.

The researchers used only samples from trees from the Alpine region but their data is valid also for large parts of Central Europe, France, Italy and Balkans - as is shown by comparative temperature measurements in the XX century.

The data show from the fourth century AD on, a grave deterioration of the climate: central and southern Europe became cold and dry. Historian speak of the "climatic pessimum of the peoples wanderings i.e the Barbarian Invasions." They know of course that it was triggered first of all by the wanderings of the Huns, which set Germans, Goths and other peoples on their way. Yet it is established that climatically caused failures of crops, famines and epidemics made the displacements more urgent, also for the Huns.

Temperatures continued to fall, and precipitations continued to diminish. Erosion of the top soil was the consequence, fields yielded ever less. The rains came back during the fourth century but the weather remained cold and glaciers grew in size.

The worst crisis was experienced in Europe in the years 536 to 546, when summer temperatures plummeted to record lows. "Our data shows for these times an extraordinary depression lasting a decade," according to Büntgen. Recently, geologists have suggested that its cause may have been the impact of a meteorite off the coast of Australia.

In the sixth century the crisis went on, the population of Europe "sank to an all time low, never to be reached again," says historian Wolfgang Behringer from University of Saarbrücken, Saarland. Archaeologists have found in Europe a great number of abandoned settlements. Pollen analysis shows a strong retreating of agriculture, forests advanced.

These were freezing times, as the new climate data shows. The consequences were terrible: in the year of famine 784 one third of the population of Europe may have died. "It was a rather cool summer," according to Büntgen's diagnosis. "With the climatic downturn in Europe, not only crops but cattle perished," according to historian Behringer. Every crop failure caused a famine. To the cold, was added humidity in the ninth century: endless rains prepared the ground for epidemics, such as leprosy.

It was the time of the wolves. Hunger brought them to Central Europe, for in their homeland Russia the climate had also considerably deteriorated. The beasts circled the villages. "The fight against the marauding animals was carried on with all possible weapons, traps, hunting, poison," says Behringer. Charlemagne ordered the creation of units of wolf-hunters in every county. In the year of famine 843 a wolf broke up Sunday mass service in the town of Senonnais in France. Büntgen confirms: "843 was colder than the years preceding or following."

In the middle of the tenth century the climate took a turn for the better, the climate optimum of the Middle-Ages settled in. The new data shows that the temperatures in Europe climbed to equality with those which were seen again only in the twentieth century. The tree line in the Alps was in many places even higher than today and wine was cultivated farther up North than at the beginning of the 21 century. The time of discoveries began: the Vikings sailed over Greenland to America.

Agriculture recovered, famine became rarer. In 150 years, the population in Europe increased by one third. Under the Hohenstaufen emperors the German empire reached its peak: Frederic II. resided in Sicily. At his court, philosophers, scientists and artists mingled thought and speech became freer. From Arabia too came scientists, who had preserved and developed precious knowledge from antiquity. Architecture changed: gothic cathedral were furnished with immense windows to take advantage of the sunlight.

Some historical records need to be reconsidered, in light of the new data. In Nuremberg in 1022 one burger claims that "from the terrible heat people collapse and die of thirst in the streets." Yet, the summer of 1022 was not particularly hot, says Büntgen. Exaggeration? Or was the brutal heat of such short duration that it did not register in the tree rings? Other events find explanation and corroboration: in 1135, for instance, there was very little rain, confirming reports that the Danube ran almost dry. The people of Regensburg, Germany, took advantage of this to build the great Stone Bridge, still today the symbol of their city.

Other indications are also verified: on September 9, 1302, vineyards froze in Alsace and after a very cold winter, peasants in Germany found on May 2, 1303 that all their seed stocks had frozen. They did not know yet how bad things would become.

The new climate data are the impassive records of a gigantic catastrophe which broke over Europe. They show in the 14th century the occurrence of many cold summers. In 1314, diluvian rains and a harsh winter came on top of it.

Behind the data, cruel occurrences appear: it began with the loss of crops due to the weather. From 1315 to 1335 the "Great Hunger" decimated populations. In 1315 already, horses and dogs were eaten. 1346 and 1347 were especially cold, wine froze, grain rotted. The weakened population had diminished resistance against epidemics: probably from China, the "Black Death" arrived. Between 1346 and 1352, half the population of Europe died.

South of the Alps, temperatures sank less steeply. It may have been one reason why the Renaissance (the "Rebirth") could blossom there. The philosophers of antiquity came again to honor, banking developed and the bourgeoisie could compete with nobility with newly found self-assurance.

Renaissance had it not easy to cross the Alps. In the North the dark might of belief still held sway. The Church blamed witches for bad crops and illnesses and had women burned at the stake in great numbers. In 1524 peasants revolted against nobility.

It became ever colder. The little ice age had begun. Around the end of the 17th century, Europe suffered grave famines. In 1709 weather precipitated one of the worst catastrophes: in the "cruel coldwave of 1709" rivers froze over even in Portugal, palm trees in Southern Europe were covered in snow. Rivers carried masses of frozen fish, cattle froze to death in the stables, dead deer lay in the fields and birds are said to have fallen as frozen clumps from the sky. In the summer of 1710, men were seen "grazing" in the fields "like sheep," say chronicles.

