The symptoms of this fatal disease were sometimes a sudden loss of

strength, confusion or weight in the head, giddiness at intervals,

oppression about the præcordia, dejection of spirits, taciturnity, an

anxious aspect, but without any symptoms of fever. In these, death

ensued within twenty-four hours; some were said to have died within a

few hours, but our author saw none of these, and is inclined to doubt

the truth of the accounts, having in several instances, where this

is said to have happened, found upon inquiry that matters had been

inaccurately stated, and that the patients had really been ill one or

two days.

In others the disorder was more perceptible. In a few hours the eyes

became muddy, the surface of the body cold, with drowsiness, lethargy,

and pain at the heart. In the progress of the distemper they frequently

lost the power of speech, the skin seldom recovered its warmth, or,

if it did, it was only by irregular flushings. The pulse sometimes

remained nearly in its natural state, but was, for the most part, low

and quick. They were “by turns delirious, confused and sensible, but

the comatose disposition was most prevalent. Towards the end they

suffered extreme inquietude. Vomiting in some occurred the first night;

in others a diarrhœa next day; both accelerating the fatal period; but

these symptoms were less frequent than in some of the other classes.

Buboes appeared only in a very few who survived the third day....

The total absence of buboes in such patients as perished suddenly I

have no doubt of, nor of their being in general very rare in others

of this class; though I suspect that the buboes might sometimes have

been concealed, where the disease ran out to the fourth or fifth day,

and for the same reason that the reports concerning the state of

the corpse were sometimes not true.... It was very rare to find

suspicious marks of infection on the bodies [of those who died within

24 hours].... Carbuncles were seldom visible till the month of May,

which was later than this form of the disease. It prevailed chiefly at

the rise of the plague in 1760, and its revival in the two succeeding

years, decreasing as the distemper spread; and though they were found

dispersed in every stage of the pestilential season, yet the number

of this class was proportionably small, compared with that of others.

Petechiæ, vibices, or broad, livid, roundish spots, occurred sometimes,

but were not common, and the two latter were seldom visible till after

death.”

This account of the most malignant form of the pestilence differs

considerably from that of Dr. Hodges, who seems to think that the

_tokens_, as he calls them, very generally were to be found on the

bodies of those who died suddenly. He mentions indeed a young man who

was suddenly seized with a violent palpitation of the heart, and thus

continued till his death, which took place in a few hours. In this case

the Doctor supposed that there might be a carbuncle broke out on the

heart. Dr. Russel has considered the description of the tokens given by

Dr. Hodges, and compared it with that of others called by Diemerbroeck

_maculæ mortis_, _spots_ or _tokens_ of _death_; and by this comparison

it appears that the former has spoken somewhat indistinctly on the

subject, confounding two different kinds of eruptions together. Dr.

Hodges, however, as we have already seen (p. 10) asserts, in his

_Loimologia_, that the tokens rise from within, and are broadest at

their bases, where he also supposes the pestilential poison chiefly to

lie. To the same purpose, in his Letter to a Person of Quality he says,

“The tokens have their original and rise from within, and afterwards

externally show themselves; which is evident, because the basis of them

is larger than their outward appearance, and the internal parts are

found very often spotted, when there is no discoloration visible on

the skin.” Dr. Russel, after quoting Diemerbroeck, makes the following

observations: “The author (Diemerbroeck) is diffuse on this subject,

and thinks it a mistaken though prevalent notion, that the maculæ

are merely superficial in the skin, proceeding from putrefaction,

ebullition, &c. in the blood or humours: on the contrary he affirms,

they arise from the internal parts, even the periosteum, broad at the

base, and tapering to their termination in the skin, being produced

by the _extinction_ and _extravasation_ of the vital spirits. Now

(says Dr. Russel) this answers exactly to one species of the tokens

described by Hodges, which therefore may be reckoned the same with the

_maculæ mortis_, and was probably the only one observed at Nimeguen,”

&c. On the same subject he quotes a book entitled _Medela Pestis_, in

which the author says that by careful dissection the _tokens_ may be

traced half-way deep in the flesh, and some, in the muscles of the

breast, have been followed by the incision knife even to the bone.

By the directions given by authority to the searchers in 1665, they

were ordered to look narrowly for these tokens, which were described

as “spots arising on the skin, chiefly about the breast and back, but

sometimes also in other parts. Their colour is something various,

sometimes more reddish, sometimes inclining a little towards a faint

blue, and sometimes a brownish mixed with blue; the red ones have often

a brownish circle about them, the brownish a reddish.”

On the subject of tokens Dr. Hodges further observes, that they

differed also in their degrees of hardness, some being easily

penetrated with a needle or penknife, while others, more callous or

horny, were penetrated with more difficulty. They so strongly resembled

warts, that they could scarce be distinguished from them; and Dr.

Hodges himself was often obliged to have recourse to a needle for

this purpose. They seemed hard to the touch, not unlike kernels under

the skin, the superfices being smooth. “When I essayed to prove some

of them (says he) I found them _almost impenetrable_.” Another very

remarkable circumstance relative to them was, that they were often

quite insensible, and this distinguished them from the carbuncle, which

is always very painful. Hodges also remarks, that a quick sensibility

in the skin was always a good sign, and those that went no farther than

the skin would sometimes slough off.

Along with these tokens we can scarce doubt that _petechiæ_ and

_vibices_ made their appearance. The former, even in the inferior

degrees of the distemper, were dangerous, the latter always fatal,

never appearing till the patient is within a few hours of death,

sometimes indeed not till death has taken place. Of the petechiæ Dr.

Russel says, that for the most part they predicted death, but not

without exception. Such as he observed were round, somewhat smaller

than a recent flea-bite. They were distinct, few in number, and

scattered irregularly about the breast and mastoid muscles. When they

did not appear till the approach of death, they were from the first

livid, or very dusky; but if they appeared early, they were of a less

deep colour, changing afterwards to livid. Hodges speaks of them as

deeper coloured than the spots of malignant fever, not fixed in any

particular spot, sometimes few, but commonly very numerous; the colour

sometimes red or purple, sometimes yellow, and sometimes livid or

black. From Gotwald, Russel quotes a description of these spots, which

he divides into four species. 1. Reddish, like flea-bites, soon growing

brown or black; appearing on all parts of the body except the face. 2.

In the form of lentils, spreading like the former all over the body;

ruddy at first, but in 24 hours growing dark or ash-coloured. 3. Large

brown spots, scattered here and there, sometimes intermixed with the

lentil kind. 4. Not unlike the measles, spreading all over the body,

rising afterwards in small blisters without any matter, vanishing about

the fifth day. Russel also takes notice of a species of petechiæ which

were very numerous, confluent, and of a dark red or dusky colour and

irregular figure. These were sometimes remarked in the interstices of

the former. Such instances occurred but rarely.

The vibices were much larger than the petechiæ. Gotwald says that

they covered the face as high as the nose, and from thence spread to

the forehead, disfiguring the patient in a frightful manner. They

did not appear till a short time before death. Often they appeared

unexpectedly, shooting up like lightning from the breast to the

face, in spots of various colours, blue, green, brown and yellow.

Diemerbroeck describes them as oblong spots of a livid or black

colour, like strokes drawn with a pen; sometimes they were larger,

the biggest resembling the strokes of a whip. Russel takes notice of

a kind of marbled appearance which took place at the height of the

disease, or a few hours before death; the colours being a faint blue,

and darkish red, both more or less obscure at times, but never bright.

It was not permanent, vanishing in one place, without leaving any

trace, and returning at short intervals. “The skin in various places

was sometimes deformed by narrow streaks of reddish purple, or livid

colour. When such took possession of the face they gave a frightful

appearance to the countenance, and frequently made such an alteration

in the features, and so completely disguised the patient, as to render

him hardly _knowable_ by his acquaintance. A streak nearly of the same

kind was sometimes observed darting from the edges of the buboes and

carbuncles. The vibices or weals were much longer and broader, and

more exactly resembled the marks left in the fleshy parts by blows or

stripes; they were found chiefly on the thighs, buttock, and back,

and made their appearance several hours before death, in some cases,

but in others not till after. Large blue or purple spots, the _maculæ

magnæ_ of authors, were sometimes observed with or without the vibices,

a little while before the patient expired, but most commonly were

discovered only on the corpse. Their figure in general was round,

sometimes irregular.”

Whether all these mortal signs appeared on such as died very suddenly

of plagues, and were by the English writers confounded under the

general name of _tokens_, cannot certainly be determined. Dr. Russel

saw none who died within the twenty-four hours, and few who died

within thirty hours, so that we cannot from him expect any particular

account of the situation of those who died suddenly. In general,

however, he says, that “in the most destructive forms of the plague,

the vital principle seems to be suddenly, as it were, extinguished, or

else enfeebled to a degree capable only for a short while to resist

the violence of the disease; in the subordinate forms, the vital and

animal functions, variously affected, are carried on in a defective,

disorderly manner, and denote more or less danger accordingly.” It

seems probable therefore that in those who are suddenly killed, the

same effects take place in a short time which are observed to take

place after a longer space in those who die gradually, buboes only

excepted, which require for their formation a longer time than is

allowed to the patient to live. Internal mortifications, or rather

eschars, are therefore to be suspected, and dissections have evinced

that this was really the case; but besides these there was an

appearance observed in the plague at Marseilles which is not taken

notice of by former physicians; viz. a preternatural enlargement of

the heart. M. Deidier on that occasion communicated an account of nine

dissections, but of these only one had died without eruptions. This

was a woman of 40 years of age, who lived till the third day. In her

“the mediastinum[101] was torn towards the upper part; the pericardium

of a livid colour; the heart larger than in its natural state, by the

swelling of its ventricles; full of thick, black blood. The liver was

also very large, and of a livid colour, with a carbuncular pustule on

the side of the gall-bladder, which was filled with very black bile.”

In others who had eruptions, and who of consequence we must suppose

to have lived longer, the enlargement of the heart was still more

remarkable. In one who lived eleven days, the heart was of double the

bigness, having scarce any blood in the ventricles, whose cavities

were filled each with a large polypus, that on the right side having

dilated the auricle to the breadth of four inches. The liver also

was larger than ordinary, and the gall-bladder full of a black and

green bile. The appearances were much the same in all the rest, but,

as the time they sustained the disease is not mentioned, we cannot

determine whether the enlargement of the heart took place at the very

first, or was only an adventitious symptom after the fever had come on.

