From the Private Observations of Magister Odo of Maribor, Physician and Student of Natural Causes
Concerning the Pestilence Called the Catriona
In the Year 1266
It hath now been seven weeks since the first afflicted were brought under my care, and I do here set down such observations as may endure beyond my own frailty, for this pestilence is of a most cruel and secretive nature, striking both peasant and burgher, weakling and hale man alike. Whether this record shall preserve lives, or serve only to name the hand by which God doth chastise us, I cannot yet say.
The sickness, now called by many the Catriona Plague, beginneth most often with a sudden heaviness of body, trembling, and a violent heat within the flesh. The patient complaineth of pain in the head, dryness of mouth, and a great thirst. Within a day there follow weakness, dizziness, and a fever so fierce that the skin burneth to the touch, though the extremities may grow cold.
Shortly thereafter appear the most notable signs: hard and swollen lumps beneath the arms, in the groin, and sometimes about the neck. These swellings are at first red and painful, then darken to a dusky purple or black, as though the flesh itself were bruised from within by some hidden blow. In many, these buboes grow to the size of a plum or even an egg, and bring the sufferer to cries when touched.
There is also seen in a number of cases a blackening of the fingers, toes, lips, or nose, as if the blood no longer nourisheth those parts but curdleth and dieth within them. The skin may show dark spots, small at first, then spreading like ink upon parchment. This sign I take to be most grave, for those in whom it appeareth rarely survive beyond two or three days.
Many vomit bitter matter, yellow or green, and some bring forth blood. Their bowels are disordered. Their breath groweth foul. Their minds become unsteady. I have seen sober men babble like children, and mothers fail to know their own sons. Some fall into a deep sleep from which they do not wake; others rage, clawing at their clothes and bed-linens as though burned by invisible embers.
In certain households the disease taketh another form, more terrible still. Those so seized begin with fever and weakness, yet soon are afflicted by a violent cough. They spit froth mixed with blood, gasp for breath, and infect those around them with dreadful swiftness. Where this form appeareth, whole chambers may be emptied in a matter of days. I do judge this manner of the illness more catching than the other, though whether it be the same plague in another guise, or a companion pestilence, remaineth uncertain.
As to the cause of this sickness, I have heard many claims, and tested what I am able.
The priests say it is divine scourge for sin, and surely no man may altogether deny the justice of Heaven. Yet sin alone cannot explain why one child dies and another, equally innocent, lingers on.
Some learned men hold that it ariseth from corrupted air, especially in narrow streets, marsh lands, dunghills, and houses wherein the sick have long lain. There is weight in this notion, for the plague thriveth in filth, foul vapors, and summer heat. Many who dwell in cramped and stinking quarters perish first. I have therefore ordered the burning of rosemary, juniper, and vinegar-soaked cloth, with uncertain success.
Others claim the wells are poisoned, or that bad conjunctions of the stars have altered the quality of the air and blood. Indeed, the heavens have of late been strange in their aspect, and many natural philosophers teach that celestial motions incline men toward sickness. I do not dismiss this, though I cannot measure it.
Yet there are observations that trouble all simple explanations.
First: those who attend the sick, or handle their garments, blankets, and straw, often fall ill soon after, even when they have not shared the same room for long.
Second: in many infected homes there is a strange abundance of rats and biting vermin, such as fleas and lice. I cannot say these creatures bear the disease, but I note their presence too often to ignore it. Where granaries are foul and verminous, there the sickness seemeth to root itself deeply.
Third: it is not always the foulest quarter that is first struck, but sometimes a busy road, an inn, or a merchant’s house wherein goods have newly arrived from afar. This suggesteth that contagion may travel in cloth, grain, hides, or upon persons yet not visibly afflicted.
Thus I am drawn to suspect that the plague spreadeth by more than one means: by corrupted airs in some places, by contact with the sick or their possessions in others, and perhaps by the bites of vermin that feed first upon beasts, then upon men. If this be true, then our danger is greater than supposed, for the enemy is not only what we breathe, but what we touch and what crawleth unseen upon us.
As to remedies, I write with sorrow that few avail much once the swellings have risen and the fever taken hold. Bleeding hath mostly weakened the patient. Purging helpeth little. Poultices of onion, garlic, vinegar, or pitch may soften the buboes, though whether they heal or merely comfort I know not. Lancing the swellings sometimes releaseth foul matter, but survival after this is uncertain. Wine mixed with crushed herbs may ease suffering. Prayer easeth the soul, if not the flesh.
The best defense, insofar as reason guideth me, is this:
Remove the healthy from the sick.
Burn or boil soiled cloth.
Air the houses.
Drive out vermin where possible.
Do not sleep beside the infected.
Do not handle the dead without wrapping the face and hands.
And let no man trust wholly in strong blood, for this pestilence humbleth the robust as readily as the frail.
If God grant me life, I shall continue these observations. But I confess here, in honest ink, that we stand before a mystery clothed in death. The Catriona doth not kill as sword or famine kill, by plain means known to all men. It moveth like a curse, yet leaveth traces like a creature of nature. Somewhere between Heaven’s wrath and the hidden workings of the world its truth may lie.
May the gods preserve us from learning too much of it by further grief.
— Magister Odo
Additional notes: Further analysis suggests mortality of infected in the absence of medical care, is in 93% of cases. However, when medical care is provided, the mortality rate drops to 89%. Individuals who survive develop complete immunity to the disease and never succumb to it again.
The Plague is named after a Nilfgaardian ship that introduced the pathogen to the northern realms.