When Pope Clement VI asked how many people had died from the plague,

he was told at least 20 million

people in Europe, and 17

million in Asia. In comparison,

around 8 million soldiers

died in World War I.

20M 8M

Q
2 million

9=
Tombs

dead Simple lead crosses were placed on corpses in mass graves. During the plague, people faced deadi every day.
Death is often realistically shown on 14th-century tombs, where images of

skeletons and decaying corpses are common.

Chantries
People often left money for masses to be said for dieir
souls. These masses were

said in special chapels inside churches known as chantries. This chantry is at Winchester, England. thought to stimulate erotic desire and

enhance sexual performance. For centuries, various substances (most notably oysters and rhinoceros horn) have been used as aphrodisiacs. In fact, no substance has a proven aphrodisiac effect. aphthous ulcer See ulcer, aphthous. apicectomy Surgical removal of the tip of a tooth root. Apicectomy may be performed as part of root-canal treatment. aplasia Absent or severely reduced growth and development of any organ or tissue. For example, in bone marrow aplasia, the rate of cell division in the bone marrow is reduced, leading to insufficient blood-cell production (see anaemia, aplastic). Some birth defects, such as stunted limbs (see phocomelia), occur as a result of incomplete tissue formation during prenatal development. aplastic anaemia See anaemia, aplastic. apnoea Cessation of breathing, either temporarily or for a prolonged period. Breathing is an automatic process controlled by the respiratory centre in the brainstem. Failure of this centre to maintain normal breathing is known as central apnoea. It may occur in babies, particularly those who are premature, and can be detected by an apnoea alarm. Central apnoea can also result from brainstem damage, for example following a stroke or head injury. In obstructive apnoea, breathing is prevented by a blockage in the airway. The most common type is sleep apnoea, in which blockage of the upper airway occurs repeatedly during sleep. Deliberate temporary apnoea occurs in breath-holding attacks. Another type of apnoea occurs in CheyneStokes respiration, in which cycles of deep, rapid breathing alternate with episodes of

breathing stoppage. Treatment of apnoea depends on the cause. In newborn babies, it resolves as they mature. In stroke or head injury, artificial ventilation may be needed temporarily until recovery occurs. apocrine gland A gland that discharges cellular material in addition to the fluid it secretes. The term is usually applied to the type of sweat glands that appear in hairy body areas after puberty. (See also eccrine gland.) apolipoprotein A group of proteins that are constituents of lipoproteins, the carriers of fat in the bloodstream. Apolipoproteins are also involved in the growth and repair of nerve tissues. aponeurosis A wide sheet of tough, fibrous tissue that acts as a tendon, attaching a muscle to a bone or a joint. apophysis An outgrowth of bone at the site of attachment of a tendon to bone. Inflammation may also occur, as in OsgoodSchlatter disease. apoplexy An outdated term for a stroke. apoptosis The natural process of programmed cell death. Apoptosis occurs in embryonic development, when the shaping of body parts is taking place and continues throughout life in the constant cycle of death and renewal of body cells. Failure of apoptosis is implicated in the development of cancers. apothecary An old term for a pharmacist. appendicectomy Surgical removal of the appendix to treat acute appendicitis. appendicitis Acute inflammation of the appendix. The cause is usually not known, but appendicitis is sometimes caused by obstruction of the appendix by a lump of faeces. The 1st symptom is usually vague discomfort around the navel. Within a few hours, this develops into severe, more localized pain, which is usually most intense in the lower righthand side of the abdomen. Symptoms may differ if the appendix is not in the most common position. For example, if the appendix impinges on the ureter, the urine may become bloodstained. The usual treatment for appendicitis is appendicectomy, which is often performed endoscopically (see minimally invasive surgery). If the treatment is delayed, an inflamed appendix may burst, releasing its contents into the abdomen. This leads to peritonitis and, in some cases, an abscess. appendix A small, narrow tube that projects out of the caecum (the 1st part of the colon) at the lower right-hand side of the abdomen. It may lie behind or below the caecum, or in front of or behind the ileum (part of the small intestine). The appendix has no known function, but it contains a large amount of lymphoid tissue which provides a