Dr. Russel takes notice that such patients as he attended complained

greatly of their heart. “A sense of oppression about the præcordia

(says he) which the sick were at a loss to describe, was, in one

degree or other, a constant attendant on the plague, except in very

slight cases of infection; and where it came on early, or persisted

in a high degree, was always a dangerous symptom. The sick showed how

severely they suffered by their perpetually changing their posture,

in hopes of relief; but, when asked where their pain lay, they either

answered hastily they could not tell, or, with a fixed, wild look,

exclaimed _kulbi! kulbi!_ (my heart! my heart!) This anxiety increasing

as the disease advanced, terminated at length in mortal inquietude,

the patient, for many hours, in the last stages, incessantly writhing

his body and limbs as if in agony. Though pain at the heart was often

conjoined with the symptom just mentioned, and by the sick seemingly

blended together, it appeared to be different, and to exist separately.

They often exclaimed as in the other, my heart! my heart! pointing also

towards the scrobiculum cordis, but then would add _eujani kulbi_, my

heart pains me; or _naar fi kulbi_, my heart is on fire.” This last

pain the Doctor supposes might have its seat in the upper orifice

of the stomach; the extreme anxiety may be accounted for from the

enlargement of the heart; but as neither of these symptoms took place

in such as died in a very short time, we must be apt to consider this

enlargement not as any primary and essential symptom of the disease,

but as one which takes place when the vital powers are able to oppose

for some considerable time the cause of the disease.

[101] The Mediastinum is a membrane by which the cavity of the

breast is longitudinally divided. The tearing of it in any disease

seems altogether unaccountable, unless we suppose an extraordinary

loss of cohesion to have taken place without any mortification. The

pericardium is a membrane surrounding the heart, and in a natural

state contains some water, condensed from vapour after death.

In his account of the origin of the plague, Dr. Russel takes notice of

the opinion that, at the communication of the infection, the sick were

sometimes sensible of having received it. This has been observed by

Dr. Lind in malignant fevers; it has also been observed in plagues,

as we have seen from Dr. Hodges, Verdoni, and others; but Russel says

he never saw any instance of this. He owns, however, that he has seen

instances of the disease quickly succeeding a panic fear of being

infested. “In cases (says he) where the disease was not discovered to

be the plague, till upon the eruption of buboes after two or three

days, I have known several persons who had, till then, without the

least suspicion, frequented the sick, struck suddenly with a panic,

and imagine themselves ill. They felt shooting pains in their groins,

confusion in the head, and a loathing. Though in some these complaints

were merely imaginary, and soon vanished, in others they proved real;

the symptoms increasing, and being followed by eruptions. In such cases

I suspected the latent infection to have been excited by terror.”

In the instance formerly quoted from Dr. Guthrie at Petersburg,

we have a notable example of this sudden seizure by a stroke. His

information was derived from the physician-general of the Russian

army. This gentleman assured him, that “he had seen men, in apparent

good health, instantaneously drop down, as if shot by a musket ball,

by the sudden action of the pestiferous miasma, and upon duty again

in 24 hours, perfectly recovered by the operation of a strong vomit.”

Whether or not these men _felt_ any stroke at the instant of their

falling we are not told: possibly it might be only a syncope very

common in the plague, which took place at the very first invasion.

Russel informs us, that “the sudden loss of strength, and disturbance

of the functions attributed to the brain and heart, are reckoned, in a

particular manner, symptoms of the plague. In their highest degree they

distinguish the most fatal forms of the disease; and, under different

modifications, adhere to all its varieties.... The early appearance of

faintness was very remarkable in the plague,” &c.

Thus we see that the plague attacks without fever in two different

modes; one, by attacking and destroying the solid parts of the body,

the other, without any disorganization of the body, attacking the

vital principle itself, or rather the blood, from which this principle

is derived, so that a temporary suspension of all the functions

ensues. The analogy between the cause of pestilence and those visible

substances called _poisons_, is very remarkable in some things, though

in others it totally fails. In the Medical Repository[102] we have a

dissertation upon this analogy by Dr. Edward Miller. He observes, that

this analogy has been generally overlooked, chiefly on account of the

invisible nature of the aerial poison, and the suddenness of death

from poisons, more frequently than from pestilential diseases. This

he accounts for from the largeness of the dose of poisons compared

with that of contagion; “but (says he) by diminishing the quantity to

an appropriate amount, these noxious substances (the poisons) may be

made to exhibit the course, duration, and nearly all the phenomena,

of what is called a malignant fever. But, above all, the attention

of physicians has been diverted from this analogy between miasmata

and poisons, by the febrile part of the character which generally

belongs to pestilential diseases, and which, in common apprehension,

is constantly connected with them. Yet these diseases are by no means

universally accompanied with what is strictly called _fever_. There is

often a degree of virulence in the Asiatic plague, in the yellow fever,

and in all the other forms of pestilential and malignant diseases,

which altogether transcends the process of fever, and extinguishes

life in a more summary manner. In the worst cases both of poison and

pestilence, the febrile part of the symptoms excites little attention.”

[102] Vol. ii, p. 409.

Our author does not say in what this virulence consists. In the cases

of those who die with the _tokens_ upon them, the cause is plainly

within the body; the destroying power acting with greatest efficacy

below the skin in the soft substance of the flesh. Where the patient is

suddenly seized in the manner described by Dr. Guthrie, the cause seems

to be something foreign to the body suddenly inhaled, the effects

being similar to those of fixed air when drawn in by the breath, and

of consequence easily expelled by a vigorous action of the powers of

the system. Guthrie observes, that, in such cases, it seems “as if the

contagious matter existed in a very loose state in the first passages

at the beginning of the disease.”

In the production of those _tokens_ mentioned by Dr. Hodges, we know

that there must have existed in the body a certain cause capable

of totally destroying the parts, and reducing them to an hard

eschar, similar to that produced by fire or by a caustic. As we are

unacquainted with any thing capable of producing this effect but fire,

we can attribute the origin of these tokens to nothing else but the

emission of the latent heat of both the solids and fluids which compose

these parts, and their consequent transmutation into an hard, and as

it were charred, substance. That such an emission of latent heat does

in some cases take place is evident from the production of a great

quantity of sensible heat when certain substances are mixed together.

Thus, upon mixing together oil of vitriol, oil of turpentine and strong

spirit of nitre, the whole mixture will take fire and burn violently,

though two of the ingredients, viz. oil of vitriol and spirit of nitre,

are by themselves incapable of being inflamed. In like manner if strong

spirit of nitre be poured upon oil of cloves or sassafras, the mixture

will burst out into a violent flame. Water poured upon quick lime

occasions great heat, and seems in great part to be converted into a

solid substance; for only a small part evaporates, and the slaked lime

falls into a powder to appearance perfectly dry, and from which the

moisture cannot be expelled without a very violent fire. In this case

Dr. Black is of opinion that the heat comes from the water, which,

as we have already seen, contains a great quantity of it in a latent

state. But, according to his experiments, the emission of 135 degrees

of heat is sufficient to reduce water to a state of solidity; and the

heat of lime when slaking is so much superior to this, that ships

have frequently been set on fire by it. We must therefore either say

that water in certain circumstances can part with much more than 135

degrees, or that the lime itself emits part of the heat it contains.

This last indeed seems to be the more probable supposition of the two;

for though fluids contain more heat in proportion to their bulk than

solid bodies, we have no reason to suppose that the latter contain none

at all: on the contrary the experiments formerly mentioned, especially

those made by Count Rumford, show that they are furnished with an

almost unlimited quantity.

The cause of the most violent kind of plague then we must suppose

to be something received into the body, which in a certain time,

probably sooner or later according to the strength of the contagion,

disposes to an irregular emission of its heat, which coming by a kind

of explosions, or, as Dr. Hodges calls them, _blasts_, produce those

eschars which have been called _tokens_, and seem to be no other than

partial combustions, by which the parts affected are reduced to a state

of charcoal, or nearly so.

In assigning this cause for the most deadly kind of plague, we must

naturally ask the question, how can all this take place without any

pain? for of those who died in this manner, many felt neither pain

nor uneasiness till within a few moments of death. This can only be

accounted for by the sudden and perfect destruction of the parts,

which did not allow time for any sensation of pain to take place; and

indeed in the application of caustic for an issue, the patient often

feels but little pain. It is impossible to avoid perceiving a very

strong connexion between this kind of plague and the dreadful cases of

spontaneous combustion related p. 182–186. In the case of the priest

indeed the fire seems to have come from without, though even this

cannot be ascertained beyond a doubt; but in those who were absolutely

consumed to ashes, it seems equally probable that it may have arisen

from within; and as none of the unfortunate persons seem to have made

any noise or struggle, the priest alone excepted, it seems probable

that the first attack had deprived them of all sensation, and that,

notwithstanding the terrible ideas with which such extraordinary

occurrences must have inspired those who saw them, the sufferers may

have died without feeling any pain. The priest seems to have felt

nothing after the first stroke.

Should this cause be admitted (indeed whether it is admitted or not) we

see that it is in vain to attempt to solve the phenomena of pestilence

by the doctrine of stimuli, excitement or debility. There is no degree

of stimulus, fire exepted, which can convert part of the body into

an hard eschar, neither can it be done by any degree of debility or

exhaustion. Besides, the irregular manner in which these eschars

are scattered up and down, shows that the cause has not acted from

a regular diffusion all over the body, but in a number of insulated

spots, between which the connexion can by no means be traced. In all

pestilential eruptions indeed the action of fire seems to be very

perceptible. Gotwald mentions his having observed in two patients what

he calls _papulæ ardentes_ “burning pimples,” which Dr. Russel supposes

to be a modification of carbuncular pustules. Gotwald calls them also

_fire-bladders_, and says that they were as broad as a shilling, of an

irregular shape, and the skin seemed as if _shrivelled with fire_. The

carbuncle itself approaches much to the nature of the eschar, and is

attended with violent heat in the adjacent parts. Gotwald, who gives an

account of the plague at Dantzic, distinguishes the carbuncle into four

kinds, (to be afterwards described.) Of these he says in general, that

they all _burn_ very violently at first, &c.

