The plague, called by historians the "Black Death" but known during the early ourbreaks as "the Pestilence" or the "Great Mortality" came in two forms, which confused doctors of the time. It is called "Bubonic Plague" now because the swellings in the groin or armpit were called "buboes", and oozed blood and pus. All bodily excretions were bloody and foul smelling, and the affected suffered great pain and usually died within five days (often in only a few hours). Later the second form appeared, causing coughing, heavy sweating and continuous high fevers and spitting of blood. plus all the foulness of breath, urine, etc. Severe depression accompanied the physical symptoms.
The first form was caused by contact, the second was spread by respiratory infection. The disease was spread rapidly and impossible to control because of the rat and flea population. Doctors had no concept of contagion, believing that disease was caused by astrological influences or the affects of the "humors", choleric and melancholic, sanguine and phlegmatic). The fact that both the rats and fleas were so common, and both necessary to spread the disease, made it even more difficult for people of the time to understand what was happening, resulting in a pervasive sense of horror. The bacteria (Pasturella pestis) lived alternately in the stomach of the flea and the blood of the rats; the bite of either spread the disease.
The disease began in India within two or three years of its appearance on a ship filled with dead and dying men in a Genoese trading post in Caffa, today Feodosiya on the Black Sea in October of 1347. By the time the first contagion died down in 1350, between 35 and 50 percent of the population between India and Greenland was dead. Today, the plague still exists, mostly in poor countries but there are usually between 30 and 100 cases per year in the American Southwest.
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