The Black Death
The Black DeathINTRODUCTIONCHAPTER I—GENERAL OBSERVATIONSCHAPTER II—THE DISEASECHAPTER III—CAUSES—SPREADCHAPTER IV—MORTALITYCHAPTER V—MORAL EFFECTSCHAPTER VI—PHYSICIANSCopyright
The Black Death
Justus Friedrich Karl Hecker
INTRODUCTION
Justus Friedrich Karl Hecker was one of three generations of
distinguished professors of medicine. His father, August Friedrich
Hecker, a most industrious writer, first practised as a physician
in Frankenhausen, and in 1790 was appointed Professor of Medicine
at the University of Erfurt. In 1805 he was called to the like
professorship at the University of Berlin. He died at Berlin in
1811.
Justus Friedrich Karl Hecker was born at Erfurt in January, 1795.
He went, of course—being then ten years old—with his father to
Berlin in 1805, studied at Berlin in the Gymnasium and University,
but interrupted his studies at the age of eighteen to fight as a
volunteer in the war for a renunciation of Napoleon and all his
works. After Waterloo he went back to his studies, took his
doctor’s degree in 1817 with a treatise on the “Antiquities of
Hydrocephalus,” and became privat-docent in the Medical Faculty of
the Berlin University. His inclination was strong from the first
towards the historical side of inquiries into Medicine. This caused
him to undertake a “History of Medicine,” of which the first volume
appeared in 1822. It obtained rank for him at Berlin as
Extraordinary Professor of the History of Medicine. This office was
changed into an Ordinary professorship of the same study in 1834,
and Hecker held that office until his death in 1850.
The office was created for a man who had a special genius for this
form of study. It was delightful to himself, and he made it
delightful to others. He is regarded as the founder of historical
pathology. He studied disease in relation to the history of man,
made his study yield to men outside his own profession an important
chapter in the history of civilisation, and even took into account
physical phenomena upon the surface of the globe as often affecting
the movement and character of epidemics.
The account of “The Black Death” here translated by Dr. Babington
was Hecker’s first important work of this kind. It was published in
1832, and was followed in the same year by his account of “The
Dancing Mania.” The books here given are the two that first gave
Hecker a wide reputation. Many other such treatises followed, among
them, in 1865, a treatise on the “Great Epidemics of the Middle
Ages.” Besides his “History of Medicine,” which, in its second
volume, reached into the fourteenth century, and all his smaller
treatises, Hecker wrote a large number of articles in Encyclopædias
and Medical Journals. Professor J.F.K. Hecker was, in a more
interesting way, as busy as Professor A.F. Hecker, his father, had
been. He transmitted the family energies to an only son, Karl von
Hecker, born in 1827, who distinguished himself greatly as a
Professor of Midwifery, and died in 1882.
Benjamin Guy Babington, the translator of these books of Hecker’s,
belonged also to a family in which the study of Medicine has passed
from father to son, and both have been writers. B.G. Babington was
the son of Dr. William Babington, who was physician to Guy’s
Hospital for some years before 1811, when the extent of his private
practice caused him to retire. He died in 1833. His son, Benjamin
Guy Babington, was educated at the Charterhouse, saw service as a
midshipman, served for seven years in India, returned to England,
graduated as physician at Cambridge in 1831. He distinguished
himself by inquiries into the cholera epidemic in 1832, and
translated these pieces of Hecker’s in 1833, for publication by the
Sydenham Society. He afterwards translated Hecker’s other treatises
on epidemics of the Middle Ages. Dr. B.G. Babington was Physician
to Guy’s Hospital from 1840 to 1855, and was a member of the
Medical Council of the General Board of Health. He died on the 8th
of April, 1866.
CHAPTER I—GENERAL OBSERVATIONS
That Omnipotence which has called the world with all its living
creatures into one animated being, especially reveals Himself in
the desolation of great pestilences. The powers of creation come
into violent collision; the sultry dryness of the atmosphere; the
subterraneous thunders; the mist of overflowing waters, are the
harbingers of destruction. Nature is not satisfied with the
ordinary alternations of life and death, and the destroying angel
waves over man and beast his flaming sword.
These revolutions are performed in vast cycles, which the spirit of
man, limited, as it is, to a narrow circle of perception, is unable
to explore. They are, however, greater terrestrial events than any
of those which proceed from the discord, the distress, or the
passions of nations. By annihilations they awaken new life; and
when the tumult above and below the earth is past, nature is
renovated, and the mind awakens from torpor and depression to the
consciousness of an intellectual existence.
