Hecker gives the following statement, which must be an exaggeration, concerning the mortality of the black death: "Cairo lost daily, when the plague was raging with its greatest violence, from ten to fifteen thousand. In China more than thirteen millions are said to have died. India was depopulated. In Caramania and Cæsarea none were left alive. On the roads, in the camps, in the caravansaries, unburied bodies alone were seen. Twenty-two thousand persons and most of the animals were carried off in Gaza within six weeks. Cyprus lost almost all its inhabitants, and ships without crews were often seen in the Mediterranean, as afterward in the North Sea, driving about and spreading the plague wherever they went on shore. It was reported to Pope Clement that throughout the East, probably with the exception of China, 23,840,000 people had fallen victims to the plague."
Probably the most constant pathological lesion found after death from this disease is an enlargement of the lymphatic glands. The disease may run so rapid a course that the enlargement of the glands is not observable during life, but, according to recent and competent observers, changes in these tissues will be found in the great majority of cases. This has led Cantline who studied the disease at Hong Kong in 1894, to propose for it the appellation of "malignant polyadenitis." The same authority offers the following definition: "Plague or malignant polyadenitis is an acute febrile disease of an intensely fatal nature, characterized by inflammation of the lymphatic glands, marked cerebral and vascular disturbances, and by the presence of a specific bacillus."
Geographically the plague has been known as far east as the island of Formosa, where it now prevails; as far west as Ireland; as far north as Norway; and there is no definite information concerning its extension southward in Africa. It has never been known in the western hemisphere, but this is only due to the fact that up to the present time there has been no opportunity of its importation to this half of the world.
In this connection the following quotation from Hecker may be of interest: "The inhabitants of Iceland and Greenland found in the coldness of their inhospitable climate no protection against the southern enemy who had penetrated to them from happier countries. The plague caused great havoc among them. Nature made no allowance for their constant warfare with the elements and the parsimony with which she meted out to them the enjoyments of life. In Denmark and Norway, however, people were so occupied with their own misery that the accustomed voyages to Greenland ceased. Towering icebergs formed at the same time on the coast of east Greenland, in consequence of the general concussion of the earth's organism, and no mortal from that time forward has ever seen that shore or its inhabitants."
