Historic Public Health Books

CHAPTER III--CAUSES--SPREAD

An inquiry into the causes of the Black Death will not be without important results in the study of the plagues which have visited the world, although it cannot advance beyond generalisation without entering upon a field hitherto uncultivated, and, to this hour entirely unknown. Mighty revolutions in the organism of the earth, of which we have credible information, had preceded it. From China to the Atlantic, the foundations of the earth were shaken--throughout Asia and Europe the atmosphere was in commotion, and endangered, by its baneful influence, both vegetable and animal life.

The series of these great events began in the year 1333, fifteen years before the plague broke out in Europe: they first appeared in China. Here a parching drought, accompanied by famine, commenced in the tract of country watered by the rivers Kiang and Hoai. This was followed by such violent torrents of rain, in and about Kingsai, at that time the capital of the empire, that, according to tradition, more than 400,000 people perished in the floods. Finally the mountain Tsincheou fell in, and vast clefts were formed in the earth. In the succeeding year (1334), passing over fabulous traditions, the neighbourhood of Canton was visited by inundations; whilst in Tche, after an unexampled drought, a plague arose, which is said to have carried off about 5,000,000 of people. A few months afterwards an earthquake followed, at and near Kingsai; and subsequent to the falling in of the mountains of Ki-ming-chan, a lake was formed of more than a hundred leagues in circumference, where, again, thousands found their grave. In Houkouang and Honan, a drought prevailed for five months; and innumerable swarms of locusts destroyed the vegetation; while famine and pestilence, as usual, followed in their train. Connected accounts of the condition of Europe before this great catastrophe are not to be expected from the writers of the fourteenth century. It is remarkable, however, that simultaneously with a drought and renewed floods in China, in 1336, many uncommon atmospheric phenomena, and in the winter, frequent thunderstorms, were observed in the north of France; and so early as the eventful year of 1333 an eruption of Etna took place. According to the Chinese annuals, about 4,000,000 of people perished by famine in the neighbourhood of Kiang in 1337; and deluges, swarms of locusts, and an earthquake which lasted six days, caused incredible devastation. In the same year, the first swarms of locusts appeared in Franconia, which were succeeded in the following year by myriads of these insects. In 1338 Kingsai was visited by an earthquake of ten days' duration; at the same time France suffered from a failure in the harvest; and thenceforth, till the year 1342, there was in China a constant succession of inundations, earthquakes, and famines. In the same year great floods occurred in the vicinity of the Rhine and in France, which could not be attributed to rain alone; for, everywhere, even on tops of mountains, springs were seen to burst forth, and dry tracts were laid under water in an inexplicable manner. In the following year, the mountain Hong-tchang, in China, fell in, and caused a destructive deluge; and in Pien- tcheon and Leang-tcheou, after three months' rain, there followed unheard-of inundations, which destroyed seven cities. In Egypt and Syria, violent earthquakes took place; and in China they became, from this time, more and more frequent; for they recurred, in 1344, in Ven-tcheou, where the sea overflowed in consequence; in 1345, in Ki-tcheou, and in both the following years in Canton, with subterraneous thunder. Meanwhile, floods and famine devastated various districts, until 1347, when the fury of the elements subsided in China.

The signs of terrestrial commotions commenced in Europe in the year 1348, after the intervening districts of country in Asia had probably been visited in the same manner.

On the island of Cyprus, the plague from the East had already broken out; when an earthquake shook the foundations of the island, and was accompanied by so frightful a hurricane, that the inhabitants who had slain their Mahometan slaves, in order that they might not themselves be subjugated by them, fled in dismay, in all directions. The sea overflowed--the ships were dashed to pieces on the rocks, and few outlived the terrific event, whereby this fertile and blooming island was converted into a desert. Before the earthquake, a pestiferous wind spread so poisonous an odour, that many, being overpowered by it, fell down suddenly and expired in dreadful agonies.

