Several great epidemics of the Plague had already devastated the world;
the plague of Athens in the fifth century, B. C.; the plague of the
second century, in the reign of Marcus Aurelius; the plague of the
third century, in the reign of Gallus; then came that most terrible
epidemic of the sixth century, known by the name of the inguinal
pestilence, which, after ravaging Constantinople spread into Liguria,
then into France and Spain. It was in 542, according to Procopius,
that an epidemic struck the world and consumed almost all the human
species.[10]
“It attacked the entire earth,” says our author, “striking every race
of people, sparing neither age nor sex; differences in habitation,
diet, temperament or occupation of any nature did not stop its ravages;
it prevailed in summer and in winter, in fact, at every season of the
year.
“It commenced at the town of Pelusa in Egypt, from whence it spread by
two routes, one through Alexandria and the rest of Egypt, the other
through Palestine. After this it covered the whole world, progressing
always by regular intervals of time and force. In the springtime of 543
it broke out in Constantinople and announced itself in the following
manner:
“Many victims believed they saw the spirits of the departed
rehabilitated in human form. It appeared as though these spirits
appeared before the subject about to be attacked and struck him on
certain portions of the body. These apparitions heralded the onset
of the malady. It is but fair to say that the commencement of the
disease was not the same in all cases. Some victims did not see the
apparitions, but only dreamed of them, but all believed they heard
a ghostly voice announcing their inscription on the list of those
who were going to die. Some claim that the greater number of victims
were not haunted either sleeping or waking by these ghosts and the
mysterious voice that made sinister predictions.
“The fever at the onset of the attack came on suddenly,—some while
sleeping, some while waking, some while at work. Their bodies
exhibited no change of color, and the temperature was not very high.
Some indications of fever were perceptible, but no signs of acute
inflammation. In the morning and at night the fever was slight, and
indicated nothing severe either to the patient or to the physician who
counted the pulse. Most of those who presented such symptoms showed no
indications of approaching dissolution; but the first day among some,
the second day in others, and after several days in many cases, a bubo
was observed on the lower portion of the abdomen, in the groin, or
in the folds of the axilla, and sometimes back of the ears or on the
thighs.
“The principal symptoms of the disease on its invasion were as I have
pointed out; for the remainder, nothing can be precisely indicated of
the variations of the type of the disease following temperament; these
other symptoms were only such as were imprinted by the Supreme Being at
his divine will.
“Some patients were plunged into a condition of profound drowsiness;
others were victims to furious delirium. Those who were drowsy remained
in a passive state, seeming to have lost all memory of the things
of ordinary life. If they had any one to nurse them they took food
when offered from time to time, and if they had no care soon died of
inanition. The delirious patients, deprived of sleep, were eternally
pursued by their hallucinations; they imagined themselves haunted by
men ready to slay them, and they sought flight from such fancied foes,
uttering dreadful screams. Persons who were attacked while nursing the
sick were in the most pitiable condition—not that they were more liable
to contract the disease by contact, however, for nurses and doctors
did not get the disease from actual contact with the sufferers, for
some who washed and laid out the dead never contracted the malady, but
enjoyed perfect health throughout the epidemic; some, however, died
suddenly without apparent cause. Many of the nurses were overworked
keeping patients from rolling out of bed and preventing the delirious
from jumping from high windows. Some patients endeavored to throw
themselves in running water, not to quench their thirst, but because
they had lost all reason. It was necessary to struggle with many of
the sick in order to make them swallow any nourishment, which they
would not accept without more or less resistance. The buboes enfeebled
certain patients who were neither drowsy nor delirious, but who finally
succumbed to their atrocious sufferings.
“As nothing was known of this strange disease, certain physicians
thought its origin was due to some source of evil hidden in the buboes,
and they accordingly opened these glandular bodies. The dissection
of the bubo showed sub-adjacent carbuncles, whose rapid malignity
brought on sudden death or an illness of but few days’ duration. In
some instances the entire body was covered by black spots the size of
a bean. Such unfortunates rarely lived a day, and generally expired
in an hour. Many cases died suddenly, vomiting blood. One thing I can
solemnly affirm, that is, that the wisest physicians gave up all hope
in the case of many patients who afterwards recovered; on the contrary,
many persons perished at the very time their health was almost
re-established. For all these causes, the malady passed the confines
of human reasoning, and the outcome always deceived the most natural
predictions.
“As to treatment, the effects were variable, following the condition
of the victim. I may state that, as a fact, no efficacious remedies
were discovered that could either prevent the onset of the disease
or shorten its duration. The victims could not tell why they were
attacked, nor how they were cured.
“Pregnant women attacked inevitably aborted at death, some succumbing
while miscarrying; some going on to the end of gestation, dying in
labor along with their infants. Only three cases are known where women
recovered of plague after aborting; while only one instance is on
record where a newly-born child survived its mother in this epidemic.
