The connections between large active trading ports, rats coming off the ships, and the severe outbreaks of the plague were understood by people at the time. It was also a subject found in many European paintings, drawings, plays, and writings of that time. The second pandemic occurred during the fourteenth century, and was called the Black Death because its main symptom was the appearance of black patches (caused by bleeding) on the skin. According to the historian Procopius, this outbreak of plague killed 10,000 people per day at its height just within the city of Constantinople. This pandemic is sometimes referred to as the Plague of Justinian, named for the great emperor of Byzantium who was ruling at the beginning of the outbreak. This sea was the busiest, coastal trade route at that time and connected what is now southern Europe, northern Africa, and parts of coastal Asia. It killed millions of citizens, particularly people living along the Mediterranean Sea. The first great pandemic appeared in AD 542 and lasted for 60 years. Although the cause of the plague was not identified until the third pandemic in 1894, scientists are virtually certain that the first two pandemics were plague because a number of the survivors wrote about their experiences and described the symptoms. A pandemic is a disease occurring in epidemic form throughout the entire population of a country, a people, or the world. Plague has been responsible for three great world pandemics, which caused millions of deaths and significantly altered the course of history. There are three major forms of the disease: bubonic, septicemic, and pneumonic. It was one of the scourges of early human history. Plague is a serious, potentially life-threatening infectious disease that is usually transmitted to humans by the bites of rodent fleas.
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