which had the power of acting at a distance, whether on account of their unwonted lustre or the distortion which they always suffer in plague, or whether in conformity with an ancient notion, according to which the sight was considered as the bearer of a demoniacal enchantment. Flight from infected cities seldom availed the fearful, for the germ of the disease adhered to them, and they fell sick, remote from assistance, in the solitude of their country houses.
Thus did the plague spread over England with unexampled rapidity, after it had first broken out in the county of Dorset, whence it advanced through the counties of Devon and Somerset, to Bristol, and thence reached Gloucester, Oxford and London. Probably few places escaped, perhaps not any; for the annals of contemporaries report that throughout the land only a tenth part of the inhabitants remained alive25.
From England the contagion was carried by a ship to Bergen, the capital of Norway, where the plague then broke out in its most frightful form, with vomiting of blood; and throughout the whole country, spared not more than a third of the inhabitants. The sailors found no refuge in their ships; and vessels were often seen driving about on the ocean and drifting on shore, whose crews had perished to the last man26.
In Poland the infected were attacked with spitting of blood, and died in a few days in such vast numbers, that, as it has been affirmed, scarcely a fourth of the inhabitants were left27.
Finally, in Russia the plague appeared two years later than in Southern Europe; yet here again, with the same symptoms as elsewhere. Russian contemporaries have recorded that it began with rigor, heat, and darting pain in the shoulders and back; that it was accompanied by spitting of blood, and terminated fatally in two, or at most, three days. It is not till the year 1360, that we find buboes mentioned as occurring in the neck, in the axillæ and in the groins, which are stated to have broken out when the spitting of blood had continued some time. According to the experience of Western Europe, however, it cannot be assumed that these symptoms did not appear at an earlier period28.
Thus much, from authentic sources, on the nature of the Black Death. The descriptions which have been communicated contain, with a few unimportant exceptions, all the symptoms of the oriental plague which have been observed in more modern times. No doubt can obtain on this point. The facts are placed clearly before our eyes. We must, however, bear in mind that this violent disease does not always appear in the same form, and that while the essence of the poison which it produces, and which is separated so abundantly from the body of the patient, remains unchanged, it is proteiform in its varieties, from the almost imperceptible vesicle, unaccompanied by fever, which exists for some time before it extends its poison inwardly, and then excites fever and buboes, to the fatal form in which carbuncular inflammations fall upon the most important viscera.
Such was the form which the plague assumed in the 14th century, for the accompanying chest affection which appeared in all the countries whereof we have received any account, cannot, on a comparison with similar and familiar symptoms, be considered as any other than the inflammation of the lungs of modern medicine29, a disease which at present only appears sporadically, and, owing to a putrid decomposition of the fluids, is probably combined with hemorrhages from the vessels of the lungs. Now, as every carbuncle, whether it be cutaneous or internal, generates in abundance the matter of contagion which has given rise to it, so, therefore, must the breath of the affected have been poisonous in this plague, and on this account its power of contagion wonderfully increased; wherefore the opinion appears incontrovertible, that owing to the accumulated numbers of the diseased, not only individual chambers and houses, but whole cities were infected, which, moreover, in the middle ages, were, with few exceptions, narrowly built, kept in a filthy state, and surrounded with stagnant ditches30. Flight was, in consequence, of no avail to the timid; for even though they had sedulously avoided all communication with the diseased and the suspected, yet their clothes were saturated with the pestiferous atmosphere, and every inspiration imparted to them the seeds of the destructive malady, which, in the greater number of cases, germinated with but too much fertility. Add to which, the usual propagation of the plague through clothes, beds, and a thousand other things to which the pestilential poison adheres,—a propagation, which, from want of caution, must have been infinitely multiplied; and since articles of this kind, removed from the access of air, not only retain the matter of contagion for an indefinite period, but also increase its activity and engender it like a living being, frightful ill consequences followed for many years after the first fury of the pestilence was past.
The affection of the stomach, often mentioned in vague terms, and occasionally as a vomiting of blood, was doubtless only a subordinate symptom, even if it be admitted that actual hematemesis did occur. For the difficulty of distinguishing a flow of blood from the stomach, from a pulmonic expectoration of that fluid, is, to non-medical men, even in common cases, not inconsiderable. How much greater then must it have been in so terrible a disease, where assistants could not venture to approach the sick without exposing themselves to certain death? Only two medical descriptions of the malady have reached us, the one by the brave Guy de Chauliac, the other by Raymond Chalin de Vinario, a very experienced scholar, who was well versed in the learning of his time. The former takes notice only of fatal coughing of blood; the latter, besides this, notices epistaxis, hematuria and fluxes of blood from the bowels, as symptoms of such decided and speedy mortality, that those patients in whom they were observed, usually died on the same or the following day31.
That a vomiting of blood may not, here and there, have taken place, perhaps have been even prevalent in many places, is, from a consideration of the nature of the disease, by no means to be denied; for every putrid decomposition of the fluids begets a tendency to hemorrhages of all kinds. Here, however, it is a question of historical certainty, which, after these doubts, is by no means established. Had not so speedy a death followed the expectoration of blood, we should certainly have received more detailed intelligence respecting other hemorrhages; but the malady had no time to extend its effects further over the extremities of the vessels. After its first fury, however, was spent, the pestilence passed into the usual febrile form of the oriental plague. Internal carbuncular inflammations no longer took place, and hemorrhages became phenomena, no more essential in this than they are in any other febrile disorders. Chalin, who observed not only the great mortality of 1348, and the plague of 1360, but also that of 1373 and 1382, speaks moreover of affections of the throat, and describes the black spots of plague patients more satisfactorily than any of his contemporaries. The former appeared but in few cases, and consisted in carbuncular inflammation of the gullet, with a difficulty of swallowing, even to suffocation, to which, in some instances, was added inflammation of the ceruminous glands of the ears, with tumours, producing great deformity. Such patients, as well as others, were affected with expectoration of blood; but they did not usually die before the sixth, and sometimes, even so late as the fourteenth day32. The same occurrence, it is well known, is not uncommon in other pestilences; as also blisters on the surface of the body, in different places, in the vicinity of which, tumid glands and inflammatory boils, surrounded by discoloured and black streaks, arose, and thus indicated the reception of the poison. These streaked spots were called, by an apt comparison, the girdle, and this appearance was justly considered extremely dangerous33.
CHAPTER III.
CAUSES.—SPREAD.
An inquiry into the causes of the Black Death, will not be without important results in the study of the plagues which have visited the world, although it cannot