This phenomenon is one of the rarest that has ever been observed, for nothing is more constant than the composition of the air; and in no respect has nature been more careful in the preservation of organic life. Never have naturalists discovered in the atmosphere foreign elements, which, evident to the senses, and borne by the winds, spread from land to land, carrying disease over whole portions of the earth, as is recounted to have taken place in the year 1348. It is, therefore, the more to be regretted, that in this extraordinary period, which, owing to the low condition of science, was very deficient in accurate observers, so little that can be depended on respecting those uncommon occurrences in the air, should have been recorded. Yet, German accounts say expressly, that a thick, stinking mist advanced from the East, and spread itself over Italy; and there could be no deception in so palpable a phenomenon. The credibility of unadorned traditions, however little they may satisfy physical research, can scarcely be called in question when we consider the connection of events; for just at this time earthquakes were more general than they had been within the range of history. In thousands of places chasms were formed, from whence arose noxious vapours; and as at that time natural occurrences were transformed into miracles, it was reported, that a fiery meteor, which descended on the earth far in the East, had destroyed everything within a circumference of more than a hundred leagues, infecting the air far and wide. The consequences of innumerable floods contributed to the same effect; vast river districts had been converted into swamps; foul vapours arose everywhere, increased by the odour of putrified locusts, which had never perhaps darkened the sun in thicker swarms, and of countless corpses, which even in the well-regulated countries of Europe, they knew not how to remove quickly enough out of the sight of the living. It is probable, therefore, that the atmosphere contained foreign, and sensibly perceptible, admixtures to a great extent, which, at least in the lower regions, could not be decomposed, or rendered ineffective by separation.

Now, if we go back to the symptoms of the disease, the ardent inflammation of the lungs points out, that the organs of respiration yielded to the attack of an atmospheric poison--a poison which, if we admit the independent origin of the Black Plague at any one place of the globe, which, under such extraordinary circumstances, it would be difficult to doubt, attacked the course of the circulation in as hostile a manner as that which produces inflammation of the spleen, and other animal contagions that cause swelling and inflammation of the lymphatic glands.

Pursuing the course of these grand revolutions further, we find notice of an unexampled earthquake, which, on the 25th January, 1348, shook Greece, Italy, and the neighbouring countries. Naples, Rome, Pisa, Bologna, Padua, Venice, and many other cities, suffered considerably; whole villages were swallowed up. Castles, houses, and churches were overthrown, and hundreds of people were buried beneath their ruins. In Carinthia, thirty villages, together with all the churches, were demolished; more than a thousand corpses were drawn out of the rubbish; the city of Villach was so completely destroyed that very few of its inhabitants were saved; and when the earth ceased to tremble it was found that mountains had been moved from their positions, and that many hamlets were left in ruins. It is recorded that during this earthquake the wine in the casks became turbid, a statement which may be considered as furnishing proof that changes causing a decomposition of the atmosphere had taken place; but if we had no other information from which the excitement of conflicting powers of nature during these commotions might be inferred, yet scientific observations in modern times have shown that the relation of the atmosphere to the earth is changed by volcanic influences. Why then, may we not, from this fact, draw retrospective inferences respecting those extraordinary phenomena?

Independently of this, however, we know that during this earthquake, the duration of which is stated by some to have been a week, and by others a fortnight, people experienced an unusual stupor and headache, and that many fainted away.

These destructive earthquakes extended as far as the neighbourhood of Basle, and recurred until the year 1360 throughout Germany, France, Silesia, Poland, England, and Denmark, and much further north.

Great and extraordinary meteors appeared in many places, and were regarded with superstitious horror. A pillar of fire, which on the 20th of December, 1348, remained for an hour at sunrise over the pope's palace in Avignon; a fireball, which in August of the same year was seen at sunset over Paris, and was distinguished from similar phenomena by its longer duration, not to mention other instances mixed up with wonderful prophecies and omens, are recorded in the chronicles of that age.

