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What Were the Symptoms of the Black Death?

Burial of Black Death Victims

A contemporary manuscript shows victims being buried in Tourmai.  Presumably this is near the beginning of the outbreak; later there were not enough survivors to property bury the dead, they were simply thrown into plague pits.

A contemporary manuscript shows victims being buried in Tourmai. Presumably this is near the beginning of the outbreak; later there were not enough survivors to property bury the dead, they were simply thrown into plague pits.

The Black Death: Swift and Deadly

The plague that hit Europe in the mid fourteenth century was not the first deadly epidemic to afflict the continent. Several centuries earlier plague had visited Constantinople and left nearly half its inhabitants dead. Smaller outbreaks of the disease carried on for a few years, but Europe was spared from the scourge of plague until around 1347.

Generally, we tend to think that the Black Death was what we now call bubonic plague. Certainly, some of the symptoms described at the time do bear out that diagnosis. However, there is a great deal of variance in the contemporary accounts of the symptoms of the plague and it is almost certain that whilst bubonic plague played a role in the Black Death, they also suggest that it was not the only form of plague stalking the population of medieval Europe.

Symptoms of Bubonic Plague

Bubonic plague is one of the plagues associated with the Black Death

Bubonic plague is one of the plagues associated with the Black Death

General Symptoms

The Black Death started with a feeling of general illness:

  • headache
  • lethargy
  • aching and
  • dizziness
  • vomiting
  • internal bleeding

Victims quickly deteriorated no doubt horrified by the quick advance of their worsening symptoms. Their horrified relatives would have tried the various cures available to them, but it was usually in vain. Few survived.

Death was usually swift, taking around a week.

Why Was it Called the "Black Death"?

Just as alarming as the buboes was the blackening of the skin. A form of gangrene could afflict the victim's extremities and it is perhaps this discolouration of the skin that gave the disease its name: Black Death.

This form of gangrene is known to be a sign of bubonic plague.

Buboes and the Plague

A commonly reported symptom of the Black Death, and perhaps the most infamous, was swelling of the lymph nodes. Victims would notice that a lump would appear in their groin, armpit or neck. These lumps were called buboes (from the Greek for "groin"), hence bubonic plague.

Sometimes the buboes were quite small, but could reach the size of an apple. Once one appeared, the victim would be afflicted by more, occasionally all over the body. The buboes might ooze pus; this could be a good sign, as it sometimes indicated that the victim might recover.

Pneumonic Plague Symptoms

Pneumonic plague was responsible for the respiratory symptoms of the Black Death and for making it spread from person to person

Pneumonic plague was responsible for the respiratory symptoms of the Black Death and for making it spread from person to person

More Symptoms of More Plagues

Other reported symptoms of the Black Death are not symptoms of the bubonic plague. Many victims were struck down with

  • chest pain,
  • breathing difficulties and
  • severe coughing.

These symptoms indicate that some people were suffering not from bubonic plague, but pneumonic plague. Pneumonic plague is just as deadly as bubonic plague and worse, it is highly infectious. Whilst bubonic plague can only be spread by a bite from an infected carrier, pneumonic plague could be spread by an infected person's cough.

Other symptoms included black rashes under the skin, the result of internal bleeding. It is possible that this was a third form of plague: septicaemic plague, the rarest but most deadly form. Bubonic, pneumonic and septicaemic plague are all caused by the same bacterium, Yersinia pestis. Many modern researchers are of the opinion that the Black Death was caused not just by bubonic plague, but a combination of all three plague forms, perhaps with other diseases playing a role too.

Three Forms of Plague

FormTransmissionMain SymptomsMortality Rate


via bite from infected flea











Swollen lymph nodes (Buboes)


via airborne bacteria




(ie from person to person due to coughing)




Coughing/chest pain



Coughing blood


via bite from infected flea


almost 100%


(sometimes person to person)




Internal bleeding




Do You Know Your Black Death Facts?

For each question, choose the best answer. The answer key is below.

