The Prognosis of Art in the Great Mortality:
The Effects of Plague on European Art

by Rachel Hsu. Advised by Anne Higonnet, Art History Department, Barnard College

Abstract: The bubonic plague had a lasting impact on Medieval visual culture that manifested in both art and architecture. Time and misinformation have eroded our memory of this plague-incited shift. My thesis is an analysis of iconography, from small plague banners to votive chapels, within the context of a capsizing society. 


In 1347, a ship arrived in Sicily.  Its crew had been decimated.  Its cargo was Yersinia pestis.

The total body count attributable to the bacterium Y. pestis is upwards of 200 million people, a stunning number even when compared to AIDS, Spanish influenza, smallpox, and tuberculosis.  In the Foster scale (a logarithmic calamity scale; a kind of Richter scale for human disaster), only World War II has surpassed the plague in terms of death toll, suffering, and societal impact.  Estimates by survivors and modern historians alike are fairly consistent in positing about a third of Europeans perished from the plague.

This study will use “plague” rather than the “Black Death” to correct a common misconception.  In 1631, the Dutch historiographer Johannes Isaacus Pontanus employed the Latin term mors atra, coined by Seneca (4 bce - 65 ce) to describe an outbreak of disease in Rome.  Pontanus claimed that this term was used in the fourteenth century to refer to the European Y. pestis epidemic, conflating his historical reference points and crafting a catchy name.  But the disease that entered Europe in 1347 earned a coterie of grand titles in its own time: it was called, variously, huge mortalitye, la moria grandissima, la mortalega grande, grosze Pestilentz, peligro grande, and très grande mortalité.  These names all translate, roughly, to “the Great Mortality”.  Terms like “plague” and “pestilence” both refer to diseases caused by divine wrath, but are not specifically linked to Y. pestis.  In recognition of the history of evolving perceptions towards the mass death caused by the disease of the bacillus Y. pestis, this paper will use the term “Great Mortality” to refer to the 14th century outbreak and “plague” to mean the larger epidemic that is commonly called the “Black Death.”

To discuss the visual culture of the plague, it is first necessary to begin with a comprehensive overview of the origin, spread, and impact of the epidemic.  An understanding of the socioeconomic and global conditions of the period, as well as the disease’s effect on its victims and survivors alike, will better inform the visual analysis, iconographical exploration, and other modes of inquiry.

For the pathogen to spark a major outbreak, a number of distinct factors had to align:

  1. Increased Mobility.  The Mongol unification of the Eurasian steppe under Genghis Khan allowed for greater fluidity of movement between borders.  Rats and their fleas that would have otherwise died in isolation traveled throughout Asia riding the saddlebags of Mongolian invaders and later scrounging within the hulls of ships and among goods traveling around the world.  The Early Middle Ages, spanning from the 6th to 10th centuries ce, was at far less of a risk of such a disease, but after crusades, globalization, and Genghis Khan’s conquests, the continent was ripe for disease.

  1. Demographics and Lifestyle.  Infectious diseases generally require a minimum population of 400,000 in order to sustain themselves, or the chain of infection is liable to break down.  Distance between settlements could also break the wave of infectious disease like patches of grassland block a forest fire’s march.  The fourteenth century was an overcrowded period; after a prosperous growth between 1000 and 1200, Europe had found itself in a Malthusian deadlock of exploding population but stagnant resources.  Stagnation turned to rot in stuffed, highly unsanitary cities, where full chamber pots were dumped into streets and animals were slaughtered in public.  Add to this the black rat (Rattus rattus), a critical disease vector which sustains itself upon human refuse and garbage, and the culture of rubbish blooms into an oasis ripe for an epidemic.

  2. Environmental Instability.  Accounts from Europe and Asia in the decades preceding the Great Mortality report volcanic eruptions, earthquakes, swarms of locusts, and flooding.  While these accounts may have been vastly exaggerated in order to justify a narrative of divine wrath, tree ring analysis shows that the early fourteenth century was “one of the most severe periods of environmental stress in the last two thousand years,” partially due to increased seismic activity.  Earthquakes and other ecological disasters may have threatened remote rodent populations by limiting food sources or destroying habitat, forcing the rodents to seek out human settlements for food and shelter.

The plague is a disease of rodents, but the black rat is not the only creature to blame; the carriers of Y. pestis were black rat fleas, Xenopsylla cheopis.  X. cheopis does not particularly favor human blood, but like most creatures, will take necessary measures to avoid starvation.  It is an unlucky coincidence that a disease that evolved to curb the rat population is so effective in likewise exterminating humans.

Bubonic plague, the most common form of plague, is the most survivable, with a mortality rate of 60%.  It incubates from 2 to 6 days after a flea bite, until revealed in the form of buboes, infected lymph nodes.  Leg and ankle bites lead to buildup of plague bacilli in the lymph nodes clustered around the groin; arm and upper-body bites cluster buboes under the armpits or on the neck.  Another far less common symptom is the emergence of petechiae, hemorrhagic bruises on the chest, back, and neck that correspond to the victim’s internal trauma.  In some cases of bubonic plague, the plague bacilli escape the lymphatic system and infect the respiratory, leading to a secondary pneumonic plague.

Pneumonic plague is spread from person to person in the same way as a cold and has an incubation period of 1 to 3 days.  This form was called the “coughing plague” by some, as it was characterized by persistent coughing and vomiting of blood.  In the earliest days of the Great Mortality, pneumonic plague was especially common in Italy.  Untreated, its mortality rate is between 95 and 100%.  

Septicemic plague is fatal.  Once plague bacilli enter the bloodstream, the ensuing toxicity is a death sentence.  Extremities blacken and stiffen and the victim cannot expect to survive beyond a day.

The Great Mortality began in central Asia and quickly spread throughout the Eurasian landmass.  The disease entered European history when a trade ship arrived in Sicily from Caffa, and soon swept up the Mediterranean coast to Marseille, where half the city was wiped out in a single winter.  It spread northwards through France, to the Flemish border, into Dover and Dorset and then London.  Meanwhile the plague swarmed into central Europe, accompanied by a rise of anti-Semitism and mass murder.  In 1349 the Great Mortality finished its successful tour of Europe by catching a ride to Norway on a ship transporting textiles to Bergen.  By the end of the summer it had claimed Sweden and Greenland.  Between 1347 and 1349, the plague irreversibly changed the course of European history.

Despite the plague’s indelible mark on society, there is surprisingly little academic exploration of its effect on visual culture.  The dearth of research in this area is not for lack of evidence, but rather due to the fact that plague imagery is frequently misrepresented and misremembered.