the black death and the dancing mania-第15章

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safety　in　flight；　or　to　shut　themselves　up　in　their　dwellings；　a　method　which　answers　in　common　plagues；　but　which　here　afforded　no　complete　security；　because　such　was　the　fury　of　the　disease　when　it　was　at　its　height；　that　the　atmosphere　of　whole　cities　was　penetrated　by　the　infection。

Of　the　astral　influence　which　was　considered　to　have　originated　the　〃Great　Mortality；〃　physicians　and　learned　men　were　as　completely　convinced　as　of　the　fact　of　its　reality。　　A　grand　conjunction　of　the　three　superior　planets；　Saturn；　Jupiter；　and　Mars；　in　the　sign　of　Aquarius；　which　took　place；　according　to　Guy　de　Chauliac；　on　the　24th　of　March；　1345；　was　generally　received　as　its　principal　cause。　　In　fixing　the　day；　this　physician；　who　was　deeply　versed　in　astrology；　did　not　agree　with　others；　whereupon　there　arose　various　disputations；　of　weight　in　that　age；　but　of　none　in　ours。　　People；　however；　agree　in　thisthat　conjunctions　of　the　planets　infallibly　prognosticated　great　events；　great　revolutions　of　kingdoms；　new　prophets；　destructive　plagues；　and　other　occurrences　which　bring　distress　and　horror　on　mankind。　　No　medical　author　of　the　fourteenth　and　fifteenth　centuries　omits　an　opportunity　of　representing　them　as　among　the　general　prognostics　of　great　plagues；　nor　can　we；　for　our　part；　regard　the　astrology　of　the　Middle　Ages　as　a　mere　offspring　of　superstition。　　It　has　not　only；　in　common　with　all　ideas　which　inspire　and　guide　mankind；　a　high　historical　importance；　entirely　independent　of　its　error　or　truthfor　the　influence　of　both　is　equally　powerfulbut　there　are　also　contained　in　it；　as　in　alchemy；　grand　thoughts　of　antiquity；　of　which　modern　natural　philosophy　is　so　little　ashamed　that　she　claims　them　as　her　property。　　Foremost　among　these　is　the　idea　of　general　life　which　diffuses　itself　throughout　the　whole　universe；　expressed　by　the　greatest　Greek　sages；　and　transmitted　to　the　Middle　Ages；　through　the　new　Platonic　natural　philosophy。　To　this　impression　of　an　universal　organism；　the　assumption　of　a　reciprocal　influence　of　terrestrial　bodies　could　not　be　foreign；　nor　did　this　cease　to　correspond　with　a　higher　view　of　nature；　until　astrologers　overstepped　the　limits　of　human　knowledge　with　frivolous　and　mystical　calculations。

Guy　de　Chauliac　considers　the　influence　of　the　conjunction；　which　was　held　to　be　all…potent；　as　the　chief　general　cause　of　the　Black　Plague；　and　the　diseased　state　of　bodies；　the　corruption　of　the　fluids；　debility；　obstruction；　and　so　forth；　as　the　especial　subordinate　causes。　　By　these；　according　to　his　opinion；　the　quality　of　the　air；　and　of　the　other　elements；　was　so　altered　that　they　set　poisonous　fluids　in　motion　towards　the　inward　parts　of　the　body；　in　the　same　manner　as　the　magnet　attracts　iron；　whence　there　arose　in　the　commencement　fever　and　the　spitting　of　blood；　afterwards；　however；　a　deposition　in　the　form　on　glandular　swellings　and　inflammatory　boils。　　Herein　the　notion　of　an　epidemic　constitution　was　set　forth　clearly；　and　conformably　to　the　spirit　of　the　age。　　Of　contagion；　Guy　de　Chauliac　was　completely　convinced。　　He　sought　to　protect　himself　against　it　by　the　usual　means；　and　it　was　probably　he　who　advised　Pope　Clement　VI。　to　shut　himself　up　while　the　plague　lasted。　　The　preservation　of　this　Pope's　life；　however；　was　most　beneficial　to　the　city　of　Avignon；　for　he　loaded　the　poor　with　judicious　acts　of　kindness；　took　care　to　have　proper　attendants　provided；　and　paid　physicians　himself　to　afford　assistance　wherever　human　aid　could　availan　advantage　which；　perhaps；　no　other　city　enjoyed。　　Nor　was　the　treatment　of　plague…patients　in　Avignon　by　any　means　objectionable；　for；　after　the　usual　depletions　by　bleeding　and　aperients；　where　circumstances　required　them；　they　endeavoured　to　bring　the　buboes　to　suppuration；　they　made　incisions　into　the　inflammatory　boils；　or　burned　them　with　a　red…hot　iron；　a　practice　which　at　all　times　proves　salutary；　and　in　the　Black　Plague　saved　many　lives。　　In　this　city；　the　Jews；　who　lived　in　a　state　of　the　greatest　filth；　were　most　severely　visited；　as　also　the　Spaniards；　whom　Chalin　accuses　of　great　intemperance。

