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GCSE · History

EDX.MED7 The Black Death, 1348-49: Causes, Spread and Contemporary Responses

EDEXCEL 1HI0 · Calculators not allowed · about 65 minutes

Total Marks

Name: _______________________________ Date: ____ / ____ / ______

Answer ALL questions. Write in full sentences for Questions 15, 16 and 17. You are advised to spend about 65 minutes on this pack.

Give the year in which the Black Death first arrived in England.

(Total for Question 1 is 1 mark)

Give the name commonly used in medieval and modern sources for the form of plague that caused swelling of the lymph nodes.

(Total for Question 2 is 1 mark)

State two typical symptoms of the Black Death in 1348-49.

(Total for Question 3 is 2 marks)

Name one medieval explanation for the cause of the Black Death that blamed bad air or fumes.

(Total for Question 4 is 1 mark)

Name one medieval explanation for the Black Death that understood it as a moral or spiritual event.

(Total for Question 5 is 1 mark)

State one treatment medieval physicians used that attempted to rebalance the four humours, and explain briefly how it was supposed to help.

(Total for Question 6 is 2 marks)

State one preventive measure towns or ports sometimes used during plague outbreaks in the later medieval period.

(Total for Question 7 is 2 marks)

Give the name of the religious movement whose members publicly whipped themselves to seek God's forgiveness during the Black Death.

(Total for Question 8 is 1 mark)

Name one herb or aromatic plant commonly used in medieval plague remedies or to scent the air.

(Total for Question 9 is 1 mark)

State two social or economic consequences of the Black Death in England after 1348-49.

(Total for Question 10 is 2 marks)

State two ways the Black Death spread across Europe to reach England in 1348.

(Total for Question 11 is 2 marks)

Describe two features of how medieval physicians attempted to treat victims of the Black Death in 1348-49.

(Total for Question 12 is 4 marks)

Explain one way in which contemporary explanations of the Black Death in 1348-49 were similar to explanations of disease in later medieval England around 1500.

(Total for Question 13 is 4 marks)

Explain why the Black Death prompted changes in public health practices in some towns and ports after 1348-49.

You may use the following in your answer:
- the scale of death and disruption caused by the epidemic
- problems controlling movement of people and goods into towns

You must also use information of your own.

(Total for Question 14 is 12 marks)

'The Black Death had only harmful effects on medieval medicine.' How far do you agree? Explain your answer.

You may use the following in your answer:
- the effect on confidence in learned physicians and humoural treatments
- the appearance of new public health practices such as isolation

You must also use information of your own.

(Total for Question 15 is 20 marks)

Mark scheme · EDX.MED7 The Black Death, 1348-49: Causes, Spread and Contemporary Responses

Question 1

B1 1348
Answer: 1348

Question 2

B1 bubonic plague
Answer: Bubonic plague

Question 3

B1 a swollen, painful buboe (swollen lymph node)
B1 high fever and delirium (or severe chills and weakness)
Answer: A swollen, painful buboe and a high fever with delirium.

Question 4

B1 miasma (bad air)
Answer: Miasma, or bad air

Question 5

B1 God's punishment
Answer: God's punishment

Question 6

B1 identifies a treatment, e.g. bloodletting or purging
B1 gives supporting detail, e.g. it was supposed to remove excess blood or humours thought to cause illness and restore balance
Answer: Bloodletting, intended to remove excess blood and restore the balance of the four humours.

Question 7

B1 identifies a measure, e.g. isolating arriving ships or imposing quarantine
B1 gives supporting detail, e.g. ships were kept at anchor for a period before landing to reduce risk of spread
Answer: Isolating arriving ships or imposing quarantine, for example keeping ships at anchor for a time before allowing landing.

Question 8

B1 flagellants
Answer: Flagellants

Question 9

B1 rosemary (or sage, lavender or rue)
Answer: Rosemary

Question 10

B1 labour shortages, leading to higher wages for workers
B1 disruption of trade and manorial labour, contributing to social unrest and changes in land use
Answer: Labour shortages that helped push up wages, and disruption to trade and manorial labour which contributed to social unrest and changes in land use.

Question 11

B1 by trade ships carrying infected rats and fleas between ports
B1 overland along trade and military routes as infected people and goods moved
Answer: By trade ships carrying infected rats and fleas into ports, and overland along trade and military routes as infected people and goods moved.

