SECTION IV.

_Of the best Methods of Preventing the Plague._

These methods may be classed in the following manner: 1. Those most

proper for avoiding the infection, supposing the disease to be

infectious. 2. The proper mode of resisting or removing those local

causes which may give rise to it, or may co-operate with the infectious

matter in giving greater force to the disease, should it happen to be

introduced; and, 3. The best method of preparing the body for resisting

pestilential attacks, should we happen to be so situated that no

external method of defence could be used.

With regard to the first of these intentions the flying from places

infected has been so universally recommended, and so generally

received, that the precept has been made up into the following

proverbial Latin distich:

“Hæc tria tabificam tollunt adverbia pestem

Mox, longe, tarde, cede, recede, redi.”

_These words prevent the plague’s infectious pain,

Go_ quick, _fly_ far, _and_ slow _return again._

This maxim hath been put in execution in all ages, but often with so

little regard to humanity that it cannot by any means be recommended

without very considerable limitation. The reparation of the sick from

all promiscous intercourse with the sound, in times of pestilence,

seems to be dictated by common sense; but this may be done without

killing them, or leaving them to expire in the miserable state to which

they are reduced by the disease. Mr. Howard informs us that in some

places ships which have the plague on board are chased away and burnt;

and instances of cruelty with regard to infested individuals have been

formerly mentioned. Dr. Mertens is of opinion that cutting off all

the communication between the infected and healthy is the only means

of preventing the disease from spreading. The good of this practice

was observed in one of the hospitals at Moscow. All the avenues to it

were shut up, but one which was strictly guarded, and every suspected

article prohibited from entering. Infected clothes and utensils were

burned, and the houses where the sick had lived were purified by the

fumes of vinegar and gun-powder.

In this mode of prevention it is of the utmost consequence to ascertain

the distance to which the contagion extends; in the next place to know

whether by means of clothes, cotton or other kinds of merchandise it

may be imported from one place to another; and in the third place

how long the infection may remain in these kinds of goods; so that

people may know when the danger is over. As to the distance, it seems

to be generally agreed, that it is but small. Some of the answers to

Mr. Howard by the physicians of whom he inquired, have been already

related. Of the infection of the plague he speaks in the following

manner:

“In my opinion this distemper is not generally to be taken by the

touch, any more than the gaol-fever or small-pox; but either by

inoculation, or by taking in with the breath the putrid effluvia which

hover round the infected body; and which, when admitted, set the

whole mass of blood into fermentation, and sometimes so suddenly and

violently as to destroy its whole texture, and to produce putrefaction

and death in 48 hours. Those effluvia are capable of being carried

from one place to another, upon any substance where what is called

_scent_ can lodge; as upon wool, cotton, &c. and in the same manner

that the smell of tobaco is carried from one place to another.

“The infection in the air does not extend far from the infected object,

but lurks chiefly (like that near carrion) to the leeward of it. I am

so assured of this, that I have not scrupled going, in the open air,

to windward of a person ill of the plague to feel his pulse. The rich

are less liable to the plague than the poor, both because they are more

careful to avoid infection, and have more large and airy apartments,

and because they are more cleanly, and live on better food, and plenty

of vegetables; and this I suppose is the reason why Protestants are

less liable to this distemper than Catholics during their times of

fasting, and likewise why the generality of Europeans are less liable

to it than the Greeks, and particularly Jews.

“It is remarkable that, when the corpse is cold of a person dead of the

plague, it does not infect the air by any noxious exhalations. This

is so much believed in Turky, that the people there are not afraid to

handle such corpses. The governor of the French hospital at Smyrna told

me, that, in the last dreadful plague there, his house was rendered

almost intolerable by an offensive scent; especially if he opened any

of those windows which looked towards the great burying-ground, where

numbers every day were left unburied; but that it had no effect on the

health of himself or family.”

It is likewise a matter of the utmost importance to ascertain the time

at which the disease is introduced into any town or district. Dr.

Canestrinus, in a treatise on this distemper, published at Saltzburg,

complains greatly of the dissensions among physicians concerning the

nature of the distemper, owing to which its existence is frequently

denied, and thus its ravages are propagated immensely beyond the

limits which might otherwise circumscribe them. Of this he gives the

following remarkable instance: “In the year 1770 a disease with

uncommon symptoms prevailed at Bodrogh in Upper Hungary, which carried

off a number of persons in a short time. A physician of the county

of Zemplin was sent to inquire into the nature of the malady. He

reported that the disease was of a suspicious nature, having a great

resemblance to the plague. His report was received by the nobility and

health-officers with indignation, as if untrue. Another was sent, who,

without hesitation, pronounced the disease an epidemic scurvy. In the

mean time the disease, being left to itself, spread wider, and raged

with such violence as to carry off seventeen persons in one house.

The nature of the disease now becoming apparent, proper measures were

taken, and the infected separated from the sound, by which means the

disease was confined within a small district.[110]” With regard to the

infection of the disease, or _contagion_, as it is commonly called,

he expresses himself as follows: “The air is not capable of diffusing

the contagion to any considerable distance from the infected subject

unimpaired in its power, but, like other poisonous matter, it is

capable of dilution in the atmosphere, so as to be rendered at length

innoxious. The contagion of the plague will be entirely prevented from

spreading if all access to, and all intercourse with, the sick be

strictly prohibited: whence the following forms a safe and infallible

prophylactic of the disease:

[110] Medical Review, vol. iii, p. 257.

“Mox, longe, tarde, cede, recede, redi.

_Go_ quick, _fly_ far, _and_ slow _return again._”

“No change in the habit takes place previous to the action of the

contagion, but the body is from the first equally susceptible of it

as of the itch, or any other infectious disease. Whilst the plague

ceases in the civilized parts of Europe spontaneously, or by human

precautions, its revival is prevented, from the care that is bestowed

in purifying or destroying every infected substance. In the east,

on the contrary, this precaution is totally neglected; whence it is

probable that the disease is not reproduced anew, but that it is

perpetuated by the former fomes, as happens with us in the small-pox.

The matter producing the ordinary epidemics is widely diffused in the

atmosphere, and capable of infecting through a widely extended space.

The pestilential poison, on the contrary, is confined to the vicinity

of the affected body, and becomes so dilute at the distance of a few

paces only as to be incapable of further action. Hence it appears that

the plague is much easier avoided than epidemic disorders. The more

abundant the contagious matter is, the further probably is the power of

its infection carried. This is the reason that the mere separation of

the sick and suspected from the healthy is so much more efficacious in

destroying it at its commencement than at a later period. To restrain

epidemics within bounds is impossible; but with the contagion of the

plague, it is certain that it can be confined by art to a narrow spot.”

Of the truth of this last assertion our author gives a remarkable,

instance in his own practice about the time that the plague stopped

at Bodrogh. Having been sent into Cassovia, along with two other

physicians, they were informed by the surgeon of the lazaretto, that

an unusual disease had broken out in the district of Zboina, which had

suddenly proved fatal to many. On inquiry it was found that it had come

from Bodrogh in the following manner: Two young men, returning from the

vintage at Tokay, slept a night in an infected house, and stole some

clothes belonging to those who had died of the plague. He who carried

the clothes died by the way: his father carried home the bundle, kept

them unpacked for some weeks, but having at last worn them, he and

all his family fell victims to the same disease. The pestilence began

to spread, and shewed an appearance of great malignity. Our author

did not hesitate to declare its true nature, and in consequence of

his declaration all communication was cut off between the adjacent

countries and the infected spot, by a cordon of the military. The

infected were separated from such as were only suspected, and these

last from the sound: three infected houses were destroyed by fire,

and other means (to be afterwards related) were used with a view to

destroy the contagion itself. Thus the disease was prevented from

spreading; and none but such as had been previously suspected were

seized.

To the same purpose the Abbe Poiret thinks it an easy matter to

extinguish the plague entirely. He was a witness to the ravages of

the disease in Barbary, and thinks it the most easily avoided of

any distemper; but the misfortune is, that there are many things in

their own nature very easily accomplished, which the inattention or

perverseness of mankind render utterly impracticable. Such, it is to be

feared, is the extinction of the plague by the means just mentioned;

for though these means might be enforced in a country district or small

town, yet, where the pestilence enters a large and populous city,

there are so many modes of concealing its existence, and the unknown

intercourse of the sick with the sound must be so frequent, that it

seems scarce possible to prevent the malady from spreading.

In London, whether it arose from a neglect of using the precautions

for too long a time, or from any other cause, cannot well be known;

but the attempts of the magistrates to separate the sick from the

sound certainly were not attended with any good consequence. “The

consternation (says Dr. Hodges) of those who were thus separated from

all society, unless of the infected, was inexpressible, and the dismal

apprehensions it laid them under made them but an easier prey to the

devouring enemy. And this seclusion was on this account much the more

intolerable, because, if a fresh person was seized in the same house

but a day before another had finished the quarantine, it was to be

performed over again; which occasioned such tedious confinements of

sick and well together, as sometimes caused the loss of the whole.

Moreover, this shutting up of infected houses made the neighbours fly

from theirs, who might otherwise have been a help to them on many

accounts; and I verily believe that many who were lost might have

been alive, had not the tragical mark upon their doors driven proper

assistance from them. And this is confirmed by the examples of other

pestilential contagions, which have been observed not to cease until

the doors of the sick were set open, and they had the privilege of

going abroad.” The Doctor sets forth also the arguments on the other

side; but whatever _might_ have been the advantages of a separation

of the sick from the healthy, if conducted in a manner less capable

of hurting the feelings of humanity, it is evident that in the London

plague the methods attempted to prevent the disease at least did no

good.

In countries where the plague generally prevails, and the Europeans are

_united_ in the opinion that it is necessary to separate themselves

from the natives, the method of shutting up is attended with the most

salutary effects, as has been attested by almost every traveller who

has resided there for any time. Accidents among them are very rare,

though not altogether without example. At Alexandria in Egypt, M.

