APPENDIX[200]

The statement of Thucydides, that all other diseases took on the similitude of the dominating pestilence, is one that reappears constantly in the literature of epidemic disease. We have already noted the frequent concurrence of plague and typhus, leading such acute observers as Diemerbroeck and Sydenham to believe that the one disease might be transformed into the other. The same close association of relapsing fever and typhus was constantly noted, and we know now that the explanation lies in the fact that each disease is transmitted by the body-louse, as plague is transmitted by the flea. Bearing in mind the close and constant association of these and other acute infectious fevers it is no matter for surprise that they should have been regarded as states and stages of one pestilential process, differing from one another, not in kind, but only in degree. As Bacon says, ‘putrefaction rises not to its height at once.’

The acute, often abrupt, onset of the Athenian pestilence, with profound depression, severe headache, and suffused conjunctivae, though met with in a moiety of cases of plague, is eminently characteristic of typhus. The striking appearance of the bloodshot eyeballs has led to much confusion between the two diseases.

The aspect of the tongue and fauces inclines rather to the side of typhus. In each disease the tongue is at first heavily coated with a thick white fur, and tends later to become dry and parched. But in typhus there is a special tendency, as the disease advances, for the tongue to bleed from fissures at the edges. So frequently is this the case, that this feature has been regarded as of diagnostic value in the presence of an outbreak of typhus. A boggy reddened appearance of the fauces is usual in typhus, and is seen also in a proportion of plague patients.

Unnatural and even foetid breath may be met with in any acute infectious fever, but foetor is in no way characteristic of any. Doubtless it was far more common in times when the alphabet of oral hygiene had not yet found acceptance as a necessary detail of medical regimen. Murchison describes the breath of typhus patients as foetid, and in addition it is well known that a repulsive odour may be given off from their bodies. Salius Diversus mentioned it three centuries ago, and it has been a commonplace of many subsequent writers. Curschmann failed to detect it, and attributed its absence to the free ventilation of the sick wards. A layman, as Thucydides was, might well ascribe to the breath a foetor permeating the whole atmosphere around the patient.

Sneezing has long been associated in popular tradition with plague, and an old legend refers the association to the plague of Rome at the commencement of the pontificate of Gregory the Great, when it is said that those who sneezed died. The most careful and observant of modern physicians do not, however confirm the connexion. Russell states that he was on the look out for it during the plague of Aleppo and did not observe it: Simpson does not even mention it. Nor does it appear to be noteworthy as a symptom either of typhus or of any other acute infectious fever, though it would be in accord with the swollen and congested state of the nasal mucosa in typhus, to which Curschmann has drawn special attention. Perhaps the tradition is a mere old wives’ tale, for sneezing has been regarded as an ominous sign from great antiquity, and as far back at least as the composition of theOdyssey. Aristotle frankly confessed himself unable to explain the connexion.

Curschmann met with hoarseness and laryngeal catarrh commonly in typhus, but though catarrh of the whole respiratory tract may occur in plague, it is not an outstanding feature. Cough is frequent in either disease; so also is vomiting, often of great severity: and if protracted will exhibit a succession of changes of colour, such as Thucydides has described, first the food contents of the stomach, then green bilious vomit, and finally blood, either red or altered to brown or black. Hiccough and empty retching are liable to ensue on severe vomiting from any enduring cause.

It is not clear to what Thucydides appropriates the term σπασμός: the context would suggest that spasm of the diaphragm, such as accompanies protracted vomiting, is indicated. But it may also signify true convulsions, which are an occasional complication of both diseases. Convulsive tremor of the limbs, and indeed of the whole body, is habitual at the height of typhus, and is not infrequent in plague.

We should naturally look to the appearance of the skin and of the eruption to afford criteria for a sure diagnosis, but such is not the case. True, there is a remarkable resemblance to Murchison’s description of the skin of typhus patients, in an English hospital. ‘The face’, he says, ‘is often flushed. The flushing is general over the entire face. It is never pink: sometimes it is reddish or reddish brown, but more commonly it is of a dusky, earthy, or leaden hue: in grave cases it may be livid.’ No corresponding appearance of the skin is to be seen in plague.

Thucydides has described the eruption as consisting of φλύκταιναι μικραὶ καὶ ἕλκη, words that have generally been rendered as ‘small blisters and ulcers’, and for this reason have been held to exclude positively a diagnosis of typhus fever. So certain a conclusion is hardly justified by the facts. Outbreaks of gangrenous dermatitis, in which multiple bullae or blisters, leaving an ulcerated base, have broken out over the body surface, have been not uncommon features of a typhus epidemic, and from their virulently contagious character such outbreaks would have been more prone to occur amid all the neglect and destitution of a beleaguered garrison. Murchison has described the resulting appearances in the following words: ‘I have seen bullae filled with light or dark fluid, or large pustules appear on various parts of the body during the progress of the fever. Stokes has observed bullae of this description followed after bursting by deep ulcers with sharp margins.’ But extensive ulceration such as this must inevitably have left permanent scarring, at least as marked as the ‘pitting’ produced by small-pox, and we can hardly presume that this could have escaped the critical Greek eye of so keen an observer as Thucydides. The whole question arises of the exact significance of the words ἕλκος and φλύκταινα.

In his treatise Περὶ Ἑλκῶν Hippocrates uses the term ἕλκος not only for open wounds and ulcers, but also for burns, wheals, and wounds in general.

