第 13 节
作者:朝令夕改      更新:2021-02-20 18:46      字数:9322
  ded upon a sufficient purification of the air; by means of large blazing fires of odoriferous wood; in the vicinity of the healthy as well as of the sick; and also upon an appropriate manner of living; so that the putridity might not overpower the diseased。  In conformity with notions derived from the ancients; he depended upon bleeding and purging; at the commencement of the attack; for the purpose of purification; ordered the healthy to wash themselves frequently with vinegar or wine; to sprinkle their dwellings with vinegar; and to smell often to camphor; or other volatile substances。  Hereupon he gave; after the Arabian fashion; detailed rules; with an abundance of different medicines; of whose healing powers wonderful things were believed。  He had little stress upon super…lunar influences; so far as respected the malady itself; on which account; he did not enter into the great controversies of the astrologers; but always kept in view; as an object of medical attention; the corruption of the blood in the lungs and heart。  He believed in a progressive infection from country to country; according to the notions of the present day; and the contagious power of the disease; even in the vicinity of those affected by plague; was; in his opinion; beyond all doubt。  On this point intelligent contemporaries were all agreed; and; in truth; it required no great genius to be convinced of so palpable a fact。  Besides; correct notions of contagion have descended from remote antiquity; and were maintained unchanged in the fourteenth century。  So far back as the age of Plato a knowledge of the contagious power of malignant inflammations of the eye; of which also no physician of the Middle Ages entertained a doubt; was general among the people; yet in modern times surgeons have filled volumes with partial controversies on this subject。  The whole language of antiquity has adapted itself to the notions of the people respecting the contagion of pestilential diseases; and their terms were; beyond comparison; more expressive than those in use among the moderns。
  Arrangements for the protection of the healthy against contagious diseases; the necessity of which is shown from these notions; were regarded by the ancients as useful; and by man; whose circumstances permitted it; were carried into effect in their houses。  Even a total separation of the sick from the healthy; that indispensable means of protection against infection by contact; was proposed by physicians of the second century after Christ; in order to check the spreading of leprosy。  But it was decidedly opposed; because; as it was alleged; the healing art ought not to be guilty of such harshness。  This mildness of the ancients; in whose manner of thinking inhumanity was so often and so undisguisedly conspicuous; might excite surprise if it were anything more than apparent。  The true ground of the neglect of public protection against pestilential diseases lay in the general notion and constitution of human societyit lay in the disregard of human life; of which the great nations of antiquity have given proofs in every page of their history。  Let it not be supposed that they wanted knowledge respecting the propagation of contagious diseases。  On the contrary; they were as well informed on this subject as the modern; but this was shown where individual property; not where human life; on the grand scale was to be protected。  Hence the ancients made a general practice of arresting the progress of murrains among cattle by a separation of the diseased from the healthy。  Their herds alone enjoyed that protection which they held it impracticable to extend to human society; because they had no wish to do so。  That the governments in the fourteenth century were not yet so far advanced as to put into practice general regulations for checking the plague needs no especial proof。  Physicians could; therefore; only advise public purifications of the air by means of large fires; as had often been practised in ancient times; and they were obliged to leave it to individual families either to seek 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 chang