Input: How many times did the plague occur in the city where Flora's painter died?

Context:
Passage 1:
The Martyrdom of Saint Lawrence (Titian)
The Martyrdom of Saint Lawrence is a 1558 painting by Titian, now in the church of I Gesuiti in Venice. It so impressed Philip II of Spain that he commissioned a second version in 1567 for the basilica at El Escorial.

See also
List of works by Titian
Passage 2:
Black Death
The Black Death (also known as the Pestilence, the Great Mortality or the Plague) was a bubonic plague pandemic occurring in Western Eurasia and North Africa from 1346 to 1353. It is the most fatal pandemic recorded in human history, causing the deaths of 75–200 million people, peaking in Europe from 1347 to 1351. Bubonic plague is caused by the bacterium Yersinia pestis spread by fleas, but during the Black Death it probably also took a secondary form, spread by person-to-person contact via aerosols, causing pneumonic plague.The Black Death was the beginning of the second plague pandemic. The plague created religious, social and economic upheavals, with profound effects on the course of European history.
The origin of the Black Death is disputed. Genetic analysis points to the evolution of Yersinia pestis in the Tian Shan mountains on the border between Kyrgyzstan and China 2,600 years ago. The immediate territorial origins of the Black Death and its outbreak remains unclear with some pointing towards Central Asia, China, the Middle East and Europe. The pandemic was reportedly first introduced to Europe during the siege of the Genoese trading port of Kaffa in Crimea by the Golden Horde army of Jani Beg in 1347. From Crimea, it was most likely carried by fleas living on the black rats that travelled on Genoese ships, spreading through the Mediterranean Basin and reaching North Africa, Western Asia and the rest of Europe via Constantinople, Sicily and the Italian Peninsula. There is evidence that once it came ashore, the Black Death mainly spread person-to-person as pneumonic plague, thus explaining the quick inland spread of the epidemic, which was faster than would be expected if the primary vector was rat fleas causing bubonic plague. In 2022, it was discovered that there was a sudden surge of deaths in what is today Kyrgyzstan from the Black Death in the late 1330s; when combined with genetic evidence, this implies that the initial spread may not have been due to Mongol conquests in the 14th century, as previously speculated.The Black Death was the second great natural disaster to strike Europe during the Late Middle Ages (the first one being the Great Famine of 1315–1317) and is estimated to have killed 30 percent to 60 percent of the European population, as well as about one-third of the population of the Middle East. The plague might have reduced the world population from c. 475 million to 350–375 million in the 14th century. There were further outbreaks throughout the Late Middle Ages and, with other contributing factors (the Crisis of the Late Middle Ages), the European population did not regain its level in 1300 until 1500. Outbreaks of the plague recurred around the world until the early 19th century.

Names
European writers contemporary with the plague described the disease in Latin as pestis or pestilentia, 'pestilence'; epidemia, 'epidemic'; mortalitas, 'mortality'. In English prior to the 18th century, the event was called the "pestilence" or "great pestilence", "the plague" or the "great death". Subsequent to the pandemic "the furste moreyn" (first murrain) or "first pestilence" was applied, to distinguish the mid-14th century phenomenon from other infectious diseases and epidemics of plague.The 1347 pandemic plague was not referred to specifically as "black" in the time of occurrence in any European language, though the expression "black death" had occasionally been applied to fatal disease beforehand. "Black death" was not used to describe the plague pandemic in English until the 1750s; the term is first attested in 1755, where it translated Danish: den sorte død, lit. 'the black death'. This expression as a proper name for the pandemic had been popularized by Swedish and Danish chroniclers in the 15th and early 16th centuries, and in the 16th and 17th centuries was transferred to other languages as a calque: Icelandic: svarti dauði, German: der schwarze Tod, and French: la mort noire. Previously, most European languages had named the pandemic a variant or calque of the Latin: magna mortalitas, lit. 'Great Death'.The phrase 'black death' – describing Death as black – is very old. Homer used it in the Odyssey to describe the monstrous Scylla, with her mouths "full of black Death" (Ancient Greek: πλεῖοι μέλανος Θανάτοιο, romanized: pleîoi mélanos Thanátoio). Seneca the Younger may have been the first to describe an epidemic as 'black death', (Latin: mors atra) but only in reference to the acute lethality and dark prognosis of disease. The 12th–13th century French physician Gilles de Corbeil had already used atra mors to refer to a "pestilential fever" (febris pestilentialis) in his work On the Signs and Symptoms of Diseases (De signis et symptomatibus aegritudium). The phrase mors nigra, 'black death', was used in 1350 by Simon de Covino (or Couvin), a Belgian astronomer, in his poem "On the Judgement of the Sun at a Feast of Saturn" (De judicio Solis in convivio Saturni), which attributes the plague to an astrological conjunction of Jupiter and Saturn. His use of the phrase is not connected unambiguously with the plague pandemic of 1347 and appears to refer to the fatal outcome of disease.The historian Cardinal Francis Aidan Gasquet wrote about the Great Pestilence in 1893 and suggested that it had been "some form of the ordinary Eastern or bubonic plague". In 1908, Gasquet said use of the name atra mors for the 14th-century epidemic first appeared in a 1631 book on Danish history by J. I. Pontanus: "Commonly and from its effects, they called it the black death" (Vulgo & ab effectu atram mortem vocitabant).

Previous plague epidemics
Research from 2017 suggests plague first infected humans in Europe and Asia in the Late Neolithic-Early Bronze Age. Research in 2018 found evidence of Yersinia pestis in an ancient Swedish tomb, which may have been associated with the "Neolithic decline" around 3000 BCE, in which European populations fell significantly. This Y. pestis may have been different from more modern types, with bubonic plague transmissible by fleas first known from Bronze Age remains near Samara.The symptoms of bubonic plague are first attested in a fragment of Rufus of Ephesus preserved by Oribasius; these ancient medical authorities suggest bubonic plague had appeared in the Roman Empire before the reign of Trajan, six centuries before arriving at Pelusium in the reign of Justinian I. In 2013, researchers confirmed earlier speculation that the cause of the Plague of Justinian (541–542 CE, with recurrences until 750) was Y. pestis. This is known as the first plague pandemic. In 610, the Chinese physician Chao Yuanfang described a "malignant bubo" "coming in abruptly with high fever together with the appearance of a bundle of nodes beneath the tissue." The Chinese physician Sun Simo who died in 652 also mentioned a "malignant bubo" and plague that was common in Lingnan (Guangzhou). Ole Jørgen Benedictow believes that this indicates it was an offshoot of the first plague pandemic which made its way eastward to Chinese territory by around 600.

14th-century plague
Causes
Early theory
The most authoritative contemporary account is found in a report from the medical faculty in Paris to Philip VI of France. It blamed the heavens, in the form of a conjunction of three planets in 1345 that caused a "great pestilence in the air" (miasma theory). Muslim religious scholars taught that the pandemic was a "martyrdom and mercy" from God, assuring the believer's place in paradise. For non-believers, it was a punishment. Some Muslim doctors cautioned against trying to prevent or treat a disease sent by God. Others adopted preventive measures and treatments for plague used by Europeans. These Muslim doctors also depended on the writings of the ancient Greeks.

