vomit blood quickly died;"[17] whilst Gui de Chauliac, the Pope's physician at Avignon, who watched the course of the disease there and left the most valuable medical account of his observations, says that the epidemic was of two kinds. The first was marked by "constant fever and blood-spitting, and from this the patient died in three days;" the second was the well-known and less fatal bubonic plague.

The characteristic symptoms of this epidemic, noted in numerous contemporary accounts, appear to be identical with those of the disease known as malignant pustule of the lung; and it would appear probable that this outbreak of the plague must be distinguished from every other of which there is any record. "I express my profound conviction," writes an eminent French physician, "that the Black Death stands apart from all those which preceded or followed it. It ought to be classed among the great and new popular maladies."[18]

Be that as it may, the disease, as will be subsequently seen in the accounts of those who lived at the time, showed itself in various ways. Some were struck suddenly, and died within a few hours; others fell into a deep sleep, from [p009] which they could not be roused; whilst others, again, were racked with a sleepless fever, and tormented with a burning thirst. The usual course of the sickness, when it first made its appearance, was from three to five days; but towards the close of the epidemic the recovery of those suffering from the carbuncular swellings was extended, as in the case of ordinary Eastern plague, over many months.[19]

Such is a brief account of the disease which devastated the world in the middle of the fourteenth century. Before following the course of the epidemic in Italy, to which it was conveyed, as De' Mussi relates, from the Crimea, some account of its ravages in Constantinople and in Sicily may be given. From the Crimea Constantinople lay upon the highway to the west. Italian ships crossing the Black Sea [p010] would naturally touch at this city, then the great centre of communication between the Eastern and Western Worlds. From the relation of De' Mussi it appears that Caffa, the plague-stricken Genoese city in the Crimea, besieged by the Tartars, was in communication by ship with countries from which it received supplies. To Constantinople, therefore, it seems not unlikely that the dreaded disease was conveyed by a ship coming from this plague centre in the Crimea. An account of the pestilence at the Imperial city has come from the pen of the Emperor John Cantacuzene, who was an eye-witness of what he reports. And although he adopted the language of Thucydides, about the plague of Athens, to describe his own experiences at Constantinople, he could hardly have done so had the description not been fairly faithful to the reality. "The epidemic which then (1347) raged in northern Scythia," he writes, "traversed almost the entire sea-coasts, whence it was carried over the world. For it invaded not only Pontus, Thrace, and Macedonia, but Greece, Italy, the Islands, Egypt, Lybia, Judea, Syria, and almost the entire universe."

The disease according to his account was incurable. Neither regularity of life nor bodily strength was any preservation against it. The strong and the weak were equally struck down; and death spared not those of whom care was taken, any more than the poor, destitute of all help. No other illness of any sort showed itself in this year; all sickness took the form of the prevalent disease. Medical science recognised that it was powerless before the foe. The course of the malady was not in all cases the same. Some people died suddenly, others during the course of a day, and some after but an hour's suffering. In the case of those who lingered for two or three days the attack commenced with a violent fever. Soon the poison mounted to the brain, and the sufferer lost the use of speech, became insensible to what was taking place about him, and appeared sunk in a deep sleep. If by chance he came to himself and tried to speak [p011] his tongue refused to move, and only a few inarticulate sounds could be uttered, as the nerves had been paralysed; then he died suddenly.

Others who fell sick under the disease were attacked first, not in the head, but in the lungs. The organs of respiration became quickly inflamed, sharp pains were experienced in the chest, blood was vomited, and the breath became fetid. The throat and tongue, burnt up by the excessive fever, became black and congested with blood. "Those who drank copiously experienced no more relief than those who drank but little."

Then, after describing the terrible sleeplessness and restlessness of some sufferers, and the plague spots which broke out over the body in most cases, the Emperor proceeds:—"The few who recovered had no second attack, or at least not of a serious nature." Even some of those who manifested all the symptoms recovered against every expectation. It is certain that no efficacious remedy has been discovered. What had been useful to one appeared a real poison to another. People who nursed the sick took their malady, and on this account the deaths multiplied to such an extent that many houses remained deserted, after all who had lived in them—even the domestic animals—had been carried off by the plague.

The profound discouragement of the sick was specially sad to behold. On the first symptoms of the attack men lost all hope of recovery, and gave themselves up as lost. This moral prostration quickly made them worse and accelerated the hour of their death.

It is impossible in words to give an idea of this malady. All that can be said is that it had nothing in common with the ills to which man is naturally subject, and that it was a chastisement sent by God Himself. By this belief many turned to better things and resolved to change their lives. I do not speak only of those who were swept away by the epidemic, but of those also who recovered and endeavoured to correct their vicious tendencies and devote themselves [p012] to the practice of virtue. A large number, too, before they were attacked distributed their goods to the poor, and there were none so insensible or hard-hearted when attacked as not to show a profound sorrow for their faults so as to appear before the judgment seat of God with the best chances of salvation.

"Amongst the innumerable victims of the epidemic in Constantinople must be reckoned Andronicus, the Emperor's son, who died the third day. This young man was not only remarkable for his personal appearance, but was endowed in the highest degree with those qualities which form the chief adornment of youth; and everything about him testified that he would have followed nobly in the footsteps of his ancestors."

From Constantinople the Italian trading ships passed on towards their own country, everywhere spreading the terrible contagion. Their destinations were Genoa and Venice, as De' Mussi relates; but as the same authority says: "The sailors, as if accompanied by evil spirits, as soon as they approached the land, were death to those with whom they mingled." Thus the advent of the plague can be traced in the ports of the Adriatic in the autumn of 1347, and there can be little doubt that it was due to the arrival of ships bound from the East to Venice. Of the islands of the ocean, and particularly of Sicily, De' Mussi speaks as having been