From all these accounts it seems plain, that in the plague there are

partial discharges of heat, from _some_ cause, upon various parts of

the body; and that, in many instances, this heat destroys the texture

of the parts entirely. When this is done instantaneosly the patient

feels no pain, but if more gradually, the pain is excessive, as in the

case of buboes and carbuncles; which the Journalist of the plague year

in London informs us were attended with such horrid pain as to make the

patients cry out in a lamentable manner. This extraordinary heat must

either come from without or within, and we have all the reason in the

world to believe that it comes from within. Mr. Hunter, in his Treatise

on the Blood, informs us that in a local inflammation there is always

an increase of heat in the inflamed part. Should this heat arise, as

it probably does, from an emission of part of the latent heat, we may

conclude, that such a quantity might be emitted, as entirely to change

the texture of the parts. Thus mortifications or destructions of those

parts may ensue, of all kinds, from the mild _pus_ to the pestilential

eschar.

In the effects of pestilential contagion we observe, if not a

_superiority_, at least a _different mode of action_ from what takes

place in poisons. All these seem to act by dissolving the blood, or

infecting it in such a manner that it supplies no sufficient quantity

of animal spirits; of consequence, the creature soon faints and

dies. In the plague, the blood does not appear to be much affected,

nevertheless it emits, in various places, certain explosions which

convert the parts into an eschar. Poisons always seem to produce the

petechiæ or purple spots which sometimes appear in the plague. In

Dr. Miller’s Treatise, already quoted, we find, among the symptoms

occasioned by arsenic, “red or dark spots appearing on the skin, and

rapid putrefaction, which renders speedy interment necessary.” Herein

it differs from the plague, for the bodies of such as die of that

distemper are not more liable to speedy putrefaction than others. Of

the vegetable poisons he also observes, that, “after death, sometimes

before, livid spots are observed on the body, the appearance of the

blood is dark and dissolved, and putrefaction speedily takes place.”

Of animal poisons--“The bite of the poisonous serpents is generally

followed by tumour, and livid colour of the part bitten, extravasation

of dark coloured blood into the adjacent cellular membrane, nausea

and vomiting, sudden prostration of strength, paralysis of the limbs,

convulsions, yellowness of the skin, hæmorrhages, &c. Livid appearances

of the body, a dark coloured and dissolved state of the blood, and a

rapid putrefaction, are observed after death.”

From all these accounts, however, it is plain, that, whatever may be

the analogy between the action of poisons and malignant fevers, they do

not in any manner operate like the contagion of the true pestilence. Of

this the constant effect is to produce buboes, carbuncles, and other

eruptions, resembling much more the effects of fire than any thing

else; or, if the patient is cut off without the appearance of these,

similar effects are observed on the internal and vital parts. Dr.

Miller’s conclusion seems therefore liable to exception; in which he

says, “that only the lighter cases of pestilence are unlike the effects

of poison, but that, in proportion to the degree of malignity, the

resemblance grows stronger.” It doth not appear that any poison hath

produced one of the characteristic symptoms of the true plague, or any

thing but what is common to animals dying of various diseases, the red

spots on the skin only excepted.

In the eighth volume of the Philosophical Transactions abridged by

Martyn, we have an account of a number of experiments by M. Deidier

and others, made upon dogs into whose veins he injected, or poured

into wounds made in the miserable animals, the bile of people dead

of the plague at Marseilles. “The consequence was, that they became

melancholy, drowsy, and without caring to eat. All of them died in

three or four days, with the essential marks of the true plague,

declared by buboes, carbuncles, and gangrenous inflammations in the

viscera, in the same manner as in the human carcases from whence the

bile was taken.”

The poisonous bile affected the creatures differently according to the

vicinity of the place of injection to the heart. In the jugular vein it

killed them in twenty-four hours, injected in the quantity of a drachm

to two ounces of water. In this short time were brought on gangrenous

inflammations, the heart was stuffed with _thick and black_ blood, the

liver was swelled, and the gall-bladder full of green bile. This shows

a very essential difference between the action of the pestilential

poison and that of others; the former, in some parts of the body at

least, coagulates the blood; the latter, in all parts, dissolves it.

In the crural vein (the vein of the leg) the effects were less violent.

In about an hour they became heavy. In the former case they instantly

became drowsy. In the second experiment they contracted such a loathing

for food, that they would neither eat nor drink any thing after the

injection was made. On the third day there appeared considerable

tumours under the _axilla_ (the fore leg I suppose) and on their

thighs, about three inches from the wound. The wound itself turned to a

gangrene, and the creatures died usually on the fourth day.

In another experiment the animal had convulsive motions all over

immediately after the injection, followed by a lethargy. Next day a

carbuncle appeared on the great pectoral muscle on the right side.

On the third, a bubo appeared on the thigh, and the same day the dog

died. From the time of the injection he had neither eat nor drank. On

dissection the fore part of the breast under the teguments was found

entirely gangrened, the inward parts and viscera full of black clotted

blood, the outward surface of the lungs was all purple, the heart was

swelled as big again as usual, and the four cavities were full of black

clotted blood. The bile of this dog, injected into the crural vein of

another, produced similar symptoms, only the latter eat a little boiled

meat, which he vomited up again in two hours. He died the third day,

with the same symptoms of the plague as the others.

The bile of people who died of ordinary malignant fevers was much less

powerful. A quantity (not mentioned how much, but probably a drachm)

mixed with four ounces of warm water, was partly injected into the

jugular vein of a dog, and a compress soaked in the rest of the liquor

applied to the wound. He appeared heavy and sleepy, and would neither

eat nor drink till the third day, when he did both willingly. On the

fourth day the compress fell off, the wound was found to be diminished

one half, and healed by degrees, the dog recovering perfectly. In

another experiment with the bile of a patient who had died of a

malignant fever, the dog not only had about a drachm of it put into a

wound in his thigh, but was made to swallow some of it; notwithstanding

which he was not seized with any distemper, and the wound healed in

fifteen days. This bile was as black as ink, in great quantity, and

very thick. In the other subjects it was of a deep green. In another

experiment, with the same bile applied on a compress, the dog likewise

escaped without any apparent disorder; but in a third, the animal died

in twenty-three hours, though at first he had shown no sign of being

affected, only that he seemed to be thirsty, and drank with greediness.

On opening him his heart was found still to beat with violence, and,

after the beating ceased, no blood was to be found in it, either in

the auricles or ventricles. “This liquor, crowded together in the

great vessels, appeared of a lively red, and very fluid, without any

of those concretions that we constantly observed in those who died of

the plague. Here appeared neither external nor internal marks of the

plague.” The bile of a person who had died of an erysipelas, injected

into the crural vein of a dog, produced no bad effect. A dog was killed

by half a drachm of Hungarian or blue vitriol injected into the jugular

vein. He died in universal convulsions: the heart was full of grumous

blood, reduced to a kind of thick pap, but without any clots. The bile,

applied to two wounds in another dog, produced no bad effect.

From other experiments it appeared that even the pestilential poison

itself, taken into the stomach of dogs, did not produce any deleterious

effects. “A dog of the Hospital of the _Mail_ in Marseilles, who

followed the surgeons when they went to dress the sick, used greedily

to swallow the corrupted glands, and the dressings charged with pus

which they used to take off the plague sores: he licked up the blood

that he found spilt on the ground in the infirmary; and this he did

for three months, being always gay, brisk, well, full of play, and

familiar with all comers.” The health and briskness of this unfortunate

dog proved his ruin, by making him the subject of philosophical

experiment. A drachm of the pestiferous bile injected into the crural

vein, killed him in four days. He had a considerable hæmorrhage from

the wound the night before he died, and he had also a disagreeable

smell both while living and after he was dead. Two other dogs, which

had swallowed a quantity of pestiferous bile, became heavy and

melancholy, refused their food, and showed other signs of disorder;

but all these went off in a short time, and no signs of the distemper

appeared.

These experiments induced M. Deidier to suppose that the contagion of

the plague lay only in the bile; but the following experiment shows

that the blood was equally infected, and capable of communicating the

disease, and that of the most malignant species. It was made by M.

Couzier, physician to the infirmary at Alais, and in the Philosophical

Transactions we have the following account: “I took a quantity of blood

from a person dead of the plague, and mixed it with warm water, which

mixture I attempted to inject into the crural vein of a dog, but the

end of the syringe being too large to enter the vein, the experiment

did not succeed. This made me resolve to try to lay some of the same

infected blood upon the wound. This I accordingly did, and covered it

with a dressing, which the dog got off in the night. I found the next

morning that the dog had licked the wound, and that he refused his

food. Towards night he began to bemoan himself, and gave signs of an

approaching death. The next morning I found him dead, the wound being

considerably swelled and gangrened, and the edges round the swelling

were likewise gangrened.

“Upon opening the body, we found the liver something larger than usual,

with spots of a livid purple, as in the bodies of persons dead of

the plague. In the stomach was found a quantity of black coagulated

blood, of the size of a hen’s egg. This in all likelihood was what he

had swallowed upon licking the wound. The heart was very large, with

a black grumous blood in the ventricles, and the auricles were turned

blackish and gangrenous.”

This last experiment naturally brings to remembrance those of Dr.

Home at Edinburgh, in which he inoculated the measles by means of

the blood of patients ill of that disorder. From the accounts he has

given in his treatise entitled Medical Facts and Observations, we can

have little doubt that _his_ experiments succeeded, however others

may have failed. One thing, however, is very obvious, viz. that if we

mean to communicate a disease by means of the blood, we must use a

much greater quantity than if we make the experiment with the matter

of an abscess. The case of contagious diseases seems to be the same as

in fermenting liquors. With a small quantity of yeast we can easily

induce fermentation in any proper liquor, but, if we skim off the

yeast, and use only the pure fermenting liquor, we must use a much

greater quantity; and to inattention to this circumstance we may with

probability ascribe the difficulty which Dr. Home himself met with in

introducing the disease, and the total want of success in others. In M.

Couzier’s experiment a considerable quantity must have been used, as he

says that in the dog’s stomach it equalled the size of an hen’s egg. A

much smaller quantity of matter taken from a pestilential abscess is

capable of producing the disease in a human body, as is evident from

the case formerly quoted of that gentleman who inoculated himself for

the plague, and of which Dr. Guthrie gives the following account: “This

was Mathias Degio, one of the surgeons of the hospital at Bucharest, a

building appropriated to the cure of the plague in the Russian army.

