it is very probable that it was largely smallpox. On the other hand, the plague of Saint Cyprian, which prevailed from 251 to 266 Anno Domini, may have been partly bubonic in nature, since, it prevailed during the fall and winter months and ceased during the hot summer. The disease was said to be communicated by means of clothing and by the look. It spread from Ethiopia to Egypt and thence through the known world.

Although the above early epidemics cannot be identified with the bubonic plague, there is nevertheless excellent evidence of the existence of this disease in remote antiquity. The first undoubted testimony on this point is that furnished by Rufus of Ephesus, who lived in the first century of the Christian era. The writings of this author are no longer extant, but they are quoted by Oribasius, the physician and friend of Julian the Apostate, who lived in the fourth century. The writings of Oribasius were discovered in the Vatican Library and were published early in this century by Cardinal Mai. In the forty-fourth “Book of Oribasius” occurs the extract taken from Rufus of Ephesus, from which it appears that “the so-called pestilential buboes are all fatal and have a very acute course, especially when observed in Libya, Egypt and in Syria. Dionysius mentions it. Dioscorides and Posidonius have described it at length in their treatise upon the plague which prevailed during their time in Libya.” The description which then follows of the buboes and of the disease is an exact counterpart of the present plague. The writings of the authors quoted by Rufus are no longer extant, but one thing is certain, and that is that the Dionysius referred to lived not later than 300 years before Christ. The other two physicians lived in Alexandria contemporaneous with the birth of Christ. It may, therefore, be considered as an established fact that the plague existed in Egypt, Libya and Syria as early as 300 years before Christ. This is of especial interest in view of the recent discovery by Koch of an endemic plague focus in British Uganda and German Kisiba, at the headwaters of the Nile. Whether it ever invaded European territory prior to the sixth century is unknown.

The great plague of Justinian which broke out in 542, Anno Domini, appeared first in Egypt, and from thence it spread east and west throughout the known world and persisted for more than a half century. So unknown was the plague in Europe at that time that the physicians of Constantinople considered it a new disease. Procopius, who was an eye-witness of the plague at Constantinople, states that the daily mortality in that city was at times over 10,000.

The pandemic of Justinian resulted in the distribution of the plague for the first time throughout the length and breadth of known Europe. From that time on the early chroniclers make repeated mention of devastating plagues consequent upon the miseries of war and famine. The descriptions of these pestilences are, as a rule, insufficient to identify them with the bubonic plague. Typhus, scurvy, smallpox and other diseases undoubtedly alternated in the work of destruction. Of the scores of epidemics thus recorded during the eight centuries following this first visitation few, indeed, can be identified to a certainty with the bubonic plague, and yet there can be no doubt but that this disease occupied no second rank during the dreary darkness of the middle ages. This era in history may be said to have been ushered in by the Justinian plague, and it was closed by an even more disastrous outbreak of this same disease. All the ravages and slaughter consequent upon the great historic battles, when taken together, pale into insignificance on comparison with that dread visitation of the fourteenth century, the ‘black death’.

It is noteworthy that this great historic epidemic did not originate in Egypt, as did many of its predecessors. Without exception the contemporaneous writers ascribe its origin to Cathay, or the China of today. This fact is of interest when it is borne in mind that at the present time we know of the existence of two endemic foci in China, besides that of Gurhwal in India, of Beni Cheir in Arabia and of Uganda and Kisiba in Africa. Whatever may have been its source, the fact is that it advanced from the Orient along the three principal routes of travel. One of these led from the Persian Gulf through Bassorah and Bagdad along the Euphrates, across Arabia to Egypt and Northern Africa. Another route passed from India through Afghanistan, and skirting the southern borders of the Caspian and Black Seas, eventually reached Asia Minor. A third route from Turkestan and China led around the northern shore of the Caspian Sea to Crimea, and thence to Constantinople. It was along these several routes that the plague advanced and spread over most of Western Asia and Northern Africa.

The European black death, however, can be traced with accuracy to the Crimean peninsula. Gaffa, a town in Crimea, now known as Theodosia, had been founded and fortified by the Genoese. It, as well as other cities along the Black Sea, was largely populated by Italians. One of these, Gabriel de Mussis, a lawyer in Gaffa, has left a faithful account of his experience and share in the introduction of the plague into Europe. In 1346 in the Orient numberless Tartars and Saracens were attacked with an unknown disease and sudden death. In the city of Tanais, through some excess, a racial struggle ensued between the Tartars and the Italian merchants. The latter eventually escaped and took refuge in Gaffa, which in time was besieged by the Tartars. During the siege, which lasted three years, the Tartar hordes were attacked by the plague, which daily carried off many thousands. The besiegers, despairing of reducing the city by direct attack, attempted to do so in another way. By means of their engines of war they projected the dead bodies into the beleaguered city, which, as a result, soon became infected. The Christian defenders took to their ships, and abandoning Gaffa, sailed westward, touching at Constantinople, Greece, Italy and France.

Wherever the infected vessels touched they left the plague. Constantinople thus became infected early in 1347. During the summer Greece, Sardinia, Corsica and parts of the Italian coast developed the disease. In the fall it reached Marseilles. The following year it spread inland into Italy, France, Spain, and even into England. In another year or two it spread over Germany, Russia, and crossed to the Scandinavian peninsula. Within four years it had completed the circuit of Europe, spreading untold death and misery. No greater catastrophe has been recorded in the history of the world.

The rapidity with which the disease spread among the fugitives from Gaffa, and in the cities visited by their ships, is despairingly narrated by De Mussis, who, returning in one of the ships to Genoa, says: “After landing we entered our homes. Inasmuch as a grave disease had befallen us, and of the thousands that journeyed with us scarcely ten remained, the relatives, friends and neighbors hastened to greet us. Woe to us who brought with us the darts of death, who scattered the deadly poison through the breath of our words.” According to this writer 40,000 died in Genoa, leaving scarcely a seventh of the original population. Venice was said to have lost 100,000, Naples 60,000, Sienna 70,000, Florence 100,000. All told, Italy lost half of its population.

Of the contemporaneous writers none has printed the horrors of the plague more vividly than does Boccaccio in his introduction to the ‘Decameron.’

“What magnificent dwellings, what notable palaces were then depopulated to the last person! What families extinct! What riches and vast possessions left, and no known heir to inherit! What numbers of both sexes in the prime and vigor of youth, whom in the morning either Galen, Hippocrates, or Æsculapius