The Plague of London

Summary: First off, a few numbers: in the early days of the plague, up to 1,000 people were dieing in London each week.  That crept up to 2,000, skyrocketing to an incredible 7,000 people per week in the worst times.  The symptoms were well known and highly visible- rosy rings, which eventually grew to pus-filled sacks in the armpits and groin (which were incredibly painful to the touch).  The breath becomes sour to the smell, and the victim  experiences seizures, headaches, muscle pain, and more.

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How did the plague come about?

1665 had experienced a very hot summer. London’s population had continued to grow and many lived in squalor and poverty. The only way people had to get rid of rubbish was to throw it out into the streets. This would include normal household waste as well as human waste. As a result, London was filthy. But this was a perfect breeding place for rats. A popular belief during the plague was that the disease was caused by dogs and cats. This was not so. The plague was caused by disease-carrying fleas carried on the bodies of rats. A pair of rats in the perfect environment could breed many off-spring. The filth found in the streets of London provided the perfect environment for rats.
Not surprisingly, the first victims of the plague were found in the poorer districts of the city. The cramped living conditions these people lived in, and the fact that so many actually lived in the slum areas of London, meant that many people could not avoid contact with either the rats or someone who had the disease.

http://www.historylearningsite.co.uk/plague_of_1665.htm
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Those who could, the wealthy, left London for the comparative safety of the countryside. No such option existed for those who lived in the slums. In fact, militiamen were paid by the city’s council to guard the parish boundaries of the area they lived in and to let no one out unless they had a certificate to leave from their local parish leader. Very few of these certificates were issued.
The poor were very badly hit by the plague. The authorities in London decided on drastic action to ensure that the plague did not spread.

In 1663 plague ravaged Holland. Charles II forbade any trade with the Dutch, partly out of wise concern, and partly because his realm was engaged in a fierce trade war with Holland which eventually erupted into armed conflict. Despite the precautions, the early spring of 1665 brought a sudden rise in the death rate in the poorer sections of London. The authorities ignored it. As spring turned into one of the hottest summers in memory, the number of deaths escalated and panic set in.
The rich flee. The nobility left the city for their estates in the country. They were followed by the merchants, and the lawyers. The Inns of Court were deserted. Most of the clergy suddenly decided they could best minister to their flocks from far, far away. The College of Surgeons fled to the country, which did not stop several of its members from writing learned papers about the disease they had been at such pains to avoid. The court moved to Hampton Court Palace.
The gates are closed. By June the roads were clogged with people desperate to escape London. The Lord Mayor responded by closing the gates to anyone who did not have a certificate of health. These certificates became a currency more valuable than gold, and a thriving market in forged certificates grew up.
Desperate Measures. By mid July over 1,000 deaths per week were reported in the city. It was rumored that dogs and cats spread the disease, so the Lord Mayor ordered all the dogs and cats destroyed. Author Daniel Defoe in his Journal of the Plague Years estimated that 40,000 dogs and 200,000 cats were killed. The real effect of this was that there were fewer natural enemies of the rats who carried the plague fleas, so the germs spread more rapidly.
Anyone in constant contact with plague victims, such as doctors, nurses, inspectors, were compelled to carry coloured staffs outdoors so that they could be easily seen and avoided. When one person in a house caught the plague the house was sealed until 40 days after the victim either recovered or died (usually the latter). Guards were posted at the door to see that no one got out. The guard had to be bribed to allow any food to passed to the inmates. It was not unknown for families to break through the walls of the house to escape, and in several cases they carefully lowered a noose over the guard’s head from an attic window and hung him so they could get away.

Plague symptoms:
This is best summed up in a popular nursery rhyme of the time:
“Ring-a-ring of roses,
A pocketful of posies,
Attischo, Attischo,
We all fall down.”
The first comment in the poem was a reference to red circular blotches that were found on the skin. These could also develop into large pus filled sacs found primarily under the armpits and in the groin. These buboes were very painful to the sufferer.
The second line refers to the belief that the plague was spread by a cloud of poisonous gas that was colourless (known as a miasma). This miasma could only be stopped, so it was believed, if you carried flowers with you as the smell of the flowers would overpower the germs carried by the miasma. There was also another ‘benefit’ to carrying sweet smelling flowers. A victim’s breath started to go off as the disease got worse. The flowers perfume would have covered up this unpleasantness.
The final symptom was a sneezing fit that was promptly followed by death. Some of the victims did not get as far as this stage presumably as their lives were so poor that their bodies were even less able to cope with the disease. For some, a swift death was merciful.  Once the disease took a hold it spread with frightening speed.

How did the plague affect different classes, groups, trades, religious denominations?

The play talks about  shipping being shut down: we know that trading with nations that had been already ravaged by the plague (such as Holland) was shut down.  Eventually,  the city was closed off, and special permits were necessary to leave.  This would have brought any sort of goods trade to a standstill.  Even before, however, tradesmen and shipping would have been greatly reduced, as few would see a trip to London as worth the risk.
The dock areas outside of London, and the parish of St. Giles-in-the Fields where poor workers crowded into ill-kept structures, were the first areas struck by the plague. As records were not kept on the deaths of the very poor, the first recorded case was a Rebecca Andrews, on 12 April 1665.
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Bubonic Plague
(from wikipedia)
Bubonic plague is the best known manifestation of the Plague, a zoonotic disease, circulating mainly among small rodents and their fleas[2], and is one of three types of infections caused by Yersinia pestis (formerly known as Pasteurella pestis), which belongs to the family Enterobacteriaceae.
The term bubonic plague is derived from the Greek word bubo, meaning “swollen gland”. Swollen lymph nodes (buboes) especially occur in the armpit and groin in persons suffering from bubonic plague. Bubonic plague was often used synonymously for plague, but it does in fact refer specifically to an infection that enters through the skin and travels through the lymphatics, as is often seen in flea-borne infections.
In humans, the bubonic plague kills about two out of three infected patients in 2–6 days without treatment. The latest research shows that the bubonic plague was the cause of the Black Death that swept through Europe in the 14th century and killed an estimated 75 million people, 30-60% of the European population.[3] Because the plague killed so many of the working population, wages rose and some historians have seen this as a turning point in European economic development.

