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London’s Plague Story

When I was a little kid, I remember covering the plague in school for the first time: The Black Death. It sounded dark and scary and disgusting, so obviously I was intrigued. I didn’t really care for details like when it happened, I just wanted to know what the disgusting symptoms were, how it was spread, how did people try and treat it. In primary school  I threw plastic rats at the boys telling them they were going to get the plague now. Yeah, I was a cool kid. Obviously. I mean, look what I grew into.

Embarrassingly, it wasn’t until I was an adult that I realised ‘THE PLAGUE’ wasn’t just one big event. Some sources suggest that between 1346 and 1671 the plague was always present somewhere in Europe. It’s severity fluctuated – sometimes it was more widespread than others, sometimes it was killing more people than others but it was always there, passing between people, a constant threat for over 300 years. 

The worst cases here in London were between 1348 and 1349 and that’s what we refer to as The Black Death, and in 1665 which we refer to at The Great Plague. 

Today I want to cover what exactly the plague was and why it was so dangerous and how it affected London in those 2 particular big outbreaks. 

What is the Plague?

Back in the 13th and 14th century, it’s safe to say, medicine wasn’t quite as advanced as it is today and people would use terms like ‘plague’ and ‘pestilence’ to describe any number of illnesses. 

Here in London, one of the first records of anyone dying from something actually called ‘plague’ was in 1259 but it wasn’t until the 1300s that the illness we now think of as ‘plague’ arrive in London. 

This disease was caused by a bacteria called ‘Yersinia pestis’ which is actually still around today. For those of you with an interest in biology, like me, it’s ‘a Gram-negative, nonmotile, rod-shaped, coccobacillus bacterium, with no spores.’ 

It infects us humans in 3 ways and causes 3 different illnesses: Bubonic Plague which is the most common and mostly affects the lymph nodes, Septicemic Plague affecting the blood which was probably the quickest to kill you and Pneumonic Plague which is probably the easiest to spread and affects the lungs. 

What I think is really interesting though, is that while we had a good idea that this bacteria is what caused the plague between the 1300 and 1600s, we didn’t know for sure until 2011. A plague pit from the 1300s *here?* at East Smithfield was excavated and is probably the most studied and one of the most important plague burial sites in the world. Scientists analysed dental pulp from the skeletons to identify the bacteria and attempted to sequence it’s DNA to understand how it has evolved over time.  

As a lot of you may know, particularly if you’re from Europe, this plague causing bacteria was mostly carried by fleas. These fleas often lived on rats and sometimes in fabric and, from here, came into contact with humans. 

Genotyping from the East Smithfield samples strongly suggests that a new strain of the Yersinia pestis bacteria evolved in the 1300s which neither rats of human immune systems knew how to fight. The theory goes that the rats started dying quickly and the fleas found new, human hosts which also began to die quickly. 

In the case of the Bubonic Plague, which was the most common,the flea would bite a person and the bacteria would enter the lymphatic system where it would quickly multiply and large black swellings, known as buboes, would form mostly in the armpits, groin and neck areas. Over the next few days, these buboes would grow, often to the size of an apple, they would get harder and cause the person incredible pain. Sometimes these would burst open, or a medic would attempt to cut them open to relieve some pressure and the smell from inside would be horrific. 

Of course, these wouldn’t be the first or only symptoms of the plague. Usually it would start with a few flu like symptoms: fever, shivering and chills, muscle cramps, headache, dizziness, fatigue, delirium and vomiting. Then the buboes would appear and everything would get worse from here: Extremities like the fingers, toes, lips and nose would turn black with gangrene, vomit may begin to contain blood, a patient may lose control of their bowels, they may have stuttering and faltering speech, seizures and slipping into a coma were even common. 

And all of this would happen within about a week or 10 days. 

Once infected, it had a 60-80% chance of killing you. 

Today we can treat the plague with a range of antibiotics including streptomycin, gentamicin, and doxycycline but obviously these weren’t available in the past.