Volney tells us, that as soon as the plague makes its appearance the

European merchants shut themselves up in their _khans_ and have no

communication with the rest of the city. Their provisions are deposited

at the gate of the khan, and received there by the porter, who takes

them up with iron tongs, and plunges them into a barrel of water

provided for the purpose. If it is necessary to speak to any one, they

keep at such a distance as to prevent touching with their clothes, or

breathing on one another; by which means they preserve themselves from

this dreadful calamity, unless by some accidental neglect of these

precautions. Some years ago a cat, which passed by one of the terraces

into the houses of the French merchants at Cairo, conveyed the plague

to two of them, one of whom died. This state of imprisonment continues

for three or four months, during which time they have no other

amusement than walking in the evening on the terraces, or playing at

cards.

The doctrine of predestination, and still more the barbarism of the

government, have hitherto prevented the Turks from attempting to

guard against this destructive disease: the success, however, of

the precautions taken by the French, has of late begun to make some

impression upon many of them. The Christians of the country who traffic

with the French merchants, would shut themselves up like them; but this

cannot be done without permission from the Porte. A lazaretto was some

years ago established at Tunis; but the Turkish police is every where

so wretched, that little can be hoped for from those establishments,

notwithstanding their extreme importance to commerce and the safety

to the Mediterranean states. The very last year afforded a proof of

this; for as violent a plague as ever was known broke out there. It was

brought by vessels coming from Constantinople, the masters of which

corrupted the guards, and came into port without performing quarantine.

Water carriers have never been attacked by it.

Mariti says, that in the island of Cyprus, and on the continent of

Syria, every European, on the slighted appearance of the plague, after

taking the necessary precautions, shuts himself up with his family.

The Mahometans alone, more intrepid, go abroad as usual, converse with

each other, give such assistance to each other as may be necessary, and

often fly to the relief of a Christian when deserted by his friends.

This arises from their belief in predestination. The Mahometans of

Syria, however, less familiarized with this scourge, make use of some

precautions, which were augmented in 1760. They published an ordonnance

forbidding every vessel attacked by the plague to enter their ports:

but their vigilance in this respect was so remiss, that it was not

sufficient to prevent the contagion. The governor of Acre checked

the progress of this plague, by giving the inhabitants the means of

retiring from its ravages; and these means, though absolutely contrary

to the dogmas of the Mahometan religion, were eagerly embraced. The

Europeans became their models; and the governor, after deriving

from them every necessary information, shut himself up, after their

example, together with his numerous family. The mufti alone, being the

protector of the Mahometan law, cannot imitate a conduct which that

law condemns. Instead of shutting himself up in a prudent confinement,

he thundered forth against this new method, reproached the governor for

his conduct, and, having treated him as an impious person, threatened

him with all the vengeance of Heaven. The governor, however, only

laughed at this pious folly of the mufti, and sent a detachment of

soldiers to impose on him a fine of two hundred and fifty sequins, for

having dared to ascribe to him, in matters of religion, an ignorance,

from every suspicion of which his age ought to have secured him.

In the time of plague, the proper precautions are, to shut one’s self

closely up, and to receive no provisions or other things, except those

on which the plague has no influence. The people of Syria, however, in

1760, admitted every kind of provisions without fear, but not without

using certain precautions. They did not receive warm bread; flesh of

every kind was thoroughly washed, and milk was strained through a

linen cloth, in order to free it from the smallest particle of animal

hair. All kinds of pulse were soaked in water, and they abstained from

peaches, apricots, and other fruits which are covered with a downy

rind. Fowls were cooked out of the house, for fear that some small

feather might adhere to them. Flowers were altogether proscribed.

Letters were opened by the person who brought them; and they were never

read until they had been steeped long enough in vinegar to be purified

without effacing the writing. Every thing was received into the house

by means of a rope of herbage suspended from a window. The governor

employed every precaution which he thought likely to guard him from the

contagion; and, by shutting himself closely up, he set an example which

the rest of the Mahometans did not neglect to follow. Besides this he

caused the streets to be cleansed; and carried his vigilance so far as

to forbid the caravans which arrived from Damascus, where the plague

swept off four or five thousand people every day, to enter the city.

He obliged them to submit to a proof of eight days without the walls,

and established regulations of the same kind respecting vessels coming

from Alexandria or Damietta. One precaution taken in the time of plague

is, to prevent _cats_ from entering houses: an open war is therefore

declared against these animals; and, wherever they are found, they are

knocked on the head with large clubs. This is a cruelty absolutely

necessary; for there is no vehicle that will convey the infection

with more certainty or rapidity than the hair of cats. Rats and mice

multiply in consequence of their destruction; but there is no instance

of their ever having propagated the plague. This disease, when it

attacks men, spares quadrupeds and birds. The furs of the one, and the

feathers of the other, however, attract and communicate the infection.

People ought particularly to keep from goats and sheep; from horses and

oxen little is to be apprehended.

All these precautions were sometimes ineffectual. The French at

Acre, who there, as well as throughout Syria, are collected into one

quarter, used every precaution that could be thought of, yet, on the

30th of March, 1760, five of them were infected. They belonged to the

hospital of the Holy Land, and the monks were instantly ordered to shut

themselves up. They did so; and eight of them died, one only escaping.

Mr. Howard likewise gives particular accounts of the precautions used

in several different countries through which he travelled. In Malta two

kinds of quarantine are performed; one for ships with clean bills, the

other for those with foul. The former lasts 18 days.[111] The crews

and passengers are allowed to buy provisions, and converse by means of

enclosures with stone posts and palisadoes. A letter received from a

Turkish ship was taken by a pair of iron tongs, dipped in vinegar, put

into a case, and laid for about a quarter of an hour on a wire grate

under which straw and perfumes had been burnt; after which the letter

was taken out and opened by one of the directors. In this island ships

with foul bills must perform quarantine eighty days; but, at the end

of forty, may change their station. The different kinds of goods are

separated and placed in proper order under cover. The cottons are

taken out of the bags containing them, and placed on rows of piles on

boards, laid on stone pillars about 18 inches from the floors; and, in

repacking them they are flung over a man who gets into the bags, and

treads down the cotton; the consequence must be the exposing him to

great danger, should any infection remain.

[111] At Aleppo 20. (Russel.)

Mr. Howard took a voyage to Venice in a ship with a foul bill, on

purpose to know every thing relative to the performance of quarantine.

“A messenger (says he) came in a gondola to conduct me to the new

lazaretto. I was placed, with my baggage, in a boat fastened by a cord

ten feet long to another boat in which were six rowers. When I came

near the landing place the cord was loosed, and my boat was pushed with

a pole on the shore, where I was met by the person appointed to be my

guard. Soon after unloading the boat, the sub-prior came and showed

me my lodging; a very dirty room, full of vermin, and without table,

chair or bed. That day and the next morning I employed a person to wash

my room; but this did not remove the offensiveness of it, or prevent

that constant head-ach which I had been used to feel in visiting other

lazarettos and some of the hospitals in Turky. My guard sent a report

of my health to the office, and, on the representation of our consul,

I was removed to the old lazaretto. Having brought a letter to the

prior from the Venetian ambassador at Constantinople, I hoped now to

have had a comfortable lodging. But I was not so happy. The apartment,

consisting of an upper and lower room, was no less disagreeable and

offensive than the former. I preferred lying in the lower room, on a

brick floor, where I was almost surrounded by water. After six days,

however, the prior removed me to an apartment in some respects better,

and consisting of four rooms. Here I had a pleasant view; but the

rooms were without furniture, very dirty, and no less offensive than

the sick wards of the worst hospital. The walls of my chamber, not

having been cleaned perhaps for half a century, were saturated with

infection. I got them washed repeatedly with boiling water, to remove

the offensive smell, but without any effect. My appetite failed, and

I concluded I was in danger of the slow hospital fever. I proposed

whitewashing my room with lime slaked in boiling water, but was opposed

by strong prejudices. I got this, however, done one morning through the

assistance of the British consul, who supplied me with a _quarter_ of

a bushel of fresh lime for that purpose. The consequence was, that my

room was immediately rendered so sweet and fresh, that I was able to

drink tea in it in the afternoon, and to lie in it the following night.

On the next day the walls were dry, as well as sweet, and in a few

days I recovered my appetite. This room was lime-whited in November,

and in a very rainy season. In the following March, in complaining

to the under sheriffs in Newgate of their inattention to the clause

which orders this in the act of parliament for securing the health of

prisoners, their excuse was, that they were afraid of dampness.”

An health-office was established at Venice in 1448, in the midst of a

very destructive pestilence. The old and new lazarettos are both built

on little islands, surrounded not only by canals, but high walls.

They have only a ground floor, and one over it, and are divided and

subdivided into a great number of apartments, each having an open

court in front, with plats of grass, which is not suffered to grow too

high; nor are any trees suffered to grow within this district, or a

good way from it. The internal government is managed by a prior, who

must not be related to the magistracy nor any of its ministers. He

must have no interest nor concern in shipping nor in trade. He must

see all the gates and doors of the apartments locked every evening by

sunset; he takes the keys into his possession, and suffers them not to

be opened before sunrise; and, in case of any suspicion of infection,

the gates must be kept constantly locked, and opened only for necessary

occurrences in presence of the prior. He must not suffer dogs, cats,

&c. to lodge in the lazaretto. He must neither buy nor sell, nor suffer

others to do so, within the lazaretto. No fishing boats or other small

craft to come within a certain distance, or keep communication with

those performing quarantine. Provisions are received by poles seven

or eight feet long, and the money dipped in vinegar and salt water

before it is received. The prior and his substitute must carefully

avoid touching either goods or passengers in quarantine, and for this

purpose they keep a cane to make those who approach them keep their

proper distance; but if by an unfortunate accident they should be

contaminated, they must perform quarantine. Any person maliciously

touching them is liable to punishment.

Ships are strictly forbid to use any ropes but such as are tarred.

Wool, silk, cotton-wool, woollen and linen clothes, and furs

especially, are accounted the most dangerous goods. Animals with long

hair are subject to full quarantine; but short haired ones purged by

swimming ashore; feathered animals, by sprinkling with vinegar till wet.