Scroll to Continue
  1. "Buboe", meaning "groin" is derived from which language?
    • Latin
    • Greek
    • Hebrew
  2. Buboes could grow to the size of:
    • An egg
    • An apple
    • A melon
  3. Which is the deadliest form of plague?
    • Bubonic
    • Septicaemic
    • Pneumonic
  4. A burst buboe signalled:
    • Imminent death
    • The final phase of the disease
    • Possible recovery
  5. The name of the bacteria causing the Black Death is:
    • Variola major
    • Orthomyxoviridae
    • Yersinia pestis

Answer Key

  1. Greek
  2. An apple
  3. Septicaemic
  4. Possible recovery
  5. Yersinia pestis

Ancient and Modern Plagues

The Black Death was only one outbreak of plague in Europe. There were plagues before and after, some small scale, some larger. People can, and do, still get infected with the plague bacterium and it can still manifest itself in the three forms outlined above. The symptoms are exactly as described above. However, what distinguishes the Black Death from other outbreaks of the plague is that it appears that all three forms, plus perhaps some other diseases, attacked the population of Europe together, causing a cataclysmic epidemic. This is evidenced partly by the range of symptoms experienced by the victims.

If you are interested in finding out more about the Black Death, I have written a hub about its causes.


Judi Brown (author) from UK on July 15, 2014:

Not sure what is unlikely DT? Catching plague? You don't need to dig up a body, Yersina pestis still exists today, though victims can be treated with antibiotics and survive if treated quickly. Indeed a Colorado man has been diagnosed with Pneumonic plague this week. Edit - just realised you maybe answering the comment left by Jay above.

DT on July 15, 2014:

Very unlikely as the bacteria will be very weak so you would be unlikely to catch it unless you had an open wound and the bacteria got in, but you would be alright to dig one up. Give it a go!

Judi Brown (author) from UK on August 18, 2012:

Hi Jay - thanks for the warning!

jay on August 18, 2012:

if you dig up a plage pit can you still get infected cheers j

Judi Brown (author) from UK on June 16, 2012:

Hi Julie - it's an interesting time in history, I share your fascination - thanks so much for your comments!

Blurter of Indiscretions from Clinton CT on June 15, 2012:

I have this weird fascination with the Black Death..thanks for sharing this interesting hub!

Judi Brown (author) from UK on June 07, 2012:

I've never read a Karen Maitland novel - I've picked them up, but never taken them home. Can't imagine why not. I really do need to read a bit more, may be one of hers would be a good start - off to the library tomorrow. Excellent!

Thanks so much for commenting and giving me something to do tomorrow :-)

Bev G from Wales, UK on June 07, 2012:

Have read a couple of Karen Maitland novels which do a fine job of putting all this into context and how it affected people. The diagnoses and treatments seem unbelievably crude to us now but it must have been logical then.

Another great hub, Judi Bee.

Judi Brown (author) from UK on June 07, 2012:

Hi PenHitsTheFan - really scary stuff - one of the commentators (Shea Duane) on my Black Death Cures hub mentions that her friend actually caught the plague whilst in Alaska! Fortunately, she survived. Hard to imagine that it is still a problem after all these centuries.

Thanks for taking the time to comment, I appreciate it :-)

Amy L. Tarr from Home on June 07, 2012:

Thanks Judi for this hub. It's frightening to think this still exists today. My friend lives in Colorado and there are walking trails that are closed to people because they have found infected rodents. Scary stuff, for sure.

Judi Brown (author) from UK on June 06, 2012:

Hi hola 123 - excellent to hear that - hope you get a good grade :-)

hola 123 on June 06, 2012:

Really helpful for my homework x

Judi Brown (author) from UK on June 06, 2012:

Hi GoodLady - it's fascinatingly horrible, isn't it! I also used to live in London and used Aldgate Station on a regular basis, that's supposed to be built over a plague pit too - think Blackheath is meant to be from Black Death, but Aldgate was, I think, the Great Plague of 1665.

Thanks for your comments, always great to hear from you :-)

Penelope Hart from Rome, Italy on June 05, 2012:

Fascinating. Oh for the benefits of living today! Voting and thanks for super information. I realize I really don't know my history at all when I read your wonderful Hubs - and to think I once rented a flat overlooking Blackheath!

