“The fever at the onset of the attack came on suddenly,—some while sleeping, some while waking, some while at work. Their bodies exhibited no change of color, and the temperature was not very high. Some indications of fever were perceptible, but no signs of acute inflammation. In the morning and at night the fever was slight, and indicated nothing severe either to the patient or to the physician who counted the pulse. Most of those who presented such symptoms showed no indications of approaching dissolution; but the first day among some, the second day in others, and after several days in many cases, a bubo was observed on the lower portion of the abdomen, in the groin, or in the folds of the axilla, and sometimes back of the ears or on the thighs.
“The principal symptoms of the disease on its invasion were as I have pointed out; for the remainder, nothing can be precisely indicated of the variations of the type of the disease following temperament; these other symptoms were only such as were imprinted by the Supreme Being at his divine will.
“Some patients were plunged into a condition of profound drowsiness; others were victims to furious delirium. Those who were drowsy remained in a passive state, seeming to have lost all memory of the things of ordinary life. If they had any one to nurse them they took food when offered from time to time, and if they had no care soon died of inanition. The delirious patients, deprived of sleep, were eternally pursued by their hallucinations; they imagined themselves haunted by men ready to slay them, and they sought flight from such fancied foes, uttering dreadful screams. Persons who were attacked while nursing the sick were in the most pitiable condition—not that they were more liable to contract the disease by contact, however, for nurses and doctors did not get the disease from actual contact with the sufferers, for some who washed and laid out the dead never contracted the malady, but enjoyed perfect health throughout the epidemic; some, however, died suddenly without apparent cause. Many of the nurses were overworked keeping patients from rolling out of bed and preventing the delirious from jumping from high windows. Some patients endeavored to throw themselves in running water, not to quench their thirst, but because they had lost all reason. It was necessary to struggle with many of the sick in order to make them swallow any nourishment, which they would not accept without more or less resistance. The buboes enfeebled certain patients who were neither drowsy nor delirious, but who finally succumbed to their atrocious sufferings.
“As nothing was known of this strange disease, certain physicians thought its origin was due to some source of evil hidden in the buboes, and they accordingly opened these glandular bodies. The dissection of the bubo showed sub-adjacent carbuncles, whose rapid malignity brought on sudden death or an illness of but few days’ duration. In some instances the entire body was covered by black spots the size of a bean. Such unfortunates rarely lived a day, and generally expired in an hour. Many cases died suddenly, vomiting blood. One thing I can solemnly affirm, that is, that the wisest physicians gave up all hope in the case of many patients who afterwards recovered; on the contrary, many persons perished at the very time their health was almost re-established. For all these causes, the malady passed the confines of human reasoning, and the outcome always deceived the most natural predictions.
“As to treatment, the effects were variable, following the condition of the victim. I may state that, as a fact, no efficacious remedies were discovered that could either prevent the onset of the disease or shorten its duration. The victims could not tell why they were attacked, nor how they were cured.
“Pregnant women attacked inevitably aborted at death, some succumbing while miscarrying; some going on to the end of gestation, dying in labor along with their infants. Only three cases are known where women recovered of plague after aborting; while only one instance is on record where a newly-born child survived its mother in this epidemic. Those in whom the buboes increased most rapidly in size, maturated and suppurated, most often recovered, for the reason, no doubt, that the malignant properties of the bubonic carbuncle were weakened or destroyed.
“Experience proved that such symptoms were an almost sure presage of a return to health. Those, on the contrary, in whom the tumor did not change its aspect from the time of its eruption, were attacked with all the symptoms I have before described. In some cases the skin dried and seemed thus to prevent the tumor, although it might be well developed, from suppurating. Some were cured at the price of a loss of power in the tongue, which reduced the victims to stammer and articulate words in a confused and unintelligible manner for the rest of their days.
“The epidemic at Constantinople lasted four months, three months of which time it raged with great violence. As the epidemic progressed the mortality-rate increased from day to day, until it reached the point of 5,000 deaths per day, and on several occasions ran up to as high as 10,000 deaths in the twenty four hours.”
Let us pass over this very important description that Procopius gives of the moral effect of this epidemic on the people, of the scenes of wild and heart-rending terror, of curious examples of egotism and sublime devotion, of instances of blind superstition developed in a great city under the influence of fear and the dread of a very problematical contagion.
Evagre, the scholastic, another Greek historian of the sixth century, recounts in his works the story of the plague at Constantinople. He states that he frequently observed that persons recovering from a first and second attack subsequently died on a third attack; also that persons flying from an infected locality were often taken sick after many days of an incubating period, falling ill in their places of refuge in the midst of populations free, up to that time, from the pestilence.