Question 12

B1 feature 1 identified, e.g. bloodletting was used in an attempt to remove contaminated humours
B1 supporting detail for feature 1, e.g. physicians and barber-surgeons applied leeches or cut veins to let blood out
B1 feature 2 identified, e.g. use of herbal remedies and fumigation to cleanse the air or body
B1 supporting detail for feature 2, e.g. nostrums, posies and aromatic compounds were prepared to drive away 'bad air' or to strengthen the patient
Answer: They practised bloodletting, using leeches or vein-cutting to remove humours, and they used herbal remedies and fumigation, preparing posies and aromatic compounds to cleanse the air or strengthen the patient.

Question 13

B1 identifies a similarity, e.g. both periods commonly appealed to miasma or bad air as a cause of disease
B1 supporting detail, e.g. physicians in 1348-49 and around 1500 recommended fumigation, carrying posies and burning aromatic substances to counter bad air
B1 identifies a second supporting point or clarification, e.g. both periods also used humoural theory to explain individual susceptibility
B1 supporting detail for that point, e.g. treatments like bloodletting and purging were recommended in both periods to restore humoral balance
Answer: Both periods commonly used miasma and humoural theory to explain disease, so fumigation and aromatic posies to counter bad air, and bloodletting or purging to restore humoral balance, were recommended in 1348-49 and still in use around 1500.

Question 14

Level 1 (1-3): Provides simple, generalised reasons why public health practices changed, with little supporting detail.
Level 2 (4-6): Identifies and begins to explain one or two reasons, supported by some accurate detail and link to consequences.
Level 3 (7-9): Explains several reasons clearly, supported by accurate and relevant detail, showing how each reason led to particular public health responses.
Level 4 (10-12): Gives a well-developed, analytical explanation of why public health practices changed, with precise supporting detail and clear links between causes and responses across different towns and ports.
Indicative content:
- The enormous scale of mortality and social disruption caused by the Black Death made it obvious that ordinary community coping methods were inadequate, prompting towns to seek practical measures to limit future outbreaks.
- High death rates among householders and port workers created fear of infection from arrivals and from contaminated goods, encouraging towns to introduce measures such as keeping ships at anchor, inspecting cargoes and restricting entry for the sick.
- Disruption of labour and trade priorities led civic authorities to try to protect remaining workers and merchants, introducing controls that had economic as well as health aims, such as isolating suspected cases to keep workshops and markets functioning.
- Experience of rapid local spread showed civic leaders that controlling movement could work to delay disease, so some towns developed ordinances to isolate the sick, regulate burial practices and restrict entry, early precursors of later quarantine law.
- Religious and communal responses also influenced public policy: fear and desire for order encouraged civic authorities to arrest or disperse flagellant processions, regulate pilgrimage and public gatherings, and to fund measures such as town fumigations or clearing of refuse.

Question 15

Level 1 (1-4): Shows limited understanding of the effects of the Black Death on medieval medicine, and offers only a simple, unsupported judgement.
Level 2 (5-8): Shows some relevant knowledge and begins to weigh positive and negative effects, but the argument is not consistently supported or developed.
Level 3 (9-12): Shows good knowledge and offers a balanced evaluation of both harmful and beneficial effects, supporting points with relevant detail and beginning to reach a judgement.
Level 4 (13-16): Shows precise, well-selected knowledge and offers a sustained, balanced evaluation of the extent of harm and benefit, reaching a clear and well-supported judgement on how far the statement is true.
Indicative content:
- Arguments supporting the statement, showing harm: the Black Death undermined confidence in traditional learned medicine and humoural theory because so many who followed physicians advice still died; prominent physicians and universities could not stop the epidemic, reducing the authority of medical elites.
- Harmful effects continued as many treatments, such as bloodletting, sometimes weakened patients further, and the scale of mortality created shortages of trained practitioners, with inexperienced or unlicensed healers filling gaps.
- Arguments against the statement, showing beneficial or impulse-driven changes: the scale of the crisis encouraged practical public health responses, such as isolation of the sick, restrictions on movement in ports and towns, and some local ordinances on burial and refuse, which anticipated later public health development.
- The epidemic also stimulated empirical observation by some practitioners: attempts to record symptoms and experiment with herbal remedies, and the spread of practical measures such as fumigation, reflect adaptive practice rather than complete collapse.
- A balanced judgement might argue that while the Black Death exposed the limits of traditional medical theory and caused immediate harm to the reputation and manpower of learned medicine, it also accelerated practical, community-level responses and small-scale changes in medical practice that had long-term influence.

The Black Death, 1348-49: Causes, Spread and Contemporary Responses - Worksheets, Questions and Revision