The Enlightenment was accompanied by a warming of the climate. "Famines were now seen as the result of mismanagement," says Behringer. Peasants took to rotating crops, irrigation was improved, better roads and dykes were built, moors dried up. The agrarian revolution saw to it that famines became more rare."

These improvements did not help against the famines of the mid-19th century (Irish famine) caused by a short recession in the climate.

For a long time, experts have been in disagreement about the future consequences of the climate change: will changes bring new catastrophes, or is a warming for the good? "Rapid climate changes have often grave, negative effects of societies," says Ulf Büntgen. The new data will give historians abundant material to discover and study such connections.

Plague, famine and sudden death: 10 dangers of the medieval period

It was one of the most exciting, turbulent and transformative eras in history, but the Middle Ages were also fraught with danger. Historian Dr Katharine Olson reveals 10 of the biggest risks people faced…

This competition is now closed

Published: July 10, 2020 at 4:00 pm


The plague was one of the biggest killers of the Middle Ages – it had a devastating effect on the population of Europe in the 14th and 15th centuries. Also known as the Black Death, the plague (caused by the bacterium called Yersinia pestis) was carried by fleas most often found on rats. It had arrived in Europe by 1348, and thousands died in places ranging from Italy, France and Germany to Scandinavia, England, Wales, Spain and Russia.

The deadly bubonic plague caused oozing swellings (buboes) all over the body. With the septicaemic plague, victims suffered from skin that was darkly discoloured (turning black) as a result of toxins in the bloodstream (one reason why the plague has subsequently been called the ‘Black Death’). The extremely contagious pneumonic plague could be contracted by merely sneezing or spitting, and caused victims’ lungs to fill up.

The Black Death killed between a third and half of the population of Europe. Contemporaries did not know, of course, what caused the plague or how to avoid catching it. They sought explanations for the crisis in God’s anger, human sin, and outsider/marginal groups, especially Jews. If you were infected with the bubonic plague, you had a 70–80 per cent chance of dying within the next week. In England, out of every hundred people, perhaps 35–40 could expect to die from the plague.

As a result of the plague, life expectancy in late 14th-century Florence was just under 20 years – half of what it had been in 1300. From the mid-14th-century onwards, thousands of people from all across Europe – from London and Paris to Ghent, Mainz and Siena – died. A large number of those were children, who were the most vulnerable to the disease.

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People in the medieval period faced a host of potential dangers when travelling.

A safe, clean place to sleep upon demand was difficult to find. Travellers often had to sleep out in the open – when travelling during the winter, they ran the risk of freezing to death. And while travelling in groups provided some safety, one still might be robbed or killed by strangers – or even one’s fellow travellers.

Nor were food and drink provided unless the traveller had found an inn, monastery, or other lodging. Food poisoning was a risk even then, and if you ran out of food, you had to forage, steal, or go hungry.

Medieval travellers could also be caught up in local or regional disputes or warfare, and be injured or thrown into prison. Lack of knowledge of foreign tongues could also lead to problems of interpretation.

Illness and disease could also be dangerous, and even fatal. If one became unwell on the road, there was no guarantee that decent – or indeed any – medical treatment could be received.

Listen: Elma Brenner of the Wellcome Library examines the state of healthcare in the Middle Ages and reveals some unusual remedies that were offered for people with injuries or diseases:

Travellers might also fall victim to accident. For example, there was a risk of drowning when crossing rivers – even the Holy Roman emperor, Frederick I, drowned in 1190 when crossing the Saleph river during the Third Crusade. Accidents might also happen upon arrival: in Rome during the 1450 jubilee, disaster struck when some 200 people in the huge crowd crossing the great bridge of Sant’ Angelo tumbled over the edge and drowned.

While it was faster to travel by sea than land, stepping onto a boat presented substantial risks: a storm could spell disaster, or navigation could go awry, and the medieval wooden ships used were not always equal to the challenges of the sea. However, by the later Middle Ages, sea travel was becoming faster and safer than ever before.

An average traveller in the medieval period could expect to cover 15–25 miles a day on foot or 20–30 on a horse, while sailing ships might make 75–125 miles a day.


Famine was a very real danger for medieval men and women. Faced with dwindling food supplies due to bad weather and poor harvests, people starved or barely survived on meagre rations like bark, berries and inferior corn and wheat damaged by mildew.

Those eating so little suffered malnutrition, and were therefore very vulnerable to disease. If they didn’t starve to death, they often died as a result of the epidemics that followed famine. Illnesses like tuberculosis, sweating sickness, smallpox, dysentery, typhoid, influenza, mumps and gastrointestinal infections could and did kill.

The Great Famine of the early 14th century was particularly bad: climate change led to much colder than average temperatures in Europe from c1300 – the ‘Little Ice Age’. In the seven years between 1315 and 1322, western Europe witnessed incredibly heavy rainfall, for up to 150 days at a time.

Farmers struggled to plant, grow and harvest crops. What meagre crops did grow were often mildewed, and/or terribly expensive. The main food staple, bread, was in peril as a result. This also came at the same time as brutally cold winter weather.