Predominant modern theory
Due to climate change in Asia, rodents began to flee the dried-out grasslands to more populated areas, spreading the disease. The plague disease, caused by the bacterium Yersinia pestis, is enzootic (commonly present) in populations of fleas carried by ground rodents, including marmots, in various areas, including Central Asia, Kurdistan, Western Asia, North India, Uganda and the western United States.Y. pestis was discovered by Alexandre Yersin, a pupil of Louis Pasteur, during an epidemic of bubonic plague in Hong Kong in 1894; Yersin also proved this bacillus was present in rodents and suggested the rat was the main vehicle of transmission. The mechanism by which Y. pestis is usually transmitted was established in 1898 by Paul-Louis Simond and was found to involve the bites of fleas whose midguts had become obstructed by replicating Y. pestis several days after feeding on an infected host. This blockage starves the fleas and drives them to aggressive feeding behaviour and attempts to clear the blockage by regurgitation, resulting in thousands of plague bacteria being flushed into the feeding site, infecting the host. The bubonic plague mechanism was also dependent on two populations of rodents: one resistant to the disease, which act as hosts, keeping the disease endemic, and a second that lacks resistance. When the second population dies, the fleas move on to other hosts, including people, thus creating a human epidemic.

DNA evidence
Definitive confirmation of the role of Y. pestis arrived in 2010 with a publication in PLOS Pathogens by Haensch et al. They assessed the presence of DNA/RNA with polymerase chain reaction (PCR) techniques for Y. pestis from the tooth sockets in human skeletons from mass graves in northern, central and southern Europe that were associated archaeologically with the Black Death and subsequent resurgences. The authors concluded that this new research, together with prior analyses from the south of France and Germany, "ends the debate about the cause of the Black Death, and unambiguously demonstrates that Y. pestis was the causative agent of the epidemic plague that devastated Europe during the Middle Ages". In 2011, these results were further confirmed with genetic evidence derived from Black Death victims in the East Smithfield burial site in England. Schuenemann et al. concluded in 2011 "that the Black Death in medieval Europe was caused by a variant of Y. pestis that may no longer exist".Later in 2011, Bos et al. reported in Nature the first draft genome of Y. pestis from plague victims from the same East Smithfield cemetery and indicated that the strain that caused the Black Death is ancestral to most modern strains of Y. pestis.Since this time, further genomic papers have further confirmed the phylogenetic placement of the Y. pestis strain responsible for the Black Death as both the ancestor of later plague epidemics including the third plague pandemic and as the descendant of the strain responsible for the Plague of Justinian. In addition, plague genomes from significantly earlier in prehistory have been recovered.DNA taken from 25 skeletons from 14th century London have shown plague is a strain of Y. pestis almost identical to that which hit Madagascar in 2013. Further DNA evidence also proves the role of Y. Pestis and traces the source to the Tian Shan Mountains in Kyrgyzstan.

Alternative explanations
It is recognised that an epidemiological account of plague is as important as an identification of symptoms, but researchers are hampered by the lack of reliable statistics from this period. Most work has been done on the spread of the disease in England, and even estimates of overall population at the start vary by over 100% as no census was undertaken in England between the time of publication of the Domesday Book of 1086 and the poll tax of the year 1377. Estimates of plague victims are usually extrapolated from figures for the clergy.
Mathematical modelling is used to match the spreading patterns and the means of transmission. A research in 2018 challenged the popular hypothesis that "infected rats died, their flea parasites could have jumped from the recently dead rat hosts to humans". It suggested an alternative model in which "the disease was spread from human fleas and body lice to other people". The second model claims to better fit the trends of death toll because the rat-flea-human hypothesis would have produced a delayed but very high spike in deaths, which contradict historical death data.Lars Walløe complains that all of these authors "take it for granted that Simond's infection model, black rat → rat flea → human, which was developed to explain the spread of plague in India, is the only way an epidemic of Yersinia pestis infection could spread", whilst pointing to several other possibilities. Similarly, Monica Green has argued that greater attention is needed to the range of (especially non-commensal) animals that might be involved in the transmission of plague.Archaeologist Barney Sloane has argued that there is insufficient evidence of the extinction of numerous rats in the archaeological record of the medieval waterfront in London and that the disease spread too quickly to support the thesis that Y. pestis was spread from fleas on rats; he argues that transmission must have been person to person. This theory is supported by research in 2018 which suggested transmission was more likely by body lice and fleas during the second plague pandemic.

Summary
Although academic debate continues, no single alternative solution has achieved widespread acceptance. Many scholars arguing for Y. pestis as the major agent of the pandemic suggest that its extent and symptoms can be explained by a combination of bubonic plague with other diseases, including typhus, smallpox and respiratory infections. In addition to the bubonic infection, others point to additional septicaemic (a type of "blood poisoning") and pneumonic (an airborne plague that attacks the lungs before the rest of the body) forms of plague, which lengthen the duration of outbreaks throughout the seasons and help account for its high mortality rate and additional recorded symptoms. In 2014, Public Health England announced the results of an examination of 25 bodies exhumed in the Clerkenwell area of London, as well as of wills registered in London during the period, which supported the pneumonic hypothesis. Currently, while osteoarcheologists have conclusively verified the presence of Y. pestis bacteria in burial sites across northern Europe through examination of bones and dental pulp, no other epidemic pathogen has been discovered to bolster the alternative explanations.

Transmission
Lack of hygiene
The importance of hygiene was recognised only in the nineteenth century with the development of the germ theory of disease; until then streets were commonly filthy, with live animals of all sorts around and human parasites abounding, facilitating the spread of transmissible disease.By the early fourteenth century so much filth had collected inside urban Europe that French and Italian cities were naming streets after human waste. In medieval Paris, several street names were inspired by merde, the French word for "shit". There were rue Merdeux, rue Merdelet, rue Merdusson, rue des Merdons and rue Merdiere—as well as a rue du Pipi.Pigs, cattle, chickens, geese, goats and horses roamed the streets of medieval London and Paris. Medieval homeowners were supposed to police their housefronts, including removing animal dung, but most urbanites were as careless as William E. Cosner, a resident of the London suburb of Farringdon Without. A complaint lodged against Cosner charges that "men could not pass [by his house] for the stink [of] . . . horse dung and horse piss."One irate Londoner complained that the runoff from the local slaughterhouse had made his garden "stinking and putrid", while another charged that the blood from slain animals flooded nearby streets and lanes, "making a foul corruption and abominable sight to all dwelling near." In much of medieval Europe, sanitation legislation consisted of an ordinance requiring homeowners to shout, "Look out below!" three times before dumping a full chamber pot into the street.Early Christians, who thought self-abnegation a cardinal virtue, considered bathing, if not a vice, then a temptation. "Who knows what impure thoughts might arise in a tub of warm water? With this danger in mind, St. Benedict declared, "To those who are well, and especially to the young, bathing shall seldom be permitted." St. Agnes took the injunction to heart and died without ever bathing.

