Of the Methods to be taken against the PLAGUE.
CHAP. I.
_Of preventing Infection from other Countries._
AS it is a Satisfaction to know, that the _Plague_ is not a Native of
our Country, so this is likewise an Encouragement to the utmost
Diligence in finding out Means to keep our selves clear from it.
THIS Caution consists of two Parts: _The preventing its being brought
into our Island_; and, if such a Calamity should happen, _the putting a
Stop to its spreading among us_.
THE first of these is provided for by the established Method of obliging
Ships, that come from _infected_ Places, to _perform Quarantaine_: As to
which, I think it necessary, that the following Rules be observed.
NEAR to our several Ports, there should be _Lazaretto's_ built in
convenient Places, on little Islands, if it can so be, for the Reception
both of Men and Goods, which arrive from Places suspected of
_Infection_: The keeping Men in _Quarantaine_ on board the Ship being
not sufficient; the only use of which is to observe whether any die
among them. For _Infection_ may be preserved so long in Clothes, in
which it is once lodged, that as much, nay more of it, if Sickness
continues in the Ship, may be brought on Shore at the end than at the
beginning of the forty Days: Unless a new _Quarantaine_ be begun every
time any Person dies; which might not end, but with the Destruction of
the whole Ship's Crew.
IF there has been any _contagious_ Distemper in the Ship; the _sound_
Men should leave their Clothes, which should be sunk in the Sea, the Men
washed and shaved, and having fresh Clothes, should stay in the
_Lazaretto_ thirty or forty Days. The reason of this is, because Persons
may be recovered from a Disease themselves, and yet retain _Matter_ of
_Infection_ about them a considerable time: as we frequently see the
_Small-Pox_ taken from those, who have several Days before passed
through the Distemper.
THE _Sick_, if there be any, should be kept in Houses remote from the
_Sound_, and, some time after they are well, should also be washed and
shaved, and have fresh Clothes; whatever they wore while sick being sunk
or buryed: And then being removed to the Houses of the _Sound_, should
continue there thirty or forty Days.
I AM particularly careful to destroy the _Clothes_ of the Sick, because
they harbour the very _Quintessence_ of _Contagion_. A very ingenious
Author[68], in his admirable Description of the _Plague_ at _Florence_
in the Year 1348, relates what himself saw: That two _Hogs_ finding in
the Streets the _Rags_, which had been thrown out from off a poor Man
dead of the Disease, after snuffling upon them, and tearing them with
their Teeth, they fell into Convulsions, and dy'd in less than an Hour.
The learned _Fracastorius_ acquaints us, that in his time, there being a
_Plague_ in _Verona_, no less than twenty five Persons were successively
kill'd by the Infection of one _Furr_ Garment[69]. And _Forestus_ gives
a like Instance of seven Children, who dy'd by playing upon Clothes
brought to _Alckmaer_ in _North-Holland_, from an infected House in
_Zealand_[70]. The late Mr. _Williams_, Chaplain to Sir _Robert Sutton_,
when Embassador at _Constantinople_, used to relate a Story of the same
Nature told him by a _Bassa_: that in an Expedition this _Bassa_ made to
the Frontiers of _Poland_, one of the _Janizaries_ under his Command
dy'd of the _Plague_; whose Jacket, a very rich one, being bought by
another _Janizary_, it was no sooner put on, but he also was taken sick
and dy'd: and the same Misfortune befel five _Janizaries_ more, who
afterwards wore it. This the _Bassa_ related to Mr. _Williams_, chiefly
for the sake of this farther Circumstance, that the Incidents now
mentioned prevailed upon him to order the burning of the Garment:
designing by this Instance to let Mr. _Williams_ see there were _Turks_,
who allowed themselves in so much Freedom of Thought, as not to pay that
strict Regard to the _Mahometan_ Doctrine of Fatality, as the Vulgar
among them do.
IF there has been no Sickness in the Ship, I see no reason why the Men
should perform _Quarantaine_. Instead of this, they may be washed, and
their Clothes aired in the _Lazaretto_, as Goods, for one Week.
BUT the greatest Danger is from such _Goods_, as are apt to retain
Infection, such as _Cotton_, _Hemp_ and _Flax_, _Paper_ or _Books_,
_Silk_ of all sorts, _Linen_, _Wool_, _Feathers_, _Hair_, and all kinds
of _Skins_. The _Lazaretto_ for these should be at a Distance from that
for the Men; and they must in convenient Warehouses be unpack'd, and
exposed, as much as may be, to the fresh Air for forty Days.
THIS may perhaps seem too long; but as we don't know how much time
precisely is necessary to purge the Interstices of spongy Substances
from _infectious Matter_ by fresh Air, the Caution cannot be too great
in this Point. Certainly the time here proposed, having been long
established by general Custom, ought not in the least to be retrenched;
unless there could be a way found out of trying when Bodies have ceased
to emit the noxious Fumes. Possibly this might be discovered by putting
tender _Animals_ near to them, particularly little _Birds_: because it
has been observed in Times of the _Plague_, that the Country has been
forsaken by the _Birds_; and those kept in Houses have many of them
died[71]. Now if it should be found, that _Birds_ let loose among Goods
at the beginning of their _Quarantaine_, are obnoxious to the
_Contagion_ in them, it may be known, in good measure, when such Goods
are become clean, by repeating the Trial till _Birds_ let fly among them
receive no hurt. But the Use of this Expedient can be known only by
Experience. In the mean time, I own I am fond of the _Thought_, in
compassion to poor Labourers, who must expose their Lives to danger, in
the attendance upon this Work: and tho' I am well aware that there are
_Plagues_ among Animals, which do not indifferently affect all kinds of
them, some being confined to a particular _Species_, (like the Disease
of the _Black Cattle_ here, a few Years since, which neither proved
infectious to other Brutes, nor to Men;) yet it has always been observed
that the true _Plague_ among Men has been destructive to all Creatures
of what kind soever.
A very remarkable Story, lately communicated to me by a Person of
undoubted Credit, is too much to the purpose to be here omitted. The
Fact is this. In the Year 1726, an English Ship took in Goods at _Grand
Cairo_, in the time of the _Plague's_ raging there, and carried them to
_Alexandria_. Upon opening one of the Bales of Wool in a Field, two
_Turks_ employed in the Work were immediately killed: and some _Birds_,
which happened to fly over the Place, dropp'd down dead.
HOWEVER, the Use of _Quarantaines_ is not wholly frustrated by our
Ignorance of the exact time required for this Purification: since the
_Quarantaine_ does at least serve as a Trial whether Goods are infected
or not; it being hardly possible that every one of those, who are
obliged to attend upon them, can escape hurt, if they are so. And
whenever that happens, the Goods must be destroyed.
I TAKE it for granted, that the _Goods_ should be _opened_, when they
are put into the _Lazaretto_, otherwise their being there will avail
nothing. This is the constant Practice in the _Ports_ of _Italy_. That
it is so at _Leghorn_, appears by the Account lately published of the
Manner, in which _Quarantaines_ are there performed: and I find, that
the same Rule is observed at _Venice_, from an authentic Paper, I have
before me, containing the Methods made use of in that City, where
_Quarantaines_ have been enjoined ever since the Year 1484; at which
time, as far as I can learn, they were first instituted in _Europe_. In
that Place all _Bales_ of _Cotton_, of _Camel_'s or of _Beaver_'s
_Hair_, and the like, are _ript_ open from end to end, and _Holes_ made
in them by the _Porters_ every Day, into which they thrust their naked
Arms, in order that the Air may have free Access to every part of the
Goods. That some such Cautions as these ought not to be omitted, is
clearly proved by the Misfortune, which happened in the Island of
_Bermudas_ about the Year 1695; where, as the Account was given me by
the learned Dr. _Halley_, a Sack of _Cotton_ put on Shore by Stealth,
lay above a Month without any Prejudice to the People of the House,
where it was hid: but when it came to be distributed among the
Inhabitants, it carried such a _Contagion_ along with it, that the
Living scarce sufficed to bury the Dead. This Relation Dr. _Halley_
received from Captain _Tucker_ of _Bermudas_, Brother to Mr. _Tucker_
late Under-Secretary in our Secretary's Office.
INDEED, as it has been frequently experienced, that of all the Goods,
which harbour _Infection_, _Cotton_ in particular is the most dangerous,
and _Turky_ is almost a perpetual _Seminary_ of the _Plague_; I cannot
but think it highly reasonable, that whatever _Cotton_ is imported from
that part of the World, should at all Times be kept in _Quarantaine_:
Because it may have imbibed _Infection_ at the Time of its packing up,
notwithstanding no Mischief has been felt from it by the Ship's Company.
