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Ambroise Paré and his times, 1510-1590 online

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parts of the body; their appetite is gone, they are
wholly changed, with a hard, dry, black tongue, a

Fare's Account of the Plague 267

horrible pinched look, and their faces pale and
leaden, or sometimes red and inflamed, with general
tremors, and spitting of blood, and many other
troubles ; from the sudden corruption of the infected
air, and the evil disposition of them that are at-
tacked. But all these troubles do not always come
at once, or to all patients ; and some have more of
them than others : so that one hardly sees two cases
of the plague that are alike, for they differ according
to the different effects that it produces. Which
comes of the variableness of the poison, the ill-health
and general condition of the patients, the times and
seasons of the year, and the parts of the body that
are first attacked : so that the plague is not always of
one sort, but of many : thus there are many names
for it — fievre pestilente, caqiiesangiie, coqiielucJie,
siiette, trousse-galant, bosse, charbo7i, pourpre, and
others, that I shall give hereafter.

The essential nature of the poison of the plague is
unknown, and past all explanation ; so that we may
call the plague a fourth kind of disease. For if it
were a simple intemperature, it would be hot or cold,
or moist or dry, or compounded of these: and then
it would be cured by its contraries, by their mere
qualities of hot, cold, dry, moist, or by an admixture
of them. If it were an incommodation, that is to
say a wrong composition of parts, it would be in

268 Ambroise P


undue conformation or figure, or in number, or
magnitude, or position. Again, if it were solution
of continuity, there would be erosion, contusion, in-
cision, perforation, laceration, puncture, or rupture;
all which things would be healed with the remedies
given to us by the ancients. But it comes not only
of simple corruption, but also of contagion of the
infected air, past all words, and past understanding;
which impresses the character of its poison on a
body already disposed to it.

You will ask how a surgeon can find any real cure
for this contagion, since the cause of it cannot be
known. The answer must be, that we must follow
the course of Nature. For this poison, which goes
straight to the heart, is abhorrent to Nature : there-
fore she sets to work, and endeavours to dislodge
and drive to the surface all the infected material
that is keeping up the mischief, whence come pesti-
lential fevers, carbuncles, buboes, purpura, and
other troubles: by which action of Nature, the
nobler parts of the body are much relieved : so that
the patient may escape and be safe, if all, or the
greater part, can be thus driven outward and kept
there. And the physician and the surgeon, who are
ministers and coadjutors of Nature, have but to fol-
low Nature's course : as in bringing about sweating
and vomiting in the first stage of the disease, and in

Pares Account of the Plague 269

the use of such things as strengthen the heart, and
all remedies proved good against putrefaction and
venenosity. In brief, we must fortify the heart
with antidotes, and draw to the surface the products
of the disease, and treat the troubles as they come,
altering our remedies according to them.

Such is my description of the plague : which is
never universal, nor all of one kind : as I have said

2. Of the Divine Causes of the Plague.

It is a thing established among true Christians, to
whom the Eternal has revealed the secrets of His
wisdom, that the plague, and other diseases common
among men, come from the hand of God ; as the
prophet teaches us : Shall there be evil in a city, and
the Lord hath not done it ? We should always be
careful to think of this, for two reasons. First, that
we may see how all our life, health, movement, and
being, come directly from the pure goodness of
God, who is the Father of light : so that we may be
thankful to Him for His gifts. Next, when we
know that these afflictions are laid on us by God,
we are in the right way to understand His just deal-
ing with our sins, and to humble ourselves like
David * under His strong hand, keeping our souls
♦ Voyez a ce propos le Ps. 39. A. P.

2/0 Ambrolse Pare

from the sin of rebellion : that being raised from de-
spair we may call on His greatness to deliver us
from all evil by His loving kindness. Thus we shall
learn to seek in God and in ourselves, in Heaven
and on earth, the true knowledge of the causes of
the plague which has visited us.

And since divine Philosophy teaches us that God
is the beginning and first cause of intermediate
causes, without which there can be no action of
secondary and subordinate causes, so these are
ordered and arranged by His secret will and design,
who uses them as instruments of His work according
to His unchangeable decree and ordinance.