Still　more　distinct　notions　on　the　causes　of　the　plague　were　stated　to　his　contemporaries　in　the　fourteenth　century　by　Galeazzo　di　Santa　Sofia；　a　learned　man；　a　native　of　Padua；　who　likewise　treated　plague…patients　at　Vienna；　though　in　what　year　is　undetermined。　　He　distinguishes　carefully　PESTILENCE　from　EPIDEMY　and　ENDEMY。　　The　common　notion　of　the　two　first　accords　exactly　with　that　of　an　epidemic　constitution；　for　both　consist；　according　to　him；　in　an　unknown　change　or　corruption　of　the　air；　with　this　difference；　that　pestilence　calls　forth　diseases　of　different　kinds；　epidemy；　on　the　contrary；　always　the　same　disease。　　As　an　example　of　an　epidemy；　he　adduces　a　cough　（influenza）　which　was　observed　in　all　climates　at　the　same　time　without　perceptible　cause；　but　he　recognised　the　approach　of　a　pestilence；　independently　of　unusual　natural　phenomena；　by　the　more　frequent　occurrence　of　various　kinds　of　fever；　to　which　the　modern　physicians　would　assign　a　nervous　and　putrid　character。　　The　endemy　originates；　according　to　him；　only　in　local　telluric　changesin　deleterious　influences　which　develop　themselves　in　the　earth　and　in　the　water；　without　a　corruption　of　the　air。　　These　notions　were　variously　jumbled　together　in　his　time；　like　everything　which　human　understanding　separates　by　too　fine　a　line　of　limitation。　　The　estimation　of　cosmical　influences；　however；　in　the　epidemy　and　pestilence；　is　well　worthy　of　commendation；　and　Santa　Sofia；　in　this　respect；　not　only　agrees　with　the　most　intelligent　persons　of　the　fourteenth　and　fifteenth　centuries；　but　he　has　also　promulgated　an　opinion　which　must；　even　now；　serve　as　a　foundation　for　our　scarcely　commenced　investigations　into　cosmical　influences。　　Pestilence　and　epidemy　consist　not　in　alterations　of　the　four　primary　qualities；　but　in　a　corruption　of　the　air；　powerful；　though　quite　immaterial；　and　not　cognoscible　by　the　senses（corruptio　aeris　non　substantialis；　sed　qualitativa）　in　a　disproportion　of　the　imponderables　in　the　atmosphere；　as　it　would　be　expressed　by　the　moderns。　　The　causes　of　the　pestilence　and　epidemy　are；　first　of　all；　astral　influences；　especially　on　occasions　of　planetary　conjunctions；　then　extensive　putrefaction　of　animal　and　vegetable　bodies；　and　terrestrial　corruptions　（corruptio　in　terra）：　　to　which　also　bad　diet　and　want　may　contribute。　　Santa　Sofia　considers　the　putrefaction　of　locusts；　that　had　perished　in　the　sea　and　were　again　thrown　up；　combined　with　astral　and　terrestrial　influences；　as　the　cause　of　the　pestilence　in　the　eventful　year　of　the　〃Great　Mortality。〃

All　the　fevers　which　were　called　forth　by　the　pestilence　are；　according　to　him；　of　the　putrid　kind；　for　they　originate　principally　from　putridity　of　the　heart's　blood；　which　inevitably　follows　the　inhalation　of　infected　air。　　The　Oriental　Plague　is；　sometimes；　but　by　no　means　always　occasioned　by　pestilence　（？）；　which　imparts　to　it　a　character　（qualitas　occulta）　hostile　to　human　nature。　　It　originates　frequently　from　other　causes；　among　which　this　physician　was　aware　that　contagion　was　to　be　reckoned；　and　it　deserves　to　be　remarked　that　he　held　epidemic　small…pox　and　measles　to　be　infallible　forerunners　of　the　plague；　as　do　the　physicians　and　people　of　the　East　at　the　present　day。

In　the　exposition　of　his　therapeutical　views　of　the　plague；　a　clearness　of　intellect　is　again　shown　by　Santa　Sofia；　which　reflects　credit　on　the　age。　　It　seemed　to　him　to　depend；　1st；　on　an　evacuation　of　putrid　matters　by　purgatives　and　bleeding；　yet　he　did　not　sanction　the　employment　of　these　means　indiscriminately　and　without　consideration；　least　of　all　where　the　condition　of　the　blood　was　healthy。　　He　also　declared　himself　decidedly　against　bleeding　ad　deliquium　（venae　sectio　eradicativa）。　　2nd；　Strengthening　of　the　heart　and　prevention　of　putrescence。　　3rd；　Appropriate　regimen。　　4th；　Improvement　of　the　air。　　5th；　Appropriate　treatment　of　tumid　glands　and　inflammatory　boils；　with　emollient；　or　even　stimulating　poultices　（mustard；　lily…bulbs）；　as　well　as　with　red…hot　gold　and　iron。　　Lastly；　6th；　Attention　to　prominent　symptoms。　　The　stores　of　the　Ara