The Black Death and The Dancing Mania | Page 5

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 fourteenth 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 medicine, 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 ditches. 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 the
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 day.
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
back 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