He, perceiving the gentlemen of his profession _condemned in a manner

to death, if punctual in the discharge of their duty_[103] had the

resolution to inoculate himself for the plague, in the full confidence

of its efficacy, and ever afterwards found himself invulnerable, whilst

his companions around him were falling victims to its fury. He produced

the disease by inserting, with the point of a lancet, under the

epidermis of his arm, matter from a pestiferous abscess, and followed

the cold regimen observed in the small-pox, as he had imitated its

mode of inoculation. On the fourth day of the puncture the fever

declared itself, and he, being perfectly devoid of fear, got through

the disease without feeling more inconvenience than if it had been that

which he imitated. He drank freely of cold water, with vinegar, or a

little wine, and kept generally out of doors. This beverage was the

only thing that had the appearance of medicine,” &c.

[103] This, among innumerable other instances that might be brought,

is a proof of the infectious nature of the plague.

From a careful attention to all these histories, it is plain that the

plague is naturally an eruptive disease, as, in all the animals in

which it was artificially brought on, eruptions took place, provided

the life of the creature was sufficiently prolonged to allow them to

come out. Dr. Russel says, that, from his diary, he noted down the

cases of _two thousand seven hundred_ patients, _all_ of whom had

eruptions of one kind or other. In this it agrees with the small-pox,

which Dr. Mead justly considers as an inferior kind of plague. In the

latter, however, the eruptions seem to resemble those called by Dr.

Hodges the _tokens_, only that the cause which produces them is less

violent in its nature; but why the eruptions of the small-pox should be

in distinct pustules, and not one continued boil all over the body, is

undoubtedly inexplicable on any theory whatever. The same is true of

the plague. No man can explain why the tokens, for instance, instead

of being collected into one great eschar, are dispersed into small

distinct pieces; or why, instead of buboes in the groin and armpit, or

instead of carbuncles in different parts of the body, there should not

be a single one equivalent in bulk and power to them all. This appears

similar to the phenomena of rain, hail or snow, which fall in distinct

drops, fluid or congealed, or in flakes, instead of being equally

diffused all over the spot on which they fall. In the latter case we

say that the phenomenon is occasioned by _electricity_: we may say the

same, if we please, of the small-pox and plague, with equal emolument.

From the accounts we have just now quoted, it appears that there is

between malignant fevers and the true pestilence a very essential

difference; the latter tending to thicken the blood, the former to make

it thinner. In this respect therefore the poisons seem to resemble

malignant fevers very considerably; for M. Fontana observed that by

mixing animal poisons with blood drawn from a vein, it was prevented

from coagulating. In the instance above related where a dog died in

consequence of bile injected into his veins from one who died of a

malignant fever, the blood was found extremely fluid. In some who died

of the hospital fever, Sir John Pringle informs us, that suppurations

had taken place in the brain; but in the true plague the tendency to

mortification always prevailed above every thing.

Lastly, that the plague proceeds from too great a quantity of heat,

either emitted from the body itself, or some how introduced into it,

seems to be pretty plain from the effect it has of augmenting the

venereal appetite to an almost inconceivable degree. This was taken

notice of in the plague of Marseilles, and indeed in many others.

Russel quotes two remarkable passages to this purpose; one in a plague

at Genoa, the other in Messina. “Amidst so many dreadful fears and

terrors, amid so many fetid and putrefying bodies, amid the shrieks,

the sighs and the groans of the sick, what would you have expected?

That the people, struck with dread and horror, remained sad, modest

and quiet. You are mistaken. They sung, played on instruments, danced,

intrigued, and Genoa never was seen so shameless, debauched, and

disorderly. I have said before, that God in this plague gathered in

a harvest for heaven; but it seemed to be also a vintage for the

lascivious of of the earth. If not so, how came so many marriages

to be celebrated in the Lazaretto of Consolation, and that so many

women, without shedding a tear for the death of their husbands,

immediately entered into new engagements? One day, in particular, five

marriages were performed, four of the bridegrooms being buriers of the

dead, and dressing themselves and their brides in clothes stripped

off from the bodies of the deceased.” On the plague of Medina he

quotes the following extract of a letter written by a gentleman who

resided in that city during the plague in 1743. “It has always been

observed, that, after _every_ plague, those who recover are addicted

in an extraordinary degree to lewdness and incontinence, which was

surprisingly visible at Messina, and carried to such a degree of frenzy

and bestiality, that many were known to violate the bodies of dead

virgins!”

That an extraordinary propensity to venery may be produced by

introducing into the body a quantity of heat, admits now of a kind

of demonstration from a fact mentioned by M. le Roy concerning

phosphorus.[104] This substance is exceedingly apt to take fire on the

application of a small degree of heat, and even by slight friction. It

is now introduced into the materia medica, and is found to be a very

powerful medicine, though dangerous on account of its inflammability,

the heat and air contained in the human stomach being sometimes

sufficient to set it on fire. The taking such a substance into the

body therefore seems not much different from taking actual fire into

it; and indeed M. le Roy mentions the case of a woman who had taken

only a single grain, and who he says had been recovered, _by it_, from

a putrid fever, but died suddenly from some imprudence. In this woman

the whole substance of the body was found luminous upon dissection, and

the hands of the operator continued luminous even after being washed.

M. le Roy, having taken three grains of this fiery substance, found

himself extremely incommoded by it for some hours, and was obliged

to drink great quantities of very cold water. Next day he found his

muscular powers amazingly increased, and had an _almost insupportable

venereal irritation_. This we see was the consequence of throwing into

the body a quantity of heat from without; but if the body itself emits

that heat which it invisibly contains, the effects must be the same as

though an extraneous quantity had been thrown into it. Neither are we

to imagine that the _quantity_ of heat contained in our bodies is small

or inconsiderable; for we have already seen that heat consists in the

efflux from any substance, of an invisible and most subtile fluid, in

all directions. When this flux is gentle, the heat is moderate, but in

proportion to the activity of the discharge, the temperature becomes

hotter and hotter, and if very violent, the cohesion of the parts is

dissolved entirely, and the substance is said to be on fire. There is

required therefore only some cause to begin the emission of this fluid;

for as soon as this begins, the immense quantity with which we are

surrounded, will supply more in abundance,[105] and continue so to do,

as long as the original cause subsists, or until the substance can no

longer bear the power which operates upon it.

[104] Memoires de Societe Medicale, &c.

[105] If we consider the composition of the atmosphere which

surrounds us, we must acknowledge that by far the greater part of

it consists of fire and electric fluid, the latter being properly

the element in a comparatively quiescent state. In deflagrating

dephlogisticated and inflammable air, the mixture has sometimes

shrunk up into a three hundredth part of its bulk; which shows that

of these airs two hundred and ninety-nine parts are fire, the single

remaining part only being earth, water, or some solid matter which we

call the _basis_ of air.

From this view of the causes of the plague, and from the facts which

have been laid down concerning it, we cannot help perceiving a very

strong similarity between the plagues mentioned in the Old Testament

and those which still exist in the world. In one of the passages

formerly quoted it is called an _inflammation_, an _extreme burning_;

and from the testimonies of different authors above quoted, it is plain

that the disease still deserves the name bestowed upon it in the sacred

writings. From the account given of its proximate cause, it is plain

that plagues of all degrees of intensity may take place, from absolute

accension of the body, and its reduction to ashes, to the mildest

state of the disease, in which the patient is not confined to his bed;

and all this from the single principle of emission of heat from the

body itself. It likewise appears that there may be either in the body

itself, or in the element which surrounds it, such a constitution as

will dispose that element which is the natural and immediate preserver

of our life, suddenly to attack and destroy it, of which the case of

the Italian priest is a most remarkable instance. In other cases, such

as the Italian lady, and the woman at Coventry, the body itself seems

to have given out its heat, though this could not be done without a

concurrence of the surrounding ethereal fluid. In a stage still lower,

the body is partially consumed, or rather partly charred into a kind

of cinder, as where the _tokens_ are produced; and when the cause acts

with still less violence, a fever is produced. In the Old Testament

we find these different kinds of plagues very distinctly mentioned.

In some cases the offenders died by actual fire, which either struck

them from without, or was kindled within their bodies. In others, they

seem to have died by that very deadly kind of plague of which we have

already said so much, which kills in a few hours. This was probably the

plague which destroyed the army of Sennacherib, and this in the tenth

chapter of Isaiah is by some thought to have been prophesied of under

the title of a _burning like the burning of a fire_.

Of these things I the rather take notice, as I perceive, in a late

oration, not only the doctrine of the plague being propagated by

contagion severely ridiculed, but the scripture itself treated in a

most indecent and scandalous manner. “In the earliest ages of the world

(says he) when ignorance and superstition led men to attribute all

extraordinary phenomena to the direct agency of supernatural beings,

pestilence was supposed to be immediately imported from heaven. This is

the opinion which appears to have prevailed among the ancient Hebrews,

and may be ranked at the head of the catalogue of absurdities on this

subject. The dominion of prejudice over the minds of that ignorant and

obstinate people appears in this instance particularly striking. Such

was the depth of their blind bigotry in favour of the healthfulness of

the globe they inhabited, that they would seem to have considered it

as even superior to that of the celestial regions. Hence, unwilling

to believe that their favourite earth could give origin to an evil so

dreadful as the pestilence, they imported the seeds of this calamity

from the more unhealthful climate of heaven!!”

In this extraordinary paragraph we find the matter so much

misrepresented, that every vestige of truth is swallowed up in it.

The Hebrews believed that they were under the immediate inspection

and government of the Deity; a doctrine which, however our author

may _disbelieve_, he cannot _disprove_. But, notwithstanding this

immediate inspection and government, the Deity never did bring upon

them any plague but by the intervention of natural causes. The agents

which he had originally created were sufficiently able to execute

his purposes. The Creator never employed any power but what already

existed in the world, and the power that he generally did employ was

_fire_. This agent he directed to exert its force in such degrees as

he pleased, and against whom he pleased. It is a mistake to think that

miracles were _immediately_ the effects of supernatural power. They

were all accomplished by the very powers which exist in the world at

this moment, only these powers were by the Creator at particular times

directed to act in a manner that they would not have done had they

been left to the mechanism of their own nature. When we read therefore

of people being consumed by fire from the Lord, there was neither

importation of fire from heaven nor any where else; the element exerted

its power on these particular persons, either by lightning proceeding

from the cloud which represented the Deity, or their bodies threw out

the latent heat which they contained, and consumed of themselves. That

in cases of this kind there was no _importation_ supposed, is evident

from an expression used about bringing water from the rock. It is not

said that the water fell from the stars, or came down with the tail

of a comet, but that the rock gave out the water which it previously

contained. At the present day the same powers exist, and sometimes

produce the same effects that they did in former times, with this

difference, that now, having no intelligent agent to interfere with

their natural mode of action, they exert their force indiscriminately,

and as the mechanism of their nature happens to be stimulated, they

destroy every thing promiscuously before them. In all this I cannot

perceive the smallest absurdity, or any thing but what a reasonable

man _may_ indeed _must_ believe, if he makes use of his reason. As to

the causes which Dr. Caldwell so much insists upon, viz. filth and

corruption, it is extremely probable that (while the Israelites were in

the wilderness) these had no existence. By their law they were enjoined

such frequent ablutions, that their bodies must always have been

perfectly clean. Human excrements were not allowed to lie above ground.