Homer uses it for wounds of every kind. It so happens that the wounds of theIliadare almost all the open wounds produced by spear and arrow, but Homer also uses it for the bite of a snake[201]and for the wound inflicted by lightning.[202]

Bion[203]uses it in consecutive lines for the wound caused by a spear, and in the generic sense:

Ἃγριον, ἄγριον ἓλκος ἔχει κατὰ μηρὸν Αδωνις,μεῖζον δ’ ἁ Κυθέρεια φέρει ποτικάρδιον ἕλκος.

Aeschylus[204]and Sophocles[205]use it also in the wider sense, as in

πόλει μὲν ἕλκος ἕν τὸ δήμιον τυχεῖν

and

τί γὰργένοιτ’ ἄν ἕλκος μεῖζον ἤ φίλος κακός;

The inference to be drawn from these passages is that ἕλκος, although usually indicating an open wound, is used with no precise significance.

The same difficulty attaches to the word φλύκταινα. Though Hippocrates uses the word frequently, there is no single passage in which the precise significance is clear beyond all doubt. He applies it to chilblains,[206]to an eruption on the skin of subjects of empyema,[207]to lesions appearing on the tongue in fatal septic cases, and so on. In one passage, in which he speaks of a φλύκταινα arising from rubbing the skin with vinegar, he seems to indicate a blister.

The first clear definition of the term we have is from the pen of Celsus, who defines it as a discoloured pustule that breaks and leaves an ulcerated base (‘genus pustularum, cum plures similes varis oriuntur nonnunquam maiores, lividae aut pallidae aut nigrae aut aliter naturali colore mutato: subestque iis humor, ubi hae ruptae sunt, infra quasi exulcerata caro apparet’). There are several passages in Aristophanes, which indicate that he at any rate applied the term as we do to a blister lesion: but at the same time, there are other passages in which this exclusive use is by no means so sure. The lesion resulting from rowing[208]or carrying a lance[209]cannot well be other than a blister. And there is a passage in theEcclesiazusae,[210]which seems even clearer:

ἀλλ’ ἔμπουσά τιςἐξ ἁἵματος φλύκταιναν ἠμφιεσμένη,‘Some vampire bloated with blood like a blister.’

ἀλλ’ ἔμπουσά τιςἐξ ἁἵματος φλύκταιναν ἠμφιεσμένη,

‘Some vampire bloated with blood like a blister.’

The image must be that of a vampire, so bloated with blood, that its body seems actually enveloped in it, simulating a blood-blister.

Aristotle applies the term to the bite of a shrew-mouse, which would presumably produce a solid local swelling, and not a blister. Procopius uses φλύκταινα for the black cutaneous lesions of Oriental plague, known nowadays as pustules: he says, too, that they were of the size of a lentil, but does not mention terminal ulceration. Procopius is so precise in his medical terminology, that it is improbable he borrowed the term from Thucydides without appreciating its exact significance: far more likely he adopted it from the medical terminology of his day.

There is something to be said for appropriating the terms used by Thucydides to the pustular lesions of Oriental plague. Many writers, ancient as well as modern, have described the so-called pustules as commencing in some cases as blisters and terminating in eroding ulcers. But, on the other hand, we know nothing of epidemics of plague without a considerable proportion of bubonic cases, while we do know from the narrative of Procopius that plague has maintained its characters unchanged for 1,500 years. In an epidemic of plague, in which death did not supervene till the seventh or ninth day the presence of buboes would be the outstanding feature of the disease, and Thucydides does not even mention them.

Assuming that typhus fever also has maintained its characters unchanged, and that the external manifestations of the Athenian pestilence were not of the exceptional type we have alluded to, but of the type habitually associated with the disease, can it reasonably be contended that the terms φλύκταινα and ἕλκη are applicable to these?

Murchison says that ‘according to its colour, the eruption may be said to pass through three stages, viz. 1, Pale dirty pink or florid; 2,reddish brown or rusty; 3, livid or petechial’. In the first stage, it is generally admitted that except on careful observation, and in a good light, the faint diffuse maculae (spots) are apt to escape detection, so that the impression is of a general suffusion of the skin—what in fact Thucydides terms ὑπέρυθρον.

In the second stage, the deeper coloration of the spots throws them into relief as individual lesions against the paler background of general suffusion of the skin. Can it be that this is indicated by the vague term φλύκταινα? Be it remembered that Thucydides was a layman, describing, as he says, the lesions of a hitherto unknown disease. Every physician is well aware of the restricted terminology that the laity possess for the description of multifarious lesions. Medicine itself is not exempt from the same confusion, for when physicians glibly speak of the subcutaneous haemorrhages of typhus as petechiae they forget that the word throws back topetigo(a scab).

There remains then for the third stage of the eruption—the haemorrhagic stage—the term ἕλκος, a generic term applicable to almost any lesion, and having no philological affinity to the Latinulcus, and the English ‘ulcer’, with which medical usage has confused it.

Reviewing, then, all the facts, it cannot be held that the description of the eruption, as given by Thucydides, is sufficient to negative a diagnosis of typhus fever, which disease is otherwise depicted to the life in all else that he says of its clinical course and characters.