The most famous symptom of bubonic plague is painful, swollen lymph glands, called buboes. These are commonly found in the armpits, groin or neck. Due to its bite-based form of infection, the bubonic plague is often the first step of a progressive series of illnesses. Two other types are pneumonic and septicemic. However, pneumonic plague, unlike the bubonic or septicemic, induced coughing, and was also very infectious and allowed person-to-person spread. Bubonic plague symptoms appear suddenly, usually 2–5 days after exposure to the bacteria. Symptoms include:

  • Chills
  • General ill feeling (malaise)
  • High fever (102 degrees fahrenheit / 39 degrees celsius)
  • Muscle pain
  • Severe headache
  • Seizures
  • Smooth, painful lymph gland swelling called a bubo, commonly found in the groin, but may occur in the armpits or neck, most often at the site of the initial infection (bite or scratch)
  • Pain may occur in the area before the swelling appears

Other symptoms include heavy breathing, continuous blood vomiting, urination of blood[citation needed], aching limbs, coughing, and extreme pain. The pain is usually caused by the decaying or decomposing of the skin while the person is still alive. Additional symptoms include extreme fatigue, gastrointestinal problems, lenticulae (black dots scattered throughout the body), delirium and coma.

Bubonic plague is an infection of the lymphatic system, usually resulting from the bite of an infected flea, Xenopsylla cheopis (the rat flea). The fleas are often found on rodents such as rats and mice, and seek out other prey when their rodent hosts die. The bacteria form aggregates in the gut of infected fleas and this results in the flea regurgitating ingested blood, which is now infected, into the bite site of a rodent or human host. Once established, bacteria rapidly spread to the lymph nodes and multiply. Y. pestis bacilli can resist phagocytosis and even reproduce inside phagocytes and kill them. As the disease progresses, the lymph nodes can haemorrhage and become swollen and necrotic. Bubonic plague can progress to lethal septicemic plague in some cases. The plague is also known to spread to the lungs and become the disease known as the pneumonic plague. This form of the disease is highly infectious as the bacteria can be transmitted in droplets emitted when coughing or sneezing, as well as physical contact with victims of the plague or flea-bearing rodents that carry the plague.

Treatment
In modern times, several classes of antibiotics are effective in treating bubonic plague. These include aminoglycosides such as streptomycin and gentamicin, tetracyclines (especially doxycycline), and the fluoroquinolone ciprofloxacin. Mortality associated with treated cases of bubonic plague is about 1-15%, compared to a mortality rate of 50-90% in untreated cases.

Bubonic plague is believed to have claimed nearly 200 million lives, although there is some debate as to whether all of the plagues attributed to it are in fact the same disease. The first recorded epidemic ravaged the Byzantine Empire during the sixth century, and was named the Plague of Justinian after emperor Justinian I, who was infected but survived through extensive treatment.[8][9]
It is generally held that the most infamous and devastating outbreak of bubonic plague was the Black Death, which killed a third of the population of Europe in the 14th century. In affected cities, proper burial rituals were abandoned and bodies were buried in mass graves, or abandoned in the street. The Black Death is thought to have originated in the Gobi Desert. Carried by the fleas on rats, it spread along trade routes and reached the Crimea in 1346. (It also spread eastward to the Yangtse river valley, and the resulting epidemic, ignored by the government, brought down the Yuan dynasty[citation needed].) In 1347 it spread to Constantinople and then Alexandria, killing thousands every day, and soon arrived in Western Europe.
Though bubonic plague is generally regarded as the probable pathogen responsible for the Black Death outbreak, there are significant differences between symptoms and spread of the Black Death and more recent bubonic plague outbreaks and several alternate theories of the Black Death have been proposed involving pathogens other than Y. pestis.
The next few centuries were marked by several local outbreaks of lesser severity. The Great Plague of Seville, 1649, the Great Plague of London, 1665–1666, the Great Plague of Vienna, 1679, and the Great Plague of Marseille, 1720, were the last major outbreaks of the bubonic plague in Europe.
A popular folk etymology holds that the children’s game of “Ring Around the Rosy” (or Ring a Ring o’ Roses) is derived from the appearance of the bubonic plague. Proponents claim that “Ring around the rosy” refers to the rosy-red, rash-like ring that appeared as a symptom of the plague. “Pocket full of posy” referred to carrying flower petals as at the time it was believed the disease was spread through the ether of unhygene, and scent stopped the spread. “Ashes, ashes” referred to the burning of infected corpses (in the UK the words of the rhyme are “atishoo, atishoo” mimicking sneezing), and “we all fall down” referred to the virulent deaths attributed to the plague.[10] Many folklorists however hold that the association of this rhyme with plague is baseless.[11][12]
In 1994 and 2010 there have been cases reported in Peru. In 2010 there was a case reported in Oregon, United States.

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