At least 10 per cent – perhaps close to 15 per cent – of people in England died during this period.


Today, with the benefits of ultrasound scans, epidurals and fetal monitoring, the risk for mother and baby during pregnancy and childbirth is at an all-time low. However, during the medieval period, giving birth was incredibly perilous.

Breech presentations of the baby during labour often proved fatal for both mother and child. Labour could go on for several days, and some women eventually died of exhaustion. While Caesarean sections were known, they were unusual other than when the mother of the baby was already dead or dying, and they were not necessarily successful.

Midwives, rather than trained doctors, usually attended pregnant women. They helped the mother-to-be during labour and, if needed, were able to perform emergency baptisms on babies in danger of dying. Most had received no formal training, but relied on practical experience gleaned from years of delivering babies.

New mothers might survive the labour, but could die from various postnatal infections and complications. Equipment was very basic, and manual intervention was common. Status was no barrier to these problems – even Jane Seymour, the third wife of Henry VIII, died soon after giving birth to the future Edward VI in 1537.

Infancy and childhood

Infancy was particularly dangerous during the Middle Ages – mortality was terribly high. Based on surviving written records alone, scholars have estimated that 20–30 per cent of children under seven died, but the actual figure is almost certainly higher.

Infants and children under seven were particularly vulnerable to the effects of malnutrition, diseases, and various infections. They might die due to smallpox, whooping cough, accidents, measles, tuberculosis, influenza, bowel or stomach infections, and much more. The majority of those struck down by the plague were also children. Nor, with chronic malnutrition, did the breast milk of medieval mothers carry the same immunity and other benefits of breast milk today.

Being born into a family of wealth or status did not guarantee a long life either. We know that in ducal families in England between 1330 and 1479, for example, one third of children died before the age of five.

Bad weather

The vast majority of the medieval population was rural rather than urban, and the weather was of the utmost importance for those who worked or otherwise depended on the land. But as well as jeopardising livelihoods, bad weather could kill.

Consistently poor weather could lead to problems sowing and growing crops, and ultimately the failure of the harvest. If summers were wet and cold, the grain crop could be destroyed. This was a major problem, as cereal grains were the main food source for most of the population.

With less of this on hand, various problems would occur, including grain shortages, people eating inferior grain, and inflation, which resulted in hunger, starvation, disease, and higher death rates.

This was especially the case from the 14th through to the 16th centuries, when the ice pack grew. By 1550, there had been an expansion of glaciers worldwide. This meant people faced the devastating effects of weather that was both colder and wetter.

Medieval men and women were therefore eager to ensure that weather conditions stayed favourable. In Europe, there were rituals for ploughing, sowing seeds, and the harvesting of crops, as well as special prayers, charms, services, and processions to ensure good weather and the fertility of the fields. Certain saints were thought to protect against the frost (St Servais), have power over the wind (St Clement) or the rain and droughts (St Elias/Elijah) and generally the power of the saints and the Virgin Mary were believed to protect against storms and lightning.

People also believed the weather was not merely a natural occurrence. Bad weather could be caused by the behaviour of wicked people, like murder, sin, incest, or family quarrels. It could also be linked to witches and sorcerers, who were thought to control the weather and destroy crops. They could, according to one infamous treatise on witches – the Malleus Maleficarum, published in 1486 – fly in the air and conjure storms (including hailstorms and tempests), raise winds and cause lightning that could kill people and animals.


Whether as witnesses, victims or perpetrators, people from the highest ranks of society to the lowest experienced violence as an omnipresent danger in daily life.

Medieval violence took many forms. Street violence and brawls in taverns were not uncommon. Vassals might also revolt against their lords. Likewise, urban unrest also led to uprisings – for example, the lengthy rebellion of peasants in Flanders of 1323–28, or the Peasants’ Revolt of 1381 in England.

Medieval records demonstrate the presence of other types of violence also: rape, assault and murder were not uncommon, nor was accidental homicide. One example is the case of Maud Fras, who was hit on the head and killed by a large stone accidentally dropped on her head at Montgomery Castle in Wales in 1288.

Blood feuds between families that extended over generations were very much evident. So was what we know today as domestic violence. Local or regional disputes over land, money or other issues could also lead to bloodshed, as could the exercise of justice. Innocence or guilt in trials were at times decided by combat ordeals (duels to the death). In medieval Wales, political or dynastic rivals might be blinded, killed or castrated by Welsh noblemen to consolidate their positions.

Killing and other acts of violence in warfare were also omnipresent, from smaller regional wars to larger-scale crusades from the end of the 11th century, fought by many countries at once. Death tolls in battle could be high: the deadliest clash of the Wars of the Roses, the battle of Towton (1461), claimed between 9,000 and 30,000 lives, according to contemporary reports.


It could also be dangerous to disagree. People who held theological or religious opinions that were believed to go against the teachings of the Christian church were seen as heretics in medieval Christian Europe. These groups included Jews, Muslims and medieval Christians whose beliefs were considered to be unorthodox, like the Cathars.

Kings, missionaries, crusaders, merchants and others – especially from the late 11th century – sought to ensure the victory of Christendom in the Mediterranean world. The First Crusade (1096–99) aimed to capture Jerusalem – and finally did so in 1099. Yet the city was soon lost, and further crusades had to be launched in a bid to regain it.

