Epidemics. 185 



the plague of 1348 as plague with a lung affection. " This 

 malady," he says, " was accompanied by fever, difficulty of 

 breathing, and spitting of blood ; the respiration was so 

 laborious that the sick were obliged to be always in an 

 upright posture ; deglutition was difficult, attended with 

 flushed countenances and great restlessness ; at the outset 

 the cough was violent, but without loss of blood ; after a 

 short time, the expectoration becoming bloody, haemorrhage 

 succeeded, when death ensued in three days ; spots and 

 abscesses sometimes formed when the disease was protracted 

 unto the fifth day." (Page 50.) 



Though lengthened, an outline of the black death or plague 

 of 1348 will be given from Dr. Hecker, translated by Dr. 

 Babington in 1833, where a brief sketch is found of its 

 history and nature, and its alliance to bubo and carbuncular 

 plague, as first fully described by Procopius. Let it be 

 observed that vomiting of blood, with mortification of the 

 bowels, was occasionally present in the Levant or Justinian 

 plague, but there is no mention of laboured breathing, spit- 

 ting of blood, and then haemorrhage, in the Justinian plague; 

 but what haemorrhage there was belonged rather to intense 

 congestion in the veins of the stomach, ending in haema- 

 temesis and vomiting from impeded circulation in the liver 

 and abdominal organs, but not at all arising from the lungs 

 in any way whatever. Hence the lung affection in the Black 

 death of 1348, and onwards, was an affection superadded to 

 the Justinian plague. 



" 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 