Thucydides was so impressed with the intensity of the internal fever, that he expected certainly to find a corresponding temperature of the body surface: hence his surprise is obvious at finding it not excessively hot. For all that, sufferers were ready to cast off every shred of clothing, till they were naked, and longed to throw themselves into cold water. Some did actually plunge into cisterns, but no amount of water sufficed to slake their thirst. Procopius mentions this same fierce longing to fling themselves into water among the plague victims of Byzantium, but raving delirium of this kind is far more characteristic of typhus than of plague. Curschmann depicts the fierce medley of wild ravings, mingled with frantic efforts at self-destruction, which give an unmistakable character to a ward of typhus patients. Murchison, quoting from Bancroft, says: ‘Some leavingtheir beds would beat their keepers or nurses and drive them from their presence: others, like madmen, would run about the streets, markets, lanes, and other places: and some again would leap headlong into deep waters.’ Intolerable restlessness and insomnia fill up the cup of misery to overflowing. Curschmann confirms the observation of Thucydides, that typhus cadavers exhibit very little emaciation, but this does not help to differentiate typhus from other acute fevers of equally brief duration.

Death commonly occurred on the seventh or the ninth day. One recognizes here submission to the authoritative doctrine of critical days. Hippocrates[211]defined them on the basis of equal and unequal numbers:

Equal—4, 6, 8, 10, 14, 28, 30, 48, 60, 80, 100.Unequal—5, 7, 9, 11, 17, 21, 27, 31.

Taking the mean of the numbers, the plague of Athens claimed its victims for the most part about the eighth day of the disease. A layman would hardly have had the opportunity, or indeed the inclination, to make an exact statistical computation, and in this fact perhaps lies this unexpected lapse of Thucydides into subservience to medical orthodoxy.

With regard to the day of death in typhus fever, Curschmann says: ‘When death is caused simply by the severity of the disease, it occurs usually in the middle or second half of the second week. A fatal termination before the ninth day, or as early as the fifth or sixth day, occurs only in the most severe forms of the disease, or in individuals with little resisting power.’ Now, not only was the Athenian pestilence severe in type, but there was also an almost complete absence of the nursing and medical regimen that will have served to prolong the duration of cases, that have ultimately proved fatal, in recent epidemics. In plague death usually occurs between the second and sixth days, seldom later, and few patients survive to the seventh or ninth day without the appearance of buboes.

If the victims survived this period, the disease fastened on the bowels and produced violent ulceration (ἕλκωσις). Initial constipation, followed, as the disease develops, by diarrhoea, which is sometimes profuse and intractable, is met with both in typhus and plague.

The disease began in the head and gradually passed through the wholebody. If the sufferer survived so long, it would often seize the extremities and make its mark, attacking the privy parts and fingers and toes. Some escaped with the loss of these and with the loss of their eyes. This terminal gangrene of the extremities is of frequent occurrence in typhus, but is rare in plague, and very rare in other acute infectious fevers. Curschmann says: ‘Many patients continue to suffer for some time after defervescence (of typhus fever) from gangrene of the ears, fingers, toes, tip of the nose, and skin of the penis and scrotum, arising during the febrile period.’ Gangrenous changes around a carbuncle are occasional in plague, but not as an independent affection of the extremities. Neglected plague buboes, even nowadays in Indian epidemics, do exceptionally become gangrenous, as the result of an intercurrent erysipelas. Necrotic ulceration of the eyeballs is well authenticated as a complication of typhus as well as of plague.

Some recovered from the disease, but with complete loss of memory. This again is a frequent consequence, usually temporary, but sometimes permanent, of typhus. According to Curschmann, ‘the patient’s recollection of his illness is almost always very limited in severe or moderately severe cases. True psychoses appear to be rare during convalescence. Mild melancholia and hallucinations are sometimes seen, and even mania has been observed.’

The combination of gangrene with mental symptoms inevitably suggests the thought of ergotism (poisoning by a fungus of rye-grain), and Read and Kobert have expended much ingenuity in support of this hypothesis. One of the Athenian corn routes did actually tap the northern shores of the Euxine, and southern Russia has been one of the chief centres of epidemics of ergotism. But there is no need to invoke this condition, to explain symptoms which are commonly encountered in typhus, and no warrant either for so doing, seeing that the clinical features of the visitation had little in common with ergotism. Kobert’s ingenious arguments in favour of ergotism, superimposed on some other unidentified disease, merely substitute oneimpassefor another.

Thucydides observes that one feature distinguished the Athenian pestilence from ordinary diseases. Birds and beasts of prey, which feed on human flesh, would not as a rule touch the bodies, but, if they did, they died. In fact, the birds of prey disappeared altogether, and werenot to be seen either about the bodies or anywhere else. In the case of the dogs this was particularly noticeable, because they live with man. The paragraph is curiously involved, but contains three statements of fact:

1. That vultures were nowhere to be seen.2. That dogs avoided the dead bodies, as a rule, but that, when they did not, they took the disease.3. That other animals, which feed on carrion, and within the walls of Athens these can hardly have been other than rats and cats, and possibly pigs, were affected like the dogs.

1. That vultures were nowhere to be seen.

2. That dogs avoided the dead bodies, as a rule, but that, when they did not, they took the disease.

3. That other animals, which feed on carrion, and within the walls of Athens these can hardly have been other than rats and cats, and possibly pigs, were affected like the dogs.

There is no evidence as to the effect on cattle, horses, sheep, and goats, because all these had been removed to Euboea.