Territorial origins
According to a team of medical geneticists led by Mark Achtman that analysed the genetic variation of the bacterium Yersinia pestis "evolved in or near China" over 2,600 years ago. Later research by a team led by Galina Eroshenko places the origins more specifically in the Tian Shan mountains on the border between Kyrgyzstan and China. However more recent research notes that the previous sampling had a very heavy East Asian bias and that sampling since then has discovered strains of Y. pestis in the Caucasus region that were previously thought to be restricted to China. There is also no physical or specific textual evidence of the Black Death in 14th century China. As a result, China's place in the sequence of the plague's spread is still debated to this day. According to Charles Creighton, records of epidemics in 14th century China suggest nothing more than typhus and major Chinese outbreaks of epidemic disease post-date the European epidemic by several years. The earliest Chinese descriptions of the bubonic plague do not appear until the 1640s.Nestorian graves dating to 1338–1339 near Issyk-Kul in Kyrgyzstan have inscriptions referring to plague, which has led some historians and epidemiologists to think they mark the outbreak of the epidemic; this is supported by recent direct findings of Y. pestis DNA in teeth samples from graves in the area with inscriptions referring to "pestilence" as the cause of death. Epidemics killed an estimated 25 million across Asia during the fifteen years before the Black Death reached Constantinople in 1347.
The evidence does not suggest, at least at present, that these mortality crises were caused by plague. Although some scholars, including McNeill and Cao, see the 1333 outbreak as a prelude to the outbreaks in Europe from the late 1340s to the early 1350s, scholars of the Yuan and Ming periods remain skeptical about such an interpretation. Nonetheless, the remarkably high mortality rates during the Datong mortality should discourage us from rejecting the possibility of localized/regional outbreaks of plague in different parts of China, albeit differing in scale from, and unrelated to, the pandemic mortality of the Black Death. What we lack is any indication of a plague pandemic that engulfed vast territories of the Yuan Empire and later moved into western Eurasia through Central Asia.
According to John Norris, evidence from Issyk-Kul indicates a small sporadic outbreak characteristic of transmission from rodents to humans with no wide-scale impact. According to Achtman, the dating of the plague suggests that it was not carried along the Silk Road, and its widespread appearance in that region probably postdates the European outbreak. There are no records of the symptoms of the Black Death from Mongol sources or writings from travelers east of the Black Sea prior to the Crimean outbreak in 1346. Finally, the Silk Road had already been heavily disrupted before the spread of the Black Death. Western and Middle Eastern traders found it difficult to trade on the Silk Road by 1325 and impossible by 1340, making spread of the plague less likely.Others still favor an origin in China or even Kurdistan, and not Central Asia. According to the theory of Chinese origin, the disease may have traveled along the Silk Road with Mongol armies and traders, or it could have arrived via ship, but this theory is still contested. It is speculated that rats aboard Zheng He's ships in the 15th century may have carried the plague to Southeast Asia, India and Africa.
Research on the Delhi Sultanate and the Yuan Dynasty shows no evidence of any serious epidemic in fourteenth-century India and no specific evidence of plague in fourteenth-century China, suggesting that the Black Death may not have reached these regions. Ole Benedictow argues that since the first clear reports of the Black Death come from Kaffa, the Black Death most likely originated in the nearby plague focus on the northwestern shore of the Caspian Sea.
Demographic historians estimate that China's population fell by at least 15 percent, and perhaps as much as a third, between 1340 and 1370. This population loss coincided with the Black Death that ravaged Europe and much of the Islamic world in 1347–52. However, there is a conspicuous lack of evidence for pandemic disease on the scale of the Black Death in China at this time. War and famine – and the diseases that typically accompanied them – probably were the main causes of mortality in the final decades of Mongol rule.
Monica H. Green suggests that the reason why other parts of Eurasia outside the west do not contain the same evidence of the Black Plague is because there were actually four strains of Yersinia pestis that became predominant in different parts of the world. Mongol records of illness such as food poisoning may have been referring to the Black Plague. Another theory is that the Black Death originated near Europe and cycled through the Mediterranean, Northern Europe and Russia before making its way to China. Other historians such as John Norris and Ole Benedictaw believe the Black Death likely originated in Europe or the Middle East and never reached China.

European outbreak
Plague was reportedly first introduced to Europe via Genoese traders from their port city of Kaffa in the Crimea in 1347. During a protracted siege of the city, in 1345–1346 the Mongol Golden Horde army of Jani Beg, whose mainly Tatar troops were suffering from the disease, catapulted infected corpses over the city walls of Kaffa to infect the inhabitants, though it is more likely that infected rats travelled across the siege lines to spread the epidemic to the inhabitants. As the disease took hold, Genoese traders fled across the Black Sea to Constantinople, where the disease first arrived in Europe in summer 1347.The epidemic there killed the 13-year-old son of the Byzantine emperor, John VI Kantakouzenos, who wrote a description of the disease modelled on Thucydides's account of the 5th century BCE Plague of Athens, but noting the spread of the Black Death by ship between maritime cities. Nicephorus Gregoras also described in writing to Demetrios Kydones the rising death toll, the futility of medicine, and the panic of the citizens. The first outbreak in Constantinople lasted a year, but the disease recurred ten times before 1400.Carried by twelve Genoese galleys, plague arrived by ship in Sicily in October 1347; the disease spread rapidly all over the island. Galleys from Kaffa reached Genoa and Venice in January 1348, but it was the outbreak in Pisa a few weeks later that was the entry point to northern Italy. Towards the end of January, one of the galleys expelled from Italy arrived in Marseilles.From Italy, the disease spread northwest across Europe, striking France, Spain (the epidemic began to wreak havoc first on the Crown of Aragon in the spring of 1348), Portugal and England by June 1348, then spread east and north through Germany, Scotland and Scandinavia from 1348 to 1350. It was introduced into Norway in 1349 when a ship landed at Askøy, then spread to Bjørgvin (modern Bergen) and Iceland. Finally, it spread to northwestern Russia in 1351. Plague was somewhat more uncommon in parts of Europe with less developed trade with their neighbours, including the majority of the Basque Country, isolated parts of Belgium and the Netherlands, and isolated Alpine villages throughout the continent.According to some epidemiologists, periods of unfavourable weather decimated plague-infected rodent populations and forced their fleas onto alternative hosts, inducing plague outbreaks which often peaked in the hot summers of the Mediterranean, as well as during the cool autumn months of the southern Baltic region. Among many other culprits of plague contagiousness, malnutrition, even if distantly, also contributed to such an immense loss in European population, since it weakened immune systems.

Western Asian and North African outbreak
The disease struck various regions in the Middle East and North Africa during the pandemic, leading to serious depopulation and permanent change in both economic and social structures. As infected rodents infected new rodents, the disease spread across the region, entering also from southern Russia.
By autumn 1347, plague had reached Alexandria in Egypt, transmitted by sea from Constantinople; according to a contemporary witness, from a single merchant ship carrying slaves. By late summer 1348 it reached Cairo, capital of the Mamluk Sultanate, cultural centre of the Islamic world, and the largest city in the Mediterranean Basin; the Bahriyya child sultan an-Nasir Hasan fled and more than a third of the 600,000 residents died. The Nile was choked with corpses despite Cairo having a medieval hospital, the late 13th century bimaristan of the Qalawun complex. The historian al-Maqrizi described the abundant work for grave-diggers and practitioners of funeral rites, and plague recurred in Cairo more than fifty times over the following one and a half centuries.During 1347, the disease travelled eastward to Gaza by April; by July it had reached Damascus, and in October plague had broken out in Aleppo. That year, in the territory of modern Lebanon, Syria, Israel and Palestine, the cities of Ascalon, Acre, Jerusalem, Sidon and Homs were all infected. In 1348–1349, the disease reached Antioch. The city's residents fled to the north, but most of them ended up dying during the journey. Within two years, the plague had spread throughout the Islamic world, from Arabia across North Africa. The pandemic spread westwards from Alexandria along the African coast, while in April 1348 Tunis was infected by ship from Sicily. Tunis was then under attack by an army from Morocco; this army dispersed in 1348 and brought the contagion with them to Morocco, whose epidemic may also have been seeded from the Islamic city of Almería in al-Andalus.Mecca became infected in 1348 by pilgrims performing the Hajj. In 1351 or 1352, the Rasulid sultan of the Yemen, al-Mujahid Ali, was released from Mamluk captivity in Egypt and carried plague with him on his return home. During 1348, records show the city of Mosul suffered a massive epidemic, and the city of Baghdad experienced a second round of the disease.

