62 • Beginningsan endemic to epidemic state.^12 He needed to look closely at the “signs” on
all his patients’ bodies and listen to their professed “symptoms.”^13 Although
plague acted like no other bodily ill, many medical authorities believed it
could develop from lesser maladies. Even ordinary fever had to be watched
because, it was thought, it could lead to spotted fever, and that disease might
develop, in turn, into true plague.^14
Plague could be suspected whenever a family member or servant developed
a high fever or shuddering cold along with frequent vomiting, headaches, and
dizziness. Between three and ten days after these initial symptoms, if plague
was really at work, the visible marks or signs started to appear. Boghurst listed
“carbuncles, buboes, blains, blisters, [and] spots riseing on the body.” Not long
after that, terminal signals began. There could be a “griping” (or cramping) in
the guts, faltering speech, faintness or an unusual pain in one area, sudden
looseness of the bowels, and shortness of breath. Frenzy, hysterical laughing,
swooning, or staggering also sometimes occurred. Many patients experienced
cold sweats and an irregular pulse. Any two or three or four of these indicators
coming together, Boghurst wrote confidently, “were infallible signs of death
now at hand and they seldom came single.”^15
The most recognizable proof that someone had become infected was a
bubo, a swelling of the lymph nodes in the groin or neck or under the arms.
With chilling detail Boghurst later described the chief varieties of buboes in
his own account of the plague of 1665 – 66 ,Loimographia: Or an Experimentall
Relation of the Plague.The wedge-shaped, red swellings rose slowly and re-
ceded gradually. More dangerous were the white ones, appearing suddenly,
soft and puffy. “Few live that have them,” he claimed.^16
Everyone knew that buboes characterized plague. When Dr. Burnet, hav-
ing survived quarantine, showed Pepys the pesthouse master’s postmortem
report on his servant, Samuel noted in his diary the mention of “a Bubo on
his right groine, and two Spots on his right thigh, which is the plague.” The
buboes did not always appear, however. Boghurst had a ready explanation:
the infection moved so quickly through the body that a victim succumbed
before the swelling started. Attention was paid to another trademark sign,
which everybody called “tokens” because they betokened almost sure death:
“Spotts riseing on the body,” as Boghurst called them. These spots came out
early on the victim’s chest—small, round, hard, and red, “like flea bites,” Dr.
Garencières wrote.^17 It was a helpful description; almanacs featured fleas in
their checklist of vermin to be cleared out during spring cleaning, and eve-
ryone knew what fleabites looked like.
The sight of the tokens on their bodies stunned people. “God’s Marks,”