1 Handbuch der historisch-geographischen Pathologie, Dr. August Hirsch, 1860.
The three forms of plague—(a) the grave (or ordinary), (b) the fulminant (pestis siderans), and (c) the larval or abortive, observed in epidemics and hereafter to be described—do not represent distinct varieties of the disease, but are merely expressions of differences in the intensity of the action of the infecting principle upon different groups of individuals in given communities—differences to be explained here, as in the other infectious diseases, in part by variations in the activity of the poison itself, in part by the individual peculiarities and susceptibilities of those exposed to it.
HISTORICAL SKETCH.—Upon the authority of Rufus of Ephesus, quoted by Oribasius,2 it is stated that the bubo plague prevailed as an endemic, and at times as an epidemic disease, in Libya, Egypt, and Syria prior to the beginning of the Christian era.
2 Medicinalia Collecta.
In the year 542 A.D., according to Procopius,3 the plague appeared in Egypt, at Pelusium; extended westward to Alexandria; eastward to Palestine, Syria, and Persia; passed from Asia Minor to Europe, where it first invaded Constantinople, whence it spread in all directions with such fury that before the close of the sixth century one-half the inhabitants of the Eastern empire had perished, either of the plague itself or of the universal destitution that followed in its train.
3 See Hirsch.
With this epidemic, known in history as the Justinian plague, this disease established itself for the first time in Europe, where it maintained foothold for more than a thousand years.
About the middle of the seventeenth century the wide prevalence of the plague in Europe began to draw to an end. In Spain it was epidemic for the last time from 1677 to 1681; in Italy the last general epidemic came to a close in 1656, although local outbreaks continued to occur till the beginning of the following century. In France it still prevailed in several provinces in 1668, although it had for the most part disappeared some years before. In Switzerland we encounter it for the last time in 1667-68; in the Netherlands in 1677; from England the plague disappeared with the great outbreak of 1665. In the early part of the eighteenth century two important epidemics occurred within the boundaries of Europe. The first spread from Turkey, through Hungary and Poland, to Russia, thence to Norway and Sweden, and along the shores of the Baltic Sea to the Low Countries. This epidemic came to an end in 1714. Six years later the last great outbreak of the plague on European soil took place. It prevailed with great fury in Marseilles in 1720-21, and overran the whole of Provence. From this date till the close of the century Europe remained free from the plague, with the exception of Turkey and the contiguous countries. During the second and third decades of the present century repeated epidemics occurred in the Balkan Peninsula and the regions bordering on the Lower Danube and the Black Sea. The plague appeared also in Malta in 1813, and prevailed till 1815, and in 1816 it reached certain of the Ionian Islands. Only twice has this pest shown itself during the present century in Western Europe—once, during the epidemic at Malta in 1815, at Noja, a town of the Neapolitan province of Bari; the second time, in 1820, at Majorca, whither it was carried over from the coast of Barbary.
Between 1552 and 1784 the plague prevailed twenty-six times in Tunis and Algiers. Some idea of the importance assumed by this scourge in the countries of North-western Africa may be found from the fact that many of these epidemics lasted continuously for years, that which came in 1784 not ceasing for fifteen years. Between 1816 and 1821 the plague again prevailed in Tunis and Algiers, and again in 1836-37.
During the first half of the present century a change took place in the prevalence of the disease elsewhere. Shortly before its complete disappearance from Europe it ceased to prevail in Western Africa (with the exception of the Nile countries), in Mesopotamia, and in Persia. It disappeared from Asia Minor, Syria, and Palestine in 1843, from Egypt in 1844.