Jews and Muslims also suffered persecution, expulsion and death in Christian Europe. In England, anti-Semitism resulted in massacres of Jews in York and London in the late 12th century, and Edward I banished all Jews from England in 1290 – they were only permitted to return in the mid-1600s.

From the eighth century, efforts were also made to retake Iberia from Muslim rule, but it was not until 1492 that the entire peninsula was recaptured. This was part of an attempt in Spain to establish a united, single Christian faith and suppress heresy, which involved setting up the Spanish Inquisition in 1478. As a result, the Jews were expelled from Spain in 1492, and Muslims were only allowed to stay if they converted to Christianity.

Holy wars were also waged on Christians who were widely considered to be heretics. The Albigensian Crusade was directed at the Cathars (based chiefly in southern France) from 1209–29 – and massacres and more inquisitions and executions followed in the later 13th and 14th centuries.


Hunting was an important pastime for medieval royalty and the aristocracy, and skill in the sport was greatly admired. The emperor Charlemagne was recorded as greatly enjoying hunting in the early ninth century, and in England William the Conqueror sought to establish royal forests where he could indulge in his love of the hunt. But hunting was not without risks.

Hunters could easily be injured or killed by accidents. They might fall from their horse, be pierced by an arrow, be mauled by the horns of stags or tusks of boars, or attacked by bears.

Status certainly did not guarantee safety. Many examples exist of kings and nobles who met tragic ends as a result of hunting. The Byzantine emperor Basil I died in 886 after apparently having his belt impaled on the horns of a stag and being dragged more than 15 miles before being freed.

In 1100, King William II (William Rufus) was famously killed by an arrow in a supposed hunting accident in the New Forest. Likewise, in 1143, King Fulk of Jerusalem died in a hunting accident at Acre, when his horse stumbled and his head was crushed by his saddle.

Early or sudden death

Sudden or premature death was common in the medieval period. Most people died young, but death rates could vary based on factors like status, wealth, location (higher death rates are seen in urban settlements), and possibly gender. Adults died from various causes, including plague, tuberculosis, malnutrition, famine, warfare, sweating sickness and infections.

Wealth did not guarantee a long life. Surprisingly, well-fed monks did not necessarily live as long as some peasants. Peasants in the English manor of Halesowen might hope to reach the age of 50, but by contrast poor tenants in same manor could hope to live only about 40 years. Those of even lower status (cottagers) could live a mere 30 years.

By the second half of the 14th century, peasants there were living five to seven years longer than in the previous 50 years. However, the average life expectancy for ducal families in England between 1330 and 1479 generally was only 24 years for men and 33 for women. In Florence, laypeople in the late 1420s could expect to live only 28.5 years (men) and 29.5 years (women).

Dying a ‘good’ death was very important to medieval people, and was the subject of many books. People often worried about ‘sudden death’ (whether in battle, from natural causes, by execution, or an accident) and what would happen to those who died without time to prepare and receive the last rites. Written charms, for example, were thought to provide protection against sudden death – whether against death in battle, poison, lightning, fire, water, fever or other dangers.

Dr Katharine Olson is a lecturer in medieval and early modern history at Bangor University

Black Death

This inquiry is framed by the compelling question “Can disease change the world?” Among the many catastrophic global pandemics in history, perhaps none achieved the notoriety of the Black Death. The Black Death was a massive outbreak of the bubonic plague caused by infectious bacteria. Thought by scientists to have been spread by contaminated fleas on rats and/or other rodents, the Black Death quickly decimated entire families and communities. In doing so, the Black Death led more than one observer of the time to ponder whether the apocalypse had begun. The Black Death began and first spread on the Silk Roads through central Asia in the early 14th century, and by mid-century moved via merchant ships into North Africa and Europe, where it would kill nearly one-half of the population. It took almost 150 years for Europe’s population to recover. By investigating the compelling question “Can disease change the world?” students consider the causes, symptoms, and reasons for the rapid geographic expansion of the disease and how this pandemic affected people of the 14th century and beyond. Through their investigation of sources in this inquiry, students should develop an understanding of the consequences of the Black Death and an informed awareness of the importance of preparing for future diseases and possible pandemics.

Compelling Question:

Can Disease Change the World?

Staging the Question:

Supporting Question What was the Black Death?

Formative Task Write a description of the Black Death that includes its symptoms and where outbreaks occurred in Europe and Asia.

Sources Source A: Excerpts from Decameron
Source B: Illustration of the Black Death

Supporting Question How did the Black Death spread so quickly?

Formative Task Construct a diagram illustrating how the Black Death spread.

Sources Source A: Plague Ecology visual
Source B: Map depicting spread of the Black Death

Supporting Question How did the Black Death affect people in the 14th century?

Formative Task Create an annotated illustration depicting how the Black Death affected different groups of people in the 14th century.