Instead people attempted treatments like inducing extreme sweating, bloodletting, forced vomiting, peeing on the buboes and burning herbs but obviously, none of these worked. 

The only thing to really do was avoid getting the plague in the first place and that was easier said than done as people didn’t really know how it was spread. 

Between the 1348 and 1665 outbreaks, records suggest there were other smaller but still major outbreaks in London every 20-30 years – each one was thought to kill around 20% of London’s population. And if these were the smaller outbreaks then how bad were the Black Death and Great Plague? Well, pretty bad, as we’re about to find out. 

1348: The Black Death

Barney Sloane wrote in his 2011 book The Black Death in London that ‘The first onslaught of the Black Death in 1347–53 remains the greatest single catastrophe to have struck mankind in recorded history.’

The worst period in London was for about 9 months between November 1348 and July 1349. 

Records suggest that the plague was already spreading across Europe in 1347 and most likely reached the UK from ships from France. London, at the time, was described as ‘A conurbation comprising the walled city, extensive suburbs, Southwark across the Thames, and Westminster, its resident population probably numbered near 80,000’ (Sloane, 2011). It was also a hub for international trade with merchants traveling by road and sea all congregating in the capital, so it seems the plague could have arrived via the fleas on any number of ships… but interestingly London wasn’t the first UK city to be infected, that was Bristol which also had a trading port. 

Over the summer months, the plague spread across the south of England and it’s likely that Londoners knew it was their turn soon but couldn’t do anything about it, especially the poorest people. Can you imagine living with that kind of fear? Essentially just being stuck, waiting to die a painful death, knowing it’s getting closer to you every day. 

Londoners were also particularly at risk because the poor living conditions meant that once the plague arrived, it would spread easily and quickly through the city. 

London was overcrowded and the sanitation was terrible. People were living in filth, throwing their toilet waste out of their windows onto the streets, the Thames was a revolting, polluted mess (far worse than it is today), stray cats and dogs and rats and all kinds of animals wandered free, spreading diseases and parasites. It was the perfect place for the plague to thrive. 

There are records of the King at the time, Edward III saying ‘“[t]he air in the city is very much corrupted . . . and most filthy stinks.’

Interestingly, some of the first reported cases of the plague were actually in the royal family. 

In July 1348, Edward’s daughter, Joan, was sent on her way to Spain for her wedding when she began to show symptoms of the plague. She died before she ever reached Spain and her future husband. She was just 14 years old.

Next up was another of Edward’s children, this time 3 month old William of Windsor who died inside London itself and was buried in Westminster Abbey in September 1348. 

Since this all happened so long ago many records of deaths have been lost or were perhaps never recorded in the first place. There are some burial records but after a while they were burying so many people it became difficult. So historians have found another way to estimate when the plague was at it’s worst: by looking at when people were making or changing their wills. 

It soon became known that the plague was basically a death sentence so when people began to notice symptoms, they would often go and change their wills. Or, if a spouse or child had died from the plague, they’d also have to go and make amendments. In The Black Death in London, Sloane goes into a lot of detail about his, talks about the numbers of wills created, what they said and what this tells us. It’s incredibly interested and I thoroughly encourage you to read the book for yourself. 

Of course, a huge problem with this is that is only tells us about the middle and upper classes – the people with enough money to need to bother with a will in the first place. The poorest people were probably most at risk from the plague thanks to the conditions they lived in but sadly, we have few records of them, so as much as we can look at patterns and make estimates and read accounts from rich people watching them at the time, it’s incredibly difficult to know just how badly the poor were affected. 

It is, however, thought that the plague was at its worst in April 1349. It’s estimated that in the 9 month period around 50% of London’s population may have died. Of course these estimates differ greatly and it could be anywhere between 12,500 and 50,000 people but when you think that London had a population of around 80,000, that’s a hell of a lot.

London it seems didn’t do a huge amount in response to the plague in the 1300s, although it’s unclear why. Many cities around Europe set up plague hospitals and hospices. London did not. 