The offals and dung of their sacrifices were carried to a distance, and

they were expressly told, that they must not allow of any uncleanness

in their camp, lest God should turn away from them and abhor them. Add

to all this the great heat and dryness of the desert in which they

wandered, which would quickly parch up and carry off the moisture from

any dead carcases or putrefying matters that might be allowed to remain

notwithstanding the injunctions to the contrary. Indeed if we consider

the dryness of the climate where these people were, and that they were

constantly attended by a large stream of water, it is difficult to

conceive any situation upon earth more healthy than that of the Jews in

the wilderness. If plagues therefore came upon them, it is difficult

to say how they could have happened according to the ordinary course

of nature; and, if not according to this, it must have been by an

alteration of it, or by miracle.

The plague, as has already mentioned, in its very severe state appears

most commonly in the beginning of an epidemic season, and is neither

very common nor very infectious. The most common mode in which it

invades the patient is with the symptoms of a malignant fever; and

of cases of this kind Dr. Russel has made up his five classes of

patients, the first or deadly kind having been already described.

In his second class, the next in malignity to the fatal kind, the

disease made its attack with a slight shivering, succeeded by fever

with giddiness, vomiting, head-ach, and sometimes looseness. In the

night the fever increased, the thirst was excessive, and the patient,

harassed by the vomiting, &c. passed a very unquiet night, frequently

with delirium or coma. Towards morning the fever abated, the sick

recovered their senses if delirium had taken place, but if coma, it

continued through the day, and the remissions were less. Throughout

the first day, and part of the second, the pulse was full and strong,

but on the second it began to alter, and some of the characteristic

signs of the disease to appear. The principal of these was a certain

muddiness in the eyes, which sometimes took place even on the first

day. This is by our author accounted a symptom very difficult to be

described, and, though he recounts the descriptions given by several

authors, none are found adequate to the real appearance. “It resembled

(says he) somewhat the dull, fixed eye observable in the last stage of

malignant fevers; but the dullness was different, muddiness and lustre

being strangely blended together. It continued with little alteration

in the remissions, and even where the patient appeared sensible and

composed it did not increase in the febrile exacerbations, but the

eyes acquired a redness that added wildness to the look, which abating

or going off in the remissions, the muddiness remained behind. It

was this which contributed chiefly in composing that confusion of

countenance which I shall not attempt to describe, but which enabled me

to pronounce with tolerable certainty whether the disease was or was

not the plague, though not independently of other symptoms. When this

muddiness disappeared or abated, it was constantly a favourable sign.

After a critical sign it often disappeared suddenly, but where there

was a succession of sweats, or where no visible crisis happened, its

disappearance was slow and gradual.”

Along with this muddiness the patient had a peculiar confusion of

countenance; the pulse quick and equal, or low and fluttering, but

rarely intermittent; the external heat moderately feverish, at other

times intense, with irregular flushings, with pain at the heart,

or oppressions about the præcordia; burning pain at the pit of the

stomach, and incessant inquietude. When to these symptoms were added a

faltering in the tongue, loss of speech, while the surface of the body

became cold and damp with clammy sweat, death was inevitable. In the

evening of the second day all the symptoms became worse; and in the

morning the patient appeared to lie quiet more from his strength being

exhausted than from any change to the better. When the vomiting had

ceased, however, there was frequently such a remission on the third day

as gave the attendants great hopes of a favourable event; but these

hopes were always fallacious and of short duration. Sometimes where

vomiting, looseness or hæmorrhage had preceded, the patient died on

the third day: at any rate, none of this class recovered, whether the

disease was left to itself, or treated with medicine. The appearance

of buboes was of no consequence, for they never came to maturity, and

the little advances they made neither accelerated nor retarded the

termination of the disease, which happened sometimes on the third, but

more frequently on the fifth or sixth day.

The third class of patients were equally unfortunate with the other

two. “The difference between the second and third consisted in the

absence of vomiting at the beginning, the later accession of coma

and other bad symptoms, and a slight tendency to perspiration, which

very rarely occurred in the second.... From the second or third night

the course of symptoms in both classes varied very little, and the

termination of the disease was in both the same: it may be added they

reigned together through all the periods of the pestilential season,

but were most prevalent in its augment; for at its height, and in its

decline, they gave place to varieties of the disease less destructive.”

The fourth class was the most numerous of all. Its distinctive marks

were, “the continuance of the inflammatory or febrile symptoms with

less interruption than in the other, a pulse more constantly sustained,

or soon recovering itself when hurried in the exacerbations; the

length and vigour of the exacerbations decreasing in the advance of

the disease; and, above all, the prevalent tendency to a favourable

discharge by the skin, with the critical sweats on the 3d, 5th, or

subsequent days.... Vomiting was a concomitant in about one fourth of

the sick. The fever, for the most part, was very moderate the first

night, very rarely accompanied with delirium, and almost never with the

comatous disposition.... The buboes and carbuncles commonly made their

appearance the first day; but it was not unusual to see a successive

eruption of these in the course of the disease.... The morning sweat,

on the third day, in some cases proved completely critical, but more

commonly produced only a remission so favourable as to encourage the

expectation of a more favourable crisis on the fifth; but, where the

patient neither sweat on the third, nor a sensible remission took place

on that day, some degree of danger was always to be apprehended....

After the sweat on the fifth, the subsequent exacerbations proved

slighter and slighter, and the buboes for the most part advancing

favourably, little or no fever was left remaining after the beginning

of the second week, except perhaps symptomatic heats occasioned by the

eruptions.” In this class the patients sometimes appeared only to have

a slight attack, and yet at last were seized with mortal symptoms,

while others who deemed to be much worse at first yet happily recovered

and did well, In general the severe pestilential symptoms did not come

on till a considerable time after the attack.

To the fifth class our author refers all cases of slight infection,

wherein the more formidable symptoms of pestilence never concurred,

and _all_ the infected recovered. “The access here was often attended

with so little apparent disorder, that the eruptions gave the first

alarm; and the fever which came on afterwards was frequently so slight

as not to confine the sick to the house. Others found themselves

indisposed for two or three days, but were not sensible of any

febrile heat whatever. But in this class the disease did not always

invade thus insensibly. The febrile symptoms, especially the first

three days, sometimes run pretty high; and the fever afterward, in

nocturnal exacerbations particularly, run out to the end of the week

or longer: but, as there was no concurrence of alarming symptoms, and

the exacerbations, terminating for the most part in sweats, gradually

diminished in force after the third or fourth night, it was not

difficult in the worst cases to foretel the event at that period, nor

necessary in others to defer the decision so long.

“_All_ the infected had buboes or carbuncles, and very often both

eruptions concurred in the same subject. Persons not confined

by indisposition were often, by the inguinal buboes, prevented

from walking abroad. The carbuncles constantly formed the _black

crust_,[106] and then suppurated; the buboes in one third of the sick

dispersed. The dispersion of the buboes was never observed to be

attended with bad consequences, notwithstanding the general neglect of

purging in the decline of the disease: indeed very few had recourse

to remedies, topical applications excepted, unless perhaps a bleeding

at the beginning, where the febrile symptoms ran high. This class was

_nearly as numerous_ as the fourth, but began to predominate rather

later, and reigned most of all in the decline of the plague in 1762.”

[106] This is in favour of what has already been observed, that

the pestilential eruptions in _all_ cases showed a tendency to

mortification.

The sixth class must be omitted, as containing dubious, anomalous

and extraordinary cases. We shall therefore proceed to consider the

accounts of the plague given by other physicians, which, without

questioning the accuracy of Dr. Patrick Russel in relating what _he_

has seen, may serve to throw some light on the subject, by relating

what _others_ have seen. Dr. Alexander Russel, in his Natural History

of Aleppo, gives the following description of it. “The distemper

in itself is the most lamentable to which mankind are liable. The

torments of heat, thirst and pain frequently unite in some patients; an

unspeakable dejection and languor in others; and even those who escape

with life do not cease to suffer from painful and putrid ulcers, the

painful remains of the disease. The desertion of relations, of friends,

and of domestic servants, the want often of the common necessaries

of life, and the difficulty of procuring medical assistance, are

circumstances likewise which aggravate the miseries of the sick, and

contribute greatly to augment the general horror.

“But, as no disease incident to mankind is in its nature more terrible

and destructive, so none is more difficult to observe. Its symptoms

are scarcely in all respects alike in any two persons, and even vary

extremely in the course of an hour in the same subject. The disease,

attended in the beginning with symptoms not highly alarming, often ends

fatally in a few hours; while the most formidable attacks, by a sudden

and unexpected alteration, sometimes terminate happily.

“The first complaints of those seized with this distemper, were,

in general, a coldness or shivering; sickness; a vomiting of large

quantities of porraceous bile, which often had a very offensive smell;

anxiety, or an inexpressible uneasiness about the pit of the stomach;

pain in the back or loins; an intense head-ach; uncommon giddiness, and

a sudden loss of strength. Some were sensible of a sharp shooting pain

darting at intervals into the parotid, axillary or inguinal glands.

To these symptoms succeeded a violent fever; in which, while the sick

complained of extreme inward heat, their skin, externally to the touch

felt little hotter than usual. Sometimes this heat became general

and intense; at other times particular parts only were affected; but

it seldom continued long in the same degree, having several unequal

remissions and exacerbations in a day. In these exacerbations the face

became florid, but would often from a deep scarlet change to a livid

colour, like that of a person almost strangled, and, again suddenly

changing, it would assume a cadaverous paleness. The eyes, soon losing

their natural lustre, acquired a kind of muddiness; and the countenance

of most of the sick was ghastly and confused beyond description. The

pulse the beginning was somewhat quicker and lower, but in other

respects varied little from the natural state. Within a few hours it

commonly increased in quickness and strength, but seldom remained

the some for an hour, nay scarcely many minutes together; incessantly

varying, both as to strength and quickness, and without any manifest

correspondence with the other febrile symptoms.