And the length of Time from its being pack'd up to its Arrival here, is
no certain Security that it is cleared from the _Infection_. At least,
it is found, that the Time employed by Ships in passing between _Turky_
and _Marseilles_, is not long enough for Goods to lose their
_Infection_: as appears not only from the late Instance, but also from
an Observation made in a certain _Memorial_, drawn up by the Deputy of
Trade at _Marseilles_[72]. _Marseilles_ is the only Port in _France_
allowed to receive Goods from the _Levant_, on Account of its singular
Convenience for _Quarantaines_, by Reason of several small _Islands_
situate about it. The _Ports_ of _France_ in the _Western Ocean_ having
had a Desire to be allowed the same Liberty, their Deputies presented,
in the Year 1701, a _Memorial_ to the _Royal Council of Trade_,
containing several Reasons for their Pretensions. To this the _Deputy_
at _Marseilles_ makes Reply in the _Memorial_ I am speaking of, in which
this Advantage of _Marseilles_ for _Quarantaines_ above the other
Ports, is much insisted upon: and, to evince the Importance thereof, it
is declared in express Words, that many Times Persons have been found in
that Place to die of the _Plague_ in their Attendance upon Goods under
_Quarantaine_. Now if it be certain, that Goods have retained Infection
during their Passage from _Turkey_ to _Marseilles_; it is too hardy a
Presumption to be admitted in an Affair so important as this, that they
must necessarily lose all Contagion in the Time of their coming to us,
because the Voyage is something longer. But besides this, there are some
few Instances of Goods, that have retained their Infection many Years.
In particular, _Alex. Benedictus_ gives a very distinct Relation of a
Feather Bed, that was laid by seven Years on Suspicion of its being
infected, which produced mischievous Effects at the End of that great
Length of Time[73]. And Sir _Theodore Mayerne_ relates, that some
Clothes fouled with Blood and Matter from _Plague_ Sores being lodged
between _Matting_ and the Wall of a House in Paris, gave the _Plague_
several Years after to a Workman, who took them out, which presently
spread through the City[74].
WHAT makes _Cotton_ so eminently dangerous, is its great Aptitude to
imbibe and retain any Sort of _Effluvia_ near it; of which I have
formerly made a particular Experiment, by causing some _Cotton_ to be
placed for one Day near a Piece of _putrefying Flesh_ from an amputated
Limb, in a Bell-Glass, but without touching it: for the _Cotton_ imbibed
so strong a Taint, that being put up in a close Box, it retained its
offensive Scent above ten Months, and would, I believe, have kept it for
Years. If, instead of the Fumes of _putrefied Flesh_ from a sound Body,
this _Cotton_ had been thus impregnated with the Fumes of corrupted
Matter from one sick of the _Plague_; I make no doubt but it would have
communicated Infection. And the Experiment would have succeeded alike in
both Cases, if instead of _Cotton_, _Silk_, _Wool_, or _Hair_ had been
inclosed in the Vessel: Animal Substances being the most apt to attract
the volatile Particles, which come from Bodies of the same Nature with
themselves.
AS all reasonable Provisions should be made both for the _Sound_ and
_Sick_, who perform _Quarantaine_; so the strict keeping of it ought to
be inforced by the severest _Penalties_. And if a Ship comes from any
Place, where the _Plague_ raged, at the Time of the Ship's Departure
from it, with more than usual Violence; it will be the securest Method
to _sink_ all the _Goods_, and even the _Ship_ sometimes: especially if
any on Board have died of the Disease.
NOR ought this farther Caution to be omitted, that when the _Contagion_
has ceased in any Place by the Approach of Winter, it will not be safe
to open a free Trade with _it_ too soon: because there are Instances of
the _Distemper_'s being stopt by the Winter Cold, and yet the Seeds of
it not destroyed, but only kept unactive, 'till the Warmth of the
following Spring has given them new Life and Force. Thus in the great
_Plague_ at _Genoa_ about four-score Years ago, which continued Part of
two Years; the first Summer about _ten Thousand_ died; the Winter
following hardly any; but the Summer after no less than _sixty
Thousand_. Likewise the last _Plague_ at _London_ appeared the latter
End of the Year 1664, and was stopt during the Winter by a hard Frost of
near three Month's Continuance; so that there remained no farther
Appearance of it 'till the ensuing Spring[75]. Now if Goods brought from
such a Place should retain any of the latent _Contagion_, there will be
Danger of their producing the same Mischief in the Place, to which they
are brought, as they would have caused in that, from whence they came.
BUT above all, it is necessary, that the _Clandestine Importing_ of
Goods be punished with the utmost Rigour; from which wicked Practice I
should always apprehend more Danger of bringing the _Disease_ than by
any other Way whatsoever.
THESE are, I think, the most material Points, to which Regard is to be
had in defending ourselves again _Contagion_ from other Countries. The
particular Manner of putting these Directions in Execution, as the
_Visiting_ of _Ships_, _Regulation_ of _Lazaretto's_, &c. I leave to
proper Officers, who ought sometimes to be assisted herein by able
Physicians.
CHAP. II.
_Of Stopping the Progress of the_ Plague, _if it should enter our
Country._
THE next Consideration is, what to do in Case, through a Miscarriage in
the publick Care, by the Neglect of Officers, or otherwise, such a
Calamity should be suffered to befal us.
THERE is no _Evil_ in the World, in which the great Rule of _Resisting
the Beginning_, more properly takes Place, than in the present Case; and
yet it has unfortunately happened, that the common Steps formerly taken
have had a direct Tendency to hinder the putting _this Maxim_ in
Practice.
AS the _Plague_ always breaks out in some particular Place, it is
certain, that the Directions of the _Civil Magistrate_ ought to be such,
as to make it as much for the Interest of infected Families to discover
their Misfortune, as it is, when a House is on _Fire_, to call in the
Assistance of the Neighbourhood: Whereas, on the contrary, the Methods
taken by the Publick, on such Occasions, have always had the Appearance
of a severe _Discipline_, and even _Punishment_, rather than of a
_Compassionate Care_; which must naturally make the _Infected_ conceal
the Disease as long as was possible.
THE main Import of the _Orders_ issued out at these Times was[76]; As
soon as it was found, that any House was infected, to keep it shut up,
with a _large red Cross_, and these Words, _Lord, have Mercy upon us_,
painted on the Door; Watchmen attending Day and Night to prevent any
one's going in or out, except such _Physicians_, _Surgeons_,
_Apothecaries_, _Nurses_, _Searchers_, &c. as were allowed by Authority:
And this to continue at least a Month after all the Family was _dead_ or
_recovered_.
IT is not easy to conceive a more dismal Scene of Misery, than this:
Families lock'd up from all their Acquaintance, though seized with a
Distemper which the most of any in the World requires Comfort and
Assistance; abandoned it may be to the Treatment of an inhumane Nurse
(for such are often found at these times about the Sick;) and Strangers
to every thing but the melancholy Sight of the Progress, Death makes
among themselves: with small Hopes of Life left to the Survivers, and
those mixed with Anxiety and Doubt, whether it be not better to die,
than to prolong a miserable Being, after the Loss of their best Friends
and nearest Relations.
IF _Fear_, _Despair_, and all _Dejection of Spirits_, dispose the Body
to receive _Contagion_, and give it a great Power, where it is received,
as all Physicians agree they do; I don't see how a Disease can be more
inforced than by such a Treatment.
NOTHING can justify such _Cruelty_, but the Plea, that it is for the
Good of the whole _Community_, and prevents the spreading of
_Infection_. But this upon due Consideration will be found quite
otherwise: For while _Contagion_ is kept nursed up in a House, and
continually encreased by the daily Conquests it makes, it is impossible
but the _Air_ should become tainted in so eminent a degree, as to spread
the _Infection_ into the Neighbourhood upon the first Outlet. The
shutting up Houses in this Manner is only keeping so many _Seminaries_
of _Contagion_, sooner or later to be dispersed abroad: For the waiting
a Month, or longer, from the Death of the last Patient, will avail no
more, than keeping a _Bale_ of infected _Goods_ unpack'd; the Poyson
will fly out, whenever the _Pandora's Box_ is opened.
AS these Measures were owing to the Ignorance of the true Nature of
_Contagion_, so they did, I firmly believe, contribute very much to the
long Continuance of the _Plague_, every time they have been practised in
this City: And no doubt, they have had as ill Effects in other
Countries.
