general distress and terror.  The first time it raged chiefly
among the poor, but in the year 1360, more among the higher
classes.  It now also destroyed a great many children, whom it had
formerly spared, and but few women.

The like was seen in Egypt.  Here also inflammation of the lungs
was predominant, and destroyed quickly and infallibly, with
burning heat and expectoration of blood.  Here too the breath of
the sick spread a deadly contagion, and human aid was as vain as
it was destructive to those who approached the infected.

Boccacio, who was an eye-witness of its incredible fatality in
Florence, the seat of the revival of science, gives a more lively
description of the attack of the disease than his non-medical
contemporaries.

It commenced here, not as in the East, with bleeding at the nose,
a sure sign of inevitable death; but there took place at the
beginning, both in men and women, tumours in the groin and in the
axilla, varying in circumference up to the size of an apple or an
egg, and called by the people, pest-boils (gavoccioli).  Then
there appeared similar tumours indiscriminately over all parts of
the body, and black or blue spots came out on the arms or thighs,
or on other parts, either single and large, or small and thickly
studded.  These spots proved equally fatal with the pest-boils,
which had been from the first regarded as a sure sign of death.
No power of medicine brought relief--almost all died within the
first three days, some sooner, some later, after the appearance of
these signs, and for the most part entirely without fever or other
symptoms.  The plague spread itself with the greater fury, as it
communicated from the sick to the healthy, like fire among dry and
oily fuel, and even contact with the clothes and other articles
which had been used by the infected, seemed to induce the disease.
As it advanced, not only men, but animals fell sick and shortly
expired, if they had touched things belonging to the diseased or
dead.  Thus Boccacio himself saw two hogs on the rags of a person
who had died of plague, after staggering about for a short time,
fall down dead as if they had taken poison.  In other places
multitudes of dogs, cats, fowls, and other animals, fell victims
to the contagion; and it is to be presumed that other epizootes
among animals likewise took place, although the ignorant writers
of the fourteenth century are silent on this point.

In Germany there was a repetition in every respect of the same
phenomena.  The infallible signs of the oriental bubo-plague with
its inevitable contagion were found there as everywhere else; but
the mortality was not nearly so great as in the other parts of
Europe.  The accounts do not all make mention of the spitting of
blood, the diagnostic symptom of this fatal pestilence; we are
not, however, thence to conclude that there was any considerable
mitigation or modification of the disease, for we must not only
take into account the defectiveness of the chronicles, but that
isolated testimonies are often contradicted by many others.  Thus
the chronicles of Strasburg, which only take notice of boils and
glandular swellings in the axillae and groins, are opposed by
another account, according to which the mortal spitting of blood
was met with in Germany; but this again is rendered suspicious, as
the narrator postpones the death of those who were thus affected,
to the sixth, and (even the) eighth day, whereas, no other author
sanctions so long a course of the disease; and even in Strasburg,
where a mitigation of the plague may, with most probability, be
assumed since the year 1349, only 16,000 people were carried off,
the generality expired by the third or fourth day.  In Austria,
and especially in Vienna, the plague was fully as malignant as
anywhere, so that the patients who had red spots and black boils,
as well as those afflicted with tumid glands, died about the third
day; and lastly, very frequent sudden deaths occurred on the
coasts of the North Sea and in Westphalia, without any further
development of the malady.

To France, this plague came in a northern direction from Avignon,
and was there more destructive than in Germany, so that in many
places not more than two in twenty of the inhabitants survived.
Many were struck, as if by lightning, and died on the spot, and
this more frequently among the young and strong than the old;
patients with enlarged glands in the axillae and groins scarcely
survive two or three days; and no sooner did these fatal signs
appear, than they bid adieu to the world, and sought consolation
only in the absolution which Pope Clement VI. promised them in the
hour of death.

In England the malady appeared, as at Avignon, with spitting of
blood, and with the same fatality, so that the sick who were
afflicted either with this symptom or with vomiting of blood, died
in some cases immediately, in others within twelve hours, or at
the latest two days.  The inflammatory boils and buboes in the
groins and axillae were recognised at once as prognosticating a
fatal issue, and those were past all hope of recovery in whom they
arose in numbers all over the body.  It was not till towards the
close of the plague that they ventured to open, by incision, these
hard and dry boils, when matter flowed from them in small
quantity, and thus, by compelling nature to a critical
suppuration, many patients were saved.  Every spot which the sick
had touched, their breath, their clothes, spread the contagion;
and, as in all other places, the attendants and friends who were
either blind to their danger, or heroically despised it, fell a
sacrifice to their sympathy.  Even the eyes of the patient were
considered a sources of contagion, which had the power of acting
at a distance, whether on account of their unwonted lustre, or the
distortion which they always suffer in plague, or whether in
conformity with an ancient notion, according to which the sight
was considered as the bearer of a demoniacal enchantment.  Flight
from infected cities seldom availed the fearful, for the germ of
the disease adhered to them, and they fell sick, remote from
assistance, in the solitude of their country houses.

