The Black Death, and The Dancing ManiaHecker, J. F. C. (Justus Friedrich Carl)
History
The Black Death, and The Dancing Mania
Hecker, J. F. C. (Justus Friedrich Carl)
Black Death; Chorea, Epidemic; Epidemics
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
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