Those in whom the buboes increased most rapidly in size, maturated
and suppurated, most often recovered, for the reason, no doubt, that
the malignant properties of the bubonic carbuncle were weakened or
destroyed.
“Experience proved that such symptoms were an almost sure presage of
a return to health. Those, on the contrary, in whom the tumor did not
change its aspect from the time of its eruption, were attacked with all
the symptoms I have before described. In some cases the skin dried and
seemed thus to prevent the tumor, although it might be well developed,
from suppurating. Some were cured at the price of a loss of power in
the tongue, which reduced the victims to stammer and articulate words
in a confused and unintelligible manner for the rest of their days.
“The epidemic at Constantinople lasted four months, three months of
which time it raged with great violence. As the epidemic progressed the
mortality-rate increased from day to day, until it reached the point
of 5,000 deaths per day, and on several occasions ran up to as high as
10,000 deaths in the twenty four hours.”
Let us pass over this very important description that Procopius gives
of the moral effect of this epidemic on the people, of the scenes
of wild and heart-rending terror, of curious examples of egotism
and sublime devotion, of instances of blind superstition developed
in a great city under the influence of fear and the dread of a very
problematical contagion.
Evagre, the scholastic, another Greek historian of the sixth century,
recounts in his works the story of the plague at Constantinople. He
states that he frequently observed that persons recovering from a
first and second attack subsequently died on a third attack; also that
persons flying from an infected locality were often taken sick after
many days of an incubating period, falling ill in their places of
refuge in the midst of populations free, up to that time, from the
pestilence.
In following the progress of this epidemic from the Orient to the
Occident, it was noticed that it always commenced at the sea-ports
and then traveled inland. The disease was carried much more easily by
ships than it could be at the present time, inasmuch as there were
no quarantines and no pest-houses for isolating patients. It entered
France by the Mediterranean Sea. It was in 549 that the plague struck
Gaul. “During this time,” says Gregory of Tours, “the malady known as
the _inguinal disease_ ravaged many sections and the province of Arles
was cruelly depopulated.”[11]
This illustrious historian wrote in another passage: “We learned this
year that the town of Narbonne was devastated by the _groin disease_,
of so deadly a type that when one was attacked he generally succumbed.
Felix, the Bishop of Nantes, was stricken down and appeared to be
desperately ill. The fever having ceased, the humor broke out on his
limbs, which were covered with pustules. It was after the application
of a plaster covered with cantharides that his limbs rotted off, and he
ceased to live in the seventieth year of his age.
“Before the plague reached Auvergne it had involved most all the rest
of the country. Here the epidemic attacked the people in 567, and so
great was the mortality that it is utterly impossible to give even the
approximate number of deaths. Populations perished _en masse_. On a
single Sunday morning three hundred bodies were counted in St. Peter’s
chapel at Clermont awaiting funeral service. Death came suddenly; it
struck the axilla or groin, forming a sore like a serpent that bit so
cruelly that men rendered up their souls to God on the second or third
day of the attack, many being so violent as to lose their senses. At
this time Lyons, Bourges, Chalons, and Dijon were almost depopulated by
the pestilence.”
In 590 the towns of Avignon and Viviers were cruelly ravaged by the
_inguinal disease_.
The plague reached Marseilles, however, in 587, being carried there by
a merchant vessel from Spain which entered the port as a center of an
infection. Several persons who bought goods from this trading vessel,
all of whom lived in one house nevertheless, were carried off by the
plague to the number of eight. The spark of the epidemic did not burn
very rapidly at first, but after a certain time the baleful fire of
the pest, after smouldering slowly, burst out in a blaze that almost
consumed Marseilles.
Bishop Theodorus isolated himself in a wing of the cloister Saint
Victor, with a small number of persons who remained with him during
the plague, and in the midst of their general desolation continued to
implore Almighty God for mercy, with fasting and prayer until the end
of the epidemic. After two months of calm the population of the city
commenced to drift back, but the plague reappeared anew and most of
those who returned died. The plague has devastated Marseilles many
times since the epoch just mentioned.
Anglada[12] who, like the writer, derives most of his citations from
Gregory of Tours, thinks that the plague that devastated Strasbourg in
591 was only the same _inguinal disease_ that ravaged Christendom. He
cites, in support of his assertion, that passage from the historian
poet Kleinlande translated by Dr. Boersch: “In 591 there was a great
mortality throughout our country, so that men fell down dying in the
streets, expiring suddenly in their houses, or even at business. When a
person sneezed his soul was apt to fly the body; hence the expression
on sneezing, ‘God bless you!’ And when a person yawned they made the
sign of the cross before their mouths.”
Such are the documents we possess on the great epidemic of inguinal
plague of the fourth century, documents furnished by historians, to
whom medical history is indebted, and not from medical authors, who
left no marks at that period.