But we must not simply attribute the cause of the
plague to immediate causes, like the Lucianists,
Naturalists, and other infidels; remembering that as
God by His omnipotence has created all things from
the highest to the lowest, so by His wisdom He
preserves, restrains, and directs all things as it seems
good to Him, and often He even changes their nat-
ural course, according to His good pleasure. That
is why the Prophet warns us, Learn not the way of
the heathen, and be not dismayed at the signs of
heavefi ; for the heathen are dismayed at them. And
let no man be so bold and full of madness as to wish
to hold God bound, who is the sovereign cause of
all things, to secondary and subordinate causes, or

Park's Account of the Plague 271

to His creatures, or to that first disposition that He
Himself has given them : which would rob God of
this title of Omnipotent, and take from Him the
freedom henceforth to change anything and order it
otherwise than He has ordered it in the beginning;
as though He could be subject and bound by the
order that He has established, and unable to make
a new disposition of things.* For whatever order
or arrangement God may have put in Nature, in the
course of the seasons, in the movement of the stars
and the planets, yet he is not bound or subject to
anything created : for He works and accomplishes
His works in perfect freedom, and is in no way sub-
ject to follow the order that He has established in
Nature. But if He wishes to punish men for their
sins, that they may see His justice ; or to pour bene-
fits upon them, that they may feel His goodness as
a Father — He without difficulty changes this order
of things as He thinks fit, and makes it serve His
will, according as He sees good and just. For as, at
the beginning of the creation of the world, by the
commandment of God, the earth brought forth
grass, and trees yielding fruit, and the sea brought
forth fish, and there was light, before the two great
lights, the sun and the moon, were created, to teach
us that it is the Omnipotent, who alone has made

* This phrase was added in 1579.

272 Ambroise Pare

all things: so, after the government of the creatures
was committed to the sun and to the planets, whence
the earth and all things on it receive food and nour-
ishment, we know how Almighty God has altered
their natural course for the good and profit of His
Church. Thus we read that the Lord went before
the Israelites, by day in a pillar of a cloud, to lead
them the way, and by night in a pillar of fire, to
give them light. Also the sun and the moon were
stayed, and changed their course, at the prayer of
Joshua. Also by the prayer of Elijah there was no
rain for the space of three years and six months.
These examples make it plain that God disposes His
creatures according to His good pleasure, both for
His glory, and for the salvation of those who call on
Him in spirit and in truth.

Now as the Lord employs these lower things to
be ministers of His will and witnesses of His grace
to those who fear Him, so they serve Him as heralds
and executors of His justice, to punish the iniquities
and offences of sinners who despise His majesty.
In a word, it is the hand of God that by His just
judgment hurls from Heaven this plague and con-
tagion, to chastise us for our offences and iniquities,
according to the threat contained in Scripture. The
Lord speaks thus, / will bring a sword upon you,
that shall avenge the quarrel of my covenant : and

Fare's Account of the Plague 273

when ye are gathered together withi7t your cities, I
will send the pestilence amoftg you ; and ye shall be
delivered into the hands of the enemy. Read also
what is written in the third chapter of Habakkuk.
The Lord of Hosts says, Behold, I send upon them
the sword, the famine, and the pestilence. Likewise
God commanded Moses to cast into the air a certain
powder, in the presence of Pharaoh, so that in all
the land of Egypt both man and beast should be
afflicted with pestilent boils, ulcers, and many
other diseases. And David is witness to this, say-
ing that God sent upon Egypt flies which devoured
their land, and frogs which destroyed them, and
gave their fruit to the caterpillar, and their labour
to the grasshopper, and spoiled their vines with hail-
stones, and their wild fig-trees with the storm : and
gave their cattle to the hail, and their flocks to the
thunderbolt. Afterward, he says. He made a way
to His anger ; He spared not their soul from death,
but gave their life over to the pestilence. Also, in
Deuteronomy, Moses threatens those who transgress
the law of God with many curses, and among others
with pestilence, boils, swellings, and fevers.

And the one example of David shows the accom-
plishment of these terrible threats: when God, for
his sin, destroyed seventy thousand men with the
plague, as Scripture is witness. The prophet Gad


274 Ambroise Pare

was sent to David with this commandment from
God, / offer thee three things ; choose thee one of
them, ayid I will do it. Which wilt thou have, that
seven years of famine come upon the land, or that for
the space of three jnonths thou flee before thine ene-
mies, and they pursue thee, or that for three days the
pestilence be on the land? Then David prays to
fall into the hands of God rather than into the
hands of men : for His mercies are great.