IT is therefore no wonder, that grievous Complaints were often made
against this unreasonable Usage; and that the Citizens were all along
under the greatest apprehensions of being thus _Shut up_. This
occasioned their concealing the Disease as long as they could, which
contributed very much to the inforcing and spreading of it: and when
they were confined, it often happened that they broke out of their
_Imprisonment_, either by getting out at Windows, _&c._ or by bribing
the Watchmen at their Doors; and sometimes even by murdering them. Hence
in the Nights, people were often met running about the Streets, with
hideous _Shrieks_ of _Horror_ and _Despair_, quite _Distracted_, either
from the violence of the Fever, or from the Terrors of Mind, into which
they were thrown by the daily Deaths they saw of their nearest
Relations.
IN these miserable Circumstances, many ran away, and when they had
escaped, either went to their Friends in the Country, or built Hutts or
Tents for themselves in the open Fields, or got on board Ships lying in
the River. A few also were saved by keeping their Houses close from all
communication with their Neighbours[77].
AND it must be observed, that whenever popular Clamours prevailed so
far, as to procure some Release for the _Sick_, this was remarkably
followed with an Abatement of the Disease. The _Plague_ in the Year 1636
began with great Violence; but leave being given by the King's Authority
for People to quit their Houses, it was observed, That _not one in
twenty of the well Persons removed fell sick, nor one in ten of the Sick
died_[78]. Which single Instance alone, had there been no other, should
have been of Weight ever after to have determined the Magistracy against
too strict Confinements. But besides this, a preceding _Plague_, _viz._
in the Year 1625, affords us another Instance of a very remarkable
Decrease upon the discontinuing to _shut up_ Houses. It was indeed so
late in the Year, before this was done, that the near Approach of Winter
was doubtless one Reason for the Diminution of the Disease, which
followed: Yet this was so very great, that it is at least past dispute,
that the Liberty then permitted was no Impediment to it. For this
_opening_ of the Houses was allowed of in the beginning of _September_:
and whereas the last Week in _August_, there died no less than four
thousand two hundred and eighteen, the very next Week the _Burials_ were
diminished to three thousand three hundred and forty four; and in no
longer time than to the fourth Week after, to eight hundred and fifty
two[79].
SINCE therefore the Management in former Times neither answers the
Purpose of _discovering the Beginning_ of the _Infection_, nor of
putting a stop to it when _discovered_, other Measures are certainly to
be taken; which, I think, should be of this Nature.
THERE ought, in the first Place, _a Council of Health_ to be
established, consisting of some of the principal Officers of State, both
Ecclesiastical and Civil, some of the chief Magistrates of the City, two
or three Physicians, _&c._ And this _Council_ should be intrusted with
such Powers, as might enable them to see all their Orders executed with
impartial Justice, and that no unnecessary Hardships, under any Pretence
whatever, be put upon any by the Officers they employ.
INSTEAD of _ignorant old Women_, who are generally appointed _Searchers_
in Parishes to inquire what Diseases People die of, that _Office_ should
be committed to _understanding and diligent Men_: whose Business it
should be, as soon as they find any have dy'd after an uncommon Manner,
particularly with _livid Spots_, _Bubo's_, or _Carbuncles_, to give
Notice thereof to the _Council of Health_; who should immediately send
skilful Physicians to examine the suspected Bodies, and to visit the
Houses in the Neighbourhood, especially of the _poorer_ Sort, among whom
this Evil generally begins. And if upon their Report it appears, that a
_Pestilential Distemper_ is broken out, they should without Delay order
all the Families, in which the Sickness is, to be _removed_; the _Sick_
to different Places from the _Sound_: but the Houses for both should be
three or four Miles out of Town; and the _Sound_ People should be
_stript of all their Clothes_, and _washed_ and _shaved_, before they go
into their new Lodgings. These Removals ought to be made in the Night,
when the Streets are clear of People: which will prevent all Danger of
spreading the Infection. And besides, all possible Care should be taken
to provide such Means of Conveyance for the _Sick_, that they may
receive no Injury.
AS this Management is necessary with Respect to the _Poor_ and _meaner_
Sort of People; so the _Rich_, who have Conveniences, may, instead of
being carried to _Lazaretto's_, be obliged to go to their
Country-Houses: provided that Care be always taken to keep the _Sound_
separated from the _Infected_. And at the same Time all the Inhabitants
who are yet well, should be permitted, nay encouraged to leave the Town,
which, the thinner it is, will be the more healthy.
NO manner of _Compassion_ and _Care_ should be wanting to the
_Diseased_; to whom, when lodged in _clean_ and _airy_ Habitations,
there would, with due Cautions, be no great Danger in giving Attendance.
All Expences should be paid by the Publick, and no Charges ought to be
thought great, which are counterbalanced with the saving a Nation from
the greatest of Calamities. Nor does it seem to me at all unreasonable,
that a _Reward_ should be given to the Person, that makes the first
Discovery of _Infection_ in any Place: since it is undeniable, that the
making known the _Evil_ to those, who are provided with proper Methods
against it, is the first and main Step towards the overcoming it.
ALTHOUGH the Methods taken in other Countries, as well as in our own,
have generally been different from what we have here recommended; yet
there are not wanting some Instances of extraordinary Success attending
these Measures, whenever they have happened to be put in Practice.
THE Magistrates of the City of _Ferrara_ in _Italy_ in the Year 1630,
when all the Country round about them was infected with the _Plague_,
observing the ill Success of the Conduct of their Neighbours, who, for
Fear of losing their Commerce, did all they could to conceal the
Disease, by keeping the Sick in their Houses, resolved, whenever
occasion should require, to take a different Method. Accordingly, as
soon as they received Information, that one had died in their City of
the _Pestilence_, they immediately removed the whole Family he belonged
to into a _Lazaretto_, where all, being seven in Number, likewise died.
But though the Disease was thus malignant, it went no farther, being
suppressed at once by this Method. Within the Space of a Year the same
Case returned seven or eight Times, and this Management as often put a
Stop to it. The Example of this _City_ was afterwards followed more than
once by some other Towns in the same Territory with so good Success,
that it was thought expedient, for the common Good, to publish in the
_Memoirs_ of the People of _Ferrara_ this Declaration: _That the only
Remedy against the Plague is to make the most early Discovery of it,
that is possible, and thus to extinguish it in the very Beginning_[80].
NO less remarkable than this Occurrence at _Ferrara_, is what happened
at _Rome_ in the _Plague_, I have taken Notice of before, in the Year
1657. When the Disease had spread itself among both Rich and Poor, and
raged in the most violent Manner; the _Pope_ appointed Cardinal
_Gastaldi_, to be Commissary General of Health, giving him for a Time
the Power of the whole _Sacred College_, with full Commission to do
whatever he should judge necessary. Hereupon he gave strict Orders, that
no sick or suspected Persons should stay in their own Houses. The _Sick_
he removed, upon the first Notice, to a _Lazaretto_ in the _Island_ of
the _Tyber_; and all who were in the same Houses with them to other
_Hospitals_ just without the City, in order to be sent to the _Island_,
if they should fall sick. At the same Time he took diligent Care to send
away their _Goods_ to an airy Place to be cleansed. He executed these
Regulations with so much Strictness, that no Persons of the highest
Quality were exempted from this Treatment; which occasioned at first
great Complaints against the _Cardinal_ for his Severity; but soon after
he had general Thanks: for in two Months Time, by this means, he
entirely cleared the City of the _Pestilence_, which had continued in it
almost two Years. And it was particularly observed, that whereas before,
when once the Disease had got into a House, it seldom ended without
seizing the whole Family; in this Management scarce five out of an
hundred of the sound Persons removed were infected[81].
I CANNOT but take Notice, that the _Plague_ was stopp'd at _Marseilles_
a full Fortnight by the same Measures, and probably might have been
wholly extinguished, had not new Force been given it by the unseasonable
Confidence of the Inhabitants upon this Intermission: which, we are
informed, was so great, that they would not believe the _Pestilence_ had
been at all among them, and publickly upbraided the Physicians and
Surgeons for frighting them causlesly[82]. At this Time, no doubt, they
must have neglected the Cautions necessary for their Security so much,
as to leave us no room to be surprized, that the Disease should after
this break out again with too great Violence to be a second Time
overcome.
