[42] Frequently in the progress of the disease there is no heat on the surface of the body; but the burning heat under the axillæ shows that the internal heat is very intense.
[43] A febrile, but not very quick pulse; sometimes almost natural.
[44] The faburra brought up by vomiting, is commonly of a dirty yellow colour, viscid, and sometimes frothy. The quantity thrown up is astonishingly great, much greater than is observed in any other fever.
[45] The petechiæ and other eruptions vary in size and colour. They are mostly small and distinct, but sometimes run together and form broad maculæ, which now and then end in carbuncles. Their colour in many instances is livid or black, in others (when the disease is milder) purplish, in some reddish. In convalescents, they turn first red, then yellow, and afterwards disappear. They are so common in the beginning of the plague, that scarcely any one dies without them; though buboes and carbuncles are not observable. Hence those who have never seen the plague under all its forms are apt to be deceived respecting the nature of the disorder.
[46] The patients complain of this more than of any other symptom. The pain begins in the frontal sinus, and the orbits of the eyes, and afterwards extends to the temples and sides of the head as far as to the back part, and gradually over the whole head; so, however, as to be most violent in the fore part.
[47] The appearance of the eyes in the plague is such as, when once seen, will ever afterwards enable even the commonest observers to recognise the disease. The eyes are unusually prominent, and the vessels of the tunica albuginea are turgid with blood, so as to produce a præternatural redness. They are, moreover, watery, sometimes full of tears (lacrymantes), and have a sparkling fierceness. But in the advanced stage of the disease, when the powers of life become exhausted, the eyes sink in, the redness gradually goes off, and a little while before death they become dull, and appear as if they had a film over them.
[48] Although the delirium is rather higher than it is in the slow type of the plague, yet it is very rarely of the furious kind, in the present type of the disease. The patients are affected with stupor, and lie motionless in a dozing state; or if they awake, they are perpetually stretching out their hands and trying to raise themselves up, as if they wanted to get out of bed. They talk incessantly, but in consequence of the turgid and swollen state of the tongue, their speech is broken and stuttering, like that of drunken people, so as to be scarcely intelligible.
[49] The buboes are dispersed or resolved by critical sweats breaking out on the first day of the attack. Often, at the same time, there is a discharge from the urethra of a white, viscid fluid, resembling pus, similar to what happens in a gleet; but this running is not accompanied with pain, and ceases spontaneously after a few days.
[50] A moderate bleeding from the nose in the beginning of the disease, was, especially in plethoric habits, sometimes salutary; but in most instances it was otherwise. Such as spat up frothy blood, mixed with a great quantity of thin phlegm, though they might not at the time exhibit symptoms of great debility, or appear to be in danger, did, nevertheless, contrary to expectation, die soon afterwards. Hæmorrhages happened more frequently, and proved more fatal to women than to men. An immoderate flow of the menses coming on suddenly and before the stated time, carried off the patient in many instances. When pregnant women were attacked with this type of the plague, they almost always miscarried, and lost their lives by the subsequent hæmorrhage. This was also very generally the case with those who were delivered after having gone their natural time.
[51] This anxiety about the præcordia may be regarded as a pathognomonic symptom of the plague in its most acute type. It is so excessive that the patients are at a loss for words capable of expressing it. It does not consist in a violent pain, but in a certain oppressive, suffocating, and altogether intolerable sensation at the pit of the stomach. In this state, they make known their anguish and show the danger they are in by sighs, tears, and lamentations, writhing their bodies in the most violent manner, and, especially when their delirium comes on, falling down upon the ground or floor, and crawling about as long as any muscular power remains. Others who are affected with extreme debility from the first, although they feel the same anguish, are not capable of tossing and writhing themselves about so much.