And if any one should say that the people did not
deserve to die for the offence of their king, it may
be answered that they were yet more wicked than
he : for God preserved David for the honour of His
holy name.*

We read also that the Lord punished idolatry, and
profanation of His service, with the scourge of the
pestilence. For He speaks thus. Because thou hast
defiled my holy place in thy infamies aiid abomina-
tions, I will break thee also, neither shall mine eye
spare, nor will I have pity on thee : for the third part
shall die of pestilence.

So let us be agreed that the plague, and other
dangerous maladies, are evidence of the wrath of
God against the sins, idolatries, and superstitions,
which reign over the earth : as even a profane author
is compelled to confess that there is something divine

* This sentence was added in 1585.

Pares Account of the Plague 275

in diseases.* And, when it pleases the Lord of
Lords, and Creator of all things, to bring His just
judgments to pass, none of His creatures can escape
His terrible fury, as David teaches us:

" Les cieux fondirent en sueur :
La terre trembla de la peur
De ta face terrible."

How then will it be with us, miserable men, who
pass away like the snow ? How shall we be able to
stand before the fire of the wrath of God, we who
are as hay and stubble, and our days vanish like
smoke ? Let us learn to leave our evil ways for the
pure service of God, not imitating those insane
patients, who bewail the heat and action of their
fever, yet reject the medicine given to cure the
cause of their suffering. Let us be sure that our best
antidote against the plague is the conversion and
amendment of our lives. And just as the apothe-
caries make theriacum of the flesh of snakes, to heal
the bite of a venomous animal, so from the cause of
our diseases, from our sins, let us obtain remedy and
healing, looking to the Son of God, Jesus Christ our
Lord, who not only heals the body of its infirmities
and diseases, but cleanses the soul of all sin and
filth. And like David let us lament and acknowledge

* Hippocrates, chap. 2, du i. livre des Prognostiques. A. P.

276 Ambroise Pare

our sins, praying to the good God with heart and
lips, as follows,

" Ne vueille pas, 6 Sire,
Me reprendre en ton ire,
Moy qui t'ay irrite," etc.

Such is the first and most important consideration
that all Christians should bear in mind, when we
would find out the divine causes of the plague, and
the precautions that we must take for the cure of it.
Furthermore, I warn the surgeon not to neglect the
remedies approved by physicians both ancient and
modern : for as by the will of God this disease is sent
among men, so by His holy will He gives us methods
and remedies, to use them as instruments for His
glory, seeking help in our troubles even from His
creatures, endowed by Him with certain properties
and virtues for the alleviation of poor sufferers; and
it is His will that we should use these secondary
natural causes as instruments of His blessing, or we
should be thankless indeed, and blind to his loving
kindness. For it is written that the Lord has given
to men the knowledge of the art of medicine, to be
glorified in His marvellous works. Wherefore we
must neglect none of all these other measures, that
shall hereafter be described.

Next, we must enquire into the natural causes and
reasons of the plague.

Pares Account of the Plague 277

3. Of the Human or Natural Causes of the
Plague: and how it is Sown among
Men by Infection of the Air.

There are two natural general causes of the plague :
one is the infection and corruption of the air, the
other is the vitiation of the humours of the body, so
that they are predisposed to take the plague from
the air. Which is proved by Galen : who says that
the humours of the body can become corrupt and
acquire venenosity.

The air becomes corrupt, when there is something
excessive in the seasons of the year, so that they lose
their natural constitution : which happens when the
year, almost all of it, has been wet with much rain
and heavy mists. The winter, for the most part,
has not been cold ; the spring, also, has not been so
cool and temperate as usual ; and in the autumn are
seen in the skies bright flames, shooting stars, and
comets of diverse shapes, which come of dry exhala-
tions. The summer is hot, and the wind blows only
from the South, and so gently that men have hardly
felt it, have only noted from time to time that the
clouds were driven from South to North. These
constitutions of the seasons are described by Hip-
pocrates in the first book of the Epidemics, and in
the third book of the Aphorisms: and they make

278 Ambroise Pare

the air altogether pestilent. Then the intempera-
ture of the air predisposes the serous humours of the
body to corruption, and the unnatural heat of the
air burns and inflames them. But all unnatural con-
stitutions of the seasons do not always engender
the plague, but rather other epidemic diseases.

