* * * * * * *
What was this plague? How did it strike men down?
"It showed itself," says Boccaccio, "in a sad and wonderful manner; and _different from what it had been in the East_, where bleeding from the nose is the fatal prognostic, here [at Florence] there appeared certain tumours in the groin or under the armpits, some as big as an apple, others as big as an egg; and afterwards purple spots in most parts of the body: in some cases large and but few in number, in others less and more numerous, both kinds the usual messengers of death... They generally died," he adds, "the third day from the first appearance of the symptoms, without a fever or other bad circumstance attending."
"It took men generally in the head and stomach, appearing first in the groin," says Villani, "or under the armpits, by little knobs or swellings called kernels, boils, blains, blisters, pimples, or plague-sores; being generally attended with devouring fever, with occasional spitting and vomiting of blood, whence, for the most part, they died presently or in half a day, or within a day or two at the most."
Less precise and minute is the description of the great surgeon, Guido de Chauliac, who nobly stayed at Avignon for the six months during which the visitation was at its worst; but he too mentions the carbuncular swellings in the axillae and the groin, the purple spots, and the violent inflammation of the lungs, attended by fatal expectoration of blood.
As for the Emperor John Cantacuzene, his description is so flagrantly a mere adaptation of the history of the plague at Athens by Thucydides that it must be received with caution. It is only in what it omits and in what it adds to the older narrative that it possesses any great historic value. It agrees with the accounts quoted above in making mention of the swellings, the blood-spitting, and the awful rapidity with which the disease ran its course. It omits all mention of the eruption on the surface of the skin, the flushed eyes, and, above all, the swollen and inflamed condition of the larynx, the cough, the sneezing, and the hiccough, which Dr. Collier found so significant.
Comparing, then, the several accounts which have come down to us, meagre though they are, it ought to be possible to arrive at some conclusions regarding the nature of the plague of the fourteenth century which, for the pathologist, would amount to certainties. The wonder is that such men as Dr. Hecker and his learned translator should have shown so much reserve--not to say timidity--in pronouncing judgment upon the question.
A layman runs a risk of incurring withering scorn at his presumption, and ridicule at his ignorance who ventures to express an opinion--or to have one--on any subject which the medical profession claims as within its own domain; and I should not dare to speak otherwise than as a very humble inquirer when the learned are silent. There are, however, some conclusions which may be accepted without hesitation and which will be admitted by all.
I. The Black Death was _not_ scarlatina maligna, as the plague at Athens undoubtedly was. [Footnote: "The History of the Plague of Athens," translated from Thucydides by C. Collier, M.D., London, 1857.]
II. It was _not_ small-pox.