Until recent years it was generally believed that no certain record of bubonic plague existed prior to that of Procopius (c. a.d. 490-560). It would seem to be necessary to revise this opinion in the face of a fragment of the writings of Rufus of Ephesus, preserved by Oribasius,[120] the Christian physician of the Emperor Julian (a.d. 355-63). He writes: ‘The buboes called pestilential are most fatal and acute, especially those that are seen occurring about Libya, Egypt, and Syria, and which are mentioned by Dionysius Curtus. Dioscorides and Posidonius make much mention of them in the plague, which occurred in their time in Libya: they say it was accompanied by acute fever, pain, and prostration of the whole body, delirium, and the appearance of large and hard buboes, which did not suppurate, not only in the accustomed parts, but also in the groins and armpits:’ and further: ‘One can foresee an approaching plague by paying attention to the ill condition of the seasons, to the mode of living less conducive to health, and to the death of animals that precedes its invasion.’
Rufus is believed to have flourished in the reign of Trajan (a.d. 98-117), and may have been his physician. Dioscorides and Posidonius were probably Alexandrine physicians who flourished soon after the Christian era. The identity of Dionysius Curtus is conjectural, but there is some reason to think that he practised medicine in Alexandria in the third century b.c. Accepting these dates, one must admit that the evidence for the existence of bubonic plague in epidemic form in northern Africa and the Levant as early as the third century b.c. is exceedingly strong. Even if we conceive buboes to have been more common than nowadays in the course of other acute infectious diseases, the above record can hardly denote anything but bubonic plague. The reference to buboes as occurring with greater frequency in other parts than the groins and armpits does not appear to have received from medical writers the attention it deserves.
We have already adduced evidence to show that Hippocrates also was familiar with bubonic plague in its sporadic, but probably not in its epidemic form. Galen,[121] too, discusses the relation of buboes to fever in such a manner as to show that he also was acquainted with a severe bubonic malady, distinct from ordinary septic buboes. Oribasius also is cognizant of bubonic fevers, but it may be asserted generally that neither Galen nor Oribasius shows any signs of knowing them as a prevalent epidemic pestilence. We may, then, justly say that the narrative of Procopius affords the first unequivocal description of an epidemic of bubonic plague.
According to Procopius[122] the plague began at the ill-starred Pelusium, spreading in one direction through Alexandria and Egypt, in another through Palestine, and thence throughout the world, which would have meant to him from the eastern limits of Persia as far westward as the shores of the Atlantic. In the light of modern knowledge it is probable that Pelusium was no more than a distributing centre en route, and that the true focus of origin lay much further back along the commercial highways to the east or south. Of its pandemic character, however, we have the fullest confirmation in a succession of historical records. Evagrius[123] says that its total duration was fifty-two years, and this also it is possible to substantiate from the annexed table of its offsets, along with the names of the authorities for each locality.
| Date. | Locality. | Authority. |
|---|---|---|
| a.d. 540 | Antioch | Evagrius. |
| a.d. 542 | Byzantium | Procopius. |
| a.d. 549 | Arles | Gregory of Tours. |
| a.d. 558 | Byzantium | Agathias. |
| a.d. 565 | Liguria | Paul the Deacon. |
| a.d. 567 | Auvergne | Gregory of Tours. |
| Narbonne | Gregory of Tours. | |
| a.d. 587 | Marseilles | Gregory of Tours. |
| a.d. 590 | Rome | Gregory of Tours. |
| Paul the Deacon. | ||
| John the Deacon. | ||
| a.d. 590 | Avignon | Gregory of Tours. |
| a.d. 591 | Strasbourg | Oseas Schadaeus. |
Procopius describes the plague as progressing by definite stages, expending its virulence on one country before passing to another, as though intent on overlooking nothing. Indeed, if at first it touched a place lightly, it always returned to it subsequently, till the full measure of punishment was exacted. Always beginning at the sea-coast it spread into the interior, so that the infection in the first place was clearly sea-borne. He states that it took over a year to reach Byzantium, where it made its appearance in the spring of a.d. 542. We know, however, from Evagrius that plague was already in Antioch in a.d. 540, earlier, therefore, than the date of its alleged appearance in Pelusium.
In his discussion of etiology Procopius borrows much of the phraseology of Thucydides, but neither here nor elsewhere does he show the least sign of being influenced by the substance of the Thucydidean narrative. Thucydides, it will be remembered, evidently attributed the plague of Athens to natural causes, declining to speculate as to what could have produced such a disturbance of nature (μεταβολή).
Procopius says that those who pretended to knowledge ascribed the pestilence to things darting down from heaven (τοῖς ἐξ οὐρανοῦ ἐπισκήπτουσιν). This is indeed harking back to primitive conceptions. But he adds that they do so without a fragment of evidence, merely for the sake of deceiving, ascribing to nature what is clearly the handiwork of God and nothing else. This opinion he bases on the ground that the plague did not confine its ravages to any single country nor fall specially on either sex or any age, but spread over the whole world, regardless of season and of differences of habit. The argument, in so far as it was negative, was certainly a strong one in the light of the medical knowledge of his time, which referred much of the distinction of different maladies to variations of climate, soil, season, habit, and other accidental circumstances. Visual and auditory hallucinations were not lacking. Procopius says that many that were stricken by the plague saw, either when awake or when asleep, visions of spirits arrayed in human forms. Some seemed to hear in their sleep a voice saying that they were enrolled in the number of the dead. They fancied that these spectres in human form struck them in some part of the body, and immediately they were seized with the disease. To avoid these demons some shut themselves up in their houses and would not come out on any account. Others tried to escape the demons by invoking that the most sacred names and by every form of expiation.
This idea of pestilential demons seems to be of oriental origin. We have already encountered it in the story of Apollonius of Tyana at Ephesus. It figures in early Indian medicine, and also in Mahometan lore. Mahomet seems to have adopted it directly from Magian tradition, as embodied by Zoroaster in the Zendavesta. The Magians conceived one supreme God and Creator of the universe, from whom also emanated two active principles, personified as Ormusd, the principle or angel of light or good, and Ahriman, the principle or angel of darkness or evil, a demon. From these two opposite principles the universe was compounded, and in the direction of its affairs these two conflicting elements were always striving for mastery. So long as the angel of light was in the ascendant it was well with the affairs of men; but if for a while the demon of darkness prevailed, then sorrow and suffering and sin were the lot of mortal man. It was inevitable that a shepherd race, tending their flocks beneath a star-lit sky in the plains of Arabia and the uplands of Central Asia should see in the light and the darkness two hostile personalities dominating their existence for better or for worse.
Mahometans believed that spirits were sent by God armed with bows and arrows to disseminate plague as a punishment for sin. Spectres of a black colour dealt fatal wounds, but those dealt by white spectres were not fatal. We shall presently find this same fancy figuring in the literature and art of mediaeval Italy. It is not without interest to have traced the conception spreading, like the plague itself, from an endemic focus in the East, first to Byzantium, and then by slow stages to Italy and the West.