A Succinct Account of the Plague at Marseilles: Its Symptoms and the Methods and Medicines Used for Curing It

In Short

This report serves as a primary medical dispatch from the front lines of the 1720 plague in Marseille. Three physicians, sent from Paris by the Duke Regent, categorize the illness into five distinct stages—ranging from near-instantaneous death to manageable, localized infections—and detail the various treatments they attempted. By stripping away the era’s popular superstitions and the claims of opportunistic "empericks," the text provides a stark, analytical look at how a city’s medical establishment attempted to impose order and rational science upon an incomprehensible and lethal public health crisis.

The Story

The narrative begins with a formal recognition of the calamity that has depopulated Marseille. The physicians, having been deputed by the Court to assist the city’s magistrates, find themselves confronted with a disease so volatile that it defies standard medical categorization. They open their analysis by observing that the plague manifests in wildly different ways across the population, forcing them to establish five distinct classes of infection to better understand the odds of survival.

In the first two classes, the physicians describe a terrifyingly swift descent. Patients are seized with shiverings, confusion, and a "cadaverous" pallor, often dying within hours or days. The physicians note with frustration that these patients are in no condition to be bled; indeed, such interventions—once considered standard medicine—only hasten the patient's collapse. The second class, while slightly more prolonged, involves internal burning heats, inextinguishable thirst, and the appearance of painful buboes and carbuncles. Here, the physicians identify a cruel irony: the more vigorous and robust the patient, the more quickly they succumb to gangrenous inflammation.

As the account progresses, the physicians move through the third, fourth, and fifth classes of the disease. They describe the transition from initial, hopeless symptoms to the more "fortunate" cases where the body manages to localize the infection into external tumors. The fourth and fifth classes offer a glimmer of clinical hope: if the buboes and carbuncles can be coaxed into successful suppuration, the patient might survive. Consequently, the later portion of the work shifts from a description of symptoms to a detailed, manual-like explanation of surgical intervention. They argue against the use of "actual or potential cauteries" for carbuncles, noting they only exacerbate gangrene, and instead advocate for careful scarification and the application of specific digestives and emollient poultices to drain the noxious matter from the blood.

The document concludes not with a triumph of medicine, but with a sober assessment of their limitations. The physicians admit that despite their best efforts, many died because of the sheer "malignity" of the infection. They emphasize that the restoration of order, the return of public courage, and the rejection of superstitious "specifics" were as crucial to the city’s recovery as any single medicine. By the end, the report stands as both a testament to their exhaustion and a final, disciplined record of a city that had been brought to its knees by an invisible, relentless adversary.

How It Unfolds

The arrival of the experts Three physicians are sent from Paris to the epicenter of the plague to provide official clinical guidance to the city's desperate magistrates. They immediately commit to recording their observations with empirical rigor, intentionally distancing their work from the rumors and misinformation spreading through the streets.

Categorizing the terror The authors divide the afflicted into five distinct classes to manage the overwhelming clinical evidence. This classification system allows them to distinguish between those for whom death is inevitable and those whose symptoms suggest a path toward recovery.

The limits of intervention The physicians systematically test and discard common treatments that prove fatal, such as bleeding and overly aggressive purging. They document the failure of various "specificks" and cordials, noting that when nature is already overwhelmed, these interventions often only serve to exhaust the patient.

The surgical focus The narrative shifts from general internal medicine to the specific management of physical tumors. The physicians detail the precise use of caustic stones, incisions, and digestive dressings as the only viable methods to help the body expel the "noxious ferment."

A call for order The final section addresses the necessity of a stable, organized response to the catastrophe. The physicians conclude that while medicine is essential, the restoration of order and the curbing of public despair were the most critical factors in allowing the city to survive the plague’s peak.

The People

The book is driven by the perspectives of the three deputed physicians—Chicoyneau, Verney, and Soullier—who act as the rational, observant eyes of the medical establishment. They are defined by their commitment to evidence-based practice; they want to map the disease’s behavior to identify what works and what is merely "vain credulity." Standing in their way is not only the biology of the plague itself, but the "popular superstition" and "greediness" of charlatans who profit from the panic.

Supporting them are the city authorities, specifically the Chevalier de Langeron and the governing sheriffs. These men represent the administrative front, and the physicians credit their "firmness and vigilance" with creating the necessary environment for medical treatment to even be possible. The patients themselves appear as a collective, ranging from the hopeless, who believe themselves "destined to certain death," to those who find the courage to endure. Ultimately, the physicians remain the central, detached observers, struggling to maintain their composure as they witness the "desertion and inactivity" of a city in the grip of mass trauma.

In Its Own Voice

The Persons thus seized, perished commonly in the Space of some Hours, of a Night, of a Day, or of two or three at farthest, as by Faintness or Extinction; sometimes, but more rarely, in convulsive Motions, and a Sort of Trembling; no Eruption, Tumour or Spot appearing without.

The physicians describe the rapid, silent, and terrifying deaths characteristic of the first class of patients, where the disease killed before the body could even produce physical symptoms.

But that which deserves to be well observed, and which has always seemed to characterise and distinguish this Disease from all others, is, that almost all had at the Beginning, or in the Progress of this Distemper, very painful Buboes, situated commonly below the Groin, sometimes in the Groin or Arm-pits.

This observation marks the clinical turning point, where the doctors identify the specific physical markers they would spend the remainder of the epidemic learning to treat.

What It's Really About

This work is a fundamental argument for rational inquiry during a time of existential collapse. It explores the tension between medical theory and the brutal reality of a mass mortality event. The underlying question is how one maintains scientific objectivity when faced with an "incurable" calamity that destroys the very social order needed to treat it. The authors move beyond simple symptom-listing to suggest that the mind of the patient—their fear, their belief in their own mortality, and their resulting despair—is a primary factor in the progression of the disease. It is a treatise on the necessity of discipline, both in the operating room and in the governance of an infected city.

Why Read It Today

Readers with an interest in the history of medicine will find this text remarkably gripping, as it captures the exact moment when clinical observation began to supersede folklore. There is a profound, somber intimacy in reading the physicians' attempts to apply logic to an environment where "desertion and inactivity" were rampant. The prose is clear and surprisingly modern in its analytical tone, though the 18th-century medical terminology—such as the use of "ptisans" or "alexiterials"—will require a bit of patience.

It is important to note that the book does not offer a narrative of triumph; it is a clinical report written in the heat of a crisis, and it carries the weight of the physicians' frustration and grief. The period attitudes toward "robust" bodies or the moralizing of the patients' "courage" are artifacts of the time, yet they provide a window into how the 18th-century mind processed the uncontrollable. What stays with the reader is the chilling clarity with which the authors describe the "leaden" faces and the "inextinguishable" thirst of the dying. It is a haunting, essential document for anyone seeking to understand the intersection of human fragility and the cold, necessary work of the physician.