The celebrated Dr. Mead, though an enemy to the cruel mode of

abandoning the sick, or treating them with any kind of harshness, was

perfectly sensible of the necessity of using every precaution for

preventing pestilential contagion from being imported. In his opinion

it is not sufficient that ships should perform quarantine, “the only

use of this being to observe whether any die among them. For infection

may be preserved so long in clothes among which it is once lodged,

that as much, nay, more of it, if sickness continues in the ship, may

be brought on shore than at the beginning of the forty days, unless

a new quarantine be begun every time any person dies; which might

not end but with the destruction of the whole ship’s crew.” He is

therefore of opinion that lazarettos ought to be established on small

islands near the sea-coast; and in this Mr. Howard agrees with him.

The latter recommends the lazaretto at Leghorn as the best in Europe.

Dr. Mead also very much insists on the utility of destroying the

clothes of the sick, because, says he, they harbour the very _essence

of the contagion_. He quotes in favour of this opinion what Boccacio

says he _saw_ at Florence in 1348; viz. that two hogs, finding in the

streets the rags which had been thrown out from off a poor man dead of

the disease, after snuffling upon them, and tearing them with their

teeth, fell into convulsions, and died in two hours. This is one of

the things which Dr. Moseley looks upon to be incredible. It is indeed

very marvellous, and seems to be contradicted by M. Deidier’s account

of the dog at Marseilles who swallowed with impunity the filthy pus

and pestilential matter adhering to the dressings of plague sores:

but, when a person of credit informs us that he _saw_ any thing,

we scarce know how to contradict him. The evidence of pestilential

contagion adhering to clothes, does not depend on such accounts. That

lately quoted from Dr. Canestrinus is decisive on the subject; and he

informs us that one of the methods used by himself to stop the plague

in Zboina, above mentioned, was, the burning of the clothes of infected

persons. He says that the pestilential contagion resembles that of the

small-pox, in being of a fixed nature; and that all who studiously

avoided communication with the sick, or with whatever fomes might carry

the contagion, escaped it altogether. “That the contagion of the plague

(says he) may lie dormant for a considerable time, and be carried to

a great distance by the medium of packages, &c. and again revive with

its former violence, is proved by various circumstances. _Chenot_

relates, in his treatise on the plague which raged in Transylvania,

that the infection was revived a whole year after it had disappeared;

and other similar instances are adduced.” If this revival happened

from infected clothes or soft goods, it shows them to be dangerous

in the extreme; but of this we have not any direct proof, neither

indeed is such a belief quite consistent with what takes place in all

plagues, viz. that the clothes of the infected are worn by the sound,

without producing any reinfection. In the great plague at London, for

instance, where an hundred thousand probably perished, and a much

greater number must have been infected, we cannot suppose that all the

clothes belonging to such an immense multitude were burned, or never

made use of again. It is of necessity therefore that we suppose the

pestilential contagion to become effete, and to lose its virulence,

after some time; and this seems to be very much hastened by exposure to

the atmosphere. The doing of this, however, by obliging people to put

their naked arms into bales of suspected goods, has such an appearance

of cruelty, that Dr. Mead has proposed to judge of the presence or

absence of infection by allowing little birds to fly about among them;

“because (says he) it has been observed, in times of the plague, that

the country has been forsaken by the birds; and those kept in houses

have many of them died.” But, though he says this upon very great

authority, no less than that of Diemerbroeck, yet we can by no means

look upon the fact to be absolutely determined. Dr. Russel indeed says

that the desertion of the birds is looked upon by the Turks to be the

_sign_ of an approaching plague; but this failed in 1760. Thucydides

says that birds of prey deserted the territory of Athens during the

great plague in his time; and he supposes them to have been poisoned by

feeding upon the bodies of such as died of the disease. It is possible

that such food might be disagreeable to them, but no proof is brought

of any of them having been actually poisoned by it. As for birds kept

in houses, it is possible that in a time of general calamity they might

have been neglected, and died for want of proper food, &c. Dr. Mead

also quotes an instance which cannot be credited in a consistency with

undoubted testimonies that pestilential contagion does not extend but

for a very little way. Upon opening an infected bale of wool in the

field near Cairo, “two Turks employed in the work were immediately

killed, and some birds which happened to fly over the place dropped

down dead.” Such accounts have arisen from a supposition that the whole

mass of atmosphere was violently infected; but this would be totally

inconsistent with the life of any human creature, and we may well put

down this, as that of pestilential infection arising from cities

like a cloud, as merely chimerical.[112] It is too well known that

pestilential contagion, instead of soaring in the air, keeps very near

the ground.

[112] About the mouth of the river Gambia in Africa, after the annual

inundation of the river, the putrefaction of the mud, mixed with

animal and vegetable substances, becomes so great, that the birds

manifest their disgust by soaring to an immense height in the air.

This is a natural consequence of the levity of putrefactive vapours

compared with the common atmosphere. As these vapours, however, are

composed of several kinds of gases, it is possible that some may

descend, while others ascend; and thus the contagious part, tending

to the earth, may violently affect the people who are confined among

it, while the birds escape; but there is still wanting some positive

evidence that ever the true plague did arise from this cause.

We now come to the second mode of prevention, viz. removing these

local causes which, in the opinion of some, may produce a plague in

any country, and, in that of others, may increase or set in action the

contagion previously existing. These causes have been enumerated by the

late Dr. Smith,[113] in a Dissertation on the pestilential Diseases

which at different times appeared in the Athenian, Carthaginian and

Roman armies, in the neighbourhood of Syracuse. They are, 1. The

climate and season. 2. The situation of the armies; and, 3. Their

condition. The climate of the island of Sicily in general he observes

is extremely pleasant at some seasons of the year; in the neighbourhood

of Syracuse particularly storms are so infrequent during the former

part of the year, that the sun is never obscured for a whole day.

Even in the month of January, however, the weather is warm, and as

the season advances the heat becomes insupportable. In autumn it is

rendered somewhat unpleasant and unhealthy by the frequent rains and

chillness of the evenings. But, in particular places, during the

hottest season, nothing can exceed its unhealthiness. According to

Barichten, “the least stagnant water is sufficient, in the heats of

summer, to poison the atmosphere: its effects on the countenances of

the poor people who live in its vicinity are evident; and a stranger

who travels through the island in this season ought to avoid ever

passing a night near them.” De Non says, that “as soon as the sun

enters the Lion, this country becomes the house of death: fevers of

the most malignant kind seize on the imprudent or unfortunate wretch

that spends a night near them (ponds and marshes) and few escape with

life when attacked by so virulent a disorder.”

[113] Med. Repository, vol. ii, p. 367.

To the poisonous effluvia of these marshes the Doctor attributes, in

an especial manner, the plagues which took place in the armies. In the

second year of the Peloponnesian war, the Athenian army was encamped,

as we are told by Thucydides, “upon marshy and unwholesome ground;”

and that such kind of encampments will produce diseases in an army

is well known. In the time of Dionysius, when the Carthaginian army

under Imilco suffered so dreadfully, or rather was totally destroyed,

his camp was situated on an eminence between two morasses, the heat

at that time being excessive. Hannibal, the predecessor of Imilco,

had also lost great part of his army by a plague, though he had been

encamped in a healthy situation; but, in order to raise a wall which

should overlook the city, he had taken the materials of the tombs

found in the common burial place, the city at that time containing

two hundred thousand inhabitants. “From the uncovering and disturbing

of so many dead bodies (says our author) arose a terrible pestilence,

which carried off immense numbers of the Carthaginians, and amongst the

rest the general himself.” To the unhealthy situation of the armies

also the Doctor ascribes the plague which took place in the Roman

and Carthaginian camps in the time of the second punic war; and the

Carthaginians suffered most, by reason of their being nearer to the

marshes. The state of mind, the cleanliness of the person, &c. also

must be taken into account; and our author shows that neither of these

could be supposed favourable to the Carthaginians.

That personal cleanliness, and breathing pure air, should contribute

to the health of individuals, or to any number of them collected

into camps or cities, seems to be agreeable to reason and common

sense; nevertheless we find that this has been denied, and even Dr.

Canestrinus says that “in the plague of Lyons and Marseilles it was

observed, that the most populous parts of these cities, _where the

streets were narrow and filthy_, suffered _less_ from the disease than

those which were more airy and clean. At the time of the plague in

London in the time of Charles II, the physicians advised that all the

_privies_ should be opened and exposed; the fetid odour from which

having pervaded the city, the plague was stopped! Is it from this cause

(the author asks) that the plague has seldomer visited Spain, the towns

of which are intolerably offensive from their want of cleanliness?”[114]

[114] Medical Review, vol. iii, p. 260.

This certainly seems a very strange doctrine, nevertheless the fact

that Spain is but little subject to the plague seems undeniable, and as

it is no less certain that the towns are excessively filthy, it would

seem that cleanliness is not effectual in preventing it. But, however

agreeable the smell of human excrements may be to the Spaniards, or

to the English physicians in former times, it seems to be less so at

present. “I am persuaded (says Dr. Ferriar) that mischief frequently

arises from a practice common in narrow back streets of leaving the

vaults of privies open. I have often observed that fevers prevail most

in houses exposed to the effluvia of dunghills in such situations.”

In Spain the opinion seems to have been but lately eradicated; for

some years ago, an order having been issued by government that the

streets of Madrid should be kept somewhat cleaner, the people were

so much exasperated at being threatened with the loss of the savoury

odour, that a rebellion had almost ensued, and the physicians declared

the smell of human excrements to be the most wholesome thing in the

world.[115]

[115] It seems, however, of late, that at least the city of Madrid is

kept clean. Swinburne says, speaking of the palace at Madrid, “To the

west it has the town, the three principal streets of which terminate

in the Pravo. These are three noble openings, excellently paved, and

clean even to a nicety; indeed so are most of the streets of Madrid

since the edict for paving and cleaning them.[116] The foreigners

that resided here before that time, shudder at the very recollection

of its former filth. Some of the natives regret the old stinks and

nastiness; as they pretend that the air of Madrid is so subtil as

to require a proper mixture of grosser effluvia, to prevent its

pernicious effects upon the constitution. The extremes of cold and

heat are astonishing in this place, and the winds so searching, that

all the Spaniards wear leathern under waistcoats, to preserve their

chests; for they pervade every other kind of clothing.”