The phenomenon of the disappearance of birds of prey before and during outbreaks of epidemic pestilence has been asserted again and again in literature. Yet it is very doubtful if the observation rests on any sure evidence. Search has brought to light only one occasion on which the truth of the fact has been deliberately tested, and then it was directly contradicted. Russell says that at the commencement of the plague of Aleppo, in which true plague was ushered in by typhus, no desertion of birds was observed, and no mortality among cattle. The old-time fancy that pestilence engendered in the clouds distempered the atmosphere almost necessarily involved the presumption that the feathered inhabitants of the air would be the first to feel its ill effects. In the same way the belief that pestilence might reach the atmosphere in the exhalations from marshes, led to similar fables attaching themselves to the marsh-dwelling frog. Aristotle alludes to the increased number of frogs in pestilential years, and Bacon and Horstius repeat his statement. These children of the marsh are conceived of as products of its undue activity. Horstius went so far as to assert the same of snails.

Livy[212]clearly asserts the disappearance of vultures from Rome before and during the epidemic of 174b.c.‘Cadavera, intacta a canibus et vulturibus, tabes absumebat: satisque constabat, nec illo, nec priore anno, in tanta strage boum hominumque vulturium usquam visum.’ [Dead bodies rotted away, untouched by dogs and vultures: and it was generally agreed that no vultures were to be seen either in that or the preceding year in spite of so great a mortality of men andcattle.] In this instance, then, it was not that they scented death from afar and held aloof, but that they disappeared beforehand. If some undetected epizootic—say of rats—had preceded the outbreak among cattle and men, the vultures may well have perished at the outset from feeding on infected material.

Other authors extend the observation to birds in general, and not only to birds of prey, as though their affection was truly epizootic. Thus Schenkius[213]says that in the plagues of 1505 and 1522 birds deserted their nests and young ones. Goclenius says the same of the plague of 1612, and that they fell suddenly to the ground dead. Mercurialis says that Venice was deserted by birds in 1576, and Short repeats this of Dantzig in 1709. Diemerbroeck says that cage-birds died in the epidemics of 1635 and 1636, and Sorbait records the same fact of the Viennese pestilence of 1679. Most, if not all this succession of epidemics, were unquestionably true Oriental plague, with or without typhus.

At present there is very little evidence of any extensive affection of the lower animals by typhus. Mosler, many years ago, failed to communicate it to dogs by injecting fresh typhus blood into their veins, or by feeding them on fresh typhus excreta, although death with typhoid symptoms followed, when the blood and stools had first been allowed to decompose. In the last few years experimenters have succeeded in communicating the disease to various monkeys by the agency of lice, but dogs, rats, and guinea-pigs have hitherto proved refractory to infection.

On the other hand, there is abundant evidence of animal infection with Oriental plague. Epizootics among rats and cats are well known. Boccaccio asserted the susceptibility of pigs, and Michoud confirmed the observation in the Yunnan epidemic of 1893. Dogs, poultry, deer, cattle, monkeys, squirrels, and marmots have all been shown by various observers to be prone to contagion.

Before accepting the evidence of Thucydides as to the disappearance of birds as weighty evidence in favour of the presence of true plague, one must consider the state of the country district around Athens, devastated by fire and the sword, and denuded of all its stock, so as to offer no promise of sustenance to bird visitors. But even so, one isstill confronted by his statement as to the domestic dogs, which are known to be susceptible to plague and not known to be susceptible to typhus.

Thucydides says that no one was attacked a second time, or if he were the result was not fatal. Immunity of this kind, comparatively complete, is alike characteristic of typhus and plague: the question is one that has provoked considerable controversy right down to modern times. Both Curschmann and Murchison are agreed as to the extreme rarity of relapses and reinfections in typhus: curiously, Murchison himself had two typical severe attacks.

In the case of plague, Alexander Massaria,[214]from his experience at Vicenza, came to the conclusion that one attack rendered a man immune with very few exceptions, but that a second attack might be mortal. Mercurialis and Van Helmont were in agreement as to the rarity of second attacks. Diemerbroeck[215]recorded two cases of reinfection in the same year of the plague at Nymwegen, and several cases at an interval of a few years. During the plague of Marseilles in 1720, various writers observed cases of reinfection, and relapse was also said to be frequent. In the plague of 1771 at Moscow, Samilowitz, prejudiced by his own advocacy of inoculation, denied the existence of reinfection, and suffered retribution for his dogmatism by three relapses in his own person. In the same plague both Mertens and Orraeus recorded cases of reinfection. In the plague of Aleppo, Russell noted 28 cases of reinfection within three years among 4,400 victims of plague. Thus the idea of complete immunity, so prevalent popularly both in Europe and the Levant, must be accepted with some reservation.