Sources Source A: Bubonic plague statistics
Source B: Illustration of the persecution of Jews during the Black Death
Source C: Social and Economic Effects of the Plague

Pre-Columbian treponemal disease from 14th century AD Safed, Israel, and implications for the medieval eastern Mediterranean

In 1912, 68 medieval crania were excavated from a cave at Safed in the eastern Mediterranean and brought to the United Kingdom. It is only recently that these skulls have been studied for evidence of disease. One adult individual demonstrates multiple lesions of the cranial vault, compatible with treponematosis. Radiocarbon dating suggests the year of death to be between 1290–1420 AD. This range equates to the mamluk period, just after the crusades. This is the oldest dated case of treponematosis in the Middle East, and the first to confirm its presence there before the epidemiologically important transatlantic voyage of Christopher Columbus. The finding has significant implications for our understanding of the introduction of the disease to the Middle East and of the medieval diagnosis of ulcerating skin conditions by medical practitioners in the Mediterranean world. Am J Phys Anthropol 121:000–000, 2003. © 2003 Wiley-Liss, Inc.

14th century Zodiac Man

The Zodiac Man or Man of Signs (homo signorum in Latin) is an age-old diagram that relates the calendar and the movement of the heavenly bodies to the human body. Sections of the body are labeled with the twelve zodiacal signs, beginning with Aries, which ruled the head, and ending with Pisces associated with the feet. This illustration demonstrates centuries of connections between astrology and human personality, health, sickness, and medical treatments. For example, Leo is associated with the heart because tradition says the strength the lion was located in its heart. Scorpio is associated with the genitals because a scorpion’s strength was located in its tail. While some of these diagrams were accompanied by a basic explanation of the associations between the body and the heavens, most did not, assuming these astrological theories governing health care were widely accepted and understood.

To learn more about the history of medicine and questionable cures, see Discovering Quacks, Utopias, and Cemeteries

4. Washing Hands and Surfaces

Washing your hands to reduce the spread of disease is an accepted part of hygiene now, but frequent hand washing was a bit of a novelty during the early 20th century. To encourage the practice, "powder rooms," or ground-floor bathrooms, were first installed as a way to protect families from germs brought in by guests and ubiquitous delivery people dropping off goods like coal, milk and ice. 

Previously, these visitors would have traveled through the home to use the bathroom, tracking outside germs with them. (Typhoid Mary infamously spread the disease from which she earns her nickname by not properly washing her hands before handling food.)

Germ theory was a relatively new concept brought to light in the mid-1800s by Louis Pasteur, Joseph Lister, and Robert Koch that held that disease was caused by microorganisms invisible to the naked eye. Having a sink on the ground floor made it easier to wash your hands upon returning home.

Speaking of health and design, there’s a reason why hospitals, subways and 1920s bathrooms were often tiled in pristine white: White tiles are easy to clean and make any dirt or grime highly visible.

Did the Black Death Rampage Across the World a Century Earlier Than Previously Thought?

For over 20 years, I’ve been telling the same story to students whenever I teach European history. At some point in the 14th century, the bacterium Yersinia pestis somehow moved out of the rodent population in western China and became wildly infectious and lethal to humans. This bacterium caused the Black Death, a plague pandemic that moved from Asia to Europe in just a few decades, wiping out one-third to one-half of all human life wherever it touched. Although the plague pandemic definitely happened, the story I’ve been teaching about when, where, and the history of the bacterium has apparently been incomplete, at best.

Related Content

In December, the historian Monica Green published a landmark article, The Four Black Deaths, in the American Historical Review, that rewrites our narrative of this brutal and transformative pandemic. In it, she identifies a “big bang” that created four distinct genetic lineages that spread separately throughout the world and finds concrete evidence that the plague was already spreading in Asia in the 1200s. This discovery pushes the origins of the Black Death back by over a hundred years, meaning that the first wave of the plague was not a decades-long explosion of horror, but a disease that crept across the continents for over a hundred years until it reached a crisis point.

As the world reels beneath the strains of its own global pandemic, the importance of understanding how humans interact with nature both today and throughout the relatively short history of our species becomes more critical. Green tells me that diseases like the plague and arguably SARS-CoV-2 ( before it transferred into humans in late 2019 causing Covid-19 ) are not human diseases, because the organism doesn’t rely on human hosts for reproduction (unlike human-adapted malaria or tuberculosis). They are zoonotic, or animal diseases, but humans are still the carriers and transporters of the bacteria from one site to the other, turning an endemic animal disease into a deadly human one.

The Black Death, as Monica Green tells me, is “one of the few things that people learn about the European Middle Ages.” For scholars, the fast 14th-century story contained what Green calls a “black hole.” When she began her career in the 1980s, we didn’t really know “when it happened, how it happened, [or] where it came from!” Now we have a much clearer picture.

“The Black Death and other pre-modern plague outbreaks were something everyone learned about in school, or joked about in a Monty Python-esque way. It wasn't something that most of the general public would have considered particularly relevant to modernity or to their own lives,” says Lisa Fagin Davis, executive director of the Medieval Academy of America. But now, “with the onset of the Covid-19 pandemic, suddenly medieval plagues became relevant to everyone everywhere.”

The project that culminated in Green’s article unfolded over many years. She says that the first step required paleogenetic analysis of known victims of the plague, including a critical study 2011. Paleogenetics is the study of preserved organic material—really any part of the body or the microbiome, down to the DNA—of long dead organisms. This means that if you can find a body, or preferably a lot of bodies, that you’re sure died in the Black Death, you can often access the DNA of the specific disease that killed them and compare it to both modern and other pre-modern strains.