BUT, besides these Examples in foreign Countries, we have one Instance
of the same Nature nearer Home. When the _Plague_ was last here in
_England_, upon its first Entrance into _Poole_ in _Dorsetshire_, the
Magistrates immediately suppress'd it, by removing the _Sick_ into
_Pest-Houses_, without the Town, as is well remember'd there to this
Time. A very remarkable Occurrence has greatly contributed towards
preserving all the Circumstances of this Transaction in Memory. They
found some Difficulty in procuring any one to attend upon the _Sick_
after their Removal: which obliged the Town to engage a _young Woman_,
then under Sentence of Death, in that Service, on a Promise to use
their Interest for obtaining her Pardon. The young Woman escaped the
Disease, but neglecting to solicite the Corporation for the
Accomplishment of their Engagement with her, three or four Months after
she was barbarously hanged by the _Mayor_ upon a Quarrel between them.
I WOULD have it here observed, that as the Advice I have been giving is
founded upon this Principle, that the best Method for stopping
Infection, is to separate the _Healthy_ from the _Diseased_; so in small
Towns and Villages, where it is practicable, if the _Sound_ remove
themselves into _Barracks_, or the like airy Habitations, it may
probably be even more useful, than to remove the _Sick_. This Method has
been found beneficial in _France_ after all others have failed. But the
Success of this proves the Method of _Removing the Sick_, where this
other cannot be practised, to be the most proper of any.
WHEN the _sick Families_ are gone, all the Goods of the Houses, in which
they were, should be _buried_ deep under Ground. This I prefer to
_burning_ them: because, especially in a close Place, some infectious
Particles may possibly be dispersed by the Smoak through the
Neighbourhood; according to what _Mercurialis_ relates, that the
_Plague_ in _Venice_ was augmented by burning a large Quantity of
infected Goods in the City[83]. A learned Physician of my Acquaintance
lately communicated to me the Relation of a Case, (given to him by an
Apothecary, who was at the Place when the Thing happened) very proper
to be here mentioned. The Story is this. At _Shipston_, a little Town
upon the River _Stour_ in _Worcestershire_, a poor Vagabond was seen
walking in the Streets with the _Small-Pox_ upon him. The People
frightened took Care to have him carried to a little House, seated upon
a Hill, at some Distance from the Town, providing him with Necessaries.
In a few Days the Man died. They ordered him to be buried deep in the
Ground, and the House with his Cloaths to be burnt. The Wind, being
pretty high, blew the Smoak upon the Houses on one Side of the Town: In
that Part, a few Days after, eight Persons were seized with the
_Small-Pox_. So dangerous is _Heat_ in all Kinds of pestilential
Distempers, and so diffusive of Contagion. And moreover the Houses
themselves may likewise be demolished or pulled down, if that can
conveniently be done; that is, if they are remote enough from others:
otherwise it may suffice to have them thoroughly cleansed, and then
plastered up. And after this, all possible Care ought still to be taken
to remove whatever Causes are found to breed and promote _Contagion_. In
order to this, the _Overseers_ of the Poor (who might be assisted herein
by other Officers) should visit the Dwellings of all the meaner Sort of
the Inhabitants; and where they find them _stifled up too close_ and
_nasty_, should lessen their Number by sending some into better
Lodgings, and should take Care, by all Manner of Provision and
Encouragement, to make them more _cleanly_ and _sweet_.
NO good Work carries its own Reward with it so much as this kind of
_Charity_: and therefore, be the Expence what it will, it must never be
thought unreasonable. For nothing approaches so near to the first
Original of the _Plague_, as Air pent up, loaded with Damps, and
corrupted with the Filthiness, that proceeds from _Animal Bodies_.
OUR _common Prisons_ afford us an Instance of something like this, where
very few escape what they call the _Goal Fever_, which is always
attended with a Degree of _Malignity_ in Proportion to the _Closeness_
and _Stench_ of the Place: and it would certainly very well become the
Wisdom of the Government, as well with regard to the Health of the
_Town_, as in Compassion to the _Prisoners_, to take Care, that all
_Houses of Confinement_ should be kept as airy and clean, as is
consistent with the Use, to which they are designed.
THE _Black Assise_ at _Oxford_, held in the Castle there in the Year
1577, will never be forgot[84]; at which the _Judges_, _Gentry_, and
almost all that were present, to the Number of three hundred, were
killed by a _poisonous Steam_, thought by some to have broken forth from
the _Earth_; but by a _noble_ and _great_ Philosopher[85] more justly
supposed to have been brought by the _Prisoners_ out of the _Goal_ into
_Court_; it being observed, that they alone were not injured by it.
AT the same Time, that this Care is taken of _Houses_, the proper
Officers should be strictly charged to see that the _Streets_ be washed
and kept clean from _Filth_, _Carrion_, and all manner of _Nusances_;
which should be carried away in the _Night Time_: nor should the
_Laystalls_ be suffered to be too near the City. _Beggers_ and _idle
Persons_ should be taken up, and such miserable Objects, as are neither
fit for the common _Hospitals_, nor _Work-Houses_, should be provided
for in an _Hospital of Incurables_.
ORDERS indeed of this Kind are necessary to be observed at all Times,
especially in populous Cities; and therefore I am sorry to take Notice,
that in these of _London_ and _Westminster_ there is no good _Police_
established in these Respects: for want of which the Citizens and
Gentry are every Day annoyed more ways than one.
IF these early _Precautions_, we have mentioned, prove successful, there
will be no need of any Methods for _Correcting the Air_, _Purifying
Houses_, or of _Rules for preserving particular Persons from Infection_:
to all which, if the _Plague_ get head, so that the _Sick_ are too many
to be removed (as they will be when the Disease has raged for a
considerable Time) Regard must be had.
AS to the _first_: _Fire_ has been almost universally recommended for
this Purpose, both by the Ancients and Moderns; who have advised to make
frequent and numerous _Fires_ in the Towns infected. This _Precept_, I
think, is almost entirely founded upon a Tradition, that _Hippocrates_
put a stop to a _Plague_ in _Greece_ by this means. But it is to be
observed, that there is no mention made of any Thing like it in the
Works of _Hippocrates_. The best Authority we have for it, is the
Testimony of _Galen_, though it is also mentioned by other Authors.
_Galen_, recommending _Theriaca_ against the _Pestilence_, has thought
fit, it seems, to compare it to _Fire_; and, upon this Conceit, relates,
that _Hippocrates_ cured a _Plague_, which came from _AEthiopia_ into
_Greece_, by purifying the Air with _Fires_; into which were thrown
sweet-scented Herbs, and Flowers, together with Ointments of the finest
Flavour. It is remarkable, that among the _Epistles_ ascribed to
_Hippocrates_, which, though not genuine, yet are older than _Galen_,
there is a _Decree_ said to be made by the _Athenians_ in Honour of this
Father of Physicians, which, making mention of the Service he had done
his Country in a _Plague_, says only, that he sent his Scholars into
several Parts, with proper Instructions to cure the Disease. By which it
should seem, that this Story of the _Fires_ was hardly or not at all
known at the Time, when these _Letters_ were compiled. And _Soranus_ may
yet more confirm us, that it was framed long after the Death of
_Hippocrates_: for _Soranus_ only says in general, that _Hippocrates_
foretold the coming of the _Pestilence_, and took care of the Cities of
_Greece_; without any mention of having used this particular Expedient.
_Plutarch_ indeed speaks of a Practice like this as commonly approved
among Physicians, which he makes use of to illustrate a certain Custom
of the _Egyptians_: of whom he says, that they _purify_ the Air by the
Fumes of _Resin_ and _Myrrh_, as Physicians correct the Foulness, and
attenuate the Thickness thereof in Times of _Pestilence_, by _burning
Sweet-Woods_, _Juniper_, _Cypress_[86] &c.
THIS I take to be the Sum of what can be learned from Antiquity in
Relation to this Point; from whence we may see, that Writers have
concluded a little too hastily for the use of _common Fires_ in this
Case, upon the Authority and Example of _Hippocrates_, though we should
allow the Fact as related by _Galen_: when it will not from thence
appear that _Hippocrates_ himself relied upon them; since he thought it
necessary to take in the Assistance of _aromatic Fumes_. But as this
Fact is not grounded upon sufficient Authority, so it is needless to
insist long upon it. The Passage I have brought from _Plutarch_ will
better explain what was the Sentiment of those Physicians who approved
the Practice. It seems they expected from thence to dispel the Thickness
and Foulness of the Air. And no doubt but such evil Dispositions of the
Air, as proceed from _Damps_, _Exhalations_, and the like, may be
corrected even by _common Fires_, and the Predisposition of it from
these Causes to receive Infection sometimes removed. But I think this
Method, if it be necessary, should be put in Practice before the coming
of the _Pestilence_. For when the Distemper is actually _begun_, and
rages, since it is known to _spread_ and _increased_ by the _Heat_ of
the _Summer_, and on the contrary checked by the _Cold_ in _Winter_;
undoubtedly, whatever increases that _Heat_, will so far add Force to
the Disease: as _Mercurialis_ takes notice, that _Smiths_, and all those
who worked at the _Fire_ were most severely used in the _Plague_ at
_Venice_ in his Time[87]. Whether the Service _Fires_ may do by
correcting any other ill Qualities of the Air, will counterbalance the
Inconvenience upon this Account, Experience only can determine: and the
fatal Success of the Trials made here in the last _Plague_, is more than
sufficient to discourage any farther Attempts of this Nature. For
_Fires_ being ordered in all the _Streets_ for three Days together,
there died in one Night following no less than four thousand (if we may
believe Dr. _Hodges_:) whereas in any single Week before or after, never
twice that Number were carried off[88]. And we find that upon making
the same Experiment in the last _Plague_ at _Marseilles_, the Contagion
was every Day spread more and more thro' the City with increas'd Rage
and Violence[89].
