have　broken　out　when　the　spitting　of　blood　had　continued　some　time。　　According　to　the　experience　of　Western　Europe；　however；　it　cannot　be　assumed　that　these　symptoms　did　not　appear　at　an　earlier　period。
  Thus　much；　from　authentic　sources；　on　the　nature　of　the　Black　Death。　　The　descriptions　which　have　been　communicated　contain；　with　a　few　unimportant　exceptions；　all　the　symptoms　of　the　oriental　plague　which　have　been　observed　in　more　modern　times。　　No　doubt　can　obtain　on　this　point。　　The　facts　are　placed　clearly　before　our　eyes。　　We　must；　however；　bear　in　mind　that　this　violent　disease　does　not　always　appear　in　the　same　form；　and　that　while　the　essence　of　the　poison　which　it　produces；　and　which　is　separated　so　abundantly　from　the　body　of　the　patient；　remains　unchanged；　it　is　proteiform　in　its　varieties；　from　the　almost　imperceptible　vesicle；　unaccompanied　by　fever；　which　exists　for　some　time　before　it　extends　its　poison　inwardly；　and　then　excites　fever　and　buboes；　to　the　fatal　form　in　which　carbuncular　inflammations　fall　upon　the　most　important　viscera。
  Such　was　the　form　which　the　plague　assumed　in　the　fourteenth　century；　for　the　accompanying　chest　affection　which　appeared　in　all　the　countries　whereof　we　have　received　any　account；　cannot；　on　a　comparison　with　similar　and　familiar　symptoms；　be　considered　as　any　other　than　the　inflammation　of　the　lungs　of　modern　medicine；　a　disease　which　at　present　only　appears　sporadically；　and；　owing　to　a　putrid　decomposition　of　the　fluids；　is　probably　combined　with　hemorrhages　from　the　vessels　of　the　lungs。　　Now；　as　every　carbuncle；　whether　it　be　cutaneous　or　internal；　generates　in　abundance　the　matter　of　contagion　which　has　given　rise　to　it；　so；　therefore；　must　the　breath　of　the　affected　have　been　poisonous　in　this　plague；　and　on　this　account　its　power　of　contagion　wonderfully　increased；　wherefore　the　opinion　appears　incontrovertible；　that　owing　to　the　accumulated　numbers　of　the　diseased；　not　only　individual　chambers　and　houses；　but　whole　cities　were　infected；　which；　moreover；　in　the　Middle　Ages；　were；　with　few　exceptions；　narrowly　built；　kept　in　a　filthy　state；　and　surrounded　with　stagnant　ditches。　　Flight　was；　in　consequence；　of　no　avail　to　the　timid；　for　even　though　they　had　sedulously　avoided　all　communication　with　the　diseased　and　the　suspected；　yet　their　clothes　were　saturated　with　the　pestiferous　atmosphere；　and　every　inspiration　imparted　to　them　the　seeds　of　the　destructive　malady；　which；　in　the　greater　number　of　cases；　germinated　with　but　too　much　fertility。　　Add　to　which；　the　usual　propagation　of　the　plague　through　clothes；　beds；　and　a　thousand　other　things　to　which　the　pestilential　poison　adheresa　propagation　which；　from　want　of　caution；　must　have　been　infinitely　multiplied；　and　since　articles　of　this　kind；　removed　from　the　access　of　air；　not　only　retain　the　matter　of　contagion　for　an　indefinite　period；　but　also　increase　its　activity　and　engender　it　like　a　living　being；　frightful　ill…　consequences　followed　for　many　years　after　the　first　fury　of　the　pestilence　was　past。
  The　affection　of　the　stomach；　often　mentioned　in　vague　terms；　and　occasionally　as　a　vomiting　of　blood；　was　doubtless　only　a　subordinate　symptom；　even　if　it　be　admitted　that　actual　hematemesis　did　occur。　　For　the　difficulty　of　distinguishing　a　flow　of　blood　from　the　stomach；　from　a　pulmonic　expectoration　of　that　fluid；　is；　to　non…medical　men；　even　in　common　cases；　not　inconsiderable。　　How　much　greater　then　must　it　have　been　in　so　terrible　a　disease；　where　assistants　could　not　venture　to　approach　the　sick　without　exposing　themselves　to　certain　death？　　Only　two　medical　descriptions　of　the　malady　have　reached　us；　the　one　by　the　brave　Guy　de　Chauliac；　the　other　by　Raymond　Chalin　de　Vinario；　a　very　experienced　scholar；　who　was　well　versed　in　the　learning　of　the　time。　　The　former　takes　notice　only　of　fatal　coughing　of　blood；　the　latter；　besides　this；　notices　epistaxis；　hematuria；　and　fluxes　of　blood　from　the　bowels；　as　symptoms　of　such　decided　and　speedy　mortality；　that　those　patients　in　whom　they　were　observed　usually　died　on　the　same　or　the　following　day。
  That　a　vomiting　of　blood　may　not；　here　and　there；　have　taken　place；　perhaps　have　been　even　prevalent　in　many　places；　is；　from　a　consideration　of　the　nature　of　the　disease；　by　no　means　to　be　denied；　for　every　putrid　decomposition　of　the　fluids　begets　a　tendency　to　hemorrhages　of　all　kinds。　　Here；　however；　it　is　a　question　of　historical　certainty；　which；　after　these　doubts；　is　by　no　means　established。　　Had　not　so　speedy　a　death　followed　the　expectoration　of　blood；　we　should　certainly　have　received　more　detailed　intelligence　respecting　other　hemorrhages；　but　the　malady　had　no　time　to　extend　its　effects　further　over　the　extremities　of　the　vessels。　　After　its　first　fury；　however；　was　spent；　the　pestilence　passed　into　the　usual　febrile　form　of　the　oriental　plague。　　Internal　carbuncular　inflammations　no　longer　took　place；　and　hemorrhages　became　phenomena；　no　more　essential　in　this　than　they　are　in　any　other　febrile　disorders。　　Chalin；　who　observed　not　only　the　great　mortality　of　1348；　and　the　plague　of　1360；　but　also　that　of　1373　and　1382；　speaks　moreover　of　affections　of　the　throat；　and　describes　the　back　spots　of　plague　patients　more　satisfactorily　than　any　of　his　contemporaries。　　The　former　appeared　but　in　few　cases；　and　consisted　in　carbuncular　inflammation　of　the　gullet；　with　a　difficulty　of　swallowing；　even　to　suffocation；　to　which；　in　some　instances；　was　added　inflammation　of　the　ceruminous　glands　of　the　ears；　with　tumours；　producing　great　deformity。　　Such　patients；　as　well　as　others；　were　affected　with　expectoration　of　blood；　but　they　did　not　usually　die　before　the　sixth；　and；　sometimes；　even　as　late　as　the　fourteenth　day。　　The　same　occurrence；　it　is　well　known；　is　not　uncommon　in　other　pestilences；　as　also　blisters　on　the　surface　of　the　body；　in　different　places；　in　the　vicinity　of　which；　tumid　glands　and　inflammatory　boils；　surrounded　by　discoloured　and　black　streaks；　arose；　and　thus　indicated　the　reception　of　the　poison。　　These　streaked　spots　were　called；　by　an　apt　comparison；　the　girdle；　and　this　appearance　was　justly　considered　extremely　dangerous。
  CHAPTER　IIICAUSESSPREAD
  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　shakenthroughout　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；　spri