The former filthiness of Madrid, together with its being situated in

a climate exposed to the vicissitudes of extreme heat and cold, and

its exemption from the plague under those circumstances, certainly

presents a most solid objection to the theory of the domestic origin

of plague. To the same purpose see below the remarks on the climate

of China.

[116] Dillon has a like remark in his “Travels through Spain.”

That the confinement of human effluvia, along with heat and want of

water, will produce a malignant fever, is certain from the example

of the unfortunate people confined in the Black Hole at Calcutta. In

this case the distemper seems to justify the opinion that plague may

be artificially produced, perhaps more than any other upon record; for

Dr. Ferriar informs us that it was attended with eruptions resembling

those of the true plague. In this case, however, the confinement was

beyond example in any situation which can be supposed incident to a

city or camp. There is no country in the world where the inhabitants

are equally numerous with those of the empire of China, its population

at present being estimated by Sir George Staunton at _three hundred

and thirty-three millions_, a number equal to _one third_ of the

supposed inhabitants of the whole globe; of consequence the cities

must be immensely crowded with inhabitants; yet it remains free from

plagues. Human effluvia therefore, in the most populous state in which

mankind can exist in society, _are not_ able to taint the atmosphere

of a country or city. The following is Dr. Clark’s account of that

celebrated empire: “The whole empire of China is represented to be

extremely delightful; the soil rich, the air pure, and the industry of

the inhabitants astonishing. As it produces every luxury and necessary

of life, it is justly esteemed one of the most fertile countries in the

world. As the Chinese prohibit emigration, and seldom or never engage

in war, their country is extremely populous. Every river maintains a

proportion of inhabitants adequate to the land, whose families live

continually in boats, without having any other place of residence.

Their number of people lays them under the necessity of carrying

industry to the greatest height; for otherwise their country, fertile

as it naturally is, would be insufficient to maintain the inhabitants.

Every inch of land is cultivated; no forests nor woods, nor even a

single tree, is suffered to obstruct the labours of the husbandman.

Canals are cut every where to water the fields, and marshes are manured

for the cultivation of rice. By these means health and plenty are, in a

great measure, the portion of its inhabitants through all the seasons

of the year. The only terrible and fatal diseases to which they seem to

be subject are the small-pox and leprosy.”

But, though our author determines in general that the air of China is

pure, this cannot apply to every part of it without exception. On the

contrary he describes in the following manner Wampoa, a village about

fourteen or sixteen miles below the city of Canton, on Canton river:

“It is the usual station of all European ships in this river. On one

side the land is low, marshy, and covered with water, forming swamps

fit only for the cultivation of rice. The extent of these swamps is

considerable; the tide rises high, and overflows great part of them;

but the intersection of the rivers renders them more pure than they

would otherwise be; and consequently the air is much healthier than one

could expect from the unfavourable aspect.”

In like manner Canton city he says “is built on a very extensive plain,

and is large and populous. Here the government allow the English,

Dutch, French, Danes and Swedes separate factories on the banks of the

river. The city, though paved, is very wet in rainy weather; and the

water makes its way under the factories of the different nations every

tide. The houses are built with bricks; the apartments are in general

small, and not very lofty, and the ground stories are very damp. When

the business of the season is over, the supercargoes remove to Macao,

a Portuguese island, subject to the Chinese government. The city of

Macao is situated on a rising ground; the whole island is dry, rocky

and barren; it is, however, plentifully supplied with provisions by

the Chinese; and, though the air is very sultry, yet it is tolerably

healthy.”

From the preceding account it is plain, that the causes which operate

in the production of plagues and epidemic diseases in other countries,

though they exist in China, do not act there with equal efficacy.

At Wampoa the marshes in the neighbourhood must, in the hot season,

emit noxious effluvia as well as any where else, and there can be no

certainty that the overflowing of the tide is sufficient to put a stop

to their malignant influence. At Canton the water penetrates below the

floors of the houses, and we have seen from Dr Fordyce[117] that _in

other countries_ the sprinkling of a floor with clean water, and the

encampment of an army upon ground where water was found at a small

depth below the surface, were sufficient to produce fevers; yet here

it is not so. In this city also the inhabitants are numerous, and the

apartments small; so that neither the perspiration of multitudes, nor

the moist exhalations from water stagnating in the streets, nay, under

the houses themselves, are able to produce the diseases in question.

Again, at Macao the sultry heat of the air has as little effect as the

rest.

[117] See p.p. 171, 172.

Lastly, in Pekin, the capital, the population and the crowd are

immense. According to Sir George Staunton,[118] the city is about one

third larger than London; but, as he supposes[119] it to contain three

millions of inhabitants, the population must be twice and a third-part

as great as that of London in proportion to its bulk. “The low houses

of Pekin (says he) seem scarcely sufficient for so vast a population;

but very little room is occupied by a Chinese family, at least by

the middling and lower classes of life. In their houses there are no

superfluous apartments. A Chinese dwelling is generally surrounded by

a wall six or seven feet high. Within this enclosure, a whole family

of three generations, with all their respective wives and children,

will frequently be found. One small room is made to serve for the

individuals of each branch of the family, sleeping in different beds,

divided only by mats hanging from the ceiling. One common room is used

for eating.”

[118] Authentic Account of an Embassy, &c. vol. ii, p. 54.

[119] Ib. p. 39.

Where diseases are prevalent, circumstances of the kind just mentioned

would certainly be urged as evident _causes_ of them; but in China

we see that _something_ disarms such causes of their power. People,

however, seldom want a salvo for any thing. “The crowds of people,

at Pekin (says our author) do not prevent it from being healthy. The

Chinese indeed live much in the open air, increasing or diminishing the

quantity of their apparel according to the weather. The atmosphere is

dry, and does not engender putrid diseases; and excesses productive of

them are seldom committed.” But, if the dry air at Pekin contributes to

the health of the people, why does not the moist air of Canton produce

diseases? Besides, in this empire there are multitudes of people who

live entirely upon the water, in a kind of houses constructed upon

junks, employed in carrying grain from place to place, or for other

purposes.[120] Sir George Staunton computes the number of inhabitants

on a branch of a single river to be no less than an hundred thousand.

What then must they be throughout the whole empire! Yet these people,

though continually exposed to moisture, as well as to an almost

inconceivably crowded situation, are yet no more subject to epidemics

than others. Our author does not specify the _excesses_ which produce

disorders. Intemperance in drinking no doubt is one of them; but Dr.

Patrick Russel expressly says, that he never saw an instance of the

plague being brought on by intemperance.

[120] Authentic Account, &c. vol. i, p. 290.

Lastly, with regard to living in the open air, Mr. McLean has ascribed

to the vicissitudes of this element the principal if not the _only_

cause of epidemics. “A fact worthy of notice (says he) is, that aged

persons and children are both seldomer and less severely attacked by

epidemics and pestilential disorders than the young and middle aged,

and women seldomer and less severely than men. Now, if contagion was

the source of these diseases, the case would be exactly reversed. Old

people, women and children, being more in the way of contagion, would

be more frequently and more severely attacked. But the young and middle

aged, being more exposed to the _vicissitudes of the atmosphere_,

the principal source of those diseases, they are consequently more

severely attacked. It has been a puzzling question to solve why old

people and children are less exposed to plague, &c. but the solution

will be no longer difficult if it should be proved that these diseases

are _always_ produced by certain states or vicissitudes of the

atmosphere, together with the application of other powers co-operating

in the production of indirect debility.” In the country we speak of,

however, this solution fails in a manner almost as evident as can be

imagined. “The removal of the embassy, (says Sir George Staunton)

was a disappointment to several persons belonging to it, who had

made arrangements for passing the winter at Pekin. Judging of its

temperature by the latitude of the place, a few minutes under 40°

north, they were not aware of the violent effect of the great range

of high Tartarian mountains, covered perpetually with snow, upon that

capital, where the average degree of the thermometer is under twenty

in the night during the winter months, and even in the day time is

considerably below the freezing point. The usual inhabitants were

guarded against cold, not only by habit, but by an increase of clothing

in proportion to its intenseness, consisting of furs, woollen clothes

and quilted cottons. They are not accustomed to the presence of fire.

They have no chimneys, except to kitchens in great hotels. Fires, on

which Englishmen chiefly depend against suffering by the sharpness of

the atmosphere, could not well answer that purpose in houses which

are so constructed as to admit the external air almost on every side.

Stoves are, however, common in large buildings. These stoves are

situated frequently under the platforms on which the inhabitants sit

in the day time, and rest at night. The worst weather experienced

in that capital might be considered as mild by the Tartars, coming

from a climate still more rude; but other foreigners are said to feel

themselves less comfortable at Pekin in the winter than in the summer,

though the heat is then raised to the opposite extreme. In both they

seem to require a seasoning. _Several individuals of the embassy fell

ill during their stay; and all did not recover._ The human frame seems

calculated for the hottest rather than the coldest atmosphere, and to

exist at the equator rather than the pole.”