Thus did the plague spread over England with unexampled rapidity,
after it had first broken out in the county of Dorset, whence it
advanced through the counties of Devon and Somerset, to Bristol,
and thence reached Gloucester, Oxford and London.  Probably few
places escaped, perhaps not any; for the annuals of contemporaries
report that throughout the land only a tenth part of the
inhabitants remained alive.

From England the contagion was carried by a ship to Bergen, the
capital of Norway, where the plague then broke out in its most
frightful form, with vomiting of blood; and throughout the whole
country, spared not more than a third of the inhabitants.  The
sailors found no refuge in their ships; and vessels were often
seen driving about on the ocean and drifting on shore, whose crews
had perished to the last man.

In Poland the affected were attacked with spitting blood, and died
in a few days in such vast numbers, that, as it has been affirmed,
scarcely a fourth of the inhabitants were left.

Finally, in Russia the plague appeared two years later than in
Southern Europe; yet here again, with the same symptoms as
elsewhere.  Russian contemporaries have recorded that it began
with rigor, heat, and darting pain in the shoulders and back; that
it was accompanied by spitting of blood, and terminated fatally in
two, or at most three days.  It is not till the year 1360 that we
find buboes mentioned as occurring in the neck, in the axillae,
and in the groins, which are stated to have broken out when the
spitting of blood had continued some time.  According to the
experience of Western Europe, however, it cannot be assumed that
these symptoms did not appear at an earlier period.

Thus much, from authentic sources, on the nature of the Black
Death.  The descriptions which have been communicated contain,
with a few unimportant exceptions, all the symptoms of the
oriental plague which have been observed in more modern times.  No
doubt can obtain on this point.  The facts are placed clearly
before our eyes.  We must, however, bear in mind that this violent
disease does not always appear in the same form, and that while
the essence of the poison which it produces, and which is
separated so abundantly from the body of the patient, remains
unchanged, it is proteiform in its varieties, from the almost
imperceptible vesicle, unaccompanied by fever, which exists for
some time before it extends its poison inwardly, and then excites
fever and buboes, to the fatal form in which carbuncular
inflammations fall upon the most important viscera.

Such was the form which the plague assumed in the fourteenth
century, for the accompanying chest affection which appeared in
all the countries whereof we have received any account, cannot, on
a comparison with similar and familiar symptoms, be considered as
any other than the inflammation of the lungs of modern medicine, a
disease which at present only appears sporadically, and, owing to
a putrid decomposition of the fluids, is probably combined with
hemorrhages from the vessels of the lungs.  Now, as every
carbuncle, whether it be cutaneous or internal, generates in
abundance the matter of contagion which has given rise to it, so,
therefore, must the breath of the affected have been poisonous in
this plague, and on this account its power of contagion
wonderfully increased; wherefore the opinion appears
incontrovertible, that owing to the accumulated numbers of the
diseased, not only individual chambers and houses, but whole
cities were infected, which, moreover, in the Middle Ages, were,
with few exceptions, narrowly built, kept in a filthy state, and
surrounded with stagnant ditches.  Flight was, in consequence, of
no avail to the timid; for even though they had sedulously avoided
all communication with the diseased and the suspected, yet their
clothes were saturated with the pestiferous atmosphere, and every
inspiration imparted to them the seeds of the destructive malady,
which, in the greater number of cases, germinated with but too
much fertility.  Add to which, the usual propagation of the plague
through clothes, beds, and a thousand other things to which the
pestilential poison adheres--a propagation which, from want of
caution, must have been infinitely multiplied; and since articles
of this kind, removed from the access of air, not only retain the
matter of contagion for an indefinite period, but also increase
its activity and engender it like a living being, frightful ill-
consequences followed for many years after the first fury of the
pestilence was past.

The affection of the stomach, often mentioned in vague terms, and
occasionally as a vomiting of blood, was doubtless only a
subordinate symptom, even if it be admitted that actual
hematemesis did occur.  For the difficulty of distinguishing a
flow of blood from the stomach, from a pulmonic expectoration of
that fluid, is, to non-medical men, even in common cases, not
inconsiderable.  How much greater then must it have been in so
terrible a disease, where assistants could not venture to approach
the sick without exposing themselves to certain death?  Only two
medical descriptions of the malady have reached us, the one by the
brave Guy de Chauliac, the other by Raymond Chalin de Vinario, a
very experienced scholar, who was well versed in the learning of
the time.  The former takes notice only of fatal coughing of
blood; the latter, besides this, notices epistaxis, hematuria, and