Sometimes a single inhalation of the infected air
from a case of plague infects every member of the

Again, the air becomes corrupt when certain
vapours — as I have already said — are mixed with it :
as by a great multitude of dead bodies kept too long
above ground, men, horses, and other animals,
making a tainted and putrid vapour which infects
the air : which often happens after a battle, or after
shipwreck, when the waves have brought many
bodies ashore : or when the sea has cast up heaps of
fish and other creatures that were swept down to it
by floods, killing them, for they cannot live in salt
water. Sometimes the sea leaves great quantities
of fish high and dry, when the gulfs or chasms made
under it by earthquakes become filled with water,
or when the waves throw on the beach great fish
that have come up out of the deep: and not long
ago a whale went rotten on the coast of Tuscany,
and brought the plague over the whole country.
* This sentence was added in 1585.

Park's Account of the Plague 279

Fish also (but this seldom happens, as Aristotle
says in the eighth chapter of the History of Ani-
mals ) * may be infected by foul exhalations arising
under the water and passing through it, so that
they feel the contagion of the air round them when
they come to the surface. For these reasons, when
the plague is in a country, many fish are found dead,
mostly in ponds, lakes, and sluggish streams, what
we call sleeping waters. Which does not happen in
the sea: for its violent movement, and the salt in it,
keep it from corruption : so that the fish are not in-
fected like those in sleeping waters.

Again, the air becomes infected by foul vapours
from lakes, muddy and marshy pools, and stagnant
water in houses where there are pipes and drains
underground, and the water does not flow off, and
in summer, from the excessive heat of the sun, it
becomes corrupt, and exhalations arise from it.
Thus we read that at Padua there was a well which
had long been kept covered : and when they opened
it, which was in summer, such putrid exhalations
came out, that the air of the neighbourhood was
corrupted through and through : whence arose a
marvellous plague, and lasted a very long time, and
great numbers died of it.

Again, the air is corrupted by the fumes and ex-

* This sentence in parentheses was added in 1579.

2 So Ambroise

halations that come of corrupt infected vapours shut
up in the bowels of the earth, long confined and
smothered in its deep dark places, and then set free
by an earthquake. For in time of earthquake, the
waters have a sulphurous or metallic taste, and are
hot and troubled by exhalations from the disturbed
and shaken earth. Diverse voices are heard, like
the groans of men dying in battle, and diverse cries
of animals : and we see come out of the earth many
animals, as toads, adders, asps, vipers, and other
vermin.* And when these exhalations are let loose,
they infect not only men and other animals, but
also plants, and all sorts of fruit and grain, and
everything that nourishes us if and as the troubled
and putrefied waters kill the fish that are in them,
so the malignant and pestiferous air is fatal to men,
altering the spirits, corrupting the humours, and at
the last killing them, and even beasts and plants, as
I have said.

And there are those cases of men digging wells,
who have met a vapour so putrid and infected that
they have soon died. Only a short time ago, in the
Faulxbourgs Sainct Honor6 here in Paris, five
healthy young men died of cleaning out a cesspool

♦These sentences, from "For in time of" to "other vermin,"
were added in 1579.

f La paste des plantes est appellee sideration, A. P.

Fare's Account of the Plagfue 281

where the ordure from some pigstyes had long been
stagnant without exhalation : and men had to fill
the hole with earth, so as to make a quick end of it
and prevent worse disasters.

A like thing was noted of old time by the philoso-
pher Empedocles, who found an opening in the earth,
among the mountains, whence came foul vapours
which caused the plague; and he had it blocked
up, and so he drove the plague out of Sicily.