Signs and symptoms
Bubonic plague
Symptoms of the disease include fever of 38–41 °C (100–106 °F), headaches, painful aching joints, nausea and vomiting, and a general feeling of malaise. Left untreated, of those that contract the bubonic plague, 80 percent die within eight days.Contemporary accounts of the pandemic are varied and often imprecise. The most commonly noted symptom was the appearance of buboes (or gavocciolos) in the groin, neck and armpits, which oozed pus and bled when opened. Boccaccio's description:

In men and women alike it first betrayed itself by the emergence of certain tumours in the groin or armpits, some of which grew as large as a common apple, others as an egg ... From the two said parts of the body this deadly gavocciolo soon began to propagate and spread itself in all directions indifferently; after which the form of the malady began to change, black spots or livid making their appearance in many cases on the arm or the thigh or elsewhere, now few and large, now minute and numerous. As the gavocciolo had been and still was an infallible token of approaching death, such also were these spots on whomsoever they showed themselves.
This was followed by acute fever and vomiting of blood. Most people died two to seven days after initial infection. Freckle-like spots and rashes, which could have been caused by flea-bites, were identified as another potential sign of plague.

Pneumonic plague
Lodewijk Heyligen, whose master the Cardinal Colonna died of plague in 1348, noted a distinct form of the disease, pneumonic plague, that infected the lungs and led to respiratory problems. Symptoms include fever, cough and blood-tinged sputum. As the disease progresses, sputum becomes free-flowing and bright red. Pneumonic plague has a mortality rate of 90 to 95 percent.

Septicaemic plague
Septicaemic plague is the least common of the three forms, with a mortality rate near 100%. Symptoms are high fevers and purple skin patches (purpura due to disseminated intravascular coagulation). In cases of pneumonic and particularly septicaemic plague, the progress of the disease is so rapid that there would often be no time for the development of the enlarged lymph nodes that were noted as buboes.

Consequences
Deaths
There are no exact figures for the death toll; the rate varied widely by locality. In urban centres, the greater the population before the outbreak, the longer the duration of the period of abnormal mortality. It killed some 75 to 200 million people in Eurasia. A study published in 2022 of pollen samples across Europe between 1250 and 1450 was used to estimate changes in agricultural output before and after the Black Death. The authors found great variability in different regions, with evidence for high mortality in areas of Scandinavia, France, western Germany, Greece and central Italy, but uninterrupted agricultural growth in central and eastern Europe, Iberia and Ireland.The mortality rate of the Black Death in the 14th century was far greater than the worst 20th-century outbreaks of Y. pestis plague, which occurred in India and killed as much as 3% of the population of certain cities. The overwhelming number of deceased bodies produced by the Black Death caused the necessity of mass burial sites in Europe, sometimes including up to several hundred or several thousand skeletons. The mass burial sites that have been excavated have allowed archaeologists to continue interpreting and defining the biological, sociological, historical and anthropological implications of the Black Death.According to medieval historian Philip Daileader, it is likely that over four years, 45–50% of the European population died of plague. Norwegian historian Ole Benedictow suggests it could have been as much as 60% of the European population. In 1348, the disease spread so rapidly that before any physicians or government authorities had time to reflect upon its origins, about a third of the European population had already perished. In crowded cities, it was not uncommon for as much as 50% of the population to die. Half of Paris' population of 100,000 people died. In Italy, the population of Florence was reduced from between 110,000 and 120,000 inhabitants in 1338 down to 50,000 in 1351. At least 60% of the population of Hamburg and Bremen perished, and a similar percentage of Londoners may have died from the disease as well, with a death toll of approximately 62,000 between 1346 and 1353. Florence's tax records suggest that 80% of the city's population died within four months in 1348. Before 1350, there were about 170,000 settlements in Germany, and this was reduced by nearly 40,000 by 1450. The disease bypassed some areas, with the most isolated areas being less vulnerable to contagion. Plague did not appear in Douai in Flanders until the turn of the 15th century, and the impact was less severe on the populations of Hainaut, Finland, northern Germany and areas of Poland. Monks, nuns and priests were especially hard-hit since they cared for people with the Black Death.

The physician to the Avignon Papacy, Raimundo Chalmel de Vinario (Latin: Magister Raimundus, lit. 'Master Raymond'), observed the decreasing mortality rate of successive outbreaks of plague in 1347–48, 1362, 1371 and 1382 in his 1382 treatise On Epidemics (De epidemica). In the first outbreak, two thirds of the population contracted the illness and most patients died; in the next, half the population became ill but only some died; by the third, a tenth were affected and many survived; while by the fourth occurrence, only one in twenty people were sickened and most of them survived. By the 1380s in Europe, it predominantly affected children. Chalmel de Vinario recognised that bloodletting was ineffective (though he continued to prescribe bleeding for members of the Roman Curia, whom he disliked), and said that all true cases of plague were caused by astrological factors and were incurable; he himself was never able to effect a cure.The most widely accepted estimate for the Middle East, including Iraq, Iran and Syria, during this time, is for a death toll of about a third of the population. The Black Death killed about 40% of Egypt's population. In Cairo, with a population numbering as many as 600,000, and possibly the largest city west of China, between one third and 40% of the inhabitants died within eight months.Italian chronicler Agnolo di Tura recorded his experience from Siena, where plague arrived in May 1348:

Father abandoned child, wife husband, one brother another; for this illness seemed to strike through the breath and sight. And so they died. And none could be found to bury the dead for money or friendship. Members of a household brought their dead to a ditch as best they could, without priest, without divine offices ... great pits were dug and piled deep with the multitude of dead. And they died by the hundreds both day and night ... And as soon as those ditches were filled more were dug ... And I, Agnolo di Tura ... buried my five children with my own hands. And there were also those who were so sparsely covered with earth that the dogs dragged them forth and devoured many bodies throughout the city. There was no one who wept for any death, for all awaited death. And so many died that all believed it was the end of the world.

Economic
It has been suggested that the plague, like some others in history, disproportionately affected the poorest people, who were already in generally worse physical condition than the wealthier citizens.  Nevertheless, with such a large overall population decline from the pandemic, wages soared in response to a labour shortage. On the other hand, in the quarter century after the Black Death in England, it is clear many labourers, artisans and craftsmen, those living from money-wages alone, did suffer a reduction in real incomes owing to rampant inflation. Landowners were also pushed to substitute monetary rents for labour services in an effort to keep tenants.

Environmental
A study performed by Thomas Van Hoof of the Utrecht University suggests that the innumerable deaths brought on by the pandemic cooled the climate by freeing up land and triggering reforestation. This may have led to the Little Ice Age.

Persecutions
Renewed religious fervour and fanaticism bloomed in the wake of the Black Death. Some Europeans targeted "various groups such as Jews, friars, foreigners, beggars, pilgrims", lepers and Romani, blaming them for the crisis. Lepers, and others with skin diseases such as acne or psoriasis, were killed throughout Europe.
Because 14th-century healers and governments were at a loss to explain or stop the disease, Europeans turned to astrological forces, earthquakes and the poisoning of wells by Jews as possible reasons for outbreaks. Many believed the epidemic was a punishment by God for their sins, and could be relieved by winning God's forgiveness.There were many attacks against Jewish communities. In the Strasbourg massacre of February 1349, about 2,000 Jews were murdered. In August 1349, the Jewish communities in Mainz and Cologne were annihilated. By 1351, 60 major and 150 smaller Jewish communities had been destroyed. During this period many Jews relocated to Poland, where they received a warm welcome from King Casimir the Great.