OXFORD: HORACE HART M.A.PRINTER TO THE UNIVERSITY

FOOTNOTES:[1]Metamorphoses, vii. 520.[2]Hist. Francorum, x. 1.[3]De Gestis Langobardorum, iii. 24.[4]A. Bastian,Ein Besuch in San Salvador, p. 318; and Frazer,Commentary on Pausanias, ii. 10. 3.[5]The Great African Island, p. 268.[6]Gordon Cumming,In the Hebrides, pp. 53 seq.[7]Aristophanes,Plutus, 733.[8]Frazer,Pausanias, ii. 2. 8.[9]Gordon Cumming,loc. cit.[10]Iliad, i. 44 seq.[11]Derby, Homer’sIliad.[12]VII. xi. 2, tr. Bloomfield.[13]Synonym for Rudra.[14]Synonym for Rudra.[15]Atharvaveda, V. xi. 10.[16]xvii. 41.[17]Hist. Anim.vi. 37. 580B.[18]Geographica, xiii. 1. 48, and iii. 104.[19]Zoologist, September 1892.[20]Strabo,Geographica, iii. 104.[21]2 Kings xix. 35.[22]ii. 141; and Rawlinson’sHerodotus, ed. 1880, vol. ii. 219-20.[23]Geographica, xiii. 64.[24]Journal Asiatique, 1st series, iii. 307.[25]i. 39.[26]Revue Numismatique, N.S. iii.[27]Nat. Anim.xii. 5.[28]Geographica, xiii. 1. 64.[29]Newton,Travels and Discoveries in the Levant, i. 130.[30]Thomas,Two Years in Palestine, p. 6.[31]Frazer,Golden Bough, ed. 1900, ii. 423.[32]Iliad, i. 39.[33]Strabo,loc. cit.[34]Aeschylus,Theb.145.[35]Pausanias, v. 14. 1.[36]Strabo,loc. cit.[37]Varro,Rerum rusticarumi. 1. 6.[38]Aymonier,Revue de l’histoire des religions, xxiv (1891) 236.[39]Morals: Essay on Envy and Hatred.[40]2 Samuel xxiv; and 1 Chronicles xxi.[41]Works, 243.[42]Tr. L. Campbell.[43]Life of Pericles.[44]Tr. W. R. Frazer.[45]xii. 58.[46]History of Greece.[47]Jowett’sThucydides. We have ventured to introduce one or two slight modifications into Professor Jowett’s translation, indicating them by italics. In medicine it makes a world of difference, whether a disease is thesameorsimilar: itscoursetoo, is something quite distinct from its character.[48]ii. 48 end.[49]The discussion of clinical details has been relegated to an Appendix, as they are rather of medical than of literary or artistic interest. They are, nevertheless, essential to a full appreciation of the merits of the description that Thucydides gives of the pestilence.[50]viii. 41. 7.[51]ii. 54.[52]i. 3. 3.[53]Pausanias, ix. 22. 1.[54]Life of Numa.[55]Frazer,Golden Bough.[56]Pausanias, ix. 22. 1.[57]Odes, I. 37.[58]I. vi. § 40.[59]Livy, i. 31.[60]Livy, i. 56, and Dion. Halic.Antiq. Rom.iv. 68.[61]Antiq. Rom.ix. 40.[62]Porphyry,De Abstinentia, ii. 56.[63]Deuteronomy xii. 31; Leviticus xviii. 21; 2 Kings ii. 5-17.[64]I. v. 2.[65]IX. viii. 2.[66]Vita Apollonii, iv. 10.[67]iii. 6.[68]iii. 8.[69]iii. 5.[70]Agnes Arber,Herbals, 1912.[71]Antiq. Rom.x. 53; and Livy, iv. 32.[72]Livy, iv. 21-5.[73]Livy, v. 13.[74]xiv. 70.[75]Livy, vii. 2.[76]Leviticus xiv. 7, and 53.[77]Nat. Hist.xxviii. 63.[78]Frazer,Golden Bough, and E. C. Gurdon,County Folk-lore, Suffolk, p. 14.[79]Aberglaube und Sagen aus dem Herzogthum Oldenburg, ii. 120, § 428.[80]Livy, vii. 27.[81]Livy, viii. 18.[82]Livy, ix. 28.[83]x. 31.[84]Livy, X. 47, andEpit. Lib.xi.[85]Valerius Maximus, i. 8.[86]See Duruy,History of Rome, i. 555.[87]ii. 10. 3.[88]xxv. 26-8.[89]Punic War, v. 580-626.[90]Livy, xxxix. 41; xl. 19; xl. 37.[91]xli. 21.[92]De Re Rustica, i. 12.[93]Metamorphoses, vii. 520 seq.[94]Bk. I.[95]iii. 5.[96]x. 2.[97]Aeneid, x. 272 seq.[98]Annals, xiv. 22.[99]Quaestiones Naturales, vi. 27. 28, and Seneca,Physical Science, Clarke and Geikie.[100]Annals, Bk. XVI.[101]lxvii. 11.[102]lxxii. 14.[103]Herodian, Bk. I.[104]Evagrius,Hist.iv. 28.[105]xxiii. 7.[106]Merivale,Hist. of Rome, vii. 578.[107]vii. 15.[108]Hist. of Rome, v. 186.[109]Commentar. I. in Hippocrat. Lib. VI, Epidem. Aph.29.[110]De Praesag. ex pulsibus, iii. 4.[111]De Simplicium Medicamentorum Temperamentis et Facultatibus, ix. 1.[112]Method. Medendi, v. 12.[113]Hist. Eccles.vii. 22.[114]Trebellius Pollio,Gallienus, tom. ii.