许多学者认为，鼠疫始于中国西北部，而其他人则认为中国西南部或中亚大草原。我们确实知道，在1331年元朝帝国爆发了爆发，可能加速了蒙古统治中国的结束。三年后，这种疾病导致河北省90％以上人口死亡，死亡人数超过500万。截至1200年，中国总人口超过1.2亿，但1393人口普查发现只有6500万中国人幸存。在元朝统治过渡期间，一些失踪人口因饥荒和动荡而丧生，但数百万人死于鼠疫。从它在丝绸之路东端的起源，黑死病在西部的贸易路线停靠在中亚的商队和中东贸易中心，随后在亚洲各地感染了人们。埃及学者Al-Mazriqi指出，“在他们的夏季和冬季营地，在牧场和季节性迁徙过程中，三百多个部落都没有明显的理由而死亡。”他声称，就朝鲜半岛而言，整个亚洲人口减少了。 叙利亚作家伊本·瓦尔迪（Ibn al-Wardi）后来在1348年自己死于瘟疫，记录了黑死病来自“黑暗之地”或中亚。从那里，它传播到中国，印度，里海和“乌兹别克人的土地”，然后到波斯和地中海。
Many scholars believe that the bubonic plague began in north-western China, while others cite south-western China or the steppes of Central Asia. We do know that in 1331 an outbreak erupted in the Yuan Empire and may have hastened the end of Mongol rule over China. Three years later, the disease killed over 90 percent of the Hebei Province’s populations with deaths totaling over 5 million people. As of 1200, China had a total population of more than 120 million, but a 1393 census found only 65 million Chinese surviving. Some of that missing population was killed by famine and upheaval in the transition from Yuan to Ming rule, but many millions died of bubonic plague. From its origin at the eastern end of the Silk Road, the Black Death rode trade routes west stopping at Central Asian caravansaries and Middle Eastern trade centers and subsequently infected people all across Asia. The Egyptian scholar Al-Mazriqi noted that “more than three hundred tribes all perished without apparent reason in their summer and winter encampments, in the course of pasturing their flocks and during their seasonal migration.” He claimed that all of Asia was depopulated, as far as the Korean Peninsula. Ibn al-Wardi, a Syrian writer who would later die of the plague himself in 1348, recorded that the Black Death came out of “The Land of Darkness,” or Central Asia. From there, it spread to China, India, the Caspian Sea and “land of the Uzbeks,” and thence to Persia and the Mediterranean.