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In the spring of 1347, a ship arrived in Italy, having returned from the Crimea. Many of the merchants and sailors on board were extremely ill, and some had already died. They had contracted the dreaded bubonic plague — later to be known as the Black Death.
The bubonic plague is thought to have been the same as the Plague of Justinian that had ravaged the Byzantine Empire under the emperor of that name several centuries earlier.
Historical evidence indicates that the 14th-century version of the horrific disease originated in China, probably in Mongolia. Mongols attacked the last trading station of Italian merchants at Caffa in the Crimea, but the plague attacked the attackers. In an early example of biological warfare, the besiegers catapulted the corpses over the walls of the city.
As the Italian merchants fled home, their ships brought with them rats with their fleas — carriers of the bubonic plague. From one port, the disease spread across Europe, eventually killing over half the population in only seven years.
Today, simple antibiotics such as the tetracyclines are usually more than adequate treatment for the plague. Yet, various inadequate treatments were tried in the 14th century, such as bleeding the victims, using laxatives, and even having sufferers visit latrines to breathe in foul odors.
One recomended treatment was for those with the disease to move to rural areas for cleaner air. While this plan allowed people to escape the unsanitary conditions of medieval cities, it also naturally served to spread the infection to new areas.
Another outbreak brought the plague from southwest China to Hong Kong through water traffic, while Australia suffered 12 outbreaks from 1900-1925, the disease being spread through its thriving shipping industry.