And we know this is true, from the infection that
came of dead bodies at Chateau de Pene, on the
river Lot : where in September, 1562, during the first
troubles that arose out of the Religion, many dead
bodies were thrown into a well about a hundred
fathoms deep, whence two months later issued a
putrid cadaveric vapour which spread over the
whole Agenois country and the places around for
ten leagues, and many were attacked by the plague.
Nor is this strange, seeing that the wind drives the
exhalations and putrid fumes from one country into
another, and in this way too we see the plague arise,
as I have said already in the first Apologia.*

Against all this it might be said that if the plague
be due to putrefaction of the air, then wherever car-
rion is lying, and in all pools, marshes, or other

* This last sentence was added in 1579. The reference is to the
edition of 1572.

282 Ambroise Pare

putrid places, the plague must always be there, be-
cause the air is disposed to putrefaction : and every
sort of putrefaction, once inhaled, must beget the
plague : which is against experience, as we see in
those who inhabit and frequent putrid places, as
fish-markets, slaughter-houses, cemeteries, hospitals,
sewers, and tan-yards ; and in those who handle and
cart manure in a putrid state, and so forth. Answer
must be made that the putrefaction of plague is
wholly different from all other putrefactions; for it
is of a hidden malignancy, past all words, which we
cannot explain any more than the lodestone attract-
ing iron, or than drugs withdrawing certain humours
from us and purging us of them. So the occult
malignancy of this putrefaction of plague does not
belong to things that are simply corrupt : yet
these things, when the plague is about, are easily
turned to a like malignancy with it : so that all boils,
and putrid fevers, and other diseases that come of
putrefaction, are apt in time of plague to acquire
this especial and most mysterious malignancy.

Therefore, when the times are thus constituted
we must avoid all infected places, and all association
with them that are stricken, lest we be infected by
the vapour and exhalation of the corrupt air. But
all who inhale the air of the plague do not of neces-
sity take the disease: for you cannot catch it unless

Fare's Account of the Plague 283

you are prepared and disposed to it; as every day's
experience proves. And Galen notes the same
thing, in his book Oti the Differences of Fevers, say-
ing that no cause can produce its effect except the
body be apt and prepared for it, or all would be in-
fected from the same cause. Nevertheless, he who
constantly frequents places and persons infected
with the poison may acquire this disposition, and
may become susceptible to the plague : for green
wood is not disposed to burn, yet, after being long
in the fire, it burns. So I advise men to take all
care of themselves, and to avoid places and persons
stricken with the plague : for the poison got by
smelling these evil vapours is wonderfully swift, and
has no need of any humour to help it to enter the
body and act as I have already said. For these
vapours being subtle are easily drawn with the air
into the lungs, thence into the heart the seat of life,
then they pass along the arteries, and so are diffused
over the whole body, disordering first the spirits,
then the humours, and at last the very substance of
the solid parts."*^

* In the edition of 1568, the word " solides " was left out : this

omission was noted as an "erratum" by Pare, in the following

note :

Au Lecteur.

" Amy Lecteur, k la page 16. ligne 9., apr^s ce mot, parties, faut

adjouster ce mot, solides. S'il se trouve d'autres fautes, elles sent

ou de petite consequence, ou aisees a un chacun de corriger."

284 Ambrolse Par^

When I speak of plague in the air, I would not be
understood to mean simple elemental air, which be-
ing simple never becomes corrupt, but by addition
and admixture of corrupt vapours diffused through
it. Now the air immediately round us is necessary
to each moment of our lives, and we cannot live
without it: for it brings about innumerable changes
in us, by the lungs drawing it into the chest, and by
its transpiration through the pores and invisible out-
lets all over the body, and through the arteries of the
skin : whereby the spirit of life is generated, and the
natural heat of the body is kept up. Therefore, if
the air be immoderately hot, cold, moist, or dry, it
changes and subdues the temperature of the body
into likeness with itself. And of all the constitutions
of the air, that is most dangerous which is hot and
moist, for these qualities cause putrefaction : as ex-
perience proves in those places where the sea-wind
from the East exercises its tyranny, where fresh
meat goes bad and tainted in less than half an hour.
Also we see how heavy rains beget an abundance of
vapours, and these, when the sun cannot break them
up and melt them, change and corrupt the air, and
dispose it for the plague. But here we must note
that the corruption of the dead bodies of men is more

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Online LibraryStephen PagetAmbroise Paré and his times, 1510-1590 → online text (page 16 of 18)