Plague and pestilence in literature and art

by Sir Raymond Henry Payne Crawfurd

In Byzantium many succumbed to the disease without any premonitory visions. In these there was a sudden onset of a mild fever without any grave symptoms, so that the victim had no apprehension of dying. Then either the same day, or a day or two after, appeared a bubo (βουβών), either in the groin or armpit, or behind the ear, or elsewhere. So far as these symptoms went, all suffered in pretty much the same way. The Byzantine plague was therefore characteristically bubonic, and the buboes seem to have been distributed in the different parts of the body, much as we find them to-day. In this and in all essential points bubonic plague still exhibits a striking conformity to the picture drawn by Procopius some 1,400 years ago. Indeed Procopius has afforded an admirable outline sketch of oriental plague, to which the most recent medical science has added little beyond some elaboration of detail. We can decipher in his narrative at least four recognized types—the bubonic, the pustular, the pneumonic, and the tonsillar—as having prevailed during this epidemic in Byzantium. Unlike Thucydides, Procopius rejects the idea of contagion, as opposed to his own observations. Physicians, nurses, and those who buried the dead were not, in his experience, specially affected, in spite of their constant contact with the sick; and contrariwise, many contracted the disease without any contact at all. The belief of Procopius in the pestilence as a special act of God almost necessitated his being a non-contagionist. He was at a loss whether to attribute the varied manifestations of the disease to differences of constitution, or to the will of the Author of the plague. In one case profound lethargy prevailed, in another maniacal delirium. The lethargic lay simply regardless of everything and died of starvation, unless food was pressed on them. The delirious in their terror tried to flee: they struggled with their attendants in the attempt to throw themselves out of windows, or to drown themselves. Their desire was not to assuage their thirst, for often they threw themselves into the sea. This is evidently a criticism of the suggestion of Thucydides that it was thirst that drove the victims to throw themselves into cisterns.

Procopius says that the physicians conceived that the source of the disease lay in the buboes. This was a not unnatural inference from the fact that, in cases of simple suppuration of the bubo, the sufferer usually recovered, as though some virulent humour had escaped by this channel. For the same reason in later years incision was performed, and suppuration encouraged, whenever practicable. When, however, the physicians opened the buboes in the hope of discovering the cause, they found nothing but a horrible growth, like a carbuncle (ἄνθραξ). The Byzantine physicians evidently regarded the disease as a morbid process within the confines of recognized pathology.

There was a pustular type of the disease, and those who got a crop of black pustules all over the body, as large as a lentil, died at once. Procopius in his φλυκταίναις μελαίναις, ὅσον φακοῦ μέγεθος, ἐξήνθει τὸ σῶμα echoes the language of Thucydides, ᾄφλυκταίναις μικραῖς καὶ ἓλκεσιν ἐξηνθηκός: and it is noteworthy that ulcers were no feature of the Byzantine plague.

Many dropped dead from spontaneous vomiting of blood, probably from the lungs, as is not infrequent in the pneumonic form of plague.

Some escaped with a defect in the speech, so that as long as they lived they stammered or stuttered, and were unintelligible. This may well have been a sequel of the tonsillar type.

The plague lasted in epidemic virulence in Byzantium for four months in all, and was at its height for three. This again, speaking broadly, has been a feature of most European and Levantine outbreaks. At the worst the daily mortality reached the appalling total of ten thousand.

Procopius dwells at length on the accumulation of dead bodies in the streets and the neglect of funeral rites. At first each man buried the dead members of his own household, sometimes throwing them into graves prepared for others; but soon buriers failed, and then corpses began to litter the streets. These Justinian commissioned his agent Theodorus to bury. When all the existing burial-grounds were filled, huge burial-pits were dug wherever they could find space all round the city. Finally, when the digging of graves could no longer keep pace with the deaths, they mounted the towers of the city walls in Sycae, the port of Byzantium, and removing the roofs threw in the bodies promiscuously: when these were filled, the roofs were replaced. But when the wind set from that quarter, the awful stench proved most distressing to the citizens. Many corpses were simply cast out on the shore, where they were piled in barges and turned adrift out to sea. We shall see these various conditions strikingly reproduced during the plague of Marseilles in a.d. 1721. John of Ephesus states that the ambulance arrangements made by Justinian for the burial of the dead met all the requirements, but it is impossible to accept his statement in face of the precise and detailed account of Procopius.

The horrors of the plague, according to Procopius, turned men from dissoluteness to piety, for fear that their own death was imminent. If, however, they fell sick and recovered, they became even more dissolute than before, in the belief that they were now safe for the future. According to Thucydides, the Athenian Greeks became reckless from the first and gave themselves over to pleasure, seeing that the disease smote virtuous and vicious alike. Perhaps, however, the difference lay more in the mental attitude of the observer than in the actual demeanour of those observed.

All work came to a standstill in Byzantium, so that famine supervened in the city, where usually everything was in profusion. Justinian himself became infected and suffered from an attack, in which a bubo appeared.

Such in brief is the account that Procopius gives of the plague of Byzantium, as he saw it with his own eyes. Unquestionably he had before him the description of the plague of Athens, for now and again he slips into an identical turn of language. But to speak of him as a flagrant plagiarist of Thucydides is sheer absurdity. Rather he gives the impression of maintaining a critical attitude towards Thucydides, and of emphasizing the points of dissent. Procopius has no doubt that he is describing the same disease as Thucydides, and is impressed by the clinical differences he has observed. The tone of Thucydides is subjective: he attempts a general description, but cannot keep in the background the symptoms of his own case. The tone of Procopius is wholly objective: he writes as an intensely interested onlooker, retailing his own observations, supplemented by the statements of those who have had the disease and recovered. The apparent resemblance of the two accounts is really no more than surface deep.