“In such as complained of pains darting either into the parotids,

the arm-pits, or the groins, a small hard, deep-seated tumour, with

external discoloration of the skin, was discovered by the touch in the

part, and these were the incipient pestilential buboes.

“The appearances now described were those of the distemper on the

first day, till evening, when the sick always suffered a severe

exacerbation, in which the heat both internal and external became

excessive; and, as they generally were by that time delirious, it was

often with difficulty that they would be kept within doors; they were

greatly disposed to talk, but faltered so in their speech, that what

they said was hardly intelligible, the tongue having shared with the

other organs in the general debility. The exacerbation lasted the

most part of the night; but the heat, delirium, and inquietude abated

towards morning, and a manifest remission took place. Some recovered

their senses entirely, some partially, and then complained of intense

head-ach, or of pains from the buboes; it was usual in this interval

also that those who had carbuncles began to complain of _burning_ pain

in those _fiery_ eruptions. The morning remission was commonly of very

short duration; the rigours, anxiety and delirium soon returning more

violent than before, attended with a strong and frequent subsultus

tendinum. These febrile symptoms did not increase regularly as the day

advanced; but went away and returned at intervals leaving short but

alarming intermissions; for each exacerbation surpassed that which

preceded it either in violence or duration. In the evening the pulse

could hardly be counted, by reason of its depression and quickness; the

patient became comatose, and the respiration was quick, laborious, and

interrupted. The buboes which, some hours before, seemed manifestly to

advance, often subsided, and sometimes almost entirely disappeared;

the carbuncles, mortifying at the top, resembled a _great eschar made

by a caustic_: and at this period also livid or black spots, of various

dimensions, often were found scattered universally on the body.

“Under these circumstances, dreadful as they seemed, some hope of

recovery still remained; for, though many of the sick died on the third

day, several had a favourable crisis on that day, by a profuse sweat;

some struggled to the fifth day, a few to the seventh, and, here and

there one, even to the eleventh; before any critical alteration took

place. Where a copious sweat happened on the third day, if it did not

prove perfectly critical, it at least always considerably abated the

fever; which, in that case, was generally totally removed by a second,

though less profuse sweat, on the fifth: and then besides weakness the

chief remains of the disease consisted in the pain of the eruptions.

“Nothing could be predicted with respect to the event of the disease

from the manner of its invasion; those who had the most favourable

escape having been often in the beginning attacked with as alarming

symptoms as others were who died in a few hours. Sometimes the febrile

paroxysm, which had set in with such formidable violence, dissolved

in a few hours, and left the patient languid indeed, and weak in an

extreme degree, but free from other complaints except the pain arising

from the bubo, which from that period increasing in size, and advancing

favourably to maturation, was, in many cases, ready to open in twelve

or fifteen days: the patient all the while, except the first day,

walking about as usual. Great numbers happily escaped, not only in the

manner just described, but likewise where the buboes never advanced;

for these tumours, so far from coming always to maturation in such as

recovered, very often discussed without any bad consequence. Carbuncles

often began to digest before the termination of the fever in a critical

sweat.

“All the infected had buboes, except such as expired suddenly, or

survived the first attack a few hours only. Instances of this dreadful

kind were more particularly observed in March 1743. The sick were

seized in the usual manner; but the head-ach, vomiting, and pain

about the præcordia, increasing every moment, proved suddenly mortal,

or terminated within a few hours in fatal convulsions.” Dr. Patrick

Russel observes, that such instances of sudden death were very rare in

the plague of 1760, 1761 and 1762; and in these they happened only in

the winter, or early in the spring. In such sudden deaths few had any

appearance of buboes; but in general the armpits and groins, or the

inside of the arms and thighs, became livid or black, and the rest of

the body was covered with confluent petechiæ, livid pustules being here

and there interspersed: but all these appearances were more especially

observed after death.

In the plague of 1760, vibices as well as livid and black spots were

frequently found on the corpse, but not constantly. They were always

suspicious in conjunction with other circumstances, but their absence

was no proof, though frequently urged as such, that the distemper was

not the plague. The vibices sometimes appeared several hours before

death, but the livid spots seldom or never.

The tongue in some was quite moist, and continued to be like that of

a healthy person throughout the disease; in others, white at first,

then yellow; at last black, and covered with a dry, foul scurf or fur.

The thirst was generally very great, but never constant; returning at

regular intervals, and never appearing to correspond with the danger

of the fever. Sometimes it was so little that the patient could not be

prevailed upon to drink a sufficient quantity. The appearance of the

urine was equally variable, and afforded no certain prognostic; being

seldom alike in any two patients in the same stage of the distemper,

and varying in the same patient every day. The vomiting commonly ceased

after a few hours, excepting where the sick were induced by thirst to

load their stomach, in which case it always returned. Sometimes the

patients were costive, in others a diarrhœa took place, but in most

the discharges were natural. No critical solution by urine or stool

seemed ever to take place. A few cases of hæmorrhages from the nose and

uterus were observed; and if they happened after the second day, were

soon followed by a plentiful sweat, which commonly proved critical;

“a circumstance different from what has been usually observed in the

plague at other places.

“From the preceding account of the plague it will readily be conceived

that nothing can be more difficult than to form any judgment or

prognostic of the event of the disease; in which, as it is justly

remarked by Morellus, our senses and our reason deceive us, the

aphorisms of Hippocrates are erroneous, and even Hippocrates (as I am

inclined to think) might have erred in his judgment.”

Innumerable other histories of the distemper might be given, but the

following, it is hoped, will be sufficient, along with what has been

already detailed, to show that the plague in former ages was the same

as at this day. In the terrible plague which broke out in the time of

Justinian, the distemper sometimes began with delirium, and the patient

instantly despaired of life; but more generally people were surprised

by the sudden coming on of a slight fever; so slight that no danger

was apprehended either from the state of the pulse or colour of the

body. This, however, was quickly followed, sometimes even on the same

day, sometimes on the second or third, by buboes or parotids (swellings

behind the ear) which when opened were found to contain a black _coal_,

or _eschar_, of the size of a lentil. If these swellings suppurated

kindly, the patient recovered, but if not, a mortification ensued, and

death was the consequence, commonly on the fifth day. Black pustules or

carbuncles, covering the body, were signs of immediate death, as was

likewise a vomiting of blood in weak constitutions; for this terminated

in a mortification of the bowels. Pregnant women generally perished,

but women were less susceptible of the infection than men; and young

persons were in more danger than old. Many, who recovered, lost the use

of their speech, and such were not secure from a relapse.

In the last plague at Moscow, the symptoms were various, according

to the persons, constitution and the weather; in general, head-ach,

giddiness, shivering, loss of strength, slight fever, sickness and

vomiting, redness of the eyes, white and foul tongue, with a dejected

countenance, buboes and carbuncles appearing on the second or third

day, but seldom on the fourth. The buboes were seated chiefly in the

glandular parts, the armpits and groin, but sometimes made their

appearance in the neck, cheeks, &c. Sometimes these suppurated

perfectly, and then they proved beneficial, but not otherwise.

Sometimes they suddenly disappeared, after having attained the

size of walnuts; and this retrocession was always supposed to be a

sign of approaching death. Sometimes they neither showed any sign

of inflammation nor were painful, and in such cases afforded no

relief. Similar swellings sometimes occured in the parotid glands,

but they were never equally beneficial with the buboes. _Carbuncles_

were gangrenous spots on the skin, resembling a burn, with black,

livid or red vesicles, bordered with an inflammatory ring, and soon

terminating in a hard, black eschar. The _anthrax_ is more prominent,

penetrating deeper into the adipose membrane, and attended with more

pain and inflammation. The disease was likewise attended with petechiæ

similar to those in putrid fevers, but larger; also with vibices,

which resembled the mark of a whip, and were considered, as well as

the petechiæ, as mortal signs. No distinct account of the pulse could

be given; as, after the disease became general, physicians did not

choose to feel the pulses of their patients but through a glove or

tobacco-leaf. Worms called _teretes_ were frequently discharged both

upwards and downwards. Women with child generally suffered abortion,

and were carried off by an uterine hæmorrhage.[107]

[107] Bonetus relates, that in 1676 in a malignant fever at Borgo di

Safia, the patients discharged live worms by the mouth, and adds that

they were sooner killed by wine than any thing.

According to Sydenham, the plague begins with chilliness and shivering,

like the fit of an intermittent, succeeded in a little time by violent

vomiting and oppression at the breast, accompanied with its common

symptoms. These continue till the disease proves mortal, or the

kindly eruption of a bubo or parotis discharges the morbific matter.

Sometimes, though rarely, the disease is not preceded by any fever;

the purple spots, which denote immediate death, coming out even while

persons are abroad about their business. But this hardly ever happens

but in the beginning of a very fatal plague, and never while it is on

the decline, or in those years in which it is not epidemic. Sometimes

swellings appear without having been preceded either by a fever or

any other considerable symptom; but he conceives that some slight and

obscure shivering always precedes the seizure.

Mariti, in his travels through Cyprus, &c. says that the plague of 1760

began with loss of appetite, pain in the shoulders, head-ach extremely

violent, delirium, vomiting, with a most excruciating pain in that

part where the tumour by which the plague is characterised, is about

to break forth. Death often took place on the third day, and very few

lived beyond the thirteenth.

The Abbe’s definition of what he calls the plague, and which seems to

be the _pestilential bubo_ of the physicians, is somewhat singular.

“The plague (says he) is an oblong tumour, shaped like a pumpkin, which

is at first of a flesh colour; but it gradually becomes red, and at

length blueish; and this is a sign that the disease is incurable. If it

continues red, and a little after inclines to yellow, it is a sign that

a suppuration will take place: the swelling is then opened, and the

patient is sometimes cured.”