This has paid off in numerous ways. First, as scientists mapped the genome, they first put to rest long lingering doubts about the role Y. pestis played in the Black Death (there was widespread but unsubstantiated speculation that other diseases were at fault). Scientists mapped the genome of the bacterium and began building a dataset that revealed how it had evolved over time. Green was in London in 2012 just as findings on the London plague cemetery came out confirming without a doubt both the identity of the bacterium and the specific genetic lineage of the plague that hit London in June 1348. “The Black Death cemetery in London is special because it was created to accommodate bodies from the Black Death,” she says, “and then when [the plague wave] passed, they closed the cemetery. We have the paperwork!”

Green established herself as the foremost expert in medieval women’s healthcare with her work on a medical treatise known as The Trotula. Her careful analysis of manuscript traditions revealed that some of the text was attributable to a southern Italian woman, Trota. Other sections, though, revealed male doctors’ attempts to take over the market for women’s health. It’s a remarkable text that prepared Green for her Black Death project not only by immersing her in the history of medicine, but methodologically as well. Her discipline of philology, the study of the development of texts over time, requires comparing manuscripts to each other, building a stemma, or genealogy of texts, from a parent or original manuscript. She tells me that this is precisely the same skill one needs to read phylogenetic trees of mutating bacteria in order to trace the history of the disease.

Still, placing the Black Death in 13th-century Asia required more than genetic data. Green needed a vector, and she hoped for textual evidence of an outbreak. She is careful to add that, when trying to find a disease in a historical moment, the “absence of evidence is not evidence of absence.” Her first step was to focus on a cute little rodent from the Mongolian steppe: the marmot.

Mongols hunted marmots for meat and leather (which was both lightweight and waterproof), and they brought their rodent preferences with them as the soon-to-be conquerors of Asia moved into the Tian Shan mountains around 1216 and conquered a people called the Qara Khitai (themselves refugees from Northern China). There, the Mongols would have encountered marmots who carried the strain of plague that would become the Black Death. Here, the “big bang” theory of bacterial mutation provides key evidence allowing us a new starting point for the Black Death. (To support this theory, her December article contains a 16-page appendix just on marmots!)

The phylogenetic findings were enough for Green to speculate about a 13th-century origin for the plague, but when it came to the mechanism of spread, all she had was conjecture—until she found a description of an outbreak at the end of the Mongol siege of Baghdad in 1258. Green is quick to note that she has relied on experts in many different languages to do this work, unsurprisingly since it traverses from China to the rock of Gibraltar, and from near the Arctic Circle to sub-Saharan Africa.

No one is expert in all the languages. What Green brought was a synthetic view that drew a narrative out of cutting-edge science and humanistic scholarship and the ability to recognize the significance of what she found when she opened a new translation of the Akhbār-i Moghūlān, or Mongol News. This source was published for the first time in 2009 by the Iranian historian Iraj Afshar, but only translated into English in 2018 as The Mongols in Iran, by George Lane. The medieval Iranian source is something of a jumble, perhaps the surviving notes for a more organized text that didn’t survive. Still, the report on the Mongol siege, Green realized, held the key piece of evidence she’d been looking for. As she cites in her article, Mongol News describes pestilence so terrible that the “people of Baghdad could no longer cope with ablutions and burial of the dead, so bodies were thrown into the Tigris River.” But even more importantly for Green, Mongol News notes the presence of grain wagons, pounded millet, from the lands of the Qara Khitai.

Suddenly, the pieces fit together. “I’ve already got my eye on the Tian Shan mountains, where the marmots are,” she says, and of course marmot-Mongol interaction could cause plague there, but didn’t explain long-distance transmission. “The scenario I’m putting together in my head is some sort of spillover event. Marmots don’t hang around people. They’re wild animals that will not willingly interact with humans. So the biological scenario I had to come up with is whatever is in the marmots had to be transferred to another kind of rodent.”

With the grain supply from Tian Shan linked to plague outbreak in Baghdad, it’s easy to conjecture a bacterium moving from marmots to other rodents, those rodents riding along in grain, and the plague vector revealed. “That was my eureka moment,” she says.

She had put the correct strain of the bacteria at the right place at the right time so that one infected rodent in a grain wagon train revealed the means of distribution of plague.

“Throughout her career, Dr. Green has combined humanism and science in ways that have brought a more clear understanding of the origins and spread of plague,” says Davis, from the Medieval Academy. “Her collaborations with historians, geneticists, paleobiologists, archaeologists and others untangle the genetic complexities of plague strains.”

That kind of interdisciplinary work would have been significant to scholars at any moment, but right now takes on particular relevance. “[Green] has worked to undermine imprecise and simplistic plague narratives and to explain to a ready public the importance of understanding historic plagues in context,” adds Davis “[Her] voice has been critical as we try to make sense of our own modern-day plague.”