The order of the seasons seemed to be inverted; rains, flood, and failures in crops were so general that few places were exempt from them; and though an historian of this century assure us that there was an abundance in the granaries and storehouses, all his contemporaries, with one voice, contradict him. The consequences of failure in the crops were soon felt, especially in Italy and the surrounding countries, where, in this year, a rain, which continued for four months, had destroyed the seed. In the larger cities they were compelled, in the spring of 1347, to have recourse to a distribution of bread among the poor, particularly at Florence, where they erected large bakehouses, from which, in April, ninety-four thousand loaves of bread, each of twelve ounces in weight, were daily dispensed. It is plain, however, that humanity could only partially mitigate the general distress, not altogether obviate it.

Diseases, the invariable consequence of famine, broke out in the country as well as in cities; children died of hunger in their mother's arms--want, misery, and despair were general throughout Christendom.

Such are the events which took place before the eruption of the Black Plague in Europe. Contemporaries have explained them after their own manner, and have thus, like their posterity, under similar circumstances, given a proof that mortals possess neither senses nor intellectual powers sufficiently acute to comprehend the phenomena produced by the earth's organism, much less scientifically to understand their effects. Superstition, selfishness in a thousand forms, the presumption of the schools, laid hold of unconnected facts. They vainly thought to comprehend the whole in the individual, and perceived not the universal spirit which, in intimate union with the mighty powers of nature, animates the movements of all existence, and permits not any phenomenon to originate from isolated causes. To attempt, five centuries after that age of desolation, to point out the causes of a cosmical commotion, which has never recurred to an equal extent, to indicate scientifically the influences, which called forth so terrific a poison in the bodies of men and animals, exceeds the limits of human understanding. If we are even now unable, with all the varied resources of an extended knowledge of nature, to define that condition of the atmosphere by which pestilences are generated, still less can we pretend to reason retrospectively from the nineteenth to the fourteenth century; but if we take a general view of the occurrences, that century will give us copious information, and, as applicable to all succeeding times, of high importance.

In the progress of connected natural phenomena from east to west, that great law of nature is plainly revealed which has so often and evidently manifested itself in the earth's organism, as well as in the state of nations dependent upon it. In the inmost depths of the globe that impulse was given in the year 1333, which in uninterrupted succession for six and twenty years shook the surface of the earth, even to the western shores of Europe. From the very beginning the air partook of the terrestrial concussion, atmospherical waters overflowed the land, or its plants and animals perished under the scorching heat. The insect tribe was wonderfully called into life, as if animated beings were destined to complete the destruction which astral and telluric powers had begun. Thus did this dreadful work of nature advance from year to year; it was a progressive infection of the zones, which exerted a powerful influence both above and beneath the surface of the earth; and after having been perceptible in slighter indications, at the commencement of the terrestrial commotions in China, convulsed the whole earth.

The nature of the first plague in China is unknown. We have no certain intelligence of the disease until it entered the western countries of Asia. Here it showed itself as the Oriental plague, with inflammation of the lungs; in which form it probably also may have begun in China, that is to say, as a malady which spreads, more than any other, by contagion--a contagion that, in ordinary pestilences, requires immediate contact, and only under favourable circumstances of rare occurrence is communicated by the mere approach to the sick. The share which this cause had in the spreading of the plague over the whole earth was certainly very great; and the opinion that the Black Death might have been excluded from Western Europe by good regulations, similar to those which are now in use, would have all the support of modern experience, provided it could be proved that this plague had been actually imported from the East, or that the Oriental plague in general, whenever it appears in Europe, has its origin in Asia or Egypt. Such a proof, however, can by no means be produced so as to enforce conviction; for it would involve the impossible assumption, either that there is no essential difference between the degree of civilisation of the European nations, in the most ancient and in modern times, or that detrimental circumstances, which have yielded only to the civilisation of human society and the regular cultivation of countries, could not formerly keep up the glandular plague.

The plague was, however, known in Europe before nations were united by the bonds of commerce and social intercourse; hence there is ground for supposing that it sprang up spontaneously, in consequence of the rude manner of living and the uncultivated state of the earth, influences which peculiarly favour the origin of severe diseases. Now we need not go back to the earlier centuries, for the fourteenth itself, before it had half expired, was visited by five or six pestilences.