Social
One theory that has been advanced is that the devastation in Florence caused by the Black Death, which hit Europe between 1348 and 1350, resulted in a shift in the world view of people in 14th-century Italy and led to the Renaissance. Italy was particularly badly hit by the pandemic, and it has been speculated that the resulting familiarity with death caused thinkers to dwell more on their lives on Earth, rather than on spirituality and the afterlife. It has also been argued that the Black Death prompted a new wave of piety, manifested in the sponsorship of religious works of art.This does not fully explain why the Renaissance occurred in Italy in the 14th century. The Black Death was a pandemic that affected all of Europe in the ways described, not only Italy. The Renaissance's emergence in Italy was most likely the result of the complex interaction of the above factors, in combination with an influx of Greek scholars following the fall of the Byzantine Empire. As a result of the drastic reduction in the populace the value of the working class increased, and commoners came to enjoy more freedom. To answer the increased need for labour, workers travelled in search of the most favorable position economically.Prior to the emergence of the Black Death, the workings of Europe were run by the Catholic Church and the continent was considered a feudalistic society, composed of fiefs and city-states. The pandemic completely restructured both religion and political forces; survivors began to turn to other forms of spirituality and the power dynamics of the fiefs and city-states crumbled.Cairo's population, partly owing to the numerous plague epidemics, was in the early 18th century half of what it was in 1347. The populations of some Italian cities, notably Florence, did not regain their pre-14th century size until the 19th century. The demographic decline due to the pandemic had economic consequences: the prices of food dropped and land values declined by 30–40% in most parts of Europe between 1350 and 1400. Landholders faced a great loss, but for ordinary men and women it was a windfall. The survivors of the pandemic found not only that the prices of food were lower but also that lands were more abundant, and many of them inherited property from their dead relatives, and this probably destabilised feudalism.The word "quarantine" has its roots in this period, though the concept of isolating people to prevent the spread of disease is older. In the city-state of Ragusa (modern Dubrovnik, Croatia), a thirty-day isolation period was implemented in 1377 for new arrivals to the city from plague-affected areas. The isolation period was later extended to forty days, and given the name "quarantino" from the Italian word for "forty".

Recurrences
Second plague pandemic
The plague repeatedly returned to haunt Europe and the Mediterranean throughout the 14th to 17th centuries. According to Jean-Noël Biraben, the plague was present somewhere in Europe in every year between 1346 and 1671. (Note that some researchers have cautions about the uncritical use of Biraben's data.) The second pandemic was particularly widespread in the following years: 1360–63; 1374; 1400; 1438–39; 1456–57; 1464–66; 1481–85; 1500–03; 1518–31; 1544–48; 1563–66; 1573–88; 1596–99; 1602–11; 1623–40; 1644–54; and 1664–67. Subsequent outbreaks, though severe, marked the retreat from most of Europe (18th century) and northern Africa (19th century). The historian George Sussman argued that the plague had not occurred in East Africa until the 1900s. However, other sources suggest that the Second pandemic did indeed reach Sub-Saharan Africa.According to historian Geoffrey Parker, "France alone lost almost a million people to the plague in the epidemic of 1628–31." In the first half of the 17th century, a plague killed some 1.7 million people in Italy. More than 1.25 million deaths resulted from the extreme incidence of plague in 17th-century Spain.The Black Death ravaged much of the Islamic world. Plague could be found in the Islamic world almost every year between 1500 and 1850. Sometimes the outbreaks affected small areas, while other outbreaks affected multiple regions. Plague repeatedly struck the cities of North Africa. Algiers lost 30,000–50,000 inhabitants to it in 1620–21, and again in 1654–57, 1665, 1691 and 1740–42. Cairo suffered more than fifty plague epidemics within 150 years from the plague's first appearance, with the final outbreak of the second pandemic there in the 1840s. Plague remained a major event in Ottoman society until the second quarter of the 19th century. Between 1701 and 1750, thirty-seven larger and smaller epidemics were recorded in Constantinople, and an additional thirty-one between 1751 and 1800. Baghdad has suffered severely from visitations of the plague, and sometimes two-thirds of its population had died.

Third plague pandemic
The third plague pandemic (1855–1859) started in China in the mid-19th century, spreading to all inhabited continents and killing 10 million people in India alone. The investigation of the pathogen that caused the 19th-century plague was begun by teams of scientists who visited Hong Kong in 1894, among whom was the French-Swiss bacteriologist Alexandre Yersin, after whom the pathogen was named.Twelve plague outbreaks in Australia between 1900 and 1925 resulted in well over 1,000 deaths, chiefly in Sydney. This led to the establishment of a Public Health Department there which undertook some leading-edge research on plague transmission from rat fleas to humans via the bacillus Yersinia pestis.The first North American plague epidemic was the San Francisco plague of 1900–1904, followed by another outbreak in 1907–1908.

Modern-day
Modern treatment methods include insecticides, the use of antibiotics, and a plague vaccine. It is feared that the plague bacterium could develop drug resistance and again become a major health threat. One case of a drug-resistant form of the bacterium was found in Madagascar in 1995. A further outbreak in Madagascar was reported in November 2014. In October 2017, the deadliest outbreak of the plague in modern times hit Madagascar, killing 170 people and infecting thousands.An estimate of the case fatality rate for the modern bubonic plague, following the introduction of antibiotics, is 11%, although it may be higher in underdeveloped regions.

See also
Black Death in England
Black Death in medieval culture
Crisis of the Late Middle Ages
Flagellant
Globalization and disease
List of epidemics
Second plague pandemic
Timeline of plague
Passage 3:
Black Death in England
The Black Death was a bubonic plague pandemic, which reached England in June 1348. It was the first and most severe manifestation of the second pandemic, caused by Yersinia pestis bacteria. The term Black Death was not used until the late 17th century.
Originating in Asia, it spread west along the trade routes across Europe and arrived on the British Isles from the English province of Gascony. The plague was spread by flea-infected rats, as well as individuals who had been infected on the continent. Rats were the reservoir hosts of the Y. pestis bacteria and the Oriental rat flea was the primary vector.
The first-known case in England was a seaman who arrived at Weymouth, Dorset, from Gascony in June 1348. By autumn, the plague had reached London, and by summer 1349 it covered the entire country, before dying down by December. Low estimates of mortality in the early twentieth century have been revised upwards due to re-examination of data and new information, and a figure of 40–60 percent of the population is widely accepted.
The most immediate consequence was a halt to the campaigns of the Hundred Years' War. In the long term, the decrease in population caused a shortage of labour, with subsequent rise in wages, resisted by the landowners, which caused deep resentment among the lower classes. The Peasants' Revolt of 1381 was largely a result of this resentment, and even though the rebellion was suppressed, in the long term serfdom was ended in England. The Black Death also affected artistic and cultural efforts, and may have helped advance the use of the vernacular.
In 1361–62 the plague returned to England, this time causing the death of around 20 per cent of the population. After this the plague continued to return intermittently throughout the 14th and 15th centuries, in local or national outbreaks. From this point on its effect became less severe, and one of the last outbreaks of the plague in England was the Great Plague of London in 1665–1666.

Background
England in the mid-14th century
It is impossible to establish with any certainty the exact number of inhabitants in England at the eve of the Black Death, and estimates range from 3 to 7 million. The number is probably in the higher end, and an estimate of around 6 million inhabitants seems likely. Earlier demographic crises—in particular the Great Famine of 1315–1317—had resulted in great numbers of deaths, but there is no evidence of any significant decrease in the population prior to 1348. England was still a predominantly rural and agrarian society; close to 90 per cent of the population lived in the countryside. Of the major cities, London was in a class of its own, with perhaps as many as 70,000 inhabitants. Further down the scale were Norwich, with around 12,000 people, and York with around 10,000. The main export, and the source of the nation's wealth, was wool. Until the middle of the century the export had consisted primarily of raw wool to cloth makers in Flanders. Gradually though, the technology for cloth making used on the Continent was appropriated by English manufacturers, who started an export of cloths around mid-century that would boom over the following decades.Politically, the kingdom was evolving into a major European power, through the youthful and energetic kingship of Edward III. In 1346, the English had won a decisive battle over the Scots at the Battle of Neville's Cross, and it seemed that Edward III would realise his grandfather Edward I's ambition of bringing the Scots under the suzerainty of the English crown. The English were also experiencing military success on the continent. Less than two months before the Battle of Neville's Cross, a numerically inferior English army led by the king himself won a spectacular victory over the French royal forces at the Battle of Crécy. The victory was immediately followed by Edward laying siege to the port city of Calais. When the city fell the next year, this provided the English with a strategically important enclave that would remain in their possession for over two centuries.