Green also sees the relevance, especially as her study of plague variants and pandemic came out just as new variants of the Covid-19 pathogen were manifesting around the world. She tells me that her work didn’t change because of Covid, but the urgency did. “Plague,” Green says, “is our best ‘model organism’ for studying the history of pandemics because the history of it is now so rich, with the documentary and archaeological record being supplemented by the genetic record. All the work the virologists were doing in sequencing and tracking SARS-CoV-2's spread and genetic evolution was exactly the same kind of work that could be done for tracking Yersinia pestis's evolution and movements in the past.”

She wants her fellow scholars to focus on human agency both in history—those Mongols and their wagon trains—and now. The history of the Black Death tells “a powerful story of our involvement in creating this pandemic: this wasn't Mother Nature just getting angry with us, let alone fate. It was human activity.”

The world is only now—thanks to Green and many others (see her long bibliography of scholars from a wide variety of disciplines, time periods, and parts of the world)—really getting a handle on the true history of the Black Death. Next, she tells me, she has an article coming out with Nahyan Fancy, a medieval Islamist, on further textual evidence of plague outbreaks to supplement the Mongol News. Many of these 13th-century sources were previously known, but if you start with the assumption that the plague couldn’t be present until the 14th century, you’d never find them.

She imagines scholars may find plague in other places, once they start looking. In the meantime, the stakes for understanding how diseases move remains crucial as we wrestle with our own pandemic. I ask her what she thinks it all means for a world today still grappling with a pandemic. She replies, with a harrowing, centuries-look ahead, “The story I have reconstructed about the Black Death is 100 percent an emerging infectious disease story. . an ‘emerging’ disease lasted for 500-600 years. ”

About David M. Perry

David M. Perry is a freelance journalist covering politics, history, education, and disability rights. He was previously a professor of medieval history at Dominican University from 2006-2017.

Genetics as a Historicist Discipline: A New Player in Disease History

H istorians in Lab Coats&rdquo&mdashthat&rsquos the new epithet for the molecular biologists who have taken the limelight in the field of disease history. 1 This role is not limited to just recent disease history, where, for example, genetics is playing a major role in tracking the evolution and pathogen mutation in still-unfolding epidemics, such as HIV/AIDS, cholera, or Ebola. The most notable work, rather, has focused on my period, the Middle Ages. True, this research is usually still heralded in the &ldquoScience&rdquo section of major newspapers, rather than the &ldquoCulture&rdquo section, where historical studies (assuming they are reviewed at all) would normally appear. But the fact that history has come to be defined by breakthroughs made by scientists, rather than historians as traditionally defined, signals a sea change. One particular breakthrough in 2011 actually elicited an editorial in the New York Times, 2 which celebrated the complete sequencing of the bubonic plague bacterium from 14th-century remains in London, an achievement that finally closed decades of debate about what &ldquoreally&rdquo caused the Black Death.

Welcoming a new player onto the field of historical research is not something we traditionally trained historians always do gracefully. But I would argue that we should embrace our new sister discipline. Despite the hype in the popular press, the molecular genetics work that has contributed so substantively to the history of plague and several other disease histories hasn&rsquot pushed us off the playing field. It has an inherent limit: genetics tells us only the story of the pathogen. 3 It does not tell us how, in the case of plague, a single-celled organism came to be dispersed over half the globe in the medieval period (and around the whole globe by the beginning of the 20th century). It does not tell us about all the animal species&mdashnot simply rats, but also marmots and gerbils and maybe camels and storks&mdashthat helped transmit the organism thousands of miles from its place of origin. Least of all does it tell us how people reacted to such massive devastation, or why they looked to the stars, or local minority groups, in their search for explanations or objects of blame.

I have just finished editing a collection of essays unlike anything I ever imagined possible. The essays constitute the inaugural issue of a new journal, The Medieval Globe, and are devoted to the topic of the Black Death. 4 The collection brings together an interdisciplinary team of scholars: archeologists, microbiologists (one of whom has expertise in biosecurity), a biological anthropologist, and historians with geographical specialties ranging across Afroeurasia. Our agenda has been straightforward: to ask how the new genetics understanding of Yersinia pestis, the causative organism of plague, can alter the way we understand the history of one of the worst pandemics in human history.

Human remains from the East Smithfield Black Death Cemetery in London. DNA fragments from this cemetery were used to reconstruct the genome of Yersinia pestis in 2011.

The reason for letting the work of molecular geneticists drive our research questions about the Black Death is simple: we historians invited them in. Geneticists have taken the lead in plague narratives because they were attempting to solve a problem that had proved unsolvable by traditional (document-based) historical methods. For a variety of reasons, the 1970s and &rsquo80s engendered new questions about whether the Black Death (usually dated 1347&ndash53) had really been caused by Yersinia pestis, the same bacterium identified as the cause of plague in 1894 during an outbreak in Hong Kong that, in spreading globally, would become known as the Third Plague Pandemic. But few people prior to the late 19th century saw bacteria, and none saw viruses. They saw (or conceived of) disturbances of the humors or qi or some other construct to explain the physiology of disease. Hence, our written historical sources would never give us a definitive answer to the question: What was the disease?

