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Few testimonies are presented to us respecting its symptoms and its course； yet these are sufficient to throw light upon the form of the malady； and they are worthy of credence； from their coincidence with the signs of the same disease in modern times。
The imperial writer； Kantakusenos； whose own son； Andronikus； died of this plague in Constantinople； notices great imposthumes of the thighs and arms of those affected； which； when opened； afforded relief by the discharge of an offensive matter。 Buboes； which are the infallible signs of the oriental plague； are thus plainly indicated； for he makes separate mention of smaller boils on the arms and in the face； as also in other parts of the body； and clearly distinguishes these from the blisters； which are no less produced by plague in all its forms。 In many cases； black spots broke out all over the body； either single； or united and confluent。
These symptoms were not all found in every case。 In many； one alone was sufficient to cause death； while some patients recovered； contrary to expectation； though afflicted with all。 Symptoms of cephalic affection were frequent； many patients became stupefied and fell into a deep sleep； losing also their speech from palsy of the tongue； others remained sleepless and without rest。 The fauces and tongue were black； and as if suffused with blood； no beverage could assuage their burning thirst； so that their sufferings continued without alleviation until terminated by death； which many in their despair accelerated with their own hands。 Contagion was evident； for attendants caught the disease of their relations and friends； and many houses in the capital were bereft even of their last inhabitant。 Thus far the ordinary circumstances only of the oriental plague occurred。 Still deeper sufferings； however； were connected with this pestilence； such as have not been felt at other times； the organs of respiration were seized with a putrid inflammation； a violent pain in the chest attacked the patient； blood was expectorated； and the breath diffused a pestiferous odour。
In the West； the following were the predominating symptoms on the eruption of this disease。 An ardent fever； accompanied by an evacuation of blood； proved fatal in the first three days。 It appears that buboes and inflammatory boils did not at first come out at all； but that the disease； in the form of carbuncular （anthrax…artigen） affection of the lungs； effected the destruction of life before the other symptoms were developed。
Thus did the plague rage in Avignon for six or eight weeks； and the pestilential breath of the sick； who expectorated blood； caused a terrible contagion far and near； for even the vicinity of those who had fallen ill of plague was certain death； so that parents abandoned their infected children； and all the ties of kindred were dissolved。 After this period； buboes in the axilla and in the groin； and inflammatory boils all over the body； made their appearance； but it was not until seven months afterwards that some patients recovered with matured buboes； as in the ordinary milder form of plague。
Such is the report of the courageous Guy de Chauliac； who vindicated the honour of medicine； by bidding defiance to danger； boldly and constantly assisting the affected； and disdaining the excuse of his colleagues； who held the Arabian notion； that medical aid was unavailing； and that the contagion justified flight。 He saw the plague twice in Avignon； first in the year 1348； from January to August； and then twelve years later； in the autumn； when it returned from Germany； and for nine months spread general distress and terror。 The first time it raged chiefly among the poor； but in the year 1360； more among the higher classes。 It now also destroyed a great many children； whom it had formerly spared； and but few women。
The like was seen in Egypt。 Here also inflammation of the lungs was predominant； and destroyed quickly and infallibly； with burning heat and expectoration of blood。 Here too the breath of the sick spread a deadly contagion； and human aid was as vain as it was destructive to those who approached the infected。
Boccacio； who was an eye…witness of its incredible fatality in Florence； the seat of the revival of science； gives a more lively description of the attack of the disease than his non…medical contemporaries。
It commenced here； not as in the East； with bleeding at the nose； a sure sign of inevitable death； but there took place at the beginning； both in men and women； tumours in the groin and in the axilla； varying in circumference up to the size of an apple or an egg； and called by the people； pest…boils （gavoccioli）。 Then there appeared similar tumours indiscriminately over all parts of the body； and black or blue spots came out on the arms or thighs； or on other parts； either single and large； or small and thickly studded。 These spots proved equally fatal with the pest…boils； which had been from the first regarded as a sure sign of death。 No power of medicine brought reliefalmost all died within the first three days； some sooner； some later； after the appearance of these signs； and for the most part entirely without fever or other symptoms。 The plague spread itself with the greater fury； as it communicated from the sick to the healthy； like fire among dry and oily fuel； and even contact with the clothes and other articles which had been used by the infected； seemed to induce the disease。 As it advanced； not only men； but animals fell sick and shortly expired； if they had touched things belonging to the diseased or dead。 Thus Boccacio himself saw two hogs on the rags of a person who had died of plague； after staggering about for a short time； fall down dead as if they had taken poison。 In other places multitudes of dogs； cats； fowls； and other animals； fell victims to the contagion； and it is to be presumed that other epizootes among animals likewise took place； although the ignorant writers of the fourteenth century are silent on this point。
In Germany there was a repetition in every respect of the same phenomena。 The infallible signs of the oriental bubo…plague with its inevitable contagion were found there as everywhere else； but the mortality was not nearly so great as in the other parts of Europe。 The accounts do not all make mention of the spitting of blood； the diagnostic symptom of this fatal pestilence； we are not； however； thence to conclude that there was any considerable mitigation or modification of the disease； for we must not only take into account the defectiveness of the chronicles； but that isolated testimonies are often contradicted by many others。 Thus the chronicles of Strasburg； which only take notice of boils and glandular swellings in the axillae and groins； are opposed by another account； according to which the mortal spitting of blood was met with in Germany； but this again is rendered suspicious； as the narrator postpones the death of those who were thus affected； to the sixth； and （even the） eighth day； whereas； no other author sanctions so long a course of the disease； and even in Strasburg； where a mitigation of the plague may； with most probability； be assumed since the year 1349； o