WHAT has been said of _Fires_, is likewise to be understood of _Firing
of Guns_, which some have too rashly advised. The proper Correction of
the Air would be to make it _fresh_ and _cool_: Accordingly the
_Arabians_[90], who were best acquainted with the Nature of
_Pestilences_, advise People to keep themselves as _airy_ as possible,
and to chuse Dwellings exposed to the Wind, situate high, and refreshed
with running Waters.
AS for _Houses_, the first Care ought to be to keep them _clean_: for as
_Nastiness_ is a great Source of _Infection_, so _Cleanliness_ is the
greatest Preservative; which shews us the true Reason, why the _Poor_
are most obnoxious to _Contagious Diseases_. It is remarked of the
_Persians_, that though their Country is surrounded every Year with the
_Plague_, they seldom or never suffer any Thing by it themselves: and it
is likewise known, that they are the most _cleanly_ People of any in the
World, and that many among them make it a great Part of their Religion
to remove _Filthiness_ and _Nusances_ of every Kind from all Places
about their Cities and Dwellings[91].
BESIDES this, the _Arabians_ advise the keeping Houses _cool_, as
another Method of their _Purification_, and therefore, to answer this
End more fully, they directed to strew them with _cooling_ Herbs, as
_Roses_, _Violets_, _Water-Lilies_, &c. and to be washed with _Water_
and _Vinegar_: than all which, especially the last, nothing more proper
can be proposed. I think it not improper likewise to _fume_ Houses with
_Vinegar_, either alone or together with _Nitre_, by throwing it upon a
_hot Iron_ or _Tile_; though this be directly contrary to what modern
Authors mostly advise, which is to make Fumes with hot things, as
_Benzoin_, _Frankincense_, _Storax_, &c. from which I see no reason to
expect any Virtue to destroy the Matter of _Infection_, or to keep
particular Places from a Disposition to receive it; which are the only
things here to be aimed at. The _Smoak_ of _Sulphur_, perhaps, as it
abounds with an _acid Spirit_, which is found by Experience to be very
_penetrating_, and to have a great Power to repress _Fermentations_, may
promise some Service this way.
AS hot Fumes appear to be generally _useless_, so the Steams of
_Poisonous Minerals_ ought to be reckoned _dangerous_: and therefore I
cannot but dissuade the use of all _Fumigations_ with _Mercury_ or
_Arsenic_. Much less would I advise, as some have done, the wearing
_Arsenic_ upon the _Pit_ of the _Stomach_ as an _Amulet_: since this
Practice has been often attended with very ill Consequences, and is not
grounded upon any good Authority, but probably derived from an Error in
mistaking the _Arabian_ Word _Darsini_, which signifies _Cinnamon_, for
the _Latin de Arsenico_, as I have formerly shewn[92].
THE next thing after the _Purifying of Houses_, is to consider by what
Means particular _Persons_ may best defend themselves against
_Contagion_: for the certain doing of which, it would be necessary to
put the _Humours_ of the _Body_ into such a State, as not to be
alterable by the _Matter of Infection_. But since this is no more to be
hoped for, than a _Specific Preservative_ from the _Small-Pox_; the most
that can be done, will be to keep the Body in such Order, that it may
suffer as little as possible. The _first Step_ towards which, is to
maintain a good State of Health, in which we are always least liable to
suffer by any external Injuries; and not to weaken the Body by
Evacuations. The _next_ is, to guard against all _Dejection of Spirits_,
and _immoderate Passions_: for these we daily observe do expose Persons
to the more common _Contagion_ of the _Small-Pox_. These Ends will be
best answered by living with Temperance upon a good generous Diet, and
by avoiding _Fastings_, _Watchings_, _extreme Weariness_, &c. _Another_
Defence is, to use whatever Means are proper to keep the _Blood_ from
_Inflaming_. This, if it does not secure from _contracting Infection_,
will at least make the _Effects_ of it less violent. The most proper
Means for this, according to the Advice of the _Arabian_ Physicians, is
the repeated Use of _acid Fruits_, as _Pomegranates_, _Sevil Oranges_,
_Lemons_, _Tart Apples_, &c. But above all, of _Wine Vinegar_ in small
Quantities, rendered grateful to the Stomach by the Infusion of some
such Ingredients as _Gentian Root_, _Galangal_, _Zedoary_, _Juniper
Berries_, &c. Which Medicines by correcting the _Vinegar_, and taking
off some ill Effects it might otherwise have upon the Stomach, will be
of good Use: but these, and all other hot _aromatic_ Drugs, though much
recommended by Authors, if used alone, are most likely to do hurt by
_over-heating_ the Blood.
I CANNOT but recommend likewise the Use of _Issues_. The properest Place
for them I take to be the inside of the Thigh a little above the Knee.
Besides, the smoaking _Tobacco_, much applauded by some, since it may be
put in Practice without any great Inconvenience, need not, I think, be
neglected.
BUT since none of these Methods promise any certain Protection; as
_leaving_ the Place infected is the surest _Preservative_, so the next
to it is to avoid, as much as may be, the _near Approach_ to the _Sick_,
or to such as have but _lately recovered_. For the greater Security
herein, it will be adviseable to avoid all _Crouds of People_. Nay, it
should be the Care of the _Magistrate_ to prohibit all unnecessary
_Assemblies_: and likewise to oblige all, who get over the Disease, to
_confine_ themselves for some time, before they appear abroad.
THE Advice to keep at a Distance from the _Sick_, is also to be
understood of the _Dead Bodies_; which should be _buried_ at as great a
Distance from Dwelling-Houses, as may be; put _deep_ in the Earth; and
_covered_ with the exactest Care; but not with _Quick-Lime_ thrown in
with them, as has been the Manner abroad: For I cannot but think that
_This_, by _Fermenting_ with the putrefying Humours of the Carcases, may
give rise to noxious Exhalations from the Ground. They should likewise
be _carried out_ in the _Night_, while they are yet fresh and free from
_Putrefaction_: Because a Carcase not yet beginning to corrupt, if kept
from the Heat of the Day, hardly emits any kind of Steam or Vapour.
AS for those, who must of necessity attend the _Sick_; some farther
Directions should be added for their Use. These may be comprehended in
two short Precepts. _One_ is, not to _swallow their Spittle_ while they
are about the _Sick_, but rather to _spit_ it out: _The other_, not so
much as to _draw in their Breath_, when they are very near them. The
reason for both these appears from what has been said above concerning
the Manner, in which a sound Person receives the Infection. But in case
it be too difficult constantly to comply with these _Cautions_,
_washing_ the _Mouth_ frequently with _Vinegar_, and _holding_ to the
_Nostrils_ a _Sponge_ wet with the same, may in some measure supply
their Place.
THIS is the Sum of what I think most likely to stop the Progress of the
_Disease_ in any Place, where it shall have got Admittance. If some few
of these Rules refer more particularly to the City of _London_, with
small Alteration they may be applied to any other _Place_. It now
remains therefore only to lay down some Directions to hinder the
Distemper's spreading from _Town_ to _Town_. The best Method for which,
where it can be done, (for this is not practicable in very great Cities)
is to cast up a _Line_ about the _Town infected_, at a convenient
Distance; and by placing a _Guard_, to hinder People's passing from it
without due Regulation, to other Towns: but not absolutely to forbid any
to withdraw themselves, as was done in _France_, according to the usual
Practice abroad; which is an unnecessary Severity, not to call it a
Cruelty. I think it will be enough, if all, who desire to pass the
_Line_, be permitted to do it, upon Condition they first perform
_Quarantaine_ for about twenty Days in _Tents_, or other more convenient
_Habitations_. But the greatest care must be taken, that none pass
without conforming themselves to this Order; both by keeping diligent
_Watch_, and by _punishing_, with the utmost Severity, any that shall
either have done so, or attempt it. And the better to discover _such_,
it will be requisite to oblige all, who travel in any Part of the
Country, under the same Penalties, to carry with them _Certificates_
either of their coming from Places not _infected_, or of their passing
the _Line_ by Permission.
