of representing them as among the general prognostics of great plagues; nor can we, for our parts, regard the astrology of the middle ages, as a mere offspring of superstition. It has not only, in common with all ideas which inspire and guide mankind, a high historical importance, entirely independent of its error or truth—for the influence of both is equally powerful—but there are also contained in it, as in alchymy, grand thoughts of antiquity, of which modern natural philosophy is so little ashamed that she claims them as her property. Foremost among these, is the idea of the general life which diffuses itself throughout the whole universe, expressed by the greatest Greek sages, and transmitted to the middle ages, through the new Platonic natural philosophy. To this impression of an universal organism, the assumption of a reciprocal influence of terrestrial bodies could not be foreign170, nor did this cease to correspond with a higher view of nature, until astrologers overstepped the limits of human knowledge with frivolous and mystical calculations.
Guy de Chauliac, considers the influence of the conjunction, which was held to be all-potent, as the chief general cause of the Black Plague; and the diseased state of bodies, the corruption of the fluids, debility, obstruction, and so forth, as the especial subordinate causes171. By these, according to his opinion, the quality of the air, and of the other elements, was so altered, that they set poisonous fluids in motion towards the inward parts of the body, in the same manner as the magnet attracts iron; whence there arose in the commencement fever and the spitting of blood; afterwards, however, a deposition in the form of glandular swellings and inflammatory boils. Herein the notion of an epidemic constitution was set forth clearly, and conformably to the spirit of the age. Of contagion, Guy de Chauliac was completely convinced. He sought to protect himself against it by the usual means172; and it was probably he who advised Pope Clement VI. to shut himself up while the plague lasted. The preservation of this pope’s life, however, was most beneficial to the city of Avignon, for he loaded the poor with judicious acts of kindness, took care to have proper attendants provided, and paid physicians himself to afford assistance wherever human aid could avail—an advantage which, perhaps, no other city enjoyed173. Nor was the treatment of plague-patients in Avignon by any means objectionable; for, after the usual depletions by bleeding and aperients, where circumstances required them, they endeavoured to bring the buboes to suppuration; they made incisions into the inflammatory boils, or burned them with a red-hot iron, a practice which at all times proves salutary, and in the Black Plague saved many lives. In this city, the Jews, who lived in a state of the greatest filth, were most severely visited, as also the Spaniards, whom Chalin accuses of great intemperance174.
Still more distinct notions on the causes of the plague were stated to his contemporaries in the 14th century, by Galeazzo di Santa Sofia, a learned man, a native of Padua, who likewise treated plague-patients at Vienna175, though in what year is undetermined. He distinguishes carefully pestilence from epidemy and endemy. The common notion of the two first accords exactly with that of an epidemic constitution, for both consist, according to him, in an unknown change or corruption of the air; with this difference, that pestilence calls forth diseases of different kinds; epidemy, on the contrary, always the same disease. As an example of an epidemy, he adduces a cough (influenza) which was observed in all climates at the same time, without perceptible cause; but he recognised the approach of a pestilence, independently of unusual natural phenomena, by the more frequent occurrence of various kinds of fever, to which the modern physicians would assign a nervous and putrid character. The endemy originates, according to him, only in local telluric changes—in deleterious influences which develop themselves in the earth and in the water, without a corruption of the air. These notions were variously jumbled together in his time, like every thing which human understanding separates by too fine a line of limitation. The estimation of cosmical influences, however, in the epidemy and pestilence, is well worthy of commendation; and Santa Sofia, in this respect, not only agrees with the most intelligent persons of the 14th and 15th centuries, but he has also promulgated an opinion which must, even now, serve as a foundation for our scarcely commenced investigations into cosmical influences176. Pestilence and epidemy, consist not in alterations of the four primary qualities177, but in a corruption of the air, powerful, though quite immaterial, and not cognoscible by the senses:—(corruptio aëris non substantialis, sed qualitativa) in a disproportion of the imponderables in the atmosphere, as it would be expressed by the moderns178. The causes of the pestilence and epidemy are, first of all, astral influences, especially on occasion of planetary conjunctions; then extensive putrefaction of animal and vegetable bodies, and terrestrial corruptions (corruptio in terra); to which also, bad diet and want may contribute. Santa Sofia considers the putrefaction of locusts, that had perished in the sea, and were again thrown up, combined with astral and terrestrial influences, as the cause of the pestilence in the eventful year of the “Great Mortality.”
All the fevers which were called forth by the pestilence, are, according to him, of the putrid kind; for they originate principally from putridity of the heart’s blood, which inevitably follows the inhalation of infected air. The Oriental Plague is, sometimes, but by no means always, occasioned by pestilence (?), which imparts to it a character (qualitas occulta) hostile to human nature. It originates frequently from other causes, among which, this physician was aware that contagion was to be reckoned; and it deserves to be remarked, that he held epidemic small-pox and measles to be infallible forerunners of the plague, as do the physicians and people of the East179, at the present day.
In the exposition of his therapeutical views of the plague, a clearness of intellect is again shewn by Santa Sofia, which reflects credit on the age. It seemed to him to depend, 1st, on an evacuation of putrid matters, by purgatives and bleeding: yet he did not sanction the employment of these means indiscriminately, and without consideration; least of all where the condition of the blood was healthy. He also declared himself decidedly against bleeding ad deliquium (venæ sectio eradicativa). 2d, Strengthening of the heart and prevention of putrescence. 3d, Appropriate regimen. 4th, Improvement of the air. 5th, Appropriate treatment of tumid glands and inflammatory boils, with emollient, or even stimulating poultices (mustard, lily-bulbs), as well as with red-hot gold and iron. Lastly, 6th, Attention to prominent symptoms. The stores of the Arabian pharmacy, which he brought into action to meet all these indications, were indeed very considerable; it is to be observed, however, that, for the most part, gentle means were accumulated, which, in case of abuse, would do no harm; for the character of the Arabian system of medicine, whose principles were everywhere followed at this time, was mildness and caution. On this account too, we cannot believe that a very prolix treatise by Marsigli di Santa Sofia180, a contemporary relative of Galeazzo, on the prevention and treatment of plague, can have caused much harm, although, perhaps, even in the 14th century, an agreeable latitude and confident assertions respecting things which no mortal has investigated, or which it is quite a matter of indifference to distinguish, were considered as proofs of a valuable practical talent.
The agreement of contemporary and later writers, shews that the published views of the most celebrated physicians of the 14th century, were those generally adopted. Among these, Chalin de Vinario is the most experienced. Though devoted to astrology, still more than his distinguished contemporary, he acknowledges the great power of terrestrial influences, and expresses himself very sensibly on the indisputable doctrine of contagion, endeavouring thereby to apologize for many surgeons and physicians of his time, who neglected their duty181. He asserted boldly, and with truth, “that all epidemic