The Black Death: How Brutal Was 14th-Century Survival? (You Won't Believe!)

It's 1347. You live in a packed medieval city, and the most dangerous thing in your house is small enough to bite your ankle. The Black Death is coming, and it brings six threats, each worse than the last. Along the way we'll test the survival tips people actually tried. Almost all of them failed.

The crowded city, where the street is the toilet

A walled city feels safe. The problem is the tens of thousands of people packed inside, and the fact that the street doubles as the toilet. One London street was more or less called Poop Borough Lane, and the king himself complained about the mess.

Your bed has roommates too. Fleas and lice, and none of them pay rent. Everyone blames the rats, and their fleas did play a part. But scientists think people's own fleas and lice may have done a lot of the spreading. Sorry, rat.

In October 1347, 12 Genoese galleys docked in Sicily. Someone ordered silk and spices. What arrived was a germ from Central Asia. Messina threw the sailors out, but it was already too late.

Survival tip one was to hold your nose. Nice try. The stink wasn't killing anyone. The fleas were.

The infection: lumps the size of an egg

A flea bites you. You might expect a fever, a few days in bed and some soup. Instead, within a week, lumps swell up in your groin, armpit or neck, as big as an egg or even an apple. Then come dark spots. One eyewitness said almost everyone died after the third day.

That was the bubonic form, and it was the mild one. Untreated, it kills 30 to 60% of its victims. If the infection got into the blood, fingers, toes and noses could turn black. If it got into the lungs, it spread with a cough and could kill within a day.

Nobody at the time called it the Black Death, by the way. They called it the Great Mortality, which sounds like a heavy metal album. Plague still exists today, and antibiotics cure it if you take them fast. In 1347 the second survival tip, waiting it out, was a firm no.

The doctors blamed the planets

If you're picturing a doctor in a creepy bird mask, you're in the wrong century. That costume dates from 1619. Your doctor in 1348 wore a robe.

When the King of France asked the top doctors in Paris what was going on, they blamed the sky. Saturn, Jupiter and Mars had lined up at 1 p.m. and spoiled the air. The people most at risk, they said, were those who exercised, bathed or worried too much.

The cures were not much better. Bloodletting, for patients who were already dying. Flowers to sniff. Theriac, a mixture of up to 80 ingredients that included opium. Crushed emeralds for the rich. For the poor, sometimes arsenic or mercury, which killed faster than the plague did.

In Avignon, the doctors fled. The Pope's doctor stayed, surrounded the Pope with fires and banned visitors. The fires did nothing. Banning visitors was basically quarantine, and the Pope never caught it.

The best advice in the medical books was to run. Leave fast, go far and come back slowly. So seeing a doctor was useless, while running worked if you could afford it.

The panic: whips, pub crawls and scapegoats

By 1349 some people had joined the flagellants, who marched from town to town whipping themselves for their sins. The sign-up terms were 33 and a half days, twice a day, four pence a day, and married men needed their wife's permission. Even the Pope, a man who had been sitting between bonfires, found that extreme. He banned them.

Others locked themselves in. Some partied from tavern to tavern. The rich fled.

And some people blamed their neighbours. Jews were falsely accused of poisoning the wells. In Strasbourg in 1349, about 2,000 Jews were murdered before the plague had even arrived. By 1351, more than 200 Jewish communities had been destroyed. The Pope condemned it, and the plague was killing Jews too, but he was widely ignored.

Whips and blame scored as useless, and deadly for the people who were blamed.

The lockdown that actually worked

Think lockdowns started in 2020? In 1348 the Italian town of Pistoia ruled that nobody could go to Pisa or Lucca, and nobody from there could come in. Funerals lost their drummers, horn players and bells, so the sick wouldn't get depressed. Medieval self-care.

Milan's ruler went further and walled up the first plague houses with the people still inside. Milan got off lightly. Was that the reason? Nobody knows.

Then, in 1377, came Ragusa, today's Dubrovnik. Arrivals from plague zones had to spend 30 days on an island first. Thirty days wasn't enough, so it became 40. In Italian that's quaranta, which is where the word quarantine comes from.

Staying apart worked. It may be the most boring breakthrough in history. The catch is that Ragusa's rule came almost 30 years after the first wave, and in 1348 most places had no rules at all.

The Great Mortality: nobody was too important

Between 1347 and 1353, somewhere between 25 and 50 million people died in Europe. That's a third to more than half of everyone. London lost more than half its people. At the peak, Paris reportedly buried 800 a day. In Siena, a man named Agnolo di Tura buried his five children with his own hands.

Being rich or important didn't help either. A 14-year-old English princess died on the way to her own wedding. England lost two Archbishops of Canterbury in one year, and Castile lost its king. Siena's huge new cathedral was never finished, and its half-built walls still stand like a giant "back in five" sign.

Say you made it to 1353. Congratulations, it came back. In 1361 it returned and hit children hardest. Then it came back again, and again. Plague was somewhere in Europe every year from 1346 to 1671, which is 325 years. The Black Death had no finish line, and surviving it once didn't make you safe.

If you want to see how the 14th century compares with nine other eras, we ranked them in How Long Would You Survive in History?. In 1347 the best medical advice was to run. Today it's to take your antibiotics.

The short version

• The plague reached Sicily on Genoese galleys in October 1347. Rats' fleas played a part, but people's own fleas and lice may have done much of the spreading.
• Untreated bubonic plague killed 30 to 60% of its victims, and the blood and lung forms were even worse.
• Holding your nose, waiting it out, bloodletting, posies, whips and blame were all useless.
• Distance worked. Fleeing early helped if you were rich, and Ragusa's 30-then-40-day isolation gave us the word quarantine.
• Somewhere between 25 and 50 million Europeans died, and plague kept returning to Europe for 325 years.