THIS I take to be a more effectual Method to keep the _Infection_ from
spreading, than the absolute refusing a Passage to People upon any
Terms. For when Men are in such imminent Danger of their Lives where
they are, many, no doubt, if not otherwise allowed to escape, will use
Endeavours to do it secretly, let the Hazard be ever so great. And it
can hardly be, but some will succeed in their Attempts; as we see it
has often happen'd in _France_, notwithstanding all their Care. But one
that gets off thus clandestinely, will be more likely to carry the
Distemper with him, than twenty, nay a hundred, that go away under the
preceding Restrictions: especially because the _Infection_ of the Place,
he flies from, will by this Management be rendered much more intense.
For confining People, and shutting them up together in great Numbers,
will make the Distemper rage with augmented Force, even to the
increasing it beyond what can be easily imagined: as appears from the
Account which the learned _Gassendus_[93] has given us of a memorable
_Plague_, which happened at _Digne_ in _Provence_, where he lived, in
the Year 1629. This was so terrible, that in one _Summer_, out of _ten
thousand_ Inhabitants, it left but _fifteen hundred_, and of them all
but _five_ or _six_ had gone through the _Disease_. And he assigns
_this_, as the principal Cause of the great Destruction, that the
Citizens were too closely confined, and not suffered so much as to go to
their Country-Houses. Whereas in another _Pestilence_, which broke out
in the same Place a Year and an half after, more Liberty being allowed,
there did not die above _one hundred_ Persons.
FOR these Reasons, I think, to allow People with proper _Cautions_ to
remove from an infected Place, is the best Means to suppress the
_Contagion_, as well as the most humane Treatment of the present
Sufferers: and, under these Limitations, the Method of _investing_
Towns infected, which is certainly the most proper, that can be advised,
to keep the Disease from spreading, will be no Inconvenience to the
Places _surrounded_. On the contrary, it will rather be useful to them;
since the Guard may establish such _Regulations_ for the Safety of
those, who shall bring Provisions, as shall remove the Fears, which
might otherwise discourage them.
THE securing against all Apprehensions of this Kind, is of so great
Importance, that in _Cities_ too large to be invested, as, for Example,
this City of _London_, the _Magistrates_ must use all possible Diligence
to supply this Defect, not only by setting up _Barriers_ without their
City, but by making it in the most particular manner their Care to
appoint such _Orders_ to be observed at them, as they shall judge will
be most satisfactory to the Country about.
THOUGH Liberty ought to be given to the _People_, yet no sort of _Goods_
must by any means be suffered to be carried over the _Line_, which are
made of _Materials_ retentive of _Infection_. For in the present Case,
when _Infection_ has seized any Part of a Country, much greater Care
ought to be taken, that no _Seeds_ of the _Contagion_ be conveyed about,
than when the Distemper is at a great Distance: because a _Bale of
Goods_, which shall have imbibed the _Contagious Aura_ when pack'd up in
_Turky_, or any remote Parts, when unpack'd here, may chance to meet
with so healthful a Temperament of our Air, that it shall not do much
hurt. But when the Air of any one of our Towns shall be so corrupted,
as to maintain and spread the _Pestilence_ in it, there will be little
Reason to believe, that the Air of the rest of the Country is in a much
better State.
FOR the same Reason _Quarantaines_ should more strictly be enjoined,
when the _Plague_ is in a bordering Kingdom, than when it is more
remote.
THE Advice here given with respect to _Goods_, is not only abundantly
confirmed from the Proofs, I have given above, that _Goods_ have a Power
of spreading _Contagion_ to distant Places; but might be farther
illustrated by many Instances of ill Effects from the Neglect of this
Caution in Times of the _Plague_. I shall mention two, which happen'd
among us during the last _Plague_. I have had occasion already to
observe, that the _Plague_ was in _Poole_. It was carried to that Place
by some _Goods_ contained in a _Pedlar's Pack_. The _Plague_ was
likewise at _Eham_ in the Peak of _Derbyshire_, being brought thither by
means of a Box sent from _London_ to a Taylor in that Village,
containing some Materials relating to his Trade. There being several
Incidents in this latter Instance, that will not only serve to establish
in particular the Precepts I have been giving, in relation to Goods, but
likewise all the rest of the Directions, that have been set down, for
stopping the Progress of the _Plague_ from one Town to another; I shall
finish this Chapter with a particular Relation of what passed in that
Place. A Servant, who first opened the foresaid _Box_, complaining that
the Goods were damp, was ordered to dry them at the Fire; but in doing
it, was seized with the _Plague_, and died: the same Misfortune
extended itself to all the rest of the Family, except the Taylor's Wife,
who alone survived. From hence the Distemper spread about and destroyed
in that Village, and the rest of the Parish, though a small one, between
two and three hundred Persons. But notwithstanding this so great
Violence of the Disease, it was restrained from reaching beyond that
Parish by the Care of the Rector; from whose Son, and another worthy
Gentleman, I have the Relation. This Clergyman advised, that the _Sick_
should be removed into _Hutts_ or _Barracks_ built upon the _Common_;
and procuring by the Interest of the then Earl of _Devonshire_, that the
People should be well furnished with Provisions, he took effectual Care,
that no one should go out of the Parish: and by this means he protected
his Neighbours from Infection with compleat Success.
I have now gone through the chief Branches of _Preservation_ against the
_Plague_, and shall conclude with some general Directions concerning the
_Cure_.
CHAP. III.
_Of the Cure of the Plague._
IT appears, from what has been said in the beginning of this Discourse,
that the _Plague_ and the _Small-Pox_ are Diseases, which bear a great
Similitude to each other: both being _Contagious Fevers_ from _Africa_,
and both attended with certain _Eruptions_. And as the _Eruptions_ or
_Pustules_ in the _Small-Pox_ are of two Kinds, which has caused the
Distemper to be divided into two Species, the _distinct_ and
_confluent_; so we have shewn two Sorts of _Eruptions_ or _Tumors_
likewise to attend the _Plague_. In the first and mildest Kind of the
_Small-Pox_ the _Pustules_ rise high above the Surface of the Skin, and
contain a digested _Pus_; but in the other, the _Pustules_ lie flat, and
are filled with an indigested _Sanies_. The two kinds of critical
_Tumors_ in the _Plague_ are yet more different. In the most favourable
Case the _Morbific Matter_ is thrown upon some of the softest _Glands_
near the Surface of the Body, as upon the _inguinal_, _axillary_,
_parotid_, or _maxillary_ Glands: the first Appearance of which is a
small Induration, great Heat, Redness, and sharp Pain near those Glands.
These _Tumors_, if the Patient recover, like the _Pustules_ of the
distinct _Small-Pox_, come to a just Suppuration, and thereby discharge
the Disease. In worse Cases of the Distemper, either instead of these
_Tumors_, or together with them, _Carbuncles_ are raised. The first
Appearance of them is a very small indurated _Tumor_, not situate near
any of the fore-mention'd Glands, with a dusky Redness, violent Heat,
vast Pain, and a blackish _Spot_ in the middle of the _Tumor_. This
_Spot_ is the beginning of a _Gangrene_, which spreads itself more and
more as the _Tumor_ increases.
BUT, besides the Agreement in these critical Discharges, the two
Distempers have yet a more manifest Likeness in those _livid_ and _black
Spots_, which are frequent in the _Plague_, and the Signs of speedy
Death: for the same are sometimes found to attend the _Small-Pox_ with
as fatal a Consequence; nay, I have seen Cases, when almost every
_Pustule_ has taken this Appearance. Moreover, in both Diseases, when
eminently malignant, Blood is sometimes voided by the Mouth, by Urine,
or the like[94]. And we may farther add, that in both Death is usually
caused by Mortifications in the _Viscera_. This has constantly been
found in the _Plague_ by the Physicians in _France_: and I am convinced,
from Accounts I have by me, of the Dissection of a great many, who had
died of the _Small-Pox_, that it is the same in that Distemper.
THIS Analogy between the two Diseases, not only shews us, that we
cannot expect to cure the _Plague_ any more than the _Small-Pox_, by
_Antidotes_ and _Specific Medicines_; but will likewise direct us in the
Cure of the Distemper, with which we are less acquainted, by the Methods
found useful in the other Disease, which is more familiar to us.