The Black Death
The term "Black Death"—which refers to the first and most serious outbreak of the second pandemic—was not used by contemporaries, who preferred such names as the "Great Pestilence" or the "Great Mortality". It was not until the 17th century that the term under which we know the outbreak today became common, probably derived from Scandinavian languages. It is generally agreed today that the disease in question was plague, caused by Yersinia pestis bacteria. These bacteria are carried by fleas, which can be transferred to humans through contact with rats. Flea bites carry the disease into the lymphatic system, through which it makes its way to the lymph nodes. Here the bacteria multiply and form swellings called buboes, from which the term bubonic plague is derived. After three or four days the bacteria enter the bloodstream, and infect organs such as the spleen and the lungs. The patient will then normally die after a few days. A different strain of the disease is pneumonic plague, where the bacteria become airborne and enter directly into the patient's lungs. This strain is far more virulent, as it spreads directly from person to person. These types of infection probably both played a significant part in the Black Death, while a third strain was more rare. This is the septicaemic plague, where the flea bite carries the bacteria directly into the blood stream, and death occurs very rapidly.A study reported in 2011 of skeletons exhumed from the Black Death cemetery in East Smithfield, London, found Yersinia pestis DNA. An archaeological dig in the vicinity of Thornton Abbey in Lincolnshire was reported in the science section of The Guardian for 30 November 2016, not only confirming evidence of the Y. pestis DNA in the human remains exhumed there but also dating the remains to mid-1349.
Genotyping showed that it was [at that time] a newly evolved strain, ancestor of all modern strains and proved the Black Death was bubonic plague. Modern medical knowledge suggests that because it was a new strain, the human immune system would have had little or no defence against it, helping to explain the plague's virulence and high death rates.The Black Death seems to have originated in Central Asia, where the Y. pestis bacterium is endemic in the rodent population. It is unknown exactly what caused the outbreak, but a series of natural occurrences likely brought humans into contact with the infected rodents. The epidemic reached Constantinople in the late spring of 1347, through Genoese merchants trading in the Black Sea. From here it reached Sicily in October that same year, and by early 1348 it had spread over the entire Italian mainland. It spread rapidly through France, and had reached as far north as Paris by June 1348. Moving simultaneously westward, it arrived in the English province of Gascony around the same time.

Progress of the plague
According to the chronicle of the grey friars at King's Lynn, the plague arrived by ship from Gascony to Melcombe in Dorset—today normally referred to as Weymouth—shortly before the Feast of St. John the Baptist on 24 June 1348. Other sources mention different points of arrival, including Bristol and Southampton. Though the plague might have arrived independently at Bristol at a later point, the Grey Friars' Chronicle is considered the most authoritative account. If it is assumed that the chronicle reports the first outbreak of the plague, rather than its actual arrival, then the arrival most likely happened around 8 May.From Weymouth the disease spread rapidly across the south-west. The first major city to be struck was Bristol. The disease reached London in the autumn of 1348, before most of the surrounding countryside. This had certainly happened by November, though according to some accounts as early as 29 September. Arrival in London happened by three principal roads: overland from Weymouth—through Salisbury and Winchester—overland from Gloucester, and along the coast by ship. The full effect of the plague was felt in the capital early the next year. Conditions in London were ideal for the plague: the streets were narrow and flowing with sewage, and houses were overcrowded and poorly ventilated. By March 1349 the disease was spreading haphazardly across all of southern England.During the first half of 1349 the Black Death spread northwards. A second front opened up when the plague arrived by ship at the Humber, after which it spread both south and north. In May it reached York, and during the summer months of June, July and August, it ravaged the north. Certain northern counties, like Durham and Cumberland, had been the victim of violent incursions from the Scots, and were therefore left particularly vulnerable to the devastations of the plague. Pestilence is less virulent during the winter months, and spreads less rapidly. The Black Death in England had survived the winter of 1348–49, but during the following winter it gave in, and by December 1349 conditions were returning to relative normality. It had taken the disease approximately 500 days to traverse the entire country.

Medical practice
Various methods were used including sweating, bloodletting, forced vomiting and urinating to treat patients infected with the plague. Several symptoms of the illness included blotches, hardening of the glands under the groin and underarms, and dementia. Within the initial phase of the disease, bloodletting was performed on the same side of where the physical manifestations of the buboes or risings appeared. For instance, if a rising appeared on the right side of the groin the physician would bleed a vein in the ankle on the same side. In the case of sweating, it was achieved with such medicines as Mithridate, Venice-Treacle, Matthiolus, Bezoar-Water, Serpentary Roots and Electuarium de Ovo. Sweating was used when measures were desperate; if a patient had tokens, a severe version of risings, the physician would wrap the naked patient in a blanket drenched in cold water. This measure was only performed while the patient still had natural heat in his system. The desired effect was to make the patient sweat violently and thus purge all corruption from the blood which was caused by the disease.Another practice was the use of pigeons when treating swellings. Swellings which were white in appearance and deep were unlikely to break and were anointed with Oil of Lillies or Camomil. Once the swelling rose to a head and was red in appearance and not deep in the flesh, it was broken with the use of a feather from a young pigeon's tail. The feather's fundament was held to the swelling and would draw out the venom. However, if the swelling dropped and became black in appearance, the physician had to be cautious when drawing the cold from the swelling. If it was too late to prevent, the physician would take the young pigeon, cut it open from breast to back, break it open and apply the pigeon (while still alive) over the cold swelling. The cupping therapy was an alternative method which was heated and then placed over the swellings. Once the sore was broken, the physician would apply Mellilot Plaister with Linimentum Arcei and heal the sore with digence.

Victims
Death toll
Although historical records for England were more extensive than those of any other European country, it is still extremely difficult to establish the death toll with any degree of certainty. Difficulties involve uncertainty about the size of the total population, as described above, but also issues regarding the proportion of the population that died from the plague. Contemporary accounts are often grossly inflated, stating numbers as high as 90 per cent. Modern historians give estimates of death rates ranging from around 25 per cent to more than 60 per cent of the total population.
The pioneering work in the field was made by Josiah William Russell in his 1948 British Medieval Population. Russell looked at inquisitions post mortem (IPMs)—taken by the crown to assess the wealth of the greatest landowners after their death—to assess the mortality caused by the Black Death, and from this arrived at an estimate of 23.6 per cent of the entire population. He also looked at episcopal registers for the death toll among the clergy, where the result was between 30 and 40 per cent. Russell believed the clergy was at particular risk of contagion, and eventually concluded with a low mortality level of only 20 per cent.Several of Russell's assumptions have been challenged, and the tendency since has been to adjust the assessment upwards. Philip Ziegler, in 1969, estimated the death rate to be at around one third of the population. Jeremy Goldberg, in 1996, believed a number closer to 45 per cent would be more realistic. A 2004 study by Ole Jørgen Benedictow suggests the exceptionally high mortality level of 62.5 per cent. Assuming a population of 6 million, this estimate would correspond to 3,750,000 deaths. Such a high percentage would place England above the average that Benedictow estimates for Western Europe as a whole, of 60 per cent. A death rate at such a high level has not been universally accepted in the historical community.In 2016, Carenza Lewis reported the results of a new method of assessing the death toll. She argued that pottery before and after the Black Death is datable because there was a change at that time from the high medieval to the late medieval style, and that counts of pottery of each type therefore provide a useful proxy for long term changes in population. She and her colleagues analysed pottery sherds from test pits in more than 50 continuously occupied rural settlements in eastern England, and found a decline in the number of pottery producing pits of 45 per cent. Norfolk had the greatest drop of 65 per cent, while there was no drop in 10 per cent of settlements, mostly commercial centres.

