PLATE XII (Face Page 110)
MADONNA AND CHILD,
S. ANNA AND SAINTS
BY G. FRANCESCO CAROTO
Photograph by Alinari, Rome
CHAPTER VII
There is no need to rewrite the history of the Black Death: that has been admirably accomplished by Hecker and by Abbot Gasquet. It is still profitable, however, to investigate its by-effects in the domains of literature and art, and to consider its broad morbid features, as a contribution to the medical history of the time. The Black Death was the first great pandemic that left in its wake a complete and continuous succession of literary and historical records, in most points complementary, in some frankly contradictory, but for all that none the less instructive.
As to the starting-point of the pandemic there is a diversity of voices. Russian records place it in India, Greek in Scythia, English in India and Asiatic Turkey, Arabian in Tartary and the land of darkness. According to Italian tradition it originated in Cathay, to the north of China, and spread in every direction from that focus; northward by Bokhara and Tartary to the Black Sea; to India and the towns south of the Caspian, and to Asia Minor; and by way of Baghdad through Arabia and Egypt to the north of Africa. The leading contemporary Italian authority is Gabrielle de Mussi, a notary of Piacenza, who himself saw its outbreak in Upper Italy. In his ‘Ystoria de morbo seu mortalitate qui fuit a 1348’, first printed by Henschel in Haeser’s Archiv für die gesammte Medicin, he describes how the plague was brought by ship from Caffa; a Genoese settlement in the Crimea. The Tartar city Tana (Port Azov), that had been appropriated by Italian merchants, was besieged in a.d. 1346 by an army of Tartars and Saracens. The Tartars expelled them, and followed them to Caffa, whither they had fled. Plague broke out fiercely among the besieging Tartars, who, in the hope of infecting the garrison, threw their dead bodies into the city by means of engines of war. The garrison in turn cast them into the sea, but the city became infected and almost completely depopulated, a few survivors taking ship and carrying the disease with them to Italy in the autumn of a.d. 1347. Speaking of the infection of Caffa, de Mussi says ‘the air became tainted and the wells of water poisoned, and in this way the disease spread rapidly in the city’. So the old idea of poison still prevails, but it is a virus derived from infected corpses, and not some extraneous poison compounded by a maleficent enemy. The poison was communicable also from man to man, for he says of the sailors coming from Caffa to Venice and Genoa that ‘as if accompanied by evil spirits, as soon as they approached the land, they were death to those with whom they mingled’.
These ships seem to have infected Constantinople en route, and an account of its ravages there survives from the pen of the Emperor Cantacuzenus.[147] It is a mistake to regard his record as worthless material, because of its plagiarism of much of the language of Thucydides. In what is not appropriated from this source he gives a valuable clinical description of the disease. He notes the early low delirium, and distinguishes pneumonic, bubonic, and carbuncular types of the disease. He mentions cervical and axillary, but not inguinal buboes, and also the dark patches on the skin, that later came to be termed ‘tokens’. He also asserts the incidence of the disease on the domestic animals.