There were however religious zealots called Flagellants. These were more common in Europe but a few made their way into London. They believed the plague was caused by God punishing up. We’d all be disgusting dirty sinners and this was our punishment and so the only way to get it to stop was for these guys to physically punish themselves ‘in reparation for the sins of the world’.

It seems most of London’s focus, however, was on figuring out where they could bury the dead. Initially they were buried in the regular church yards but these soon began to fill up, there wasn’t enough space or workers to keep up with the number of bodies. 

Large patches of land were bought around London to be used as burial grounds – places where they could quickly bury large numbers of bodies, often without coffins or ceremony. Today you might have heard of these referred to as plague pits. No one quite knows how many plague pits are under London or where they all are but it’s safe to say there were pretty extensive. 

I actually read this interview with a guy who is an archeologist working for Crossrail and he said that ‘Just about every green space you find in the city was probably a form of a burial ground. A lot of those will still have human remai in ns below ground. But they’re not marked.’ 

That’s not to say they’re all plague pits specifically but when you think about it, London is kind of literally built on death. It kind of makes you stop and think and really reminds you that, when you’re enjoying an afternoon in the park or walking around the museums or doing a bit of shopping… you’re surrounded by history, even beneath you. It’s one of the things I love about London, all the stories it has to tell. 

There are some plague pits that we do know about though: One mass grave has been found in Spitalfields, we also know about a large plot of land purchased here (map) which Londoners began to call Nomanneslond. 

Similarly, another large plot of land was later purchased at East Smithfield which has today been excavated and studied in detail. One thing that’s interesting about this area is that it shows us that plague pits were surprisingly well organised. Despite what the name suggests, they were just large holes in the ground that people were thrown into. The East Smithfield plot, for example, was split into 2 main areas – the eastern and western plots and each area was organised into rows of graves. Some were individual graves but most contained around 5 bodies stacked one on top of the other. 

One thing accounts tell us from the time is that there were so many bodies that the smell that came from these mass graves and even regular churchyards was apparently so disgusting you could smell it from a distance and no one wanted to go near them. 

Before we move on to the 1600s I just want to talk a little about the consequences of the Black Death in London because losing that many people in such a short space of time had a HUGE effect on life for everyone. 

The plague didn’t discriminate in who it killed – man or woman, child, eldery or a strong, previously healthy adult. This means a huge percentage of the working population was suddenly lost. As businesses shut and skilled labourers became hard to find they started charging more and more. People were refusing to put themselves at risk and leave the house to work unless they were paid an absurd amount. This had a huge impact on the economy and it resulted in King Edward III passing the Ordinance of Labourers in June 1349. 

This included a whole bunch of different rules including the following: 

  • All those below 60 years, fit, having neither trade, professional craft or private lands and means, and currently unemployed, must take up employment if it is offered, but for wages at the levels they were in 1346
  • Any proven to have refused such work should be jailed until they recant.
  • Butchers, fishmongers, innkeepers, brewers, bakers, poulterers, and all other dealers in foodstuffs, are bound to sell produce at a reasonable price. Those charging higher will pay twice the sum charged in recompense, if proven
  • Beggars who are able to work should not receive alms, with contravention punishable by prison, so that they will be forced to work for a living.

Ultimately though, it didn’t really help that much, what it did do is cause a hell of a lot of resentment among the working and lower classes which was made even worse when the Statute of Labourers was passed in 1351. Eventually this was a huge contributing factor leading to the Peasants Revolt in 1381. 

1665: The Great Plague

As I mentioned before between the mid-1300s and mid-1600s records show there was constant plague somewhere in Europe. The last big outbreak was in 1665 and this outbreak has become known as The Great Plague. 

By this time people were referring to this illness by a large number of names: plague, pestilence, infection, distemper, contagion, visitation, and just The Sickness. It definitely had a reputation. 