Impact of the Black Death: 1349
Archbishop Zouche of York issued a warning throughout the diocese in July 1348 (when the epidemic was raging further south) of "great mortalities, pestilences and infections of the air".
The Great Mortality, as it was then known, entered Yorkshire around February 1349 and quickly spread through the diocese. The clergy were on the front line of the disease, bringing comfort to the dying, hearing final confessions and organising burials. This, almost by necessity, put them at a greater risk of infection.
Estimates suggest that the death rate of clergy in some parts of the archdiocese could have been as high as 48 per cent. This is reflected in the Ordination Register, which shows a massive rise in ordained clergy over the period—some being recruited before the arrival of plague in a clerical recruitment drive, but many once plague had arrived, replacing those who had been killed. In 1346, 111 priests and 337 acolytes were recruited. In 1349, 299 priests and 683 acolytes are named, with 166 priests being ordained in one session alone in February 1350."

Social distribution
Russell had trusted the IPMs to give a true picture of the national average, because he assumed death rates to be relatively equal across the social spectrum. This assumption has been proven wrong, and studies of peasant plague mortality from manor rolls have returned much higher rates. This could be a consequence of the elite's ability to avoid infection by escaping plague-infected areas. It could also result from lower post-infection mortality among those more affluent, due to better access to care and nursing. If so, this would also mean that the mortality rates for the clergy—who were normally better off than the general population—were no higher than the average.

The manorial records offer a good opportunity to study the geographical distribution of the plague. Its effect seems to have been about the same all over England, though a place like East Anglia, which had frequent contact with the Continent, was severely affected. On a local level, however, there were great variations. A study of the Bishop of Worcester's estates reveal that, while his manors of Hartlebury and Hanbury had a mortality of only 19 per cent, the manor of Aston lost as much as 80 per cent of its population. The manor rolls are less useful for studying the demographic distribution of the mortality, since the rolls only record the heads of households, normally an adult male. Here the IPMs show us that the most vulnerable to the disease were infants and the elderly.There seem to have been relatively few deaths from the Black Death at higher levels of society. The only member of the royal family who can be said with any certainty to have died from the Black Death was in France at the time of her infection. Edward III's daughter Joan was residing in Bordeaux on her way to marry Pedro of Castile in the summer of 1348. When the plague broke out in her household she was moved to a small village nearby, but she could not avoid infection, and died there on 2 September. It is possible that the popular religious author Richard Rolle, who died on 30 September 1349, was another victim of the Black Death. The English philosopher William of Ockham has been mentioned as a plague victim. This, however, is an impossibility. Ockham was living in Munich at the time of his death, on 10 April 1347, two years before the Black Death reached that city.

Consequences
Economic, social and political effects
Among the most immediate consequences of the Black Death in England was a shortage of farm labour, and a corresponding rise in wages. The medieval world-view was unable to interpret these changes in terms of socio-economic development, and it became common to blame degrading morals instead. The landowning classes saw the rise in wage levels as a sign of social upheaval and insubordination, and reacted with coercion. In 1349, King Edward III passed the Ordinance of Labourers, fixing wages at pre-plague levels. The ordinance was reinforced by Parliament's passing of the Statute of Labourers in 1351. The labour laws were enforced with ruthless determination over the following decades.

These legislative measures proved largely inefficient at regulating the market, but the government's repressive measures to enforce them caused public resentment. These conditions were contributing factors to the Peasants' Revolt in 1381. The revolt started in Kent and Essex in late May, and once the rebels reached London they burnt down John of Gaunt's Savoy Palace, and killed both the Chancellor and the Treasurer. They then demanded the complete abolition of serfdom, and were not pacified until the young King Richard II personally intervened. The rebellion was eventually suppressed, but the social changes it promoted were already irreversible. By around 1400 serfdom was virtually extinct in England, replaced by the form of tenure called copyhold.It is conspicuous how well the English government handled the crisis of the mid-fourteenth century, without descending into chaos and total collapse in the manner of the Valois government of France. To a large extent this was the accomplishment of administrators such as Treasurer William de Shareshull and Chief Justice William Edington, whose highly competent leadership guided the governance of the nation through the crisis. The plague's greatest effect on the government was probably in the field of war, where no major campaigns were launched in France until 1355.Another notable consequence of the Black Death was the raising of the real wage of England (due to the shortage of labour as a result of the reduction in population), a trait shared across Western Europe, which in general led to a real wage in 1450 that was unmatched in most countries until the 19th or 20th century. The higher wages for workers combined with sinking prices on grain products led to a problematic economic situation for the gentry. As a result, they started to show an increased interest for offices like justice of the peace, sheriff and member of parliament. The gentry took advantage of their new positions and a more systematic corruption than before spread. A result of this was that the gentry as a group became highly disliked by commoners.

Religious and cultural consequences
The omnipresence of death also inspired greater piety in the upper classes, which can be seen in the fact that three Cambridge colleges were founded during or shortly after the Black Death. England did not experience the same trend of roving bands of flagellants, common on the continent. Neither were there any pogroms against the Jews, since the Jews had been expelled by Edward I in 1290.The high rate of mortality among the clergy naturally led to a shortage of priests in many parts of the country. The clergy were seen to have an elevated status among ordinary people and this was partly due to their purported closeness with God, being his envoys on earth. However, as the church itself had given the cause of the Black Death to be the impropriety of the behaviour of men, the higher death rate among the clergy led the people to lose faith in the Church as an institution—it had proved as ineffectual against the horror of Y. pestis as every other medieval institution. The corruption within the Catholic priesthood also angered the English people. Many priests abandoned the terrified people. Others sought benefits from the rich families who needed burials. The dissatisfaction led to anti-clericalism and the rise of John Wycliffe, an English priest. His ideas paved a path for the Christian reformation in England. Some people did not lose their Christian faith, if anything it was renewed; they began to long for a more personal relationship with God—around the time after the Black Death many chantries (private chapels) began to spread in use from not just the nobility, but to among the well-to-do. This change in the power of the papacy in England is demonstrated by the statutes of Praemunire.
The Black Death also affected arts and culture significantly. It was inevitable that a catastrophe of such proportions would affect some of the greater building projects, as the amount of available labour fell sharply. The building of the cathedrals of Ely and Exeter was temporarily halted in the years immediately following the first outbreak of the plague. The shortage of labour also helped advance the transition from the Decorated style of building to the less elaborate Perpendicular style. The Black Death may also have promoted the use of vernacular English, as the number of teachers proficient in French dwindled, contributing to the late-14th-century flowering of English literature, represented by writers such as Geoffrey Chaucer and John Gower.