[115]Pomponius Laetus,Rom. Hist.tom. ii.[116]Pontius,Vita Caecilii Cypriani.[117]Compend. Historiarum, ex versione Xylandri, p. 258.[118]Gallienus, iv and v.[119]Hist. Eccles.ix. 8.[120]Œuvres de Oribase, Bussemaker et Daremberg, lib. 44. c. 17.[121]De Differ. Febr.i, tom. vii, p. 2; 96, ed. Kuhn.[122]De Bello Persico, ii. 22-3.[123]Hist.iv. 28.[124]Hist.iv. 28.[125]Hist.v. 12.[126]Hist. Francorum, iv. 5.[127]vi. 14.[128]iv. 31.[129]Hist. Francorum, x. 1.[130]x. 23.[131]De Gestis Langobardorum, ii. 4.[132]Hist. Eccles.vii. 22.[133]xiv. 37.[134]Hist. Francorum, x. 1.[135]De Gestis Langobardorum, iii. 24.[136]Hist.vi.[137]This penitential procession has been wonderfully depicted by Dudden in hisGregory the Great, vol. i, p. 217.[138]Hist.ii. 3, and iii. 1.[139]Bk. I, c. 25.[140]Essai sur la mortalité à Strasbourg, p. 79.[141]De Gestis Langobardorum, vi. 5.[142]Caxton,Golden Legend; Jameson,Sacred and Legendary Art.[143]See Frontispiece.[144]Bascombe,History of Epidemic Diseases.[145]Kremer,Ueber die grossen Seuchen des Orients, nach arabischen Quellen.[146]Caxton,Golden Legend; Jameson,Sacred and Legendary Art.[147]iv. 8.[148]Golden Days of the Renaissance in Rome.[149]Epistolae de rebus familiaribus, viii. 7.[150]Bk. I, c. 4.[151]Traité II, Doct. ii, ch. 5.[152]Epidemics of the Middle Ages.[153]Histoire des Juifs.[154]Krafft-Ebing,Geschichte der Pest in Wien.[155]Chronicon, 1580.[156]E. S. Prior,Cathedral Builders.[157]Prior and Gardner,Mediaeval Figure Sculpture in England, p. 390.[158]Ode 4.[159]Bk. I, Eleg. 3.[160]Aeneid, vi. 644.[161]Passus xxiii. 100-5.[162]Rio,L’Art chrétien; and Crawfurd,Proceedings of Roy. Soc. of Med., 1913, vol. vi, pp. 37-48.[163]Duff Gordon,Story of Perugia(translation).[164]Pestblätter des xv. Jahrhunderts.[165]Vol. i, Bk. I, and Trollope,History of Commonwealth of Florence, vol. iv.[166]Gruyer,Raphael et l’Antiquité.[167]Nat. Hist., lib. xxxv.[168]Aenid, iii. 140.[169]Lanciani,Golden Days of the Renaissance.[170]Bk. I, § 27 seq.[171]Translated by Miss Egerton Castle,Italian Literature.[172]Léon Gautier,La Médecine à Genève jusqu’à la fin du dix-huitième siècle.[173]Livre de la Peste.[174]Horatio Brown,The Venetian Republic.[175]Molmenti,Venezia.[176]Translated inA Tragedy of the Great Plague of Milan, R. Fletcher, M.D. 1895.[177]Joshua vi. 26.[178]Deuteronomy xiii. 15-18.[179]Nicolas Poussin, p. 134.[180]p. 84.[181]From an engraving in the author’s possession.[182]De Peste.[183]De Peste.[184]De Peste.[185]Reports to Royal Society.[186]Researches into the Laws and Phenomena of Pestilence.[187]Loimologia, and Dict. of Nat. Biog.[188]Rabbi Joshua, ii. 403.[189]Krafft-Ebing,Geschichte der Pest in Wien.[190]Traité de la Peste, 2 vols., Genève, 1721;Johns Hopkins Hospital Bulletin, August 1898.[191]Janus, 1897, p. 297; andJohns Hopkins Hospital Bulletin.[192]La Peste de 1720, p. 96.[193]Essay on Man, iv. 107-8.[194]vol. x, p. 91.[195]p. 214.[196]Richer,L’Art et la médecine.[197]Histoire de Napoléon, ed. 1834, vol. i, p. 354.[198]Bourrienne et ses erreurs.[199]Mémoires sur Napoléon.[200]Curschmann’s contribution, in Nothnagel’sEncyclopaedia of Practical Medicine, is perhaps the most graphic and succinct account of Typhus Fever in modern medical literature. The record of Thucydides should be studied closely side by side with this. Murchison’s article, in hisTreatise on Continued Fever, though admirable, is so diffuse as to make comparison difficult.[201]Iliadii. 723.[202]Iliadviii. 405 and 419.[203]Adonis, 16-17.[204]Agamemnon, 645.[205]Antigone, 652.[206]On Ancient Medicine, § 16.[207]Coacae Praenotiones, § 396.[208]Frogs, 236.[209]Wasps, 1119.[210]Ecclesiazusae, 1057.[211]Epidemics, iii.[212]xli. 21.[213]Obs.p. 870.[214]Tract. de Peste, ed. 1669, p. 509.[215]De Peste, Lib. IV. Hist. 37. 45.