The Great Plague arrived in London in Spring of 1665 and over the next year killed over 100,000 people in the capital – that was nearly 20% of the population at the time. 

Some of the first cases were in a little parish just outside the city walls called St Giles-in-the-Fields which was a poor, overcrowded area with terrible sanitation. It began spreading to other parishes and, before it could infect them, the richest people, including most of the doctors, fled the city. Even King Charles II and his family left to live in Oxford for a while. 

Charles did leave behind instructions and orders for the Mayor of London, who had stayed behind, to enforce with the aim of reducing the spread of the plague as much as possible. 

Some of these rules included:

‘That if any House be Infected, the isick person or persons be forthwith removed to the said pest-house, sheds, or huts, for the preservation of the rest of the Family: And that such house (though none be dead therein) be shut up for fourty days, and have a Red Cross, and Lord have mercy upon us, in Capital Letters affixed on the door, and Warders appointed, as well to find them necessaries, as to keep them from conversing with the sound.

12. That at the opening of each Infected house (after the expiration of the said Fourty Days) a White Cross be affixed on the said door, there to remain Twenty days more; during which time, or at least before any stranger be suffered to lodge therein, That the said house be well Fumed, Washed and Whited all over within with Lime; And that no Clothes, or Householdstuff be removed out of the said house into any other house, for at least Three months after, unless the persons so Infected have occasion to change their habitation’

Actually, not so terrible ideas. Quarantining the sick… pretty smart, in fairness I reckon the death count would have been a lot higher without these rules being enforced. 

King Charles’ other plan, however, wasn’t quite so great. So, for background, there was this idea at the time called miasma theory which claimed that the cause of diseases, including the plague, was from breathing in a toxic, bad smelling vapour in the air. Therefore, “clean the air” and you’ll prevent the disease spreading… right?! 

On a small scale this meant people would burn herbs and carry flaming torches around their homes, people would fill bowls in their home with spices or burn incense. On a larger scale, in September 1665, Charles ordered that great fires be lit in the streets around London to, and I quote “correct and purify the air”. They burnt for 3 days before it rained heavily and they were all extinguished. 

Honestly, a useless stunt on a practical level BUT it did boost public moral – people thought they were being looked after, that their king cared, they felt safer. And funnily enough after that, just the next month, the numbers of people dying from the plague started to drop… the worst was over. 

And this wasn’t only the big stunt pulled in London to try and save people from the plague. Some people actually got fairly close to figuring out the cause of the plague but just missed the mark ever so slightly… they thought animals were spreading it, however instead of looking at the rats and their fleas, they suspected cats and dogs. People got jobs as animal killers and would just go around London killing any stray cat or dog they saw – from reports and journals it’s estimated over 40,000 dogs and 200,000 cats were killed during The Great Plague.

Life was pretty horrific in London by this point. I don’t know about you guys but when I think of the plague I always think of that story they tell of rolling a cart through the street filled with dead bodies… and it turns out this isn’t some kind of urban legend or exaggeration. It’s exactly what happened. 

People were dying so quickly that they only way they could cope with the large number of burials was for a ‘dead-cart’ to go door to door calling for people to “bring out your dead”. 

At one point this was only allowed at night because they figured it would just scare people even more but it got to the point where there were just too many bodies and not enough drivers and people ended up leaving bodies just lying out in the streets. So, they had to allow day time collection as well. Because what’s more horrifying: A cart full of rotting dead people OR piles of rotting dead people left in the street? Hmmmmm… It is a tough call. 

While a few people tried to cure the black death back in the 1300s, people got really creative… or desperate depending on how you look at things, in the 1600s. Of course, most of the actual doctors had fled the city in the spring so the only people really left to take care of the sick were self-appointed plague doctors, people calling themselves medical astrologers, a few apothecaries, dodgy healers calling themselves ‘wise women’ and ‘white witches’, and a lot of priests and vicars and other religious leaders. 

