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；　only　16；000　people　were　carried　off；　the　generality　expired　by　the　third　or　fourth　day。　　In　Austria；　and　especially　in　Vienna；　the　plague　was　fully　as　malignant　as　anywhere；　so　that　the　patients　who　had　red　spots　and　black　boils；　as　well　as　those　afflicted　with　tumid　glands；　died　about　the　third　day；　and　lastly；　very　frequent　sudden　deaths　occurred　on　the　coasts　of　the　North　Sea　and　in　Westphalia；　without　any　further　development　of　the　malady。
  To　France；　this　plague　came　in　a　northern　direction　from　Avignon；　and　was　there　more　destructive　than　in　Germany；　so　that　in　many　places　not　more　than　two　in　twenty　of　the　inhabitants　survived。　Many　were　struck；　as　if　by　lightning；　and　died　on　the　spot；　and　this　more　frequently　among　the　young　and　strong　than　the　old；　patients　with　enlarged　glands　in　the　axillae　and　groins　scarcely　survive　two　or　three　days；　and　no　sooner　did　these　fatal　signs　appear；　than　they　bid　adieu　to　the　world；　and　sought　consolation　only　in　the　absolution　which　Pope　Clement　VI。　promised　them　in　the　hour　of　death。
  In　England　the　malady　appeared；　as　at　Avignon；　with　spitting　of　blood；　and　with　the　same　fatality；　so　that　the　sick　who　were　afflicted　either　with　this　symptom　or　with　vomiting　of　blood；　died　in　some　cases　immediately；　in　others　within　twelve　hours；　or　at　the　latest　two　days。　　The　inflammatory　boils　and　buboes　in　the　groins　and　axillae　were　recognised　at　once　as　prognosticating　a　fatal　issue；　and　those　were　past　all　hope　of　recovery　in　whom　they　arose　in　numbers　all　over　the　body。　　It　was　not　till　towards　the　close　of　the　plague　that　they　ventured　to　open；　by　incision；　these　hard　and　dry　boils；　when　matter　flowed　from　them　in　small　quantity；　and　thus；　by　compelling　nature　to　a　critical　suppuration；　many　patients　were　saved。　　Every　spot　which　the　sick　had　touched；　their　breath；　their　clothes；　spread　the　contagion；　and；　as　in　all　other　places；　the　attendants　and　friends　who　were　either　blind　to　their　danger；　or　heroically　despised　it；　fell　a　sacrifice　to　their　sympathy。　　Even　the　eyes　of　the　patient　were　considered　a　sources　of　contagion；　which　had　the　power　of　acting　at　a　distance；　whether　on　account　of　their　unwonted　lustre；　or　the　distortion　which　they　always　suffer　in　plague；　or　whether　in　conformity　with　an　ancient　notion；　according　to　which　the　sight　was　considered　as　the　bearer　of　a　demoniacal　enchantment。　　Flight　from　infected　cities　seldom　availed　the　fearful；　for　the　germ　of　the　disease　adhered　to　them；　and　they　fell　sick；　remote　from　assistance；　in　the　solitude　of　their　country　houses。
  Thus　did　the　plague　spread　over　England　with　unexampled　rapidity；　after　it　had　first　broken　out　in　the　county　of　Dorset；　whence　it　advanced　through　the　counties　of　Devon　and　Somerset；　to　Bristol；　and　thence　reached　Gloucester；　Oxford　and　London。　　Probably　few　places　escaped；　perhaps　not　any；　for　the　annuals　of　contemporaries　report　that　throughout　the　land　only　a　tenth　part　of　the　inhabitants　remained　alive。
  From　England　the　contagion　was　carried　by　a　ship　to　Bergen；　the　capital　of　Norway；　where　the　plague　then　broke　out　in　its　most　frightful　form；　with　vomiting　of　blood；　and　throughout　the　whole　country；　spared　not　more　than　a　third　of　the　inhabitants。　　The　sailors　found　no　refuge　in　their　ships；　and　vessels　were　often　seen　driving　about　on　the　ocean　and　drifting　on　shore；　whose　crews　had　perished　to　the　last　man。
  In　Poland　the　affected　were　attacked　with　spitting　blood；　and　died　in　a　few　days　in　such　vast　numbers；　that；　as　it　has　been　affirmed；　scarcely　a　fourth　of　the　inhabitants　were　left。
  Finally；　in　Russia　the　plague　appeared　two　years　later　than　in　Southern　Europe；　yet　here　again；　with　the　same　symptoms　as　elsewhere。　　Russian　contemporaries　have　recorded　that　it　began　with　rigor；　heat；　and　darting　pain　in　the　shoulders　and　back；　that　it　was　accompanied　by　spitting　of　blood；　and　terminated　fatally　in　two；　or　at　most　three　days。　　It　is　not　till　the　year　1360　that　we　find　buboes　mentioned　as　occurring　in　the　neck；　in　the　axillae；　and　in　the　groins；　which　are　stated　to　have　broken　out　when　the　spitting　of　blood　had　continued　some　time