[26] Compare on this point, _Ballings_ treatise “Zur Diagnostik der Lungenerweichung.” Vol. XVI. ii. 3. p. 257 of lit. Annalen der ges. Heilkunde. [27] It is expressly ascertained with respect to Avignon and Paris, that uncleanliness of the streets increased the plague considerably. _Raim. Chalin de Vinario._ 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 his 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.[28] [28] _De Peste_ Libri tres, opera _Jacobi Dalechampii_ in lucem editi. Lugdani, 1552. 16. p. 35. _Dalechamp_ has only improved the language of this work, adding nothing to it but a preface in the form of two letters. _Raymond Chalin de Vinario_ was contemporary with _Guy de Chauliac_ at Avignon. He enjoyed a high reputation, and was in very affluent circumstances. He often makes mention of cardinals and high officers of the papal court, whom he had treated; and it is even probable, though not certain, that he was physician to Clement VI. (1342--1352), Innocent VI. (1352--) and Urban the V. (1362--1370). He and _Guy de Chauliac_ never mention each other.