Here we are involved in difficulties much greater than before. It

appears that even the fine climate of China is healthful only to its

own inhabitants. They can bear the _vicissitudes_ of the air, which

Europeans cannot. The prevention of plagues or mortal diseases then

must consist in some mode of living by which people can accommodate

themselves to the country which they inhabit, and without which every

other precaution will be ineffectual. The diseases with which the

attendants of the ambassador were seized could not be owing to any

slovenliness or dirtiness in their lodgings or food, or to want of

apparel; nor were they more exposed to the inclemencies of the air than

others; only they were in a strange country, where that inexplicable

constitution of the elements acted upon them in a manner different from

what it did on the natives, and, while it was friendly to the latter,

proved pernicious to the former. But there was a time when even China

was as unhealthy as other countries; for the great plague in 1346 began

in the northern part of it. We have seen, in a former section, that

this was preceded by the most dreadful and violent wars throughout the

whole Asiatic continent. Since the cessation of these violent wars

the Chinese have staid at home, and applied themselves to the arts of

peace, particularly to agriculture, which they have carried, we may

say, to its utmost perfection. This seems therefore to be the true

method of removing all those local causes which produce epidemics, or

at least of preventing them from doing hurt; and, without attention to

the natural duties and occupations of man, it is to be feared that all

artificial modes of prevention will be found not only precarious but

ineffectual.

Dr. Smith in the dissertation above mentioned observes, that “it may

be doubted whether any _moral_ cause would be sufficient to protect,

for a long period, an unaccustomed resident in a marshy situation from

the usual consequences.” This is no doubt very probable but, from the

example of Lord Macartney’s attendants in China, it appears equally

probable that it makes little difference whether the country be marshy

or not. Dr. Lind has many excellent observations upon the subject of

unhealthy countries, and gives particular directions for strangers how

to act, when obliged to expose themselves to the inclemencies of the

weather; but none of these being effectual in preventing the access

of the true pestilence, we must still adhere to the old Latin adage

already quoted, p. 302. Flight seems to be the most effectual method.

To avoid migrations to those countries where it usually rages, and,

if it were possible to persuade the inhabitants of such countries,

to imitate the example of Chinese industry, instead of allowing the

greater part of the territories they possess to lie waste, would in all

probability gradually lessen both the frequency and violence of this

terrible disease. Migrations of large bodies of people, especially for

the purposes of war, are greatly to be dreaded. If a few Englishmen,

possessed of every thing necessary, could not keep their health at

Pekin, what must have been the probable consequence of landing an

army of an hundred thousand, with a view to conquest? Or what could

we expect if the Chinese were to “pour forth by millions” into other

countries in order to conquer them? Dr. Lind takes notice that even

of the first Portuguese adventurers to Africa, such as escaped the

first sickness continued afterwards to enjoy good health. He likewise

observes that many who left Britain, after being seasoned to the

countries to which they went, chose rather to remain abroad for life,

than to run a new risk by going back to their own country. It is not

therefore so much the greater unhealthiness of the country to which we

go, as the _change_, which is to be dreaded. If therefore great bodies

of men will employ themselves in constant rambling from one country to

another, no wonder that diseases break out among them, unknown, either

in the countries they have left, or those to which they go.

We come now to the third mode of prevention, viz. that of destroying

the infection after it has begun to exist. This is varied according

to the nature of those things which we suppose to be infected. The

general notion of infection taking place in the atmosphere has been

already spoken of; but the uncertainty of this hypothesis, and the

apparent impossibility of altering a constitution of the atmosphere,

must certainly leave very little room for hope in this case. It hath,

however, been attempted by various methods. Hippocrates adopted the

opinion that all diseases were produced by the air, and from him it was

borrowed by Lucretius, as we are informed by the annotator on Creech’s

Translation of that author. “In his book _de Flatibus_ (of winds) says

the annotator, after a long narration of the effects that the air

produces, he at length falls on the subject of diseases, all of which

he affirms to be bred and generated in the bodies of animals by means

of the air. First (says he) I will begin with the most common fevorous

disease, which accompanies, in a manner, all diseases whatever. For

there are two sorts of fevers, one that is promiscuous, and common to

all, and is called the _plague_; the other, by reason of unhealthful

diet, is peculiar only to such as use that diet; but of both these

kinds of fevers the air is the sole author and cause, for the common

fever or plague happens alike to all, because they all breathe the same

air; and it is certain that the like air, being alike mingled in like

bodies, must beget like fevers.” In consequence of his theory, this

great physician advised to have recourse to fire as a purifier of air

in times of pestilence. But experience doth not warrant the success of

this method; neither indeed can we suppose that it could be successful,

unless people were able to kindle such fires as would absorb the whole

atmosphere of a country. This method was tried in London without the

least success; nay, seemingly with bad effect; for, the very night the

fires were lighted, more than four thousand people died; and, a few

days after, an end was put to the experiment by such violent rains as

extinguished all the fires at once.

The burning of infected clothes has already been taken notice of; but

though this must certainly prevent any new infection from arising from

_these_ clothes, it will not prove that the infection may not evaporate

during the time of burning, and, being volatilized even beyond its

natural pitch, by the heat, may do mischief at a greater distance than

could have happened had they been let alone. The instance, formerly

quoted from Dr. Huxham, of the small-pox being disseminated by the

smoke of burning infected clothes, if not a _proof_, affords at least a

strong presumption, of the danger of such a practice. The only way of

perfectly ensuring safety in such a case would be to burn them by the

sea-side, when the wind blows from the shore. Were the smoke allowed to

pass over land, and great piles burnt at once, it is impossible to say

how far the contagion might be carried.[121]

[121] In the time of the great fire at London, in 1666, ashes are

said to have been carried to sixteen miles distance.

Another mode of purification is by exposing suspected goods to heat,

to the vapour of vinegar, &c. fumigating with gun-powder, sulphur, &c.

and on this principle various powders of fumigation have been invented;

some of which are said to have been very successful in Russia; and the

composition of one is given by Dr. Alexander Russel in his Natural

History of Aleppo; but all these are undervalued by Dr. Guthrie,[122]

who calls the practice of fumigation or smoaking, an “inadequate and

ineffectual ceremony.” Dr. Mitchel, also discommends them, saying that

they are advised “without any proof that these destroy pestilential

matter, and while, at the same time, it is certain that they diminish

more or less the wholesomeness of the atmosphere with which they are

mingled.”[123] Of late the vapours of pure nitrous acid (the _nitric_,

according to the new nomenclature) has been recommended, with the

boldest appeal to experience; but the consideration of this naturally

belongs to the second part of this work, where we shall have occasion

also to consider the theory of the septic acid. In the mean time

we must go on with some farther account of the different modes of

fumigation.

[122] Duncan’s Med. Comment. vol. viii p. 350.

[123] Med. Repos. vol. ii, p. 433.

“There is no better corrective (says Allen from Diemerbroeck[124])

of a pestilential air, than fire; as much experience has taught us.

Hippocrates subdued and extinguished that famous plague, which came

amongst the Grecians from Ethiopia; for he commanded great fires to

be kindled throughout the whole city, especially in the night time,

to purge away the pollutions of the air. It is believed that a fire

made with juniper-wood or ash, tends much to correct the venomous

corruptions of the air. The kindling of sulphur and gun-powder purify

the air, and drive away its corruptions; so does the burning of amber,

pitch, frankincense, &c. so do the fumes of vinegar raised with red-hot

irons, or bricks.” According to Etmuller, “Hippocrates drove away _that

famous plague_ in Greece by the use of sulphur; the fumes of it are

very much commended to correct the air, and make drink more wholesome;

it prevents all manner of corruptions and alterations, as well as the

putridinous alteration of the blood. In a great degree of malignity,

the shirt and clothes may be impregnated with the fume of sulphur.”

[124] Synopsis, vol. i, p. 80.

Here we have accounts of a disease, called _that famous plague_, driven

away by two different methods; and, to complete our dilemma, Dr.

Canestrinus tells us that the _plague at Athens_ is said to have been

staid “by sprinkling the streets with wine.” What an expensive remedy,

when the odour of _privies_ was afterwards found to answer as well!

“Whilst the plague was raging at Oczakow, an _earthquake_[125] happened

on the very day that it began to decline. In this case did any vapour

issue from the earth destructive of the pestilential contagion? or did

former noxious exhalations cease in consequence of the convulsion of

the earth?[126] Sorbait relates, that, in the time of the vintage in

the neighbourhood of Moselle, the plague ceased like a miracle, while

the must was in a fermenting state. At Vienna likewise it was observed

that, during and at the close of the vintage, the disease manifestly

declined; which may have been owing to the great quantity of fixed air

in the atmosphere.”

[125] Earthquakes, as we have already seen, might be accounted

rather a _sign_ or _cause_ of the beginning of pestilence, than of

its departure. A great quantity of electricity in the atmosphere

has accordingly been enumerated among the signs of an approaching

pestilence. Thus in Burnet’s Thesaurus, p. 699, we find among the

previous signs of a plague, “plurima et fere continua nocturna

fulgora, sine pluviis et tonitruis, cœlo non nubiloso existante.”

Very much and almost continual lightning at night, without rain or

thunder; the sky in the mean time not being covered with clouds.

[126] Before we can attach any degree of probability to either of

these suppositions, it must be proved that plagues arise out of the

earth. But this, though as plausible as many other hypotheses, is not

yet supported by any direct proof.

To this our author adds, that “places adjoining to spice-shops have

generally remained free from infection; and, in the plague of London,

all those employed in shipbuilding escaped the disease. Smiths also

and cooks remained uninfected.” M. Volney tells us that, in Egypt,

water-carriers are exempted; and Baldwin, that oilmen are in the same

happy predicament; while on the other hand Allen quotes Boerhaave

saying, that “Forestus, Diemerbroeck, the French, English, and Germans,

observed, that all dealers in soap, washers, and all who by their

business used soap, nay, _who only wore shirts washed with soap_,

presently died of the plague.”

From so many and so discordant opinions, the only conclusion we can

draw is, that, when once a pestilence has invaded a country, there is

not any possibility of operating upon the contagion in such a manner as

to destroy it. If the plague ceases, it must do so naturally, and we

_cannot_ accelerate this cessation. This is entirely conformable to the

opinion of Dr. Patrick Russel. Speaking of the decline of the plague at

Marseilles, and the vigorous exertions of the magistrates to put a stop

to it, he says, “The causes now enumerated might no doubt have some

effect, but a more powerful and general cause had begun long before to

restrain the havock of the pestilence, which had declined visibly in

the month of September, and in those of October, November and December

declined with a rapidity not ascribable to the exertions of the most

vigorous police. This cause is generally supposed to be some change in

the constitution of the air; but which has hitherto been defined with

no better success than that peculiar state of the atmosphere which,

in conjunction with contagion, is absolutely necessary to render the

plague epidemical.”