Were it in any degree within the power of human research to draw
up, in a vivid and connected form, an historical sketch of such
mighty events, after the manner of the historians of wars and
battles, and the migrations of nations, we might then arrive at
clear views with respect to the mental development of the human
race, and the ways of Providence would be more plainly discernible.
It would then be demonstrable, that the mind of nations is deeply
affected by the destructive conflict of the powers of nature, and
that great disasters lead to striking changes in general
civilisation. For all that exists in man, whether good or evil, is
rendered conspicuous by the presence of great danger. His inmost
feelings are roused—the thought of self-preservation masters his
spirit—self-denial is put to severe proof, and wherever darkness
and barbarism prevail, there the affrighted mortal flies to the
idols of his superstition, and all laws, human and divine, are
criminally violated.
In conformity with a general law of nature, such a state of
excitement brings about a change, beneficial or detrimental,
according to circumstances, so that nations either attain a higher
degree of moral worth, or sink deeper in ignorance and vice. All
this, however, takes place upon a much grander scale than through
the ordinary vicissitudes of war and peace, or the rise and fall of
empires, because the powers of nature themselves produce plagues,
and subjugate the human will, which, in the contentions of nations,
alone predominates.
CHAPTER II—THE DISEASE
The most memorable example of what has been advanced is afforded by
a great pestilence of the fourteenth century, which desolated Asia,
Europe, and Africa, and of which the people yet preserve the
remembrance in gloomy traditions. It was an oriental plague, marked
by inflammatory boils and tumours of the glands, such as break out
in no other febrile disease. On account of these inflammatory
boils, and from the black spots, indicatory of a putrid
decomposition, which appeared upon the skin, it was called in
Germany and in the northern kingdoms of Europe the Black Death, and
in Italy, la mortalega grande, the Great Mortality.
Few testimonies are presented to us respecting its symptoms and its
course, yet these are sufficient to throw light upon the form of
the malady, and they are worthy of credence, from their coincidence
with the signs of the same disease in modern times.
The imperial writer, Kantakusenos, whose own son, Andronikus, died
of this plague in Constantinople, notices great imposthumes of the
thighs and arms of those affected, which, when opened, afforded
relief by the discharge of an offensive matter. Buboes, which are
the infallible signs of the oriental plague, are thus plainly
indicated, for he makes separate mention of smaller boils on the
arms and in the face, as also in other parts of the body, and
clearly distinguishes these from the blisters, which are no less
produced by plague in all its forms. In many cases, black spots
broke out all over the body, either single, or united and
confluent.
These symptoms were not all found in every case. In many, one alone
was sufficient to cause death, while some patients recovered,
contrary to expectation, though afflicted with all. Symptoms of
cephalic affection were frequent; many patients became stupefied
and fell into a deep sleep, losing also their speech from palsy of
the tongue; others remained sleepless and without rest. The fauces
and tongue were black, and as if suffused with blood; no beverage
could assuage their burning thirst, so that their sufferings
continued without alleviation until terminated by death, which many
in their despair accelerated with their own hands. Contagion was
evident, for attendants caught the disease of their relations and
friends, and many houses in the capital were bereft even of their
last inhabitant. Thus far the ordinary circumstances only of the
oriental plague occurred. Still deeper sufferings, however, were
connected with this pestilence, such as have not been felt at other
times; the organs of respiration were seized with a putrid
inflammation; a violent pain in the chest attacked the patient;
blood was expectorated, and the breath diffused a pestiferous
odour.
In the West, the following were the predominating symptoms on the
eruption of this disease. An ardent fever, accompanied by an
evacuation of blood, proved fatal in the first three days. It
appears that buboes and inflammatory boils did not at first come
out at all, but that the disease, in the form of carbuncular
(anthrax-artigen) affection of the lungs, effected the destruction
of life before the other symptoms were developed.
Thus did the plague rage in Avignon for six or eight weeks, and the
pestilential breath of the sick, who expectorated blood, caused a
terrible contagion far and near; for even the vicinity of those who
had fallen ill of plague was certain death; so that parents
abandoned their infected children, and all the ties of kindred were
dissolved. After this period, buboes in the axilla and in the
groin, and inflammatory boils all over the body, made their
appearance; but it was not until seven months afterwards that some
patients recovered with matured buboes, as in the ordinary milder
form of plague.
Such is the report of the courageous Guy de Chauliac, who
vindicated the honour of medicine, by bidding defiance to danger;
boldly and constantly assisting the affected, and disdaining the
excuse of his colleagues, who held the Arabian notion, that medical
aid was unavailing, and that the contagion justified flight. He saw
the plague twice in Avignon, first in the year 1348, from January
to August, and then twelve years later, in the autumn, when it
returned from Germany, and for nine months spread 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.