If, therefore, we consider the peculiar property of the plague, that in countries which it has once visited it remains for a long time in a milder form, and that the epidemic influences of 1342, when it had appeared for the last time, were particularly favourable to its unperceived continuance, till 1348, we come to the notion that in this eventful year also the germs of plague existed in Southern Europe, which might be vivified by atmospherical deteriorations; and that thus, at least in part, the Black Plague may have originated in Europe itself. The corruption of the atmosphere came from the East; but the disease itself came not upon the wings of the wind, but was only excited and increased by the atmosphere where it had previously existed.

This source of the Black Plague was not, however, the only one; for far more powerful than the excitement of the latent elements of the plague by atmospheric influences was the effect of the contagion communicated from one people to another on the great roads and in the harbours of the Mediterranean. From China the route of the caravans lay to the north of the Caspian Sea, through Central Asia, to Tauris. Here ships were ready to take the produce of the East to Constantinople, the capital of commerce, and the medium of connection between Asia, Europe, and Africa. Other caravans went from India to Asia Minor, and touched at the cities south of the Caspian Sea, and, lastly, from Bagdad through Arabia to Egypt; also the maritime communication on the Red Sea, from India to Arabia and Egypt, was not inconsiderable. In all these directions contagion made its way; and, doubtless, Constantinople and the harbours of Asia Minor are to be regarded as the foci of infection, whence it radiated to the most distant seaports and islands.

To Constantinople the plague had been brought from the northern coast of the Black Sea, after it had depopulated the countries between those routes of commerce, and appeared as early as 1347 in Cyprus, Sicily, Marseilles, and some of the seaports of Italy. The remaining islands of the Mediterranean, particularly Sardinia, Corsica, and Majorca, were visited in succession. Foci of contagion existed also in full activity along the whole southern coast of Europe; when, in January, 1348, the plague appeared in Avignon, and in other cities in the south of France and north of Italy, as well as in Spain.

The precise days of its eruption in the individual towns are no longer to be ascertained; but it was not simultaneous; for in Florence the disease appeared in the beginning of April, in Cesena the 1st June, and place after place was attacked throughout the whole year; so that the plague, after it had passed through the whole of France and Germany--where, however, it did not make its ravages until the following year--did not break out till August in England, where it advanced so gradually, that a period of three months elapsed before it reached London. The northern kingdoms were attacked by it in 1349; Sweden, indeed, not until November of that year, almost two years after its eruption in Avignon. Poland received the plague in 1349, probably from Germany, if not from the northern countries; but in Russia it did not make its appearance until 1351, more than three years after it had broken out in Constantinople. Instead of advancing in a north-westerly direction from Tauris and from the Caspian Sea, it had thus made the great circuit of the Black Sea, by way of Constantinople, Southern and Central Europe, England, the northern kingdoms, and Poland, before it reached the Russian territories, a phenomenon which has not again occurred with respect to more recent pestilences originating in Asia.

Whether any difference existed between the indigenous plague, excited by the influence of the atmosphere, and that which was imported by contagion, can no longer be ascertained from facts; for the contemporaries, who in general were not competent to make accurate researches of this kind, have left no data on the subject. A milder and a more malignant form certainly existed, and the former was not always derived from the latter, as is to be supposed from this circumstance--that the spitting of blood, the infallible diagnostic of the latter, on the first breaking out of the plague, is not similarly mentioned in all the reports; and it is therefore probable that the milder form belonged to the native plague--the more malignant, to that introduced by contagion. Contagion was, however, in itself, only one of many causes which gave rise to the Black Plague.

This disease was a consequence of violent commotions in the earth's organism--if any disease of cosmical origin can be so considered. One spring set a thousand others in motion for the annihilation of living beings, transient or permanent, of mediate or immediate effect. The most powerful of all was contagion; for in the most distant countries, which had scarcely yet heard the echo of the first concussion, the people fell a sacrifice to organic poison--the untimely offspring of vital energies thrown into violent commotion.