Obviously many people turned to prayer and repentance and begging God to save them and their loved ones and, obviously, nothing happened… 

Others sent their sick to plague hospitals and pesthouses… these were mostly for the poorest people who had no where else to go and couldn’t afford anything else. Pesthouses were often buildings or small clusters of hut-like buildings where ill people were shut up in essentially forced quarantine, usually until they died. The City Pest House here in London, for example, was built in 1594 and housed people suffering all kinds of illnesses including the plague during the 1600s. Often, but not always, these pesthouses had graveyards and plague pits attached or nearby. 

But not everyone was just leaving the sick to die, some offered cures. They didn’t work but it’s unclear whether the majority of these people were just con-artists or if they genuinely thought they could help people. 

Medical astrologers would ‘use the stars’ to give advice to people about how to avoid and cure the plague. Wise women would offer up a range of herbal potions and pastes and all sorts. Apothecaries helped a little more by offering up goodies to help ease the symptoms: Opiates for sleep, for example. 

The few doctors and surgeons who stuck around would offer typical remedies like blee I ding, sweating, inducing vomiting and using lancets to pop the buboes. 

There’s a record of one doctor recommending: ‘that it was safe to throw saltpeter, oil, or a bag of gunpowder into their outdoor braziers to ward off the infected air. He also recommended ringing bells and firing off guns.’


You might have also seen plenty of images of these figures. Plague doctors. Yes that mask is terrifying and something that haunts my nightmares but surprisingly, there was a little bit of logic behind the all the get-up and it’s likely it DID protect the doctors a little. 

Thanks to the miasma theory, the aim was to avoid breathing in the “bad air” carrying the koi disease, so they wore masks with these large beaks which they stuffed with herbs and spices. 

They’d also wear these long, floor-length coats with hoods and hats and gloves – every part of them was covered. The fabrics were often waxed which was mostly so they were easier to clean but the interesting thing is, this actually provided a really strong physical barrier so that the fleas carrying the disease couldn’t touch them… it was fairly decent protection. 

And finally you’ll notice most plague doctors carry a large cane. Some believe this was to make the doctors appear more legitimate, it was a bit of a status symbol at the time, but on a more practical level it was so the doctor could poke and prod and inspect their patient without getting too close. 

All this said, the plague doctors didn’t really do much… treatment. Mostly they were glorified administrators – they spent a lot of time recording the numbers of people ill and dying and sometimes performed the odd autopsy here and there. 

Towards the end of 1665 winter set in and interestingly, the number of people suffering from the plague began to drop. There are a few theories about this: were people finally starting to develop something of an immunity to the disease? Or maybe it was the rats? One theory is that fewer rats were dying from the plague so the fleas didn’t need to jump away and find a new host, so they weren’t infecting as many people. 

Some people believe that the Great Fire of London in 1666 helped kill off a bunch of the disease-ridden rats and fleas but, honestly, the worst was over by this point and it’s unclear if it really had any effect at all. 

Other suggest that the enforced quarantines, slow improvements in hygiene and other measures helped slow the spread of the disease. Chances are, it was a mix of all these factors.


The thing is, the plague still exists today. We have not wiped it out completely. It’s mostly found throughout Africa, Asia and South Africa but it’s definitely not as common and it’s no longer a death sentence. 

The World Health Organisation reported that between 2010 and 2015 there were 3,248 cases of people being infected around the world and only 584 died. I mean, of course it would be better if that number was zero, but it’s a vast improvement from what had an 80% mortality rate. 

Obviously as I mentioned in the beginning, we have a range of antibiotics available to us today which can treat the plague but it’s still important to remember that it’s not gone completely. 

The plague is something I’ve always found interesting but when I was younger, it was a bit like a made up horror story in my head full of grizzly details to make you squirm. The older I get the more it hits me that this was real. This must have been such a terrifying time to live in – not only for those who got sick or saw loved ones die but for everyone because it was a constant threat looming over them for hundreds of years. The plague had no favourites and no exceptions and can, and often did, infect and kill anyone and everyone. 

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