Judi Brown (author) from UK on June 05, 2012:

Hi GClark - there's a lot to be thankful for, isn't there!

Thanks for taking the time to comment, I appreciate it :-)

GClark from United States on June 05, 2012:

Interesting article that truly makes one appreciate the advances in present day medicine. Voted Up. GClark

Judi Brown (author) from UK on June 05, 2012:

Hi TheMagician - glad you enjoyed reading this. Yes, three different strains of the plague, all horrible. Hoping to do more on this subject, hope you will enjoy those too.

I appreciate you taking the time to comment, thanks very much :-)

Kay B from Tampa, FL on June 05, 2012:

Wow, I didn't know there were different types of the plague! Crazy stuff. Love learning about the Black Death and this time period, so I really enjoyed this article :)

Judi Brown (author) from UK on June 05, 2012:

Hi artofadulthood - it is scary and you have just reminded me that a researcher into plague died a few years ago, possibly from contracting it - will go and look that up!

Thanks for your comments, much appreciated :-)

artofadulthood on June 05, 2012:

Great information. Now I'm going to be nervous every time my lymph nodes swell up! Really is scary and probably possible that something like that could happen today - and probably spread faster. Like the movie Contagion. Thanks again for the well researched hub!

Judi Brown (author) from UK on June 05, 2012:

Hi Natashalh - sadly antibiotics are getting less effective with lots of diseases. I don't know about the US, but here in the UK it's now really difficult to get antibiotics from your doctor as they are trying to cut back on them - in the past they dished them out too readily and this has made apparently contributed to diseases becoming resistant.

Many thanks for your comments, much appreciated :-)

Judi Brown (author) from UK on June 05, 2012:

Hi twinstimes2 - yes, definitely one of those subjects that makes you worry next time you have a headache or a rash! Glad you found it informative though!

Thanks so much for your comments, I appreciate them :-)

Natasha from Hawaii on June 05, 2012:

Wow - very in-depth and definitely creepy! It kind of worries me that the pneumatic plague is getting more difficult to treat with antibiotics.

Karen Lackey from Ohio on June 05, 2012:

I agree with the other comments, Judi Bee, well researched. I will say that it gave me the heebie jeebies but i learned quite a bit! Very informative!

Judi Brown (author) from UK on June 05, 2012:

Hi joanveronica - I don't know about the Duke of Lancaster, but I do know that Edward III's daughter Joan was one of the first English victims, dying of plague in France en route to meet her fiancé, a prince of Castille. The plague reached England soon after.

Thanks very much for your comments, great to hear from you :-)

Judi Brown (author) from UK on June 05, 2012:

Hi Yourglobalgirl - glad you found this interesting and thank you for commenting, I appreciate it :-)

Joan Veronica Robertson from Concepcion, Chile on June 05, 2012:

Hi, I found this Hub so interesting, mainly because throughout my multiple readings of historical novels, I have often come across description of characters in the novel who are afflicted and die. If my memory is correct, the famous Duke of Lancaster (the King-maker)who married Blanche of Castille somewhere along the way, had a wife who was a victim. I don't remember which one, or whether she died, but the description was harrowing!

I also remember a novel by Daphne du Maurier, that included the plague somewhere in it. The name was something about "sands". Very good story, I read it several times, and then lost track of the book. Voted up, awesome and interesting!

Yourglobalgirl from UK on June 05, 2012:

Very interesting- thanks

Judi Brown (author) from UK on June 05, 2012:

Hi Deb - it is a gross subject, but curiously fascinating. I can only imagine that you hoped the end would be quick, it all sounds so dreadful. I wasn't aware that it was still around, but luckily antibiotics make it reasonably treatable.

Thanks for commenting, always appreciate your visits :-)

Deborah Neyens from Iowa on June 05, 2012:

Very well researched hub, Judi Bee, even though the subject matter gives me the creeps. Can you imagine the horror people must have felt when the symptoms started to appear?

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