The pandemic that struck Europe in 1347 was probably the most serious outbreak of a lethal infectious disease in history in terms of the percentage of the population that died and the speed with which it spread. This outburst involved the whole of continental Europe, the Channel Islands, the British Isles, Iceland and Greenland (Shrewsbury, 1970; Kohn, 1995).

This pandemic was called the Great Mortality or the Great Pestilence by contemporary writers. It was named the Black Death in English historical writings in 1823 and was introduced into medical literature as such in 1833 because of the black blotches, caused by subcutaneous haemorrhages, that appeared on the skin of the diseased humans near the time of death (Kohn, 1995). Shrewsbury (1970) stated that the latter name was inappropriate because, although the cadaver of a victim of the plague may exhibit a purplish discoloration, the corpse did not turn black. However, since the pseudonym ‘The Black Death’ is so firmly entrenched in historical writing we shall continue to use it.

Although contemporaneous written records are scattered and scarce, the Black Death has been discussed exhaustively (see Creighton, 1894; Nohl, 1926; Hirshleifer, 1966; Deaux, 1969; Ziegler, 1969; Shrewsbury, 1970; Gottfried, 1983; Twigg, 1984; Carmichael, 1986, 1997; Horrox, 1994; Kohn, 1995; Ormrod & Lindley, 1996), covering, in particular its origins, the pattern of spread, the number of deaths from the disease and the role of the rat as a carrier.