According to our author, the symptoms of the plague do not appear

till fifteen days after the infection is received; and this is the

reason of a law which subjects to a proof of twenty days every person

suspected of being diseased. In this plague it was observed that people

of the soundest constitutions were the most subject to it, and the

least capable of resisting it. On the other hand, it appeared to spare

weak and delicate persons, whose cure, in case of an attack, was much

less difficult. A greater number of Moors than of any other nation

were attacked by it; and when once they were seized, their case was

absolutely desperate. Those who had recovered from the disease were

less liable to a second attack, but were not absolutely safe. “I have

known some (says our author) who have been ill seven times, and have

died of it at last.”

Dr. McBride informs us that in the plague which raged at Marseilles and

the adjacent places in 1720, people on their first seizure seemed as if

intoxicated with drink; they lost the power of their limbs entirely,

and became so dejected that they gave themselves over to despair from

the very first attack. Along with the bilious vomitings and purgings

which generally took place on the second day, quantities of small worms

like ascarides were thrown off. The more plentiful these evacuations

were, the more salutary; for those who vomited and purged but little

sunk down, oppressed with the disease, and died before the fourth day,

covered with livid blotches and petechiæ; those who had the largest

evacuations had also the most plentiful eruptions of buboes and parotid

abscesses. When these appeared, the patients rose, walked about, and

became remarkably hungry; the heat and thirst subsided, but the face

continued pale and languid, the pulse hard and frequent. On the sixth,

seventh, or eighth day, if the suppuration stopped, and the humours

went back, then came on oppression, difficulty of breathing, furious

delirium and convulsions, which ended in death. When carbuncles, or

biles, with mortified sloughs, appeared in different parts of the body,

either alone or accompanied with the glandular swellings, the patients

scarcely ever escaped. In great numbers of people tumours appeared

without any previous febrile symptom, and, in a few cases, went off by

resolution; in others they continued in a schirrous state; but it was

best when the tumours came to suppuration.

These are the most remarkable symptoms of this fatal disease, which

have been recorded by the physicians of greatest eminence who have

written upon the subject. It remains still to give some particular

description of the buboes and carbuncles, which are supposed to

constitute in a particular manner the characteristic signs of the

distemper. Of these the following account, given by Dr. Alexander

Russel, seems to be sufficiently clear and explicit.

Only a very few, and such as died suddenly, were exempted from buboes,

but only about one half had carbuncles. In the latter plagues their

proportion was still smaller; but they seldom appeared earlier than in

the months of April or May. In 1742 and 1743, the buboes often appeared

on the first commencement of the distemper, sometimes not till twelve

hours after; in a few instances not till two or three days; but in

1744 they were sometimes the first symptoms of the disease. The buboes

were generally solitary, the inguinal and axillary more frequent than

the parotid. “The inguinal bubo for the most part was double; that is,

two distinct glands swelled in the same groin. The superior, which in

shape somewhat resembled a small cucumber, lay obliquely near the large

vessels of the thigh, lower than the venereal buboes are usually found,

and it was that which commonly came to suppuration; the inferior was

round, and in size much smaller. I once met with a case in which an

axillary bubo divided in like manner into two parts, one of which got

under the pectoral muscle, the other sunk deeper into the armpit: both

grew painful and inflamed, but that in the armpit only suppurated.”

The bubo was at first a small hard tumour, painful but not inflamed

externally. These indurated glands were deeply seated, sometimes

moveable, at others more or less fixed, but always painful to the

touch. Sometimes they would increase to a considerable size in a few

hours, with intense pain, then suddenly subside; and these changes

would take place several times in twenty-four hours. “An exacerbation

of the pestilential symptoms immediately upon the decrease of the

bubo, sometimes prompted me to imagine it owing to the retrocession

of the tumour; but this did not happen so constantly as to make me

think it was so in reality. The buboes, as far as I could learn, never

advanced regularly to maturation till such time as a critical sweat

had carried off the fever. In ten, twelve, or fifteen days, from the

first attack, they commonly suppurated; having been all along attended

with the usual symptoms of inflammatory tumours. But I have known

them sometimes, nay, frequently, disappear soon after the critical

sweat, and discuss completely without any detriment to the patient.

At other times, though grown to a pretty large size, the tumour,

about the height of the disease, would sink and mortify, without any

fatal consequences; for, as soon as the crisis was complete, the

mortification stopped, and the gangrened parts separating gradually,

left a deep ulcer, which healed without difficulty. I met with no

instance of a bubo in which fever did not either precede or follow the

eruption.”

On the subject of carbuncles, Dr. Patrick Russel observes, that “there

are certainly varieties in them, but perhaps these varieties have been

unnecessarily multiplied, from the same eruption having been viewed

in different stages of its progress; for all of them sooner or later

are covered with a black eschar.” Dr. Alexander Russel describes

them as follows: “The carbuncles were commonly protruded the second

day of the disease; and though the muscular and tendinous parts were

more especially affected, no part whatever could be said to be free

of them. The carbuncle at first resembled an angry confluent pock in

its inflammatory stage, but was attended with intense, burning pain,

and surrounded by a circle of a deep scarlet hue, which soon became

livid. By a progress very rapid, it then spread circularly, from the

size of a silver penny to an inch and an half, two inches, nay, even

three inches, diameter; and the supervening gangrene often penetrated

deep into the substance of the parts affected. In such of the sick

as recovered, the gangrene usually ceased spreading on the third day;

and, a day or two after, signs of suppuration were observed at the edge

of the black crust, the separation of which, advancing gradually, was

completed rather in less time than that of the eschar in issues made

by caustic. In cases where the patient died, I was informed (for I saw

none of those cases myself) that a quantity of ichorous matter oozed

from beneath the eschar, which remained itself shrivelled and hard,

without any favourable signs of separation or digestion.”[108]

[108] Dr. Gotwald, formerly quoted, describes four varieties

of carbuncles, the differences between which seem to be pretty

distinctly marked. 1. “One kind rises pretty high, is of a dark

brown colour, the cuticle appearing as if it were burnt, and it is

surrounded with a lead-coloured circle. In the beginning it is no

bigger than a pea, but, if not prevented, soon grows to the size

of a crown piece; inwardly it is moister than the rest, and may be

more easily separated. Its seat is generally in the fleshy parts,

as on the shoulders, neck, hips, arms and legs. 2. The second lie a

little deeper, and do not rise so high; the eschar in the middle is

entirely dark and ash-coloured, full of small chops, as if it would

burst by too great dryness: it has a strong lead-coloured circle,

behind which the sound flesh looks red and shining. It eats into

the flesh round about it, and takes deep root: it generally fixes

in the most fleshy parts, as the buttocks, calves, &c. 3. The third

is not very large at first; it appears like a blood swelling, not

so dark as the former, with a wrinkled skin; as it increases, small

blisters arise in the middle, and form an eschar, in little clusters,

which, as an ingenious physician observed, were small carbuncles.

They commonly are situated in membranous and tendinous parts about

the knees, toes, and behind the ears, &c. 4. The fourth is the most

curious, as Purman, in his treatise on the plague, has well observed.

Sitonius calls them pale, livid, ulcerous papulae: they appear with a

high, yellowish blister, which seems full of corruption: the circle

round it is first red, then of an ash colour: the blister soon

falls, and, with the carbuncle, appears scarce so big as a pepper

corn, continually eating deeper and wider. They are seated upon the

cartilaginous or gristly parts. Gotwald found them near the pit of

the stomach, upon the cartilago ensiformis and short ribs. All the

four take root and burn very violently at first, but the two former

most of all.”

Dr. Alexander Russel also describes another kind of pustule, which he

says appeared in a small number of the sick, but which his brother Dr.

Patrick had no opportunity of observing in 1760. It had no livid or

discoloured circle surrounding it, but was filled with laudable pus;

and, when dry, the crust fell off, as in the distinct small-pox. This

was looked upon as a favourable symptom, all who had it happening to

recover.

We have now detailed, at considerable length, the symptoms of the

plague as mentioned by authors of great eminence. To give a detail

of _all_ that has been said upon this subject would be impossible;

neither indeed can it be thought necessary in the present treatise.

Whatever may have been omitted or too slightly mentioned in this

section, will naturally be considered when we come to treat of the

cure. It now therefore only remains to say, whether the approach of a

plague may be known by any visible signs, so that people might in some

measure prepare themselves for the ensuing calamity.

Were we in possession of an accurate and authentic history of the

world, this question might be very easily decided; but the uncertainty

of ancient records, the mutilated state of those which we do possess,

the diversity of opinions among mankind, and the unhappy disposition

to _misrepresent_, so common in all ages, render it very difficult to

say any thing upon the subject. If the theory hinted at in this section

(that plagues arise from some commotion in the electric fluid) can be

allowed to have any foundation in nature, then it ought to follow, that

the forerunners of pestilence would be some electric phenomena; and,

from a perusal of the first and second sections of this work, it will

appear that such an opinion is not altogether unfounded.[109]

[109] See p. p. 61, 62.

The appearance of immense numbers of insects has likewise been

accounted a sign of approaching pestilence; but if we suppose their

appearance to be a _sign_, we can scarce imagine their putrefaction

to have been a _cause_, of pestilence. In the east we are informed

by Dr. Russel that the inhabitants of Aleppo account the appearance

of insects, and even _eclipses_, as presages of the plague. They

suppose also that the stillness of frogs is a sign of pestilence;

but the same author informs us that all these signs failed in 1760.

Violent earthquakes and famines seem to be more certain signs, though

even these are not always to be depended upon; it being evident

from historical accounts that pestilence has sometimes preceded,

and sometimes followed, earthquake and famine. Mr. Gibbon, however,

ascribes to the above-mentioned causes, viz. insects, earthquakes, and

even _comets_, the dreadful plague which took place in the reign of

Justinian. At least, all these preceded it; but perhaps the _insects_

were only meant to be accounted the cause of the plague. The cause

of the _insects_ must remain in obscurity. According to him, “In a

damp but stagnating air, this African fever is generated from the

putrefaction of animal substances, and especially from the swarms of

locusts, not less destructive to mankind in their death than in their

lives.”

This dreadful plague was preceded by comets and most violent

earthquakes. A remarkable comet appeared in 536, supposed to be the

great one observed by Sir Isaac Newton in 1680. This, we are told by

astronomers, revolves round the sun in a period of 575 years; but the

failure of astronomical predictions in the return of the expected

comets of 1759 and 1789, shew the futility of such calculations.