Dr. Russel takes notice of the methods of extinguishing contagion

already mentioned, by kindling fires, &c. and disapproves of them.

We shall not therefore spend more time in considering whether or not

there is any probability of eradicating or mitigating the violence of

a plague when once it is introduced. However this may be impracticable

in so large a space, it seems that it certainly may be done in

smaller spaces, ships for instance; or, if not with the true plague,

at least with malignant and infectious fevers. Dr. Trotter, in his

Medicina Nautica, has laid down methods for accomplishing this, and

expresses the highest confidence in their success. He adopts the

doctrine of _contagion_, of which he gives the same definition that

in this treatise is given of _infection_, viz. “Something propagated

from diseased bodies, or from substances that have been in contact

with them, producing a similar disease in other persons[127]--the

propagation of contagion, as well as its reception into the healthy

body. A more aggravated degree of malignity will generate a greater

quantity of infection, and, as it may be confined in a larger or

smaller space, it will be less or more noxious. A fever may be called

malignant, when, with the symptoms of debility, there is a cadaverous

smell arising from the body, an unusual fœtor of the breath, stools,

and other excretions, the tongue black and parched, the eye dusky or

yellow, the countenance bloated and dejected, and the skin sallow.

In approaching a sick bed of this kind, a person not much accustomed

to such visits will be very liable to receive the infection; and the

unpleasant smell will be much sooner perceived than by the physician

or other attendants. We conclude that a malignant typhus is more apt

to generate contagion, because slight cases are found not to extend to

others, even though no mode of precaution has been used. The disease

itself is incapable of generating infection, till after a certain

period; but this period is uncertain: it seems to depend on the

nature of the symptoms, whether they are mild or malignant. _We are

assured of this fact, from a timely separation having prevented the

farther progress; and by this means_ ALONE, _I apprehend, we eradicate

contagion in_ SHIPS, _or_ ANY WHERE ELSE. In the small-pox[128] the

disease seems incapable of infecting another person before the second

or third day of the eruption. With the measles it is otherwise. The

disease may be propagated at the most early stage of the eruption; and,

if I was to be allowed to conjecture on the subject, I would say, that

the contagion is the offspring of the catarrh (the cough and hoarseness

resembling a cold) which accompanies the measles.

[127] Medicina Nautica, p. 173, _et seq._

[128] In the plague, Dr. Russel has observed, that those who die in

a very short time are much less ready to communicate infection, than

those who live longer. He also takes notice, that “the plague, though

a contagious disease, is not equally contagious in every period of

the pestilential season. In the beginning those frequenting the sick

often escape unhurt, or one only, out of several, is infected. The

escape of persons employed about the sick, proves a frequent cause

of misleading the popular opinion of the disease, and has in many

instances occasioned much mischief, by encouraging the neglect of due

precautions till too late.”

“Substances imbued with the exhalations from infected bodies, if not

exposed to the air, have their powers of communicating the disease

increased; or, in other words, the infection from _fomites_ (infected

cotton, clothes, &c.) is said to become more virulent than it was when

first separated from the body.

“I am of opinion, with others, that the exhalations or excretions of

the sick are the vehicles of contagion. It is these which impregnate

the atmosphere with noxious matter: they affect in like manner

bed-clothes, or apparel, and every thing that can imbibe them, when

in contact with the diseased body. When bed-clothes, or body-linen,

but particularly silk or woolen cloth, have been exposed to these

exhalations, and then heaped together for a length of time, the noxious

effluvia are, as it were, multiplied, and will more certainly infect

others than they did at first. The bales of goods which brought the

plague to Marseilles, and affected the people that opened them so

suddenly, had their virulence increased by not being duly ventilated.

When the jail-fever was brought into court by the prisoners at Oxford

assizes, and more lately at the Old Bailey, the fever was propagated

from the clothing of the prisoners; no doubt, from being confined in

impure, ill-aired cells, this infection became more virulent. The

highly concentrated state of contagion, in the bales of goods, could

only have been brought to that degree of virulence from the closeness

of the package: it cannot be supposed that human beings could have put

them together otherwise. The nurses of hospitals know well, as Dr. Lind

tells us, that there is most danger of catching a fever when they pile

heaps of bed-clothes or body-linen together for a few days, before it

is carried to the wash-house. The washer-women at Haslar have also told

me the same thing. They know when a dangerous fever is in the hospital

by the bad smell of the clothes: this makes them air them abroad, till

the smell is gone, and then they can wash them with safety. But, if it

happened, from the hurry, that this could not be done, or if it was

neglected by design, many of them were seized with the sickness. The

porters and people employed in cleaning and fumigating the blankets and

beds at Haslar are well acquainted with this fact, and they measure

the danger by the badness of the smell. This ought to instruct every

body to stand to windward of these infected substances when they are

opened; as the current of air would then carry it the other way. In one

of the courts of justice, the people who stood between the prisoners

and a window, into which the wind blew, escaped the infection, while

those on the other side were sufferers.

“In the summer of 1793, while the Orestes brig, commanded by Lord

Augustus Fitzroy, lay at Plymouth, she was anchored very near and to

leeward of an army transport, which had on board a very malignant

fever among the soldiers. While the soldiers were moved on deck, to

go on shore to the hospital, the crew of the Orestes, from curiosity,

walked on deck to look at them. Such was the concentrated state of

the contagion among the clothing and bedding of these troops, on

bringing them from below, that eighteen people belonging to the brig

were quickly seized with the same fever, the infection of which had

been conveyed by the current of wind. It did not, however, extend much

farther in the Orestes, from the attention of her commander. But this

ought to be a caution for ships to keep clear of those that have fevers

on board, as a _virulent_ CONTAGION _may be conveyed to a considerable

distance_.

“Dr. Lind is inclined to think that washing the bed-linen in hot water,

even when first shifted, is attended with much risk; and that the

noxious matter may be volatilized by the heat of the water, and affect

the woman. For this purpose he has recourse to his favourite process,

of _fumigation_, to insure the washer-woman. The heat of his fumigating

furnace would no doubt dry the linen, and exhale any moisture; but our

practice in the Charon (the hospital ship) was, to plunge everything as

it came from the bed into a tub of hot water kept ready on purpose. The

linen was washed and dried immediately after. We had in that hospital

many malignant cases of typhus, and some deaths, yet no infection was

ever spread there.”

Our author next proceeds to inquire into the cause of this excessive

concentration of the infectious matter in _fomites_, or clothes,

bed-clothes, bale-goods, &c. The most plausible reason, he says,

that could for some time be assigned for this, “was, the generation

of animalcula; the cotton or woollen clothing was said to serve as

a nest for the corpuscles to multiply; and thus the contagion was

thought to increase seven fold.” This theory had an effect on the

practice of physicians, both as to the prevention and cure of fevers

supposed to proceed from thence. Our author looks upon the hypothesis

to be chimerical, because none of these animalcules have ever been

made visible by the best microscopes. But there is no necessity for

supposing the animalcules to be invisible to the naked eye. They may

creep on the ground, or fly in the air, without being observed by us.

Mr. Baker’s discovery of the insect which not only poisoned _eleven

hundred thousand_ times its bulk of water, but infected a much greater

bulk of air, with its effluvia,[129] shows that such a thing may be

_possible_; and in dubious matters bare possibility ought always to

produce inquiry. If the perspiration of human bodies when confined

becomes noxious, why may not that of a multitude of insects be so too?

There is no necessity for supposing that an insect must be swallowed,

or inhaled by the breath, before it can do hurt. What Dr. Trotter says

of the variolous contagion emitted from the human body will apply

equally to insects. “What has been called the insensible perspiration

(says he) which arises from the surface and the lungs, we have a right

to believe carries with it in solution a portion of the variolous

matter which charges the atmosphere with the contagion of small-pox,

even in such quantities as to impregnate the clothing of attendants and

visitors; by which means it has been frequently carried to families and

villages many miles distant from its source.” The smallness of size of

insects can be little objection here. A skunk is but a small animal,

yet it spreads its odour farther than an hundred diseased human bodies

could propagate the plague.[130]

[129] P. 189.

[130] Here, I hope, it will not be thought unreasonable to digress a

little in favour of the sensations of humanity which on all occasions

ought to predominate in our minds. Birds are the natural enemies of

that hateful class of beings we call _insects_, and which in general

are the natural enemies of man. In proportion to the havock we

make among the former, the latter will multiply upon us whether we

will or not. The wanton, indiscriminate, and I may add _provoking_

destruction exercised among this useful as well as beautiful and

agreeable part of the creation, must certainly be sometimes attended

with bad consequences. Though birds feed on many different kinds of

insects, yet there are exceptions. If then we totally exterminate

a species of birds, is it not probable that a species of insects

might appear, the mischief done by which we could not be able to

counteract? _Quere._ Is it not possible that the _Hessian fly_ may

have made its appearance from this cause?

On this subject, however, we may remark, that though the nurses and

attendants on hospitals measure the degree of infection by the smell,

yet people are by no means safe in approaching patients about whom no

smell can be perceived. We have already seen, from Dr. Fordyce, that

what may be called the _pure_ infection of fevers is not perceptible

by any of our senses; and there are examples of very offensive smells

issuing from diseased bodies without any contagion ensuing. Dr. Trotter

tells us, that “a patient in typhus was sent from the Venerable to the

hospital ship, with a fœtor about him, that exceeded any thing of the

kind that ever came within the Doctor’s knowledge. After being washed

and shifted, it still continued, and was perceived at a considerable

distance. He died in a few days, yet nobody was infected from him,

either in his own ship, or in our hospital. There was probably some

peculiarity of constitution here.” In M. Deidier’s experiments, above

related, the dog which eat the dressings of the plague sores, after

being infected with the disease, emitted a very disagreeable odour,

but we do not find that the odour was in any way infectious. In the

Encycloped. Britan, art. Med. _Hydrophobia_, we find an account of an

hydrophobic patient (and a patient who recovered) in whom the blood

drawn from a vein was as black as ink, and stunk abominably, yet

this stench was attended with no bad consequence. There is therefore

no essential connexion between offensive smells and contagion; yet,

as they are sometimes united, the absence of the smell ought not to

encourage us rashly to go into suspicious places, neither ought the

presence of it to deter us from venturing where we have otherwise good

reason to do so.

