What Strategies Did Societies Use against the Black Death ?


By Dorsey Armstrong, Ph.D.Purdue University

Some communities had been spared the first time around the Black Death swept through Europe. Either because of unique geographic features that helped these communities remain isolated or via strategies like draconian quarantine measures, or strict regulations concerning sanitation, places like Iceland, Finland, Milan, and Nuremberg came through the first wave virtually unscathed. They were not so lucky with this next outbreak.

Northern lights over a church in Iceland
Iceland was one of the communities that wasn’t so lucky the next time the plague visited. (Image: Michal Balada/Shutterstock)

Centers of the Renaissance

Milan, which had come through the first wave with a mortality rate of just around 15 percent, was particularly devastated in 1361. The great Florentine poet Petrarch, who traveled throughout the medieval world—including to Avignon, where he had first laid eyes on his great love, Laura—was in Milan when the 1361 outbreak occurred.

Once again, many people opted to flee the great Italian cities and wait out the epidemic in the countryside, and Petrarch was invited to do so, but he declined, stating that, “To face death in fear is a base weakness.” Petrarch survived that wave, but his son Giovanni was not so lucky and died of the plague at the age of 25. 

Sunrise city skyline at Milano Duomo Cathedral, Milan, Italy.
Milan was particularly devastated in 1361. (Image: Noppasin Wongchum/Shutterstock)

Milan’s luck seemed to have run out after its miraculous escape from the first wave, and for the next two centuries, it was repeatedly hit by new outbreaks.

Nuremberg, too, was unable to maintain its relative immunity. With a mortality rate of 10 percent, it had one of the best survival rates in all the medieval world. But eventually, it, too, was ravaged by the plague—in 1405, 1435, 1437, and on several more occasions until 1534. But it had managed to avoid the most devastating wave of plague, and this fact alone meant that Nuremberg was poised to become the center of the German Renaissance in the 15th and 16th centuries.

Learn more about the communities that survived the first wave.

Luck Ran Out for Societies

Iceland managed to avoid the plague for almost 50 years after the first outbreak. But eventually, their luck would run out. When the plague struck that island nation in 1402, it carried off half the population. Many scholars see the years 1400–1800 as marked by a significant decline in Icelandic culture—a decline that began when the Black Death finally penetrated the natural defenses that the ocean had provided for half a century.

While the recurrence of the plague certainly disrupted the attempts of local governments and other entities to try and recreate what had been normal in the pre-plague world, it also spurred them to grow and change. For it wasn’t too long before most communities realized that this thing was going to come back with some regularity, and as such, there needed to be some strategies in place to combat it. 

Italian cities like Florence took steps to create a Board of Health in the aftermath of the first outbreak. Soon, other cities instituted similar policies and created administrative bodies that were specifically tasked with dealing with the plague.

This is a transcript from the video series The Black Death: The World’s Most Devastating Plague. Watch it now, on Wondrium.

Pesthouses: A Welcome Strategy against the Black Death

One new creation that came into existence was the pesthouse or lazaretto. Sometimes called lazar houses—after the biblical figure of Lazarus, whom Jesus raised from the dead. These were places where those sick with plague were sent to either die or recover. These were different from typical medieval hospitals in that they only came into being during a plague epidemic. 

Once a plague epidemic was declared in a particular city—and this was a particularly fraught civic decision, as you might imagine, but one that became a clear necessity after the first wave of Black Death after an epidemic was declared then certain buildings would be designated pesthouses or lazar houses.

The Italian city-state of Venice was one of the first to institute this practice, and when they did so, they made use of the natural defenses of islands. It was in the Venetian territory of Dubrovnik, in what is now Croatia, that scholars think the first pesthouse was established on the island of Mljet in 1377. In Venice itself, the city leaders had a plague hospital constructed in 1403.

Marseille, another one of the earliest hit cities during the first wave, instituted similar policies, building a facility specifically dedicated to the care of plague patients in 1383. Pretty soon, pesthouses were being constructed or designated throughout the medieval world—Milan, Florence, Barcelona, the German cities of Ulm and Überlingen, and many more.

Learn more about the Black Death’s political outcomes.

A man digging a grave on a dark night
Some, like gravediggers, were forced to work in the dangerous situations during the plague. (Image: rbkomar/Shutterstock)

Problems of Owning a Pesthouse

While pesthouses seemed like a very reasonable step to take in the face of the plague—and, indeed, shows that medieval people were smart enough to recognize the basics of the epidemiology of plague and come up with some strategies to try and contain it—conditions in the pesthouses ranged from okay to horrific, depending on how bad the outbreak was. 

There was the bureaucratic burden of staffing and supplying these pesthouses, and this meant a significant outlay on the part of local governments. As you might imagine, to get anyone to work there voluntarily required paying high wages and offering other incentives. 

In some cases, people who held lower-ranking positions like cleaners or gravediggers were compelled to work at the pesthouse. And, of course, the people who worked there were very likely to contract the disease themselves, so replacing them was another added burden that civic organizations had to constantly worry about.

Common Questions about Strategies Societies Used against the Black Death

Q: How did Iceland manage to not be afflicted with the plague for 50 years?

The ocean gave them a natural defense against the plague since they were surrounded by water. It was nature’s strategy against the Black Death, but unfortunately, it didn’t stop the plague entirely.

Q: What was the purpose of pesthouses?

They were among the strategies against the Black Death implemented in the later waves of the plague. The purpose was to quarantine the sick in a confined space so they could get better or die there but not spread the disease to healthy people.

Q: What were some of the issues when it came to managing a pesthouse?

Being the primary strategy against the Black Death, the pesthouses had to be staffed, but most people wouldn’t volunteer for such dangerous work unless they were paid handsomely. And staffing had to happen consistently since many of the staff did die, as they would catch the infection.

Keep Reading
Response to the Plague in Cities and in the Countryside
The Great Mortality and the New Economy
The Economic Impact of the Plague