FOOTNOTES:

[1]Metamorphoses, vii. 520.

[2]Hist. Francorum, x. 1.

[3]De Gestis Langobardorum, iii. 24.

[4]A. Bastian,Ein Besuch in San Salvador, p. 318; and Frazer,Commentary on Pausanias, ii. 10. 3.

[5]The Great African Island, p. 268.

[6]Gordon Cumming,In the Hebrides, pp. 53 seq.

[7]Aristophanes,Plutus, 733.

[8]Frazer,Pausanias, ii. 2. 8.

[9]Gordon Cumming,loc. cit.

[10]Iliad, i. 44 seq.

[11]Derby, Homer’sIliad.

[12]VII. xi. 2, tr. Bloomfield.

[13]Synonym for Rudra.

[14]Synonym for Rudra.

[15]Atharvaveda, V. xi. 10.

[16]xvii. 41.

[17]Hist. Anim.vi. 37. 580B.

[18]Geographica, xiii. 1. 48, and iii. 104.

[19]Zoologist, September 1892.

[20]Strabo,Geographica, iii. 104.

[21]2 Kings xix. 35.

[22]ii. 141; and Rawlinson’sHerodotus, ed. 1880, vol. ii. 219-20.

[23]Geographica, xiii. 64.

[24]Journal Asiatique, 1st series, iii. 307.

[25]i. 39.

[26]Revue Numismatique, N.S. iii.

[27]Nat. Anim.xii. 5.

[28]Geographica, xiii. 1. 64.

[29]Newton,Travels and Discoveries in the Levant, i. 130.

[30]Thomas,Two Years in Palestine, p. 6.

[31]Frazer,Golden Bough, ed. 1900, ii. 423.

[32]Iliad, i. 39.

[33]Strabo,loc. cit.

[34]Aeschylus,Theb.145.

[35]Pausanias, v. 14. 1.

[36]Strabo,loc. cit.

[37]Varro,Rerum rusticarumi. 1. 6.

[38]Aymonier,Revue de l’histoire des religions, xxiv (1891) 236.

[39]Morals: Essay on Envy and Hatred.

[40]2 Samuel xxiv; and 1 Chronicles xxi.

[41]Works, 243.

[42]Tr. L. Campbell.

[43]Life of Pericles.

[44]Tr. W. R. Frazer.

[45]xii. 58.

[46]History of Greece.

[47]Jowett’sThucydides. We have ventured to introduce one or two slight modifications into Professor Jowett’s translation, indicating them by italics. In medicine it makes a world of difference, whether a disease is thesameorsimilar: itscoursetoo, is something quite distinct from its character.

[48]ii. 48 end.

[49]The discussion of clinical details has been relegated to an Appendix, as they are rather of medical than of literary or artistic interest. They are, nevertheless, essential to a full appreciation of the merits of the description that Thucydides gives of the pestilence.

[50]viii. 41. 7.

[51]ii. 54.

[52]i. 3. 3.

[53]Pausanias, ix. 22. 1.

[54]Life of Numa.

[55]Frazer,Golden Bough.

[56]Pausanias, ix. 22. 1.

[57]Odes, I. 37.

[58]I. vi. § 40.

[59]Livy, i. 31.

[60]Livy, i. 56, and Dion. Halic.Antiq. Rom.iv. 68.

[61]Antiq. Rom.ix. 40.

[62]Porphyry,De Abstinentia, ii. 56.

[63]Deuteronomy xii. 31; Leviticus xviii. 21; 2 Kings ii. 5-17.

[64]I. v. 2.

[65]IX. viii. 2.

[66]Vita Apollonii, iv. 10.

[67]iii. 6.

[68]iii. 8.

[69]iii. 5.

[70]Agnes Arber,Herbals, 1912.

[71]Antiq. Rom.x. 53; and Livy, iv. 32.

[72]Livy, iv. 21-5.

[73]Livy, v. 13.

[74]xiv. 70.

[75]Livy, vii. 2.

[76]Leviticus xiv. 7, and 53.

[77]Nat. Hist.xxviii. 63.

[78]Frazer,Golden Bough, and E. C. Gurdon,County Folk-lore, Suffolk, p. 14.

[79]Aberglaube und Sagen aus dem Herzogthum Oldenburg, ii. 120, § 428.

[80]Livy, vii. 27.

[81]Livy, viii. 18.

[82]Livy, ix. 28.

[83]x. 31.

[84]Livy, X. 47, andEpit. Lib.xi.

[85]Valerius Maximus, i. 8.

[86]See Duruy,History of Rome, i. 555.

[87]ii. 10. 3.

[88]xxv. 26-8.

[89]Punic War, v. 580-626.

[90]Livy, xxxix. 41; xl. 19; xl. 37.

[91]xli. 21.

[92]De Re Rustica, i. 12.

[93]Metamorphoses, vii. 520 seq.

[94]Bk. I.

[95]iii. 5.

[96]x. 2.

[97]Aeneid, x. 272 seq.

[98]Annals, xiv. 22.

[99]Quaestiones Naturales, vi. 27. 28, and Seneca,Physical Science, Clarke and Geikie.

[100]Annals, Bk. XVI.

[101]lxvii. 11.

[102]lxxii. 14.

[103]Herodian, Bk. I.

[104]Evagrius,Hist.iv. 28.

[105]xxiii. 7.

[106]Merivale,Hist. of Rome, vii. 578.

[107]vii. 15.

[108]Hist. of Rome, v. 186.

[109]Commentar. I. in Hippocrat. Lib. VI, Epidem. Aph.29.

[110]De Praesag. ex pulsibus, iii. 4.

[111]De Simplicium Medicamentorum Temperamentis et Facultatibus, ix. 1.

[112]Method. Medendi, v. 12.

[113]Hist. Eccles.vii. 22.

[114]Trebellius Pollio,Gallienus, tom. ii.

[115]Pomponius Laetus,Rom. Hist.tom. ii.

[116]Pontius,Vita Caecilii Cypriani.

