"The Tartars followed these fugitive Italian merchants, and, surrounding the city of Caffa, besieged it likewise.12 Completely encircled by this vast army of enemies, the inhabitants were hardly able to obtain the necessaries of life, and their only hope lay in the fleet which brought them provisions. Suddenly 'the death,' as it was called, broke out in the Tartar host, and thousands were daily carried off by the disease, as if "arrows from heaven were striking at them and beating down their pride."
"At first the Tartars were paralysed with fear at the ravages of the disease, and at the prospect that sooner or later all must fall victims to it. Then they turned their vengeance on the besieged, and in the hope of communicating the infection to their Christian enemies, by the aid of the engines of war, they projected the bodies of the dead over the walls into the city. The Christian defenders, however, held their ground, and committed as many of these plague-infected bodies as possible to the waters of the sea.
"Soon, as might be supposed, the air became tainted and the wells of water poisoned, and in this way the disease spread so rapidly in the city that few of the inhabitants had strength sufficient to fly from it."13
The further account of Gabriele de' Mussi describing how a ship from Caffa conveyed the infection to Genoa, from which it spread to other districts and cities of Italy, must be deferred to the next chapter. Here a short space may be usefully devoted to a consideration of the disease itself, which proved so destructive to human life in every European country in the years 1348–1350. And, in the first place, it may be well to state that the name Black Death, by which the great pestilence is now generally known, not only in England, but elsewhere, is of comparatively modern origin.14 In no contemporary account of the epidemic is it called by that ominous title; at the time people spoke of it as "the pestilence," "the great mortality," "the death," "the plague of Florence," etc., and, apparently, not until some centuries later was it given the name of "the Black Death." This it seems to have first received in Denmark or Sweden, although it is doubtful whether the atra mors of Pontanus is equivalent to the English Black Death.15 It is hard to resist the impression that in England, at least, it was used as the recognised name for the epidemic of 1349 only after the pestilence of the 17th century had assumed to itself the title of the Great Plague. Whether the name Black Death was first adopted to express the universal state of mourning to which the disease reduced the people of all countries, or to mark the special characteristic symptoms of this epidemic, is, under the circumstances of its late origin, unimportant to determine.
The epidemic would appear to have been some form of the ordinary Eastern or bubonic plague. Together, however, with the usual characteristic marks of the common plague, there were certain peculiar and very marked symptoms, which, although not universal, are recorded very generally in European countries.
In its common form the disease showed itself in swellings and carbuncles under the arm and in the groin. These were either few and large – being at times as large as a hen's egg – or smaller and distributed over the body of the sufferer. In this the disease does not appear to have been different from the ordinary bubonic plague, which ravaged Europe during many centuries, and which is perhaps best known in England as so destructive to human life in the great plague of London in 1665. In this ordinary form it still exists in Eastern countries, and its origin is commonly traced to the method of burying the dead in vogue there.
The special symptoms characteristic of the plague of 1348–9 were four in number: —
(1) Gangrenous inflammation of the throat and lungs;
(2) Violent pains in the region of the chest;
(3) The vomiting and spitting of blood; and
(4) The pestilential odour coming from the bodies and breath of the sick.
In almost every detailed account by contemporary writers these characteristics are noted. And, although not all who were stricken with the disease manifested it in this special form, it is clear that, not only were many, and indeed vast numbers, carried off by rapid corruption of the lungs and blood-spitting, without any signs of swellings or carbuncles, but also that the disease was at the time regarded as most deadly and fatal in this special form. "From the carbuncles and glandular swellings," says a contemporary writer, "many recovered; from the blood-spitting none."16 Matteo Villani, one of the most exact writers about this plague at Florence, says that the sick "who began to 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 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 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