Another comet appeared in 539, and these comets were attended with

an extraordinary paleness of the sun. Mr. Gibbon observes, that

earthquakes, which he calls a fever of the earth, “raged with uncommon

violence during the reign of Justinian. Each year is marked by the

repetition of earthquakes of such character, that Constantinople has

been shaken above forty days; of such extent, that the shock has been

communicated to the whole surface of the globe, or at least of the

Roman empire. An impulsive or vibrating motion was felt; enormous

chasms were opened, huge and heavy bodies were discharged into the air,

the sea alternately advanced and retreated beyond its ordinary bounds,

and a mountain was torn from Liburnia, and thrown into the waves, where

it protected as a mole the new harbour of Botrys in Phenicia.”

According to Dr. Sydenham the plague at London in 1665 was preceded

by a very cold winter; the first continued till spring and went

off suddenly towards the end of March. Peripneumonies, pleurisies,

quinsies, and other inflammatory disorders, then made their appearance,

along with an epidemic fever of a particular kind, which did not yield

to the remedies successful in other epidemics. About the middle of

the year the plague began, and increased in violence till the autumnal

equinox, when it began to abate, and by the ensuing spring was entirely

gone. Our author says that the plague seldom rages violently in England

but once in thirty or forty years; but since his time, which is upwards

of a century, no plague hath appeared. He supposes the plague and

other epidemics to depend on some secret constitution of the air,

but pretends not to say what that constitution is. But, besides this

constitution, he is of opinion that there must be another circumstance,

viz. the receiving the effluvia or seminium from an infected person.

Thus he supposes that a single infected person is sufficient to poison

a whole country; the general mass of atmosphere being infected by the

breath of the diseased and the effluvia of the dead bodies. “Thus

(says he) the way of propagating this dreadful disease by infection is

rendered entirely unnecessary; for though a person be most cautiously

removed from the infected, yet the air received in by breathing will

of itself be sufficient to infect him, provided his juices be disposed

to receive the infection. I much doubt, if the disposition of the air,

though it be pestilential, is of itself able to produce the plague;

but the plague being always in some place or other, it is conveyed by

pestilential particles, or the coming of an infected person from some

place where it rages, to an uninfected one, and is not epidemic there,

unless the constitution of the air favours it. Otherwise I cannot

conceive how it should happen, that, when the plague rages violently in

one town in the same climate, a neighbouring one should totally escape

it, by strictly forbidding all intercourse with the infected places; an

instance of which we had some few years ago when the plague raged with

extreme violence in most parts of Italy; and yet the Grand Duke, by his

vigilance and prudence, entirely prevented its entering the borders

of Tuscany.” As to the nature of the disease, when once produced,

Dr. Sydenham is of opinion that it is altogether inflammatory; for

which he gives the following reasons: 1. The colour of blood taken

away that resembles that in pleuritic and rheumatic disorders. 2. The

carbuncles resemble the mark of _an actual cautery_. 3. The buboes are

equally disposed to inflammation with any other tumours that come to

suppuration. 4. The season of the year may be adduced in proof of this;

for between spring and summer, inflammatory disorders, as pleurisies,

quinsies, &c. are common.

Before we put an end to this section, it may now be proper to say a

few words by way of apology for the many apparent digressions from

the subject which have appeared in it. In the first place, then, the

work being intended for general inspection, and not merely for medical

readers, it became absolutely necessary to introduce a number of things

which for medical readers would have been totally superfluous. It was

to be supposed that the book might come into the hands of some who had

not read any thing concerning the structure of the body, who had not

heard of any of the systems of medicine now prevalent, or the different

doctrines they contain. It was impossible to write in an intelligible

manner for such people without giving some few hints concerning all

these subjects: the same consideration made it necessary to enter

pretty largely into the discoveries concerning the composition of

the atmosphere and various kinds of elastic fluids, concerning heat,

&c. In doing this the writer was under a necessity either to adopt

some of the doctrines he took notice of, or to animadvert upon them.

If he has ventured freely to give his sentiments, it is not with a

view to establish a theory of his own, but to direct the attention of

the reader to those natural agents which seem to be at present too

much overlooked, principally because they are less accessible to our

senses, and of consequence less subject to experiment, than others.

If therefore in this treatise it is suggested that the atmosphere

acts on the human body by its internal or latent heat, and by its

electricity, as well as by its other properties; if the writer is

inclined to believe that these are in fact the most powerful parts of

it; that we never can act without them, and that in short our life

and health are in immediate dependence upon them; I say, that none of

all these things are in opposition to any fact hitherto discovered,

either of the medical kind or any other. On the other hand, in all ages

physicians have sought for some constitution in the air, inexplicable,

and perpetually unknown, to which diseases might be ascribed that could

not be supposed to originate from any of its ordinary properties. To

explore this constitution is as great a desideratum at the present

moment as two thousand years ago; and any attempt to investigate it,

or a conjecture relating to it, cannot be supposed inconsistent with

any thing already discovered and ascertained. There are many things

which lead us to think that electricity is very much concerned in

diseases, and among the rest we must account the new discovery of Dr.

Perkins’s metallic conductors a very notable proof of it. These, when

first ushered into the world, were made by many a subject of ridicule;

but the evidence in favour of their efficacy, both in America and in

various parts of Europe, seems now to be decisive in their favour;

and, if they act at all, it is almost impossible to suggest any other

principle than that of electricity to which their efficacy can be

owing. No doubt it is difficult to draw the line properly betwixt

credulity and skepticism, but where credible testimony determines any

thing to have actually happened, or where solid reasoning gives room to

suppose any thing to be probable, it never can be invalidated by any

argument _a priori_ formed against the _possibility_ of such a thing

taking place.

In page 128 it is said, that M. Lavoisier, by introducing the new

chemical nomenclature, “has entailed the greatest curse upon the

science it ever met with.” All apology for this bold assertion is

absolutely necessary, and the quotation made from Dr. Ferriar may be

deemed inadequate, or perhaps misapplied. In passing this censure on

the nomenclature I wrote from experience. The new nomenclature, instead

of promoting _my_ improvement in chemistry, hath had a direct contrary

tendency. An instance of the inconvenience and ambiguity arising from

it is given p. 135, when speaking of Dr. Girtanner’s theory. But a

much more remarkable example is to be met with in the review of Dr.

Monro’s Chemical Treatise, where we find him censured for the very

same ambiguity taken notice of with regard to Dr. Girtanner. “He might

have observed (say the reviewers) the distinction between the hydrogen

and inflammable air, and between the oxygen and pure air, as well as

between the azote and impure air: he has mentioned these as synonimous,

whereas they are terms that express bases, or substances in a concrete

state (what I have called the condensable part) and the compounds

of these substances and heat, when they assume the form of gases or

elastic fluids.” (Monthly Rev. for 1790, p. 26.)

That the terms invented by Lavoisier and others have not been received

with perfect unanimity by the chemists of the present day, is evident

from Dr. Pearson’s “Translation of the New Chemical Nomenclature,”

which is not only a _translation_, but a _vindication_ of it. In the

course of his work he quotes the translator of the Chemical Dictionary

saying, that, “from the zeal of reforming language, such a number of

reformers may arise, that our ears will not be less stunned, nor our

understandings less perplexed, than if we were exposed to the clamour

of Babel, or the _thaw of words_ of Sir John Mandeville.” To this

Dr. Pearson replies, that there is no reason to fear any such bad

consequences. “The distinguished superiority of a system produced by

a _De Guyton_, a _Lavoisier_, or a _Bergman_, would surely supercede

the work of persons of _inferior ability_.” It is impossible to know

the persons here designated, unless the Doctor points them out. If he

chooses to call _himself_ one of them, we can have no objection. He

certainly has dissented, in one article, from “the system produced

by De Guyton, Lavoisier and Bergman,” and this is with regard to the

word _azote_. This is the term announced to us as the most proper for

denoting a certain kind of air. But Dr. Pearson determines _nitrogen_

to be more proper. Even this has not given entire satisfaction,

for Dr. Mitchell has adopted the word _septon_ in preference to

both _azote_ and _nitrogen_. Thus, instead of the original phrase

_phlogisticated air_, used by Dr. Priestley, we have four; for as

long as the works of Dr. Priestley remain, the original term will

be used by some, while with others it will be so much disused that

perhaps they will not understand it when it happens to occur. Nor are

corrections of this kind all that we have to fear. Professor Wiegleb,

who has written a System of Chemistry in quarto, has therein changed

almost all the nomenclature invented by Lavoisier. Instead of it he

gives a nomenclature of his own, in which he makes very much use of

the termination _cratia_, from a Greek word signifying strength; thus,

instead of saying the _acid of fluor_, we are to say _fluoricratia_. I

must confess that to me the perpetual repetition of this termination

has a very ridiculous appearance; but the misfortune is, that in the

case of nomenclatures we have no choice. We cannot choose one and

reject another: good or bad, we must take both; and were an hundred

new ones to arise, we must be condemned to learn them all. Nor is even

this the worst. Wiegleb’s scholars, for instance, accustomed to the

language of their teacher, will be apt to put it into their writings,

perhaps without proper explanation; and thus such writings must be

unintelligible both to old and new chemists: and thus it will be with

as many others as choose to invent new chemical terms.

Were this a proper place for entering into a discussion of Lavoisier’s

nomenclature, it might easily be shown that the terms are not more

proper than those which preceded them; but no real inconvenience can

arise from the propriety or impropriety of a mere name. It is the

_resemblance_ of the terms to one another, and the facility with

which mistakes may be made, that gives just ground of complaint.

Nor is it any just reason to accuse a person of want of judgment or

carelessness because he hath mistaken these terms. We see that even

Dr. Monro has not attended to every circumstance; and if a man of his

experience and accuracy hath been inaccurate in this respect, what

is to be expected from others? How easily may the words _sulfate_,

_sulfite_, _sulphuret_ and _sulphure_, be mistaken for one another,

either in writing or conversation! Yet a mistake of this kind would

totally pervert the meaning of the person who used it. The scripture

finds fault with those who make people offenders for a _word_; but here

we are in danger of being made offenders for a _letter_. In short,

taking into account the inconveniences arising from this nomenclature

itself, the numberless corrections and amendments (no matter whether

real or imaginary) to which it may be subjected, and the number of

others totally different from it which may arise, I cannot help looking

upon the introduction of it into chemistry as an evil of the first

magnitude; an evil which cannot be remedied by any art, but must

continually become worse and worse.