Having given up the doctrine of animalcula, the Doctor goes on to

explain the doctrine of concentrated contagion in a manner very

similar to that given in this treatise, viz. from the decomposition

of some kind of gas. “The fœtor of the breath (says he) perspirable

matter, &c. evidently demonstrate that they differ from the healthy

state. The smell, to our senses, comes very near what is called

_sulphurated-hydrogenous gas_. Some of the fluids within the body would

seem to be in some degree in a state of actual decomposition; unless

we can suppose the mucous glands of the lungs secreting a fluid that

taints the expired air in this manner. The decomposition of the fat,

which sometimes disappears very suddenly in fevers, may give some

ground for the supposition that a large portion of these exhalations

are composed of hydrogenous gas. But, whether we can go thus far or

not, what is separated from the body, it is plain, is more disposed

to decomposition than when the body is in health. Now this process

will still go on, whether exposed to the atmosphere or not, with

this difference, that, by exposing substances which have imbibed the

exhalations of the diseased to a free air, the noxious gases will be

dissipated as quickly as they are evolved; while, on the other hand, by

laying the clothes in a heap, packing them firm in a chest, or making

up cloth into small bales, the gases are concentrated into a small

space; and woe to the man who first inspires them.... Now this does not

hold out an idea that the powers of contagion are multiplied, as by

generation; for that would be to say, that these gases are _themselves_

what we call the matter of infection. I would only go so far as to

assert that they are the vehicles of it, till more certain experience

shall determine farther.”

With respect to fumigations with nitrous acid, our author repeatedly

declares that he has no confidence in them; nay, he brings instances

where they seemed to have bad effects. But as the dispute about

fumigation has no connexion with the true plague, nitrous acid having

never been used as a preventive for it, we shall defer any farther

consideration of it to the second part of this treatise, to which it

naturally belongs.

We come now to the fourth and last mode of prevention, viz. a

consideration of those means by which an individual, without separating

himself from society, and who is daily obliged to have communication

with the sick, may yet secure himself against infection. Here the

means recommended are extremely various, and some of them so opposite,

that we can scarce avoid suspecting them all. The misfortune is, that

though a person should go, without fear, among the sick, though he

should constantly take a medicine, and should never have the distemper,

yet we cannot say whether the medicine did preserve him or not. Were

it possible to know the particular constitution of the body which

disposed some to resist the attack of the disease, attempts might be

made to bring the constitutions of others to the same standard, but

unfortunately our ignorance here is so great, that any attempt to

alter the constitution of the body has generally proved unfortunate

even in other diseases. Dr. Lind informs us, that the first Portuguese

adventurers in Africa, having observed, that “such as had the good

fortune to escape a fit of sickness or death, soon after their arrival,

enjoyed afterwards a pretty good state of health, thence concluded,

that the blood of such persons had been entirely changed by the diet

of the country. Upon this erroneous principle they adopted a most

fatal method of seasoning people to these unhealthy climates. They,

by small quantities, frequently repeated, took away as much blood

as they supposed to be contained in the body, and thus they reduced

the patient to a state of extreme weakness.” From its being observed

that people of delicate constitutions are less liable to the plague

than others, such a mistake probably has also been made with regard

to this distemper, but with equally bad success. Allen tells us from

Diemerbroeck, “_Phlebotomy_, though mightily cried up by many of the

ancient and modern physicians, yet we reject it altogether, _as very

dangerous and detrimental_; for it appeared by experience that those

who made use of it for prevention’s sake were seized with the plague

soon after bleeding, wherefore we forbad it to all.” This may seem

surprising, as we find bleeding so much recommended by Sydenham as a

remedy; but by others it is equally reprobated; nay, Dr. Hodges tells

us that he never knew but one who recovered from the disease after the

use of it. Issues seem more likely, if not to prevent, at least to

render the disease more mild if it should attack. They are recommended

by Diemerbroeck, and Russel speaks of them as, “by some authors,

represented as almost infallible.” He cannot, however, recommend them

from his own experience, having never seen them opened for the purpose

of preventing the plague; and he justly observes, that when habitual

on any other account, they may perhaps lose their effect in this.

“Multitudes (says he) of both sexes at Aleppo had issues in their arms,

it being there a very common remedy in a variety of chronic disorders:

but, notwithstanding those outlets, numbers perished; and I did not

remark that those who had them were in any degree less liable than

others to be infected.”

Tobacco has been recommended as an excellent preservative, particularly

by Diemerbroeck, who writes with a kind of enthusiasm in its favour.

“Being called (said he) to visit a patient afflicted with the plague,

as soon as I entered his chamber I felt a most offensive smell of

excrements (for he had a diarrhœa) with which I was greatly affected.

Leaving the house after a very short visit, I instantly found myself

seized with giddiness, nausea, and uneasiness at the heart; so that I

had no doubt of my having caught the pestilential contagion. Laying

aside all business, therefore, I immediately returned home, and smoked

five or six pipes of the best tobacco; by the use of which all the

above-mentioned symptoms so totally vanished, that I felt not the

least uneasiness any more. Then, being again desirous to go abroad

and visit other sick people, I took a drachm of theriaca, and from

thence-forward was in perfect health. The same thing happened to me

three or four times during the time of this pestilence; and without

loss of time, according to the quantity of infection I supposed that

I had taken in, I had recourse to the more plentiful use of tobacco,

by which my health was restored. I always looked upon tobacco to be

an excellent preventive remedy, and its smoke I have sometimes found

useful to myself even in an incipient attack of the disease.[131]” He

then proceeds to inform us of a report that in a violent plague at

London all the dealers in tobacco were exempted. At Nimeguen, however,

they were not so fortunate; yet of the family of the principal tobacco

merchant (Thomas Peters, an Englishman) which was very large, none were

infected, excepting only one servant maid, and she quickly recovered.

[131] Diemerbroeck, Hist. 17, lib. 4.

On this remedy Dr. Russel makes the same remark as on the issues. “The

custom of smoking (says he), is universal among both men and women at

Aleppo. This too, from its being habitually practised, might perhaps

lose part of its prophylactic virtue: at the same time those who use it

as a preservative must always be supposed in some degree accustomed to

it, otherwise the violence of its operation on most persons, on their

first beginning to smoke, might prove hurtful. It should further be

observed, that the tobacco commonly used in Syria is much milder than

the American, and that the oriental smokers seldom or never spit.”

It hath been observed that the plague is stopped either by great heat

or great cold, but more readily by the former than the latter. “It has

generally been supposed (says Dr. Canestrinus) that the cold of winter

was destructive of contagious matter; but various instances of the

contrary may be collected. The plague in Transylvania continued through

the very severe frost in 1709. On the contrary it has been found, that

excessive heat has extinguished, or at least diminished, pestilential

diseases. During the plague at Aleppo the weather was unusually hot in

the beginning of July, and it was remarked that the disease declined

considerably; and in general Dr. Russel observed, that the plague

ceased at the hottest season of the year. The plague at Ockzacow,

which raged in the years 1738 and 1739, began in the month of April,

and continued with violence till July, when it declined considerably,

and entirely ceased in the month of September; in February of the year

following it re-appeared, and totally ceased in July.”

From these facts we might be led to suppose that a warm regimen, or

occasionally exposing the body to great heat, might be advantageously

used by way of prevention; but Dr. Russel justly observes, that the

human frame, “could it support such an application of fire and smoke as

is necessary to expel or destroy contagion from infected substances,

would probably receive little benefit from it, if infected; nor could

those in health sustain, without prejudice, the heat and dense smoke

which is probably required for the perfect extinction of the infectious

effluvia floating in the confined atmosphere of a morbid body.” He is

of opinion, however, that some kinds of fumigations may be of use,

and he mentions some of these, but says that the perfumes ordered by

the college are perhaps as proper as any, though their forms might be

rendered more simple. Heat alone can scarce be thought very proper

for prevention, and, when the disease is once begun, is said to be

detrimental. Dr. Guthrie quotes Baron Ash saying, that “in heated

rooms the disease is ungovernable: it is only in free air that it is

to be treated.” But of late a discovery has been made of a surprising

power in heated oil of removing this disease, insomuch that, if we

can believe what has been published of it, we must suppose it to be

little less than a specific. So great indeed has been the confidence

put in this method, that, by order of the Academy of Sciences at

Lisbon, it has been translated into Arabic, French and Portuguese.[132]