Recurrences
The Black Death was the first occurrence of the second pandemic, which continued to strike England and the rest of Europe more or less regularly until the 18th century. The first serious recurrence in England came in the years 1361−62. Little is known about the death rates caused by these later outbreaks, but the so-called pestis secunda may have had a mortality of around 20 per cent. Genetic analysis performed on remains recovered from the abbey of St. Mary's Graces dating between 1353 and 1364 found the pPCP1 plasmid, a plasmid only found in Yersinia pestis and not the related environmental agent Yersinia pseudotuberculosis, revealing that this outbreak was also caused by Yersinia pestis just as the initial outbreak had been. This epidemic was also particularly devastating for the population's ability to recover, since it disproportionately affected infants and young men. This was also the case with the next occurrence, in 1369, where the death rate was around 10−15 per cent.Over the following decades the plague would return—on a national or a regional level—at intervals of five to 12 years, with gradually dwindling death tolls. Then, in the decades from 1430 to 1480, the disease returned in force. An outbreak in 1471 took as much as 10–15 per cent of the population, while the death rate of the plague of 1479–80 could have been as high as 20 per cent. From that point outbreaks became fewer and more manageable, due largely to conscious efforts by central and local governments—from the late 15th century onward—to curtail the disease. This included quarantines on people and goods coming from infected places, bans on public gatherings (such as fairs), enforced household quarantine for the infected (known as 'locking up') and quarantines on ships and crews coming from ports where Plague outbreaks had occurred. From the early seventeenth century there was also greater use of quarantine facilities, called pesthouses, in preference to household quarantine. Some of these, such as the Forlorn Hope Pesthouse established by Bristol in 1665–6, appear to have been proper quarantine hospitals, staffed by doctors. The establishment of such a hospital may help to explain why the death rate in Bristol in the 1665–66 outbreak was "only" c.0.6 percent. This was much lower than the mortality rate of 10–20 percent witnessed in Bristol's Plague epidemics of 1565, 1575, 1603–04 and 1645. The Great Plague of 1665–66 was the last major outbreak in England. It is best known for the famous Great Plague of London, which killed 100,000 people (20 per cent of the population) in the capital. Other places hit hard included Eyam in Derbyshire, Derby itself and Norwich.

See also
Passage 4:
2013 Houphouët-Boigny stampede
The 2013 Houphouët-Boigny stampede occurred as crowds departed a New Year's Eve fireworks display in the early hours of 1 January 2013 near the Félix Houphouët-Boigny Stadium in Abidjan, Ivory Coast. It resulted in 61 deaths and over 200 injuries, mostly women and children. This was the second time in four years that a fatal stampede occurred at the stadium.
President Alassane Ouattara declared three days of mourning and promised an investigation.

Incident
At some time between 1 and 4 am according to sources, following the New Year's Eve celebration and fireworks display, crowds stampeded as they exited the stadium into the Boulevard de la République near the Hotel Tirama. This was the second year that fireworks had been held by the government to commemorate the end of the 2010–2011 Ivorian crisis and the Second Ivorian Civil War, following the controversial 2010 presidential election. According to official reports, 61 individuals were killed, with upwards of 200 injured. According to Alain Lobognon, the Minister of Youth, 26 children were among the dead, most of whom were between the ages of 8 and 15, as well as 28 women and six men.

Investigation and reaction
The cause of the stampede is not yet clear, however a senior police spokesman has confirmed they are investigating. Lieutenant Colonel Issa Sako, the officer in charge of the military responding to the disaster, said that the deaths were caused when "people were walked over and suffocated by the crowd". According to an Ivorian government official, approximately "50,000 people [were] on the streets ... going home" after the New Year's celebrations. Witnesses have alternatively claimed that two large crowds moving in opposite directions collided, and that security forces attempting to break up the crowd leaving the stadium caused a panic.Visiting the injured in hospital, President Alassane Ouattara said that the national tragedy would be investigated. Minister of the Interior Hamed Bakayoko stated in a national television broadcast on Radiodiffusion Television Ivoirienne that "the government extends its condolences to the families of those deceased and assures them of its solidarity" and that the Ivorian government would help by "all means possible." Bakayoko went on to say that "the precise circumstances of this tragic occurrence are being looked into by the security services".
Passage 5:
2010 Elazığ earthquake
The 2010 Elazığ earthquake was a 6.1 Mw earthquake that occurred on 8 March 2010 at 02:32 UTC (04:32 local time). The epicentre was Başyurt in Elazığ Province, in eastern Turkey. Initial reports in global media said as many as 57 people had died. By 10 March, reports in the Turkish media placed the death toll at 41 and later, the death toll rose to 42. Another 74 were injured, many after falling and jumping from buildings. A stampede through the streets led to further injuries.The earthquake came one week to the day after the Turkish Chamber of Civil Engineers sent a report to parliament detailing inadequate building projects and the possibility that Istanbul would be destroyed by an earthquake, which could kill tens of thousands of people, at some point in the next three decades.

Earthquake
The quake occurred on the East Anatolian Fault, a major transform fault which represents  the boundary between the Anatolian Plate and the Arabian Plate.

Damage
According to officials, most of the deaths occurred in three villages: Okçular, Yukarı Kanatlı and Kayalı. At least five villages, though, suffered loss of life. Villagers fled buildings, spending the night outside and lighting fires in the streets for warmth.Thirty houses collapsed in Okçular, and the death toll is at least 17. Reports from the scene indicate "the village is totally flattened" and "everything has been knocked down – there is not a stone in place".At least 25 people died in Yukarı Demirci, and emergency services went to Kovancılar.Many people used vehicles and taxis to drive to the hospital. Most were asleep at the time the quake struck, with four sleeping sisters perishing in one house. Farm animals were also killed, and minarets fell down.

Aftershocks
Several aftershocks were felt, the strongest measuring 5.5 (at 09:47 local time), 5.1 (at 12:14) and 5.3 (at 13:12). A total of over 20 aftershocks were counted within a short time following the quake. Villagers were told to stay away from buildings for several days due to the potential of further aftershocks.Onur Tan et al. (2011) analyzed 2130 aftershocks (ML≥0.3) and reported in Geophysical Research Letters.

Response
Turkey: Four government ministers, including Deputy Prime Minister Cemil Çiçek, visited the scene as soon as news of the earthquake was reported. The Red Crescent and Turkey's disaster management centre donated blankets and tents. Prime Minister Recep Tayyip Erdoğan later arrived. Pakistan: Prime Minister Yousaf Raza Gillani sent a condolence message to his Turkish counterpart Recep Tayyip Erdoğan over the loss of lives and property and said that "We have learnt with utter sense of shock and profound sadness the news of the massive earthquake that has hit your beautiful country, today. Our hearts go out to our Turkish brethren over the loss of precious lives and destruction of property. I wish to convey, on behalf of the people and Government of Pakistan and on my own behalf our deepest condolences and commiserations to the people and Government of Turkey in bearing this enormous natural calamity." Israel: Defense Minister Ehud Barak ordered an aid proposal to be put together but later said that Turkey informed Israel that it did not require assistance at this time.

See also
2020 Elazığ earthquake
List of earthquakes in 2010
List of earthquakes in Turkey
Passage 6:
Flora (Titian)
Flora is an oil painting by Italian late Renaissance painter Titian, dated to around 1515 and now held at the Uffizi Gallery in Florence.

History
The work was reproduced in numerous 16th century etchings. Later, it followed an unclear series of changes of hands at Brussels and Vienna. In the 17th century, it was sold by the Spanish ambassador at Amsterdam to Archduke Leopold Wilhelm of Austria and was cited by Rembrandt in his Saskia Dressing as Flora  of London and in two portraits in Dresden and New York. Later included in the Kunsthistorisches Museum of Vienna, it was one of the works exchanged with the Uffizi.
In the 18th century, it was erroneously attributed to Palma the Elder.

Description
It portrays an idealized beautiful woman, a model established in the Venetian school by Titian's master Giorgione with his Laura. Her left hand holds a pink-shaded mantle, and her right holds a handful of flowers and leaves.
The woman was portrayed by Titian in numerous other works of the period, including the Woman at the Mirror, the Vanity, Salome and Violante, as well as some Holy Conversations. The meaning of the painting is disputed: some, basing for example to inscriptions added to the 16th century reproductions, identifies the woman as a courtesan; other consider it a symbol of nuptial love, although her dress is not a dressing one. The identification with Flora, the ancient goddess of Spring and vegetation, derives from the presence of Spring flowers in her hands.

See also
List of works by Titian

Notes

Answer: 22