IN short, as in the _Small-Pox_, the chief Part of the Management
consists in clearing the _Primae Viae_ in the beginning; in regulating the
Fever; and in promoting the natural Discharges: so in the _Plague_ the
same Indications will have Place. The great Difference lies in this,
that in the _Plague_ the Fever is often much more acute than in the
other Distemper; the Stomach and Bowels are sometimes inflamed; and the
Eruptions require external Applications, which to the _Pustules_ of the
_Small-Pox_ are not necessary.
WHEN the Fever is very acute, a cool _Regimen_, commonly so beneficial
in the _Small-Pox_, is here still more necessary. But whenever the Pulse
is languid, and the Heat not excessive, moderate Cordials must be used.
THE Disposition of the Stomach and Bowels to be inflamed, makes
_Vomiting_ not so generally safe in the _Plague_ as in the _Small-Pox_.
The most gentle _Emetics_ ought to be used, none better than
_Ipecacuanha_; and great Caution must be had, that the Stomach or Bowels
are not inflamed, when they are administer'd: for if they are, nothing
but certain Death can be expected from them: otherwise at the beginning
they will be always useful. Therefore upon the first Illness of the
Patient it must carefully be considered, whether there appear any
Symptoms of an Inflammation having seized these Parts: if there are any
Marks of this, all _Vomits_ must be omitted; if not, the Stomach ought
to be gently moved.
THE _Eruptions_, whether _glandular Tumors_, or _Carbuncles_, must not
be left to the Course of Nature, as is done in the _Small-Pox_; but all
Diligence must be used, by external Applications, to bring them to
_Suppurate_. Both these _Tumors_ are to be treated in most respects
alike. As soon as either of them appears, fix a _Cupping-Glass_ to it
without _scarifying_; and when that is removed, apply a _suppurative
Cataplasm_, or _Plaster_ of warm Gums.
IF the _Tumors_ do not come to _Suppuration_, which the _Carbuncle_
seldom or never does; but if a thin _Ichor_ or Matter exudes through the
Pores; or if the _Tumor_ feel soft to the Touch; or lastly, if it has a
black _Crust_ upon it, then it must be _opened_ by _Incision_, either
according to the length of the _Tumor_, or by a _crucial Section_. And
if there is any Part _mortified_, as is usually in the _Carbuncle_, it
must be _scarified_. This being done, it will be necessary to stop the
Bleeding, and dry up the _Moisture_ with an _actual Cautery_, dressing
the Wound afterwards with _Dossils_, and _Pledgits_ spread with the
common _Digestive_ made with _Terebinth. cum Vitel. Ov._ and dip'd in a
Mixture of two Parts of warmed Oil of _Turpentine_, and one Part of _Sp.
Sal. Ammon._ or in _Bals. Terebinth._ and over all must be put a
_Cataplasm of Theriac. Lond._
THE next Day the Wound ought to be well _bathed_ with a _Fomentation_
made of warm _aromatic_ Plants with Spirit of Wine in it; in order, if
possible, to make the Wound digest, by which the _Sloughs_ will
separate. After this the _Ulcer_ may be treated as one from an ordinary
_Abscess_.
FARTHER, in the _glandular Tumors_, when they suppurate, we ought not to
wait, till the _Matter_ has made its way to the outer Skin, but to open
it as soon as it is risen to any Bigness: because these _Tumors_ begin
deep in the Gland, and often mortify, before the Suppuration has reached
the Skin, as the Physicians in _France_ have found upon dissecting many
dead Bodies.
THIS is the Method in which the _Plague_ must be treated in following
the natural Course of the Distemper. But the Patient in most Cases runs
so great Hazard in this way, notwithstanding the utmost Care, that it
would be of the greatest Service to Mankind under this Calamity, if some
artificial Discharge for the corrupted Humours could be found out, not
liable to so great Hazard, as the natural Way. To this Purpose _large
Bleeding_ and _profuse Sweating_ are recommended to us upon some
Experience.
DR. _Sydenham_ tried both these Evacuations with good Success, and has
made two very judicious Remarks upon them. The _first_ is, that they
ought not to be attempted unless in the Beginning of the Sickness,
before the natural Course of the Distemper has long taken Place:
because otherwise we can only expect to put all into Confusion without
any Advantage. His _other_ Observation is, that we cannot expect any
prosperous Event from either of these Evacuations, unless they are very
copious: there being no Prospect of surmounting so violent a Malignity
without bolder Methods than must be taken in ordinary Cases.
AS for _Bleeding_, by some Accounts from _France_, I have been informed,
that some of the Physicians there have carried this Practice so far, as
upon the first Day of the Distemper to begin with bleeding about twelve
Ounces, and then to take away four or five Ounces every two Hours after.
They pretend to extraordinary Success from this Method, with the
Assistance only of cooling _Ptisanes_, and such like Drinks, which they
give plentifully at the same Time. Such profuse Bleeding as this may
perhaps not suit with our Constitutions so well as with theirs; for in
common Cases they use this Practice much more freely than we: Yet we
must draw Blood with a more liberal Hand than in any other Case, if we
expect Success from it. I shall excuse myself from defining exactly how
large a Quantity of Blood is requisite to be drawn, for want of
particular Experience: but I think fit to give this Admonition, that, in
so desperate a Case as this, it is more prudent to run some hazard of
exceeding, than to let the Patient perish for want of due Evacuation.
AS for _Sweating_, which is the other Method proposed, it ought, no
doubt, to be continued without Intermission full twenty-four Hours, as
Dr. _Sydenham_ advises. He is so particular in his Directions about it,
that I need say little. I shall only add, that _Theriaca_, and the like
solid Medicines, being offensive to the Stomach, are not the most proper
_Sudorifics_. I should rather commend an Infusion in boiling Water of
_Virginia Snake-Root_, or, in want of this, of some other warm
_Aromatic_, with the Addition of about a fourth Part of _Aqua
Theriacalis_, and a proper Quantity of Syrup of Lemons to sweeten it.
From which, in Illnesses of the same kind with the _Goal Fever_, which
approaches the nearest to the _Pestilence_, I have seen very good
Effects.
WHETHER either of these Methods, of _Bleeding_, or of _Sweating_, will
answer the Purpose intended by them, must be left to a larger Experience
to determine; and the Trial ought by no means to be neglected,
especially in those Cases, which promise but little Success from the
natural Course of the Disease.
_FINIS._
[Illustration]
Footnotes:
[1] See the Dedication.
[2] _Vide_ Huet. De rebus ad eum pertinentibus, _pag._ 23.
[3] Observations sur la Peste de Marseille, p. 38, 39, 40.
[4] Ibid. _p._ 113.
[5] _Vid._ Philos. Transactions No. 370.
[6] Le Journal des Scavans, 1722. _pag._ 279.
[7] _Vid._ Dissertation sur la Contagion de la Peste. A Toulouse 1724.
[8] _Vid._ Mechanical Account of Poisons, _pag._ 24.
[9] Vid. Philos. Trans. No. 372.
[10] _Vid._ Lettre de Messieurs _Le Moine_ et _Bailly_.
[11] Astruc, Dissertation sur la Contagion de la Peste. A Toulouse,
1724. 8o.
[12] _Diemerbroek_ De Peste, _p._ 120.
[13] In these Words, _Where it can be done_.
[14] _Vid._ the _Gazettes_ of the Years 1665. _and_ 1666.
[15] Celsus de Medic. in Praesat. Morbos ad iram deorum immortalium
relatos esse, et ab iisdem opem posci solitam.
[16] Libr. De morbo sacro; et libr. De aere, locis, et aquis.
[17] Observat. et Reflex, touchant la Nature, etc. de la Peste de
Marseilles, pag. 47. et suiv.
[18] Journal de la Contagion a Marseilles, pag. 6.
[19] Lib. 2. +Hoti heteros aph' heterou, therapeias
anapimplamenoi, hosper ta probata ethneskon; kai ton pleiston phthoron
touto enepoiei; eite gar me theloien dediotes allelois prosienai,
apollunto eremoi, kai oikiai pollai ekenothesan aporia tou
therapeusantos; eite prosioien, diephtheironto, kai malista hoi aretes
ti metapoioumenoi.+ The beginning of this Passage, as it here stands,
though it is found thus in all the Editions of _Thucydides_, is
certainly faulty, +therapeias anapimplamenoi+ being no good
Sense. The Sentence I shall presently cite from _Aristotle_ shews that
this may be rectified only by removing the Comma after +heterou+,
and placing it after +therapeias+, for +prosanapimplemi+
in _Aristotle_ absolutely used signifies _to infect_. With this
Correction, the Sense of the Place will be as follows: _The People took
Infection by their Attendance on each other, dying like Folds of Sheep.