The development of ancient DNA (aDNA) technologies and analytics has broken through the 19th-century barrier because they can now retrieve bacterial (and even viral) fossils. As with plague (Yersinia pestis), whole genomes have now been sequenced from historical remains for the 1918&ndash19 strain of influenza virus, leprosy (Mycobacterium leprae), cholera (Vibrio cholerae), and tuberculosis (Mycobacterium tuberculosis complex). 5

The particular relevance of genetics for the narrative of disease history, however, goes beyond simply confirming the presence of particular pathogens at certain times and places in the past. More profoundly, the new molecular genetics creates an evolutionary history of the pathogen: it shows the historical relationships between different strains, it suggests a general chronology of development, and, most useful to us historians, it grounds those evolutionary narratives in geographical space. Most genetics work on Yersinia pestis has not been done on historical remains (which continue to be rare, subject to fortuitous retrievals by archeologists) but on modern samples of the organism. These can document only strains that have survived to modern times. Nevertheless, their spatial distribution contributes to a &ldquostory&rdquo of how the organism has moved around and developed. The new genetics allows the creation, even if only in a tentative way, of a unified history of plague: one that covers nearly the whole of Eurasia and even incorporates Africa one that looks across a wide variety of species and environments that may have proved hosts to plague and one that connects a broad chronological expanse, from the 13th century to the present day.

Filling in all the still-blank spaces of chronology, geography, and host environments and landscapes demands the traditional skills of the historian, who can draw from a rich array of written sources and other products of human culture. It demands linguistic competence to read those sources in their original languages and cultural competence to &ldquoread&rdquo them for all their nuances of contingent local meaning. Yes, we remain uniquely dependent on the geneticists for certain aspects of our interpretations. Although I have inspected human remains from the London Black Death Cemetery (see photo), I have never seen any of the molecular fossils scientists claim to have extracted from them. But after immersing myself in their published work for the past eight years, I understand why the geneticists are making the inferences they make. Taking their conclusions as working hypotheses, I and my colleagues have been able to put forward several robust hypotheses of our own, including how, when, and why plague emerged out of its evolutionary home in the Tibet-Qinghai Plateau in the 13th century. I have even tentatively postulated, on the basis of the genetics, that plague may have reached areas that have never been part of Black Death narratives before.

Our experience suggests, then, that the biological sciences can be usefully deployed to inform historical analysis. Molecular genetics has the power to reconstruct a history of material existence&mdashin this case, of microbes&mdashat a level that no other kind of historical source or method can reach. Moreover, in the case of an ecologically complex disease like plague, other fields&mdashsuch as zoology, entomology, and bioarchaeology&mdashhave great potential to inform our work. And my experience suggests that, if introduced thoughtfully, such science can be deployed even in the undergraduate classroom. Being challenged in this way by a discipline so utterly different in its methods and questions from our own can make us better historians and highlight the unique contributions we make as humanists.

Monica H. Green is a historian of medieval medicine and global health. In 2009 and 2012, she ran a National Endowment for the Humanities Summer Seminar in London, &ldquoHealth and Disease in the Middle Ages&rdquo participants wrestled with the problem of opening up dialogue between the humanities and the historicist sciences.

The December issue of the American Historical Review features a roundtable entitled &ldquoHistory Meets Biology.&rdquo Authors of the roundtable articles are John L. Brooke, Clark Spencer Larsen, Edmund Russell, Randolph Roth, Kyle Harper, Walter Scheidel, Lynn Hunt, Julia Adeney Thomas, Norman MacLeod, and Michael D. Gordin. Read the 10 essays at www.historians.org/ahr.

1. Lester K. Little, &ldquoPlague Historians in Lab Coats,&rdquo Past and Present, 213 (2011): 267&ndash90.

3. There is also genetics work that looks at disease history from the perspective of human genetics, such as evolutionary responses to malaria, tuberculosis, and cholera. I am referring here only to work that focuses on the pathogenic organism of infectious diseases.

4. Monica H. Green, guest editor Carol Symes, executive editor, &ldquoPandemic Disease in the Medieval World: Rethinking the Black Death,&rdquo The Medieval Globe 1 (2014), http://www.arc-humanities.org/inaugural-issue.html. Open-access publication has been generously underwritten by the World History Center, University of Pittsburgh.

5. The key scientific studies on these organisms are: Kirsten I. Bos et al., &ldquoA Draft Genome of Yersinia pestis from Victims of the Black Death,&rdquo Nature 478 (October 27, 2011): 506&ndash10 Jeffery K. Taubenberger et al., &ldquoCharacterization of the 1918 Influenza Virus Polymerase Genes,&rdquo Nature 437 (2005): 889&ndash93 Verena J. Schuenemann et al., &ldquoGenome-wide Comparison of Medieval and Modern Mycobacterium leprae,&rdquo Science 341 (July 12, 2013): 179&ndash83 Alison M. Devault et al., &ldquoSecond-Pandemic Strain of Vibrio cholerae from the Philadelphia Cholera Outbreak of 1849,&rdquo New England Journal of Medicine 370 (2014), 334&ndash40 and Kristen I. Bos et al. &ldquoPre-Columbian Mycobacterial Genomes Reveal Seals as a Source of New World Human Tuberculosis,&rdquo Nature, published online August 20, 2014, http://dx.doi.org/10.1038/nature13591.

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