[117]Compend. Historiarum, ex versione Xylandri, p. 258.

[118]Gallienus, iv and v.

[119]Hist. Eccles.ix. 8.

[120]Œuvres de Oribase, Bussemaker et Daremberg, lib. 44. c. 17.

[121]De Differ. Febr.i, tom. vii, p. 2; 96, ed. Kuhn.

[122]De Bello Persico, ii. 22-3.

[123]Hist.iv. 28.

[124]Hist.iv. 28.

[125]Hist.v. 12.

[126]Hist. Francorum, iv. 5.

[127]vi. 14.

[128]iv. 31.

[129]Hist. Francorum, x. 1.

[130]x. 23.

[131]De Gestis Langobardorum, ii. 4.

[132]Hist. Eccles.vii. 22.

[133]xiv. 37.

[134]Hist. Francorum, x. 1.

[135]De Gestis Langobardorum, iii. 24.

[136]Hist.vi.

[137]This penitential procession has been wonderfully depicted by Dudden in hisGregory the Great, vol. i, p. 217.

[138]Hist.ii. 3, and iii. 1.

[139]Bk. I, c. 25.

[140]Essai sur la mortalité à Strasbourg, p. 79.

[141]De Gestis Langobardorum, vi. 5.

[142]Caxton,Golden Legend; Jameson,Sacred and Legendary Art.

[143]See Frontispiece.

[144]Bascombe,History of Epidemic Diseases.

[145]Kremer,Ueber die grossen Seuchen des Orients, nach arabischen Quellen.

[146]Caxton,Golden Legend; Jameson,Sacred and Legendary Art.

[147]iv. 8.

[148]Golden Days of the Renaissance in Rome.

[149]Epistolae de rebus familiaribus, viii. 7.

[150]Bk. I, c. 4.

[151]Traité II, Doct. ii, ch. 5.

[152]Epidemics of the Middle Ages.

[153]Histoire des Juifs.

[154]Krafft-Ebing,Geschichte der Pest in Wien.

[155]Chronicon, 1580.

[156]E. S. Prior,Cathedral Builders.

[157]Prior and Gardner,Mediaeval Figure Sculpture in England, p. 390.

[158]Ode 4.

[159]Bk. I, Eleg. 3.

[160]Aeneid, vi. 644.

[161]Passus xxiii. 100-5.

[162]Rio,L’Art chrétien; and Crawfurd,Proceedings of Roy. Soc. of Med., 1913, vol. vi, pp. 37-48.

[163]Duff Gordon,Story of Perugia(translation).

[164]Pestblätter des xv. Jahrhunderts.

[165]Vol. i, Bk. I, and Trollope,History of Commonwealth of Florence, vol. iv.

[166]Gruyer,Raphael et l’Antiquité.

[167]Nat. Hist., lib. xxxv.

[168]Aenid, iii. 140.

[169]Lanciani,Golden Days of the Renaissance.

[170]Bk. I, § 27 seq.

[171]Translated by Miss Egerton Castle,Italian Literature.

[172]Léon Gautier,La Médecine à Genève jusqu’à la fin du dix-huitième siècle.

[173]Livre de la Peste.

[174]Horatio Brown,The Venetian Republic.

[175]Molmenti,Venezia.

[176]Translated inA Tragedy of the Great Plague of Milan, R. Fletcher, M.D. 1895.

[177]Joshua vi. 26.

[178]Deuteronomy xiii. 15-18.

[179]Nicolas Poussin, p. 134.

[180]p. 84.

[181]From an engraving in the author’s possession.

[182]De Peste.

[183]De Peste.

[184]De Peste.

[185]Reports to Royal Society.

[186]Researches into the Laws and Phenomena of Pestilence.

[187]Loimologia, and Dict. of Nat. Biog.

[188]Rabbi Joshua, ii. 403.

[189]Krafft-Ebing,Geschichte der Pest in Wien.

[190]Traité de la Peste, 2 vols., Genève, 1721;Johns Hopkins Hospital Bulletin, August 1898.

[191]Janus, 1897, p. 297; andJohns Hopkins Hospital Bulletin.

[192]La Peste de 1720, p. 96.

[193]Essay on Man, iv. 107-8.

[194]vol. x, p. 91.

[195]p. 214.

[196]Richer,L’Art et la médecine.

[197]Histoire de Napoléon, ed. 1834, vol. i, p. 354.

[198]Bourrienne et ses erreurs.

[199]Mémoires sur Napoléon.

[200]Curschmann’s contribution, in Nothnagel’sEncyclopaedia of Practical Medicine, is perhaps the most graphic and succinct account of Typhus Fever in modern medical literature. The record of Thucydides should be studied closely side by side with this. Murchison’s article, in hisTreatise on Continued Fever, though admirable, is so diffuse as to make comparison difficult.

[201]Iliadii. 723.

[202]Iliadviii. 405 and 419.

[203]Adonis, 16-17.

[204]Agamemnon, 645.

[205]Antigone, 652.

[206]On Ancient Medicine, § 16.

[207]Coacae Praenotiones, § 396.

[208]Frogs, 236.

[209]Wasps, 1119.

[210]Ecclesiazusae, 1057.

[211]Epidemics, iii.

[212]xli. 21.

[213]Obs.p. 870.

[214]Tract. de Peste, ed. 1669, p. 509.

[215]De Peste, Lib. IV. Hist. 37. 45.

Back to Index Next