“The method was first proposed by George Baldwin esq. agent for his

Britannic Majesty, and consul-general at Alexandria. He communicated

his method to Lewis de Pavia, chaplain and agent to St. Anthony’s

Hospital at Smyrna; who, after five years experience, pronounces it to

be the most effectual remedy hitherto made use of in the hospital of

which he has had the management for twenty-seven years. Immediately

after a person is perceived to be infected with the plague, he must

be taken into a close room; and, over a brazier of hot coals, with a

clean sponge, dipped in warm olive oil, his body must be very briskly

rubbed all over; for the purpose of producing a profuse sweat. During

the friction, sugar and juniper berries must be burned in the fire,

which raise a dense and hot smoke, that contributes to the effect. The

friction ought not to be continued more than four minutes, and a pint

of oil is enough to be used at each time. In general the first rubbing

is attended by a very copious perspiration; but, should it fail of this

effect, the operation may be repeated, first wiping the body with a

warm, dry cloth; and, in order to promote perspiration still farther,

the patient may take any warm sudorific drink, such as elder-flower

water, tea, &c. It is not necessary to touch the eyes; and other tender

parts of the body must be touched gently. Every possible precaution

must be made use of to prevent the patient from taking cold, nor must

the linen be changed till the perspiration has entirely subsided. The

operation should be repeated once a day, until evident symptoms of

recovery begin to appear. If there are already tumours on the body,

they should be gently and more frequently rubbed, till they appear to

be in a state of suppuration, when they may be dressed with the usual

plasters. The operation ought to be begun on the first appearance of

the symptoms of disease; if neglected till the nerves and the mass of

blood are affected, or a diarrhœa has commenced, little hopes can be

entertained of a cure; but still the patient should not be despaired

of, as, by an assiduous application of the means proposed, some few

have recovered, even after diarrhœa had commenced. During the first

four or five days the patient must observe a very abstemious diet; the

author allows only a small quantity of vermicelli, simply boiled in

water. Nor must any thing be taken for thirty or forty days, except

very light food, as, he says, an indigestion in any state of the

disorder might be dangerous. He does not allow the use of wine till

forty days. There is no instance of the person rubbing a patient having

taken the infection. He should previously anoint himself all over with

oil, and must avoid receiving the infected person’s breath into his

mouth or nostrils. The precaution to be used in all circumstances is

that of carefully anointing the body, and living upon light and easily

digestible food. Mr. Baldwin observes, that among upwards of a million

of people carried off by the plague in Upper and Lower Egypt, in the

space of four years, he could not discover a single oilman, or dealer

in oil.” _Lisbon, July, 1797. By Royal Permission._

[132] Annals of Medicine for 1797, p. 373.

With regard to diet, and the use of spiritous liquors, opinions, as may

well be imagined, have been very discordant. Allen quotes Diemerbroeck

advising _poor people_ to take two or three spoonfuls of the best

white wine vinegar every morning, which he looked upon to be one of

the best preservatives: he recommends also the frequent application to

the nostrils of a spunge dipped in _treacle vinegar_. With regard to

himself he says that his principal care was to avoid uneasy passions of

the mind; and that when he found himself any way disturbed by these, he

cheered his heart by three or four glasses of wine: his common drink

was beer, and also white wine, small, or moderately strong, which

sometimes he drank to cheerfulness, but never to drunkenness. Dr.

Patrick Russel also says, that “a glass of generous wine, or any other

cordial more agreeable to the choice, may be taken before dinner, in

case of languor, or oppression at the stomach, from fatigue, fœtor,

or apprehension. _I found a rummer of old hock very agreeable on such

occasions._” Allen goes on to inform us from Diemerbroeck, that,

“as to diet, it is advisable in a pestilential disposition to use

temperance, which very much contributes to the preservation of health;

but all sudden changes are dangerous; wherefore it is most dangerous

suddenly to alter the usual rule of diet. It is very ill in the plague

to go abroad with an empty stomach: hog’s flesh is looked upon to be

very pernicious: all sweet things are to be avoided: wine moderately

made use of is good, but the abuse of it very dangerous.--Mercurialis

testifies, that among the Patavians and Venetians, most of the tipplers

died, who thought to drive out the plague with strong wines.” Mr.

Howard informs us, that a person in high station at Constantinople,

attributed his recovery entirely to the use of _green tea_, others to

_brandy_. He also mentions a Mr. Hare, master of a merchant vessel at

Senegal, who, during the prevalence of a malignant fever there, was

very much exposed to the infection, and who out of humanity waited

upon a negro, whom nobody would go near. He took no medicines, neither

did he taste either spiritous or fermented liquors, and was the _only_

European that entirely escaped the contagion.[133]

[133] The opinion of those physicians whom Mr. Howard consulted upon

this subject are given at large in the APPENDIX.

These accounts seem to evince that little or nothing is to be expected

from a change of diet. This is an attempt to change the constitution

of the body, and cannot be expected to succeed any more than bleeding.

There is a certain quantity, and a certain species, both of food and

drink, different in different persons, necessary to preserve health,

and those who require both in larger quantity or better quality than

others, are no more to be charged with intemperance than those who are

supported by the smallest quantity of the coarsest fare. In times of

danger, therefore, those who have been accustomed to spiritous liquors

ought not to give them over; neither ought those to begin the use of

them who have not used them before. From the account formerly given

of the structure of the human body, it appears to be furnished with

an apparatus for _exhaling_ or throwing out a perspirable matter as

well as for _inhaling_ or taking in one equally subtile. How far the

skin may be able to _inhale_ or rather _imbibe_ surrounding effluvia,

may be doubted; but with the lungs there cannot be any doubt; and

the effluvia taken into them must unquestionably affect the blood,

and of consequence the vital principle, almost without any medium.

To deprive the body of its due portion of nourishment therefore is

to _throw a temptation in its way_ (if I may use the expression) to

absorb _any thing_; and the same effect must ensue from any other mode

of debilitating it, either by intemperance, terror, or the like; and

hence to visit infected places while under any such debility must be

very imprudent. Dr. Russel agrees that it is a general and rational

precept, never to go abroad fasting. For those who cannot easily bear

fatigue without eating between breakfast and dinner, some light food

may be proper, at an intermediate hour, in order to avoid going into

the chambers of the sick with an empty stomach in the forenoon. “In

such circumstances (says he) after a long and fatiguing morning, I

have often found myself disagreeably affected in my latter visits, and

have been sensible of slight giddiness, and of the appetite flagging

at dinner, as if something lay on the stomach. I have known others

much more strongly affected in this manner, and consequently much

more alarmed. In such cases much no doubt may depend on the fancy;

but in those times the power of the imagination requires management.

So intimately is it connected with the accidental state of the body,

that the same risk, from which a man shrinks in a state of languor and

fatigue, he will encounter undauntedly after a temperate meal: the

strange, unusual sensations, which amount almost to a persuasion of

having caught the infection, will often, like the phantoms of a vision,

vanish after a few glasses of wine.[134] Whether any slight degree

of real infection can be thus dissipated, I shall not take upon me to

determine; it is sufficient for the present purpose to indicate the

means of restraining those alarming sensations which, when aggravated

by imagination, are apt to depress the spirits, and, according to the

general opinion, to reduce the human body to that _relaxed_, _inhaling_

state peculiarly susceptible of contagion.”

[134] This _doctrine_ of _fancy_, or _imagination_, ought

undoubtedly, as Dr. Russel says of the imagination itself, to be

under some management. The indiscriminate use of the word has been

carried to such a length as in a manner to supersede all evidence,

testimony, argumentation or reason. With some it is sufficient to

discredit the most positive testimony (even upon oath) if they take

it into their heads that such a thing _cannot be_: which by the

bye is as strong an evidence of _ignorance_ as any man can give.

If imagination is given as a _cause_, the extent and nature of

its powers ought to be ascertained; but who has done this? On the

contrary I may say that not one in five hundred who makes use of

the word would be able to define it. But the most curious mode of

reasoning used by these _imaginary_ gentlemen is, if they are asked,

“How do you prove that such a thing is the effect of imagination?”

they are ready to answer, “I can indeed bring no proof that it is so,

but how do you prove that it is not?” Here the _imaginaries_ have

not _reason_ sufficient to show them that _they_ ought to bring a

proof, and not those who say they saw or felt any thing. But, waving

this, _sense_ is the highest faculty in our nature; _imagination_ as

well as _reason_ are inferior to it; because neither the one nor the

other can be conversant except about the objects of sense. If any

person therefore says that he _sees_ or that he _feels_ any thing,

nobody can, with any shadow of reason, say that he neither _saw_ nor

_felt_ any thing. If one man sees what another cannot see, while the

supposed object is easily within reach of the eyes of either, then

the one who cannot see it has a right to suspect that the object

is imaginary; but, if the person himself feels any slight pain or

uneasiness, and that should go off in a short time, after drinking

a glass of wine, there is as little reason to suppose that the pain

was imaginary, as that the drinking of the wine was imaginary. In

Dr. Russel’s case, though his strength was in general sufficient

to resist the contagion in which he was immersed, yet, when that

strength began to decay, it was no wonder that he found the contagion

beginning to invade: a few glasses of wine gave vigour to the system,

and enabled it to repel the attack. Had he been much fatigued with

bodily labour, and found himself greatly relieved by a few glasses of

wine, surely he would not suppose that his former fatigue was merely

imaginary. Just so must it be in the former case; the one has no more

to do with imagination than the other.

As to other modes of precaution, the Doctor advises that such as are

about the sick “should guard the mouth and nostrils with vinegar, avoid

drawing in the breath while close to the bed side, or swallowing their

spittle while in the infected chamber. Before they approach the bed in

order to examine the eruptions, the bed-clothes ought to be removed,

to give time for the dispersion of a confined steam which immediately

discovers itself to the senses; and it will be advisable to dip the

hands in vinegar before examining the parts. On coming out of the

chamber it will also be proper to rinse the mouth, and wash the hands,

with vinegar, plain or camphorated.” He advises also to fumigate the

clothes with nitre, sulphur, and juniper berries, burnt on a red-hot

iron.

“Upon returning home it may be advisable to shift clothes immediately,

hanging those taken off upon lines in a small chamber, to be again

smoked, and afterwards aired. The mouth and hands ought once more to be

well washed, and the hair might be fumigated with a little nitre and

sulphur, by means of a pipe, so as not to incommode the lungs.”

One other mode of prevention, not of the disease, but of incurring

danger from it, is inoculation. This is greatly recommended by Baron

Ash above mentioned, and not only for the plague among the human

species, but for that among cattle, which frequently destroys great

numbers of those necessary animals. The case of Mathias Degio related

p. 272, shows the practicability and the safety of it. The only solid

objection that can be made to it is, that those who have once had the

plague are not secure from having it a second time, or oftener. Yet, if

we consider the extreme fatality of the disease when it attacks in the

natural way, and that the number of those who have the plague only once

is much greater than of those who relapse, this practice will certainly

be found to merit consideration, and, unless some objection to it be

discovered greater than any that has yet appeared, seems likely to be

advantageous to the human race in general.