And this Effect of the Disease was the principal Cause of the great
Mortality: for either the Sick were left destitute, their Friends
fearing to approach them, by which means Multitudes of Families perished
without Assistance; or they infected those who relieved them, and
especially such, whom a Sense of Virtue and Honour obliged most to their
Duty._
The Sense here ascribed to the word +anapimplemi+ is confirmed
yet more fully by a Passage in _Livy_, where he describes the Infection
attending a Plague or Camp Fever, which infested the Armies of the
_Carthaginians_ and _Romans_ at the Siege of _Syracuse_, in such words,
as shew him to have had this Passage of _Thucydides_ in view; for he
says, _aut neglecti desertique, qui incidissent, morerentur; aut
assidentes curantesque eadem vi morbi repletos secum traherent_. Lib.
xxv. c. 26.
[20] L. 6. v. 1234.
----nullo cessabant tempore apisci
Ex aliis alios avidi contagia morbi.
Et v. 1241.
Qui fuerant autem praesto, Contagibus ibant.
[21] Sect. I. +Dia ti pote ho loimos mone ton noson malista tous
plesiazontas tois therapeuomenois prosanapimplesi?+
[22] +Peri diaphoras pyreton, Bib. 1.+
[23] De Peste, c. iv. annot. 6.
[24] Evagrii Histor. Eccles. l. iv. c. 29.
[25] Gastaldi De avertenda et profliganda Peste, p. 117.
[26] Ibid. p. 118.
[27] Ibid. p. 117.
[28] See Bills of Mortality for the Year 1665.
[29] The Sweating Sickness.
[30] Nat. Hist. l. vii. c. 50.
[31] Histor. l. ii.
[32] Histor. Ecclesiast. l. iv. c. 29.
[33] De Bello Persico, l. ii. c. 22.
[34] Vid. Hodges De Peste.
[35] Vid. Istorie di Matteo Villanni, l. I. c. 2.
[36] Mezeray Hist. de France, Tom. i. p. 798.
[37] Villani, loco citato.
[38] Vid. Huet. Histoire du Commerce des Anciens, p. 88.
[39] Relation Historique de tout ce qui s'est passe a Marseille pendant
la derniere Peste.
[40] Vid. Serv. Comment. in Virgil. AEneid, l. iii. v. 57.
[41] This was a kind of _Expiatory Sacrifice_, as the _Scape-Goat_ among
the Jews, _Levit._ xvi. And the Wretches thus devoted to dye for the
Sins of the People were called +Katharmata+, _Purgations_. Vid.
Aristophan. in Plut. ver. 454. et in Equit. ver. 1133. et Scholiast.
ibid. _Suidas_ adds that when the Sacrificed Person was cast into the
Water, these Words were pronounced, +Peripsema hemon genou+, _Be
thou our Cleansing_. And I observe, by the by, that the Apostle _Paul_,
1 _Corinth._ iv. 13. alluding very probably to this wicked Custom, makes
use of both these Words, where speaking of himself in the plural number,
he says, +Hos perikatharmata tou kosmou egenethemen, panton peripsema+;
for some of the best MSS. instead of +Os perikatharmata+, read +Hosper+,
or +Hosperei katharmata+; that is, _We have been looked upon as Wretches
fit only to be Sacrificed for the Public good, and cast out of the World
by way of Attonement for the Sins of the whole Society._
[42] Vid. Le Brun Voyage au Levant, c. 38.
[43] Vid. Ludolf. Histor. AEthiop. lib. i. c. 13. et D. August. De
civitat. Dei, lib. iii. c. ult.
[44] Vid. Ludolf. Histor. AEthiop. lib. i. c. 5. et Comment.
[45] J. Leo Hist. Afric. lib. i.
[46] Lib. vi. v 1100.
[47] Rhas. et Avicen.
[48] Essay on Poysons, p. 178.
[49] Cicero de Nat. Deor. lib. i. Sec. 36. speaking of these Birds, says:
_Avertunt Pestem ab Aegypto, cum volucres angues ex vastitate Libyae
vento Africo invectas interficiunt atque consumunt; ex quo fit ut illae
nec morsu vivae noceant, nec odore mortuae._
[50] Newton's Optics, Qu. 18 to 24.
[51] Gastaldi, De Peste, p. 116.
[52] Journal de ce qui s'est passe a Marseilles, _etc._
[53] Vid. The London Gazette, July 23, 1743.
[54] Kircher, Langius, _&c._
[55] Toulon, Traite de la Peste.
[56] _Hippocr._ Epid. l. iii. That _Hippocrates_ describes here the
Constitution of Air accompanying the true _Plague_, contrary to what
some have thought, _Galen_ testifies in his Comment upon this Place, in
libr. De Temper. l. i. c. 4. and in lib. De differentiis Febr. lib. i.
c. 4.
[57] Vid. _Mercurial._ Praelect. De Pestilent.
[58] Notitia Eccles. Diniensis.
[59] Histor. lib. lxii.
[60] Sydenham De Peste.
[61] Vid. Caium, De Febr. Ephemer. Britan. and Lord _Bacon_'s History of
_Henry_ VII.
[62] Pag. 162. Edit. Lovan.
[63] Vid. Rondinelli Contagio in Firenze, et Summonte Histor. di Napoli.
[64] Lord _Herbert_'s History of _Henry_ VIII.
[65] Thuani Histor. lib. 5.
[66] Lord _Verulam_'s History of _Henry_ VII.
[67] Vide Sydenham, De Peste, An. 1665.
[68] Boccaccio Decameron. Giornat. prim.
[69] De Contagione, l. iii. c. 7.
[70] Observat. l. vi. Schol. ad Observ. 22.
[71] Diemerbroeck, De Peste, l. 1. c. 4.
[72] Memorials presented by the Deputies of the Council of Trade, in
_France_, to the Royal Council, Pag. 44 and 45.
[73] Alex. Benedict. De Peste, cap. 3.
[74] In a Paper of Advice against the _Plague_, laid before the King and
Council by Sir _Theod. Mayerne_ in the Year 1631. _MS._
[75] Hodges, De Peste.
[76] Vid. _Directions for the Cure of the_ Plague _by the_ College _of_
Physicians; _and Orders by the_ Lord Mayor _and_ Aldermen _of_ London,
_published_ 1665.
[77] Vid. a Journal of the Plague in 1665. by a Citizen. London, 1722.
[78] Discourse upon the Air, by _Tho. Cock_.
[79] Vid. The shutting up Houses soberly debated, _Anno_ 1665.
[80] Muratori governo della Peste, lib. I. c. 5.
[81] Cardin. Gastaldi, De avertenda Peste, c. 10.
[82] Journal de ce qui s'est passe a Marseilles, &c. p. 9, 10, 11.
[83] De Pestilent. cap. 21.
[84] Camden. Annal. Regin. Elizab.
[85] Lord _Verulam_, Natural History, Cent. 10. Num. 194.
[86] Plutarch lib. de Isid. et Osir.
[87] De Peste, c. 22.
[88] Hodges, De Peste, pag. 24.
[89] Journal de la Peste de Marseilles, pag. 19. et Relation Historique
de tout ce qui s'est passe a Marseilles pendant la derniere Peste, pag.
77.
[90] Rhazes, De re Medica, lib. 4. c. 24. & Avicenn. Can. Med. lib. 4.
c. 1.
[91] Gaudereau Relation des Especes de la Peste que reconnoissent les
Orientaux.
[92] Mech. Account of Poisons, Essay III.
[93] Notitia Ecclesiae Diniensis.
[94] Vid. Observ. et Reflex. sur la Peste de Marseilles, p. 333.
Transcriber's Notes:
In the original text, the Preface is printed in italics. For ease of
reading, non-italicized text in this section is represented by =text=.
In the remainder of the text, passages in italics are indicated by
_underscore_.
Long "s" has been modernized.
The original text includes Greek characters. For this text version these
letters have been replaced with +transliterations+.
The following misprints have been corrected:
"Phsician" corrected to "Physician" (page 4)
"that that" corrected to "that" (page 50)
"Qarantaine" corrected to "Quarantaine" (page 92)
"the the" corrected to "the" (page 95)
Other than the corrections listed above, inconsistencies in spelling and
hyphenation have been retained from the original.
End of Project Gutenberg's A Discourse on the Plague, by Richard Mead